The subject of women’s health and what shapes our understanding of it is complex. Healthcare systems are shaped by the societies that create them, and historically those societies have not treated everyone equally – particularly when it comes to women.
This article will look at:
• the history of how women’s health has been understood
• the role the National Health Service has played in improving women’s health
• and the challenges we face today through inequality, privatisation and distrust in health systems.
We can only briefly touch on some of the themes, but I hope it encourages people to read more and write more on the issues raised.
THE HISTORICAL ROOTS OF WOMEN’S HEALTH INEQUALITY
For centuries medical theory framed women’s bodies as fundamentally unstable or irrational.
Diagnoses such as ‘hysteria’ were used to explain a wide range of symptoms in women, from anxiety to chronic pain. The legacy of medical thought, as sanctioned by religion, saw women and women’s bodies as deviant, inferior and defective, always governed by the whims of the womb. It wasn’t just the unruly womb that was seen as problematic, but the assumption was that this led to women being emotionally unstable.
These underlying assumptions shaped and continue to shape research priorities and clinical practice.
For example, for decades medical trials largely excluded women because their hormonal cycles were considered ‘too complicated’ for research. As a result, many drugs and treatments were tested primarily on male bodies.
Even today, women are around 50% more likely than men to receive an initial misdiagnosis following a heart attack, because the symptoms women experience can differ from the malecentred medical model.
These examples, and numerous others in regard to physical and mental health treatment, demonstrate how the myths and biases surrounding women’s physical and mental health are built into health systems.
THE CREATION OF THE NHS: A VICTORY OF THE LABOUR MOVEMENT
The biggest positive change in relation to women’s health was the creation of the National Health Service in July 1948. It was one of the most transformative social achievements in British history.
The NHS was established by the Labour government elected after the Second World War. Often, the creation of the NHS is taught in schools as part of a so-called ‘post-war consensus’, as if all political parties agreed on it; but that isn’t true.
The Tories opposed the creation of the NHS and voted against the NHS Bill 22 times during its passage through Parliament. There were also political battles inside the Labour movement itself between those who supported the creation of a universal public health system and those who opposed it. It was created by a movement based on working-class struggle and protest; 1944 marked the peak of wartime strike action, with over two thousand stoppages involving the loss of 3,714,000 days' production.
So the NHS was not the product of consensus – it was the result of class struggle and political pressure from the labour movement.
Its purpose was explicitly social and collective. The founding legislation placed a clear duty on the Minister of Health: to establish a comprehensive health service designed to improve the physical and mental health of the population, and to provide those services free of charge at the point of use.
That principle transformed lives.
Before the NHS, working-class families often delayed or avoided medical care because they simply could not afford it. For working-class women in particular, the impact was enormous. The NHS expanded access to maternity care, reproductive health services, vaccinations, cancer screening and general healthcare. Maternal mortality fell dramatically across the twentieth century, and access to healthcare was no longer dependent on income.
The NHS represented a fundamentally different idea of healthcare – not as a commodity, but as a social right.
STRUCTURAL BIAS IN HEALTHCARE SYSTEMS
However, even within the NHS, structural biases remained.
Healthcare systems were largely designed around male bodies, male employment patterns, and male health risks.
Historically, clinical trials relied heavily on male participants. This meant that diagnostic standards and treatment protocols were often based on male physiology.
The result is that women’s symptoms are still more likely to be dismissed or misunderstood.
In mental health care, women’s symptoms are often framed through emotional instability or hormones rather than receiving full diagnostic assessment.
This contributes to conditions such as autism and ADHD being underdiagnosed in women, because diagnostic criteria were historically developed around male presentations.
Even though, as mentioned previously, the focus was on women’s reproductive role, this doesn’t mean that it is properly funded or that provision is good. In the UK, maternal death is rare, but it remains a serious indicator of inequality. Recent data shows that around 13 maternal deaths occur per 100,000 pregnancies in the UK. What is even more striking is the inequality within those figures.
Research monitoring maternal deaths across the UK shows that Black women are nearly three times more likely to die during pregnancy or shortly after childbirth than white women, and women living in the most deprived areas have almost double the risk compared with those in the least deprived areas.
On 26 February 2026, an interim report from the National Maternity and Neonatal Investigation Committee found that maternity services in England are failing ‘too many’ families, with problems ‘at every stage’ of the maternity journey.
Racism, staffing and accountability issues were among six factors identified so far by the review. The findings included: Services depleted or stopped because of capacity pressures, with stretched antenatal wards and delivery units resulting in delays to admissions and the use of community midwives in delivery units impacting safety.
‘Poor relationships’ between team members, including obstetricians and midwives. Racist and bullying behaviour of senior clinicians was not always dealt with by management.
