Women’s Health Strategy

11:03:00

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the women’s health strategy.

I thank the hon. 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 every10 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.

For too long, a woman’s experience of the health service has been one of being pushed from pillar to post. Crucially, women’s voices have been ignored and responses to their pain, suffering, poor sex lives and traumatic births have been too slow. Overall, women have a sense of being forgotten. Some 2.4 million more women were in work under our Conservative Government. Pain and suffering were affecting too many women and their ability to remain in the labour market, resulting in early retirement or not having their true career potential fulfilled. We took direct action, crucially, by listening to women’s experiences. We had almost 100,000 responses to our call for evidence on the gender health gap. We appointed Dame Lesley Regan as the woman’s health ambassador, and Helen Tomlinson as the cross-government menopause ambassador to find out the experience of women employed in different sectors. We delivered and funded new women’s health hubs and created joined-up services in the community. The Royal College of Obstetricians and Gynaecologists estimates that removing the requirement of integrated care boards to have a woman’s health hub will impact 600,000 women on waiting lists in England, creating longer waits, disease progression that could be prevented, and resulting in more women attending A&E, unable to work, care or live a fulfilled life. Labour’s manifesto said that it will prioritise women’s health. Women are now reported to be a lobby group, relegated to being unheard once again. Will the Minister confirm whether it is true that the targets to deal with women’s needs will be dropped? If so, what is her justification for that? Will she be delivering on the roundly welcomed women’s health strategy from 2022? A total of 1,300 families gave evidence to the all-party group on birth trauma. What are the plans to drive up maternity safety standards across the country? Will there be a response to that? Will Dame Lesley Regan be sacked, will she remain the women’s health ambassador, or will she be replaced, as Helen Tomlinson was, by someone who seems more interested in selling books than in delivering on the ground for women? What steps are being be taken on sex-specific language in health communications and guidance—

Order. The shadow Minister will know that there is a time limit, which she has exceeded. I have been very generous. I call the Minister.

I addressed most of those points in my outline statement. I think the shadow Minister wrote her comments when the Opposition thought that we were cancelling things, only to find out that we are not cancelling things. I have made clear our commitment to the women’s health strategy and how we seek to instruct the system at a local level to serve the needs of women and particularly prioritise those waiting lists. As I have outlined, the targets have already been achieved. Unusually, I will give a bit of credit to the other side, because a lot of this was rolled out and it was good practice, and the system still thinks that it is good practice, so sometimes Opposition Members should take a win. We are committed to that, it is embedded in the system, and we look forward to outcomes being improved for women.

I call the Chair of the Women and Equalities Committee.

The Committee report on women’s reproductive health, started under our fantastic predecessors, laid out how medical misogyny has left far too many women suffering. Women have been left undiagnosed for debilitating conditions such as endometriosis for an average of eight years—not for treatment, for diagnosis. Black women are four to five times more likely to die during childbirth, and the rate of maternal death in the UK has risen by 15% in the last 10 years. The leading cause of that is suicide, accounting for 39% of deaths in the first year postpartum. Does the Minister therefore agree that women, and women of colour especially, have borne the brunt too often of 14 years of disastrous health policies? How can the Government reverse this trend?

I thank the Committee Chair for her question. I think she was congratulating the previous Committee and Chair rather than those who are now in opposition. I was very pleased to witness some of that work when we were in opposition, and she is absolutely right about it. The work of many women Members when in opposition, and, to be fair, of many women in the previous Government, have made sure that issues around endometriosis have risen up the agenda; indeed, we had a good debate in the Chamber recently. We are committed to taking forward the strategy. We think the health hubs, for example, are doing a good job, but there is a lot of learning to be done on them, and we will continue to do that.

I call the Liberal Democrat spokesperson.

Nearly 600,000 women are waiting for treatment on gynaecology waiting lists in England; the longest waits are leading to preventable diseases progressing and it is one of the worst specialties for long waits. The Care Quality Commission has investigated and reported that 65% of maternity units are not as safe as they should be. That high number could almost be considered a public health crisis, and it has led to the highest amount of negligent payouts due to avoidable injury and even death. This absolutely needs to be addressed. Many women, such as my partner Emma, have had to fight for years to get just a diagnosis for endometriosis, let alone any treatment, having been told for years that the symptoms are completely normal and do not need investigating. In the Government’s—

Order. I know I am being difficult on time limits, but the Liberal Democrat spokes- person should have one minute in an urgent question, which the hon. Gentleman has already far exceeded. Perhaps he will come up with a question in one sentence for the Minister.

