Category: Speeches

  • Jim Shannon – 2022 Speech on Visas for International Doctors

    Jim Shannon – 2022 Speech on Visas for International Doctors

    The speech made by Jim Shannon, the DUP MP for Strangford, in Westminster Hall on 2 November 2022.

    I thank you for allowing me to participate in the debate, Mr Stringer. I thank the hon. Member for Boston and Skegness (Matt Warman) for bringing this matter to light. It is good to see the Minister in his place—a return to duty in his ministerial role—and I am confident that, like the rest of us, he will be keen to address the key issues of the debate and why this issue is so important. I wish him well in this new role and look forward to his response to our questions.

    The issue of visas is always a difficult one. I am incredibly aware of the need to protect our country and ensure that only those who have a desire to enjoy British life and to enhance it should be given visas. I understand the system of immigration and agree that it should be rigorously implemented. However, within that, we very much need to have the appropriate systems for the appropriate types of visa. That is why I believe that changes need to be made, as outlined by the hon. Member. Talented and skilled doctors want to come here and contribute to our society but unfortunately, due to the visa system, they are not always able to do so. For me, the issue is: how can we help them to help us in the United Kingdom of Great Britain and Northern Ireland?

    Margaret Ferrier

    As the hon. Member for Boston and Skegness (Matt Warman) said, a difficulty that many international medical graduates face is that many GP practices do not have a visa sponsorship licence in place, making it harder to meet the requirements before the student’s studies end. Does the hon. Member share my concerns about the general level of the Home Office backlog and the associated impact on IMGs?

    Jim Shannon

    I agree with the hon. Lady. I hope that through today’s debate and contributions, this issue can be addressed. Again, we look to the Minister to give us some help, direction or support in how we can go through the vigorous bureaucracy that is clearly there. People with talent and skills want to come here; it is about how we can make that happen.

    I have raised immigration on multiple occasions with Home Office Ministers—in particular, with regard to visas for those working on fishing boats in my constituency and the skilled work done by Filipino fishermen. The previous Minister was most helpful. That work is undoubtedly skilled, but it is under the pay threshold, so visa requirements sometimes restrict that opportunity.

    Junior doctors, nurses and others do work that is not highly paid but highly skilled and necessary. That is why there must be time-sensitive application systems for those vital jobs and staff members. We need flexibility in the system. I say this again because it is important: those highly skilled and highly talented people who wish to come here will add to society and enable us to fill some of the vacancies.

    I cannot speak for the United Kingdom mainland, but I can certainly speak with some knowledge of Northern Ireland. I am my party’s health spokesperson, and the research we did for this debate shows that 6,613 vacancies are listed for the five trusts in Northern Ireland. I know that they are not entirely for medical staff, but it is clear that we are desperately in need of staff, and there are many opportunities for doctors.

    In my constituency and neighbouring constituencies, we are having problems in relation to GPs. I absolutely agree that there is a need for restrictive immigration, but we must not cut off our nose to spite our face. I am sure those numbers are replicated throughout the entire UK; perhaps the Minister will give us some figures for GP vacancies. I know that the Government have set out a strategy for employing and recruiting more GPs—that is good news.

    During the Brexit discussions, we were told that there would be distinct differences between the visa systems. That is as it should be. The hon. Member for Boston and Skegness said that the system needs to be altered to meet the need, and that is what we need to do today.

    The hon. Gentleman mentioned GPs, and we are of the same mindset. In a neighbouring constituency, a GP surgery, which is 10 minutes from my office, is set to close down because there are not enough GPs. In response, the GPs in my area have issued a moratorium on joining or leaving local practices. In other words, they will not take any more patients, and in some cases they are directing patients who live outside the area—that was okay a few years ago—to go elsewhere.

    The trust is hopeful that it will get more GPs to take over the practice, but the fact is that we simply do not have enough GPs. That puts more pressure on the existing ones, which leads to more burnout, and the vicious cycle continues. GPs are under incredible pressure. Patients want to meet their GP; they want face-to-face appointments. That has been lost to them over the past two and a half years due to covid, but they are trying hard to get back in the queue.

    The hon. Gentleman said that 40% of all GP trainees are international medical graduates—the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) referred to that—but they have difficulties obtaining visas. I do not have the exact numbers for Northern Ireland, but I do know that we cannot afford the loss of any more GPs. I therefore add my voice to those of others in the Chamber requesting that a special dispensation be granted not simply to allow those trainees to stay but to enable us to recruit further.

    If there a block of trainee GPs who have almost completed their degrees and courses and are ready to come here, let us encourage them to do so. The question is not why it cannot happen, but how we can make it happen. The thought of training GPs to understand how we do medicine and run our practices, only for them to leave—not because they want to but because the system is not working for them—is madness. That needs to be addressed through this debate.

    Recently, medical professionals outlined to me that the mental health and self- esteem of our medical community are at an all-time low because the staff are simply burned out. I have met many nurses, GPs and surgeons who are absolutely exhausted with the work they do. For those who are on call and have a duty rota to complete, being sent an SOS text to cover shifts is no longer exceptional; it is standard. That tells us that the GPs need to be employed and some of the pressure taken off.

    We need to change the way that things are done, by giving GPs more admin support and funding for on-site nutritionists, physios and mental health teams, which we need within all health clinics. In my constituency, they are trying to do that regularly, and it should help to diagnose early, whether the problem is diabetes, arthritis or dementia. Whatever the issue, doing that correctly in GP surgeries is the way forward.

    It is impossible to imagine that things can go on much longer the way they have for the past two and a half to three years throughout the United Kingdom of Great Britain and Northern Ireland. We need change, flexibility and help, Minister. We do not want to put all the pressure on the Minister, but in this case there are ways forward. The hon. Member for Boston and Skegness has outlined them, as have I and others. We look forward to a successful conclusion to this debate, with a way forward from which we can all benefit across this great United Kingdom of Great Britain and Northern Ireland.

  • Matt Warman – 2022 Speech on Visas for International Doctors

    Matt Warman – 2022 Speech on Visas for International Doctors

    The speech made by Matt Warman, the Conservative MP for Boston and Skegness, in Westminster Hall on 2 November 2022.

    I beg to move,

    That this House has considered visas for international doctors.

    It is a pleasure to serve under your chairmanship, Mr Stringer.

    This is a debate about doctors, but I want to begin with the story of a hypothetical patient. Let us call her Marjorie and say that she lives in Skegness. She is in her 80s or thereabouts. She is registered with a local GP practice, and she has a trainee doctor as her GP. They have a really good relationship and know each other well. They have the continuity of care that means that Marjorie’s needs are looked after. For a couple of years, Marjorie has gone back and forth to her doctor with little ailments, as people often do. In her final consultation, her doctor mentions that she will be moving on relatively soon.

    Thereafter, Marjorie finds herself with another GP, and the continuity of care is broken. Marjorie struggles to get the type of relationship that she built up over the past few years, and she finds herself bouncing in and out of hospital. She is fine, but not as well as she would be if her care had been provided by a doctor who was able to make sure that they knew each other well. The reason for the break in continuity of care is that the doctor she had in training was an international medical graduate who was being trained at the surgery in Skegness. Unfortunately, for a whole host of reasons, the surgery was not registered to take international medical graduates once they had qualified, and it was not what is called a sponsoring practice—it was not able to say that it would sponsor the visa for that doctor.

    The reason I make that point in such a way is because the people who are suffering as a result of the approach we currently take to visas—on one level, they are doctors who are dealing with the immensely stressful visa process—are ultimately patients, who should be our priority. The doctor I mentioned is one of 40% of trainee GPs who come from abroad. While they are training, their visas are sponsored by Health Education England.

