Woman's Hour - England's Lionesses Quarter Final against Spain; Women's Health Strategy; Women and the Web;

Episode Date: July 20, 2022

Today the government launches its much awaited Women’s Health Strategy for England. For generations women have lived with a healthcare system that is designed by men, for men. Despite making up 50 percent of the population and living longer than men, women have been under-represented in research, with little known about some female-specific issues, spending a greater proportion of their lives in ill health and disability, with growing geographic inequalities in women’s life expectancy. Having spoken to nearly 100,000 women the government say this will reset the dial on women’s health. Krupa Padhy speaks to Women's Health Minister Maria Caulfield and Dame Professor Lesley Regan the newly appointed Women's Health Ambassador.Tonight England's Lionesses will take on Spain in the quarter finals. The two teams will go head to head in Brighton, in what will be the first knockout game of the tournament. Although both are strong teams, England and Spain have previously competed against each other 15 times resulting in the Lionesses winning twice as many games as their opponents. England have also been scoring more goals than any team has ever done in the group stage. BBC Women's Sport Reporter, Jo Currie gives us an overview of the brilliant Lionesses taking to the pitch this year. Tim Berners Lee is often credited as the inventor of the World Wide Web. But who are some of the women who played an instrumental role in building the internet and the technology that surrounds it? We hear about Karen Spärck Jones, Sophie Wilson and Hedy Lamarr. And with a fifth of women in the UK experiencing online harassment and abuse, how can the internet be made more friendly to women? Krupa Padhy speaks to Charlotte Webb, who teaches internet equality at University of the Arts London and is the co-founder of the Feminist Internet and to Dame Stephanie Shirley who founded an all-women software company in the 1960s.Presenter: Krupa Padhy Producer: Kirsty StarkeyInterviewed Guest: Marie Caulfield Interviewed Guest: Dame Professor Lesley Regan Interviewed Guest: Catherine Burns Interviewed Guest: Jo Currie Interviewed Guest: Dame Stephanie Shirley Interviewed Guest: Charlotte Webb

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2. And of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme. Peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hello, this is Krupa Bhatti and you're listening to the Woman's Hour podcast. Hello, welcome to the programme. Much of the next hour is going to be dedicated to talking about the publication of England's first women's health strategy. It's aimed to tackle the gender gap with more training for doctors, more cancer checks and one-stop hubs across the NHS.

Almost 100,000 women spoke up sharing their experiences of healthcare in England. And we want to continue that conversation and hear from you. Are you a woman who has had to push to have the healthcare that you need? Do you feel like your concerns

have been taken seriously by medical staff? What do you want to change? You can text Women's Hour on 84844. Over on social media, you'll find us at BBC Women's Hour on Twitter and on Instagram. And of course, you can always email us through our website. Dame Lesley Regan, the first ever Women's Health Ambassador for England and the Women's Health Minister Maria Caulfield will join us too. Also, a big evening ahead for England's lionesses as they enter the knockout stages of the Euros. It's the quarterfinal and they're up against Spain.

Our correspondent will tell us how the team is holding up. And this question for you, what if the internet was run by women? Would it be a very different place? We will discuss. For generations, women have lived with a healthcare system that is designed by men for men, said Nadine Doris, then the Minister for Patient Safety, Suicide Prevention and Mental Health. That was back in March 2021. And despite making up 50% of the population and living longer than men, women have been underrepresented in research. They spend a greater proportion of their lives in ill health with growing geographic inequalities in women's life expectancy. Promising to reset the dial on women's health, the government has said it would create the first government-led

National Women's Health Strategy for England. Nearly 100,000 women have come forward since April 2021 and they've shared their healthcare experiences. And we now have those results, the launch of the government's much-awaited Women's Health Strategy for England. I am joined by Women's Health Minister Maria Caulfield and

Dane Professor Leslie Regan, the newly appointed Women's Health Ambassador. Welcome to you both. Good morning. Good morning. Good morning. But first, let's hear from our BBC Health correspondent, Catherine Burns. Good to have you on the programme, Catherine. I've touched on it there, but can you expand on why we need this specific women's health strategy? It's a really good question because a lot of people will always throw the statistic at you that men have shorter life expectancies than women. So why do we need this? So let me throw some other stats at you.

Women tend to spend over a quarter of their lives in poor health. That's compared to a fifth for men. They also tend to be affected by disability at an early age. They spend more time off sick than men. In fact, right now, if you were to look at the numbers of men and women who are off long-term sick, there's more than 100,000 extra women who are off sick than men. So ministers are saying, you know, the NHS belongs to all of us,

but women are 51% of the population. They have obstacles getting their care and they want to right these wrongs. It makes for grim listening hearing you read out those numbers. So we've got this strategy now. What is it exactly setting out? Do you know what? I think it's important to start with how this all came about. So you touched on that consultation then of about 100,000 people getting in touch in England.

To give you a bit of context, the last four government consultations this year have had about 7,000 responses. So ministers will say, you know, they were quite overwhelmed by the response they got here. And the message that came through loud and clear was that women do not feel listened to. 84% of the people who spoke about their experiences said that healthcare professionals don't listen to them. And they gave tens of thousands of stories of testimonies of not feeling listened to, having their symptoms dismissed, having pain dismissed. I've been out speaking to women about this. One of them said to me, you can either have a vagina or a voice, you can't have both. So this strategy is an attempt

to sort all of that out. And let's face it, that is a lot. The overarching aim and ambition is to boost health outcomes for women over 10 years. The phrase you're going to hear a lot today, I imagine, is a life course approach. So this is everything a woman needs all the way through her life. Now, let me just give you a few of the specifics. They're going to try and get better access to IVF, especially for female same-sex couples. There's something about baby loss. So if parents lose a baby before 24 weeks of pregnancy, if they want to, they'll be able to get this recognised with a pregnancy loss certificate. There's going to be an attempt to make sure endometriosis services have the most up-to-date advice so patients can expect a better

standard of care. But what there is not is a lot of new money. So there's £10 million that's been put forward for breast cancer screening, that's targeting women who aren't coming forward for their mammograms. But £10 million over a 10 year strategy, that's not a lot so far. So that's the upfront money. And you talk about an approach that will essentially help women at every stage of their lives. What does that exactly mean? Because women are different. Yes. And the strategy does recognise that. So it has specific measures for women at various stages.

