The physical and mental health of women in the UK is compromised every day by a healthcare system that discriminates against them twice over. Diagnosis and treatment is based on male-centred research that ignores females’ different biology; and gender stereotypes and biased medical textbooks lead to women’s ill health being disbelieved and taken less seriously than men's. For the first time WE are putting sex and gender at the centre of healthcare policy to support healthier outcomes all round - from access and provision to treatment and support.
WE stand for:
Transforming medical research and treatment
Women are disbelieved and dismissed by the health system - females are rarely used in biomedical research and trials because of "hormonal interference", therefore we don’t understand the effect of drugs on women, who are 60% more likely to react to prescription drugs than men. Public health programmes and diagnostic criteria for heart disease and attacks emphasise symptoms experienced by men, despite this being one of the leading causes of death of women in Britain.
WE will establish a health research institute for women and girls to invest in careful research and medical testing on females, and spearhead research on reproductive health throughout women’s lives. The institute will investigate any conditions or symptoms disproportionately experienced by women. WE will update regulations and standards for the approval of clinical and pre-clinical trials to require them to systematically account for sex differences. For all existing medication, WE will require labelling to make it clear if testing and analysis has taken account of sex differences. WE will review and reform medical curricula so that medical students learn to identify and treat diseases and conditions as they present in women, including gender bias and how that intersects with other inequalities including race, age, social class and disability. WE will introduce quotas for commissioners of research (such as NICE, universities and government representatives) to have 50% women on their decision-making boards.
A new approach to mental health services
Mental health is framed as a biomedical issue yet inequality and discrimination play a big role in mental ill-health. Women are more likely to experience violence, to live in poverty, to live alone (particularly in older age) and to be carers for other people, all of which contribute to poorer mental health. Almost twice as many women as men are likely to be diagnosed with anxiety disorders and 75% of those diagnosed with Borderline Personality Disorder are women.
WE will update the Mental Health Act to comply with international human rights legislation and ensure that people are not harmed or abused within services. WE will prioritise trauma-informed therapies, focusing on the causes of mental health issues rather than symptoms. WE will work towards having a mental health lead in every GP practice and ensure access to non-medical crisis housing as an alternative to mental health acute wards. In line with our Equal Education policies, WE will address early gender stereotyping that damages everyone. WE will ensure every school has a mental health nurse and ring-fence funding for Child and Adolescent Mental Health Services (CAMHS) specialist services.
Gynaecological, reproductive and sexual health
Gynaecological research has focused on female bodies as reproductive vessels rather than for health or pleasure. Little is understood about vaginal conditions and there are medical textbooks that omit the clitoris entirely. WE will reverse cuts to specialist sexual and reproductive health (SRH) services, immediately suspend vaginal mesh surgeries in all parts of the UK and follow up on the Westminster Government’s investigation. WE will invest in research into effective and pain-free solutions to pelvic organ prolapse and investigate the prevalence of the so called “husband stitch".
WE will require every GP practice to have at least one woman GP and will educate health professionals to ensure that cervical screening is offered to all women, trans men and intersex people. WE support a fully-funded NHS-provided fertility treatment service that is equitable and non discriminatory. Pre-menopausal women will be offered egg freezing before beginning damaging cancer treatments and WE will ask women engineers and designers to review medical equipment. WE will review regulations for 'feminine hygiene products' and bring in legislation to protect women taking sick leave resulting from menstruation or menopause.
Human rights and consent in childbirth and maternity care
Having a baby is the most common reason for admission to hospital in England, but maternity care represent only around three percent of health spending. Suicide is the biggest killer of women between six weeks and one year after giving birth. The need for woman-centered care, reduced medical interventions, increased support for breastfeeding and continuity of midwifery care is well-evidenced.
WE will make sure all women and their partners have access to perinatal mental health services. WE will develop family-integrated care models in neonatal services so that mothers are not separated from their premature or sick babies. As pregnant women are at an increased risk of domestic abuse (which also increases the risk premature and underweight babies) the model must incorporate prioritisation of mothers’ agency and wellbeing. Black, Asian and ethnic minority women, working class and poor women are more likely to die in childbirth than white wealthier women; WE call for urgent investigation and for outreach programmes to ensure early access to maternity services. WE will end the relocation of asylum-seeking women by the UK Border Agency during and shortly after pregnancy and create parity of care for women in the criminal justice system.
WE will put the International Code Against Marketing of Breast Milk Substitutes into UK law and require employers to provide breastfeeding breaks (and safe, private and clean areas for feeding, expressing and storing milk) to support the 80% of women who give up breastfeeding before they want to.