    Margaret Ferrier (Rutherglen and Hamilton West) (Ind)

    A result of the difficulties around trainee GP visas is that many IMGs feel that they have no choice but to take on other roles within the NHS, or they leave the NHS altogether. Many may even return home. Does the hon. Member agree that this is yet another area where the Home Office must look at the bigger picture, rather than trying to plug gaps on an ad hoc basis?

    Matt Warman

    Ultimately, this is where we need joined-up government, whereby the Home Office and the Department of Health and Social Care deliver on the same priorities, and I really do think that they can.

    As I say, 40% of trainee GPs come from abroad. In the final months before they qualify as GPs, the last thing they should be doing is dealing with the stress of a potential visa application and considering whether the practice where they might want to apply for a job is registered on the programme, and whether they can reasonably jump through the Home Office hoops at that precise moment. We are increasing stress for doctors, and we are increasing the risks for patients at the same time.

    The hon. Lady alluded to figures from the Royal College of General Practitioners which show that some 30% of GP trainees are considering not working as GPs when they qualify for these visa-related reasons, and some 17% think they might have to leave the UK either temporarily or, at worst, permanently. That is some 1,200 doctors who are considering not working in the health service as a result of this system. In Lincolnshire alone, a third of practices have thought about registering as a visa-sponsoring practice, but just one in 10 have actually done it. We are really limiting the options for GP trainees and for the health service.

    This is a political choice, and it reveals an inequality between different sorts of doctors. It will probably take a hospital doctor five years to qualify. After those five years, they will qualify for indefinite leave to remain in a much easier way. Because GP trainees take just three years to complete their programme, they need to go through this visa process, because three years is not five years, and the Home Office has decided that five years is what is required.

    There are other associated problems. When it comes to applying for a visa, the GP practice that needs to register will consider whether that process is worth while. It may, in theory, be worth while in advance, and some practices do register in advance, but many do not. They then find themselves confronted with a brilliant candidate, and they try to register, but with the best will in the world, the timescales are very tight for doctors to apply for visas when they have a job offer from a practice that is already registered. There are lots of things to line up, and it is stressful for practices and for doctors. Even if there were no backlog in the Home Office, it would be a very tight timescale.

    Mrs Pauline Latham (Mid Derbyshire) (Con)

    I thank my hon. Friend for giving way and congratulate him on securing this important debate. I have recently returned from an International Development Committee visit to Jordan, where I spoke to a number of highly educated Jordanians, as well as Syrian refugees. Some of the Jordanians were already doctors and nurses, and the Syrian refugees in the camps in Jordan cannot get an education beyond the age of 18 but wish to become doctors, engineers and so on. They speak amazing English and would love to train here in the UK.

    At the moment, Germany is hoovering up a huge number of these doctors and people who would like to study to become doctors, to satisfy the demands of its health service. Does my hon. Friend agree that it would be helpful for the Minister to consider opening up more visa routes for brilliant young medical students from countries such as Jordan that have long been strong international partners of the UK, in order to ease some of the workforce pressures on our NHS? It is important that we increase the numbers, and that would be one way of doing it.

    Matt Warman

    I absolutely agree with my hon. Friend that increasing all those routes is hugely important. Of course, we would all like to see more doctors trained in this country, and the Government have gone some way towards doing that, but where people want to work abroad, Britain should be as attractive a place as we can be. That is why, on the GP point specifically, the Government should be removing every single barrier in that visa process.

    The most straightforward thing we could do, which would remove the need for a practice to register as a visa-sponsoring practice, is simply to say that when a GP qualifies in this country, they get the indefinite leave to remain that other doctors get. These are people in whom the UK has already invested. They are already here; they already have a visa. The extension of that visa into another form seems simply to be a bureaucratic hoop that we are putting in their way as doctors and in the way of GP practices. We are putting extra bureaucracy into a system, while on the other hand the Government say, “We desperately need people to come to this country to work in the NHS, and we will try to do everything we can.” The health service does hugely good work to try to recruit such people and specifically encourages them to train as GPs, but then we put an additional barrier in their way.

    The response from the Government in the past has been, “Actually, the visa process registration is not terribly onerous and GP practices can do it.” They point to the numbers that have and do, which is fine as far as it goes, but it does not answer the question of why we put a barrier in the way in the first place. It should not be a cost of doing business when we say that we really want to make it as easy as possible.

    Equally, it should not be a reasonable thing to put different sorts of doctors on different sorts of levels. It is not reasonable to say to people that, just as they have gone through the most stressful part of qualifying with exams, they should also be thinking about their immigration status. That calls into question their probity when we have things such as the General Medical Council making sure that they are upstanding members of our communities, and many of them have tens of thousands of patients to testify to that.

    I do not think it really washes when the Government say that we need to put barriers in place, and I do not think that the Department of Health, where the Minister was previously a Minister of State, would agree, in an ideal world, with the Home Office stance. We could work together across Government to try to secure a sensible outcome.

    I have talked about GPs, but there are broader issues around visas for doctors, many of which come back to the Home Office backlogs that I know my right hon. Friend the Minister is working really hard to address. There is a good argument for simply scrapping visa fees altogether for people coming to work in the health service. That is an argument for another day, but when it comes to GPs I think that lowering the five-year limit for indefinite leave to remain to three years is the neatest way to address the issue.

    On the broader issues, ultimately this comes back to how many doctors we are training in the UK. We all want, as I said to my hon. Friend the Member for Mid Derbyshire (Mrs Latham), to see more people trained in this country. That is what we are doing and that is what the Government continue to pursue, but until we reach that moment—the NHS has never reached entire self-sufficiency in the UK—we should make it as easy as possible for doctors, dentists, nurses, people working in social care, and all those who work in different parts of the health service, to come to the UK. It is not primarily a question about backlogs; it is a question about process. At the moment there is a degree of bureaucracy that simply does not need to exist.

    Steve Brine (Winchester) (Con)

    It is great to hear my hon. Friend making such an eloquent case, as always—more so than I can. The issue matters for all the reasons he has set out, but would he agree that because of the retention challenge in the health service, the more we pour in at the top is sometimes, in part at least, offset by those who go out at the bottom? There is a wider picture here to do with pension pots—the whole retention piece is part of the wider jigsaw, which I appreciate is not the remit of this Minister, but perhaps was in his previous job.

    Matt Warman

    I thank my hon. Friend for that intervention. It is always tempting to ask the Minister to go and have a word with his former self, but we cannot do that. I think he has read the last couple of points that I want to make.

    There are a number of relatively low-hanging pieces of fruit that the NHS has repeatedly asked for. I want to thank the RCGP, the British Medical Association, the radiologists, the British Dental Association, and also groups such as EveryDoctor, which have helped me with this debate and have identified the fact, as my hon. Friend implied, that there are a small number of things that could and should be sorted as quickly as possible. Busting the barriers around pensions and the bureaucracy around visas are things that would make a real difference to recruitment and retention across the health service. There are plenty of things that are difficult when it comes to addressing the NHS’s challenges, particularly as we approach winter. On the narrow point of GP provision, we have a visa process that puts pressure on, in particular, small GP practices, where the added burden of registering as a visa sponsoring practice is even greater now as they are under such huge pressure. It is also a burden on GPs at what is a particularly stressful point in their careers.

    I know the Minister will make entirely legitimate points around putting a process in place, but the reality is that there is a political choice to be made to ease some of those burdens. There is a powerful, compelling case to be made for doing a small number of easy things that could address the GP crisis in particular, which, as my hon. Friend the Member for Winchester (Steve Brine) alluded to, is acute.