But one thing I think is really interesting is the idea of women's health hubs. So there isn't really anything happening on that scale right now. There's a handful of places that focus on maybe just one thing. So I went to one recently in Liverpool. This is a hub that focuses on contraception. So it makes it easier for women to come forward and get long-acting contraception, so coils and implants. And it's really working.

Since they've started, they've seen a 30% uptake in the number of women accessing it. But if you read the strategy carefully, look at the wording here, it says one of its top commitments is encouraging the expansion of women's health hubs around the country. Encouraging doesn't mean funding. Now, Dr Stephanie Cook is the clinical lead here. She's got big plans to expand this hub to other areas areas but also she's got some very real concerns about how she's going to make that happen. So we're really thrilled to being able to improve access for women and provide these services closer to home and to see more women coming through these women's health hubs. What we want to do now is add in other services

so that we can provide help withnd drwy menopws, a phobl sydd angen gwasanaethau iechyd eraill, fel newidiadau pwysau a phobl sy'n mynd drwy heriau eraill. Rydyn ni eisiau darparu gofal cyd-drech arnynt. Yr hyn rydyn ni wir angen yw cymryd cymorth, ariannu, ariannu, now is increased support, funding, finance, education, so that we can make this happen. Catherine, do stay with us because I do want to return back to you, having heard the conversation

that we are about to have with Maria Colfield, Minister for Women's Health, and also Dame Professor Lesley Regan, the newly appointed Women's Health Ambassador. Maria Colford, let me start with you. We've just heard that clip there, the call for increased support, funding, finance and education. That is what is needing. Is that what this strategy is going to deliver? So, you know, it is a 10 year strategy. One of the areas that we want to look at is the women's health hubs. I think there are exciting opportunities there because these are hubs that are staffed by people who have got an experience and interest in women's health.

So hopefully women will feel when they go to them a very different experience to what they reported in the call for evidence. What we want to do with the ones that have started already is to evaluate that experience and to show the difference that they do make. And obviously then that will, you know, if we're able to demonstrate the difference it makes, and we've heard in your report that it seems to be already getting increased attendances and they want to develop extra services. If we can show that, then then we can go to Treasury and look for extra funding in the lifetime of this strategy. So I think, you know, we're starting to make those small changes that will have a ripple effect over the whole lifetime of this strategy. And you mentioned funding, and I do want to unpick some

of that a little later in our conversation. But Leslie, let me bring you in here. What will this strategy mean for women as someone who has dedicated her life to the healthcare of women? What do you think it's going to change? Well, I think it's going to change a lot. And you emphasised in your introduction, Grupa, that everyone was rather overwhelmed by the massive response of over 100,000 submissions to the public consultation. And I think an enormous, a lot of progress has already been made in women feeling that they have been listened to. And now, of course, they want to see action. And I think that what Maria was just saying about using women's health hubs is important. But I think what I'd like to emphasise

is it's not so much about new money, but it's about using the services that we're already funding more efficiently. So when I go and see the things that I need to do to keep myself healthy as a woman, they're not complicated. And my problem is often accessing them in the same place. Because of our historical commissioning, we've often got things, we know we're often making women move around lots of different facilities to do things that could be sorted out in an hour in the same place if we catered for them and their needs and wrapped the services around them. So I really do think that we could do better for less if we were able to think about women's needs

and ensure that they access these maintenance services easily. Because most of the time that women visit healthcare professionals, they are not ill. They are merely trying to do maintenance things. You mentioned accessing contraception. Lots of the contraceptive products that are currently available to us are the mainstay of managing heavy or painful periods. And as we've heard over the last six months or so, there's a lot of women who would like to be able to access help for their menopause. And one of the other things that I think this strategy has

focused very clearly on is trying to make, or you know, we won't try, we will ensure that the NHS website becomes the go-to place for women and health professionals to gain the information they need. Because at the end of the day, women's health needs are predictable. And that's what this life course approach is all about. You can map out on a sheet of paper what you need and I need. And I think what we should aim to be doing is ensuring that the resources we have, those existing resources more efficiently, where have we been going wrong? Because the UK is found to have the largest female health gap in the G20 and the 12th largest globally. That is stark. Is this going to make a difference if, as Leslie says, the emphasis should be in part on using what we have more efficiently. Yeah, no, absolutely. And I think, you know, we heard from women that the system currently,

you know, their frustration is it doesn't listen to them when they come forward and ask for help with their healthcare needs. And the system actually doesn't, you know, reach out to them in their communities. Women have to kind of really push to get uh seen uh and the health uh hub example is is one of of that coming out to women uh and helping them if you look at the the commitment in the women's health strategy around cervical cancer for example um that's about using existing resources we could eradicate cervical cancer um if the uptake of the vaccine is is strong with with young women there are certain groups of young women who are not coming forward with the vaccine.

There are certain groups of young women, or all women, not coming forward and having their cervical smear tests. And some of the exciting work that's been done is around kits that you can do your cervical smear at home. So this is about changing the culture and the emphasis and trying to reach out to women. These are women often juggling jobs, young families, caring responsibilities.

