Women make up 51% of the population, yet women’s health has historically been left behind.
Investment in services has been inadequate and fragmented, alongside a persistently low level of investment in research on women’s health and responses to treatment.
This means that health services can miss the opportunity to ask the right questions, and provide the right information, care and support at the right time, to make the biggest difference in women’s health throughout their lives.
The next UK government must set out an ambitious vision for women’s health throughout the life course, including a specific focus on how women can be better supported to access healthcare, how to improve safety, and how the impact of policies across government departments on women’s health and wellbeing will be considered.
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The government must prioritise improving women’s healthcare across the life-course. This includes continued commitment and funding for the implementation of the ten-year Women’s Health Strategy, which should include regular reporting on progress, and clearly outlining future priority areas. In addition, the government should maintain the post of Minister for the Women’s Health Strategy, and support the ongoing roles of Women’s Health Ambassador and National Clinical Director for women’s health within NHS England.
The RCOG has called for the establishment of Women’s Health Hubs for several years, so we welcomed the funding allocated for the creation of a hub in all Integrated Care Systems in England. Women's Health Hubs have the potential to ensure women are seen in the right setting, by the right professional, at the right time, through better integration of women’s health services across primary, secondary and sexual and reproductive health care. The government must commit to the success of Women’s Health Hubs by investing in the training and development of the healthcare professionals working in hubs so they have the skills needed to deliver high-quality care across women’s health and ensure the long-term sustainability of hubs.
The government must significantly improve maternity care by implementing fully funded policies and programmes to ensure all women receive high-quality, personalised and safe maternity care, which supports women’s physical and mental health during and after pregnancy.
Women living in the most deprived areas of the UK have a life expectancy many years shorter than their least deprived counterparts, and are more than twice as likely to die during or shortly after pregnancy. Racial and ethnic health inequalities persist in many areas of women's healthcare: in pregnancy, women from Black ethnic backgrounds are three times more likely to die during or shortly after pregnancy compared to white women.
The government must commit to a time-limited target to end the higher risk of maternal mortality among Black, Asian and ethnic minority women, and for women living in more deprived areas. To drive urgent cross-departmental innovation, improvement and investment, it is vital that this commitment is accompanied by ring-fenced funding. No woman should fall through the cracks, and so the government must also include targeted interventions and policies to support those who experience additional barriers to maternity care, such as refugees, women seeking asylum or with unofficial migration status, and women in prison.
O&G doctors are one of the specialties most at risk of burnout, so there must be a continued focus on measures to help retain the current maternity workforce. The government should explore ways to build more supportive and learning cultures, encourage multi-disciplinary training, and increase flexible working.
Women are waiting longer than ever for their care, with RCOG analysis showing that gynaecology waiting lists have doubled in England since the start of the COVID-19 pandemic. However, gynaecology waiting lists have consistently outstripped growth compared to other specialties since at least 2018, showing that these long waits are not just due to the COVID-19 pandemic. Huge geographic disparities also exist, creating a postcode lottery for specialist care.
Living with often worsening symptoms whilst waiting for care puts huge limits on women’s lives and livelihoods. 77% of women surveyed by the RCOG reported that their ability to work or take part in social activities had been negatively impacted whilst being on a waiting list, and 80% reported that their mental health had been negatively impacted.
The Department for Health and Social Care and NHS England should set up a joint taskforce to address the disproportionate growth in waiting lists in gynaecology.
One in three British women will have an abortion in their lifetime, but despite this, abortion law in England and Wales is the oldest healthcare law in existence, being covered under the Offences Against the Person Act 1861, the Infant Life (Preservation) Act 1929, and the Abortion Act 1967. It is in urgent need of being updated.
The Government should commit to parliamentary time for abortion law reform. Abortion law must be grounded in the fundamental right of a woman to access abortion, ensuring that women’s choices, autonomy and consent are at the centre of their access to healthcare. Under the current law women remain at risk of imprisonment and must be removed from the criminal law for ending their own pregnancies.
Healthcare professionals must be able to provide abortion care without the threat of criminal sanctions which do not apply to any other healthcare procedures and abortion law should be modernised so that doctors no longer fear specialising in abortion care due to the specific threat of criminalisation.
The government must continue to prioritise sexual and reproductive healthcare and rights within its work on gender equality and global health. This includes returning spending on SRHR back to pre-cut levels of 5% of the Official Development Assistance budget or £750m.
Overall morbidity for women and girls due to non-cancerous gynaecological conditions outweighs the combined morbidity from malaria, TB and HIV/AIDS in low and middle-income countries. To address this enormous unmet need, gynaecological health should be mainstreamed throughout the FCDO’s SRHR programming and prioritised in its healthcare programming more generally.