Firstly, it is important to say that it is essential we address all forms of discrimination in our NHS. However, for this column I am going to focus on sexism because of two important recent reports.
The plan for women’s health published by the Scottish government and the BMA’s report on sexism and medicine show that this problem, both structural and on an individual level, is impacting the care women and girls receive, and the careers women are able to pursue in medicine.
While neither publication directly links these things, it isn’t a great leap to believe they may be connected.
It’s disappointing we still have to be so explicit that women deserve access to the care they need, and that it requires such a comprehensive plan.
I have been asked why “women’s health” is important – and have responded because the health of over 50 per cent of the population is unarguably important. I do think the report might have been better titled the “Health of Women” report as “Women’s Health” has sometimes been regarded as a niche area of medicine of little interest to mainstream healthcare and therein may lie the problem.
We need everyone in healthcare to be engaged in addressing inequality of health outcomes in women and girls. The plan itself has welcome timescales to address inequality of outcomes for women for things like heart conditions and clear steps to tackle delays between presentation, diagnosis and effective treatment for issues such as endometriosis, menstrual disorders and the menopause.
These will be challenging given the huge pressure our NHS and its workforce are under. However, without a plan like this there is real danger these issues are squeezed out due to the sheer scale of what the NHS is already being asked to do. Such an eventuality would be a damaging step backwards and hopefully this plan will be one way of mitigating against that risk.
An important aspect of this is the need for women and girls' understanding and expectations of their health to be high so they feel enabled to come forward, but just presenting for care is not enough. We need to have the facilities and the resources to adequately manage those presentations with a focus on the staffing and resourcing of the NHS, including primary care.
Published at the same time, the BMA’s Sexism in Medicine report showed the stark reality of gender-based discrimination in our health service. The figures from the report make for challenging and uncomfortable reading for everybody.
They highlight the detrimental impact that sexist behaviour is still having on the medical profession, preventing people from entering particular specialities, impacting on their health and well-being, and discouraging them from having the work-life balance they need.
We must hope that shining a light on these poor behaviours will drive change toward a more equal, diverse and inclusive NHS – for the benefit of both the workforce and our patients.
Taken together these two reports really do lay down a challenge to us to address the bias that exists within our NHS.
Dr Patricia Moultrie is a GP and deputy chair of the BMA’s Scottish council