    I appeal to the Minister and the Government to work as closely as they can with the Department of Health and Social Care to understand these challenges and see what can be done, and I urge my right hon. Friend to take seriously the suggestion that if someone qualifies as a medical doctor in this country, and in particular as a GP, they should have indefinite leave to remain. At the moment, it effectively comes with that if they qualify in a hospital but not in general practice. That is an inequality that the Minister can look to fix, and I hope he will do so as soon as is practicable.

  • Steve Baker – 2022 Speech on Derry Addiction Centre

    Steve Baker – 2022 Speech on Derry Addiction Centre

    The speech made by Steve Baker, the Minister of State at the Northern Ireland Office, in Westminster Hall on 2 November 2022.

    It is a real pleasure to reply to this debate, Mr Gray, and I am genuinely very pleased that the hon. Member for Foyle (Colum Eastwood) has secured it; in this, we can make common cause. I am also pleased to see the former Secretary of State, my right hon. Friend the Member for Skipton and Ripon (Julian Smith), in the Chamber today. I pay tribute to all the work he did to get the New Decade, New Approach agreement in place.

    The Government welcome this opportunity to make it clear that we are committed to supporting the Derry/Londonderry addiction centre and providing it with £1 million from unique circumstances funding under the New Decade, New Approach agreement. The hon. Gentleman particularly mentioned Northlands. I will come back to that, but I know it is a very valued service, and it seems to me a very sensible approach to use Northlands to deliver what is required.

    Health is, of course, a devolved matter in Northern Ireland. The issue of a lack of clarity came up, but we are absolutely clear that health is a devolved matter, and we would like it to be governed, and governed well, in Northern Ireland. It is therefore for the relevant Northern Ireland Executive Department—in this case, the Department of Health—to formulate its proposals on how to use the allocated £1 million of unique circumstances funding to support those experiencing addition in Northern Ireland.

    Before I go any further, I want to say that I am personally very committed to this issue, as I know the hon. Member for Foyle and other Members present are. A few years ago, I had the opportunity to participate in an inner-city challenge with the Centre for Social Justice, which saw me spend three days and two nights in rehab with some very serious ex-offenders, including people convicted of murder. It felt like a much longer time. I went through with them, in their counselling sessions, what it means for them to be addicted and how they had come to be in the circumstances they were in. I was particularly moved by the service user’s account that the hon. Gentleman shared.

    Given the social problems that our country faces—indeed, that all countries face—with drugs, we need to get alongside people where they are and lift them up. It is too easy for people to see the tremendous consequences of addictions on our society and rush to condemn, but people in the grip of an addiction need treatment and sympathy. That is one of the things I saw when I was with those people in that centre. Indeed, I have stayed in touch with one of them, and I was in touch with him last night when preparing for this debate. He has completely rebuilt his life, become a good father and got into work. It is an amazing thing to see.

    In thanking the staff of Northlands, and all staff across the UK who deal with addictions, including in Wycombe, I particularly want to acknowledge the point that the hon. Member for Foyle made about the countless people who are grateful. That needs to be understood by everyone. Genuinely, countless people are affected by addictions, because the consequences that spread out as people suffer under addictions are enormous and almost impossible to see. Those consequences spread and spread, generationally as well as geographically, so it is really important that we understand addictions and deal with them. As such, I am personally committed that this money needs to get into Northlands and to deliver against NDNA.

    I stress that the Government stand ready to provide the funding once we have received and approved the Northern Ireland Executive Department of Health’s proposals for the Derry/Londonderry addiction centre. As I said earlier, Northlands seems a particularly sensible way to proceed. The Northern Ireland Office continues to engage with counterparts in the Executive to make that happen.

    We do not have an Executive, and we are moving towards declaring an election, as is our legal duty. We fervently hope that a functioning Executive will be in place as soon as possible. Our officials have been advised by the Northern Ireland Department of Health that, at this stage, it is too early to state what impact, if any, the absence of an Executive will have on the delivery of its proposals. However, NIO officials will keep that aspect under review with the Department of Health.

    The hon. Member for Foyle asked four specific questions. First, what happens if we do not have an Executive? We will have a response plan, and we will take the steps necessary to ensure that public services continue. However, as he knows, we do not wish for direct rule any more than he does; we wish to have a functioning, stable and high-quality devolved Government. We have to proceed with great caution. I know that he will not expect me today to pre-empt announcements that we will make in due course.

    Secondly, the hon. Gentleman asked whether we are still committed. I think I have made it absolutely clear that, personally and as a Government, we are absolutely committed. Thirdly, he raised the impact of instability, which is very real and very much felt in people’s lives. I absolutely appreciate the strength of feeling and the real concern of Unionists, in particular my friends in the Democratic Unionist party. I am a proud Unionist and a proud Brexiteer, and I very much regret that we have the problems we have with the protocol, which are keenly felt by the DUP.

    Let me take this moment to put it on the record that everyone needs to understand that we will be challenged to deliver a devolved Government until the issue of the Northern Ireland protocol is resolved. That, I am afraid, puts things firmly in the hands of the European Union. Until it is willing to negotiate on the basis of regard for the legitimate interests of Unionism—a point I have tried to make clearly, but respectfully so—we will not be able to satisfy the DUP or many Conservative MPs that we have made progress. If we cannot satisfy the DUP, it clearly has the power and the opportunity to prevent a devolved Government from being formed. I wish to be respectful about that, just as I have been respectful—I think famously—to the EU and Ireland about their legitimate interests.

    The hon. Gentleman asked about the impact of instability specifically in relation to the addiction centre. Here we see the impact of political instability, which causes real harm to real lives, not just for those who are addicted, but for their family and the many people who suffer the consequences of addiction.

    Fourthly, the hon. Gentleman asked what we will do. We will of course proceed to govern as best we can in the absence of devolved institutions, within the bounds of not wishing to institute direct rule. We will announce our response plan in due course. I hope that we will be able to satisfy the hon. Gentleman. As he has raised the issue, I will certainly make it my priority to investigate what is happening with the centre.

    This debate is an excellent example of democracy working. We have so many things before us at this time, but this debate secured by the hon. Member for Foyle on behalf of those he represents has raised the matter up my priority list. Working with my officials, I will try to ensure that we drive it forward.

    I have a few words to say about addiction, which is a complex and multifaceted issue that affects the whole of our society. It takes a terrible toll on family and friends. It is therefore vital that people in Northern Ireland and indeed across the UK are able to access the right addiction and support services at the right time. As I said, it is a devolved matter, but the Government are committed to providing the additional funding. That commitment reflects the Government’s strong desire to see improved health outcomes for everyone across Northern Ireland.

    The Government’s commitments under the New Decade, New Approach agreement include making £40 million available for a range of projects focused on addressing Northern Ireland’s unique circumstances. The unique circumstances projects are aimed at supporting community and reconciliation initiatives to remove barriers, to bring the people of Northern Ireland together, and to build a safer and more secure society in Northern Ireland.

    One of the projects identified was the Derry/Londonderry addiction centre. The Government are steadfastly committed to providing £1 million in funding as a non-Barnett addition to the Northern Ireland Executive’s block grant. We of course continue to urge all those involved to form an Executive to deliver the proposals but, as I said, I appreciate why that has not proven possible so far. Funding for unique circumstances projects is an important component of the New Decade, New Approach agreement, and the Government remain focused on ensuring the investment of this funding for the benefit of the local community.

    It may help to say a little more about the context of New Decade, New Approach. The agreement was reached between the UK Government, the Irish Government and Northern Ireland parties in January 2020, and it enabled the restoration of the Northern Ireland Executive after a three-year hiatus. Again, I pay tribute to the former Secretary of State, my right hon. Friend the Member for Skipton and Ripon, for his leading role in that work. The agreement contains commitments for the UK Government, the Irish Government and the Northern Ireland Executive to fulfil. This Government have delivered over half of their commitments under the New Decade, New Approach agreement and we will continue to implement the remainder of the agreement to support a stronger, more prosperous and inclusive Northern Ireland in which everyone can participate and thrive.

