This series of articles has been commissioned by Eleanor Mills, Editor in Chief at Noon about the inequalities facing Queenagers in health care. This series of articles has been edited by her and reflect her editorial judgement. The articles have been paid for by Theramex.
Carolyn Harris MP pops up on my Zoom screen a picture of vitality: her pink hair matching her pink wallpaper. A true Queenager, Harris is living proof of our Noon motto: “So Much More to come! It is never too late and you are never too old!”
She was 54 when she became an MP in 2015. “I had my first son Martin when I was 21 and worked as a school dinner lady and as a bar maid to fit in around child care before getting restless and going back into education in my late thirties. I knew I had more to give.”
These days she is Parliament’s unofficial menopause champion, and has led a super-successful one-woman crusade to put menopause on the political map. On World Menopause Day this year – October 18th – she’s launching an APPG report into menopause in the work place, a book of menopause journeys, and leading an afternoon rally in Parliament Square. “Come and join us!” she says gleefully. (You can join her before then, too, as she is appearing on our Noon “How to Make the Menopause More Inclusive” debate on 17th October at 6pm – click here to for the link).
She is also the MP behind the private members bill which will make HRT free – or much cheaper at any rate; thanks to Carolyn’s campaign women in England will now only have to pay one prescription charge for a year’s supply, a huge improvement on the expensive multiple bills women had to pay before.
But that’s not all: today we announce a campaign supported by her and a Parliamentary Petition to incorporate menopause into the Quality and Outcomes Framework (QOF) for GPs. That would mean that just as all women are called in by their GP for a breast cancer screening when they hit 50, or have to go for cervical smears (and doctors are financially rewarded for ensuring that they do), this same kind of mass call-out would happen for all women when they hit menopause.
“The biggest problem of all is the lack of training amongst GPs about menopause.” Says Carolyn. “That is being addressed by the new Women’s Health Strategy which sets out that from now on, all GP training courses will include menopause. But it’s seven years before doctors being trained that way will qualify. So between now and then, there’s not enough knowledge amongst the medical profession, to identify menopause. There’s also not enough confidence within the medical profession to prescribe HRT, if that’s what the person wants. Of course if you have had breast cancer you have to be careful but it can be possible even then. A lot of women are missing out because of doctor’s lack of confidence and lack of knowledge. So including menopause in the QOF would definitely help with that.”
Harris warmth and enthusiasm shines through the screen as she speaks at great speed in her broad Swansea accent. She is adamant that HRT prescribing doesn’t have to be done by a GP. “It can be a GP pharmacist, it can be a women’s health nurse, as long as they’re able to prescribe. I don’t see why we can’t have menopause clinics in every doctor cluster. And if, when all these newly qualified doctors come out trained in menopause, they want to change it again, fine. But at least in the next seven years if menopause is in the QOF all women – particularly the poorest ones – will actually get access to quality medication, support and resource, because at the moment they really haven’t.”
Carolyn is passionate about having a more inclusive conversation when it comes to menopause. “I was talking to a group of shop workers the other day about menopause and one of them said: “Aren’t you posh having a menopause!” That’s another reason why menopause should be included in the QOF – so all women get the care that they need, not just the ones who can access private medical care. I worry about the women on low incomes, they are working all day and they don’t have access to the right information. They have all these symptoms and they don’t know that there is an answer, they just think it is to do with their age. They end up on anti-depressants, really suffering. It is really sad and unfair. That lower income demographic of women, they are the ones that we really need to reach. ”
She is right. The latest data from the NHS Business Services Authority on Hormone Replacement Therapy (HRT) – which can be prescribed to relieve menopause symptoms – shows that there were 7.8 million HRT prescriptions in England last year, a 35% increase on 2020/21. But scandalously, “areas of greater deprivation had the lowest number of identified patients being prescribed HRT” Indeed, twice as many people are being prescribed HRT in the most affluent areas of the country compared to those in the most deprived areas. There is also a massive discrepancy in the treatment received by BAME women. As Dr Nighat Arif, a women’s health expert explains; “In my community there is no word for menopause, it is just barren”. Too many women are being left out of the conversation.
This blatant inequality in information and access to health care has to stop. That is why Noon, along with Carolyn Harris MP, The Sunday Mirror and People, Netmums, The Menopause Charity, Vira Health, Theramex and Henpicked are launching a campaign today to make the debate about menopause more inclusive.
