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Mr. Peter Luff (Mid-Worcestershire): On a point of order, Mr. Deputy Speaker. Yesterday, as you know, the House passed a draconian and very tight programme motion on the Hunting Bill for its recommittal to the old Standing Committee, requiring that Committee to report by Monday next week. The first opportunity for the Programming Sub-Committee to meet, for the convenience of the Chairman and the Clerk, was at 6.15 this evening.

The Programming Sub-Committee met, it was not a particularly easy meeting, and the motion was controversial. Eventually, at about 6.50 this evening it was agreed that the Committee would probably meet at 9.25 am tomorrow, and the Clerk left the Committee Room to ensure that the cards were put on the board so that members of the Committee were aware of the decision of the Programming Sub-Committee. At that stage, it was an informal decision on which no vote had taken place. It was an attempt to ensure that hon. Members were aware of the fact that the Committee would meet tomorrow.

I have just been to the board and the cards are still not there, so no member of the Committee can know formally that the Committee is to meet tomorrow, at what time or where. Furthermore, the time of the meeting has been changed from the usual time of 8.55 am to 9.25 am. There will be considerable confusion tomorrow morning, as a result of the excessively tight programme motion. As no formal notification has been given to members of the Committee that the Committee is to meet, can it properly meet?

Mr. James Gray (North Wiltshire): Further to that point of order, Mr. Deputy Speaker. Is that not symptomatic of the fact that, contrary to any precedent that I can find in "Erskine May" or anywhere else, the recommittal of the Bill to Committee has taken far less time than any previous recommittal and is greatly more controversial than other recommittal? Most recommittals are only for technical matters that need to be corrected by the Committee. This is the first occasion that I can find, in any precedent that I have looked at, on which such a controversial and difficult matter has been returned to the Committee in this way.

Giving us only two days in which to table amendments, write speaking notes and consult outside bodies is an extraordinary way to treat the matter. Symptomatic of it is the fact that the Clerks have asked for extra time tomorrow morning. They have asked us to sit at 9.25 am to allow them extra time to get the

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amendments, and so on, in order before the Committee sits. Surely it would be more proper for us to come back to the House to request that the Committee sit next week, so that we have more time properly to consider the difficult amendments to such a controversial matter?

Mr. Deputy Speaker (Sir Michael Lord): May I say to the hon. Member for North Wiltshire (Mr. Gray) that the House has taken a clear decision on recommittal, and that is not for the Chair to comment on this evening? With regard to the cards that were the subject of the first point of order, that is entirely a matter for the Chairman of the Committee. I understand the concern of the hon. Member for Mid-Worcestershire (Mr. Luff), and I understand that every effort is being made to get the cards in place as quickly as possible. We must now move on.

Mr. John Whittingdale (Maldon and East Chelmsford): On a point of order, Mr. Deputy Speaker. We understand that tomorrow the Government intend to publish a White Paper that will contain major policy announcements about the future of the national lottery. We further understand that the Secretary of State for Culture, Media and Sport is to give a press conference and a major speech on the matter, but given previous rulings by Mr. Speaker, I am sure you would deprecate it if such announcements were made at press conferences and on the "Today" programme, but not through a statement in the House. Have you had any indication that the Secretary of State intends to make a statement to the House?

Mr. Deputy Speaker: I have no information as far that point is concerned, but Mr. Speaker has made his views on these matters very clear on many occasions and the hon. Gentleman has now put his point firmly on record.

Mr. Eric Forth (Bromley and Chislehurst): Further to that point of order, Mr. Deputy Speaker. If what my hon. Friend the Member for Maldon and East Chelmsford (Mr. Whittingdale) says is true, it would be very helpful and reassuring to the House if you were prepared, through your good offices, to let it be known to the Secretary of State for Culture, Media and Sport that there should be no question of her touring the studios or giving a press conference before coming to the House in order to make herself available to be questioned about the White Paper, which is, by definition, a major policy statement. Mr. Speaker has repeatedly made it clear—he did so recently—that on policy statements above all, the Secretary of State must come to this House first. It would be helpful—I do not think that this is an unreasonable request—if you now made that very clear, to ensure that the Secretary of State is under no illusions about the views of Mr. Speaker.