Apologies, Madam Deputy Speaker. Yes, in one sentence: the Government’s manifesto rightly said that “Never again will women’s health be neglected”. Can we have assurances that we will not remove the ICB requirement to have women’s health hubs?

The hon. Gentleman is right to highlight those long waits. That is why we particularly highlighted gynaecology for attention in the elective reform plan. It is shocking that the last Government left 600,000 women on these lists, and moving back to making sure people wait no longer than 18 weeks will predominantly be helping those women. The hon. Gentleman is also right to highlight the appalling maternity situation. The Secretary of State and my noble Friend Baroness Merron, who leads in this area, have met many families to discuss their experiences, and we know those experiences are unacceptable. We know there are big issues around staffing, and it is a priority to work with NHS England to make sure that we grow workforce capacity as quickly as possible so that we can be sure that those situations are safe. There are many debates in this place about the issue and we will continue to update the House.

Under the last Government, five times more research went into erectile dysfunction, which affects 19% of men, than went into premenstrual syndrome, which affects 90% of women. Women are waiting more than eight years for endometriosis diagnoses. GPs are not required to undertake a gynaecological rotation within their training. Women’s health must be put at the head of our agenda. Will the Minister assure women in this country that things will change under this Government?

I absolutely will give my hon. Friend that assurance. The situation will change partly because there are more people like her and more women in this place. We have more women across all parties raising this issue and more women in senior positions in the National Institute for Health and Care Research. Crucially, we have women leading in science and research. Dealing with the misogyny around the system and in medical systems is also important for making sure that women lead this work. We want to make sure that the NIHR, which has a strategy to address this issue, rectifies the situation that she outlines.

The Minister will be aware of the Ockenden report back in 2022, which highlighted the tragic cases of more than 200 mothers and babies who were killed over a period of years at the Shrewsbury and Telford Hospital NHS Trust. Donna Ockenden recently returned to the trust and said that she was surprised and disappointed to hear from those parents and families affected that the trust had not been communicating as well as it should have been and had not been updating the families in a timely manner. Does the Minister agree not only that communication is key, but also that reviews, such as those undertaken by Donna Ockenden, should have the remit to go back to check and monitor the progress of maternity services that are either improving or not?

I completely agree with the right hon. Member. Donna Ockenden’s work is hugely valuable, and a lot of faith and trust has been placed in it, particularly by families. I do not know specific dates, but the Secretary of State and my noble Friend Baroness Merron, who leads on this work, have been discussing the matter with Donna Ockenden. I am happy to get back to the right hon. Member with the details. On the specific point about the remit, I do not know the answer to that question. It is entirely sensible to look at progress and learn from mistakes. I know it is a challenge system, and we have to learn from those areas. If there are specific things to report back to the right hon. Member, I will get back to him, but this issue is absolutely a priority. The Secretary of State is meeting families directly. We know and understand that we have to do much better on this for everybody.

Having listened to the shadow Minister, I am slightly tempted to suggest to the Minister that our women’s health strategy include provision for the treatment of collective memory loss. The shadow Minister completely ignored the fact that the Tories let our NHS fall into disrepute over the past 14 years. I want to ask specifically about how our health strategy will deal with treatment and support for young people, particularly young women, suffering from depression and anxiety. That follows a tragic case in my constituency and a coroner’s report last week, which found that our local hospital was not able to support that patient.

My hon. Friend is right to highlight some tragic incidents, and I know she will be working hard on behalf of her constituents. We are absolutely committed to the women’s health strategy. Clearly, that will be taken forward as part of the 10-year plan, and it is an important part of that. I met my noble Friend Baroness Merron yesterday and the team supporting that plan to make sure that we understand how those key issues are taken forward. This is an opportunity, if I may, Madam Deputy Speaker, to say that the consultation on that plan is still open for ideas. We are keen to hear in particular from young people to make sure that we get a true representation. These sorts of things are not often consulted on, so we encourage young people and people who are suffering from depression and mental health issues to contribute their thoughts about the system they face as part of our 10-year plan consultation.

