Women's Health Inequalities

1. Questions to the First Minister – in the Senedd at on 21 May 2024.

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Photo of Buffy Williams Buffy Williams Labour

(Translated)

4. How will the Welsh Government will tackle women's health inequalities? OQ61131

Photo of Vaughan Gething Vaughan Gething Labour 2:03, 21 May 2024

Thank you. For too long, there have been deep-seated and entrenched inequalities in the healthcare provided to women. I've regularly said in the past that, if the same healthcare inequalities existed for men, they would have been acted on long ago. We are committed to change and improve women’s and girls’ health and are taking action to improve the health outcomes for women in Wales, including the development of the women’s health plan.

Photo of Buffy Williams Buffy Williams Labour

Thank you, First Minister. It has been almost a year since I held my short debate on PMDD, premenstrual dysphoric disorder. Women who suffer with PMDD experience debilitating symptoms, both physically and mentally. The illness affects work, relationships and social lives in a way that non-sufferers will never understand. When I suffered, I was unable to do anything for three weeks out of each month.

The pressure for too many women gets too much. Many want to take their own lives. It's thought that one in 20 women suffer with PMDD, but, due to lack of awareness, this figure is likely to be higher, with some women wrongly diagnosed with endometriosis and other conditions.

In her response to my short debate, the Cabinet Secretary for health stated that there has been insufficient recognition of PMDD, that better training and awareness is needed, including amongst practitioners, and that more information must be provided on health boards’ and 111 websites. So, will the First Minister please provide an update on the progress made over the last year, and please outline any plans that are due to take place in the future?

Photo of Vaughan Gething Vaughan Gething Labour 2:05, 21 May 2024

Thank you. And thank you for the question, for raising this issue in the first place some time ago and for coming back to it to ensure that progress has been made. And I do agree. I'm not sure what the Member has said, but the Cabinet Secretary for health has said previously about providing greater awareness on a range of women's health conditions, including PMDD. And it goes back to the point I made in an earlier question about normalising questions around women's health, including menstrual health. So, what we have done is we've ensured that information about PMDD is included on the NHS Wales 111 website, so it's publicly available, and that signposts information to the Mind website, where even more information is available and has been assured.

Menstrual health is an important broader well-being matter, and I go back to the point that it's an important part of our relationships and sexuality education code—it's a mandatory part of that. So, it's about making sure that each generation coming through our school system learns that this is a normal part of life, to want to make the space for it to be a normal conversation, in the way it still isn't today. 

There has been some progress made, but there is much more to do, which is why we have a Period Proud action plan, which is why we do need to keep on taking the steps that have been set out in the women's health plan for the first time with a national clinical lead, both to ensure that women's health issues are recognised and that we deal with issues like misdiagnosis as well. So, I recognise that we have some things we can point to where we can say there's progress being made, but I also recognise that there's much more for us to continue to do, and I'm sure the Member will continue to raise the issue in this Chamber and beyond to make sure we do that.

Photo of Laura Anne Jones Laura Anne Jones Conservative 2:06, 21 May 2024

First Minister, I was struggling with the menopause without knowing what it was for a few years, with symptoms getting progressively worse at the end of last year to a point where I thought I was actually dying. I shared my story in the press to try and help others and increase awareness of menopause—something that half the population deal with in some form, at some level at some point. Since my diagnosis in December that I was in the middle of the menopause, not even perimenopause, and now having the help I needed, talking to others it's glaringly apparent there's a lack of education or awareness of menopause amongst girls and ladies, but also amongst men and boys and family members. Nine-hundred thousand women left a job in 2022-23 because of menopause symptoms. First Minister, it's important that all people, businesses and organisations have a greater understanding of the effects and symptoms of menopause. It's clear there's an awful lot more that needs to be done to normalise and ensure greater awareness of menopause. What will you and this Government commit to undertake to ensure that this is the case? Surely, an investment in this inequality will pay dividends in health, in the workforce, in the future and for future generations. Thank you.

Photo of Vaughan Gething Vaughan Gething Labour 2:07, 21 May 2024

Thank you for the question. I welcome the comments that the Member has made. We will, of course, as part of the women's health action plan, be considering what more we can do around better services for the menopause. Many years ago, I went to a menopause cafe to have a conversation with women who were directly affected, but also men who wanted to find out in a way where they didn't feel they'd be judged, but were curious and wanted to know what they could do. Again, we go back to, if this was an issue that men faced and, at some point, often at the most productive part of your career, when you've had lots of experience, if you then faced the situation of actually it could affect your own productivity, where you question yourself and potentially employers could lose you, because some women do leave the workforce during this time, then I'm confident it's an issue we would have resolved a long time ago. And I'm pleased the Member has felt confident and positive enough to share her own story.