    The agreement was accompanied by a £2 billion financial package, consisting of £1 billion of additional funding and a £1 billion Barnett-based investment guarantee. It is the largest deal from a Northern Ireland talks process to restore the Northern Ireland Executive. The UK Government have now honoured the £1 billion Barnett-based investment guarantee, as set out in NDNA. The investment guarantee was that the Executive would get a capital department expenditure limit Barnett consequential of at least £1 billion over a five-year period, from 2021 to 2024-25. That has been honoured as, based on the spending review 2021 settlement, the Northern Ireland Executive will receive over £1 billion by 2024-25 in additional CDEL Barnett consequentials.

    We expect that £769 million from the £1 billion financial package in the agreement will have been spent by the end of the current financial year. The release of funding has been tied to the delivery of reform and transformation of Northern Ireland’s public services, which I will now discuss in a little more detail.

    The agreement reflected the unique challenges faced by Northern Ireland. The aims of the financial package were to provide immediate support to the health service and to address budget pressures, to enable investment to transform public services, to turbocharge infrastructure delivery in Northern Ireland, and to address Northern Ireland’s unique circumstances. The Government’s substantial package played a vital role in supporting the incoming Northern Ireland Executive and in promoting economic growth. Of course, we are deeply disappointed at the continuing lack of a fully functioning Executive, but we will continue to press forward to serve the people of Northern Ireland.

    The £769 million spent so far has been used to bring to an end the nurses’ pay dispute in January 2020, with £200 million used over three years to deliver pay parity with nursing counterparts in England and Wales; to provide a one-off funding settlement to the Northern Ireland Executive of £350 million in 2021-22 to relieve budgetary pressures and deliver effective public services in Northern Ireland; and to drive the transformation of public services by providing £142 million to support the Northern Ireland Executive in its transformation programme. The Executive have so far directed the transformation funding towards improving health outcomes. The NDNA transformation projects are embedded in the Northern Ireland Department of Health’s rebuild framework, “Building Better, Delivering Together,” which progresses health and social care system rebuilding work in Northern Ireland.

    The funding has supported the Northern Ireland Executive in delivering a fleet of low-carbon buses for Belfast and the north-west, with £50 million invested in low-carbon transport. Government funding under NDNA means that 100 zero-emission buses have been produced by Wrightbus in Northern Ireland. The funding also led to the opening of the Northern Ireland graduate medical school in Derry/Londonderry to students in September 2021. So far, we have invested £11.5 million, with another £48.5 million to be invested, to deliver a brand-new facility and investment for the north-west of Northern Ireland. The training of more doctors will also help address the shortage of medical professionals in Northern Ireland in the long term.

    Turning to the unique circumstances money, the Government have committed £140 million to address Northern Ireland’s unique history. That consists of £100 million for legacy implementation and £40 million for those unique circumstances. The £40 million in Government funding has been reserved for the themes set out on page 53 of NDNA, in annex A.

    The funding is to be deployed in areas including mental health, which I am sure will matter to everyone here; tackling paramilitarism; and tackling deprivation and improving opportunity—of course, one of the major factors leading to deprivation is addiction. The funding is also to be deployed on a culture and community fund; support for marking the 2021 centenary and related projects; support for languages and broadcasting; support for the armed forces and veterans; a fund to promote the competitiveness of Northern Ireland’s economy; additional funding to support the Derry/Londonderry addiction centre; and the UK contribution to the international fund for Ireland.

    As I run through those commitments, I think the whole House will appreciate the extraordinary work led by the former Secretary of State, my right hon. Friend the Member for Skipton and Ripon, with all the relevant parties, to deliver so much for Northern Ireland. What we now need to do is press forward.

    The five parties reached the NDNA agreement, leading to the restoration of the Northern Ireland Executive in January 2020. The funding allocations were later agreed by the previous Secretary of State with the First Minister and Deputy First Minister. Good progress continues to be made, and funding has been approved across a range of projects, including on tackling paramilitarism, support for veterans, the Veterans Commissioner, NIO centenary projects, and so on.

    On tackling paramilitarism, the Government’s funding has helped to support the Executive’s Communities in Transition project, which is designed to support and empower those communities that have been most impacted by paramilitarism, criminality and ongoing coercive control. Many Members present will appreciate the interaction between drugs and paramilitarism; I do not wish to get into that in great detail, but the two subjects are closely related. By tackling paramilitarism and criminality, we will help to deal with the problem of addictions.

    The Government’s commitment to veterans under the agreement resulted in the appointment of Mr Danny Kinahan as the first Northern Ireland Veterans Commissioner in September 2020. As with the release of all Government funding, we undertake robust assessments and business case approvals before funding is provided.

    Despite the absence of a Northern Ireland Executive, the Government continue to deliver on their NDNA funding commitments. That includes releasing the remaining £276 million of funding, including £103 million to drive public service transformation; £48.5 million to help fund the graduate medical school at the Magee campus in Derry/Londonderry; £100 million to address the unique history of Northern Ireland, including legacy; and £24.5 million of the £40 million reserved for the 13 themes referred to on page 53 of NDNA, in annex A.

    The Government’s financial package was accompanied by stringent financial conditions to deliver a greater level of accountability for public spending, and to ensure that the Northern Ireland Executive build sustainable public services for people in Northern Ireland. Members will know that that is extremely important at the moment. It included the creation of the independent Northern Ireland Fiscal Council in 2021. That body is an important component in delivering greater accountability for public spending, and it is already playing a valuable role in Northern Ireland.

    Earlier this year, Parliament passed the Northern Ireland (Ministers, Elections and Petitions of Concern) Act 2022 to implement the institutional reforms agreed in NDNA. These reforms have included enabling Northern Ireland Executive Ministers to continue in office for a defined period to allow time for Executive formation—although I lament that in this case that has not worked—reforming the petition of concern mechanism used in the Northern Ireland Assembly, and updating the ministerial code of conduct with regard to the expectations and behaviour of Ministers.

    The Government’s priority continues to be a return to a fully functioning and stable devolved Government as soon as possible, and to ensure the necessary delivery of public services for the people of Northern Ireland. We regret that the parties failed to elect a Speaker and form an Executive before the 28 October deadline. In line with his legal obligation, my right hon. Friend the Secretary of State will soon confirm the date of the next Northern Ireland Assembly election, as required by law. Following that election, and regardless of the result, the Northern Ireland parties really do need to come together to restore the devolved institutions and lead the people of Northern Ireland through the challenging times ahead. I think we all appreciate the significance of that to people in Northern Ireland; the hon. Member for Foyle made very clear the real impact on people of not having an Executive to deliver.

    The significance of NDNA in this context cannot be forgotten. The agreement shows how collaborative working and compromise can create the right conditions for stability—

    James Gray (in the Chair)

    Order. I am sorry to stop the hon. Gentleman, but I must now suspend the sitting until half-past 2 this afternoon.

  • Colum Eastwood – 2022 Speech on Derry Addiction Centre

    Colum Eastwood – 2022 Speech on Derry Addiction Centre

    The speech made by Colum Eastwood, the SDLP MP for Foyle, in Westminster Hall on 2 November 2022.

    I beg to move,

    That this House has considered delivering on New Decade, New Approach commitments to a Derry addiction centre.

    It is a pleasure to serve under your chairmanship, Mr Gray. I will begin with a quote from a service user of the Northlands addiction centre in Derry, which has served the people of our city for almost 50 years. It reads:

    “My mother on one side of me, crying her heart out, my elder sister on the other side with a Kleenex in one hand and her head in another. I didn’t know how I felt. I didn’t know how to feel. I was numb. No tears, no emotions, just nothingness. All I could do was stare at a spot on the carpet and try not to look up and see the hurt and pain in my mum’s face.