And unless we make the health service work for them, they'll continue to have barriers seeking help. But can I jump in there, Maria? The steps you mentioned about cervical cancer, are they anything new? Well, you know, certainly around the home screening kits, yes, they are new. There's pilot studies being run in parts of the country, which is showing that for those hard to reach women who don't come forward for their smear test, the uptake is improving. And so, yeah, there are some measures that will make a big difference if we can roll those out nationally. And if you look at some of the other elements in the health strategy around IVF one of the big things is the inconsistency across the country in some parts of the country you can access IVF relatively easily others you can't and

we need to make sure that there's a consistent approach across the country so you know this is about making sure that the health needs that women have, whatever stage of their life they're in, that we make it as easy and as accessible. And we're just simply listening to women. You know, the Ockenden Review, which only reported a short time ago, classic, you know, women weren't listened to during their pregnancy. And, you know, the outcomes, you know, failed them. If you look at the Cumberledge report, similar experiences where women were coming forward, expressing concerns, again, weren't listened to. So it's not just about the services, it's not just about the funding, it's changing the culture that the health service must meet the needs that women are asking for. Let's continue talking about cancer screening. We've had this message from Em who says,

I was told by my GP that my breast lump was nothing because it was painful and because I was 35. I'm now living with incurable breast cancer and I still can't get my GP to take me seriously with my side effects. Thank goodness for my oncology team. Let's talk about breast screening. The headline there is that there is extra funding, £10 million for breast screening.

Can I ask you, Minister, is this a fund that was already there, let's say a COVID backlog, or is this new money? And if it's new money, where is it coming from? So this is new money. It's coming from a fund to try and, we call it OHID funding,

where we're trying to reach out to communities that where screening uptake is not where it should be and it's about taking screening out into communities and making it as easy as possible and obviously our ambition across cancer whether it's breast cancer, cervical cancer, ovarian cancer is to try and get people diagnosed as early as possible because we know outcomes are better the earlier that you are able to diagnose a cancer. So this funding is really, you know, one of many streams of funding to try and improve and open up access to cancer services. You know, I'm very sorry to hear about the experience, you know,

of someone, you know, young being kind of dismissed. You know, we do hear that from women a lot and you know we've opened up rapid diagnostic centres across the country so that if GPs have any doubts they can refer straight into them get a range of diagnostic tests especially to rule out cancer at an earlier stage and then if someone does have cancer to get them into the system as quickly as possible. Okay let me bring Leslie back in here. Leslie, we know that women live on average for longer than men, but they spend more of their life in poor health. And a link to that and in the hope of changing that are these women's health hubs around the country. Can you explain exactly

what they are and how they'll work? Well, I can only at the moment draw on the positive experience I've gained from listening to those or rather visiting and talking to people who are running the ones that have been piloted recently. You mentioned Liverpool, there's some examples in Manchester that I know of, and in Hampshire. And I think you heard, we heard earlier Steph Cook saying that she wanted to, if you like, widen the women's reproductive services or sexual health services that she was currently providing in the Liverpool hub that she's running to other aspects of women's health. So I'm hoping that what we will be able

to do is we'll be able to access breast screening, for example, and other forms of screening, we know that the vast majority of women in this country are actually going to die from heart disease and the complications of osteoporosis and frailty. So there are all sorts of things that we can do if we anticipate what women are going to need. And that, I think, will make a big contribution to the statistic that you've just cited, Grupa, which is that women live longer, but in poorer health., I think, will make a big contribution to the statistic that you've just cited, Grupa, which is that women live longer but in poorer health. And I think there are a lot of measures that we can implement to improve that. Linked to what you were just saying about how these hubs may well be able to provide more support to women's regular needs, contraceptive needs, let's say. There's this email from a GP who says,

I'm a GP with an interest in women's health. We already provide long-acting contraception, managing heavy periods, menopause, bone health, smears. Access to these services should be available at all GPs' surgeries. And that's from Louise. That's a valid point. Why do we need these special women's hubs? Should these services not be inherent in what GPs are already providing, Lesley?

Well, I think there are a lot of answers to that question, because I think what we've got to understand is that GPs are looking after everybody in the population and they're looking after men and women and I don't think it's quite realistic to expect every general practitioner to have a particular interest in the women's health issues. But it's 50% of the population. I agree but that's why I think we need to focus on providing centres where women can go and hopefully the GP light that has contributed to your programme this morning will be one of the leading lights in that. Because, yes, you mentioned that they said that they are providing long-acting reversible contraception. And as I mentioned a little bit earlier, it's not just to prevent unplanned pregnancies that. Long-acting reversible contraception is one of the mainstays to managing menstrual problems, both heavy periods and painful periods.

And that, after all, takes you back to that point about women having more time off sick. One of the commonest reasons to go and see a gynaecologist like myself is because you've got heavy, painful periods. So if we've got the abilities to prevent those symptoms, and we also have information for women that allows them to judge whether they need to seek help or not as well, then I think we're going to be able to keep a lot more of them in work and in education, for example, because it happens to young women as well, and also providing the caring responsibilities,

which they take a very large share of, as you will know. And just to follow up on what you were saying there, Leslie, the idea that it cannot be expected for GPs to take this all on and these women's hubs are going to help in filling that gap. But, you know, we don't really have men's hubs, do we? Well, I think the whole of the health service is actually being built around the needs of men. But I don't want to get really into that argument now because it will sound as I'm being carpy and I'm not. I'm just very, very welcoming. And we know that you're committed to providing better health care for women. So, will sound as I'm being carpy and I'm not. I'm just very, very welcoming. And we know that you're committed to providing better healthcare for women. So, I mean, I'm sure it's something that is playing on our listeners' minds as well. Maria, let me bring you back in on

this. Funding for these hubs, where's the money going to come from? Well, the first few that have been set up, we're doing a valuation to make sure that firstly they are meeting the needs of women and that women are getting better outcomes and there's a range of measures that we'll be looking at but also that it improves the experience for women they they do find them accessible that they are feeling that they are being listened to and so once we've gathered that evidence we're doing the same with family hubs we're rolling out 75 family hubs in the most deprived parts of the country to help new young mums with some of the services they need, whether that's mental health support, advice on breastfeeding, advice on vaccination. And again, we'll be evaluating those. Once we've got the evidence base to show the difference that they make, we can then look for further funding to roll them out more widely.

