A few weeks ago, a police officer came to my urogynaecology clinic for a follow-up appointment. She told me that, since her surgery, her life had changed completely. When I first met her she had been waiting years for treatment for incontinence, and she was miserable. She’d been taking more and more time off work as her condition deteriorated, and had started to feel that there was no hope. Now, after a relatively simple operation, she’s back at work and thrilled with life. I love my job, and I cannot measure the joy that we give to patients when we manage to help them, but I’m frustrated that they often have to wait so long.
As a new report from the Royal College of Obstetricians and Gynaecologists (RCOG) shows, women such as my patient are the tip of the iceberg. It found that more than three-quarters of a million women are on waiting lists trying to get treatment for serious gynaecological conditions – and they are just the ones who have seen a GP and been referred onwards for specialist care. Gynaecology has one of the worst waiting lists across the UK. More than three-quarters (76%) of women waiting for care reported worsening mental health and more than two-thirds (69%) said they were unable to take part in daily activities, including work, socialising, having relationships and caring responsibilities. Many of them mentioned experiencing pain, exhaustion, breathlessness, dizziness, anaemia and infections because of their worsening conditions.
Obviously, the effects on every single woman waiting for treatment are profound and unacceptable. But this dire situation has repercussions for the whole NHS. A quarter of the women who were surveyed for this report had been to A&E because of their symptoms, and many of them needed emergency interventions. As a consultant gynaecologist, it’s frustrating to know that many of my patients could have been treated quickly with physiotherapy or other outpatient care, had they been seen by a specialist earlier.
This is also a problem that is costing the country millions. Just consider all those women who are unable to work, care for others or live their lives for months or years on end because of treatable gynaecological conditions. A recent report by the NHS Confederation suggested that, for every additional £1 of public investment in obstetrics and gynaecology services per woman in England, there would be an estimated return of £11. That’s an additional £319m of gross value added across the whole economy, just from prioritising women’s health.
I have been a consultant since 2002, and what I am seeing now is a crisis in gynaecological care caused by the underfunding and deprioritisation of women’s healthcare by successive governments. When the RCOG published its report Left for too long in 2022, the then shadow secretary of state for women and equalities, Anneliese Dodds, accused the Conservatives of “failing women” with their “woeful mismanagement of our NHS”. It’s devastating to learn that waiting lists have grown by more than a third since then. The new Labour government has committed to prioritising healthcare for women, promising “Never again will women’s health be neglected”. So, this is what it must do.
Research into women’s health is woefully underfunded compared to research into conditions that affect everyone. This government should commit to providing ringfenced funding to enable innovation and pilot studies to improve women’s primary healthcare across the UK. And it must do this in a way that removes the current inequalities in the system rather than exacerbates them. We know that women living in areas of deprivation often wait the longest for treatment, and this has to change. I call on the government to expand women’s health hubs across the UK so that we can ensure that all women receive the same quality of integrated care wherever they live.
NHS staffing should also be a priority – and that means not just doctors but physiotherapists and nurses, who could be based in the community so women don’t have to come into hospitals for secondary care when they don’t need to. This will enable the right patient to be seen in the right place by the right healthcare professional – a win-win for all. So should better communication with patients – it’s wrong that we can find out when our bus is going to come but not when our major gynaecological operation is going to happen, or what we can do to help alleviate our condition while we are waiting. In fact, I’d like to change how we run the whole service so that we enable and empower patients. In my experience, a woman knows if she’s incontinent – is it really necessary for her to go to a GP first in order to be referred to someone who can help?
The longer I do this job, the more I feel that my role is not just looking after patients but fighting for them. The women on these waiting lists need urgent help, but we also need to see a long-term commitment to sustained funding and smarter thinking to address the complex systemic issues behind the delays. I’m prepared to believe in Labour’s promise to never again allow women’s health to be neglected. My patients and the country need them to act on that promise, now.