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Dame Lesley Regan vows to ‘revamp’ UK’s Women’s Health Strategy – “we’ve let women and girls down”
The Women’s Health Ambassador for England, Dame Lesley Regan, has promised to overhaul the government’s 10-year strategy, as she revealed the scale and cost of the UK’s gender health gap three years on.
Speaking at Women’s Health Week in London earlier this month, Regan revealed that Health Secretary Wes Streeting has tasked her with “revamping” the government’s Women’s Health Strategy, following the publication of his 10-year plan to reform the NHS.
Promising to “rise to the challenge”, Regan also hinted at plans to streamline pathways for innovators, to fast-track solutions into the NHS, and said that the system must stop “admiring the problem” and start redesigning care around women’s lives.
“We are the only country I know in the world with a national health service free at the point of delivery,” said Regan, during her closing keynote speech on Thursday 16 October.
“Yet we’ve got so complacent about the important things in women’s health that we’ve really let girls and women down.”
Major health challenges for women
A Professor of Obstetrics and Gynaecology at Imperial College London, Regan painted a stark picture of the state of women’s health in 2025.
As well as huge gaps in care for women and girls experiencing menstrual symptoms such as PMS and menopause, women face a raft of wider health challenges.
Contraception has become increasingly difficult to access, resulting in almost half of all pregnancies being unplanned, and as well as having the highest teenage pregnancy rate in Europe, abortion rates are also rising among women over 32.
Meanwhile, cervical screening uptake is at an all-time low, with marginalised women at greatest risk despite cervical cancer being preventable with HPV vaccination and smear tests.
The number of high-profile maternity scandals in recent years reflects a flawed system, where the annual amount spent on litigation costs by NHS Resolution exceeds the allocated total funding for maternity care.
Maternal mortality is three times higher in Black women and twice as high in Asian women, with suicide now a leading cause of direct maternal death, one in four among teenage girls.
According to Regan, many of those are known to mental health services.
“In the last maternal mortality report, every single woman who died was known to mental health services,” she said.
“I have to conclude that we let them down.”
Regan also highlighted gender disparities and inequalities in chronic health conditions, which often go undetected or misdiagnosed in women.
Conditions like Parkinson’s and Alzheimer’s, for example, present differently in females, who are twice as likely to be diagnosed with dementia.
And while women are twice as likely to die from cardiovascular disease as from cancer (52 per cent deaths annually), they are often diagnosed later than men, due to a lack of understanding of their symptoms.
Major causes of morbidity and mortality, frailty and osteoporosis, also disproportionately affect women.
More than a fifth of females (21 per cent) are affected, compared to six per cent of men, with women typically experiencing twice as many fractures.
There are vast geographical inequalities, too.
Every year, 500,000 fragility fractures occur throughout the UK, but less than 53 per cent of the population can access Fracture Liaison Services in the community, with quality and standards varying significantly.
“Until very recently, most politicians across the globe viewed women’s health as maternity,” said Regan.
“But women spend most of their lives post-reproductive, and we have never really catered for that… We’ve got to look after women’s health across their life course.”
Delivering on women’s health hubs
The Women’s Health Strategy, first published in 2022, was shaped by the largest ever call for evidence in a Department of Health consultation, gathering a total of 100,000 responses. Out of these, 84 per cent of women reported not being listened to by healthcare professionals.
In response, the strategy set out a six-point plan which promised to address these inequalities, including through the establishment of women’s health hubs.
Regan believes hubs are crucial for delivering on the promises of the 10-year plan, including shifting from hospital to community care, moving from analogue to digital, and pivoting from treatment to prevention.
Successful case studies from hubs in some of the most deprived areas of England have demonstrated early benefits of these hubs, including reduced secondary-care referrals, shorter waiting lists, improved access and equity, workforce retention, more specialised training, and fewer adverse outcomes.
But not all Integrated Care Boards across England are offering all core services.
Delivering more Women’s Health hubs is part of a five-point plan moving forward, according to Regan, which also includes improving maternity and menstrual care, tackling inequalities and funding more research.
“We’ve continued to admire the problem, but that’s what we’ve got to stop,” Regan said.
“The most important thing to be able to do things better is that you have to be willing to do it differently.”
A “front door” for change
Building on this, Regan expressed her “frustration” at some of the challenges faced by startups trying to bring solutions to market, hinting at plans for a hub or a “big front door” to streamline regulatory approval processes.
“Almost every time I talk to entrepreneurs or investors, they tell me the same story: ‘We’ve been knocking on the door of government, and we always get pushback’,” she said.
“I want to paint that door bright yellow so you’ll never miss it, and when it opens, I want people to be welcoming. We need to stop sending people off to navigate endless pathways. There should be a hub that sorts it.”
Benefit to the UK economy
There’s a strong economic argument for the UK government to deliver on these promises.
Global life expectancy is increasing, and while women typically live longer than men, they spend more of their lives in poor health.
A woman will experience ill health for an average of nine years throughout her life, impacting her ability to be present and/or productive at home, in the workforce, and in the community.
Regan shared analysis from McKinsey Health Institute, which shows that more than half of the women’s health gap affects women during their working-age years, significantly impacting the UK’s GDP.
At least 56 per cent of Disability-Adjusted Life Years stem from conditions which impact women differently or disproportionately.
Taking this into account, closing the gender health gap in the UK could generate more than £36bn in annual GDP by 2040, a figure that could exceed $1 trillion globally.
A 2024 report published by the NHS Confederation estimates that the economic cost of absenteeism due to severe period pain and heavy periods, alongside endometriosis, fibroids and ovarian cysts, is nearly £11 billion per year, while 60,000 women are thought to be unemployed due to menopause symptoms.
