Endometriosis: Women in the Workplace

Motion made, and Question proposed, That this House do now adjourn.—(Keir Mather.)

19:04:00

I am grateful for this opportunity to raise the plight of women with endometriosis and the everyday struggles they face in the workplace. Endometriosis was first identified in 1860, but progress in improving the lives of women suffering from it has moved at a glacial pace since then. As the Women and Equalities Committee so accurately put it: “Women and girls are missing out on their education, career opportunities, relationships, social lives and are having their fertility impacted because of neglected reproductive health conditions.” This debate focuses on the impact of endometriosis on women in the workplace. I chose this specific focus of attention because an examination of all the issues facing women with this condition would far exceed the time constraints of an Adjournment debate; it would span an entire Parliament and more.

I commend the hon. Lady for raising this massive issue. I have in my office a girl who joined as a 16-year-old and has been with me for almost 12 years. She got married on new year’s day. At the age of 28, she had menopause to try to help her endometriosis. As a caring employer, I obviously made sure that she had all the days off that she needed, but not every workplace will ensure that such women get the time off that they should. Does the hon. Lady agree that, although the debate will raise awareness, there is a role for the Government to ensure that there is training for businesses so that they understand their obligations?

I thank the hon. Member for that point. The issue has been known about for a long time. The women’s health strategy, published in 2022, painted a picture of what workplaces should be like over the next 10 years, arguing that women should “feel able to speak openly about their health and to be confident that they will be supported by their employer and workplace colleagues, with an end to taboos” and that “women experiencing women’s health issues such as period problems, endometriosis, fertility treatment, miscarriage and menopause” must “feel well supported in their workplaces.” This is a far cry from the reality facing women in the workplace today.

It is fortuitous that you are in the Chair tonight, Madam Deputy Speaker, given all the work you did on these issues in the last Parliament as Chair of the Women and Equalities Committee. I think that the hon. Lady attended my Westminster Hall last year, and I am grateful to her for securing this Adjournment debate. As a direct consequence of my Westminster Hall debate, Essex police contacted me, saying, “We are looking into doing this. Can you give us advice on the workplace?” It was a great example of the impact of this place, and employers will be listening to her debate. Des she agree that education and sunlight will help a lot of employers make the right decisions?

I thank the right hon. Member for that intervention, and I absolutely agree. I pay tribute to you, Madam Deputy Speaker, and to the right hon. Member for the efforts he has put in over many years. Stigma and a lack of awareness by employers means that reproductive health conditions can have a significant effect on women’s experiences at work. It is almost impossible to remain at work when suffering from chronic pain and the mental toll that these conditions cause.

I thank my hon. Friend for the fantastic speech she is making. Endometriosis UK, which provides the secretariat of the all-party parliamentary group on endometriosis, of which I am the chair, released a report last year that found that 47% of women had visited their GP 10 or more times with symptoms prior to diagnosis. Many of those women are likely to face issues with getting time off work to attend these appointments, or experience some form of disciplinary action because of it. Does my hon. Friend agree that being understanding and tolerant about the number of appointments needed to secure a diagnosis is critical to being an endometriosis-friendly employer, and that, ultimately, we need to take steps to ensure that the process does not take several years and so many appointments?

I thank my hon. Friend. The average length of time taken is now eight years, which is not good. Many women feel unable to speak openly about endometriosis as they would other conditions, as if it were something to be ashamed of. Research shows that 23% of women take time off work because of period health issues while 80% lie about reasons for absence if they are related to periods. Having said that, endometriosis is not just about periods; it is a whole-body complaint. I do not think there is an organ in the body up to the chest that has not been found to be affected by what is a crippling disease.

I want to build on what the hon. Lady said about endometriosis in the workplace. The condition often comes with infection of the digestive system, which can make many women incontinent to the point that they suddenly have to run. That is important to consider, as this is not just about appointments and time off but the conditions in which people work and the understanding they need from their colleagues and bosses.

