Hansard

I very much welcome this debate on women’s health. The creation of a plan that provides a co-ordinated and inclusive strategy for women’s health is overdue, and I am pleased that, in this parliamentary session, the Government is prepared to focus on women’s health and bring together many issues that MSPs and campaigners have pressed it on for many years. It is welcome that we recognise the connectedness of all those issues. Women’s health has been marginalised, unacknowledged and devalued, and there have been, and continue to be, systematic, institutional or societal failures in the treatment, public health messages and support that women receive.

The minister referred to “Invisible Women: Exposing Data Bias in a World Designed for Men”. That book revealed the inequalities of a society that is created for men. The needs of women have been ignored in the planning or design of things from the ridiculous, such as the temperature in our offices, to the dangerous, such as the design of car seat belts. Perhaps that has not been deliberate or malicious, but women have been treated as second-class citizens and given not even an afterthought. That has affected all areas of society, including healthcare.

The author of that book—Perez—highlighted the example of heart disease and its perception as a male disease. The consequences of women facing missed diagnosis and disadvantage in treatment are also addressed in the British Heart Foundation’s “Bias and Biology” briefing paper, which Kenneth Gibson mentioned. It is welcome that the Scottish Government now recognises the specific needs of women with heart disease, but the paper points to inequalities at every stage of a woman’s medical journey and the importance of a much broader rethink. I hope that the women’s health plan will bring that.

The lack of support for women experiencing perimenopause and menopause is gaining a higher profile, which is welcome. There is more open debate and discussion about the symptoms that women can experience, and there is more effort to reduce stigma and tackle shame, which has been driven by decades, if not centuries, of the representation of women as crazy or barren simply for experiencing a natural process. In her book “Perimenopause Power”, Maisie Hill makes clear the broader impacts of menopause symptoms and how they can affect relationships and work performance. The average age of menopause is 51, and the age group of women with the highest suicide rate is 50 to 54. That is a stark fact that highlights the importance of evidence-based guidance and the provision of support, including on the use of hormone replacement therapy.

It is vital that women can access proper support, and routes to specialist care need to be improved. There is only one specialist centre in Scotland for menopause, so the first port of call in most instances is a general practitioner. We must ensure that women are confident that their concerns will be listened to by GPs and that they will not be deterred from asking for help. Misdiagnosis is a key issue in women’s health, and women too often feel that their point of view has been dismissed when they have approached their GP. We must increase the number of available specialists and the amount of training for GPs, reduce waiting times, and encourage self-referral so that access to treatment is straightforward and responsive. We need workplace strategies that better recognise changes throughout women’s lives and how they impact on women’s working lives.

The Health and Social Care Alliance Scotland report on future planning was brought together by the lived experience sub-group of the women’s health group. In the report, women highlight difficulties in accessing services, particularly for some marginalised groups. They say that there was no mention of mental health in the plan, with the focus being on physical health—although I noted the minister’s opening comments on that. Making appointments around work and caring responsibilities is still difficult, the need for GP referrals for specialist services can add a further layer of delay, and requesting female GPs or interpreters can put additional pressure on women who are seeking appointments. We must have clear, accurate and up-to-date information readily available online, including accessible videos in a range of physical locations and in other languages.

I will briefly mention the need for investment in research into women’s health. A woman’s health plan is vital to address inequalities in health provision, to provide standards and deliver expectations for women’s health needs, and to ensure that, when they seek health services, women are taken seriously and provided with choices to enable them to live healthy, rewarding lives.