Women’s Health in Scotland – a changing agenda

New health plan is important piece in jigsaw of improving womens’ health.

As the Scottish Government launch the new Scotland’s Women’s Health Plan, it is worth reflecting on what women say about the challenges that need addressed in relation to their health. As part of the design of the plan, the Health and Social Care Alliance Scotland (the ALLIANCE) set up a lived experience subgroup to ensure that the voices of Scotland’s women were at the centre. Our engagement used open and targeted digital sessions and an online survey to canvas the views of around 500 women across Scotland.

It was sad but not surprising to hear from women about the stigma still attached to periods, menopause, contraception, and conditions like endometriosis.  Collectively it was felt that open discussion in schools and encouraging family and female role models to have comfortable conversations about puberty, growing up and periods was a good place to start. Some women from minority communities referred to such topics as “taboo” and outlined the need for an incremental approach, starting with a trusted person who could answer questions in private and in confidence, while longer term cultural shifts take place, including outreach from the NHS into communities to advise on services available and how to access them. The importance of health and social care professionals navigating cultural barriers in a sensitive way was stressed by women from ethnic minority and gypsy traveller communities.

One of the strongest themes running through the consultation was access to services. Women described often frustrating situations where walk-in clinics were so busy that time taken off work to access was wasted.  Equally for unpaid carers, who too often put the needs of the person that they care for before themselves, accessing services in the right place at the right time is paramount.

Many women said they felt uncomfortable talking about intimate health issues with male GPs but often felt challenged if they asked for a female doctor or interpreter. It is really important going forward that women do not have to explain a preference and that their requests are listened to. Some groups, particularly young people and those from ethnic communities, worried about the issue of confidentiality, which for some can be a barrier to accessing services. It is vital that whether these concerns are real or perceived, we make it clear that contact with a GP practice is always entirely confidential unless the person is endangering themselves or others.

In relation to abortion services, women want a telephone service to discuss options in a protected and private way. Once they had come to a decision, woman want quick access to non-judgemental services.

Being taken seriously and being heard is something that we regularly hear from those who speak to health and social care professionals. The recent Cumberlege report (this link will take you away from our website) – First Do No Harm – is a case in point. It has been uplifting to see in recent times the rights of women with mesh implants being addressed after a long campaign by women themselves. The ALLIANCE undertook a range of engagements with mesh injured women, and one of the clearest messages was not always having the right information or being listened to.

Having been a member of the first Scottish Parliament intake in 1999, I was very struck that the high percentage of women MSPs did create a different and better opportunity very early on to raise issues around domestic violence, unpaid carers nursery education and so on.

Increasingly seeing women in politics and in government sets an aspiration for young women that anything is possible – “it’s not where you come from but where you’re going to that counts”. The Women’s Health Plan – by shining a light; recognising the need to address inequality and bring women’s health out of the shadows – sets an important tone and a platform on which to build. But as with any policy document, the proof is in how we bring about changes. Services are an important part of the jigsaw but for all of us in our schools, communities and workplaces there is a role to play. Each of us can contribute to this important piece of work by acknowledging, respecting and promoting women’s health in Scotland.

First featured in the Scotsman (this link will take you away from our website)

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