Breaking a ‘male by default’ health system in the EU and UK

We live in a healthcare system that is mostly designed for men. Although about half the European population is female, knowledge gaps persist on conditions that only affect women, or about those that affect men and women* but differently. The “second sex” has often been left out of scientific studies that informed political choices, and damaging stigmas around women’s health have prevented them from speaking up about their health issues. As a result, women often end up being misdiagnosed and/or receiving healthcare advice that is not appropriate for their situation, with potentially detrimental health outcomes.

While some focus has been put on women’s reproductive rights, on issues such as the menstrual cycle, pregnancy, and contraception, it is important to acknowledge that women have different experiences than men with a number of illnesses, like cancer, mental health and cardiovascular disease, to name only a few. Fortunately, policymakers on both sides of the Channel are increasingly starting to recognise gender-specific health risks and are taking steps to push women’s health to the forefront of the policy discourse. 

While, historically, health has always been a Member State competence (i.e., laws related to health are passed at a national level), it is interesting to see that the EU and UK continue to take similar paths on some key issues when it comes to women’s health. With a firm foot on both sides of the Channel, Whitehouse is ideally placed to make sense of these debates taking place in Brussels and Westminster.

 

Growing political willingness in Brussels, but little concerted efforts across the EU

The EU’s Gender Equality Strategy for 2020-2025 notes that, in the EU, women’s health suffers from the fact that, in comparison to men, women usually have lower financial resources and time constraints for their treatment and recovery. This can be ascribed to the lasting gender pay, earnings and pension gaps and caring responsibilities.

As such, a gender dimension has been integrated into the recent Europe’s Beating Cancer Plan, setting out a renewed commitment to cancer prevention, treatment and care by using new technologies, research and innovation, taking into account inequalities across the EU. A notable action specific to the gender dimension is to support Member States’ efforts to extend routine vaccination against human papillomaviruses (HPV) of girls and boys – in order to eliminate cervical cancer and other cancers caused by HPV.

The European Parliament is moving to act, too. The European Parliamentary Forum (EPF) for Sexual and Reproductive Rights is a network of MEPs committed to protecting women’s sexual and reproductive health rights (SRHR), organising events, producing reports and outlining calls to action on an array of women-specific health issues.

Spearheaded by the European Parliament’s Committee on Women’s Rights and Gender Equality (FEMM), the European Parliament called upon EU Member States to ensure women are offered high quality, comprehensive and accessible SRHR, and to remove all barriers impeding them from using these services. MEPs have also stressed the need for access to abortion (a controversial topic for Poland, Malta and Ireland particularly), contraception and sex education. They have called upon Member States to acknowledge menstrual products as essential basic goods, such as by applying the flexibility introduced in the VAT Directive and apply exemptions or 0% VAT rates. In the EU, only Ireland does not tax tampons, sanitary pads and panty liners, and while some others have cut down the tax rates on hygiene products in the past years, there is still a long way to go before they are not treated as luxury items anymore across Europe.  

In a different report published in January 2021, the European Parliament also stressed the need for a gender-sensitive response to all aspects of health in light of the COVID-19 crisis. Among other things, the Parliament stressed the need to develop an understanding of the (long-term) health impact of the virus put in place because of the pandemic, requiring gender-balanced representation in clinical research; to guarantee quality and affordable access without discrimination to SRHR services, information and commodities; to ensure access to essential aspects of women’s and men’s quality medical and psychological healthcare unrelated to COVID-19, such as cancer screening and treatment, maternal and neo-natal healthcare and urgent care for those suffering from heart attacks and strokes; and to boost mental health support initiatives during and after this crisis. MEPs also urged Member States to invest in robust and resilient health systems and to commend and support essential workers (the majority of which are women) by ensuring safe working conditions, providing appropriate equipment, establishing conditions for fair pay, offering professional development, and ensuring access to services such as childcare and mental health services. Member States are also urged to address gender-based violence faced by girls and women as a result of the COVID-19 pandemic, including by ensuring the provision of effective, accessible, affordable and quality medical and psychological support for victims of gender-based violence, including SRHR.