    That was over two years ago, and thankfully, I haven’t had to lift a drink since I came in here. Today though, I can feel, I can cry, and I can see what my mother and my sister meant all that time ago. I can see for myself the hurt and the pain and the despair my drinking was causing to my family and myself. Today, the difference is, I can do something about it. I am learning about myself and this horrible disease every day of the week, and for today anyway I didn’t drink, and for me as an alcoholic, that’s a miracle. The treatment in Northlands along with the help of AA since then has given me my life back; it’s given me a life!”

    That is just one of many thousands of stories from people in the city of Derry and right across Northern Ireland who have been affected by the disease of alcoholism and drug addiction, and who have been helped by the wonderful volunteers and staff at the Northlands centre in Derry.

    Jim Shannon (Strangford) (DUP)

    I commend the hon. Gentleman for bringing this issue forward. I talked to him at the airport on Monday, and today as well. Unfortunately, what he is referring to in his constituency is replicated across Northern Ireland and in my own constituency, where there are addiction and drug issues, and where young people are committing suicide. I know that is replicated in the hon. Gentleman’s constituency, so I commend him for securing the debate.

    My understanding is that the Department of Health is holding the money up. Does the hon. Gentleman feel that, through this debate and through the Minister, we might be able to ensure that the money that was promised can be allocated to the maiden city, and to the hon. Gentleman’s constituents, to make things better for them? There seems to be a wee hold-up.

    Colum Eastwood

    The hon. Gentleman is absolutely right to say that the impact of the disease of addiction is felt keenly right across our constituencies. Of course, it is important to say that the Northlands centre, which is referred to in the New Decade, New Approach agreement, serves people from right across Northern Ireland. Every single constituency is affected by it.

    Now that I see the former Secretary of State, the right hon. Member for Skipton and Ripon (Julian Smith), in the Chamber, I might say a word about how we got to this point. For three long years, we did not have an Executive—it feels a bit like we are approaching that period again. During the long hours of torturous negotiation, there was a lot of publicity around a couple of issues, but some of us were focused on a lot more. We wanted to see an Executive back, but an Executive that actually worked on issues that matter to people.

    Late one Friday night, the right hon. Gentleman and I had a long discussion about what it would take to get us back into the Executive if we had a successful negotiation. People will understand that, for me, one of those things was the expansion of the Magee university campus. Another was the Northlands centre, which, after many decades of work, has a strong proposal for a world-class addiction centre in Derry. True to his word, as always, the former Secretary of State got that commitment into the New Decade, New Approach agreement. I was very grateful for it, as were the people of Derry.

    However, as we know in Northern Ireland, words on a page are not enough. What we need is money in a bank account and proper commitment. To be fair, we had that commitment from the previous Government in the form of New Decade, New Approach, and I have had support from the current Government. We now really need an Executive in Stormont to deliver that. Unfortunately, even when we had an Executive—and we had a Minister up until last Friday—we still could not get the money out.

    There are a number of things that I would like this Government to commit to now. What we need is an understanding of what happens if we do not have an Executive. I think all of us in the Chamber want to see an Executive as soon as possible. I would love to see all parties commit to get into government urgently—to get round the table and do the job that we were all elected to do. However, I want the Minister to answer a number of questions for me in the event that that does not happen.

    Are the British Government still committed to delivering on the Derry addiction centre aspect of NDNA? We hear an awful lot about all the commitments, but this is a very important commitment for many people. What is the impact of the political instability on this particular proposal, and how will this Government act if we do not have a functioning Executive? As much as we all will it and want it, if we do not get to the point of having a functioning Executive, will those people who rely on this world-class service, and those who do not even know that they are going to rely on it, be able to access it?

    Mhairi Black (Paisley and Renfrewshire South) (SNP)

    Last year and the year before, on average almost every day in Northern Ireland somebody died because of the way that they misused alcohol. Does the hon. Member agree that if that number of deaths were caused by any other issue, Government would absolutely be on top of it and we would have the Executive up and running and functioning? Does he agree that there is no excuse for the lack of clarity from Government?

    Colum Eastwood

    The hon. Member is absolutely right; one person every single week dies from alcohol-related disease in Northern Ireland. If we add in drug-related deaths, we are talking about 10 deaths a week. Imagine the outcry if that was happening in full public view; we would be rushing to deal with the issue at every level of Government. Frankly, there is no excuse any more for anybody to stand in the way of this commitment.

    New Decade, New Approach was an international agreement, signed off by two Governments and supported by five political parties. Some of us actually went into government on the basis of this and other commitments. Everybody in the Chamber knows about the cost of living crisis and the time it takes to access the health service. We should all know about the impact of drug addiction and alcoholism in our communities. We should be rushing to get this money out the door and spent.

    Northlands has a very proud record. I want to put on record just how grateful the people of our city, and the people of Northern Ireland, are to all the staff and volunteers at Northlands, as well as all the people who put their money in the boxes to support that wonderful service. Over the past five years alone there have been 1,186 weeks of treatment for hundreds of people attending the six-week residential programme at Northlands, and 12,886 non-residential counselling slots have been used. On average, over 35% of people for whom the data is available in that period are in recovery, with an average of under 10% in relapse management.

    Julian Smith (Skipton and Ripon) (Con)

    Will the hon. Member talk a little more about the team behind Northlands? I recall from my time as Secretary of State that it is not a commercial or money-making enterprise; it is local people who understand the specific issues with addictions in Derry and are passionate about those priorities. They are deeply impressive, and I think it would be useful for the Minister to hear a bit more about the people behind Northlands.

    Colum Eastwood

    I am grateful for the right hon. Member’s intervention and I want to put on record my gratitude to him for getting the commitment in writing in the agreement. He went to meet the people behind the Northlands centre—people like Denis Bradley and many others, who over many years gave of their time, expertise and love for the people of our city and the people who have been struggling with this disease. The House would not believe the number of people who are very grateful for the work they have done.

    It is also important to say that in our city and in other parts of Northern Ireland, we are faced with another problem: the grip of paramilitarism. Paramilitaries use drug addiction and abuse to coercively control communities in a way that needs to be tackled. In my view, the best way to tackle it—because we have tried everything else—is to deal with the root cause, which is addiction. Organisations such as the Northlands centre do that in a way that needs huge support. What better way to do that than to get this money into that organisation’s bank account and to get this project delivered?

    Before I finish, I ask again: will the Government continue to be committed to funding this service? What will happen if we do not see an Executive formed as a matter of urgency? Will this Government step in if we do not get a Health Minister at Stormont? I hope that we do, and I assume the Minister is going to talk about the need for an Executive. He has no bigger supporter in that call than me, but if we do not get an Executive, what are this Government going to do? Of course, it was this Government who committed to getting this money to Northlands and getting the project up and running. I am grateful to the Minister for being here, but I will be even more grateful if we can get this money spent, as has been committed to.

  • Maria Caulfield – 2022 Speech on Black Maternal Health Awareness Week

    Maria Caulfield – 2022 Speech on Black Maternal Health Awareness Week

    The speech made by Maria Caulfield, the Parliamentary Under-Secretary of State for Health and Social Care, in Westminster Hall on 2 November 2022.

    It is a pleasure to serve under your chairmanship, Mr Gray. I thank the hon. Member for Streatham (Bell Ribeiro-Addy) for securing this debate. As she highlighted, we had a similar debate recently. I hope that my comments reassure her that we are taking action and making progress in this area.