I am sure we all welcome the move to reduce waiting lists and recognise that the women’s health strategy is a 10-year plan. But given the enormous problems highlighted by the hon. Member for Luton North (Sarah Owen) and my hon. Friend the Member for Winchester (Dr Chambers), does the Minister appreciate that, to many women who are having trouble accessing often fragmented gynaecological services, it will seem like a vital facility is about to be lost and that the Government’s promises of “never again” will sound hollow? What will the Government do to reassure all the women who are concerned about this move?

I am not entirely clear what the hon. Member is referring to. I have been clear that we are committed to the women’s health strategy, and we will take it forward as part of the 10-year plan. Most of the—[Interruption.] If it was about the women’s health hubs, they are mainly there but in different forms and with different levels of services. We want to ensure that the systems reflect their local population needs. That is an entirely proper way to go about things. As I said, unusually, we think that many of the hubs, which were rolled out as pilots under the previous Administration, are doing a good job in most areas—although not everywhere, so we want to learn from the pilots. Our commitment is absolutely to women. That is why gynaecology waiting lists are particularly targeted: we had 600,000 women on them. Women should feel really assured about the support that the Government are giving them and their health, to prioritise their health. We are keen to learn more about women’s health hubs. They will be different in different places because they have different populations, and that is entirely in keeping with the direction of travel of the Government.

I also thank my hon. Friend the Member for Luton North (Sarah Owen) for her work in raising the serious health inequalities that women across the UK face every single day. Does the Minister agree that we need more expertise in women’s health issues in primary care settings to ensure early diagnosis and that women get the treatment they need at the earliest point?

My hon. Friend makes an excellent point about both the work of the Chair of the Select Committee, my hon. Friend the Member for Luton North (Sarah Owen), and the importance of primary and community care recognising, listening to and supporting women through women’s health, as well as making sure that our knowledge and good practice is spread across the team. This is an area where different systems have women’s health hubs using different teams and different technology, and they have different links to secondary care colleagues and specialist colleagues. By listening to each other and working together, they are so good at spreading some of that good practice.

I welcome the Minister coming to the House to answer the urgent question, because the argument she is putting forward seems slightly confused. First, women’s health hubs seem to be working on the whole, and there are lots of them, so why remove the target for everybody to have them if we are already 90% there? Secondly, many of the hubs seem to be doing good work, and best practice is clearly emerging, so why cancel the target for the programme rather than spread that good practice throughout the system? I think the broad question from the Opposition is: why remove the targets specifically relating to women from the Government’s agenda going forward? It feels to many women and to the Royal College of Obstetricians and Gynaecologists, which has been in contact with me, that that downgrades the status of women in the NHS.

I will try to be brief, but this is hard to explain—[Interruption.] No, this is to answer the right hon. Gentleman. Targets in the NHS have not been met since 2015, which was under his Government’s watch but, actually, this target has been met—there are only three places in the country that do not have a hub—so there is no target for them because that has already been met. The issue now is to look at the outcomes from those hubs to see how they are performing. We think, and the system thinks, that they do a good job. That is why they are staying, why we are committed to them, and why we want to learn from them.

Bedford hospital once had a gold-standard home-birth service, but in recent months it has been run down within the wider trust due to unfilled vacancies. Many of my constituents are concerned at the prospect of losing that service, which puts women’s needs and health choices first. Will the women’s health strategy ensure that women can access a consistent midwifery service that provides genuine choice for safe home births?

My hon. Friend makes an excellent point about maternity services, which are inconsistent and not good enough around the country. It is a source of great alarm for many people. Maternity absolutely remains a high priority within the overall women’s health strategy.

If you are black and having a baby, you are more than three times more likely to die than if you are white and having a baby. I am sure that the Minister and Members across the House will agree that that is a national disgrace. I was encouraged to hear the Minister mention a target for maternal mortality disparity in her opening remarks, but I would be grateful if she could confirm that the elimination of that disparity is the target and update the House on when the NHS plans to achieve that.

The hon. Lady makes the point about using targets. This is something that is a high priority, but it is not happening. That is absolutely why I mentioned it in my opening comments—to ensure that that happens.

