House_of_Commons_19_06_25_13_47_00

Express & Star

Dudley MP Sonia Kumar leads the first ever parliamentary debate on incontinence

Transcript

00:00Progress must also mean equity and treating women's sport not just as an

00:04add-on but as an essential part of this country's culture. Collectively I'm

00:09sure that all members of this House will join me in getting behind the teams in

00:12our villages, towns, cities and schools, encouraging the future of women's

00:17football to be written on school fields and local pitches by the next

00:21generation. I'd just like to take this opportunity to wish both Wales and

00:25England the very best of luck for the tournament. Thank you. The question is,

00:31as on the order paper, as many that are appealing to say aye. Aye. On the contrary,

00:36no. The ayes have it. The ayes have it. Right, we now go on to the next set of

00:46business. If colleagues are exiting, they should exit very quickly, very quietly.

00:53We now come to the backbench debate on incontinence. I call Sonia Kumar, who will

01:01speak for around 15 minutes. Sonia Kumar. Thank you, Madam Deputy Speaker. I beg to

01:08move that this House has stood incontinence care. I'd like to thank the

01:12backbench committee and its chair, the honourable member of Harrow East, who

01:16helped secure this debate. And I'm delighted that we are debating this vital but

01:21often ignored issue during World Continence Week. The definition of a taboo is a

01:27subject so difficult, repulsive, or offensive that it can't be mentioned in

01:32polite conversation. And it can only be articulated in hushed, embarrassing tones.

01:37Once menstruation was a taboo, we weren't supposed to talk about it. Once cancer was a taboo, and some communities it still is.

01:46Once mental health was a taboo, people covered it up. We now can discuss these

01:52things more openly, without embarrassment. We can seek the right medical advice and

01:58treatment, and we can offer the support to one another, and fight for decent

02:02health care for every aspect of the human body. How did I get here, in this chamber,

02:09talking about human bodily functions. This has been a journey for me. I spoke in the

02:15Westminster Hall debate on women's health in February. As a physiotherapist, I talked

02:20about pelvic health and the importance of rehabilitation and pelvic floor exercises. And

02:26my words seemed to struck a chord. Colleagues, residents and professionals all emailing me,

02:33thanking me, for speaking out and sharing their experiences. And it started to snowball. And I

02:41asked myself, why aren't we talking about this more? And I'm advised that this is the first ever

02:48general debate on this topic in this chamber, so I congratulate the House today. Now, what are we

02:55actually talking about? We're talking about the voluntary loss of faeces and urine, which can be caused by

03:03pregnancy, neurological conditions, MS and spinal cold surgery, musculoskeletal conditions, disabilities,

03:11menopause, and prostate-related conditions, and many, many more reasons. The crippling fear for

03:18patients is it might happen at work, in public, on a social setting. And I've spoken to patients who've

03:25told me they feel like a prisoner in their own home, caught by a condition that means that people avoid

03:32each other, don't go out, can't go to work, don't have relationships, and they feel a crushing sense

03:39of shame. For those people with mental health, and it suffers beyond a point to serious illness.

03:47And our language reflects society's attitude, wetting your knickers, peeing your pants,

03:54or ruder variants, which I will not say today.

03:56Yet we are talking about a range of conditions that affect millions of our residents. Did you know,

04:03Madam Deputy Speaker, that bladder and bowel incontinence is more common than hay fever?

04:09The NHS estimates that 14 million people are living with bladder problems. That's one in five in the

04:16population. And it's men, as well as women. And the NHS says that two million men experience a

04:23voluntary loss of urine. A third of women are living with these conditions right now. That's right,

04:30a third. Yet this is another aspect of health woefully unsupported and pushed off the agenda.

04:37And it affects 1.5 million children and young people. One in 12 children across the UK are

04:46battling these debilitating symptoms, including bed wetting, chronic constipation and soiling.

04:51Half a million adults have bowel conditions leading to voluntary loss of feces. Madam Deputy Speaker,

05:00we have a population which is getting older, surviving complex conditions such as cancer,

05:05and this will increase the prevalence of bladder and bowel dysfunction. And when it comes to bowel

05:11conditions, we're talking about involuntary loss of fecal matter, which can be because of IBS,

05:17Crohn's disease or other such conditions like bowel cancer. And I haven't even touched on what people

05:24suffer when they have double E incontinence. Our NHS collects data on anything and everything,

05:31yet the number of patients with continence care needs to be routinely published, and it is not.

05:37So my first ask to the Minister, and I have several, is why not? The House will note if I'm avoiding the

05:45term incontinence and contents. Notwithstanding the title today's debate, I've spoken to so

05:51many people with bladder and bowel conditions, and my feeling is that it's a wrong word to use,

05:58and it carries too much stigma. To give justice to this debate, I've conducted roundtables with experts,

06:05with patients, and shared anonymous surveys. And I spoke to Dawn, who shared her story. She noticed

06:13some urine leakage 10 years ago when she was 50. And now at the age of 60, she spoke to me about her

06:20journey. She didn't go to the GP because she felt ashamed. It got worse, and she began to see the

06:27gynaecologist. And she got the strength to speak to the GP, who gave her tablets. Three rounder

06:33tablets of not working and her symptoms getting worse, ruin her leakage, and she wasn't able to

06:38leave the house. The gynaecologist referred her to a physiotherapist and specialist nurses. And I asked,

06:45what went wrong here? Lack of prevention. Prevention, prevention, prevention is key.

06:53Physiotherapy is recommended as a part of an integral part of women's health, and especially

06:59with pelvic floor dysfunction. Physiotherapy is by far the most effective intervention, preventing

07:05and treating mild to moderate incontinence and prolapse, according to the 2019 NHS long-term plan.

