Men’s Health Strategy

Nick Fletcher Excerpts

Tuesday 22nd March 2022 Westminster Hall

[Graham Stringer (in the Chair)]

Nick Fletcher will move the motion and I will then call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention in these 30-minute debates.

[Nick Fletcher (Don Valley) (Con)]

I beg to move,

That this House has considered the potential merits of a men’s health strategy.

It is a pleasure, as ever, to serve under your chairmanship, Mr Stringer. Although this is only a 30-minute debate, I would still like to extend my thanks to the Backbench Business Committee for granting the time to discuss this extremely important issue. I am pleased that the Minister for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), will respond, given her very positive contribution to the Westminster Hall debate on prostate cancer earlier this month. I am confident that she will give a positive response today.

Over the past year, the all-party parliamentary group on issues affecting men and boys, which I chair, has continually heard from a range of national and international experts that there is a need for an improved focus on and a far more co-ordinated and strategic approach to men’s health in England. This approach has been adopted elsewhere, in countries, such as Australia and Ireland, which have their own men’s health strategies, as does the World Health Organisation in Europe. We all agreed that there are serious challenges in men’s health.

It is important to place on the official record that nearly one in five men do not live until they are 65, with an increasing gender age gap; that 13 men take their own lives every day; that men in some parts of Kensington and Chelsea live 27 years longer on average than those in some parts of the north; that one man dies of prostate cancer every 45 minutes; that nearly 6,000 men die an alcohol-related death every year; and that two thirds of men are overweight or obese.

The troubling matter for me is that the situation is not improving but seems to be getting worse. The time has come for the Government to take a fresh and strategic approach that is in keeping with their positive levelling-up agenda and their What Works approach to policy making. The Government approach to men’s health is based on individual conditions and is disease-based. However, as well as not having the impact that we would hope for, such an approach looks only at the outcomes of poor men’s health, not at the causes. To me, that is key.

We need to address and prevent the underlying causes and barriers that have a negative effect on men’s health, while also making the health system more responsive. For instance, if we continue to address suicide, alcoholism and obesity as separate issues, we will fail to see that they are often a result of similar circumstances. Why are men who live in economically disadvantaged areas dying from a whole range of illnesses far earlier than men who live in wealthy areas? There is no innate biological reason for that. We need to strategically join the dots on the causes, not place the outcomes in separate buckets labelled condition A, B or C, as is currently the case.

A men’s health strategy would ask more questions of the health sector. What of the gender age gap? It is a well-known fact that women live longer than men. Why is that? It was not always so. This is not something that we should just shrug our shoulders at and accept as normal. I want all men to have a long life and for those lives to be lived in a state of wellbeing. I am sure that nobody in the country would disagree with that ambition.

Another issue is that despite making up 75% of all suicides, men make up only 34% of those referred for specialist therapy. Why is that? Is it because they are not being referred or because suicidal men are not accessing the health system in the first place? It could be a combination of the two, of course, but why are men not getting the support they need, and what is being done to address that? We need to look at this at a systemic level. Of course, men need to adapt and help themselves, but the final responsibility has to be on society and the health system to change to help men.

During the APPG’s evidence sessions, the experts raised a number of points that struck home. When I visit my GP, which is thankfully rarely, I always notice how few other men of working age are there. We have to work out why and address that. Is it hard to get time off work? Are GP opening hours flexible enough? Do men fear that their bosses or workmates will raise questions about whether they are healthy and fit enough to do their job? Do they just get on with it? It could be all or none of those reasons.

Campaigns to encourage men to access the health system are necessary and welcome, but deeper issues need to be addressed. We also need to ensure that we do not look at men’s health from a negative perspective. Our approach should be based on the needs of men and boys, rather than on men and boys having to accept what they are given. That is the positive What Works approach taken by a number of men’s health strategies around the world. I hope that the Government can draw comfort from the fact that they do not need to start from scratch in devising a strategy, because strategic work is already being done in Ireland, Australia and elsewhere.

