Women’s Health

Rupa Huq Excerpts

Thursday 27th February 2025 Westminster Hall

[Several hon. Members rose—]

[Dr Rupa Huq (in the Chair)]

Everyone who wants to speak should be bobbing, because we will be calculating the time limit depending on how many there are.

[Alice Macdonald (Norwich North) (Lab/Co-op)]

It is a pleasure to serve under your leadership, Dr Huq. I thank my hon. Friend the Member for Hastings and Rye (Helena Dollimore) for securing this important debate. As we have heard for far too long, women have been paying the price of an NHS that simply is not working. Women know that; in a survey that I saw, half of women said that they believed that their health was treated as second class.

Our economy is also paying the price. There are many areas that we could mention, but I want to focus on one in particular: the often very challenging journey that people experience when trying to have a baby. More than 3.5 million people in the UK go through some kind of fertility challenge, and that obviously has a huge impact on women. It can happen for a variety of reasons and is often heartbreaking. There is no one-size-fits-all approach to addressing fertility, but the National Institute for Health and Care Excellence guidelines are clear that, for women under 40 with a clinical diagnosis requiring in vitro fertilisation, or with unexplained infertility for two years, three NHS-funded cycles of IVF should be offered. The guidelines also recommend that women aged between 40 and 42 should be offered one cycle of IVF on the NHS, subject to some conditions.

Yet the reality is a postcode lottery. It is down to local integrated care boards to decide their approach, and only around a quarter of ICBs in England offer a full three cycles. The east of England, where my constituency is, has the lowest proportion of NHS-funded cycles, and my own ICB of Norfolk and Waveney offers two cycles. In other areas—north-east London, for example—the full three cycles are funded, whereas in areas such as Hampshire only one is.

Recent data tells us that fewer than 27% of IVF patients receive NHS funding nationally. When we think about our NHS, that is a huge anomaly. It means that most patients are paying for their treatment. Other factors also come into play: inequalities are stark when it comes to access and outcomes for black and ethnic minority patients, as well as for those in female same-sex relationships.

The postcode lottery needs to end. We must address those inequalities in access to NHS funding. There also needs to be greater education for healthcare professionals around fertility, regarding diagnosis and treatment, and for people themselves, so that patients have the choice and know what to do when it comes to their own fertility.

Beyond medical treatment, there is also not enough support in the workplace. We really need a whole-of-Government approach to this issue. It is not just about the Department of Health and Social Care; there are so many other areas, including, importantly, the Department for Work and Pensions. There is no legal right to time off for fertility treatment and currently, under the Equality and Human Rights Commission’s code of practice, fertility treatment is compared with cosmetic dental surgery. That means that many employers regard fertility treatment as a “nice to have”—an elective choice. Instead, it should be treated as a medical procedure that is needed.

I have heard stories of women losing their jobs simply because they have attended an IVF appointment. That needs to change. That is why I am campaigning, with Fertility Matters at Work and others, for a change in the law, so that people—women, in particular—have a right to paid time off for fertility treatment. I have met the Minister for Employment, my hon. Friend the Member for Birkenhead (Alison McGovern), to discuss the issue, and I welcome the continued engagement with the Government. I hope the Minister will meet us to discuss those demands. Many companies, including Centrica, E.ON and Cadent, already give women time off because they know it makes sense for productivity and happiness at work. Almost one in five people undergoing fertility treatment end up leaving their jobs because of the impact.

I also want to touch on miscarriage, another aspect of the journey; I know that my hon. Friend the Member for Walthamstow (Ms Creasy) will mention it as well. We need a right to time off for miscarriage before 24 weeks. It causes huge trauma, and women do not recover from it straight away. They need to be given time.

In the 30 seconds that I have left, I want to touch on gynaecology in my area of Norfolk. The situation is dire: we have the worst wait for gynaecology treatment in England. We are nowhere near the 92% target of 18 weeks: the figure is 44% in Norfolk and Waveney. Research from the House of Commons Library shows that more than 1,000 patients have been waiting for more than a year in Norfolk and Waveney, and that has a massive impact on women’s health.

I have to stop there. I wanted to talk about women’s health hubs, but I am sure that others will. There are so many issues to discuss, but when it comes to fertility and gynaecology, we simply cannot wait. Our manifesto promised that we will not neglect women’s health again, and I am sure that we will live up to that promise.