    I take the issue of maternal disparities very seriously; that is why when I was in post previously I set up the maternity disparities taskforce, which has brought together a range of specialists and campaigners. We have heard from groups such as Five X More and the Muslim Women’s Network to hear their views on what is going wrong right now, what systems we need to put in place to improve outcomes and also the experiences of black women in maternity services.

    The data shows the disparities in black maternal health. We have heard about them clearly this morning, and I do not think anyone is in any disagreement about the scale of the problem we are facing. As the hon. Member for Streatham said, it is harrowing to hear those figures. The MBRRACE annual surveillance report shows that women of black ethnicity are four times more likely to die from pregnancy and birth compared with white women. I do not think there is a dispute about that; we fully acknowledge it and we want to reverse that trend as quickly as possible.

    Caroline Nokes

    I want to make a quick point about MBRRACE and the data. Data collection remains tricky, with some hospitals not reporting women’s deaths—not necessarily maternal deaths—until up to 500 days after they have happened. Then there is a delay with the medical records and notes, which might indicate the reasons for that. What reassurance can the Minister give that she will work to reduce those times?

    Maria Caulfield

    My right hon. Friend is absolutely right. Although Five X More does its surveys about the experience of women, the data on outcomes is very delayed. When we put measures in place, we cannot see the difference they make until the data comes through, roughly 18 months to two years later, as my right hon. Friend said. That lag does not help us determine whether the measures we are putting in place are actually making a difference. Getting that on track is a key priority for me so that we can accurately measure what is happening.

    From the data that we do have, The Lancet series in April last year found that black women have an increased relative risk of 40% of miscarriage compared with white women, and the stillbirth rate in England for black babies is 6.3 per 1,000 births, compared with 3.2 per 1,000 births for white women. That is completely unacceptable, and as the hon. Member for Streatham said, we cannot come back here, debate after debate, without seeing those figures move. One potential cause for optimism is that we do not have up-to-date data on the benefits of the interventions that we have put in place, so it might be better than we think. However, we absolutely need that data, not only to measure what is happening, but to know whether we are heading in the right direction if we set targets in the future.

    To reassure Members, I want to clarify the point about not setting a target because the problem is too small. I do not agree that the problem is too small; it is a significant problem. Even if it is affecting one or two women, it is a significant problem, so that is not a reason not to set a target. As the hon. Member for Putney (Fleur Anderson) pointed out, there are multiple factors in why black women often face poorer outcomes in pregnancy and birth, and for their babies. It is a mix of personal, social, economic and environmental factors. Air quality, which the hon. Member touched on, also has an impact on overall health. The maternity disparities taskforce found that being in a lower socioeconomic group has a significant effect on maternal outcomes, and black and ethnic women are often in those groups and so face a double whammy in terms of their likely outcomes.

    We cannot just fix this in isolation at the Department of Health and Social Care. That is why I am pleased that in my role for women’s health—I am also the Minister for Women, across the board—I can bring in other Departments, because we need to take a cross-Government approach to this issue. Whether it is the Department for Environment, Food and Rural Affairs on air quality, the Department for Levelling Up, Housing and Communities on housing, or the Department for Work and Pensions on employment, we need to work together so that all the factors affecting black maternal health are addressed in tandem to address this issue.

    We know from a health perspective that pregnant black women are more likely to suffer from some chronic diseases that will affect their maternity outcomes, and in particular cause poorer mental health. There are health initiatives that we can put in place to ensure that we improve the outcomes for black women, but that cannot be done in isolation from the other factors that also negatively affect them.

    Given the risks that such conditions pose in pregnancy, there is a need for safe personalised care for black women and women from ethnic backgrounds, because the needs of women from each and every community are so different. Just nationally introducing blanket systems will not address some of the problems; there is no one single solution that will improve the statistics and improve the outcomes for women.

    The issue is not just the outcomes from maternity services. As we heard from the hon. Member for Streatham, the Five X More survey also reflects the general experience by black women of the healthcare system. Although black women are often at a more difficult point to start with, when they engage with health services they often have a very negative experience. We have seen that in the recent publication of the East Kent maternity report and in the Ockenden maternity review, which highlighted that there is racial discrimination present in some parts of the maternity services.

    We cannot allow that to continue, because if we want black women to come and engage with services and to come forward when they have concerns, if they feel that they are not being listened to or if they raise concerns and they are dismissed, why would we be surprised when they do not engage with services in the future? Regarding the East Kent report in particular, I will look at the calls for action on how we improve black women’s experience of the healthcare system and considering how we can address those issues as urgently as possible.

    When we consider the actions that we are putting in place, and I will touch on some of the ones that have already started, I am very much a supporter of Professor Marmot’s idea of proportionate universalism, whereby we introduce good services across the country but then we target those people who are most in need; in the case of black maternal health, that is clearly women from the black community. We need to go to them rather than expecting them to come to the health service: we have a universal offer, but ensure that it is targeted specifically at those who do not experience the best outcomes.

    On targets, as my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) touched on earlier, we have an issue with data collection across the board in health services, including in maternity services. Black women often experience the worst outcomes, although some of the data that we are seeing is from 2020. For some of the initiatives that we have put in place in the last year or 18 months, we are not yet seeing the benefit of those initiatives in terms of outcomes. I am being very candid here: we have not got a handle on what is making a difference, or on which parts of the country are doing well—as was acknowledged by the hon. Member for Bolton South East (Yasmin Qureshi), the shadow Minister, there are some very good practices in place—and which parts of the country are still not supporting women in the way that women want.

    We are working with NHS England, the Office for National Statistics, MBRRACE-UK and the National Neonatal Research Database, because there are also multiple sources of data. We need to pull all the data together and get it as close to real-time data as we can, so that when we introduce interventions and measures we can know whether they work.

    As part of the maternity disparities taskforce, I am also keen to make sure that we include black women more in the national patient survey, because the shadow Minister was quite right that we had over 100,000 responses to the women’s health strategy but only a small percentage of those responses came from black and ethnic minority women. That illustrates the problem that we are talking about—that black women do not feel represented, or do not feel engaged with the process. So we have to change things and work is being done to address that situation.

    We are introducing some measures. First, we have set guidance that each local maternity system is now working in partnership with women and their families and their local areas to draw up equity and equality action plans. For each local maternity system’s local area, there has to be a plan in place about how to improve the outcomes for women. The plans are agreed by the local maternity systems and the new integrated care boards, which were set up in the summer. They were published last week, so I encourage hon. Members to look at their local action plans to see what they are putting forward and to challenge them if they feel that they are not meeting local community needs. That is why they are done on a local basis: what is appropriate in my constituency of Lewes may be different to what is needed in Streatham, Putney, Leicester East, or Romsey and Southampton North. It is really important that we look at those action plans to make sure that they address the problems that we are concerned about. Every plan is being reviewed by NHS England, which will identify areas of good practice and the support that is needed to drive them forward.

    In addition, we have also commissioned 14 maternal medicine networks covering the whole of England, which will ensure that women have access to specialist management. We know that black women are more at risk of high blood pressure, diabetes and sickle cell anaemia and yet many of those risk factors for their pregnancy and birth are not dealt with or managed. The maternal medicines network will bring in specialists so that, at an early stage of their pregnancy, those women can access those specialists to help them manage their pregnancy. They will also be offered pre-conception advice for further pregnancies. We have never done that before. We are targeting the risk factors of black women, and all women who are at risk, to make sure that they get the medical support and advice that they need during and after their pregnancy.

    The Department also launched the £7.6 million health and wellbeing fund last year, which is supporting 19 projects throughout England to try to generate best practice guidelines that we can introduce to help reduce disparities. These projects include supporting expectant young black fathers in child development and providing perinatal mental health support for black mothers. If we can get some evidence-based best practice, we can look to roll that out across the country in the coming months and years. There is a lot of work going on.

