Women's health plan

Foreword by the Minister for Public Health, Women's Health and Sport

I am proud to present the Scottish Government's Women's Health Plan. I believe that our vision for Women's Health is an ambitious one – and rightly so. Women's health is not just a women's issue. When women and girls are supported to lead healthy lives and fulfil their potential, the whole of society benefits.

In our debate on Women's Health I quoted from Caroline Criado Perez's thought-provoking book 'Invisible Women' and I wish to do the same here at the beginning of our Women's Health Plan, as she says so much in the few words: 'women are not, to state the obvious, just men.'

She goes on to explain: 'Historically, it has been assumed that there wasn't anything fundamentally different between male and female bodies other than size and reproductive function, and so, for years, medical education has been focussed on the male "norm", with everything that falls outside that designated as "atypical" or even "abnormal".' This has to change. Women are not atypical – they are 51% of Scotland's population.

Whilst we know that across Scotland there are examples of excellent and innovative services for women there is a clear need for wider systemic change to ensure that all our health and social care services meet the needs of all women, everywhere. Together, we are working to address the inequalities in all aspects of health that women are facing. The Women's Health Plan focusses on specific priority areas where a need for improvement was identified. But the Plan is one part of a much wider picture when it comes to women's health and wellbeing.

The Scottish Government is committed to a range of actions to improve women's health. The mental health of women and girls is a priority within the Mental Health Transition and Recovery Plan. We have taken decisive action in relation to mesh, including halting its use in 2018, and we will pursue the outcomes set out in the Mesh Survivors' Charter. Cancer screening remains a priority and we will continue to deliver our Screening Inequalities Fund to tackle inequalities in the national population screening programmes, setting aside £2 million over the next two years to tackle inequalities including those that have arisen as a result of COVID-19. We are continuing to implement our Recovery and Redesign: Cancer Services Action Plan. We are tackling violence against women and girls through the implementation of our Equally Safe Strategy. The Gender Pay Gap Action Plan is driving forward the changes needed to reduce the gender pay gap for employees in Scotland.

Additionally, the Government's 2021 Manifesto made a range of new proposals in relation to women's health. Work is underway now to develop new actions connected to these proposals. So, while they are not addressed in this iteration of the Women's Health Plan, they will be progressed by the Scottish Government during this parliamentary term.

This includes new action in relation to:

• establishing a dignified and compassionate miscarriage service tailored to the needs of women;
• the provision of paid leave for miscarriage and stillbirth, delivering this within the public sector and calling on the UK Government to make the necessary changes to employment law to make it available for everyone;
• a review of midwifery and health visiting pathways;
• unexpected pregnancy complications;
• age thresholds for Screening; and
• the establishment of a Scottish Institute for Women's Health.

The work on the Women's Health Plan began before the pandemic – and the evidence was already stark about the inequalities impacting women's health and the need for decisive action to address them. But Covid-19 shone an even brighter light on these inequalities.

Women have been even more adversely impacted by the Covid-19 pandemic. Inequalities have been exposed and exacerbated. The challenges of balancing childcare, paid work and caring responsibilities with the stresses and uncertainties of the pandemic have been truly daunting for many women, and have undoubtedly affected their health.

Learning from the pandemic – the needs of women, and its impact on services – has been central. Changes in service delivery have also highlighted positive opportunities for change and these have been brought into the Plan.

But we know that the inequality women face throughout their lives existed before Covid. For too long women have been disadvantaged, and this has impacted their right to health. It is time that this disadvantage is addressed and the inequality that women experience in relation to their health is eradicated.

For example, when we provide high-quality information and education on menstrual health, young women and girls are empowered to understand what is 'normal' and when they need to ask for help. When women are well informed and supported about the menopause, they can make informed choices about what they need, in healthcare, in the workplace and beyond. When research includes women, medicine can become more equitable. When we understand that heart health does not manifest 'abnormally' in women, we can save lives. When women's needs are taken into account, we all flourish.

Women's Health is not only about reproductive health. Our Women's Health Plan aims to reduce avoidable health inequalities for women and girls across the course of their lives – from puberty to the later years – focussing on those areas that are stigmatised, disregarded or dismissed as 'women's problems'. By supporting health in women and girls we can expand their choices and opportunities to achieve their potential.

Central to the development of the Plan have been women's voices. It is vital that women continue to inform their health and the health of women in Scotland – I look forward to hearing from them as we implement the Plan and drive forward improvement.

As Minister for Women's Health, I am ambitious for women in Scotland. I am determined that we drive change in women's health. This, our first Women's Health Plan, signals this ambition and determination that we see change for women in Scotland, for their health and for their role in society. We can be World Leaders in Women's Health – starting here and now.