Women’s Health Strategy

Commons Urgent Question

The following Answer to an Urgent Question was given in the House of Commons on Thursday 30 January.

“I thank the honourable Lady for giving me the opportunity to set out our commitment to the women’s health strategy and everything that this Government are doing to fix our broken NHS, clean up the mess that the Conservatives left after 14 years and get women treated on time again.

When we came into office we inherited record waiting lists. The gynaecology waiting list stood at just under 600,000 women. Let that sink in—600,000 women in pain, waiting to be cared for. Almost half the women on gynaecology waiting lists are waiting more than 18 weeks. That is why the Prime Minister kicked off 2025 with our elective reform plan, setting out how we will cut the longest waiting lists from 18 months to 18 weeks. Our new agreement with the independent sector will mean that, where there is spare capacity in the private sector, women will be treated faster for gynaecology care, paid for by the state.

The Government are also committed to rooting out the appalling inequalities in maternity care. We are supporting failing trusts to make rapid improvements, training thousands more midwives for the first time, and we will set an explicit target to close the black and Asian maternal mortality gap. We are piloting a training programme to help avoid brain injury for babies in childbirth and, if successful, we will crack on with rolling it out nationally this year. In October, we extended the baby loss certificate service to help mums and dads who have suffered the heartbreak of pregnancy loss.

Let me also address the issue of women’s health hubs. There was a target in last year’s planning guidance to roll out pilot women’s health hubs across the country by last December. Today, there are at least 80 hubs, and at least nine out of every 10 integrated care systems have an open women’s health hub.

Let me correct some fake news. We are not closing these hubs; we are not cutting them. The target to roll them out was in last year’s planning guidance. It was achieved in 93% of integrated care systems, which is why the target is not repeated in this year’s guidance—it has been met in 39 out of 42 areas.

Today, we have slimmed down the number of targets for the NHS so that we can focus on fixing the fundamentals —the system that the previous Government broke. We are instructing the NHS to prioritise: cutting waiting times for operations, A&E and ambulances; making it easier for people to see a GP or a dentist; and improving the mental health of the nation. That will mean around 60,000 women with suspected cancer are diagnosed earlier and treated faster; more than 200,000 extra women will be treated within 18 weeks, as we drive down long waits; and fewer women will be forced to wait 12 hours in A&E. That is the difference that a Labour Government are making to women’s health”.

15:34:00

My Lords, nearly 600,000 women are waiting for treatment on a gynaecological waiting list in England. Labour’s 2024 general election manifesto made a commitment that: “Never again will women’s health be neglected. Labour will prioritise women’s health as we reform the NHS”. Why, then, are the Government removing the requirement on integrated care boards to implement women’s health hubs? The Answer given to this Urgent Question by the Minister in the other place stated that at least 90% of ICBs already have women’s health hubs, which is terrific. If they have been rolled out so effectively, why not complete the job and follow through to reach 100%? Perhaps the Minister could tell us what exciting plans she has to do this.

I would be glad to give information to the noble Baroness, whom I thank for reminding your Lordships’ House of the situation that we inherited—600,000 women on gynaecological waiting lists—and the challenge before us. My honourable friend in the other place was quite right about the planning guidance, but I commend the effort of the noble Baroness’s Government for pump-priming the introduction of women’s health hubs to the point where there are some 80 across the country—in nine out of 10 areas, there is at least one. It was never a long-term planning situation. The noble Baroness will also be aware of the informed observation from the noble Lord, Lord Darzi, that planning guidance has too many specifics. We therefore needed a new approach, which is what we have done. The planning guidance is not the catalogue of all the levers, nor of all that happens, in the NHS.

My Lords, women’s health hubs have proved enormously popular with practitioners, who are able to give multiple treatments in one session, and with women, who no longer have to take time off on different days to go to different clinics for different procedures. Given this, why are the Government not backing this cost-effective strategy, not least because it prevents women showing up at A&E, which is far more expensive?

We are not closing women’s health hubs—it is important to put that on record. I have already said how successful the pilot has been; it therefore does not require a further target. I hope that noble Lords have seen that the changes to the planning guidance move away from the old centralised operating model to give more control and direction locally. As I said, the decision not to mandate women’s health hubs reflects a new approach to the guidance: fewer national directives and more empowerment of local leaders. Women’s health hubs are also described in the elective reform plan, which is one example of another area where their importance is recognised and boosted.