I completely agree, and it has serious consequences. Women may need to have a stoma because of the damage done to their bowels. The right hon. Member and I have both met quite young women their 20s who have needed to have hysterectomies and will never be able to bear a child. Endometriosis should not mean that women have to put their careers on hold and leave the jobs they have worked hard to get. Employers can take simple steps such as offering flexible working, access to period products and time off to attend appointments to build the type of workplace envisioned in the women’s health strategy. I am pleased that the Government have brought forward the Employment Rights Bill, which will be the biggest boost to workers’ rights in a generation. That offers the perfect opportunity to begin to change the workplace experience of women with endometriosis.

I thank my hon. Friend for securing this important debate. As she mentioned, endometriosis can have a knock-on effect on many areas of a woman’s life. It can affect mental health, and it can also have an impact on fertility, yet there is no statutory right to time off work for fertility treatment, or indeed in many other scenarios. Does she agree that we should welcome the support that employers provide in this area and encourage others to do much more to support women going through endometriosis and so many other difficult conditions?

I thank my hon. Friend for that point, and I completely agree. Although the Employment Rights Bill does require large employers to publish equality action plans, there is no specific mention of reproductive conditions. What discussions is the Minister having with her colleagues in the Department for Business and Trade to ensure that those issues are not forgotten? What hope can we have that employers will understand the condition if even some medical professionals do not? All too often, we have heard stories from women who have been told, “It’s just a heavy period” and, “Suck it up—every woman goes through this.”

I met women from the endometriosis support group in Derby, and so many reported that they had had to give up work because of their symptoms as well as the huge delays in their diagnosis and treatment. Does my hon. Friend agree that until this gets real priority and understanding, we will continue to lose out on the talents and skills of women with endometriosis?

Absolutely, and I will come to that shortly. That leaves women feeling dismissed, ignored and belittled by the very people who should be helping them. The result is that it takes almost nine years on average to get a diagnosis of endometriosis in the UK. I therefore look forward to hearing from the Minister on the steps she is taking to promote better awareness.

Will my hon. Friend give way?

I am sorry; I have got to make progress. I do not underestimate the task for Ministers in fixing our NHS after it was left in tatters by the previous Government. Waiting lists for gynaecological care have grown faster than those for any other specialty in recent years, leaving many women in agony. The women’s health strategy correctly identified some of these chronic issues, but in the absence of funding to back that up, we have gone further and further backwards from what we need. For instance, women’s health hubs have improved women’s access to healthcare services, but the previous Government failed to give them long-term certainty and their funding is set to run out in March. As the Government work hard to rebuild the NHS, improving gynaecological care must be at the centre of that, because women have waited long enough. Will the Minister therefore update the House on how the Government will implement the measures in the women’s health strategy? We must continue to encourage research into endometriosis. Our world-leading researchers are doing vital work in clinical trials to find better ways to manage and treat this condition. They will not stop until they find a cure. Therefore, will the Minister outline what steps she is taking to support clinical research and ensure that women are able to get on to those clinical trials? If we have a cure, it is obvious that we will not have any of the problems that I have spoken about. I commend the Women and Equalities Committee on its excellent report into women’s reproductive health conditions. It has made a number of recommendations, including on employment rights, and I look forward to reading the Government’s response. I hope that they will listen to calls to give specific mention to reproductive health as part of the Employment Rights Bill, which has cross-party support. I also praise Endometriosis UK for its invaluable work in supporting women with this condition and campaigning for change. It acts as the secretariat for the all-party parliamentary group on endometriosis, of which I am an officer.

I thank my hon. Friend for securing this critical debate. With an average of eight-plus years for a diagnosis, does she agree that employers must build a more supportive and flexible approach that embeds policies to help women, such the endo-friendly employers scheme? Will she join me in thanking campaigners such as the Endo Warriors West Lothian for their tireless awareness-raising efforts?

My hon. Friend is absolutely right—that is what we are talking about. For many years, the APPG was chaired by our dear friend David Amess. David campaigned tirelessly for improvements to endometriosis care, and he will forever remain on our minds as we continue his legacy.