    I will touch on the issue of racial discrimination. It is clearly unacceptable that black, Asian and ethnic minority women feel that the health service is not accessible or not responsive to their needs. There is education and training for NHS staff on health disparities to eliminate bias and racism in obstetrics and gynaecology. The Royal College of Obstetricians and Gynaecologists’ race equality taskforce has developed e-learning cultural competencies. They now form part of the colleges’ members continuing professional development. The Nursing and Midwifery Council is also looking at how to promote and embed equality and respect in professional practice, so that they can create an environment where everyone feels that they can access the services they need. We will obviously continue to look at this with the maternity disparities taskforce, which is bringing in campaigners, experts and professionals to try to drive momentum on this issue.

    Data is the key. I can give a commitment here that has been highlighted already. We need that data. We cannot be working with data that is two years old to see if we are making a difference because, if we are, we will not know about it for two years and will not be able to roll out good practice in other parts of the country. In my brief as the Minister for Women, I am aiming to bring that across other Departments as well.

    I hope I have reassured hon. and right hon. Members in today’s debate that I am committed to continuing the work to tackle the disparities in outcomes to ensure that everyone has the opportunity to live a long and happy life. I am happy to work with the APPG on black maternal health, which is chaired by the hon. Member for Streatham, because it is only by working together to identify good practice and raising it when things are not working well that we can eliminate the disparity: it is unacceptable that black women are four times more likely to die during pregnancy simply because they are black women.

  • Yasmin Qureshi – 2022 Speech on Black Maternal Health Awareness Week

    Yasmin Qureshi – 2022 Speech on Black Maternal Health Awareness Week

    The speech made by Yasmin Qureshi, the Labour MP for Bolton South East, in Westminster Hall on 2 November 2022.

    It is a pleasure to serve under your chairmanship, Mr Gray. I thank my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for obtaining this debate, and for all the work she has been doing on this issue for many years. I also thank the incredible campaigners who continue to work tirelessly to end black maternal health inequalities.

    Maternal health inequalities exist throughout our country. It is very much a case of hit and miss: in some parts of the country the statistics are good, while in others they are not. However, black maternal health inequalities do seem to persist throughout our country. I also thank the right hon. Member for Romsey and Southampton North (Caroline Nokes), the Chair of the Women and Equalities Committee, who talked about the work that her Committee has done, but also noted that although this issue has been discussed for so many years, not much progress has been made on many of the concerns. My hon. Friend the Member for Putney (Fleur Anderson) spoke eloquently about the issues in Wandsworth and generally. In particular, she touched on bereavement services, the quality of which varies across the country as well. I thank the hon. Member for Leicester East (Claudia Webbe) for the very passionate speech she made. I agree with her: all mothers are superheroes. I do not think any debate would be complete without an intervention or speech from the hon. Member for Strangford (Jim Shannon), who is not in his place; I thank him for his intervention as well.

    As we have heard repeatedly in this debate, it is shameful that black women continue to be over four times as likely, and Asian women over twice as likely, to die in childbirth or pregnancy than white women. I am very grateful for the work of campaigners, obstetricians, midwives, and black and Asian women with lived experience of maternal health complications for sharing their experiences and expertise on the issue. They are clear that socioeconomic determinants and comorbidity only partially explain those disparities in treatment. Black and Asian women and their partners are not being listened to, they are not being respected and they are certainly not being cared for. When they voice pain or concern during pregnancy or childbirth, they are often branded as aggressive or angry, while dangerous stereotypes about the strong black woman mean that they are often not offered the same treatment as white women. Meanwhile, the lack of cultural competency in medical training in our country means that many complications are not spotted early enough.

    That structural inequality exists both inside and outside our health services. Many black, Asian and ethnic minority women experience it long before and long after pregnancy. However, the Government have done nothing to address this outrageous inequality. In fact, on their watch over the last 12 years, maternal mortality for black women has actually increased from 28 deaths per 100,000 in 2013 to 2015, to 34 per 100,000 in the years 2016 to 2018.

    Gynaecology wait times are very high. A survey from the charity Five X More found that 27% of women surveyed felt that they received a poor or very poor standard of care during pregnancy, labour and postnatal care. Also, 42% of women repeatedly felt discriminated against during their maternity care, with the most common reasons given being race, at 51%, ethnicity, at 18%, age, at 17%, and class, at 7% of respondents. More than half the women reported facing challenges with healthcare professionals during their maternity care, while over half the black women reported not receiving their preferred method of pain relief.

    Where is the Government’s action on this? In the last 18 months alone, we have seen their response to the Commission on Race and Ethnic Disparities fail to address black maternal inequality, as well as a women’s health strategy that completely fails to establish what concrete action the Government will take to protect the lives of black, Asian and ethnic minority mothers. It is hardly a surprise that the women’s health strategy has failed black, Asian and ethnic minority women, given that just 2% of the respondents who were surveyed were Asian and 3% were black. I am not trying to be party political here, but while the Government are busy crashing the economy and causing chaos at a time of national crisis, black, Asian and ethnic minority women continue to face the consequences of their inertia and ineptitude.

    Last year, in passing the Health and Care Act 2022, the Government had an opportunity to prioritise the health of black, Asian and ethnic minority women by voting for Labour’s amendment to mandate the Secretary of State to prepare and publish a report on disparities in the quality and safety of England’s maternal services, including maternal mortality rates. However, the Government chose to vote against it. It was a very simple measure that could have helped, but no, they voted against it. The Labour party has committed to setting a target to end the horrendous inequality faced by black, Asian and ethnic minority women as soon as we are in government.

    That will be part of our commitment to end structural inequality at the root, with a landmark race equality Act to be introduced by the next Labour Government. We are committed to pulling the NHS out of crisis so that it can deliver for everyone, including black, Asian and ethnic minority mothers. We will enact the biggest extension of medical school places in history. We will double the number of district nurses, train 5,000 new health visitors and, crucially for maternal health, introduce an extra 10,000 nursing and midwifery clinical placements each year. Our fully costed plan will be funded by ending the non-domicile tax status regime, which, it is estimated, would raise more than £3.2 billion every year. Growing the NHS will also grow the economy and eradicate these inequalities once and for all.

    I welcome the Minister to her new position. Like me, she has just recently joined this brief. While we wait for these changes, what is being done to address structural inequalities and build trust in maternity services for BME mothers, their partners and midwives from ethnic minority backgrounds? Additionally, what plan does the Minister have to improve cultural competency and unconscious bias training in medical schools and the health service?

    There is also the huge issue of the lack of available data, which has not been tackled in either the women’s health strategy or the Government’s response to the Commission on Race and Ethnic Disparities. As we have heard, accurate data disaggregated by ethnicity is central to closing the gap in maternal mortalities. Will the Minister commit to ensuring that all maternity services record the specific ethnicity of all mothers? Fatalities are just the tip of the iceberg, with many women speaking of near misses and poor treatment, so will the Minister commit to collecting and publishing that data?

    Some midwives also consider that the continuity of carer model could help to end these inequalities. A 2016 study found that women who see the same midwife throughout their pregnancy are 16% less likely to lose their baby. Despite that, the NHS has recently been forced to drop targets included in the NHS long-term plan to ensure continuity of carer for 75% of BME women by 2024 as a result of staffing shortages. It is clear that the Government are failing these women. What steps is the Minister taking to end the staffing shortages in maternity care so that those targets can be reintroduced and met by 2024?

    I have to say, it is scandalous that the Government have not yet even set a target to end this inequality. They have been in power for 12 years—that is a very long time in which to have comprehensively changed the system. Will they now commit to doing so immediately? We did it for stillbirths. Why has black maternity mortality not been a priority for the Government?

