Meeting of the Parliament 12 November 2024
Like my colleagues, I am pleased that we are taking time to debate the subject of women’s health. It is an issue that regularly appears in my constituency postbag, and a number of important points have been raised in the course of the debate.
The motion does not detract from the fact that there is still much work to be done to develop women’s health services further, but the women’s health plan is an important first step towards addressing the inequalities that impact half the population of Scotland. Nowhere are the long-standing health inequalities that impact women more evident than in the justice space, and I will focus on that a little later in my speech.
I am enormously proud of a health system that has, in the past few months, seen me receive my flu jab, my Covid jab, my cervical screening, my free eye test, my well-woman check, my mammogram, my asthma review, my audiology referral and a free prescription for antibiotics. Those are all effective and important preventative approaches that are part of the wider programme of activity to keep women in good health and that intersect with the priority areas in the women’s health plan, which include menopause, menstrual health, pregnancy, contraception and endometriosis.
A few months ago, I had the pleasure of visiting the women’s health services team at Aberdeen Royal infirmary, where I heard about the significant progress that is being made to develop health services for women, including endometriosis services and breast screening. I heard about the fantastic progress that is being made by NHS Grampian, alongside the University of Aberdeen and Kheiron Medical Technologies, to develop Mia—or mammography intelligent assessment—which is a promising artificial intelligence technology that can identify minuscule traces of breast cancer that can be missed through conventional practice. As one of the team acknowledged, even doctors are human, so they get tired, they might have been up all night with a crying baby or they might be full of the cold.
I have a number of constituents who are interested in seeing the women’s health services model extended further to that of a hub. I am grateful to the minister for her previous engagement with me on the issue, with specific regard to menopause services for women. I welcome any further update that she can provide on progress in hub provision in the north-east. I was interested to hear Emma Roddick’s reference earlier to the Highland hub.
The issue of urinary tract infection has been raised with me, and, although the women’s health plan makes reference to recurring UTI, it does not refer to chronic UTI, which we know has a significant impact on women who experience it.
Typically, we are probably all members of the worried well population in society—thankfully, more well than worried—but I welcome that the plan acknowledges what is commonly known as the inverse care law, whereby those, including women, who most need healthcare are often least likely to access it. I commend the work that has been done recently by the universities of Glasgow and Edinburgh on how to tackle the inverse care law in general practice in Scotland.
That brings me to my final point, which is the challenge that women in the justice system face in their health and wellbeing. The women’s justice leadership panel report, “The Case for Gendered and Intersectional Approaches to Justice”, outlines how women typically enter the justice system in different ways from men and for different reasons. Scotland has a relatively high incarceration rate for women compared with other countries, including those in Europe, and it is commonly accepted that the health needs of women in prison are often not met due to a complex layer of factors, including domestic abuse, addiction, trauma and compromised mental health.
For women who have family members in prison, the practical harms that are associated with reduced household income, stigma, the loss of the practical and emotional support that they previously relied on from the imprisoned family member and even the cost of travel for prison visits can take a significant toll on their health and wellbeing, which further drives the health inequalities that we know disproportionately impact women who are caught up in the justice system. To a great extent, women serve a hidden sentence of their own in that regard.
The priorities that are set out in the plan apply equally to women in prison, who do not stop having periods, having the menopause or even being pregnant, so humanising healthcare in that space will help women to be well and more resilient when they leave prison.
Across Scotland, the establishment of trauma-informed community custody units for women, such as the Bella centre and the Lilias centre, is leading the way in preparing women to leave prison. Such units provide a real opportunity to insert even better healthcare services at that crucial release point.
I would be very interested to hear any update that the minister can provide on what opportunities might exist to insert some more focus on women’s health in prisons into the next stage of the women’s health plan. I very much look forward to following, and even contributing to, the plan’s future development.