New women’s health strategy for England aims to end decades of inequality

[helvella]

This is a ten-year strategy.

I find it difficult to believe that this can possibly correct decades of inequality in that sort of timescale. And the delays that have already occurred hardly help in fostering such a belief.

However, it is still better that something is published, that something changes in the right direction, than nothing.

New women’s health strategy for England aims to end decades of inequality

Among proposals to ‘reset the dial’ on women’s health are training for doctors and hubs across the NHS

Ministers have vowed to tackle decades of “systemic” and “entrenched” gender health inequality in England with plans to introduce compulsory women’s health training for doctors, more cancer checks and “one-stop shop” hubs across the NHS.

Access to contraception, IVF, maternity support and mental health services will also be improved, the government has pledged in its first women’s health strategy.

Rest of article accessible here:

theguardian.com/society/202...

This is obviously a huge topic, and it is likely there will be many who wish to comment. However, please:

Avoid party-political comments;

Try to consider and post about thyroid-related aspects.

There are many other places to have deep and long online conversations about politics and parties.

[ Adding ]

Just want to emphasise that this is specifically England - those in Northern Ireland, Scotland and Wales might see this largely pass them by.

[kellyjoan]

Nothing will change. I have a list of published documents which have promised so much and none of it has come to fruition. If any document contains the word ‘strategy’, treat it with the utmost cynicism.

[RedApple]

They could make a start in all four nations by tackling the decades of “systemic” and “entrenched” attitudes about thyroid disorders and medications!

[crabapple]

It could be the way it's reported but looks less about culture of inequality and more about women's "bits" (for want of a better word).

[crabapple in reply to crabapple]

BTW Woman's Hour is covering it.

[nellie237 in reply to crabapple]

Yes it is all about women's bits. Cardiology & Osteoporosis get a passing remark, but that's it. I think they ought to give auto-immune at least a mention, as many more women are affected whatever the auto-immune problem.

[tattybogle]

i'm still trying to get my head round how come GP's haven't already been receiving compulsory training in women's health issue's ... is it me ???? ...

how can you claim to have adequately trained a "General Practitioner" if you didn't make them study common issues related to the reproductive systems of 50% of the population?

Can mechanics be classed as 'qualified' without learning about gearboxes ?

[crabapple in reply to tattybogle]

Ah, but Obs and Gyne is a specialism...

[BB001 in reply to crabapple]

Ear, nose and throat is a specialism too, but GP's still get training in that. I too was taken aback that GPs didn't get training in aspects that affect 50% of the population. A good comparison would be to find out if GPs get training in prostate, as it too only affects 50% of the population.

[crabapple in reply to BB001]

I replied (tongue in cheek) to tattybogle who refered to "the reproductive systems of 50% of the population". Sorry if that wasn't clear.

[kellyjoan in reply to tattybogle]

Absolutely right. They are trained in women’s health issues. It’s a nonsense to say they’re not. The fact that they choose to treat women’s health issues as emanating from depression and anxiety is the problem. It’s medical misogyny.

Women are not listened to. You can have a vagina or a voice, but not both

[Levojunkie in reply to kellyjoan]

Brilliant. Spot on assessment. Even women doctors apply this medical misogyny. Do they become 'surrogate men' when accepted into the doctoring fraternity??

[humanbean in reply to Levojunkie]

Yes, I think so.

[helvella Administrator]

Indeed.

But how much worse that the mechanic might take the owner's report of an issue (indicator doesn't flash, flat tyre on rear offside, brakes don't work as well as they should) differently depending on the gender of the owner.

[kellyjoan in reply to helvella]

They do!

[Rapunzel]

I can give a witness to that. Granted just over a decade ago, chatting with my company's fleet manager about what car to have, he spoke of a red one, a green one or a silver one being available. Doubtless with a male colleague, he would have spoken of torque and engine size but not lil ole girlie me 🙄

[kellyjoan in reply to Rapunzel]

Everyone knows that women can only make cakes

[Rapunzel]

Everyone knows that women can only make cakes ...play with kittens and sew embroidery...