My Lords, the Minister will know that women’s health hubs are vital in reducing gynaecological waiting lists. We have seen that through their success in areas such as Birmingham, Tower Hamlets and Liverpool. I hear what the Minister has been saying, but there is strong concern from the sector that many of the existing hubs are in their infancy or are not yet operational. They will not progress unless there is operational guidance for the NHS or formal commitment to them from the Government. With their removal from the planning guidance, what actions is the Minister taking to ensure that every ICB has a women’s hub? Given what she said about local decision-making, what steps are being taken to make sure that we learn from the success of the highest-performing hubs and share it with others?

We continue to learn from the best. I am committed to speaking with the leadership of ICBs about the importance of women’s health hubs, not least because it is about improving women’s healthcare. Having visited a women’s health hub myself, I can testify to the points that the noble Baronesses have made. However, I gently repeat that we need to look not just in the planning guidance but in the elective reform plan, which states about the NHS that: “In gynaecology we will support … innovative models offering patients care closer to home”. That is exemplified by the women’s health hub. The Neighbourhood Health Guidelines, published just last week, include women’s health hubs as an example of a neighbourhood health model.

My Lords, the history of health policy through successive Governments has been one of too many priorities and targets which are not delivered, so I support the Government in this analysis. It has also been one of poorer outcomes for women and minorities. Given the shift in leadership from the Department of Health and others, how will the Government ensure better outcomes for women and minorities? How will those be monitored? Will they intervene early if they do not see that direction of travel?

I thank the noble Baroness for her welcome for the new approach in the planning guidance. As she commented, and as noble Lords opposite will know, just because something is in the guidance does not mean that it will happen. For example, despite targets for A&E performance or ambulance response times being written into planning, they were not delivered. This is not where we want to be. We will continue to work with NHS England; for example, to ensure that women’s health is key. I should also emphasise that, as we move towards the 10-year health plan, women’s health will feature not as an adjunct but run throughout.

My Lords, I welcome the Minister’s comments. We know that black women are three to four times more likely to die during childbirth and that the rate of maternal deaths in the UK has risen during the past 10 years, which I am sure she will agree is a national disgrace. Does she therefore accept that women—and especially women of colour—have been ill served for many years? How will the Government reverse this trend?

I agree with the noble Baroness. It is a disgrace that there is such a huge inequality in maternity care. Maternal mortality rates are some 2.3 times higher for black women and 1.4 times higher for Asian women, while those living in the most deprived areas have a maternal mortality rate nearly twice as high as that for those who live in the least deprived areas. That cannot be acceptable in 2025. I am glad that we have taken a number of actions to ensure that trusts who fail on maternity care are robustly supported. We will set an explicit target to close black and Asian maternal mortality gaps. Trusts are also required to publish a suitable plan to tackle this and to put it into action. It is a challenge, but not one that we shy away from.

My Lords, I declare my interest as set out in the register. What is the Government’s timetable for a revised or updated version of the women’s health strategy? Can the Minister also assure the House that there will be adequate funding for its implementation when it is brought in?

Let me assure my noble friend and other noble Lords that there are no plans to cancel the women’s health strategy. I know my noble friend did not say that, but it is very important to put that on record. We continue to implement it; for example, since I have been in post, through measures such as supporting pregnancy loss through a full rollout of baby loss certificates, introducing menopause support in the workplace, and boosting women’s participation in research and clinical trials. As I said, our priorities for delivering the strategy will be through the 10-year plan. Funding decisions will be announced in due course.

My Lords, given that one-third of all new breast cancer cases occur in women over the age of 70, will the Minister consider extending automatic screening for those women? At the moment, it stops at that age.

Women over 70 can request an assessment if they feel it is appropriate for them. We act on and apply the scientific advice and evidence that we are given. On World Cancer Day, perhaps it would be appropriate to say to the noble Baroness that some 700,000 women across the country will take part in a world-leading trial to test our cutting-edge AI tools, which will be used to catch breast cancer cases earlier. This morning, I was at the Royal Marsden Hospital in Sutton with Minister Vallance to see the incredible contribution that AI is making to improved cancer services, including for women.