Forty years ago this month, my wife almost died of an eclamptic seizure because a general practitioner had failed to recognise the symptoms of pre-eclampsia. According to the most recent report on pre-eclampsia, four times as many women are dying of pre-eclampsia today than were dying in 2012. That is an absolute disgrace. If men got pre-eclampsia, they would have solved the problem many, many years ago. [Hon. Members: “Hear, hear.”] Will the Minister assure me and everyone else that the women’s health strategy will focus on pre-eclampsia, and try to finally find a solution?

My hon. Friend makes a very powerful case and talks of an experience that he and his wife went through forty years ago, which highlights that it can sometimes take an unacceptably long time to get what is known as good practice through the system and to have that consistency for women and their families across the overall system. We absolutely need to ensure that maternity services understand best practice and that it is rolled out properly across the country.

In an earlier answer, the Minister rightly talked about the arrangement the Government have over spare capacity in the independent sector. My female constituents and women up and down the land want to know what that actually means in practice: what does that mean for the 260,000 women waiting more than 18 weeks for gynaecology treatment? How many treatments will the independent sector be delivering, and to what timescale? We need to get those women the treatment that they need.

The hon. Gentleman can tell his women constituents what I hope everyone across the House will be able to tell their constituents: this Government inherited 600,000 women on those waiting lists, and we are committed—as said in our elective reform plan, which highlighted gynaecology in particular—to getting those waiting lists down from 18 months to 18 weeks in the lifetime of this Parliament.

I represent almost 40,000 women, and they and the men who love them would invite the Minister to state explicitly that the Government will not draw down their access to women’s health hubs or remove their women’s health targets.

I have made that commitment several times from this Dispatch Box. We think the women’s health hubs are working across the country—I do not know exactly how the hon. Gentleman’s hub is working at the moment. Only three areas do not have a women’s health hub, and we expect them to get on with that and have one. We will ensure we have the learning from them across the country.

The Minister got her tone wrong in dealing with this urgent question. If a Minister turns up late for a UQ, the least they can do is take the questions from the Opposition Front Bench seriously. Amanda Pritchard, the CEO of NHS England, has said that the health service does not “always have the needs of women at its heart.” What message do the Government think scrapping women’s health targets will send?

The chief executive is right that the previous Government did not have women’s health at the heart of their strategy, and that is why we do.

As chair of the all-party parliamentary group on HIV, AIDS and sexual health, may I ask the Minister about the very low take-up of pre-exposure prophylaxis among women in the UK? What steps are being taken to change that? Obviously, there are barriers such as stigma and low levels of information, but does she agree that PrEP should not just be made available in sexual health settings, particularly as we have had the roll-out of opt-out testing?

I thank the right hon. Gentleman for the work he does in this area. He does an excellent job and makes an excellent point. I do not know the detailed answer to that question—it is not directly my area—but I am very happy to make sure that we write to him.

I thank the Minister very much for her answers. The women’s health survey for Northern Ireland closes tomorrow. Through it, the Department of Health back home is hoping to have a greater understanding of how government fails women. The results of this Northern Ireland-wide project will ensure the Department will be able to find the areas that are lacking, in particular endometriosis support. Will the Minister make contact with the Northern Ireland Assembly to discuss the health strategy and to share the results and the data, so that the UK Government and the Northern Ireland Assembly back home can work better together to make women’s health better across this great United Kingdom of Great Britain and Northern Ireland?

As I hope the hon. Gentleman knows, I think the health needs of women in Northern Ireland and the waiting lists there are particularly problematic, so finding out anything our Department can to do support or share learning across the United Kingdom is a personal commitment of mine. I will absolutely make sure that we do that. I am happy to meet, talk or even visit, which I always like doing.

On a point of order, Madam Deputy Speaker. On this incredibly important issue of the women’s health strategy, and the fact that the word “woman” has been excluded from the updated planning guidance, could you help me understand this? As a common courtesy to both you and the House, when a Minister is unable to organise herself such that she can get to the Chamber on time, is it not courteous to apologise to those of us she has kept waiting before we were able to discuss this important subject?

I thank the right hon. Lady for her point of order. She is, of course, correct that it is courteous to the House for an apology to be made. Five minutes of time was wasted this morning. I think the Minister would like to make a further point of order.

Further to that point of order, Madam Deputy Speaker. I absolutely, unequivocally apologise.

I thank the Minister.