By Dr Sarah Simons
At the British Medical Association’s (BMA) annual meeting last June, Glasgow University medical student Eleanor Wilson stood up and talked in detail about her first-hand experiences of period poverty in the NHS. She talked about the numerous people she’d met, the damaging impact of period poverty on hospital patients’ mental health and self esteem and why she thought it was absolutely vital that medical professionals know about period poverty.
At the time, Eleanor asked the BMA to join her campaign for the eradication of period poverty and asked for their support for the provision of sanitary products in hospital. Convinced that this is an important cause, the BMA committed to support her efforts to enable the universal provision of sanitary products in NHS hospitals and look into the problem of period poverty in healthcare.
Since then, the BMA has done their homework to investigate the scale of the problem within the NHS. They submitted Freedom of Information requests to all NHS hospital trusts and the responses published this week flagged up a large discrepancy across the country in menstrual hygiene supplies. Only a little over half of the answers said that their hospitals supplied sanitary products and 42% of responses said that the hospital trusts would not supply sanitary products unless it was an emergency and therefore they would expect someone to supply their own sanitary pads or tampons as soon as possible.
Any which way, 100% of respondents said their NHS trust did not have a policy in place to enable or protect the provision of period supplies. Managing menstruation is not a new problem for hospital inpatients, but it’s one that we have successfully managed to avoid, out of ignorance or stigmatising attitudes or most likely, a potent combination of both these things.
When someone is admitted to an NHS hospital they are provided, free of charge, with basic necessities for a hospital stay; pyjamas, toothbrush, toothpaste, soap, shampoo, a comb, endless loo roll, three meals a day, towels and a bed with linen, blankets and pillows as well as the necessary medical care and medication. Patients are welcome to bring in their own food and encouraged to wear their own pyjamas, for example, but the bottom line is that the NHS will provide these items if needed. If you want to shave, the majority of the time razors and shaving are readily provided, too. There is no onus or urgency for anyone to provide their own supplies of these items; if you’re our patient, the NHS will look after you, unless you’re on your period, in which case, it seems that a lot of the time you’re on your own.
If you need to be admitted to hospital, chances are you’re already not feeling your best. Sleeping in a different bed, eating hospital food at specific times and relying on strangers to help you, sometimes with very personal needs such as going to the loo or showering, often whilst you’re in pain and in an unfamiliar place, can make someone feel very vulnerable. It is absolutely mortifying as a person, let alone as a healthcare professional, to have to tell someone in pain, on drips or in plaster casts or recovering from an operation that no, we don’t have a spare tampon on the ward and they’ll have to sort themselves out or head down to the wildly overpriced hospital gift shop.
However, I imagine it doesn’t come close to being the person stuck in a hospital bed, menstruating and uncomfortable and unable to do much about it. Not providing supplies for menstruating patients is at odds with the NHS’ core values of respect, dignity and patient-centred care.
Cost is an excuse often swatted at the problems of the NHS. However, the trusts who responded to the BMA’s questions disclosed that they spent an average of 71p per bed per year. When the calculations are scaled up to work out the costs of providing all NHS inpatients with period provisions, it comes to a yearly total of approximately £120,000, or roughly £550 per trust. This is markedly less than the annual salary for one chief executive in the smallest NHS trusts and a relative drop in the great ocean of NHS expenditure. There is no financial reason that menstrual supplies should not fall into the category of basic NHS provision.
The World Health Organisation defines health as a “state of complete physical, mental, and social well being, and not merely the absence of disease or infirmity” and menstrual health firmly falls into this definition; mental and social wellbeing surrounding menstruation is well-researched and really important. And as Eleanor and so many others have rightly pointed out, period poverty is not just a health issue - it’s also a human rights issue, a mental health issue and a political and social justice issue.
Our National Health Service was founded a little over 70 years ago on the important and timeless premise that health for all is a human right and in 2019 it’s never been more timely to remember this. Not only is this recognition and campaign from the British Medical Association for the free provision of sanitary products for the duration of an inpatient stay absolutely necessary, it is warmly welcomed and long overdue.
Dr Sarah Simons is a junior doctor currently working in the NHS. She has an academic interest in global health, focussing on human rights in healthcare and is currently undertaking an MSc part-time in Global Health in London. Sarah’s efforts were recognised by Amnesty International’s Suffragette Spirit project last year and she occasionally tweets at @SarahNSimons.