It might be worrying, though, that you've said on a couple of occasions that you are looking for funding yet we have this strategy but it doesn't sound like the funds are in place. Another listener here has been in touch to say what about funding more research? Yes absolutely so we what we have you know we've already got a quite a large existing funding pot for research the National Institute for Health Research holds. What we find though is that those projects, those research projects, those research studies for women's health are not coming forward. So the lack of funding for research isn't necessarily the issue, it's that we're not getting the research coming through for women's health issues and we're not getting women being targeted to take part in research studies. So, you know, dementia, for example, the largest single killer of women, there's a severe lack of research in terms of women taking part in

dementia research, the funding is available. And what we want to do as part of this strategy is to work with clinicians, researchers, charities, to get them to come forward with proposals, so that the funding that is available for research is being used for women's health. I want to talk about the effectiveness overall of this strategy, considering the current state of the government, because this strategy has gone through the hands of three health ministers, Matt Hancock, Sajid Javid and now Steve Barclay. Why should the public feel like the government is going to see this through when there is so much turbulence within the party right now? And how can you reassure women, Maria, that these bold ambitions are not just going to remain as just that, ambitions? So, you know, as a Conservative government, we're the first government ever to take up the mantle for women's health.

You know, we did the call for evidence. We were overwhelmed with the response. And it just shows that no matter who the health secretary is or who the health minister for women's health is, we are carrying on with that work. And it's an absolute priority for us. And I think it's 51% of the population, a politician of any colour

who ignores 51% of the population will not be forgiven. So I don't think it matters who the health secretary is and who the prime minister is. This will be taken forward because, you know, if you look at the level of interest in debate, whether it's backbenchers, opposition members, members of the government, this is an absolute priority now. And I'm really proud that we're introducing the first ever women's health strategy. We've got the first ever women's health ambassador. And I'm sure

Leslie will be holding everyone's feet to the fire in making sure that the strategy happens so i think we must harness this opportunity and make sure that we do carry it forward but i'm pretty confident that that will happen but specifically speaking you've got a an incoming leader a new incoming leader in a matter of weeks we've got this huge cost of living crisis upon us. And we know that a crisis like this is more likely to impact the most vulnerable women and children. How is the government going to ensure that this cost of living crisis doesn't overshadow women's health? Well, I think, you know, I think if we didn't take women's health as part of that cost of living pressure, then that's missing the main aspect if you look at the family hubs that are part of the women's

health strategy that is targeting the the most deprived communities because we know that there are within the women a female population there are certain groups of women who have got poorer outcomes and we need to focus on those that's why we've set up the maternity disparities task force because if you look at while outcomes for pregnancy are improving you know we've seen a reduction in neonatal death by by 25 there's certain groups of women from either ethnic backgrounds or from deprived areas where those outcomes aren't improving and so we need to be very targeted in that and so the cost of living pressures emphasizes even further that within the female population,

there are certain groups of women that we absolutely need to be laser focused on to improve outcomes. I want to go back to the specifics of the strategy there. Lesley, there's lots of talk about teaching and assessments for all incoming doctors who will be trained in women's health. The first thing that comes to my mind, Lesley, are they not already trained in women's health? What's actually going to change here? Well, this is the medical licensing accreditation that the GMC have promised to introduce in 2024, from 2024. And this is trying to ensure that incoming doctors or newly qualified doctors

appreciate this holistic approach that we're trying to provide for women in this strategy. So to actually put them at the centre and work out what they need so that if a woman goes along to have all these various maintenance checks or needs help with contraception or getting pregnant or her menopause or her problem periods that she'll be able to do that in a single visit and I think there's a there's a lot to be I mean there is women's health conditions are certainly in the syllabuses both undergraduate and postgraduate for training in this country but I think that thinking about women across the life course as opposed to how we can prevent problems developing as opposed to what to do with a condition when they present with it is not emphasised to the extent that we would like it to be or I'd like it to be. So I'm hoping that that's what we will be able to achieve with that. The strategy also talks about a greater focus on women's specific health conditions

including fertility and pregnancy loss as part of the pregnancy loss strategy there is the introduction of certificates for baby loss and of course this cannot take away from the grief that a woman feels at the loss of her baby but what does it change practically for women? Well as you probably know I've spent a large part of my career looking after women with repeated miscarriages and stillbirths so I know that this will be a gesture towards them to recognise the pain and the loss that they've experienced and I think that parents will be particularly grateful that this is going to be brought in because they want to have the recognition of what has happened to them. I think recognition is the key word there.

I'm trying to speed through the many areas of this strategy in the last few minutes of our conversation. This message from a listener who says, GPs always offer women antidepressants. They don't listen. They scoff. They don't refer. My friends often take their husbands and get better services. GPs are not trained in vitamins and minerals which prevent a lot of problems maria a key area identified for focus from your consultation with the public is mental health provision and women as we know are more likely to suffer from mental health problems and the coalition government did promise parity of esteem in this area. Is it addressed in the strategy? Because I cannot see it in the material that we have received so far. So there's separate pieces of work being done on mental health. Of course, it is covered.