    This is an avoidable inequality. There are many steps we could be taking to end these awful disparities. Instead, the Government have done nothing while the issue has got worse. The Government must take action to address maternal health inequalities. We need a national strategy to tackle health inequality as a matter of urgency, which must include a commitment to eradicating the mortality gap between black, Asian and ethnic minority women and white women. Only Labour can deliver that strategy as part of our plan to tackle structural inequality at the root and lift the NHS out of crisis.

    I hope that the Minister will answer some of those questions today and commit to specific action that will be taken, because this cannot go on. These appalling statistics—the fact that black women have four times the mortality rates of others—are not acceptable in a decent, civilised society.

  • David Linden – 2022 Speech on Black Maternal Health Awareness Week

    David Linden – 2022 Speech on Black Maternal Health Awareness Week

    The speech made by David Linden, the SNP MP for Glasgow East, in Westminster Hall on 2 November 2022.

    It is a pleasure to serve under your chairmanship, Mr Gray. I, too, congratulate the hon. Member for Streatham (Bell Ribeiro-Addy) on securing the debate and on opening it so well.

    I was not due to speak in this debate on behalf of the Scottish National party; it was supposed to be my constituency neighbour and hon. Friend the Member for Glasgow North East (Anne McLaughlin), who has sadly been incapacitated and remains in Glasgow. I hope that those present will bear with me.

    I speak primarily from my position as chair of the all-party parliamentary group on premature and sick babies, because our APPG has looked into the issue of racial disparities in maternal healthcare, as well as inequalities more generally in maternal healthcare and neonatal services. These topics merit more attention from the Government. As hon. Members have said, there have been numerous debates, questions, early-day motions and all those kinds of things on this topic. The benchmark for whether the Government are getting this right is whether we will be back in this Chamber in 10 or 15 years’ time to have the same conversation. I certainly hope we will not.

    The Birthrights report, “Systemic racism, not broken bodies”, outlines the systematic racism in maternity services. That report confirms the devastating fact that black, Asian and mixed-ethnicity women are more likely to experience baby loss and illness, or to become seriously ill, and have worse experiences of care during pregnancy and throughout childbirth. I want to advocate for the report’s conclusion, which calls for a commitment to anti-racism by all maternity and neonatal services, and a commitment to ensuring that there are more black and brown women and birthing people decision makers in the wider maternity system. We have to look at the ticking time bomb in the neonatal and maternity workforce; that absolutely has to be in the mix. The report also calls for a safe and inclusive maternity and birthing experience for all parents, which I think we would all want to get behind.

    Healthcare is devolved in Scotland, which is largely why I do not want to impose too much in this debate. However, the SNP Scottish Government believe that there needs to be an open and honest conversation about race and institutional racism right across these islands—Scotland is not immune—in order to identify solutions that will lead to equality and positive outcomes for black and minority ethnic communities. Members have asked a number of questions of the Government; for the sake of brevity, and so as not to repeat what has been said, I will just say that I would like to hear the Minister respond to those, particularly the seven points made by the hon. Member for Putney (Fleur Anderson).

    I am very grateful to the hon. Member for Streatham for securing this debate and giving us an opportunity to focus on this issue. Most importantly, I am looking forward to hearing what the Government have to say, and to seeing what best practice can be rolled out in Scotland, because no part of these islands have a monopoly of wisdom or ideas.

  • Claudia Webbe – 2022 Speech on Black Maternal Health Awareness Week

    Claudia Webbe – 2022 Speech on Black Maternal Health Awareness Week

    The speech made by Claudia Webbe, the Independent MP for Leicester East, in the House of Commons on 2 November 2022.

    You are very kind, Mr Gray, and it is an honour to serve under your chairship. I thank the hon. Member for Streatham (Bell Ribeiro-Addy) for securing this vital debate.

    The health of our nation is reflected in the health of our mothers, and the shocking statistics paint a picture of nothing short of gross negligence. I thank Tinuke and Clo for producing the groundbreaking “Black Maternity Experience Report”. Their platform, Five X More, helped to spread information about the survey. I also thank the participants for sharing their powerful testimonies, and the all-party parliamentary group on black maternal health for demanding an urgent solution to the crisis.

    It is worth repeating that black mothers are four times more likely to lose their life during childbirth, and they are up to twice as likely to have severe pregnancy complications. Some 42% of women surveyed in the Five X More report felt that the standard of care they received during childbirth was poor or very poor. Successive Governments since at least the 1970s have systematically failed to address the shocking statistics on black maternal health, including on the standard of care they receive during childbirth. The “Black Maternity Experiences” report reveals that, even today, professionals still display racist and white supremacist attitudes and insensitivity towards black mothers without remorse. Black mothers suffer in silence through fear of reprisals, and fear that their care will become worse if they complain.

    If ever there was a need for the Government’s long-promised White Paper on health inequalities, it is now. Will the Minister urge for it to be put back on the agenda? Shelving the health disparities White Paper only compounds the suffering and pain of black mothers. Without it, any progress made by the newly appointed maternity disparities taskforce will be slowed.

    There is a crisis in midwifery up and down the country. Home birth teams are underfunded, delivery suites are closing, and the maternity workforce have seen management changes that prevent them from doing their jobs effectively. The disproportionate number of deaths of black mothers and their babies cannot simply be reduced to genetic or cultural factors. Equity in access to first-class healthcare is a must, and that means setting targets and specific funding for highly trained healthcare professionals, as outlined in the Five X More report. We know that black women are poorer, live in inadequate housing and suffer disproportionate environmental pollution, and that their educational chances and outcomes are disproportionately lower. Wealth inequalities are rampant.

    The fiscal shortfall of £35 billion that was recently announced by the new Chancellor will drive the Government’s tax-and-spend plans; the Government are looking at 101 ways to cut spending. This is the worst news possible for black maternal healthcare. It demonstrates a callous ideology that seeks to cut spending instead of taxing earth-shattering levels of idle wealth—an ideology that risks further harm to black women and other racialised groups by avoiding wholesale investment in healthcare.

    As we know, all mothers are superheroes who nurture babies, children and society, but black mothers have to overcome systemic barriers put in place by successive Governments, which result in black women’s wealth, health, education and environmental access not being equal to that of their counterparts. Alongside improving treatment and care, we have to start having frank conversations about the racialised distribution of wealth in the UK and what we need to do to tackle it and eradicate race inequalities in health outcomes. Mr Gray, I am sure you will agree that black mothers cannot wait any longer. The time for action is now.

  • Jim Shannon – 2015 Parliamentary Question to the Cabinet Office

    Jim Shannon – 2015 Parliamentary Question to the Cabinet Office

    The below Parliamentary question was asked by Jim Shannon on 2015-10-12.

    To ask the Minister for the Cabinet Office, how many people in each Office for National Statistics age group were diagnosed with melanoma in each of the last five years.

    Mr Rob Wilson

    The information requested falls within the responsibility of the UK Statistics Authority. I have asked the Authority to reply.

  • Douglas Carswell – 2015 Parliamentary Question to the Home Office

    Douglas Carswell – 2015 Parliamentary Question to the Home Office

    The below Parliamentary question was asked by Douglas Carswell on 2015-10-12.

    To ask the Secretary of State for the Home Department, what plans her Department has to publish the details of commercial arrangements with and training offered by the College of Policing to the government of the Kingdom of Saudi Arabia.

    Mike Penning

    The College of Policing sets standards of practice and is the professional body for those working in policing. In common with other organisations, the College does not routinely publish details of commercial contracts and has no plans to do so. In relation to international assistance, the College works closely with the Home Office, the Foreign and Commonwealth Office and other partners across government. It provides as much information as possible under the Freedom of Information Act, including the total income it has received from international activity.