19:16:00

I congratulate my hon. Friend the Member for Sheffield Brightside and Hillsborough (Gill Furniss) on securing this important debate on the impact of endometriosis on women in the workplace. In opposition I supported the work of the APPG. I echo the praise for the campaigning work of Endometriosis UK and the support that you, Madam Deputy Speaker, and others in the Chamber have given to the APPG. I also remember the work of our friend David Amess. I echo the recognition of the recent report by the Women and Equalities Committee on reproductive health conditions. My Department is working across Government on our response, which will be published in due course. I welcome the progress made on raising awareness—we are moving very fast on this—and on providing better support for women’s health conditions, including endometriosis. Nevertheless, this Government recognise that women with endometriosis have been failed for far too long, and we acknowledge the impact that it has on women’s lives, relationships and participation in education and the workforce. There is still much more work to be done. We are committed to improving support for any women and girls whose periods or women’s conditions disrupt their normal life, work or education. In addition to receiving support in the workplace, all women should have access to healthcare support to help diagnose and manage this condition. We are making progress to ensure that those with endometriosis receive a timely diagnosis and effective treatment.

There has been a lot of cross-party work on this issue. I led a debate—the last one before the general election was called, I think—on endometriosis education. It is not prescribed that schools should educate about what a bad period is—I still meet women born in this century who do not know. If someone does not know what a disease is, how do they know that they have it? I urge the Minister to ensure that those messages are pushed in the Department for Education, as we need to ensure that people know what diseases they could have.