[humanbean]

One of the biggest problems I have with doctors from any medical discipline is that doctors think they are all perfect. They can never make mistakes. The patient must be wrong. Doctors have no humility.

Another HUGE problem is that doctors think that medical records are 100% correct. If the patient tells you something different then only the patient can be wrong, never the doctor.

For example, I had a surgeon recording in my notes after a laparoscopy that I had two perfectly healthy ovaries and he found no problems. This was impressive because one of my ovaries had been removed six years before. For years I kept on getting smirks and scowls from doctors if I mentioned having only one ovary because they simply didn't believe a word I was saying.

The other thing that happens that destroys a patient's chances of getting taken seriously is having warning flags put on their records. The patient isn't told they are there, although they might guess. The patient has no idea what the warning flag actually accuses the patient of, although they might guess that too. If the patient has been complaining of A for X years, and is eventually found to have been justified then the flags that were added to the records as a result of that problem are never removed.

So, a woman can be deemed to be a drug-seeker, an attention-seeker, a hypochondriac in her teens, and those warning flags stay there for life. It's like getting a criminal record for murder while the supposed victim is still alive, and this happening with a secret trial, with no possibility of parole, and no appeal.

[kellyjoan in reply to humanbean]

Very well put. There is no chance of anything changing. Misogyny is rife among professionals, not just the medical profession.

[Rapunzel in reply to humanbean]

Word.

[arTistapple in reply to humanbean]

The opposite also happens when it is (allegedly) designed for benefit. Things are flagged up on records (e.g. butterfly for dementia in Scotland, don’t know about elsewhere) for sometimes good reason. In the case of dementia details/appointments etc are supposed to go to those with Powers of Attorney/Carers. Can’t tell you how often this is ignored and info is sent to the patient. Whilst patients remain in their own home this becomes a nightmare for whoever is responsible for their care. The patient in question just puts the letters away, so appointments are missed and nobody (including the medics and admin people) have a clue what is going on. When I phone my surgery this is part of the long winded intro. XXX number of patients missed their appointments last month. It costs the NHS lots of money. It costs the prospective patients listening, money and irritation, especially when appointments are hard to come by. The surgeries don’t appear to be examining the ‘why’. I can think of a good number of legitimate reasons why patients don’t turn up. Death, illness, in hospital, dementia, failure of transport, in an accident, traffic jams, family emergency, genuine brain fog issue, last minute call to Royal Garden Party. The system is completely fallible. Surprised?

[humanbean in reply to arTistapple]

Is the fact they have dementia normally kept from the patient then?

I realise they may well forget eventually just as a fact of the disease. But aren't they told at diagnosis?

[arTistapple in reply to humanbean]

That butterfly is for the admin side of things to remind admin NOT to send anything directly to the patient! Maybe even for a new doctor or nurse with the patient in front of them for the first time, so they know better what they might be dealing with. It is ‘good practice’ to tell the patient about their diagnosis well before they lose that comprehension but as you can imagine that is not always possible. The patients tend to forget eventually. The carer and the medical staff and admin people continue to be aware of the ‘butterfly’ but it means nothing to the patient by the nature of their illness. It’s supposed to be for efficiency of service for the patient.

[helvella Administrator in reply to humanbean]

My mother knew she had problems and went for a memory test. I thought she'd be really upset but it didn't seem to sink in properly.

[humanbean in reply to helvella]

Perhaps your mother had already "accepted" the diagnosis before she saw the doctor, although if dementia is already advanced before the diagnosis is made it may be impossible for it to really sink in.

[Ria8 in reply to humanbean]

I imagine I have warning flags on my records. I get strange looks from the receptionist. I don’t care. I am the one feeling the pain and suffering.

[humanbean in reply to Ria8]

I get scowled at by receptionists too. And many doctors have acted as if they are just brick walls. I can tell them my symptoms and they just sit there not responding, not diagnosing, not suggesting tests or treatments. It's been happening since I was a teenager.