In addition, a host of leading men’s health experts and charities in the UK are ready and able and want to help the Government. The Government should look at the great work that is being done on men’s health in Leeds—everything good in life starts in Yorkshire. The Government could also harness the knowledge, expertise and help provided by a number of great, growing and pioneering organisations that support men’s health, including, to name a few, Andy’s Man Club, UK Men’s Sheds, Prostate Cancer UK, Lions Barber Collective, Men Walking and Talking, MANvFAT, Mates in Mind, Football Fans in Training, and Black Men’s Health UK.

In addition to their great work, all of those organisations know that men do talk and take action on their health when the right environment is created. Many of those initiatives also prove the importance of taking support to where men are, not to where it is thought that they should go—many experts have made that point. I am sure that those organisations are all on stand-by to help the Government, as are a number of health bodies, such as the Men’s Health Forum and the Patients Association, which support the proposal to create a strategy, with the former leading a national campaign.

Since becoming a Member of Parliament in 2019, I have been struck by how the Government are taking a fresh, constructive and positive look at all policy areas. Old ways of thinking are no longer taken as read. We can see that in the field of women’s health, where the Government are introducing a strategy for the first time, which I am sure all of us in the House support. To be clear, that is not a reason in itself for a men’s health strategy, but it does signal the need to have a consistent, cross-Government approach that takes into account specific, gender-based aspects affecting the health of women and men. Without a change in policy, it would be incumbent on the Government in the coming months to explain, with hard evidence, why and how their current approach is improving men’s health.

My concluding point is that a men’s health strategy would benefit not just men and boys but the women and girls with whom they share their lives and society. They all have fathers, uncles, brothers, cousins. This is a strategy for the nation as a whole. It would also be cost-effective, saving the health service millions of pounds in treating illnesses, and helping employers in reducing sickness levels. It is a win-win situation and would lead to a healthier, happier and more productive society for all. The Government have an ideal opportunity, with the coming White Paper on disparities, to start the ball rolling, and I am confident that they will take it. I look forward to hearing the Minister’s comments on this incredibly important issue.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I thank my hon. Friend the Member for Don Valley (Nick Fletcher) for securing this important debate, which provides us with an opportunity to discuss the health issues that affect men across the country. Although I am passionate about tackling the health inequalities that women face, there is no doubt that men also face specific issues.

I thank my hon. Friend for his work as chair of the APPG on issues affecting men and boys. It does a huge amount of work in this area and its report, “The Case for a Men’s Health Strategy”, is compelling reading. I thank him and all the members of the APPG for their work on that. He has discussed with the Secretary of State for Health and Social Care the potential merits of a men’s health strategy, and further meetings are planned as part of an ongoing discussion.

I do not want to generalise and put people in different categories, but there is a difference in the way in which women and men access the healthcare system. More than 100,000 women replied to our call for evidence. They told us that they often access healthcare but feel that they are not listened to and that it is a challenge to get the services they want. Men, on the other hand, often do not access healthcare services at all, and that is a significant barrier. They do not come forward for a variety of reasons, and my hon. Friend touched on some of them, including ease of access to services and sometimes the attitudes of employers or colleagues on seeking help. There are different barriers that certainly make a difference. It is true that the average male life expectancy in the United Kingdom is below that of women, although women spend a greater proportion of their lives in ill health and disability.

We also know that male and female life expectancy differs depending on where they live. We are absolutely passionate about ending that. It should not matter where someone lives or where they come from. Everyone should have the same health outcomes. A man in Blackpool can expect to live over 10 years less than a man in Westminster. We will publish our health disparities White Paper later this year to seek to address the gaps in life expectancy for men and women. I am particularly keen that the issues my hon. Friend has raised today are looked at as part of the health disparities White Paper, because he has provided some stark statistics that absolutely need to be tackled if we are to improve outcomes for men in particular.

The Department is already taking action to address conditions that affect men in particular, including suicide, heart disease and cancer, and other risk factors such as smoking. Although I do not want to generalise, we know that some men are less likely than women to seek help or to talk about suicidal feelings, and they can be reluctant to engage with health and other support services. Men are around three times more likely to die from suicide than women, and suicide prevention requires co-ordinated action and a national focus on men’s low uptake of services to help with suicide prevention more broadly.

