Hansard

Over the years, I have raised concerns about a range of women’s health issues, from endometriosis and pre-eclampsia to cardiovascular conditions and breast cancer. Those important female health issues have long required further action, and I welcome the opportunity to discuss them in the context of the women’s health plan.

The plan is undoubtedly a step in the right direction, but I believe that there are still significant gaps to be addressed. I will focus on four key areas that should be central to ensuring that women’s health is properly prioritised and supported. First, I will focus on endometriosis, which several members have mentioned. Seven years ago, I led a members’ business debate that ultimately resulted in significant progress, with the involvement and solid support of the then Cabinet Secretary for Health and Social Care, Jeane Freeman, and the then Minister for Public Health and Sport, Aileen Campbell, securing the opening in Glasgow of a third accredited endometriosis unit to complement those in Edinburgh and Aberdeen.

Although the women’s health plan outlines positive aims through the endometriosis pathway, including improved access to specialist endometriosis centres and reducing diagnosis time, I believe that those actions fall far short of what is needed. In Scotland, it still takes an average of eight and a half years from the onset of symptoms to receive a diagnosis of endometriosis. That is simply not good enough to meet the needs of the more than 100,000 women who live with that debilitating condition.

To truly prioritise women’s health, we need more specialist treatment centres. In Ayrshire, for example, we must reduce the burden of long travel times and journeys and make it easier for families and support networks to be involved in care, expanding access to that care closer to home. The added stress of long journeys only serves to make treatment more difficult. That is important not just to improving healthcare access, but to improving lives.

My second point concerns cardiovascular disease, which remains a leading cause of death among women in Scotland, where 95,000 women currently live with coronary heart disease. The condition significantly impacts quality of life and claims the lives of twice as many women as breast cancer. Thanks to British Heart Foundation research, sex-related differences in presentation and management of heart disease are now much better understood. However, women continue to face significant challenges, such as misdiagnosis, receiving fewer treatments and being underrepresented in clinical trials, which, in many cases, contribute to sub-optimal care that is not tailored to their needs.

Although there has been a 14 per cent reduction in coronary heart disease deaths over the past decade, recent trends show an increase, highlighting the need for sustained and focused action. It is alarming that heart disease accounts for a quarter of maternal deaths in the UK, with 77 per cent of the women who died not knowing that they had a cardiac condition. That underlines a critical failure in our health service to identify, let alone effectively manage, heart disease in women.

However, I am encouraged by the progress that has been made through the women’s health plan, which takes an important step forward in addressing those challenges. The plan’s focus on increasing research funding and recognition of gender-specific health needs, particularly in cardiovascular care, is welcome and much needed. We must build on that momentum and continue to raise awareness of women’s heart health across Scotland, ensuring that women receive vital heart health advice and support at every stage of their lives, with health service interaction at every available opportunity.

Recognition of the need for high-blood-pressure management is vital, as hypertension is a key risk factor for cardiovascular disease, which is responsible for around half of heart attacks and strokes. Clinicians, particularly obstetricians and midwives, must be equipped with the necessary knowledge and resources to offer advice and support to women who are at risk. By prioritising women’s heart health, investing in early diagnosis and developing tailored treatments, we have a real opportunity to improve outcomes.

Pre-eclampsia affects around 5,000 pregnancies in Scotland each year, but it is noticeably absent from the women’s health plan, despite being in the original 2021-24 plan. Perhaps the minister can tell us why it is absent. That life-threatening condition is serious and requires immediate attention, but it remains overlooked in a strategy that is meant to address women’s health needs.

However, I am pleased to note that NHS Lothian has taken a positive step forward by introducing targeted blood tests to reduce the risk for pregnant women. The placental growth factor test, which NHS England has used since 2016, is a significant development in helping doctors to diagnose pre-eclampsia. The test not only helps to reduce the number of unnecessary hospital admissions but, more importantly, ensures that expectant mothers receive the care and support that they need. A roll-out is taking place, but it is slower than it should be. Given the severity of the condition, which is manageable with early detection, I ask the minister, as I have asked her predecessors, when PIGF testing will take place routinely across all health board areas in Scotland, which will ensure that every pregnant woman has access to that vital test.

My son died on his due date. My wife’s liver ruptured, and she then spent 19 days in an intensive care and high-dependency unit because of a failure by midwives and doctors to diagnose pre-eclampsia.

After the event, women who suffered from pre-eclampsia are twice as likely to have heart attacks and strokes as women who did not, but there appears to be no follow-up whatsoever, which is a matter that I have raised previously with the minister. Instead, there is a suggestion that such women—lay members of the public—self-monitor their blood pressure for the rest of their lives. Even the women’s health champion, Professor Anna Glasier, who is in the public gallery, calls that a rather “tall order” in the health plan.

Finally, I turn to primary biliary cholangitis, which is a chronic liver disease that many women across Scotland are living with. Following a round-table meeting at the Scottish Parliament, which Gillian Mackay kindly chaired, a recent report highlighted significant disparities in the experiences of women living with liver conditions. The findings revealed that experiences vary widely, depending on geography, with many women reporting feelings of stigma associated with their liver condition, despite it not being caused by any action of their own, such as alcohol consumption.

The report recommends wider roll-out of the intelligent liver function test, which is currently used routinely to assess liver health in Tayside and Fife. Research by the University of Dundee shows that the test increases diagnosis of liver disease by 43 per cent, which allows for earlier and more effective treatment. Expanding access to the test would improve early diagnosis and care for women living with liver conditions across Scotland. Scottish ministers should also actively raise awareness of PBC.

The women’s health plan provides us with a clear path forward, but much remains to be done. By continuing to build on progress, we can ensure that women across Scotland receive the care and support that they deserve when they need it most.