Menopause

Nick Smith Excerpts

Thursday 26th October 2023 Commons Chamber

[Peter Dowd]

The hon. Member is absolutely spot on. That is why the APPG is working across so many areas to develop people’s understanding of menopause—not just women but, importantly, men as well.

The days of whispering the word “menopause” and keeping the changes in women’s bodies a secret and just getting on with it, so to speak, are thankfully beginning to be a thing of the past. The “Manifesto for Menopause” was launched last week at a celebratory breakfast in Parliament to mark World Menopause Day. Alongside the publication of the group’s “Manifesto for Menopause”, the reception featured new findings from a recent survey by Menopause Mandate of over 2,000 women. It found—it is important to get this into context—that 96% of menopausal women’s quality of life suffered as a result of their symptoms and almost 50% took over a year to realise that they might be peri or menopausal.

[Nick Smith (Blaenau Gwent) (Lab)]

My hon. Friend is making a great contribution. Women have told me that, when they experience symptoms such as itchy skin, aching bones, depression and anxiety, their GPs advise them on how to treat those symptoms, although the cause could be the menopause. Does he agree that extra training and support could help GPs to recognise menopause symptoms better, and could therefore help many women across the country?

[Peter Dowd]

That is a valid point and I shall be touching on it later.

According to the survey, only 12% of menopausal women were diagnosed by healthcare professionals, with a huge 60% discovering through their own research that they might be menopausal, and only 20% having had a positive GP experience. Among working women, 64% said that the menopause had a negative impact on them, but only 29% of their employers had a menopause policy.

--- Later in debate ---

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

I congratulate the hon. Member for Swansea East (Carolyn Harris) on securing this debate, and I am sad she is not here to join us this afternoon because we have held this debate on almost an annual basis and have made huge progress in achieving some of her asks. She is a tireless voice for women in this place, always raising awareness and inspiring action, and I am very proud to be working with her as co-chair of the menopause taskforce. One key piece of work by the Government has been to respond to one of her asks and reduce the cost of NHS prescriptions for HRT. Of course, there is much to be done. Our women’s health strategy has made the menopause a key priority area. For far too long, women’s health was a secondary consideration. This Government have put it top of the agenda—menopause, fertility, baby loss, dementia and osteoporosis are now priority areas for this Government—and we are the first Government to do so.

There has been a menopause revolution here this morning. I really thank the hon. Member for Bootle (Peter Dowd) for presenting the debate. We have heard from four male colleagues—the hon. Members for Merthyr Tydfil and Rhymney (Gerald Jones) and for Bootle, my hon. Friend the Member for Walsall North (Eddie Hughes) and the hon. Member for Strangford (Jim Shannon)—which is twice the number of women Back Benchers contributing. It is absolutely positive news that we have made so much progress that the menopause matters to men as much as it does to women. In my own Department, to mark World Menopause Day we organised a session during which officials tried on the world’s first menopause simulator, so that men could experience some of the side effects. It was a great success, and many male colleagues went away with an enhanced appreciation of women’s experience of the menopause. I also thank the all-party parliamentary group for its important work. It does a huge amount to shine a light on the issues, particularly with its manifesto for menopause.

I hope the House will give me some time to update it on the progress we have made since our last debate in the Chamber. First, a number of Members have mentioned the HRT prepayment certificate. It has been rolled out since April, and women can pay less than £20 a year for all their HRT prescriptions for 12 months. Many women are on multiple products—they are often on dual hormones—and each of those has a prescription cost. However, just to reassure colleagues, about 89% of all prescriptions are not paid for and there are no charges, and for HRT about 60% pay no prescription charges at all. For those who do, the £20 a year absolutely makes a difference, and it could save women hundreds of pounds on the cost of their HRT. In the spring, we launched a successful campaign to alert women to these changes, and I am really pleased to say that, as of the end of September, well over 400,000 women in England had purchased a HRT prescription prepayment certificate. For anyone who has not got one yet, they can be purchased online, but they can also be purchased in some pharmacies.

The shadow Minister, the hon. Member for Erith and Thamesmead (Abena Oppong-Asare), mentioned HRT supply, which has been an issue over recent months. We have seen a huge wave of women coming forward asking for HRT from their GP, and GPs have been much more comfortable in prescribing HRT, which did put pressure on supplies. There are over 70 products available in the United Kingdom, and in fact the majority of them remain in good supply. We have held six roundtables with suppliers, wholesalers and community pharmacists to discuss the challenges they were facing, and these have delivered results. Since April last year, there were 23 serious shortage protocols for HRT—relevant to 23 products—but as of today only one of those remains in place. That means that at the moment there is only one product for which there is a serious shortage protocol, meaning alternative dispensing or reduced dispensing occurs. We are holding a seventh roundtable later this month, and manufacturers are confident that, in producing and securing more, there will be supplies to be used. That is a real success story, and when women have their prescription, they can be confident that their prescription will be available at their pharmacy.