07:13Insufficient physiotherapist numbers mean that women who experience pelvic floor dysfunction

07:18or prolapse wait months or years or miss out entirely on treatment to address these. Women

07:24often end up needing surgery which could have been avoided with early intervention. Dawn eventually

07:30received specialist care and her symptoms have vastly improved, and she only gets the odd leakage here

07:36and there. Her advice to others is, see your GP, don't leave it, and ask for a referral to see a specialist.

07:44I had a privilege to see such a specialist service in my constituency, Dudley Adult Bladder and Bowel

07:52Service known as DABS, where I met patients and practitioners like Ola Rowlings, team lead and

07:59clinical pelvic health physiotherapist who shared her story. It was eye-opening. Patients told me

08:05that they want to see the GP, but they only talk about bowels and seldom bladders. A patient Leanne told me

08:15she in fact gnawed, fobbed off and misdirected. One felt like she was a prisoner. Her patients felt like

08:22a bouncing ball across different parts of the system. How men were reluctant to see self-help groups,

08:29especially those with prostate cancer. How many men didn't even know they had a pelvic floor and they thought

08:35it was only women. Yet these symptoms can be easily treated and they were the right interventions and

08:42treatment and the right course of rehabilitation. Research shows that every £1 spent on women's health services,

08:49there's a return of £13 thanks to reduction in emergency services emissions, fewer missed days at work and better

08:56long-time health outcomes. I know the Department of Health is currently consulting on the men's health

09:02strategy and I trust the Minister to ensure that this aspect of men's health is front and centre.

09:08The DABS service, I quote, call themselves a Cinderella service. The testimony of patients and

09:14professionals is humbling to hear but it makes me so angry. We are letting too many people down.

09:21So what must change? We need to talk about the taboo and we need action too. A renaissance of public

09:29toilets for Ansel, maintaining the ones that we have, opening the ones that are closed, building new ones.

09:35I want to see bins in both men's and women's toilets to see that we can throw these products in the bin.

09:41I support the Boys Need Bins Campaign by Prostate Cancer UK and I congratulate the APBG for

09:49bladder and bowel contents for their work. And I ask Madam Deputy Speaker, or shall I say now Mr Speaker,

09:56that if this place could be a pioneer in this place to place bins in all men's toilets. We also need

10:03better food labelling so fibres listed on products so people understand how they can get better bowel

10:09health. And ensuring that AI and robotics revolution in healthcare does not miss bladder and bowel

10:14care. We need a joint service between GPs, hospitals, clinics and patient groups. Perhaps more

10:22sympathetically, a more subtle surnage in healthcare settings. Products provided outside healthcare

10:28settings could have simple labels on shelves such as body care instead of incontinence products.

10:33It tackles the embarrassment of being seen by a friend or neighbour in the shops.

10:37And I urge the Minister as the 10-year plan nearest publication to ensure that bladder and bowel

10:43care is in this plan. So much needs to be changed, but today I have five concrete asks for the Minister.

10:51First, we need a public health information campaign to raise awareness and smash the stigma. A recommendation

11:00from Dr Sarah Webb, Royal College of Midwives. The NHS spends millions on campaigns such as cancer screening,

11:08the use of 111, sepsis and quite rightly too. And can the Minister commit to a campaign on bladder and bowel

11:15care? I wish you give way. I'm happy to give way. Thank you. Many years ago when I worked in the NHS, the

11:22Board tried to save money by changing the incontinence products that people used. As products were not

11:29quite the same, it caused a lot of distress for those people who used them and also a lot of

11:33inconvenience for the health professionals working with patients, particularly the district nurse team.

11:38And in the end, it didn't really save any money. So does my hon. Friend agree with me that it's important

11:43that people get access to the products that work for them. Thank you, Ma. I'd like to thank my hon. Friend and I

11:50agree products do need to be readily available and actually it's one of my recommendations as I come forward.

11:56Second, beyond awareness is prevention. We need real understanding and I want Bladden Bell Health to be

12:02formed part of the school syllabus enmeshed into the curriculum. A recommendation from surgeon Dr Robinson, Robert

12:09from Royal College of OBS and Gynae. Let's give teachers the tools to teach it. I want to be

12:14thought a part of the training of all healthcare professions so that the medical profession understands

12:20bladder and bowel care from the earliest times of their job. We need a specialist workforce of

12:26physiotherapists, nurses and surgeons and many more. And can the minister commit to placing this high in the agenda

12:32for schools and build a specialist MDT workforce who have the skills and knowledge for the future?

12:40Second, third, we need enhanced R&D into bladder and bowel conditions and the treatment. That doesn't

12:47necessarily mean vastly increasing the spending but reviewing how current resources can be better

12:51prioritised. We can't diagnose, treat and rehabilitate or look for future medical interventions if we

12:56had limited research. Fourth, the recommendation from Dr Ashish Pradhan, Chair of the British Society of

13:04Urogynaecology. Can the minister commit to ban a misleading advertisement which gives the wrong

13:09message to people? Where products with no regulation are advertised and patients are told to live with

13:15their symptoms. Fifth, a recommendation from a patient who I met, Leanne. A one-stop shop where all services are

13:24under one roof and care is closer to home. And products from shops are cheaper and contents products are

13:30currently exempt to VAT if they are purchased for personal use or used by a registered charity.

13:36But what if they are purchased by a care home? Five demands, five things that will show real progress,

13:43backed by experts. I look forward to the minister's response. And lastly, let me say this to men,

13:50women and young children and young people who are listening to this debate. You are not alone and there

13:56is no shame. People are often

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