Jenni Minto: 'My husband would divorce me if porridge was on the banned list'

In some ways Jenni Minto is in charge of the largest portfolio in the Scottish Government. As the minister with responsibility for both public health and women’s health, her remit, which she says covers “everything from pre-birth to post-death”, extends to every single person in the country, and her ministerial diary reflects that. Before we meet, she has attended meetings with funeral directors, clinicians and school children, and appeared before parliament’s Health, Social Care and Sport Committee to answer questions on proposed legislation around abortion centre buffer zones. 

All of it matters – all of it could have huge implications for the nation’s health – but it is the work that is being done around women’s healthcare that Minto feels could be the most impactful.

“Bringing the perspective of women into public health is hugely important […] because for the last 75 years or so I think we can safely say that there’s been a lot of concentration on general health, but actually not that acceptance that if a woman has a heart condition, then that’s different from a male heart condition,” she says.

Symptomatically, heart disease presents differently in men and women, with the former becoming ill when their large arteries become blocked but the latter when it is the smaller vessels that are clogged. As diagnostic tools were built by male practitioners for use in male patients this was not historically well understood though, with women being failed by the healthcare system as a result. For Minto, the 2023 appointment of Professor Anna Glasier, emeritus professor in the Centre for Reproductive Health at the University of Edinburgh, as women’s health champion was a watershed moment in righting that historical wrong.

Minto with First Minister Humza Yousaf during his 2023 Summer of Independence tour 

“I think it’s hugely important that women have a voice and, boy, do we have a great voice with Professor Anna Glasier,” she says. “Every meeting I’ve had with her I’ve learned so much about women’s health from many different angles. She’s such a great advocate for women and women’s health and she’s very well respected so can have really powerful conversations with the NHS, with clinicians, with researchers. I attended a round table about research into endometriosis with a mixture of clinicians, researchers, academics, but also women [affected by the condition], and it was fascinating to hear what they are doing around that.”

Though it affects around 100,000 women in Scotland, endometriosis – which can last from puberty to menopause and often causes crippling pain – is not well understood, meaning those suffering from the condition often have to wait many years for a diagnosis and treatment. Improving that situation is a key area of focus for Glasier – and the government’s Women’s Health Plan – but Minto is clear that it is not just those already practising healthcare that need to be educated on how to better understand the nuances of women’s health, but the wider population too.  

“I’ve told this story before, but I can remember when I was at secondary school and the girls went into one classroom and the boys went into the other and we got told about the menstrual cycle – the boys didn’t get told about that,” she says. “One of my friends said, ‘so you said to us this starts when you’re about 14 and ends when you’re in your mid-40s or so – what happens then?’ And the answer was, ‘oh, it just stops’ or ‘they just stop’. It wasn’t until I listened to Andrea McLean on [ITV talkshow] Loose Women – she wrote a book about it – that I suddenly realised what I was living through [with the menopause].

I’m very clear that there shouldn’t be non-smokers vaping, but I do accept that vaping is a suitable public health response

“Education is so important, and I recently had a really good visit to Napier University. They’re looking at women’s health and looking to see if they can have a specific course on it. I think that’s hugely exciting because there’s the hope that that is going to help change the healthcare culture as well. I know I specifically chose a GP practice when I was living in Glasgow that was all women doctors because I thought they’re the ones that are going to recognise more if I’m going in with [women’s] conditions. The practice I’m in now I live on Islay is a mixed one and that’s absolutely fine, but at that stage in my life, I was pleased to know that I was going to see a woman because of that connection.”

Living on Islay has put other public health challenges into sharper focus for Minto, with both her and her husband – the writer Les Wilson – having to be helicoptered off the island to access emergency healthcare. In Wilson’s case the emergency was the result of a freak accident – he was trampled by cattle while out walking during the coronavirus pandemic – and in Minto’s it was an unexpected health scare. “I was helicoptered off the island with a diagnosis of severe appendicitis, which resulted in me arriving at the QEUH and being in the operating theatre for three hours to be, as one of the nurses described it, cleaned out,” she says. 

