Reva Gudi: Our politicians have a responsibility to cultivate a better public understanding of the NHS | Conservative Home

Dr Reva Gudi is a GP, and former Conservative parliamentary candidate for Feltham and Heston.

Reading the headline, “Medical misogyny sees women told to “put up” with pain” felt like a punch to the gut.

This alarming message is from the recent BBC news coverage, which references the report from the parliamentary Women and Equalities Committee, led by Labour MP Sarah Owen, raises serious allegations against GPs as primary healthcare professionals.

In particular, it suggests that “systemic misogyny” is at the heart of women’s healthcare struggles. This paints an image of healthcare professionals driven by misogyny: hatred or the belief that men are superior to women. This is deeply troubling.

The report states that a common theme in the evidence received was that of women’s pain being dismissed, not just due to a lack of understanding as to what might be causing it but because of a lack of empathy and “medical misogyny”. Women reported not feeling listened to and being “gaslit”, especially when accessing NHS services about a gynaecological issue that included pain.

Whilst I agree that gender bias certainly exists amongst some healthcare professionals, as it does across society, and that unconscious bias and lack of awareness regarding women’s health conditions may contribute to the difficulties some women face, for politicians to label this as acts of “systemic misogyny” is a sweeping and unwarranted accusation against an entire profession and is unjust, harmful and irresponsible.

If such rhetoric is promoted to the public, it risks instilling unnecessary fear and mistrust making the jobs of healthcare providers more difficult; the very people who have dedicated their lives to patient care. The morale of healthcare professionals is critical in an already strained healthcare system that demands our collective collaboration and constructive engagement.

This damaging narrative of failure within the report overshadows the countless number of women who are treated successfully in primary care, knowing that heavy menstrual bleeding and pain are conditions we see commonly in General Practice.

As a practicing GP for over 25 years, and a former senior healthcare commissioner and non-executive director on the board of a major NHS Trust, I find other conclusions and recommendations in the report both unsurprising and welcome.

There is a recognised need for greater investment, adequate resources, support for research, acknowledging the immense pressures our healthcare system is currently under, and why fragmented commissioning poses a challenge to delivering quality care.

The struggles of women with gynaecological conditions such as heavy, painful periods, endometriosis, adenomyosis, Polycystic Ovary Syndrome (PCOS), and Premenstrual Dysphoric Disorder (PMDD) are genuine and should never be dismissed, and indeed as doctors we must always reflect on and challenge attitudes and behaviours where there is a need.

However, the report, sadly, lacks both nuance and a comprehensive understanding of clinicians, the world of healthcare, and its delivery. It offers a limited, one-sided view of what happens in the consulting room and fails to acknowledge the complexity of the system and the genuine efforts and frustrations of countless healthcare professionals striving to provide compassionate care.

The report is critical of GPs for managing these symptoms without a definitive diagnosis. The reality is that often women can present early, with symptoms and we manage them using established treatment protocols, skilfully, and with pragmatism. It may require several consultations to determine what works best for my patient, which in the report is misconstrued as, delaying referral to a specialist, or lacking education.

It is important to point out that the workforce has a higher percentage of female GPs, and often women prefer to see a female GP, and yet, within the report, there is one example of a male GP perceived to be failing a patient with symptoms. I leave the readers to draw their conclusions.

The contradiction in the report’s recommendations further complicates matters. It criticises GPs for focusing too much on symptom management rather than diagnosis, warning that this approach could lead to disease progression with life-altering consequences. Yet, GPs are urged to put more effort into the “pre-referral” pathway, advocating for more women and girls to be treated in the community, while those on waiting lists should be reserved for more severe cases requiring invasive procedures or surgery.

The contradiction here is glaring: GPs are being asked to both improve diagnostic accuracy, with the diagnosis often being made by a specialist and invasive investigations, and at the same time being asked to manage more cases in the community, and being vilified for “referring late”.

The recommendation to incorporate specific performance indicators, on the diagnosis and treatment of women’s reproductive health, in the GP appraisal process, is another troubling aspect. While keeping up to date and continuous professional development is crucial, no matter how busy, the purpose of annual appraisals should not be about micromanaging the specifics of patient care and scrutiny. The focus must be dedicated time for the practitioner to reflect on the year, his or her health and well-being, and overall personal and professional growth and development.

The report asserts that, “The NHS must do more to monitor and enforce protocols. A risk assessment that allows a patient to make an informed choice on the recommended procedure should be undertaken as standard, accounting for any relevant medical and personal history. This should include consideration of the full range of options on pain relief, including anaesthesia.”

This not only reflects a complete misunderstanding of patient care but is sanctimonious and ignorant. Monitoring and forcing protocols undermines the role of clinical judgment and real-world experience by treating patients as mere metrics rather than individuals. Established guidelines are used widely, and referrals in many places are vetted, in the knowledge that clinicians will at times refer outside the standard pathway often for very good reasons.

Seeking informed consent and discussions of options available, are practices foundational to ethical healthcare delivery, and where they are insufficient, with gaps, we must focus on addressing them.

Additionally, proposals such as reimbursing women for travel costs to access healthcare further afield are impractical, given the current financial constraints on the NHS. While the intention to eliminate barriers to care is commendable, such recommendations often disconnected from the realities of healthcare funding and logistics.

I also fail to understand how this will not be thought of as discriminatory to others who face barriers to accessing care. We need systemic improvements, not short-term solutions, and crystal clear clarity on how and where the taxpayer’s money is best spent.

Through my recent engagement in politics as a parliamentary candidate for the party and background, I understand the challenges faced by politicians and policymakers. I empathise with their dilemmas. As a reflective clinician, I fully acknowledge that there are undoubtedly areas where we can and must do better for our patients.

Yet I assert that our politicians have a responsibility to present balanced, evidence-based perspectives, that lead to accurate conclusions and meaningful recommendations, grounded in reality. The damaging rhetoric of “medical misogyny” alienates GPs and primary care professionals, who are already working under immense pressure, as gatekeepers, managing the resources available.

It also demonstrates poor understanding of expectation management, and difficulties these narratives present to those like me on the front line. Instead of perpetuating unfounded, divisive, and damaging narratives, we must cultivate a better understanding amongst healthcare professionals, politicians, policymakers and the public, striving towards an NHS and healthcare system that serves us all effectively and compassionately.