Despite what was said earlier, I am not in the least embarrassed about being here this morning. Male Members of Parliament have wives and daughters and we speak to one another about these matters. Our constituents occasionally talk to us about them. I am pleased, therefore, to have this opportunity to join in the debate on women's health.
Due to the structure of our society, women play a central role in the health of the nation. They are in a position to influence the health of others and to promote good and preventive health habits in our children. They are the major carers through their role in the Health Service and in the family and the community. That is one reason why their health should be of prime importance to the Government and to this House.
Today, more than ever, women are expected to cope with a diversity of roles, with little or no support. More women work today than ever before—some out of choice, others because of the pressures of a materialistic and consumer society, and many out of pure need. Most are in low paid and low satisfaction work. Few are in positions of power or influence. At the same time we expect them to provide a good family life and to care for our children, the sick and the elderly.
In the poorer sections of the community, these pressures are added to by intolerable housing and living conditions. We hear a lot about Victorian values. In many respects this Government have reintroduced Victorian legislation for the social services and the welfare state. However, it is time that we recognised that the structure of society is not what it was. Gone is the extended family and the close-knit community that could offer help and relief from the pressures of caring for children, the sick and the elderly. Today our carers are often isolated and expected to cope on their own. I do not find it surprising that women suffer from the effects of stress, anxiety and depression. It is time that we cared for the carers.
With the emphasis on community care, it is important that we should replace the old network with a full range of community services. There should be adequate day care facilities, creches, mobile clinics, day centres, home helps and visits and short-term respite facilities. There should also be improved benefits to relieve the financial burden that is often placed on our carers. With an improvement in these services, it may be easier for men to take on the role of carers, thereby giving women the freedom of choice that they should have.
It is with some concern that I note that district health authorities are finding it necessary to close down their family planning clinics in budget-saving exercises. Family planning clinics offer a wider choice of contraceptives. The staff are often better trained in these matters than the general practitioner and can offer more time for consultations than the average GP. It has already been said twice that many women prefer to go to clinics. Quite often, it is the only opportunity that they have to be seen by a woman doctor. Family planning clinics have proved to be cost-effective and we should consider expanding, not diminishing their number.
I welcome the Under-Secretary of State's claim in a speech to the Royal College of Nursing on 19 May 1988 that the Government do not want health authorities to cut back on the provision of family planning clinics. While district authorities continue to suffer from a shortage of funds, the position is unlikely to improve.
We hear much from the Government about freedom of choice. Many of their policies are justified by that cry, yet the centralisation and rationalisation programme in the hospital service and the cuts due to the financial crisis have limited the choice for many women. For instance, it is often the maternity wings of hospitals that are hit. Expectant mothers find that the criterion of choice becomes not the services provided but how far and for how long they will have to travel to reach a hospital.
The centralised programme is sometimes justified by the claim that health authorities are providing centres of excellence, equipped with all the latest advances in technology and equipment. When that claim is applied to obstetrics, we are in danger of pressurising women into giving birth in unnatural clinical surroundings and, in the majority of cases, with unnecessary technical equipment. The Government are on record as saying that their aim is to encourage hospital births in order to reduce the mortality rate, yet there is no confirmed evidence to support the theory that the fall in the mortality rate is due to hospital confinements. Hospitals have a far higher rate of infection of the mother than have home births. There needs to be more scientific evaluation of present methods before we continue to pressure women into high-tech births.
The real choice for women will come when we view pregnancy and birth as the natural phenomena that they are. We should provide the maternity services that the World Health Organisation recommends. The expectant mother must be given the opportunity, in consultation with her doctor and midwife, to choose the birth that suits her best. Therefore, the number of midwives needs to be increased and after-care services expanded.
That latter point is particularly important, because, as a result of financial and staffing pressures, more and more women are being sent home 24 hours after giving birth. The latest information from the Royal College of Midwives is that, between 1979 and 1987, the birth rate increased by a further 40,000 babies, but the claim that more midwives are being employed could be challenged and the Royal College of Midwives says that we are talking about only half a midwife per unit per week.
Later in life, many women have to suffer the effects of the menopause without any hope of alleviation of the symptoms of menopause-related diseases such as osteoporosis, which is connected with the death of many older women. In June 1986, the Nursing Times and Nursing Mirror estimated that osteoperosis treatment was costing the Health Service £2 million per week, with a third of hospital beds occupied by women suffering from related ailments. We have heard with interest about hormone replacement therapy, which may offer women a better quality of life. However, before it becomes commonplace, there should be a further investigation of the short and long-term effects of such treatments, and more information and training should be given in methods of prescribing it.
The current financial crisis and long waiting lists mean that many women needlessly suffer the pain and discomfort of osteoarthritis and other conditions. Yet we hear of more ward closures and of a doctor in Sheffield contributing a third of his salary to keep his specialist osteoporosis unit for another two months. In the majority of areas, provision is not good enough. In Southport, we are lucky: a new hospital is due to open at the end of the year, although there again, it is to replace outdated buildings.
Four major causes of death in women have been identified as coronary disease, lung cancer, breast cancer, and cervical cancer. The last two are specific to women and I welcome the Government's attempt to improve matters through screening programmes. However, those programmes will not be completely successful unless the Government also provide and fully fund the necessary back-up services. I note with concern that units that began their programmes in January are already having to close because of a shortage of scientific and laboratory staff. With increased emphasis on preventive screening and new laboratory techniques it is imperative that the Government tackle the problem by improving and funding pay awards and improving career structures in the service.
The mammography programme requires a better training scheme for radiologists to prevent unnecessary recalls, and possibly the employment of specialist teams to ensure that the correct diagnosis is made and the correct treatment given. Both screening programmes should involve more counselling and after-care services for women who are proved positive.
Perhaps most important of all, the hospital services must be given the means to provide the treatment necessary. There is little point in introducing systems of early detection if treatment is thwarted by lack of equipment, lack of staff, and long waiting lists. There is also a danger that in the current crisis, less serious gynaecological cases will be pushed further down the list, with the result that more women will suffer months, if not years, of ill health, perhaps with more serious consequences.
The Governnment must look at the whole picture. Women play a pivotal role in our society. In an ideal world, men would share that role, but until the structures of our society are changed to accommodate that, it is especially important that women are given the local, community and work-based services that they require to meet the demands that society and Government place on them. The better health that women enjoy, the more benefit will accrue to us all.