[Levojunkie in reply to humanbean]

This is utterly appalling. I knew far more than I ever wanted to know about doctors' misogyny, arrogance, cast iron rectitude and all, but not about the warning flags. It's downright Kafkaesque. Are we allowed to see if our records hold any flags? Can we challenge them if so?

[humanbean in reply to Levojunkie]

I am not aware of doctors ever admitting that warning flags are on a patient's records. I don't think we can see then if they are there. I think doctors would consider it to be bad for our mental health if we saw them or knew about them. Personally, I think knowing that these warning flags must be there based on the way we are talked to and treated is worse for my mental health than having them kept a secret.

[Levojunkie in reply to humanbean]

You really know about this stuff and the damage it causes. The arrogance of doctors believing that they're right is off the charts. I mused on the fact that the DWP ladies who came to assess my health and disabilities and their impact on my life and my family got to know more about me in 2 hours or so than the GPs will ever know. Yet the GPs really believe they know how to treat me! I dare say I have flags too. I ask questions and don't take what they say as gospel. The likelihood of flags would explain some things to me. If you have them, how do you think they'd have got there?

I wonder if men get just as many flags as women? I just remembered that years ago I had a tenant who was a GP. Very pleasant and uncharacteristically humble. We used to have a cuppa and a chat from time to time. She told me about the notations that her colleagues would put on px notes. E.g. "NFTN" = Normal for this neighbourhood, and meant disparagingly. She didn't participate in this though. Did the flags evolve from this horrible demeaning attitude? I've also been told that it's a bad idea to let them know your academic qualifications too....

[humanbean in reply to Levojunkie]

Since I've never seen any warning flags I can only speculate.

Over the years I have refused to go on statins, and have also refused to go on anti-depressants. Both of these things will cause a flag on my records to say I'm "not compliant" with medical advice.

Another possibility is that the patient is in pain and asks for help and pain relief. If the cause of the pain cannot be found then the patient is probably going to be flagged as a drug-seeker, particularly if they persist.

Another problem is that a flag on your records in your teens (for example) is never, ever removed, even if you were proved right in saying you had a problem that was causing pain. It's a life sentence.

[Levojunkie in reply to humanbean]

Thank you for your thoughts. It all makes me wonder who benefits most from these flags? I can see the utility of alerting colleagues to someone with a drug problem. Yet how often do they work? My friend's son died from being given tablets that were toxic to him despite the 'note' or flag in his medical records.

Despite my note on registration form re preference for no tablets. They still persisted (in defiance? to exert control?!) in trying to give me more tablets than I ever thought possible to take! So I didn't. I took the very minimum and, wouldn't you know it, I survived! So I've definitely got those non-compliant flags. Oh, and I successfully litigated an abusive HCP. That's me with a double life sentence then!!

Are flags always negative towards the px? Would they flag, say, an abused child so that doctors in her/his adulthood could more easily spot ACE (adverse childhood experiences) related diseases like rheumatoid arthritis and other autoimmune conditions and MH/trauma issues? If they don't then it could all look to me rather like control freakery and self-defence. So much for team work, candour and honesty.

Where does GDPR come into all this? The data subject's right to access, correct and delete information held on them. Forgive me, I have lots of questions and thoughts about all this. I'm going to see what research I can do and put together some sort of article.

[humanbean in reply to Levojunkie]

I'd be very interested in reading it. I don't know the answers to all your questions. I don't know how the flags work in practice for most people.

[serenfach]

My "bits" have been generally well looked after. Its the rest of me that is ignored.

[crabapple in reply to serenfach]

I think helvella's point about ten years is relevant here. "Bits" hived off from GPs in 10 years , the rest will have to wait for the next new strategy.

[kellyjoan in reply to serenfach]

All my bits have gone 😟

[LindaC]

😆🔍🐍🦕 Would be a treat, eh? Thanks for posting helvella!