The findings suggest that for every additional £1 invested in obstetrics and gynaecology per woman in England, the return on investment is estimated at £11.
Dutch collaboration
Regan has now been invited to the Netherlands to help officials there develop their own Women’s Health Strategy.
In conversation with Dutch Minister Judith Tielen, Regan highlighted the need for international collaboration to accelerate wider global change when it comes to women’s health.
The Netherlands is already collaborating across ministerial department’s including employment and social security, with education next.
Tielen shared the outcomes from an initiative at Amsterdam University Medical Centre, which offered free gynaecology consultations to female staff to reduce sick leave.
“Hundreds of women signed up in days, and sickness absence dropped significantly,” she said.
“It’s a societal question, not one for women to solve alone.”
Regan agreed, adding: “We cannot afford for women not to be part of the solution.”
Australia’s drug advisory committee has recommended wider funding of triptorelin for women with breast cancer or endometriosis.
The recommendation comes after AstraZeneca announced plans to remove Zoladex from the market, risking leaving more than 7,500 women with breast cancer without an alternative treatment.
Both medicines block the release of oestrogen and testosterone and can be used as part of treatment, or for fertility preservation, in some forms of cancer.
The Pharmaceutical Benefits Advisory Committee met urgently in July and recommended making triptorelin unrestricted under the Pharmaceutical Benefits Scheme (PBS), which would mean it was funded for all uses.
The drug has been listed on the PBS for prostate cancer since 2006.
Triptorelin and Zoladex can also be used to treat endometriosis and to block puberty for either precocious puberty or gender-affirming care.
Vicki Durston, director of policy and advocacy at Breast Cancer Network Australia, described the recommendation as “a significant step forward” and said access to the medicine could mean the difference between life and death for some patients.
She said some women had already chosen to have their ovaries removed because of uncertainty over Zoladex supplies.
Marilla Druitt, Victorian state chair of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said it remained unclear whether triptorelin would work exactly the same way as Zoladex, but the recommendation was likely to be positive for patients with endometriosis and pelvic pain.
She said: “I’m glad we’ve got an alternative.”
“That’s fantastic, and it remains to be seen whether or not it will be as good, but pain is so complex, pain is a really hard thing to study because it’s got so many contributors.”
Druitt said further research would be needed after the medicine was introduced.
If accepted by the federal government, the recommendation would also allow PBS funding of triptorelin for puberty suppression in precocious puberty and gender-affirming care.
This would make gender-affirming care federally funded through the PBS for the first time and would remove a financial barrier for transgender children in Queensland and the Northern Territory.
Stuart Aitken, medical director of Gender Health Australia, said the recommendation had sparked “absolute joy” among his patients.
He said: “It takes away a huge barrier to accessing evidence-based care.”
“It means that the ban has a very limited effect.”
By Women’s HealthX
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Sahar Abid is a Science Associate at Ema EQ, where she works on cultural sensitivity and bias in AI.
A woman asks an AI health assistant about postpartum depression.
She mentions that her in-laws are telling her to “push through” and skip medical help, even as her symptoms get harder to manage. She never says where she is from or names her background.
The assistant describes the condition and gives her a hotline number. It sounds correct, but it misses what she needs.
That gap is more common than the industry admits, and it points to a blind spot in how we test health AI for bias.
Most bias testing looks at what people explicitly say.
The typical way to check an AI for bias is to label a prompt with someone’s demographic details and see if the answer changes. That catches some problems but misses a bigger one.
Most people do not lead with their identity. They lead with their situation. The woman above told the assistant everything it needed to help her, just not in the form of a label.
Her real question was not only “what is postpartum depression?” It was “how do I get care when the people around me don’t want me to?
When family members hold sway over health decisions, and in many communities they do, advice that asks someone to overrule their family is not something they can act on.
The AI didn’t say anything factually wrong. It answered a different question than the one she was living.
We call this culturally implicit bias, meaning the AI misses the cultural context a situation implies rather than the context a person spells out.
When systems are trained to notice only the explicit cues, they fall back on a default answer built for the majority. For everyone else, the response can feel generic, off-target, or discouraging enough that they stop looking for help.
In health, that is not small. The people most likely to be missed are often the ones the system already underserves.
What we set out to test.
At Ema, we wanted to know how well AI picks up on cultural context that is implied but never stated. So we built our own way to test for it, across a range of communities and real situations like postpartum depression and fertility, using questions that carried cultural meaning without announcing it.
The patterns were consistent. Models often missed the meaning underneath the question. They dropped the specific details a person did share and smoothed them into something generic.
And even when they pointed toward real care, they tended to offer one option instead of choices that might actually fit a person’s life. Any one of those can be the difference between someone following the advice and walking away from care.
Why this matters for anyone building health AI.
Getting this right is the right thing to do, and it also works better.
When an answer reflects a person’s real context, people trust and act on the recommendations more, so they get the help and support they need.
Testing for it is harder than the shortcut most teams use. Swapping a name or a demographic label in and out is easy. Checking whether a model actually understands the human context around a question takes more care.
The shortcut teaches models to perform cultural competence instead of practicing it. No matter how much or how little someone chooses to share, they deserve an answer that is warm, complete, and usable.
A better question.
The bar for equitable health AI should be “does it serve someone who never told you who they are?” It is the harder test, but it determines whether real people get help.
The work of getting there is far from finished, and it is exactly what we are building toward at Ema.
Sources: Naidoo, V., & Chadha, K. K. (2025), Culturally responsive AI chatbots: from framework to field evidence, Computers in Human Behavior: Artificial Humans. Souligne, N., & Subbian, V. (2026), FairLogue: A toolkit for intersectional fairness analysis in clinical machine learning models.
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