It's one of the seven priority areas in the strategy. And whether you look at whether it's young women with body image issues, and we've done work on, you know, Botox, not making that allowed for under 18s, whether thatants when actually um you know a course of HRT uh may be uh more appropriate so there there is definitely a focus on mental health but we do have separate mental health uh legislation uh going through parliament at the moment to overall improve uh mental health so you know the strategy pulls all of this together so there will be often different strands that are going on in tangent with this. So, you know, for example, with the menopause, we've got the prepayment certificate that's coming out in April

that will make it much cheaper for women on HRT to be able to get their prescriptions. So the strategy pulls these things together, but mental health is one of the seven priority areas across the life course of a woman. And, you know, whether that's dementia as well, we want to make sure that the research is there helping with diagnosis helping with treatment and so you know I would just reassure people that we take mental health issues for women extremely seriously. And some may say

that those commitments aren't anything new but Lesley let me bring you back in here so many of the messages that we are having through into this programme as we speak are about misdiagnosis and how this is a specific concern amongst women. How is this strategy going to ensure that this trend does not continue? Well, the focus is on listening to women and placing their needs at the centre and wrapping the services around them. I don't think we're going to solve everything next week, but I think that over the next year, certainly we're going to make big inroads into assuring women that their concerns are being listened to and that they're able to access the services they need and the diagnostic

tests that they need to come to clear diagnosis swiftly. I'd just like to make a comment as well about, you know, the questions that have been raised about funding and the sort of political crisis that we face at the moment. And I've always been a believer during my career that you should never waste a good crisis because I think the most extraordinarily positive and innovative things come out of crises. And in response as well to that comment about, you know, what about men's health? I think it's marvellous if someone would like to champion men's health. I wouldn't be the person you'd come to for that because it's not my area of expertise.

But what I do know from working in the UK and globally is that when you get things better for women, everybody else in society benefits. Thank you, Dane Professor Leslie Regan. On the subject of funding, a question that one of the audience wanted to put to you was about where the staff for these hubs are coming from and, of course, staff need to be paid. But this conversation is far from over. Another listener here has got in touch to say, please, can you talk about lipoedema,

a long-term condition that affects mostly women? It needs to be on their gender. That one from Mary. I'll try and pepper in a lot more of your comments throughout the rest of the programme. But Women's Health Minister Maria Caulfield and Dame Professor Leslie Regan, the newly appointed Women's Health Ambassador,

we wish you all the best as you work through this new Women's Health Strategy. We wish you all the best as you work through this new women's health strategy. Listening to that conversation was our BBC Health correspondent Catherine Burns. Your reflections upon hearing what our guests had to say. What a massive task this is. You know, they're talking about a massive ambition, improving the health outcomes for women over 10 years. And just some of the subjects that came up there, the range of problems that women are experiencing and therefore need fixing is huge. I would say though, this is not going to be a quick fix. And they acknowledge that, you know, Maria Caulfield spoke about small changes starting to make a ripple effect. They know that this is not going

to be a quick thing. But then we need to think about, well, what's missing? There's so many things that they have included. Now, earlier this year on this programme, I was reporting about gynaecology waiting lists, how over the pandemic they'd seen the sharpest increase. Since then, that has continued. So the most recent figures show that since February 2020, gynaecology waiting lists have gone up by 79%. To give you context, the average across other treatments is 49%. Now, there is nothing specific in the 127-page document of the strategy that specifically deals with those gynaecology waiting lists. Mental health, you brought it up, you know, is one of the seven priority areas. But actually, all of the areas that the minister spoke about, they're things

that are already happening, other initiatives. I can't see anything new in this particular strategy that's going to focus on that. And then obviously, a lot of the chat was about where is the money? Because £10 million on breast cancer screening over 10 years is not enough to deal with 51% of the population. Now, the minister, Maria Caulfield, I interviewed her yesterday. She knows that. She says we are going to be going to Treasury and asking for more. And she did make the point, she wants things to be evidence based, she wants to make sure that the hubs are going to be good

value for money for getting that. But it was really interesting, I thought what Leslie Regan was saying about, you know, we can do better for less, we can just look at the pots of money we've got and see. So that will be interesting. The other question about momentum, this is coming in right at the end of summer. MPs are about to go home. And when they come back, there will be a new prime minister. So is that momentum going to carry on? Now, I think that both the guests you spoke to, they feel very strongly about that very clearly. You know, the phrase this is an absolute priority. Something that will be key, I think, will be Leslie Regan. She is the Women's Health Ambassador. So her role is to make sure that this actually happens.

Maria Caulfield spoke about her holding their feet to the fire. Leslie Regan has a reputation as someone who is passionate about what she does. I cannot imagine that she's the kind of person who will take a lack of progress lying down. And just one other thing, the government has aimed to come back with a progress report after two or three years so let's see what they do then and in the meantime we shall keep speaking to you Catherine Burns thank you so much our BBC health correspondent thank you to all of you who have been in touch with stories about your health care Elaine says there was a point in my breast cancer treatment when I had to when I when I had a question and the answer was addressed to my husband who was accompanying me. And Linda writes, five years ago I was diagnosed with endometrial cancer

and the care and treatment I received here in Northern Ireland was exemplary. I could not fault it from the start from my GP right through to surgery and beyond that from Linda. Thank you to all of you who have been in touch. I will certainly try and read more of your messages as we go through the rest of the programme. through to surgery and beyond that from Linda. Thank you to all of you who have been in touch. I will certainly try and read more of your messages as we go through the rest of the programme. But on the subject of messages, we do want to hear from you because Listener Week begins on the 22nd of August. It's the week when you're in charge and you decide the agenda and the topics that you want us to explore here on Woman's Hour. So if there is something that you are dying for us to discuss or someone that you'd love to hear on the programme, please do get in

