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Government 'Glacial' Progress on Menopause Described as a 'Missed Opportunity'

photo of Caroline Nokes
MP Caroline Nokes

Women are being let down by "glacial" Government progress on menopause and the workplace, with its response a "missed opportunity".

In response to the Women and Equalities Committee's first report on menopause and the workplace the Government has rejected five of the Committee’s 12 recommendations outright, including the recommendation to consult on making menopause a protected characteristic under the Equality Act 2010 and pilot a specific menopause leave policy. 

In a letter to Health Minister Maria Caulfield, the Chair of the Women and Equalities Committee, the Rt Hon Caroline Nokes MP, expressed concern that the Government had "ignored the significant evidence base" for equality law reform and called on the Government to review its position. The Committee also highlighted the "low cost but high impact" opportunities for model workplace menopause policies and menopause leave, which the Government had dismissed.

"The Government has rejected the Committee's recommendations around promoting model workplace menopause policies and piloting specific menopause leave with a public sector employer. Both these recommendations would have had a positive impact and been low in cost to implement", Nokes wrote.

The Committee's report, published in July 2022, argued that the overlooked impact of menopause is causing the UK economy to "haemorrhage talent". It also argued that the current law does not sufficiently protect women experiencing menopause, and does not offer proper redress to those who suffer menopause related discrimination, with evidence that many women have to demonstrate their menopausal symptoms "amount to a disability" to get redress. 

Asked to comment by Medscape News UK, a Government spokesperson said: "We encourage employers to be compassionate and flexible to the needs of their employees, and are committed to supporting more flexible working patterns – having consulted on making flexible working the default unless employers have good reasons not to."

'Missed Opportunity' to Support Women in the Workplace

Last year, in a move that demonstrated a commitment to support female staff experiencing the menopause, NHS England, the House of Commons, and the Civil Service signed the Menopause Workplace Pledge.

The pledge, organised by the Wellbeing of Women charity, called on signatories to recognise the "impact that menopause can have, create open environments to talk about the issue, and provide active support for staff".

The Department of Health and Social Care (DHSC) said at the time that becoming a signatory of the pledge demonstrated the Government's ongoing commitment to "support women in the workplace", including helping to generate more conversations between managers and employees, and creating a more "inclusive workplace which enables women of all ages to thrive".

Reacting to the Government's response to the Committee’s report of 28 July 2022, Nokes highlighted that the response was received "some 3 1/2 months late".

"This belated response to our report is a missed opportunity to protect vast numbers of talented and experienced women from leaving the workforce and leaves me unconvinced that menopause is a Government priority," she said.

She pointed out that "urgent action" was needed across healthcare and work settings to properly address women's needs and accused the Government of "glacial" progress and of a "complacent" response. 

The spokesperson for the Government emphasised how the Government recognised that the menopause can be a "challenging" time for women, which is why "we have put women’s health at the top of the agenda as part of the first-ever Women's Health Strategy for England".

Recommendations Accepted, Partly Accepted, or Accepted in Principle

Though the Government said it had accepted, partly accepted, or accepted in principle, some of the recommendations, it came under criticism from the Committee for not actually committing to any new work in response to the report.

In its response, the Government reiterated several commitments made to the Committee, which included the introduction of a pre-payment certificate for hormone replacement therapy (HRT), the introduction of a day-one right to request flexible working, and the appointment of a Menopause Employment Champion.

The Government accepted in principle that it should lead on disseminating "good quality and accurate" information about menopause. This would require it to launch a visible public health campaign around menopause, and to work with schools and menopause experts to develop high quality, accurate and inclusive resources and ensure that teachers have the knowledge, confidence and ability to teach this important aspect of the curriculum to all pupils.

Regarding the committee's recommendation that "all GP surgeries should ensure at least one member of their clinical staff has received specific training around menopause", the Government commented that it was "not within the remit of central government to require that one member of clinical staff in every GP surgery has training on menopause". It explained that "menopause care is a core competency of all qualified GPs", and that that there were "existing national frameworks" to support the education and continuing professional development of doctors.

In response to the recommendation that by 2024 there should be a menopause specialist or specialist service in every clinical commissioning group area, the Government responded that it did not accept this recommendation and stated that "It is not within the remit of central government to commission specialist health services", and that this was the responsibility of integrated care boards (ICBs).

However, the Government spokesperson explained: "We are implementing an ambitious programme of work with the NHS to improve menopause care so all women can access the support they need."

Lower Cost HRT

The Committee had recommended the Government "act urgently" to ensure that lower cost HRT prescriptions were being issued and dispensed.

The Government emphasised how it is "committed to reducing the cost of HRT prescriptions" and that work to develop a bespoke pre-payment certificate (PPC) for HRT medicines licensed to treat the menopause was "underway". The Government confirmed this be introduced from April 2023, subject to the on-going consultation with relevant representative bodies. The plan, it said, was for patients to be able to purchase an HRT PPC at the cost of two prescription charges - currently £18.70, which the Government said meant that "most women, if not all", on HRT would benefit from reduced prescription costs.

The Government said that, at the moment there, were "no plans" to encourage GPs to issue 12-month prescriptions for HRT because this could have a "detrimental impact" on the current supply situation for HRT medicines.

In the letter, the Committee highlighted "it was "extremely disappointing" that the Menopause Taskforce had not met since prior to the summer recess, and that the industry roundtable on HRT supplies has been delayed a number of times."

Nokes questioned the Government's "refusal" to even consult on reforming equalities law, and urged it to "look again", and perplexed how it "doesn’t make sense".

"This signals a level of complacency in Government on this area when there is a still a huge amount to be done," accused Nokes.

See also Doctors Struggle to Balance HRT Message After the 'Davinia Effect'.