Wes Streeting pledged yesterday to dismantle what he called an “appalling culture of medical misogyny” within the NHS, as the government relaunched its Women’s Health Strategy with a series of binding clinical and financial measures.
Speaking at Trafford General Hospital, the Health Secretary said the current system routinely dismissed women’s pain and failed to diagnose serious conditions in reasonable time. He described the pattern as “medical gaslighting” and said it would no longer be tolerated.
The announcement came alongside data showing that women in England spend significantly more of their lives in poor health than men. Half of all women surveyed reported that a medical professional had ignored or dismissed their health concerns at some point.
Diagnosis delays
Among the most significant figures cited was the average wait for an endometriosis diagnosis: nine years. For women from diverse ethnic backgrounds, that figure rises to eleven years. Fibroids, another common gynaecological condition, face similarly prolonged diagnostic timelines.
Streeting said these delays represented a failure of the health system, not the complexity of the conditions. “Women are told to suck it up,” he said. “That ends now.”
The revised strategy commits to cutting wait times for both conditions, though specific targets were not confirmed at the time of the announcement. A 117-point action plan is expected to set out detailed timelines in the coming weeks.
Pain relief and consent
The strategy introduces a mandatory standard requiring clinicians to proactively offer pain relief before invasive gynaecological procedures. This applies to coil fittings and hysteroscopies, procedures that have historically been performed without anaesthesia, often on the assumption that discomfort would be tolerable.
Patient groups have long reported that women are frequently not informed of their options before these procedures, or are discouraged from requesting pain relief. The new standard would require providers to offer it as a matter of course rather than in response to a patient’s request.
The government will also establish Women’s Health Hubs as single referral points, designed to prevent patients from being directed between multiple departments without receiving a diagnosis or treatment. Streeting described the current system as a “holding pattern of wait-and-see.”
Financial penalties
The most contested element of the plan ties NHS provider funding directly to patient experience data. Under a trial mechanism, hospitals and providers will face budget consequences if women rate their care poorly.
Streeting said the approach was intended to create accountability where cultural pressure alone had failed. “If they won’t change the culture, we will hit them in the wallet,” he said.
Some clinical leaders have cautioned that financial penalties without corresponding investment in specialist staff are unlikely to resolve systemic problems. The strategy has not been accompanied by a dedicated funding package, and workforce shortages in gynaecology remain a significant constraint.
Economic dimension
The Department of Health framed the strategy in part as an economic intervention. Ministers have pointed to rising numbers of working-age women classified as economically inactive due to long-term health conditions that are manageable but remain undiagnosed or untreated.
Streeting argued that the NHS’s failure to address conditions such as endometriosis and severe menopause symptoms was contributing to workforce withdrawal, and that improved care would reduce pressure on the benefits system as well as on individuals.
The Treasury is understood to have taken an interest in the reform on those grounds, though no formal joint commitment between the two departments was announced.
Reaction
Patient advocates welcomed the announcement, with several groups describing it as an overdue acknowledgment of failures that women had been reporting for decades.
Medical leaders were more cautious. Several noted that the 117-point action plan was ambitious and that delivery would depend on resources not yet allocated. Without new funding for specialist training and capacity, they warned, the strategy risked remaining a statement of intent rather than a programme of change.