Over the coming year we will review the suicide prevention strategy for England and focus on high-risk groups, including middle-aged men. I encourage the APPG to take part and scrutinise that to make sure that it addresses the very important issues that my hon. Friend has raised. We are making funding available. Almost £5.5 million is available this financial year through a suicide prevention grant to support the voluntary sector in particular.

I was interested to hear about the work in Yorkshire. My hon. Friend is right that part of the failure of NHS services to reach out to men is that we often expect men to come to those services. Organisations such as Men’s Sheds, where services can be brought to men, are often more effective, so I very much take his point and it is something that we need to look at.

Heart disease is one of the leading causes of death in men. The long-term plan is committed to several key ambitions to improve outcomes for individuals with cardiovascular disease, including enhanced diagnostic support in the community. I hope that our community diagnostic centres will bring healthcare into communities so that men are able to go for tests, screening and appointments slightly more easily than at present. Our ambition is to prevent 150,000 heart attacks, strokes and dementia by 2029, and we hope that our initiatives will improve outcomes for men.

Although smoking rates have fallen consistently across the population, the rates for men remain consistently higher than those for women. Men, however, generally report more success when they attempt to stop smoking, but it is still the case that smoking rates are higher for men than for women. We are undertaking an independent review of our tobacco control policies, led by Javed Khan. The review will make a set of policy recommendations that will give us the best chance to reduce smoking and achieve the Government’s smoke-free 2030 ambition. Again, I encourage the APPG to look at that work and to feed into it.

Finally, I will touch on cancer, because we know that lung cancer outcomes in particular are poorer for men than for women. We are trying to target our diagnostic services towards high-risk groups. One of our most successful areas has been our targeted lung health checks, which took place in 23 locations last year, with a further 20 being rolled out this year. We are using low-dose CT scans and are targeting, in particular, individuals who have smoked for a long time, those in high-risk groups and those in high-risk areas of the country. We are seeing remarkable success rates, with lung cancer being identified at stages 1 and 2 when it would otherwise have taken months for those individuals to show symptoms. Those checks will seek to improve the lung cancer outcomes for men.

[Nick Fletcher]

I believe that a lot of smoking, obesity and alcohol problems stem from men being lonely. Many years ago, there was an advert that said that “You’re never alone” with a certain brand of cigarette I think that many men use those things as comforts and to pass the time. When men are feeling low, they might drink or go to the fridge. The men’s health strategy should look at that, and take an overarching view of all the issues, bringing them together. Clubs such as Andy’s Man Club are a fantastic place for men to talk and to feel valued and part of society, so that they do not feel lonely. When men do not feel lonely, perhaps they do not need to reach for those items that otherwise help them get through the day. I take on board what the Minister said about getting GP and health services to those clubs—that would be a fantastic thing to do. We should then automatically see a reduction in the issues that we are testing for now, such as cancer. However, I do also welcome the centres that the Minister has spoken about.

[Maria Caulfield]

My hon. Friend is absolutely right. Although we are focusing on trying to diagnose lung and prostate cancer as early as possible, encouraging men to come forward and making them aware of the signs and symptoms, he is right that prevention—reducing smoking, alcohol and obesity—will help keep men healthier for longer. He is right that if men are lonely or do not feel like they have other avenues to meet people and get involved in society, they will reach out to smoking or drinking. Often, gambling is a way to meet people down the betting shop; a racecourse near me is very popular indeed. Men do have a different way of dealing with their emotional problems. They will not often talk about them, but meeting other people is a way of coping with some of the issues they face.

I have touched on several separate issues, which is exactly what my hon. Friend said we should not be doing. However, there is a golden thread running through all of them. The health inequalities for some groups of me, whether in life expectancy, life outcomes or accessing healthcare, are different from the issues and challenges that women face. We should not be dismissive of that, because those challenges are equally important.

I want to reassure my hon. Friend that the health issues facing men are being taken seriously. He has met the Secretary of State already and will be having further meetings. I think that today’s debate, in addition to our previous debate on prostate cancer, is the start of the conversation about how we improve outcomes for men. There are specific issues that they face, but there are also common threads that run through those issues. If we do not tackle those, we will not improve the overall health and life expectancy of men. I look forward to working with my hon. Friend further and to taking up some of the challenges that he has raised.

Question put and agreed to.