Mr. Deputy Speaker: I can only repeat to the right hon. Gentleman the point that I have already made. Mr. Speaker feels extremely strongly about these matters and I have no doubt that those on the Government Front Bench will have heard the points that have been made.

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EUROPEAN COMMUNITY DOCUMENTS

Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation) and Order of 4 June,

Section 5 of the European Communities (Amendment) Act 1993


Question agreed to.

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Endometriosis

Motion made, and Question proposed, That this House do now adjourn.—[Margaret Moran.]

7.31 pm

Miss Anne Begg (Aberdeen, South): I am delighted to have secured this debate on the treatment of endometriosis. I am chairman of the all-party parliamentary group on endometriosis, and tonight's debate coincides with a mass lobby that was held this afternoon in Westminster Hall. It was organised by the two charities that work with sufferers of endometriosis—the National Endometriosis Society and the SHE Trust.

I must begin, however, by blaming my constituent, Shelby Thomas, for my presence here tonight. If it had not been for Shelby, I would still be as ignorant of this gynaecological condition as the vast majority of the population and, I have to admit, some of the medical profession. It was Shelby who wrote to me describing how endometriosis had devastated her life. She asked me to become involved in lobbying for more resources and helping to raise awareness of this debilitating condition. Believe it or not, until today I had not met her face to face. We had corresponded by letter and often spoken on the telephone, but we never managed to meet up until she made the long trek down to London today to attend the mass lobby in Westminster Hall. I am delighted that Shelby and her friend Amanda, who is also from Aberdeen, were able to stay for the debate. They have a sleeper to catch and I hope that they will still make it, but they are in the Gallery now listening to this debate.

It was thanks to Shelby that I innocently wandered along to the inaugural meeting of the all-party parliamentary group on endometriosis two years ago. Even more innocently, I found myself being elected as chair to the group. I felt a complete and utter fraud, as I knew so little about endometriosis at the time. I knew little about its causes and effects, and about what could be done to alleviate the worst of its symptoms. It is said that a year is a long time in politics, and I now know so much more about the condition that I am even more determined to do everything I can to help ensure that sufficient resources are available for diagnosis, treatment and awareness raising.

Endometriosis is a gynaecological condition that affects 2 million women in the UK. It is often an extremely painful disease, especially during menstruation and after intercourse. Sufferers can experience infertility, fatigue, relationship problems and depression. It can frequently lead to lost days at work. Consequently, sufferers can lose their jobs and have to deal with the financial insecurity on top of everything else. Yet this crippling disease, which is so common and affects so many women in our communities, is little known or understood.

There is a lack of knowledge about endometriosis that ranges not only from those of us in this place, but to educators, the medical profession and young women who may suffer from the condition but have never received an accurate diagnosis.

Shelby Thomas's story is typical. If I may, I will explain a wee bit about her background. She suffered pain from the age of nine, but it was not until she was 27

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that she was diagnosed as having endometriosis. When she visited her general practitioner, she was told, as so many are, that it was merely bad period pains and that she would have to learn to live with it. Eventually, she was referred to a gynaecological specialist, but that specialist—a woman, who she thought would feel more sympathy—was as unsympathetic as her GP. It was not until she insisted on seeing another consultant that she finally received the right diagnosis. At the age of 28, she had a hysterectomy; now, aged 31, she is post-menopausal. That is not an untypical story, and it reflects the difficulty, first, of getting the level of pain that is being suffered taken seriously, then of getting an accurate diagnosis of what exactly is the matter.

I asked for tonight's Adjournment debate not only to bring this widespread but little heard of condition to the attention of the House, but to ask the Government to end the situation whereby it takes seven years on average for an endometriosis sufferer to be accurately diagnosed. That is an awful state of affairs, and it is leading to prolonged and unnecessary suffering by endometriosis victims. I ask the Government to provide the necessary investment to end that lack of awareness in the health service and particularly, if the Minister is able to do only one thing, to concentrate that funding on GPs. They are the first line of service. It is to GPs who women with severe gynaecological pain first present, and we depend on GPs to think that it might be more than just a severe period pain. If GPs and practice nurses are made aware of endometriosis and what its symptoms are like, hopefully more women will be referred to an endometriosis or gynaecological specialist much more quickly, so that one of the treatments can start.

