Background  

The Young Women’s Movement is Scotland’s national organisation for young women’s leadership and rights. We have existed for 100 years. Our movement is focused on protecting and progressing the rights of young women and girls. Our vision is a fairer Scotland where young women and girls are meaningfully heard, valued and supported to lead collective action and enact transformational change throughout society, systems and structures.  

Summary 

The Young Women’s Movement welcomes this debate on access to healthcare in rural Scotland. We are increasingly concerned about the lack of progress in improving access to healthcare in rural Scotland, and the detrimental impact this is having on the health and wellbeing of young women and girls. Young women and girls appreciate that the NHS is stretched at present but demand better healthcare for those living rurally.  

Young women in rural and island communities across Scotland face substantial obstacles to having their right to healthcare fulfilled.  

The below analysis is taken from our research report, The Status of Young Women in Scotland 2022-2023: Experiences of Accessing Healthcare. As part of this research, we surveyed over 900 young people from across Scotland, including focus group discussion with young women from rural communities. This briefing highlights the engagement and research we have been undertaking with (and on behalf of) young women and girls, highlighting young women’s experiences of accessing healthcare in rural Scotland. 

“I feel like I’m being penalised for living in a place that I love” [SYWS 2022-23 participant] 

“it’s just like a postcode lottery […] it’s crazy to me that it can be so wildly different and there seems to be no regulation on the most basic of things” [SYWS 2022-23 participant] 

Lack of standardisation across localities  

Young women in rural areas told us that they struggle to access the healthcare they need in rural areas due to lengthy waiting lists and understaffed GP surgeries. Many young women expressed feeling that there is a lack of specialist services in rural areas across Scotland. They noted that mental health services, for example, are particularly stretched, or non-existent, in their communities, resulting in the need to travel miles for diagnoses or support. 

Young women also told us of the complexities surrounding receiving healthcare in small communities and the impact that this has on their confidence in their patient anonymity: 

“Everything spreads around so quickly on Shetland […] the fear that everyone’s going to find out what’s happened to you.” [SYWS 2022-23 participant] 

This was a particular concern due to the need to explain your health issues to receptionists at the GP, as a form of triage. Young women understand that the NHS is particularly stretched but want to feel certain that their healthcare will be confidential.  

Recommendations 

1. We ask that the Scottish Government work closely with NHS Boards to promote a more holistic approach to person-centred care across Scotland, ensuring a range of services are available in rural and island communities, including access to specialist services, such as mental health services.  

2. We ask that there are tighter and more transparent parameters to ensure all of those working in healthcare, including receptionists, have a legal duty to retain patient anonymity and that this messaging is clearly conveyed to all healthcare staff to improve patient trust.  

Having to travel for healthcare: the hidden costs of living rurally 

The lack of facilities in rural areas of Scotland means that young women have to travel to get the healthcare they need, often incurring additional costs and extended travelling time. 

“Travel’s a huge issue especially in rural areas … I can’t drive and the buses don’t go straight there so I have to get the bus in town and wait hours for another bus, or I’ve got to rely on my parents to give me a lift in.” [SYWS 2022-23 participant]  

Young women feel that there is a lack of consideration that people need to travel for appointments and therefore have to take time off work, resulting in outgoings for the cost of the travel, and potential loss of earnings in time taken off work. This is also an important consideration for those whose children need specialist services.  

One young woman told us of the unreliability of trains from her rural community to Glasgow for appointments at the Children’s Hospital. A lack of transport meant that her mother had to take time off work to drive her there. Due to her mother’s working schedule, this often meant that she had to miss appointments: 

“We would mention that it was a struggle to get there and they would offer to reschedule the appointment and that was it.” 

Recommendations 

3. We ask that the Scottish Government publicises the Highlands and Islands Patient Travel Scheme amongst young people in rural communities, removes the £10 patient contribution for young people aged 16 to 25, and evaluates the use and effectiveness of the scheme going forward. 

4. We ask that the Scottish Government extend free bus travel for young people aged 25 and under, to those in receipt of benefits including asylum seekers, and cap the cost of public transport. 

Conclusion 

The Young Women’s Movement believes that young women and girls deserve to be listened to by MSPs to meaningfully tackle inequalities in access to healthcare.  

The next iteration of the Scottish Government’s Women’s Health Plan must include a detailed plan on how to reduce health inequalities in rural and island communities for young women and girls. We ask that the Women’s Health Plan works with young people from rural and island communities, asking them what works and what doesn’t work for them, in order to improve their access to healthcare. For young women, girls and people of marginalised genders – whose experiences and perspectives have historically been overlooked – the collection and use of gender-sensitive, intersectional data can help address entrenched health inequalities in rural and island communities and inform solutions that strengthen their rights.  

Alternative ways to access healthcare need to be more widespread and standardised across Scotland. Young women want to be able to engage digitally, such as through e-consultation and online registration, or making appointments online.  

Pursuing a gender-neutral approach to tackling access to healthcare in rural Scotland means that young women and girls will continue to fall between the cracks in healthcare legislation, policy and practice. Ignoring the unequal impacts of access to healthcare will only make it harder to achieve a gender-equal Scotland.  

At The Young Women’s Movement, we believe that young women deserve to be meaningfully heard and listened to on issues that affect their health and wellbeing. Young women deserve a future with an improved quality of life, more fairness, and better outcomes. The Scottish Parliament should consult young women about their access to healthcare in rural areas, in order to understand their wants and needs. We ask MSPs to consider their views and concerns when participating in this debate today. 

For further information   

Contact: Saffron Roberts, Research and Policy Coordinator at The Young Women’s Movement. Email: saffron@youngwomenscot.org.