A key part of our menopause taskforce has been talking about research into the menopause and management of the menopause. The National Institute for Health and Care Research has conducted an exercise to identify research priorities, which concluded in January. I cannot remember which hon. Member mentioned testosterone, but research into how testosterone can alleviate menopausal symptoms has been identified as a gap. It is not licensed for use in the menopause because there is not currently the evidence base for the Medicines and Healthcare products Regulatory Agency to allow a licence. Having that research into testosterone and the improvements it could bring is a crucial step towards any licensing of that hormone. That is why it requested bids for organisations to come forward with research proposals in this area, and we expect an update in December. I am also pleased to update that between April last year and July this year, the NIHR has invested £53 million to support women’s health. On World Menopause Day, it funded the James Lind Alliance to launch its menopause priority-setting partnership. That is crucial in developing the evidence base for better management of the menopause.

I will just touch on a number of other points that were raised. First, on health checks, I have asked the NHS health check advisory group to review the case for including the menopause in the NHS health check alongside its broader future considerations on the health check, following the delivery of the digital check next spring. I will keep the House updated on that work, particularly the hon. Member for Swansea East, as co-chair of the menopause taskforce, because it is crucial that it is included.

We have started the process to set up women’s health hubs across every ICB in the country, because our ambition is for women and girls to access services for women’s health more generally in the places where they live. That is why we are investing £25 million to expand women’s health hubs across England. Hubs will deliver a range of healthcare experiences, but we would expect the menopause and advice on it to be covered by women’s health hubs. We are meeting ICBs shortly to get an update on progress.

One other point raised was about conducting a review into specialist menopause care. It is important to remember that specialist menopause care is not funded by central Government, but is commissioned by integrated care boards and implemented at a local level. They have a statutory responsibility to commission healthcare that meets the needs of whole populations, including for the menopause, but we know that is not always happening on the ground.

[Nick Smith]

I acknowledge that the Government are making good progress on this topic, and I thank the Minister for that. Having said that, my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) spoke from the Labour Front Bench about training and development for GPs on supporting women with menopause symptoms. Can I press the Minister to tell us more about the Government’s plans to boost training and development for clinicians to help women experiencing the menopause?

[Maria Caulfield]

The hon. Gentleman makes a valid point, and I will come on to that in a moment, because we are making huge progress there. If I may, I will touch on specialist support for the menopause. We will be working with ICBs, and when we meet shortly to ask for updates, we will be looking at the progress being made at the local level in providing that support. We have tried to ensure that information for women is as accessible as possible. We launched our dedicated women’s health area on the NHS website recently, where there is advice and support on the menopause, as well as for other health conditions. That will be updated regularly. Women now have a trusted source to go to for healthcare and advice. That includes a new HRT medicines hub, providing information about the different types of HRT and other options, because HRT does not work for every woman, and sometimes women have to try several types to get one that works for them.

Workplace support has also come up. As Employment Minister, my hon. Friend the Member for Mid Sussex (Mims Davies) has made huge progress. In March, we appointed Helen Tomlinson, who is the menopause employment champion. This month, she published a report with a four-point plan to improve menopause support in the workplace. Organisations such as Wellbeing of Women offer support to businesses, small and large, on how to improve their offer to women. Many of the suggestions that have been made in this place are being taken up, and they do make a difference. We hear from women all the time about the difference they make. This month we launched a new space for guidance on the helptogrow.campaign.gov.uk website. Large or small, businesses can get advice there about the difference they can make in the workplace not only in retaining women, but in having open conversations in the workplace. Flexible working is a key part of that.

To touch on the GP point, we are looking this year to consult on the future of the quality and outcomes framework, which is one of the measures used to look at health conditions, to see whether the menopause should be included. We fully recognise the importance of ensuring that GPs ask the right questions so that women get the right support. We intend to have those conversations with GPs about the QOF framework.

We are also, rightly, looking at staff training and developing education and training materials for healthcare professionals across the board, not just GPs, so that healthcare professionals have better awareness of the menopause. My hon. Friend the Member for Walsall North and the hon. Member for Strangford pointed out that women often go and ask for help, but their signs and symptoms are not recognised as being related to the menopause. Our women’s health ambassador, Professor Dame Lesley Regan, is doing crucial work on engagement in this place. We are also ensuring that GPs are assessed on menopause as a measure in their training. From next year, all medical students will have to complete a module that includes menopause so that doctors, whether GPs in primary care or in secondary care, have better awareness of the signs and symptoms and management of the menopause, so that when women approach for help, they will be better supported.

I thank all hon. Members for their contributions to the debate. We have taken great strides in the last 12 months in supply of HRT and reducing the cost, rolling out women’s health hubs, but I know that there is more work to be done. I know also that the hon. Member for Swansea East will be back to hold my feet to the fire, and I look forward to working with her as co-chair of the menopause taskforce.