Chamber and committees

I thank Ruth Maguire for securing parliamentary time today for such an important topic.

Margaret Atwood said:

“A word after a word after a word is power”.

Everyone should be free to read and write, but women and girls in Afghanistan face what Human Rights Watch describes as

“the world’s most serious women’s rights crisis”.

What the Taliban is doing to women is spine chilling. As one Afghan woman said, the Taliban

“want us to die while we’re alive.”

It really is a real-life “The Handmaid’s Tale”. However, women will not be silenced. The 21 female writers in Afghanistan who authored “My Dear Kabul” after the capital fell showed tremendous courage. The organisation Untold Narrative supported those courageous female writers and others to share their stories beyond the walls of their home and the borders of their war-torn country. That bravery shows the power of the pen, and the importance of freedom of expression.

Since I was elected as an MSP, back in 2021, freedom of speech has loomed large over the political landscape. Legislation such as the controversial Hate Crime and Public Order (Scotland) Act 2021 has facilitated discussion and debate over the balance of rights and the important question of who decides—who actually decides.

In December 2022, I attempted to attend the screening of the documentary “Adult Human Female” at the University of Edinburgh. I was shocked at the vitriol and aggression from the protesters who succeeded in preventing the screening from taking place on multiple occasions. Freedom of speech was censored in the very environment where it should be sacrosanct.

We have seen gender-critical female writers in Scotland such as Magi Gibson and Jenny Lindsay ostracised by publishers and Scotland’s cultural community for criticising gender identity ideology. In her latest book, “Hounded”, published by Polity, Jenny Lindsay has written about the human cost of speaking out and the cultural authoritarianism that she is experiencing and has experienced in Scotland. She said:

“the harms women face for speaking out are both disproportionate and anathema to the project of social, liberal democracy.”

Jenny is right. What is happening represents a slippery slope towards censorship and repression, and it is happening in Scotland. I thank Scottish PEN for issuing a robust defence of Jenny, calling out the culture of fear that has pervaded online communities and has prevented healthy criticism and debate.

It is often writers who are unwilling to surrender to moral cowardice, but they are also the ones who bear the human cost of refusing to stay silent. That cost might involve the loss of income, credibility, professional opportunity and their peers—or, as Ruth Maguire’s motion notes, it can mean persecution, imprisonment and death. We must speak out and we must stand against what is happening, and, ahead of the day of the imprisoned writer, we must remember all those writers who have lost their freedom and who have lost their lives for speaking freely.

Will you explain what the current problems are in relation to accessing legal aid for environmental cases in Scotland?

As you say, those with the right to access legal aid do not include community groups. I should declare that I have spoken to environmental groups such as Save Our Mearns and Angus Pylon Action Group. What is your view of their right to access legal aid in relation to energy infrastructure?

In relation to the point about not being able to access legal aid, what is your view of the right to a public inquiry for community groups being taken away? I am particularly interested in cases where productive farmland, or the health and wellbeing of communities, is negatively affected. What is your view of the justice of that?

Professor Reid, you spoke about a lack of justice and unfair cracking of the whip. Do you have a view on this topic?

Do any other witnesses want to say anything about that subject?

Thank you. Unless you have deep pockets or get pro bono advice, there is no legal aid, so you are stuffed, really. You are nodding your heads. Thank you. Back to you, convener.

Does Carol Mochan agree that there needs to be a separate road map for women and that the women’s health plan needs to be sex specific?

As the first women’s health plan comes to an end, I welcome the opportunity to take stock. I thank Jenni Minto and her team for the cross-party working that they have undertaken so far. It has been constructive, so I give praise where praise is due.

I also thank Professor Anna Glasier, who is in the public gallery today, for her leadership. I have enjoyed our lively conversations and I have valued Professor Glasier’s frankness, expertise and insight. Eighteen months—and just four days a month—was precious little time in which to deliver on the ambitions for the women’s health plan, so I am pleased that Professor Glasier will remain in post. If only the SNP had appointed her sooner and had not left the plan in limbo for so long. The minister would probably expect me to say something like that.

Throughout the life cycle, from menstruation to menopause, a woman is adapting and adjusting to major changes in her body. She is also contending with a healthcare system that, as Caroline Criado Perez’s “Invisible Women” describes, is

“systematically discriminating against women, leaving them chronically misunderstood, mistreated and misdiagnosed”.

Too often, women do not feel heard. Too often, their legitimate concerns are dismissed. We should not have to put up and shut up when it comes to pain. Healthcare cannot be one size fits all. The male default bias has dominated the diagnosis and treatment of women for far too long.

MSP colleagues might want to dodge the bullet on this, but healthcare must be sex specific. That is why women’s health needs require a completely separate road map, a dedicated advocate and rigorous oversight in the long term. That is why data in the NHS matters, and it is why objective and immutable biological sex must be recorded on medical records. Terms such as “chest feeders” perpetrate the erasure of women in healthcare in the name of so-called inclusivity.

The Scottish Conservative amendment drills down into the failings in women’s healthcare that have occurred under the SNP Government. The reality is that, under the SNP, women’s healthcare has worsened. Waiting times for vital services such as women’s reproductive health, cardiac care and cancer screening and treatment are unacceptably high. Earlier this year, more than 500 women in NHS Grampian with suspected breast cancer had to travel more than 125 miles for diagnosis because the health board could not meet demand. The centralisation of maternity services in rural areas such as Stranraer and Moray is forcing prospective parents to travel for more than an hour and a half. There is an alarming postcode lottery in the provision of perinatal mental health services, and a simple test for pre-eclampsia is only just being rolled out by health boards, thanks to proactive campaigning by the charity Action on Pre-eclampsia, years after its roll-out in NHS England.

The SNP cannot reduce the gender health gap if healthcare in Scotland is inaccessible, but that is the stark reality for too many. After two years as the shadow minister for women’s health, I recently took on the equalities brief and joined the Equalities, Human Rights and Civil Justice Committee. It is clear from our pre-budget scrutiny that budget decisions are made from a central-belt perspective, without thinking about policy coherence or the bigger picture. The centralisation of NHS services is having a negative impact on women in rural communities, with my constituents having to travel from outlying Forfar to Dundee to have a simple intra-uterine device fitted. Gender and geographical inequalities are becoming further entrenched under the SNP’s centralisation agenda.

I have been working with the north-east endo warriors, and I recently met representatives of Endometriosis UK regarding the distressingly long diagnosis time for endometriosis. There is growing awareness of this debilitating condition, but training and education are not enough. I have been told that the waiting list for diagnostic tools such as laparoscopy is two years at minimum. That urgently needs to change—two years is just not good enough.

As we look to the next iteration of the plan, I welcome Professor Glasier’s commitment to prioritise pelvic floor rehabilitation. From relationships to participating in sport, the physical and emotional impact of pelvic organ prolapse on women is absolutely horrendous. The minister asked for examples, so I would like her to look at countries such as France, where women are automatically offered pelvic floor therapy as part of their post-natal care. In Scotland, women are told to do Kegel exercises and wear Tenor underwear—it is an absolute disgrace.

This is not just about reducing the gender health gap; it is about how women experience the healthcare system and how that system supports them through their whole life cycle so that they can live happy, productive and pain-free lives. To achieve that, Scotland’s NHS must be efficient, reliable and accessible for all women, always. We have a long way to go.

Will the minister take an intervention?