Women's Health

Part of the debate – in the House of Commons at 9:36 am on 10th June 1988.

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Photo of Mrs Edwina Currie Mrs Edwina Currie , South Derbyshire 9:36 am, 10th June 1988

The hon. Lady should beware of challenging me on such topics. I had a healthy supper with the extremely eminent physician concerned on Tuesday night. We discussed some of the circumstances surrounding his work. The press has been less aware of the fact that he receives £700,000 for his research from the Medical Research Council. It was suggested that he might like to discuss what he will want to do in the future with the regional health authority, the district health authority and the Medical Research Council. I believe that that is now happening. The reason why I had supper with him was that I have invited him to be one of the speakers at the conference. The work being done on osteoporosis in units such as the MRC-funded one in Sheffield is important, and I have conveyed that interest to the health authorities concerned. I hope that that answers the hon. Lady's question.

Osteoporosis is 10 times commoner among women than men, and among older women it often shows itself as dowager's hump. Women can lose as much as 6 inches in height a year as spinal bones collapse. One realises when looking around our towns and villages, how many women suffer from that painful and disabling condition. I see that my hon. Friend the Member for Billericay (Mrs. Gorman) is in her place primed to give the answer. She is aware of the close interest that my Department is taking in the work of the Amarant trust, which she chairs, and which advocates hormone replacement therapy. My hon. Friend will, I know, understand our caution about any treatment which involves drug therapy over a long period. hope that she will also feel able to support and advocate those preventive measures, which are emerging from research, as the best advice to women, particularly before they reach menopause: do not smoke and stay physically active so that the bone mass is maintained. There is evidence that bone mass is significantly greater among women who take regular exercise than among those who do not. Even for post-menopausal women, exercise can slow down the rate of loss, or even reverse it somewhat. So, I am afraid that it is on with the tracksuits girls, and leave those fags at home, and I invite all hon. Members to join me. Incidentally, HRT, where appropriate, is available on the National Health Service. Patients are not obliged to seek private treatment.

Among the other organisations that are interested and involved, we help the National Osteoporosis Society, the Women's Aid Federation,—the battered wives organisation—and Maternity Alliance. We grant-aid the Widows Advisory Trust, the Miscarriage Association and many other organisations. Our male colleagues would be surprised if they saw a list of the wide range of groups concerned with women's health that we support.

The other main chunk of work carried out for women, which has experienced important developments lately, is maternity care. As it will not be one of the subjects discussed at the women's conference, I shall spend a few moments considering it. Since 1981, following the Social Services Select Committee report on perinatal mortality, vigorous efforts have been made to improve services. We set up the maternity services advisory committee, which published three reports under the title "Maternity Care in Action". The first, in 1982, was entitled "Antenatal Care", the second, in 1984, was entitled "Care during Childbirth", and the third, in 1985, was entitled "Postnatal and Neonatal Care". Those reports are a comprehensive guide to good practice and a plan for action for health authorities.

The resulting improvements in perinatal mortality are well-known. Between 1979 and 1987, the death rate among babies in the first month after birth dropped from 14·6 per 1,000 live births to 8·9 per 1,000 live births. It is more revealing if we look at absolute numbers. In 1979, there were just over 600,000 births and nearly 5,000 stillbirths, whereas in 1987 there were 645,000 births—many more pregnancies went to full term—and only 3,200 stillbirths. Far more babies are being born alive. We had therefore about 40,000 more babies to care for last year than in 1979.

Similarly, the chances of survival of tiny, low-birthweight babies have improved dramatically. In 1976, there were 38,000 births below 2·5 kg—about 5·5 lb—of whom 84 per cent. survived. In 1987, there were over 45,000 births below 2·5 kg, of whom 92 per cent. survived. Many thousands more tiny babies now survive every year. The amount of care needed to achieve that success is enormous. The object of the exercise is a healthy baby and a contented mother and family.

Over a 10-year period—indeed, a 20-year period—some matters have not improved. In 1976, the number of low-birthweight babies born alive represented about 6·5 per cent. of the total. In 1986, it was 6·8 per cent. The figure has been about 7 per cent. for over 20 years. The failure of the these statistics to change is a matter of considerable concern. Low-birthweight babies are far more likely to be sick babies in the future. They have a far higher death rate in the first few months of life, when they seem especially prone to infections.

In some parts of the country, such as Leeds, which I visited last year, the proportion of low-birthweight babies is over 9 per cent., yet in Scandinavia it is 3 per cent. In Scandinavia, a higher proportion of babies go to full term and are born at full weight. We do not know why our figures are so high, except that perhaps there is a link with smoking. A drop in the birthweight of the baby and increased perinatal mortality are directly linked to the number of cigarettes smoked. Therefore, heavy smoking is likely to produce a stronger effect.

We undertook a survey of health authority maternity care in 1985 following the MSAC reports, but we propose to write again to the district health authorities in England and ask how they are implementing MSAC. This time we shall particularly look at the antenatal care side and at the levels of care in the community. We are looking for responses within less than 12 months.