Carolyn Harris, the Labour Member of Parliament, has talked about this issue a lot, and I think it's one of those areas where there is genuine cross-party support. And I mention her because she arranged for some men to put on a menopause suit to experience some of the heat and hot flushes. When that was then reported in some sections of the media, it was seen as an attempt to be woke, in a way that I thought was really unhelpful. The men were criticized for actually doing something, because some of them were in leadership positions in public and private sector organisations. I think it's more important, not less, that men recognise that we have to be part of the answer in this, and what that looks like is still about listening and understanding other people's experience, and understanding what we can do to make the change that takes place one that is as easy as possible, with all the reassurance we need, because it's in our interest for that to happen, as well as the direct work that is being taken forward on the medical services and the healthcare support to be provided. It's a much, much bigger issue than that, including for the future of the economy.

Photo of Delyth Jewell Delyth Jewell Plaid Cymru 2:10, 21 May 2024

I welcome what you were saying, First Minister, because the menopause is one of those taboo subjects that our society has decided that we shouldn’t talk about. It’s one of the most natural things that can happen to our bodies as we get older, but there’s nothing natural or normal about being made to feel like you can’t talk to your employer about how the menopause is affecting you. As we’ve heard, menopause symptoms can be extremely difficult, they can be isolating, from exhaustion to crippling anxiety, a sense of disconnection, and it can isolate women terribly.

Now, the European Court of Human Rights has issued guidance to employers on steps that they can take to help employees, but the guidance itself is not legally binding. So, building on what you’ve just said, what more do you think the Welsh Government can do not just to alert employers to their obligations, but also to empower women so that they can feel less alone when they’re going through this?

Photo of Vaughan Gething Vaughan Gething Labour

I think the Member talks about a couple of things that I think are perhaps worth while. There’s a point around where does guidance go, even when it’s not statutory, but to understand what ‘better’ looks like and to make the case that this is actually good for any public service or any business. Any employer should see there’s a benefit in getting this right and being as supportive as possible. There’s the broader point, though, about how you normalise a conversation about an entirely normal subject. It is an event that will take place, and so how do you understand it for your colleagues, for people around you, potentially for you as well? Because part of the disconnection that women regularly talk about is that they weren’t sure what was happening, they didn’t really know, and so that understanding, for yourself, but for others as well—that’s why people need to be genuine allies in listening to consider this. If there were to be changes in the employment field, those are things that I think a future Government should take seriously, but, more than that, to change the culture, to normalise the conversation and to make it a supportive one so people really can reach out and talk to people, and not to be embarrassed about an entirely natural event in a person’s life.

Photo of Jane Dodds Jane Dodds Liberal Democrat 2:12, 21 May 2024

Good afternoon, First Minister, and I do associate with my colleagues Buffy and with Laura Anne, and with Delyth as well. Thank you for raising this issue. But I wonder if it would be okay for me just to take a zoom-out position, really, on women’s health inequalities and look at the link between poverty and women’s health. According to figures produced by the Office for National Statistics in March, healthy life expectancy at birth in Wales has steadily decreased since 2011, with the decline particularly pronounced for women, who can now expect just 60 years of good health. These statistics become even more stark when factoring in poverty. Data from 2022 shows that women in the most deprived areas of Wales have a healthy life expectancy around 20 years lower than women in the more affluent areas. So, women in our poorest communities can expect to live more than a third of their entire lives with an activity-limiting illness or a disability. So, my question on this issue is: what specific measures is the Welsh Government taking to tackle poverty in order to raise healthy life expectancy for women in the poorer parts of Wales? Diolch yn fawr iawn. 

Photo of Vaughan Gething Vaughan Gething Labour 2:13, 21 May 2024

Thank you for the question. I don’t think I can do justice to the scale of the challenge the Member has laid down in a minute response. I do, though, recognise the point she makes about inequality and about the intersectionality of living in poverty. It has a direct impact on health outcomes, on life outcomes, and I think, actually, for the first time now, the average life expectancy is lower for women than men, which is extraordinary.

I also recognise a number of the causes. So, people in single-parent households are more likely to be living in poverty, more likely to be led by an adult woman. People in part-time working households, again, exactly the same picture. And actually, particularly now with the cost-of-living crisis in addition, women are much more likely to skip meals to feed their children as well. That all exacerbates and adds to the picture of poverty.

Now, our child poverty strategy does focus on removing barriers to employment and career pathways. There’s a whole range of measures that need to take place. We’ve talked about workplace culture and action—that’s part of it. We’ve talked about valuing women’s work on a regular basis, and making sure that women aren’t underpaid for the job that they do—that’s a big part of it. And we talk about the support we already provide through our employability programmes and beyond in making sure people have the skills to return to work and the childcare to allow women with children to go into the workplace or to go into education and training to allow them to go into the work that they have chosen to do. There’s a multiplicity of measures that we are already taking that we describe in our tackling poverty plan, but there is always more that we can do, and then the assessment of what difference we are making, together with those measures where we need to see a change in approach from the UK Government, and I'm hopeful that will happen in the not-too-distant future.