I thank the right hon. Gentleman for that point, which I will talk about later. On the Employment Rights Bill, our plan to make work pay sets out a significant and ambitious agenda to ensure that workplace rights are fit for a modern economy, empowering working people and contributing to economic growth. On 10 October, the Government fulfilled their manifesto commitment to introduce legislation within 100 days of entering office, by introducing the Employment Rights Bill. As part of the Bill, we are taking the first steps towards requiring employers to publish action plans alongside their gender pay gap figures. The relevant clause sets out that regulations may require employers to develop and publish action plans relating to gender equality, which include measures to address the gender pay gap and support employees going through the menopause. It deliberately does not provide an exhaustive list of matters related to gender equality, giving us the scope to be led by the actions themselves. This reflects the fact that many of the actions employers take will be beneficial for people in a lot of different circumstances; for example, improved provision of flexible working can be valuable for an employee balancing childcare as well as someone managing a health condition such as endometriosis. In the same way, ensuring that employers support staff going through the menopause will necessitate them taking steps that are positive for supporting women’s health in the workplace more broadly. For example, menopause best practice includes greater discussion around women’s health and awareness of potential workplace adjustments—things that have a much wider potential benefit. As my hon. Friend said, we need to start to reduce the stigma and taboos and remove them from the debate. Through the Employment Rights Bill, the Government are also making statutory sick pay payable from the first day of sickness absence. This will particularly benefit those who suffer from conditions such as endometriosis, who may need to take time off to manage a flare up. We are also removing the lower earnings limit and extending statutory sick pay to up to 1.3 million additional low-paid employees, particularly benefiting women, young people and those in part-time work. The Minister for Equalities, my hon. Friend the Member for Llanelli (Dame Nia Griffith), leads for the Government on the Bill from the equalities team, and I can assure my hon. Friend the Member for Sheffield Brightside and Hillsborough that we are working with her and talking about this issue throughout the Government. For example, I regularly join Women and Equalities questions here in the Chamber to make sure we work closely together, and I will continue to work closely with colleagues on these issues. The new measures we are seeking to introduce build on existing Government support for employers, which recognises their key role in increasing employment opportunities and supporting disabled people and those with health conditions to thrive as part of the workforce. The Government’s current offer to employers includes a digital information service that provides tailored guidance to businesses to support employees to remain in work. That includes guidance on health disclosures and having conversations about health, as well as guidance on legal obligations including statutory sick pay and reasonable adjustments. The service is available across Britain and can currently be accessed from a range of trusted locations, including both the Health and Safety Executive and ACAS websites. We are also taking steps to better understand the challenges faced by women with endometriosis in the workplace and to improve workplace support for those with the condition. The Government health and wellbeing fund has awarded almost £2 million to 16 voluntary, community and social enterprise organisations leading projects focused on supporting women who experience reproductive health issues to remain in or return to the workplace, including a project on endometriosis delivered by Endometriosis UK. An Office for National Statistics study is investigating the impact of endometriosis on women’s labour market outcomes. This important study will be a vital step to improving our understanding and will inform future actions policy work. The first publication in this research project, on the characteristics of women diagnosed with endometriosis in England between 2011 and 2021, was published in December. In addition to providing workplace support for endometriosis, the Government are committed to improving healthcare support and ensuring that women with endometriosis can receive timely diagnosis and treatment. We recognise that patients have been let down for too long while they wait for the care they need. Nearly 600,000 women are on gynaecology waiting lists. It is unacceptable that patients are waiting too long to get the care they need. I thank my hon. Friend the Member for Sheffield Brightside and Hillsborough for her sympathy with the task of reducing those lists, but that is our priority. Cutting waiting lists, including for gynaecology, is a key part of our health mission and a top priority for this Government. We have committed to achieving the NHS constitutional standard that 92% of patients should wait no longer than 18 weeks from referral to treatment by the end of this Parliament, and that absolutely includes those waiting for gynaecology treatment. My noble Friend Baroness Merron, the Minister responsible for patient safety, women’s health and mental health, and I recently met with the Government’s women’s health ambassador, Professor Dame Lesley Regan, and NHS England to discuss progress on women’s health and current issues including gynaecology waiting lists. Following that meeting I am pleased that our recently published plan for reforming elective care sets out commitments to support the delivery of innovative models in gynaecology offering patients care closer to home and piloting gynaecology pathways in community diagnostic centres for patients with post-menopausal bleeding. Enabling access to adequate healthcare support begins with providing high-quality education and information on menstrual health, as the right hon. Member for Wetherby and Easingwold (Sir Alec Shelbrooke) highlighted, so that women and girls know when and how to seek help for symptoms such as heavy or painful periods. The compulsory aspects of the curriculum on relationships, sex and health education means all pupils are taught about several areas of women’s health, including menstruation, contraception, fertility, pregnancy and menopause. My right hon. Friend the Secretary of State for Education has committed to providing teachers with clear guidance that focuses on the wellbeing of children. Her Department will look carefully at all relevant evidence and engage with stakeholders, including young people and parents, ahead of publishing a consultation response and the revised guidance later this year. I am pleased that Dame Lesley Regan, in her role as women’s health ambassador, has been feeding women’s health perspectives into this work. My Department has worked with NHS England to improve and create new content on endometriosis symptoms, diagnosis and treatment options on the NHS website and YouTube channel. NHS England has also published a decision support tool for managing heavy periods to support women’s understanding of their symptoms and appropriate treatment options to discuss with clinicians. Education and clinical guidelines support healthcare professionals to provide care for women with endometriosis. The General Medical Council has introduced the medical licensing assessment for most incoming doctors, including all medical students graduating in the academic year 2024-25 and onwards. The content for the assessment includes several topics relating to women’s health, including menstrual problems and endometriosis, and will encourage a better understanding of common women’s health problems in all doctors as they start their careers in the UK, which we all want to see. Endometriosis is also already in the core curriculum for trainee GPs, obstetricians and gynaecologists. Last year, the National Institute for Health and Care Excellence published updated guidelines on the diagnosis and treatment of endometriosis, and the new and updated recommendations on referral and investigation should help women receive a diagnosis more quickly. Through the National Institute for Health and Care Research, the Department has also commissioned a number of studies focused on endometriosis diagnosis and treatment and patient experience. In closing, I thank my hon. Friend the Member for Sheffield Brightside and Hillsborough for tabling this debate and for her continued long-standing advocacy for women’s health. Let me affirm the Government’s commitment to supporting the many women who live with endometriosis in the workplace and beyond. This Government are committed to prioritising women’s health as we build an NHS fit for the future. My noble friend Baroness Merron is carefully considering how we take forward the women’s health strategy by aligning it to the Government’s missions and forthcoming 10-year health plan, and women’s equality will be at the heart of our missions. It is vital that we work with women to better understand their experiences and address their concerns, which have been ignored for far too long. Question put and agreed to. 7.27 pm House adjourned.