The European Institute for Gender Equality (EIGE) reported that the EU is closest to gender equality in the domain of health, showcasing political strides taken to address the issue. However, it is clear that gaps remain, and one may say that a more joined-up strategic plan may be needed to encourage and support EU capitals to further reduce health inequalities, particularly in the wake of the COVID-19 crisis. More harmonised measures would ensure that women across the EU can expect to access the healthcare they require, whether they are in their home country or not.

Ambitious plans in the UK

The government’s forthcoming Women’s Health Strategy is set to take significant steps in addressing women’s healthcare needs. Earlier this year, the former Secretary of State for Health and Social Care, Matt Hancock, and the current Minister of State for Mental Health, Suicide Prevention and Patient Safety, Nadine Dorries, urged women and organisations with expertise in women’s health to submit their suggestions to the government on how it can ensure the health system works for the whole nation.

Views were sought to connect different areas of women’s health across their lifespan. Themes of interest to the government include placing women’s voices at the centre of their health and care; improving the quality and accessibility of information and education on women’s health; ensuring research, evidence and data support improvements in women’s health, and; understanding and responding to the impacts of COVID-19 on women’s health.

The Department of Health and Social Care (DHSC) is currently analysing the responses and is expected to publish the ambitious strategy later this year. Whitehouse was proud to facilitate a discussion on how the strategy can achieve gender parity in healthcare with an expert panel made up of Dr Jenny Douglas, Chair, Black Women’s Health and Wellbeing Research Network; Rebecca Taylor, Policy Manager, Endometriosis UK; Shaista Gohir, Women’s Voices Lead, Royal College of Obstetricians and Gynaecologists and Chair, Muslim Women’s Network; Dr Anita Mitra, aka The Gynae Geek and Registrar in Obstetrics and Gynaecology, and; Sara Gorton, Head of Health, UNISON. Please see the recording of our webinar here.

In the face of rising rates of sexually transmitted infections (STIs), high rates of unintended pregnancies, widening inequalities and increasing pressure of services, the government also announced plans for a new Sexual and Reproductive Health Strategy. The updated strategy is planned for publication later this year. Also in the field of reproductive health, the so-called “tampon tax” was axed on 1st January 2021, with a 0% of VAT applying to women’s sanitary products. You can read more on the campaign here. The government has also published a Strategy on tackling violence against women and girls (like stalking, sexual offences, domestic abuse and female genital mutilation (FGM)) to also address the detrimental impact on mental health and reduce the amount of women and girls who have been victims of these crimes that engage in poorer health behaviours, among other things.

Meanwhile, campaigns seeking to tackle women’s health issues, such as FIVEXMORE, an organisation committed to addressing racial disparities in women’s maternal health outcomes, have captured the attention of UK policymakers. Working through parliamentary mechanisms, such as the All-Party Parliamentary Group on women’s health, members of both Houses of Parliament are advocating for women’s health rights, ensuring that they can make an informed choice about the best treatment for them and are treated with dignity and respect. As the publication of the government’s Women’s Health Strategy nears, these policymakers will be receptive to similar campaigns, eager to understand more about issues that have long-been ignored.

The UK is taking big steps in addressing women’s health, something that is not as clearly cut-out at a European level. Fortunately, they are both moving in a similar direction. While inequalities are (slowly) being smoothed out, the hope is for Brussels and Westminster to implement their plans and continue sharing knowledge and best practices. That way, more can be done for improving health for everyone.

The Whitehouse team has a vast amount of experience in health, human rights and equality, and education, supporting organisations, both large and small in having their voice heard in the United Kingdom, the European Union, its Member States and beyond. For more information, please contact our Chair, Chris Whitehouse, at chris.whitehouse@whitehousecomms.com.

More about health policy can be found here.

* While this blog focuses on cisgender men and women, Whitehouse acknowledges the existence of a number of other gender identities. Although ‘sex’ and ‘gender’ are two different concepts, for the sake of clarity, we have used these words interchangeably for this blog to refer to those whose gender identity matches their sex assigned at birth. More on this here.