Equality in health to end violence against women
Survivors of gender-based violence are more likely to have poor physical and mental health.
Working with professional health bodies and specialist violence against women (VAWG) services, WE will incorporate training, information and support for GP practices and healthcare workers to improve identification and signposting of different forms of VAWG, including inspection criteria on best practice monitoring and intervention.
WE will guarantee refugees and immigrants the right to an interpreter to support their access to all health care services. Yarl’s Wood detention centre should be closed down, adequate physical and mental health care must be immediately provided to the women detained.
Equality in aging and end of life care
Women live longer than men and make up a larger portion of the older age population, and are more likely to spend more time in ill health. The care commitments that women disproportionately take on over their lifetime is a risk factor for developing dementia, the leading cause of death for British women. In heterosexual couples, men are less likely to take on domestic work which makes it more difficult for women to access support services.
WE will review health, care and equalities legislation to ensure that the rights of those living with dementia are upheld. WE will ensure that people who opt to die at home are given properly funded support to avoid end-of-life care falling to women. WE will support community-based approaches to end of life care, such as “compassionate cities”, which join up services including hospices, churches and charities. Working with organisations like Changing Places, WE will install a national network of accessible public toilets, so disabled and older people are not forced to use catheters or risk dehydrating in order to use public spaces.
Building a workforce for the future
Women are the backbone of our National Health Service (NHS), making up around three quarters of the workforce in each of the nations of the UK. But only 15 to 16% of Chairs of Clinical Commissioning Groups in England, which make local health service funding decisions, are women; and only 15 out of the 100 highest paid consultants in Scotland are women. In order to create an equitable workplace for women it is vital to tackle the gender pay gap, lack of flexible working, and the bullying and harassment reported by 24% of NHS England staff.
WE will end pay restraint, reinstate the bursary for student nurses and midwives, and negotiate with the British Medical Association (BMA) and junior doctors for a fair and equitable contract that does not discriminate against women, who are more likely to have caring responsibilities. WE will introduce quotas for women as senior managers and directors, consultants, surgeons and specialists, and introduce criteria in the relevant national inspectorates to report on the progress of trusts and quotas for male nurses and caring assistants, to improve balance at all levels. WE will work with professional bodies and the workforce to make the NHS a leader in flexible and part-time working, including training opportunities, and to attract staff back from agencies. WE will adopt a migration policy that allows the NHS to recruit and retain European staff.
Giving women equal access to sterilisation as a permanent contraception
Men have the freedom of choice to have a vasectomy, yet women are restricted regarding tubal occlusion. Women need permission of their husband and GP and will only be considered after all other avenues (including discussing vasectomy) have been tried and resulted in clinical contraindications. Women who wish to remain childless are forced to take hormone-affecting medication, use intrusive barrier methods, abstain, or run the risk of unwanted pregnancy.
WE will treat women’s choices in terms of permanent contraception through sterilisation on the same terms as men’s choices.
Protecting the long-term sustainability of the NHS
The sustainability of the NHS is a deeply gendered political issue as women make up 89% of nurses and 90% of support staff; the NHS relies on 97,000 women from overseas (of whom 47,000 come from the EU and EEA). The NHS is underfunded because the UK does not value care - which is primarily the work of women, who most often provide this unpaid.
WE will adopt the recommendations of Lord Patel’s cross-party committee, including creating an independent Office for Health and Care Sustainability to identify the healthcare needs of a changing and ageing population - including a long-term staffing and funding plan. This will address salaries of low-paid staff; morale and retention, a bureaucracy and regulation review that includes a strategy for technology and innovation (in order to promote best practice and administration), whilst maintaining a tax-funded, free-at-the-point-of-use model to deliver health services now and in the future.
Developing Social care policies
The impact of funding cuts on essential local services (supporting disabled children, adults and carers in the community) disproportionately affected women because a greater proportion of disabled people are women (54.4%), more family carers are women (72%), and most professionals working in the care sector are women (80% plus). Public spending on adult social care is set to fall to less than 1% of GDP. We have to find a way to plug the estimated £2.6 billion funding gap and stop critical frontline services from being withdrawn along with the professionals leaving and the impact upon vulnerable families.
Long term these cuts do not save money, requiring more expensive care and/or hospital admission later. We must agree a longer-term investment plan that recognises our pledge to spend equally on social infrastructure as on physical infrastructure because WE understand that spending on social infrastructure is an investment in women and in our national economy.
WE are developing social care policies to incorporate into our Equality in Health policies.