Both cases highlighted how isolated rural communities can be when it comes to accessing services, but also how connected public health is to other areas of government, such as transportation. It is an important point that Minto says she comes up against on a daily basis, with the government’s plans for taking action to crack down on vaping among teenagers as well as foods that are high in salt, sugar and fat – both of which have strong health-related imperatives – causing knock-on concerns for retailers, who form the backbone of the economy and who are concerned that they are being overburdened by regulatory load.

“Vaping does worry me,” she says. “I was visiting a high school in my constituency and one of the teachers came out of a classroom with six or seven vapes in her hand and I was kind of shocked, but the teachers were telling me that that happens a lot. When I’m in Edinburgh I stay in Leith and can see the littering impact from an environmental perspective. I’m very clear that there shouldn’t be non-smokers vaping, but I do accept that vaping is a suitable public health response [to help people stop smoking].  

Minto with her husband, Les Wilson, on her first day in parliament | Alamy

“We’ve put out a high fat, salt, and sugar content consultation and as part of the work we’ve done on that we’ve spoken – as we did with smoking and vaping – to young people, we’ve spoken to businesses, we’ve spoken to a wide range of stakeholders, which I think is incredibly important to get their views. We have regular cross-ministry meetings – in fact, we had one this morning on food – and I think that’s incredibly important because I think it brings in different perspectives. It’s actually one of the things that the first minister made very clear when he appointed me as a minister [last March], that I’m not in a silo, that I’ve got to work with others […] When we were looking at high fat, salt and sugar content the conversations and round tables we had with businesses were as important as the ones that we had with health and third-sector organisations.”

Given the conflicting priorities of those involved in such consultations it can be difficult for government to make progress on its public health aims. Last year there was an outcry when it began consulting on plans to potentially crack down on the marketing of alcohol, with those in healthcare in support of strict measures to protect the public from alcohol-related harms while those working in the drinks industry felt many of the mooted proposals were too draconian. The consultation was ultimately shelved by Humza Yousaf when he became first minister but is due to be brought back in an amended form.

There was a similar response last month when the government published its fat, sugar, and salt consultation, with the inclusion of processed porridge oats on a list of potentially problematic foodstuffs leading to accusations that politicians were attempting to outlaw porridge. Though she says she never eats the stuff herself, Minto says the notion the government would make such a move is ludicrous.

“My husband would divorce me if porridge was on the banned list,” she says. “I don’t actually like porridge – I’m a granola, yogurt and fruit eater and occasionally I’ll have a slice of brown toast with my husband’s homemade marmalade – but it’s not our wonderful Scots porridge that’s included, but the ones that have additional sugar.”

Ultimately, while health secretary Neil Gray is responsible for dealing with what is going on in Scotland’s healthcare settings, where waiting times remain notoriously high and access to healthcare is a perennial issue, for Minto the focus is on keeping people out of hospital in the first place. Creating healthier homes, she says, will result in a healthier population, which is why the government’s work on vaping, tobacco and unhealthy foods is so important.

Minto with her dog Jim, a rescue collie

“When I think about the health impacts on people that I know a lot of it is non-communicable diseases, whether that’s diabetes, whether that’s cancer, whether that’s heart disease, and it’s finding ways to ensure that we’re providing the best services for these,” she says.

“So, with regards to cancer, the government’s 10-year framework that was launched in June last year [looks at prevention with a focus on risk factors including smoking, obesity, physical activity and alcohol consumption]. With diabetes, we’ve given additional funding to try and support with the closed loop system [an insulin pump that monitors glucose levels and administers insulin as required].

"I also think it is incredibly important, because I don’t have all the answers, that we work closely with researchers and also with the third sector as well. I see that as a key partnership, so you’ve got government, health boards, academia, and also the third sector.”

From her own point of view, despite the scare they got when her husband was out walking during Covid, Minto says she attempts to look after her own health by taking long walks with her dog when she is back home on Islay. 

“We’ve lived on Isay for 13 years – my husband and I fell in love with the place,” she says. “The day after we moved here, we got our first dog, Nell. Sadly, Nell’s no longer with us but we’ve got the most amazing dog called Jim and that’s the way I switch off – walking the dog on the beach.”