This week, we’ll go to the polls to vote in a General Election in which multiple crises are front and centre, from the cost of living to housing and the climate. One area which may be especially pressing? That of the NHS, and the lack of timely access to the healthcare that so many desperately need.

This is true across the board. But, when it comes to gynaecology, things are especially dire. In England alone there are almost 600,000 women on gynaecology waiting lists, our maternity services are in crisis, and conditions that affect women disproportionately (like thyroid conditions or fibromyalgia) or differently (like cardiovascular disease or ADHD) remain hugely under-prioritised, under-funded and under-researched.

Unlike the US, Canada and much of Europe, we also don’t yet have clear, consistent guidelines requiring medical researchers to include women and account for sex and gender in their work.

The political situation and women’s health

The last few years have seen landmark shifts to the political conversation around women’s health, with the Government publishing the first ever Women’s Health Strategy for England in summer 2022. Similar plans were published by the devolved Governments in Scotland and Wales, and a plan for Northern Ireland is currently in development. Clearly, though, far more must be done.

So, with the General Election just days away – and the NHS the top priority for voters – how have our main political parties pledged to improve the health of 51% of the population? A team of clinicians, academics and policy experts at Imperial College London has dug through the manifestos so you don’t have to, and produced an in-depth analysis of how each party’s pledges could improve our health.

Researchers looked at direct impacts, like improving access to healthcare, but also the indirect effects of wider social issues on our health, like tackling the housing crisis, violence against women, and cost of living.

The expert team behind the analysis

‘We wanted to evaluate whether the political parties are really considering women, and how their manifestos measured up against 15 key priorities’ says Dr Kate Womersley, co-lead of the WHAM (Women’s and Girl’s Health And Party Political Manifestos) project, doctor in psychiatry, and sex and gender researcher.

‘This list was compiled by our team of experts based on the key policy recommendations and advocacy topics in UK women’s health and wellbeing over the last five years – including gynaecology waiting lists, maternity safety, childcare support and the gender pay gap.’

‘We then scored the manifestos on whether they included and costed these priorities. Where a party suggested a policy the WHAM team saw as regressive or harmful, this was awarded minus points.’

Of course, she adds, the analysis only assesses what the parties are pledging, which doesn’t necessarily reflect what they would do in government. ‘Manifestos are not binding; they are what the parties promise to do and what they’ll be judged against if in power. In 2019 the Tories promised 40 new hospitals, and the NHS is still waiting.’

‘They also pledged 6,000 more GPs by 2025 but, as of January 2024, there were actually fewer GPs than there were in 2019. Not only that but, due to introducing less qualified healthcare workers in primary care, extraordinarily there are a growing number of GPs out of work despite public demand for more consultations,’ she says.

In general, all the main UK-wide parties racked up lacklustre scores, between eight and 10 out of a possible 30, with the exception of Reform who barely scraped in above nil points.

So, let’s take a closer look at how they ranked.

Labour: 10/30

Coming in joint first with the Lib Dems, the Labour Party – polling as the favourite to form our next government – score particularly well on their commitment to tackling violence against women and girls.

Their manifesto includes mention of all but three of the researchers’ 15 priority areas for tackling women’s health, meaning they cover more of the key issues than any other party. But WHAM would have liked to see more emphasis and funding given to most of them.

The Labour Party’s pledges include providing safer maternity care and tackling racial disparities in maternal mortality. But there’s no mention of improving care and support for women’s health prior to conception or postnatally.

Liberal Democrats: 10/30

The Lib Dems score highly on plans to tackle violence against women and girls, and on providing affordable early years and wraparound childcare to support mothers returning to work. But they make no mention of issues like the gender pay gap, or ensuring the impact of economic policies on women is considered.

They score higher than Labour on ensuring healthcare policies reduce racial and gendered health inequalities – including a pledge to protect reproductive choice – but lower on setting specific targets to tackle racial inequalities in maternity care. And, like Labour, they make no mention of improving preconception health or postnatal support.

Conservative: 8.33/30

As the architects of the Women’s Health Strategy, the Tories are the only party to mention continuing the roll out of Women’s Health Hubs – one of the strategy’s flagship policies – to improve access to expert care for menstrual, reproductive, menopause and lifelong health issues.

However, the Government’s efforts to establish this network of ‘one-stop-shop’ women’s health clinics has so far been underwhelming, and criticised for a lack of sustainable, ring-fenced funding.

The Tories get the worst score of all the parties for ensuring its healthcare policies address racial and gendered health inequalities. But they score higher than Labour and the Lib Dems for pledges to improve postnatal care.

On wider policies affecting women’s health, they rank well for pledges on affordable childcare and tackling violence against women, but make no mention of equal pay or considering the impact of economic policies on women.

Green: 8.33/30

Early in June, the Green Party was roundly criticised for its ‘irresponsible’ policy on reducing caesarean rates and promoting birth as a ‘normal, non-medical’ event. The policy was hastily deleted from the party’s website and doesn’t appear in their general election manifesto, but will have left a sour taste for many mums and mums-to-be.

Disappointingly, their manifesto makes no specific mention of women’s health, focusing instead on more general NHS policies – but WHAM researchers were satisfied that these address key priorities like tackling safe staffing levels and reducing waiting lists.

The Green Party manifesto mentions several of the wider social determinants of women’s health, including tackling violence against women and girls, improving access to safe and affordable housing, and providing affordable early years and wraparound childcare.

On economic factors, the Greens equalled Labour’s score on equal pay and ensuring the impact of economic policies on women is considered.

Reform: 0.67/30

Perhaps not a huge surprise, Reform score less than 1/30 for the impact of its manifesto pledges on women’s health.

Nigel Farage’s party was given more minus scores than any other party, including for whether its healthcare policies would tackle racial and gendered health inequalities, and its plans for childcare – again, not hugely surprising after the party’s Deputy Leader described mothers going to work as ‘a travesty’.

Most of WHAM’s key women’s health priorities aren’t addressed by the Reform ‘contract’, but there are pledges on tackling NHS waiting lists and staff shortages, as well as ending the housing crisis. There’s not a lot else to say about it, really.

Devolved nations

Plaid Cymru: 8.67

Slightly outranking the Tories and Greens overall, Plaid Cymru got its top scores (like many of the parties) for policies on improving childcare and tackling violence against women and girls.

Scottish National Party: 6.5

Ranking lower than most of the main parties, the SNP’s highest score was also for providing affordable early years and wraparound childcare.

Democratic Unionist Party: 3

Finally, the DUP in Northern Ireland scores just 3 out of 30, including a minus score for its policy opposing access to abortion services.

The experts’ verdict

In general, the WHAM analysis concluded, the parties address two issues well: childcare and supporting mothers returning to work, and tackling violence against women and girls.

All the main parties also include a general commitment to reduce NHS waiting times, but none specifically mention gynaecology, where the waiting list grew by more than any other specialty during the pandemic.

Inclusion of women in medical research and clinical trials don’t feature in any of the manifestos, and several other issues – including decriminalisation and access to abortion, improving preconception care, and ensuring policy is built in consultation with women – are considered by none or only one of the major parties.

So, while some parties scored better than others, the unconvincing scores across the board prove there’s no room for complacency when it comes to getting the healthcare we deserve.

‘There’s still a risk that women’s health in the UK could fall off the political radar,’ says Dr Womersley.

Well. Not on our watch.