There is no cure for endometriosis, but there are some treatments, not all of which work for every person. Once a woman overcomes the first hurdle in getting an accurate diagnosis, two types of treatment may be possible. The first is drug therapy, whereby endometriosis sufferers are given hormone drugs that mimic pregnancy or the menopause to prevent the growth of the endometriosis. Often, however, the endometriosis grows back and the sufferer has to undergo another course of medication or surgery. The second option, surgery, can be very radical. Sometimes it is keyhole surgery, but as often as not it is open surgery and, again, it is not necessarily the end of the matter because the endometriosis can grow back. A well balanced diet can also sometimes alleviate the symptoms of endometriosis.

Since I became chair of the all-party parliamentary group on endometriosis, I have heard the testimonies of many sufferers who have described the combinations of surgery and drug therapy that have been used, but have brought them no relief. Just this afternoon, after a lobby in Westminster Hall, we held a meeting in one of the Committee Rooms upstairs, where, as women told their story, other women frequently found themselves in tears because the story was all too familiar to them all. It was the story of being told that all they had was a bad period pain and that they should grow up and stop being such a wimp; of the difficulty that they have with relationships and the understanding that is required of their husbands and partners; of the search for an effective treatment; and, worst of all, of the constant pain that is often never relieved.

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I want to pay tribute to the two main charities that carry out the work with endometriosis sufferers—the National Endometriosis Society and the Simply Holistic Endometriosis Trust, which is better known as the SHE Trust. Their work is complemented by that of many local organisations, all of which offer services and support to those with the condition—for instance, free all-year confidential helplines, usually staffed by volunteers. They have UK-wide support groups, and provide replies to medical questions from endometriosis experts. It is quite difficult for women in rural areas, or areas where no member of the gynaecological team may be an endometriosis expert, to obtain such information. They also offer self-management and volunteer training courses. There is, of course, the website that everyone has nowadays; there are publications and information leaflets; and the groups organise national endometriosis health days and lobbies of Parliament. There is a tremendous amount of voluntary support, and it is thanks to the hard work of those organisations that endometriosis is finally getting on to the health agenda.

One of the all-party group's initiatives of which I am very proud is our organisation of a seminar at the end of April last year. We invited a number of GPs, gynaecologists, researchers, nurses and endometriosis sufferers, as well as parliamentarians, to engage in a much needed sharing of information in Portcullis House. It was a very successful day: it focused people's minds, and enabled them to concentrate on what they wanted the Government to do. We were lucky in that the Minister for Crime Reduction, Policing, and Community Safety, my hon. Friend the Member for Salford (Ms Blears), was able to attend before being transferred to the Home Office in the recent reshuffle.

This was the first time that a Minister had attended an endometriosis event, and many of us remarked that that represented a sea change: at last the Government were prepared to act positively. Indeed, the Minister described endometriosis as a key issue for Government—citing its long-term nature and the fact that the waiting time for accurate diagnosis was staggering—and said that medical training and awareness must be a top priority. She also said that specialist centres were still on the agenda for consideration. I invite the new Under-Secretary of State for Health to associate herself with those remarks, and to assure us that that is still the Government's position.

A number of suggestions were made at the seminar, and we hope that they will be translated into action in the coming year. One was the establishment of national treatment centres to provide specialist help. Arguably the most important point, however, concerned the need for a national framework. That has worked very well in the context of diseases such as cancer, as we have seen in England and Wales and—although perhaps not in quite the same way—in Scotland.

There was a great deal of discussion about the need to raise awareness of the condition among women and health professionals—particularly school nurses, who can explain to young girls what may be going on in their bodies and not be dismissive when they present with severe period pain. It was felt that charities involved with endometriosis needed support, and that there should be a mechanism allowing a consistent programme of dialogue between doctors, consultants,

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the national health service, voluntary organisations and parent forums. The all-party group played its part in organising that first seminar, but we hope to arrange more in the coming years—perhaps dealing with different aspects of the condition.

Inevitably, there was the ubiquitous request for extra funds—funds for research, and for treatment and awareness-raising. The Minister has listened patiently. I hope she will ensure that endometriosis moves up the priority list when it comes to deciding on NHS funding. The well-being of many women with the condition depends on that.


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