[Dr Rupa Huq (in the Chair)]

With a time limit of four minutes—the clock is counting backwards—I call Jim Shannon.

--- Later in debate ---

[Wera Hobhouse]

I could not agree more. We already have a crisis, which that will only exacerbate, so I thank my hon. Friend for rightly highlighting that issue.

My Bath constituents are at particular risk. A recent report said that appointment waits have doubled since the pandemic—another serious trend that the Government need to look at. A constituent recently reached out to me about the length of time it takes to get an endometriosis diagnosis in the NHS, which has already been mentioned today. That is not only a problem in Bath; far too many women wait far too long. The Government need to look at that.

In better news, the national maternity survey 2024 found that Bath’s Royal United hospital received a top Care Quality Commission rating over its treatment of patients. The survey found that those giving birth felt confidence and trust in staff during their care at the RUH. There was also praise for the dignity and respect people that were treated with. I am grateful to the RUH and all its staff for setting such a brilliant example, and offer them my congratulations.

In such a debate, I cannot, as chair of the eating disorders APPG, leave out eating disorders. Although they affect more women than men, it is not only women who suffer from them. One issue of particular concern is online platforms recommending harmful eating disorder-related content to young users. The Center for Countering Digital Hate, whose representatives I met this week, recently published research on the dangerous eating disorder videos recommended by the YouTube algorithms. It set up an account for a 13-year-old girl searching for body image and dieting content, and found that, of the next videos recommended by the YouTube algorithm, one in four was harmful eating disorder content. That is alarming.

I urge the Government to look into that and to hold these powerful digital platforms to account. In 2025, it is not acceptable that there are continuing disparities in women’s health and, in particular, young women’s health on this issue. I urge the Government to take action.

[Dr Rupa Huq (in the Chair)]

I am sorry to do this, but I am imposing a newly reduced time limit of three and a half minutes.

--- Later in debate ---

[Dr Evans]

I am really sorry; I am tight on time. Question No. 4 is, could the Minister kindly clarify, confirm and commit to that promise? If not, why not?

On the menopause, when the women’s strategy was announced in 2022, the then shadow Health Secretary—now the current Health Secretary—said:

“I challenge the Secretary of State to go further than the proposal he outlined to train incoming medical students and incoming doctors. What plans do the Government have for clinicians who are already practising? We need to upskill the existing workforce, not just the incoming workforce. However, let us be clear: informing clinicians is no good if we do not also improve access to hormone replacement therapy, so where is the action in the strategy to end the postcode lottery for treatment?” —[Official Report, 20 July 2022; Vol. 718, c. 977.]

As we are now eight months into the Labour Government, question No. 5 is, when will the strategy document he talked about be produced and presented to the House? Has he made an assessment since July 2024 of HRT medication access in terms of locality?

Turning to workforce, we know that the demand for women’s services is outstripping the supply of generalist and specialist support. The Royal College of Obstetricians and Gynaecologists has highlighted ongoing problems with maternity workforce staffing and agreed that the NHS long-term workforce plan was a good first step on the way to properly staffed maternity services. Therefore, question No. 6 is this: we know that the Government will be looking at a refresh of the plan this summer, so will the Minister give an undertaking today that women’s health will be a priority in both primary and secondary care? Will she update the House on the obstetrics workforce planning tool, which the DHSC commissioned to help maternity units calculate staffing requirements, and when it will be rolled out across the country?

Given that time is tight, I will close by saying that I have heard it said that a healthy woman means a healthy family, a healthy community and a healthier world. That is hard to dispute that; it is now for the House to deliver it.

[Dr Rupa Huq (in the Chair)]

Finally, for what we think is her first outing as a Minister in Westminster Hall—although she is a veteran of the Chamber already— I call Ashley Dalton.

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

It is a pleasure to serve under your chairship, Dr Huq. I congratulate my hon. Friend the Member for Hastings and Rye (Helena Dollimore) on securing this really important debate on women’s health. She and all Members who have participated today have raised a number of important points.

Let me begin by agreeing that reading the Ockenden review is harrowing, and progress on women’s health has been far too slow. I want to address some of the key issues that Members have raised; I will attempt to cover as many as I can, but if I miss anything, please get in touch, and I will endeavour to fill any gaps after the debate.

