Meeting of the Parliament (Hybrid) 15 June 2021
I declare an interest, in that I am a practising doctor.
Healthcare inequality exists. In fact, it is rife in the health service and in society at large. That is never more true than with regards to gender. Women’s health has long been an issue denied by, dictated by and decided by men. It might therefore seem perverse that I am standing here talking about it but, when I see the needs of my patients not being addressed, I am forced to speak up.
In talking about women, we need to be clear that that includes transgender patients. Trans men and non-binary individuals require access to many of our services, and they should be given in a sensitive and inclusive manner. If Scotland is your home, you are one of us.
The root of the problem is that health and care systems have been designed by men for men. In a lot of cases, white Caucasian men are the default patients, research models and target demographic. Sadly, since the inception of the system, very little has been done to alter the status quo to better represent our current society and values. Women’s health has been marginalised and stigmatised with taboos. For example, there is the stigma of the human papillomavirus in cervical cancer screening. There is a lack of knowledge and teaching, and there are research inequalities.
Women also suffer when it comes to work. They bear the brunt of childcare and tend to have less job security. As Craig Hoy said, the gender pay gap also exists in the NHS. Therefore, we are already behind the curve when it comes to gender equality, as we are rowing against hundreds of years of unequal tides.
“But surely it’s better today,” I hear members say. Well, during the pandemic, female staff had significant trouble finding personal protective equipment that was fit for purpose because—you guessed it—the masks were designed to be fitted on men. That literally put women’s lives at risk. That is simply not good enough.
Members should not be fooled into thinking that newer interventions are ironing out the inequality. The digital revolution in healthcare is in fact reinforcing existing stereotypes. Treatment algorithms that are currently used in primary care are sexist. A man who presents with chest pain requires accident and emergency assessment, as he could be experiencing a heart problem, but a woman who presents with chest pain is thought to be panicking or anxious. It is no coincidence that, historically, the Greek root of the term “hysteria” pertains to the uterus. Such ideas are so inculcated that they have become woven into the very fabric of the language that we use.
We need to stop casual sexism creeping into our systems and, to do that, we need a bottom-up rethink. We need to change the way that we teach topics at medical school to include period health, fertility, menopause and endometriosis so that it better represents the practical health problems that women suffer.
Rachael Hamilton and Annie Wells talked about the distressing eight-and-a-half-year wait for an endometriosis diagnosis. In her maiden speech, Evelyn Tweed spoke eloquently about the misery, pain and cyclical nature of that horrible disease. I see all too much of it in my surgeries.
We need to equip young women with the tools and education that they need, including sex education that includes menstruation, pregnancy, contraception, female genital mutilation, termination, LGBTQ+ issues and, of course, healthy, respectful and empowered relationships.