Following a review chaired by the Independent Medicines and Medical Devices Safety Review in July, it has transpired that certain NHS treatments, including vaginal mesh implants, Primodos pregnancy tests and epilepsy drugs have devastated the lives of thousands of women.
Countless women have been ignored, and had their complaints rejected by health professionals, as they were dismissed as ‘women’s problems’. The women who claim to have been affected by these treatments span generations – highlighting the sheer scale of the ignorance of health officials surrounding women’s health, and the failure of the UK’s healthcare system to provide quality healthcare for women.
Primodos, withdrawn from the market in 1978, is a hormonal pregnancy test that is now associated with miscarriages and birth defects, despite the drug manufacturer claiming there is no correlation between the drug itself and physical abnormalities in babies. Sodium valproate is a drug used by epilepsy sufferers, which helps to prevent seizures. Thousands of pregnant women have taken the drug and yet it has proven harmful if taken during pregnancy, causing deformities, autism and developmental delays in babies.
Tragically, this revelation is not a reflection of a single incident, as these injustices have been ongoing for many years. Headlines such as ‘Hernia mesh implants used ‘with no clinical evidence’’ and ‘Mesh implants victims give ‘heartbreaking’ evidence to MSPs’ date back to as early as 2014. Baroness Julia Cumberlege, chair of the Independent Medicines and Medical Devices Safety Review, claimed “Much of this suffering was entirely avoidable, caused and compounded by failings in the health system itself”. Evidently, the refusal of health professionals to listen and accept what was occurring post-operation has led to too many women being left traumatised by procedures and prescriptions that doctors initially claimed were intended to improve their health.
So why has this problem spiralled into such an alarming situation? When considering the fact that GP’s allow ten minutes per consultation, there is an argument to be made that consultations have become more about adhering to restrictions and saving the NHS money than about focusing on what truly matters: the patient. However, there is a darker undertone to this problem, one which lies in gender prejudices. Yvonne McIntosh, who had vaginal mesh inserted in 2013, claimed “They [the NHS] didn’t believe us. They didn’t and that was the hard part […] I think you sort of felt a bit foolish, because they didn’t believe you, and that was just – it wasn’t easy to cope with”.
The harrowing findings of this review highlight that there is bias against women’s suffering inherent within our health system. Ten minutes may not be enough time for explanation, examination, questions and solutions, but is enough for a health professional to understand there is something seriously wrong and the patient is suffering immensely. To ignore a patient and downplay their pain is to belittle, humiliate, and to undermine what that patient is experiencing, and these women have fallen victim to a system of arrogance and blatant ignorance.
The review isn’t unique in highlighting the sexism that permeates the NHS; as Esther Chen, an emergency medicine doctor at Zuckerburg San Francisco General Hospital, claims, “Seeing women treated differently in the emergency department is a fairly well established phenomenon”. And in 2016, an article published by The Independent article claimed “Research has found that in A&E, when women and men present the same severity of abdominal pain, men wait an average of 49 minutes before being treated, while the average wait for women is 65 minutes”, and “women are consistently prescribed less pain-relieving medication, even when controls for weight are applied.”
What is more, Jennifer Billock stated in a BBC Future article that “In 2009, my doctor told me that, like “a lot of women”, I was paying too much attention to my body. Saying there wasn’t an issue, he suggested I just relax and try to ignore the symptoms.” These cases are just some of the evidence of a gender divide in diagnosis; women have been betrayed by the healthcare system for years, and such cruel sexism has not been targeted on a level that ensures change will be enacted.
We must question why there is a divide in diagnosis, and why women are treated differently. In an article by The New York Times, Dr. Fiona Gupta is quoted saying “As women, we’ve been taught from an early age to rationalize warning signs of physical or mental health problems,” which insinuates that women see their pain as a reflection of their own hysteria, and therefore deduce their pain as unworthy of attention. But this isn’t just a perception women have of themselves – when complaining of pain, health care providers often see women as overreacting, self-diagnosing, which subsequently justifies the health care provider’s failure to correctly diagnose. It is the implicit bias within the NHS that governs the belief that, unless it is visible, women’s pain isn’t worthy of attention.
At a time when the country is relying on the NHS more so than ever before as we face a pandemic that is devastating lives across the globe, the lack of confidence in the health care network following this revelation will be telling. The NHS has a reputation for being a beacon of remarkable health care, but if patients cannot trust their doctors to provide the quality health care they are promised and deserve, the ethos of the NHS is fundamentally tainted. Perception is everything; whilst these headlines continue to filter through the mainstream media, and sexism lingers in the corridors of Britain’s hospitals, the credibility of the health system continues to be eroded.
Amongst the recommendations the review suggests is the appointment of an independent patient safety commissioner, an overhaul of the Medicines and Healthcare products Regulatory Agency, and the expansion of the General Medical Council register to include a list of financial interests for all doctors. But perhaps more important is an improvement to the culture of ignorance and denial that has led to unnecessary trauma and suffering. This will not change the lives of the victims concerned in the review, but will ensure the health care system is equal, diverse and representative, so no more women will have to suffer at the hands of ignorance and negligence within the NHS. As Nadine Dorris, the health minister, states, “Our health system must learn from those it has failed, ensure those who have felt unheard have a voice and, ultimately, that patients are better protected in future.”
We pride ourselves on having a health care system that is free, representative and welcoming. But as headlines such as ‘No one believed my pain’ continue to see light, we must question whether the reality is somewhat different to the ideal.