My hon. Friend the Member for Hastings and Rye raised the story of our very good friend Margaret McDonagh and how her experience feeds into the medical misogyny that has been highlighted on a number of occasions. In addition, it was very powerful to listen to my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), who put an important focus on women’s voices and said how important it is that those are heard in this space. Those voices can lead to the important cultural shift that my hon. Friend the Member for Stafford (Leigh Ingham) raised and that underpins all of this.

The hon. Member for Strangford (Jim Shannon) and my hon. Friend the Member for Cumbernauld and Kirkintilloch (Katrina Murray) spoke about the devolved Governments. We are committed to ensuring that we have closer working between the UK and devolved Governments so that we can share insight and best practice and cut waiting lists right across the UK.

My hon. Friend the Member for Cumbernauld and Kirkintilloch and the hon. Member for Wimbledon (Mr Kohler) raised issues relating to eating disorders and women in online content. The Government inherited a broken NHS, in which patients wait too long for eating disorder treatment. The 10-year plan will overhaul the NHS, and the Online Safety Act 2023 will prevent children from accessing harmful online content on eating disorders.

The hon. Member for Canterbury (Rosie Duffield) raised the differences in heart attack symptoms between men and women. NHS staff can now access guidance through the British Heart Foundation, and there are learning sessions available to support training. NHS England ensures that there is clear messaging on atypical symptoms in women in all public campaigns, and training on heart attacks and the identification of gender and sex are a core part of the cardiology curriculum. The hon. Lady will be aware that the National Institute for Health and Care Research has a very clear definition of sex and gender, which has an important impact on delivering the right healthcare to everybody.

I was really interested to hear from my hon. Friend the Member for Dudley (Sonia Kumar), who has expert knowledge of perinatal pelvic health services, which are being rolled out across England to ensure that women have access to physiotherapy for pelvic health issues during pregnancy and for at least one year after birth. Those services incorporate a range of interventions aimed at improving the prevention and identification of perinatal tears and other perinatal conditions.

The Chair of the Women and Equalities Committee, my hon. Friend the Member for Luton North (Sarah Owen), spoke about the Committee’s recent report, which we welcome and take extremely seriously. We are grateful to everyone who gave their time and expertise to the inquiry, and to the Committee for its thoughtful recommendations. My Department has looked closely at the findings, however chunky they are, and has worked with NHS England to consider the recommendations and develop a Government response. I assure her that it will be published very soon.

The hon. Member for Epsom and Ewell (Helen Maguire) spoke about contraception. Let me make one thing really clear: we are committed to ensuring that the public receive the best possible contraceptive services, which are vital in helping women to manage their gynaecological health. Since 2023, the NHS Pharmacy Contraception Service has allowed pharmacists to issue ongoing supplies of contraception that have been prescribed by GPs and sexual health services. That service was relaunched in December 2023 and will be continued.

We have also talked about fertility issues. Access to fertility treatment across the NHS has been varied across England, and funding decisions are made by integrated care boards, based on the clinical needs of the people they serve. We expect those organisations to commission fertility services in line with the guidelines set by the National Institute for Health and Care Excellence. We recognise that provision is variable across England, and we intend to support ICBs to implement the updated evidence in the revised guidelines to benefit all affected groups.

We recognise the significant physical and psychological consequences of birth trauma and the devastating impact it has on women. I thank hon. Members for their contributions to the report of the APPG on birth trauma—the hon. Member for Canterbury was intrinsic to it. The Government will ensure that lessons are learned from the recent inquiries and investigations, including the APPG report, and that the experiences of women and their families are listened to and woven into our efforts to improve services.

For too long, women have been let down by their healthcare. The system is broken—it does not work for them. This Government are committed to fixing women’s health as a key part of building an NHS fit for the future. As a first step, we have delivered 2 million more appointments since July, in line with our manifesto commitment of delivering 2 million more appointments in the first year. We have achieved that seven months early. That includes appointments for breast cancer care, for gynaecological conditions such as endometriosis and for many other conditions.

However, we are still nowhere near satisfied with the state of women’s healthcare. Kate’s story, which my hon. Friend the Member for Hastings and Rye shared, is testament to that state.