touch via our website. It's at bbc.co.uk forward slash Woman's Hour. We do hope to hear from you. Now, on a lighter note, with the Women's Euros currently underway, England will take on Spain tonight in the quarterfinals. The two teams will go head to head in Brighton in what will be the first knockout game of the tournament. And although both are very strong teams, England and Spain have previously competed against each other 15 times, resulting in the Lionesses winning twice as many games as their opponents. England have also been scoring more goals than any team has ever done in the group stage. So lots of positive news there. BBC Women's Sports reporter Jo Currie is with us

to give us an overview of how they are doing. So lots of praise for them, Jo. Lots of people commenting on how cool and calm that they've been throughout this tournament. How are they going to fare this evening in your opinion I mean England have really really impressed in the group stages on paper they've won all three games relatively comfortably they've scored 14 goals and conceded none you know they put eight goals past Norway who are widely regarded as one of the best teams in the world right now

and I think that made a lot of people sit up and go, right, England mean business. But against Spain, Spain, a few months ago coming into this tournament, were actually being pushed as one of the favourites, if not the favourites. And it's largely down to the fact that a lot of the Spanish national team players play for Barcelona. And Barcelona is widely regarded as probably the best domestic women's football team in the world right now. Having said that, they lost one of their key players, Jennifer Hermoso,

a month or so before the tournament. and they lost their real star player. She's currently World Player of the Year, Alexia Puteas, on the eve of the tournament. And without those two, Spain, I wouldn't say have struggled, but they don't look quite as free-flowing as they have done. So I think it's now England will actually start tonight as favourites, but please do not write off Spain. This team can pass the ball, they can keep the ball, and when they need to, they can score. Yes, I've heard lots about how they're very good at possession. In terms of the players who stand out on the Lionesses team, who are they? There is only one, and if you watch the game tonight,

you'll probably hear a chant of Beth Mead's on fire, your defence is terrified. And that's simply because she is having the tournament of her life. In the three opening games group games Beth Mead has scored five goals including one hat trick and has three assists as well I mean this is a player who missed out on going to the Olympics with Team GB last year she wasn't picked and she's talked about the hurt that that caused so I think that's what's really driving her this season and at the moment Beth Me, nothing can stop her scoring, it seems. So Beth Mead up on your top list there.

Let's talk about Serena Wiggum. England have scored 93 goals in their 16 games under her, netting an average of 5.8 goals per game. I didn't figure that out by myself. That's written down. But what is Wiggum's influence on her team and her coaching style, let's say? I was going to say your maths are better than mine. I think there are two things to say about Wegman. And one is that she has brought clarity to this team.

Because since Phil Neville left, we had quite a long period of time before she started. And the England team did not perform well in that time. And I think they just needed to come in who was calm and collected and proven, like Wegman is, at the last Euro tournament she led the Netherlands to the last trophy in 2017 on their home soil so she knows exactly what it takes to win a tournament of this magnitude and what I hear from the players is that they love her communication she's Dutch she's direct she's I wouldn't say strict but she's stern and what she's very good at is if you're doing something wrong she'll tell you what you're doing wrong and will correct you.

As players, when they're performing well, she'll praise you. And if you're not in the team, she'll explain why. And I think they've been crying out for this kind of calm clarity for a very long time. But I'd also say that she's unleashed this ruthlessness with England. Now, when it comes to those stats, 93 goals in 16 games. I mean, they scored 20 goals against Latvia. It was 20-0. And, you know, those goal stats are largely down to the fact that a lot of the teams they've been playing in World Cup qualifiers are so far beneath England in terms of rankings that they're putting a lot of goals past them. But Serena has finally unlocked the Lionesses' ruthlessness. They've always had these wonderful players, particularly, you know, attacking players, but she's really

brought out this goal-scoring machine in them. And we know that she's had to miss the last match because of COVID and might be forced to miss tonight's match as well. Do you think that's going to impact England's performance on the pitch? Well, when she spoke yesterday, we had a virtual press conference with her. So we weren't allowed anywhere near her quite clearly. And she said she was very hopeful of stepping out with the team tonight, but would have to wait and see, which certainly implies

that she was still testing positive as of yesterday. I mean, she wasn't there for their match against Northern Ireland, but the difference was against Northern Ireland, they had already qualified for the group stage in top spot

and it was a game they were very much expected to win. This is knockout football. This is, in the words of Leah Williamson, the captain, this is do or die. And so it's a very different kettle of fish tonight.

Now, from what I understand, the last game, and it'll be the same tonight, if if she can't be there she'll be in her hotel room in the Lensbury in the south west London the England base and has a line directly to the technical staff so she's basically on the phone probably with an earpiece shouting directions but it's not the same but she's also one of these managers that during a game she's not up shouting and screaming she's very calm in games so again Leah Williamson Leah Williamson, the captain, said yesterday that, you know, we still very much feel her influence. We're still having a lot of meetings with her, although virtually,

and that they'll just concentrate on what they can control tonight. And that's simply what they do on the pitch. You rightly point out that this game is going to be very different. These are the knockout stages now. Some tough training yesterday in the heat for the England team. How have they fared? I mean, I don't want to make it all about me, but I'm going to. We were allowed into England training

yesterday for 15 minutes. It was quarter past 10 in the morning and it was 35 degrees. And we were allowed to stay for 15 minutes. After 10, we were all happy to go because there wasn't any shade. So goodness knows how the players have been training. They've moved training forward yesterday to in theory bring it out of the real heat of the day.