Structural racism and persistent inequalities leading to ’notably higher risk of adverse outcomes’ for women from Black and Asian backgrounds and women from more deprived areas. Discrimination against disabled women, Muslim families, refugee and asylum women and LGBT families was also reported.
A lack of compassion and transparency when baby loss and harm occurs, which can lead to mothers wrongly blaming themselves, compound trauma and impede opportunities to learn from mistakes.
Care being delivered in outdated and dilapidated buildings, in some cases compromising clinical care. Bereavement spaces were insufficient or nonexistent in some trusts.
Staff reporting maternity units did not have enough personnel to provide safe care.
INEQUALITY AND PREVENTIVE HEALTHCARE
Health outcomes are also shaped by the inequality that is seen in the provision of preventative health care.
For example, breast cancer screening programmes aim for around 70% uptake across the population, but in many areas with higher deprivation or larger Black and Asian populations, screening uptake falls below that level.
Barriers include language access, working hours, cultural barriers, and distrust of institutions.
Women living in the most deprived communities are significantly more likely to be diagnosed with cancer at a later stage.
So, healthcare inequality is not just about treatment – it’s about the social conditions that determine who can access care in the first place.
AUSTERITY, PRIVATISATION, AND NHS REFORM
Over the past 40 years, political changes have increasingly reshaped and undermined the provision of universal health care.
One major turning point was the Health and Social Care Act 2012. This legislation significantly expanded the role of market competition within the NHS and opened more services to private providers. At the same time, austerity policies led to cuts across the healthcare system.
The NHS transformed the lives of working-class people, particularly working-class women’s lives, by establishing healthcare as a universal right; but that achievement was not inevitable, and it is not guaranteed to last.
Cuts to services such as sexual health clinics, reproductive healthcare, community services and mental health support have disproportionately affected women – as patients, carers and staff.
More recently, the Health and Care Act 2022 introduced further structural changes to the organisation of NHS services.
While presented as improving integration between health and social care, the reality is that these reforms continue to expand the role of private providers and reduce democratic accountability within the health system.
Keep Our NHS Public provides important statistical analysis of this. They show that in some of the 42 integrated care boards, the percentage of funding going to private health care providers is as high as 25–35%. They also provide details in regard to, amongst other things, the vast amount of money being spent on IT contracts, the proportion of funding given to private hospitals in elective care, and funding given to private providers of specialist diagnostic services such as autism and ADHD assessments.
Notably the attacks on trans healthcare and particularly bans on access to puberty blockers haven’t only increased transphobia and discrimination against trans people, but have also led to the creation of private companies who will, under some conditions, give access to the required medication but only at a huge cost. So, drugs that are cheap and safe only become accessible to those who can pay for them, and it means another sector of private healthcare grows.
Together, these changes represent a shift away from the founding principle of the NHS as a fully public, comprehensive service.
THE COMMERCIALISATION OF HEALTH
Alongside these political changes, we have seen the rise of private clinics, online healthcare platforms, and the rapid growth of the wellness industry.
Globally, the wellness market is now estimated to be worth over $4 trillion.
Many of these products are marketed directly at women — supplements, hormone tests, detox programmes, fertility tracking apps, and anti-ageing treatments. Most of these are expensive, poorly regulated, and promoted through social media rather than scientific evidence.
Health is increasingly presented as something individuals must purchase and manage privately rather than something society provides collectively.
DISTRUST AND THE POLITICS OF HEALTH
At the same time, political polarisation and the rise of far-right movements internationally have contributed to growing distrust in medical institutions as well as the more obvious attacks on abortion rights.
While critical scrutiny of healthcare systems is necessary, extreme distrust can lead people to reject beneficial care such as vaccinations, screening programmes, or medical treatment.
This rise of the far right harms public health and creates a toxic environment of unscientific, irrational thought that paves the way for further attacks on public health provision.
CONCLUSION: REBUILDING A PUBLIC HEALTH SERVICE
Women’s health is not just about biology, it is about history, inequality, politics, and the organisation of healthcare systems.
The NHS transformed the lives of working-class people, particularly working-class women’s lives, by establishing healthcare as a universal right; but that achievement was not inevitable, and it is not guaranteed to last.
It was won through struggle, and it can only be defended and rebuilt through struggle.
If we want to protect women’s health, we need a renewed movement:
• That defends the founding principles of the NHS. That means reversing the market reforms introduced by the Health and Social Care Act 2012 and the Health and Care Act 2022, and rebuilding a health service that is truly comprehensive, publicly provided, and free at the point of use.
• That tackles the inequalities and biases in research and in health provision.
• That scraps all the anti-trade union laws that stop us from organising to defend services and improve the pay and conditions of those who work in health.
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