One of the big problems affecting how HRT is prescribed is what is known as the local formulary. Essentially, each local authority area has a board which decides what doctors in that area can prescribe and what the local Health Authority will fund in terms of prescriptions. This leads to local black spots where HRT isn’t available – often not because there isn’t any, but because that authority hasn’t approved different varieties and the ones that are authorised have run out.
“What we need is a National Formalry,” insists Carolyn. “A list of nationally approved HRT products. Currently, every Health Board has a local formalry. The stuff that they haven’t got on their local formalry doesn’t cost any more, and it’s just as good quality, but because the meeting of the local board hasn’t happened – and many are so far behind – perfectly good products take forever to get passed. This means there are lots of good HRT products in pharmaceutical warehouses which go out of date because they are not on local formalry, so they are not being prescribed in a particular area.”
The backlog in the system means that having a National Formalry, or list of approved products and providers for medications, would be helpful in increasing supply and preventing the black spots for HRT which are all too common. This is one of the recommendations which has been put forward by the Equalities Committee chaired by Caroline Nokes MP in the wake of the HRT shortages earlier this year. There was an outcry last summer when HRT dried up – we had many anguished messages to Noon from women who couldn’t get hold of their precious gels. I was on a whatsapp group with women anxious to get hold of their medicine. Many were desperate. As one Noon woman wrote: “I need that oestrogel, without it I can’t sleep, I get hot flushes, I feel terrible. This is not a joke!”
Harris nods when I tell her about this. “It’s stupid. The boards aren’t meeting regularly enough. It’s just a mess and it needs to be fixed.” There is also a problem with recruiting doctors to work in deprived areas. A vicious circle is in place. Poorer women have less access to doctors because of the shortages, so are even less likely to get the care they need.
Harris first started talking about menopause publicly in 2018, long before Davina McCall’s television documentaries or conversation about menopause policies at work became more commonplace. “Menopause is the biggest problem for women when it comes to health inequalities. Women have been having the menopause forever but until now no-one has campaigned to equalise the health system. Did you know that a man with erectile problems can get free Viagra if they say their mental health is being affected? (otherwise is by paid-for prescription) Yet only 14% of women are getting treated for menopause. I first started talking about menopause in 2018, when I was completely unaware that I was menopausal. But then I began listening to the experts and I realised my extreme tiredness wasn’t just me getting on, it was menopause! I find that all the time. I talk to educated women and it is not till they hear a list of the symptoms that the penny drops. We need far more awareness of all of this.”
Thanks to Carolyn, menopause is becoming part of the national conversation. “It was in 2021 when I introduced my private members bill that it began to really take off. I’ve discovered the great thing about being an MP is that it gives you a platform, if you start talking about something and people listen.”
If ever there was an example of a Queenager changing the world this has got to be one. Carolyn is also walking proof of the importance of having representation from all walks of society – an older, working class Welsh woman is still not a common sight in the hallowed halls of Westminster. If there were more MPs like her maybe women’s issues wouldn’t be such a neglected area.
When I thank her for all she has done for women, Carolyn bats it off. But she really has made a difference. Eventually she accepts the compliment. “I mean, you’re right, it’s really changed. Menopause used to be one of those taboo subjects. But I find the more you say the words vaginal dryness, the less shocking they get. I don’t even flinch now!”
She is particularly pleased that men are now part of the conversation. In her constituency she invites women to bring their bosses to her menopause sessions. “We get men to wear the Menovests which mimic a hot flush, we talk about the best diets for menopause, we tell people all the symptoms of menopause, many of which are psychological it’s not just about hot flushes and periods stopping.
One in four women can become so depressed they feel suicidal. One in ten leave their jobs. Yet until now so many women have suffered in silence. And large swathes of the population, particularly those who are disadvantaged to begin with, are still suffering.
Making menopause a QOF would mean equal access to the treatment all women need. I want every woman to be able to talk about this and to have access to the best care.”
If you would like to be part of this campaign to make menopause a more inclusive experience. Help us to incorporate menopause into the QOF by signing our Parliamentary Petition, here….
If you are fired up by watching this and would like to sign the Noon petition, backed by everyone on the panel, to make menopause a QOF then click here
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