There were water breaks going on, there were sprinklers going and there was worry tonight that if those high temperatures followed us to Brighton that Spain may benefit from playing in those temperatures more often back home. But I'm pleased to say when we arrived in Brighton last night, it rained and I've never been so happy to see rain. And today it is, I'd almost say, normal weather. I mean, it's still a see rain and today it is I'd almost say normal weather I mean it's still a heat wave 29 yeah yeah if it's blow 30 we're happy at the moment right which is

bizarre um so I think I think it's been a tough few days for well for everyone I think it you know athletes out training in the sun not much fun but from what I hear looking at the forecast um tonight should be a little cooler and they have had a bit of rest haven't they in between games yeah absolutely you tend to have the best part of four days off between games i know that they've had days off completely from football there was talk of a spa day um they've they had a group barbecue on saturday now in the last few days i know that things have been tightened i don't think they've been able to see friends and family now because of covid but um you know they don't train heavily during tournaments not just because of the, but because you're playing matches every few days and you need to protect players.

So it's not, you know, it's not all doom and gloom, put it that way. Are there specific concerns about playing against Spain, considering that they are so highly regarded as a team? Yeah, I mean, this Spain team, when they get it right, it's beautiful to watch their ball retention, the passing of the ball. The last time England played them was back in april in the arnold clark cup which was a new cup that england were hosting and if i'm honest spain it was a nil nil draw and england at the better of those two sides said and because england spain have lost these two key players coming to this tournament they just don't seem to have hit the heights that we have been expecting of them and maybe we've been hyping them up too much

but um you don't want to write them off either because I don't want to be that person that says yes England of course will win tonight um I think England have everything they need to win tonight they'll start as favourites I think it'll also be how they control those nerves but we're back at Brighton they've already played one group game here they know what it's like here the crowd were insane here last time so I think that can only go in their favour. Did you ever expect the team to do so well? Yes in a word simply because the last three major tournaments the World Cup in 2015 and 2019 the last European Championships in 2017 England have got to the semi-final point in all three of those tournaments and so now going forwards anything less than a semi-final spot is very much deemed

I guess a failure for this side so I think a semi-final spot is very much deemed, I guess, a failure for this side. So I think a semi-final spot, again, is very much the baseline level of what they should be aiming for. But there's a real belief in this team that this is finally the team that can not just get to the final, which they did in 2009 and were heavily beaten by Germany, but this could be the team that goes on and actually wins it. They've got this really exciting young squad that a lot of these players haven't almost been scarred by these previous semi-final defeats. They've got a manager who knows exactly what it takes

to win a European Championships on home soil. She did it last time around. And it's a home tournament, so we're never going to get the support again. But just to point out that as well as the likes of Spain, you've still got Germany in the tournament, you've still got Sweden, you've still got France and you've still got the Netherlands.

So a long way to go yet. A long way to go. On a slightly different note, let's rewind to 1972 because the Lionesses team there, they finally been awarded caps for their win against Scotland that year. And this is after the FA failed to do so at the time. Why do you think this is happening now? Why has it taken so long? I mean, there's been such a long line of injustices in women's football. This is sadly just another one that's taken a long time to put right. And it's almost that the team themselves, a team of 1972,

have had to stand up themselves and say, Oi, FA, where are our caps? We did this. We represented you. And it's hard to explain why the FA have taken so long to do it. But it's certainly the right thing to do. Women's football back in the 1970s, it didn't exactly hit the headlines the way that it does now. And they're very much the forgotten team of the Lionesses.

So I think it's wonderful they're finally going to get their caps because they do have caps, but they went out and bought their own replica ones. Oh, did they? Goodness. Well, better late than never, I say. Thank you so much for joining us here on Women's Hour. Tim Berners-Lee is often credited as the inventor of the World Wide Web. But who are some of the women who played an instrumental role in building the Internet and the technology that surrounds it? With a fifth of women in the UK experiencing online harassment and abuse, how can the internet be made more friendly to women? I'm joined by

Charlotte Webb, who teaches internet equality at the University of the Arts, London, and is the co-founder of the Feminist Internet. And I'm also joined by Dame Stephanie Shirley, who founded an all-women software company back in the 1960s. Great to have you both on. Lovely to be here. Charlotte, let me begin with you. Who are some of the British women who we might not have heard of who have made a significant contribution to setting up the internet as we know of it today? Yeah, so I suspect listeners may have heard of Ada Lovelace. She's a British mathematician, quite widely considered to be one of the world's first computer programmers.

But there are plenty of other very pioneering women who've shaped today's technologies who are a bit less well known. So for example, Karen Spark-Jones was a pioneer in information retrieval. So think about searching for stuff online, as well as natural language processing. So how computers understand text and speech. And Karen worked on that at Cambridge University in the 1950s. Her work was way ahead of its time. And what she did then really has been adopted as standard in web search engines today, which obviously many of us use multiple times a day. Then there's also Sophie Wilson. She was also a Cambridge scholar. She designed an early computer that was sold by Acorn from the late 70s. And she actually co-designed the BBC microcomputer. She also designed the operating system for that computer.

