It’s 2022 – why has it taken England this long to prioritise women’s health?

At its core this is about some basic but difficult biases: the way women’s pain is disregarded, says Ian Hamilton

A new women’s health strategy says medics should be given lessons on women’s health issues (Alamy/PA)

Most government consultations attract a few thousand responses at best. But when the Department of Health recently called for a public response to a strategy on women’s health, it received over a hundred thousand responses.

It confirmed what many have been saying for a while: women’s health is not taken as seriously as men’s. Despite making up 51 per cent of the population, living longer than men, and experiencing more years of disability, there is still a lack of research on women’s health and treatment that meets their needs.

In July, the government published its first ever Women’s Health Strategy to tackle the gender health gap in England. The Department of Health and Social Care said it “sets bold ambitions to tackle deep-rooted, systemic problems within the health and care system to improve the health and wellbeing of women and reset how the health and care system listens to women”.

Or to put it more bluntly, as one respondent to the consultation did: “you can have a vagina or a voice, not both.”

From 2024, all medical students and incoming doctors will be trained in how to assess women’s health. This goal alone makes clear just how severe the problem is; the idea that women’s health wouldn’t feature in medical training, or that aspiring doctors wouldn’t be coached in how to tune into women’s specific problems, is staggering. The system has finally recognised the need to tackle this systemic bias at its roots.

But little money is attached to this strategy: £10m over 10 years. In many ways, the problems aren’t related to resources, and throwing money at this issue would likely be ineffective.

At its core this is about some basic but fiendishly difficult cultural and social biases: the way women’s pain is disregarded or misattributed to other things; lack of choice over contraception or interventions that could ease symptoms of menopause; lack of appropriate intervention following domestic violence, psychological abuse and ensuing trauma.

There are isolated pockets of good practice, such as the women’s contraceptive hub in Liverpool, which has proved to be successful in engaging women and providing tailored contraception. At least some knowledge transfer can take place from these beacon services. But that can only happen if those areas not currently offering such services are receptive to learning and reorganising what they offer at the moment.

Therein lies the rub. We already have some knowledge and insight as to what needs to change to improve women’s health, so this strategy will succeed or fail not on organisation, but on attitudes and motivation of NHS staff. If women’s health is to show any signs of transforming for the better, we need to change hearts and minds.

As with education about race, ethnicity, religion or sexual orientation, you can be taught the right things to say without changing your practice or how you engage with people. This produces the worst outcome where there is a veneer of change but absolutely nothing has, ensuring existing gender health bias is maintained and that women’s health doesn’t improve.

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I’ve lost count of the number of reports that all reach the same conclusion: women’s voices aren’t heard, they aren’t listened to and as a result their health suffers needlessly. At least this is a strategy that aims to take action and not simply, albeit importantly, report the current gender bias within health and research.

There is a commitment in the strategy to “check in” with women every two years to gain feedback on their experience of reproductive and other services. If the recent response to this consultation is anything to go on, they won’t be left wondering what women think and hear first-hand how services are performing.

Let’s hope that groundswell of feedback and engagement produces the services and experience of health for women that men have taken for granted.