And over a period of 10 years, more than a million of those were sold and they were used in schools across the country. And if that's not impressive enough, she actually also designed a machine processor that's used in loads of digital products like phones, TVs, video games, and billions of those processors have been shipped around the world. So, you know, those are three British women who've had, I think, quite an... And three British women who clearly need to be celebrated more. Dame Stephanie Shirley, let me bring in you here. You started your career by building computers also back in the 1950s. Tell us about that. Well, because I've been advocating for women, excuse me. I've been advocating for women

for 60 years now. And I was really set up a social business that was designed not to make money, though we did eventually make serious money. But as an antidote to the sexism that I was meeting in the workplace, I don women were ignored, the way in which women were not promoted, not considered suitable for promotion, really made an atmosphere that was that was the sort of company that I wanted to work for and that I thought a lot of other women would want to work for and of the first 300 staff 297 were women so we really practiced what we preached and it was it was called Freelance Programmers. We started in 1962. We did serious work in operations research, scheduling freight trains for British Rail. We did the black box flight recorder for supersonic Concorde. concerned taking about 40,000 analog devices, reading them, converting them to digital, checking that all was well with the plane, all before the next flight took off. So it was quite a sort of time critical work. We did a lot of scientific work, but in the main it was commercial work, operations, research, logistics and so on. I've had a wonderful career in computing.

It could not have been more exciting, more innovating. You felt also that you were doing something that was important. I was the founding funder of the Oxford Internet Institute. And, you know, that is so important today. The internet pervades all society, education, health, everything. And it's wonderful to have been able to make an impact in that field. And you've certainly got an impressive portfolio there, but you did have to go to some extensive lengths. You even had to change your name, as I understand it. I was writing perhaps naive letters to promote the company's services. And I was signing them with that double feminine, Stephanie Shirley, and getting no reply whatsoever.

And my late husband suggested that I use the family nickname of Steve. And so I wrote the same sort of letters to the same sort of prospects, signing them as Steve Shirley. And surprise, surprise, I began to get some responses and began to get some interviews and began to get some work and the company took off. And then what happened when these individuals realised that you weren't Steve, you're Shirley? Well, there was a sort of frisson of excitement as I walked through the door. But I had a good story to tell. after a few minutes they'd got over that and were I think intrigued

as to what I could or could not do. Yes and I should have said from Steve to Stephanie because you are Stephanie Shirley but either way you've clearly made your mark and you've changed the course for so many women

who have followed after you. Charlotte let me bring you back in here. In your opinion, how different would the Internet be if there were more women involved in how it works, how it functions today? That's a great question. I mean, I think lots of the complex issues that we see with the Internet would look quite different if different people have been involved. We know that having more diverse teams thinking about developing products and services means that they take into consideration the experiences of the people that use those technologies in a more nuanced way. And if you look at an issue like, for example, online abuse, which you've already mentioned, you know, that is one of the biggest barriers to internet equality that we're facing today. Women are 27 times more likely than men to be harassed online.

And this is much worse for black women. It's much worse for non-binary folks as well. And so I think that if we had more women involved in the development of the big tech companies that facilitate all of that online abuse, the issue would look very different. When you're developing technologies without any experience of harassment that happens in the real world, quote unquote, it's very difficult for you to empathise about the consequences of the products that you're building. So, yeah, I do think it would look very, very different. And what about, I mean, that's in terms of how it would behave in terms of making it a safer place. But I'm keen to also understand from you, Dame Stephanie, whether or not you think it would look different visually? I don't think the way in which the internet looks is as important as how it behaves and operates in the real world.

What I do know is that an alternative internet designed with a mixed design team would be a lot fairer to everyone. It would be more environmentally sustainable. It would perhaps have more emphasis on social justice and corporate responsibility and awareness of non-Western cultures. I mean, we are, you know, the internet is very white and male and Western. Yes. Charlotte, what is the change that you would like to see to make the internet more equal?

How long have we got? About a minute and a half. Go for it. I could be quick, but I mean, there is no silver bullet here i think that inequalities on the internet do reflect inequalities in society they're not really just technological problems and i do think we have a lifetime's work to do to challenge social injustice but there are some kind of more practical crucial things i want to see happen firstly we need better access we need meaningful connectivity across across the world and for women in particular that means regular internet use appropriate devices for everybody

enough data fast connections that kind of thing and then as i've already emphasized when people get there they need to be safe we really need to denormalize the idea that if you are a woman if you are a woman in public life and you're online, you're going to experience abuse. This is a massive threat to democracy. It's a threat to political participation. And I think we need to look at that systemically. Social media companies need to really keep improving safety for women online and civil society organisations, other institutions, they need funding and support so that they can continue to do the work they're doing to provide digital safety education and tools we need more equality in the technology sector you know more women of color people of color lgbtq plus folks in positions of

power and influence that's really important we need better regulation we need better laws but crucially i really think we need a revolution of the imagination. We need to hold a creative vision for a different current and future Internet that's systemically different from what we have now. And then gather communities around that vision to really put it into practice. People from different disciplines coming together to to to manifest something that's fundamentally different to what we have now. Charlotte Webb, co-founder of the Feminist Internet and Dame Shirley Stephanie, or rather Dame Stephanie Shirley,

thank you for joining us here on Women's Hour. Just enough time to squeeze in a few of your messages. Lots of you getting in touch about the women's health strategy. This one from Sammy writes, I kept tripping up and walking into things. The male GP dismissed this as clumsiness. Another one here from Yvonne who says, I also experienced a considerable difference in care

when a female consultant was performing one of my IVF cycles. She was compassionate and kind. And this is why compulsory training is vital for all medical professionals. Please do keep your messages coming in. But for now, that is it from Women's Hour for today. Please do join us again tomorrow. And don't forget, get your messages in for Listener Week. Thanks for listening.

There's plenty more from Women's Hour over at BBC Sounds. J Edgar Hoover created and ran the FBI for almost 50 years. Nobody should have that powerful position for that length of time. His job was to enforce the law, but he did not always follow it. Hoover was basically creating a secret police. Find out what his FBI looked like. This is like Stassi. And hear firsthand from the group who had an astonishing plan to expose him. We became convinced that the FBI was illegal.

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