Women’s Health Outcomes

Baroness Nicholson of Winterbourne Excerpts
Thursday 8th July 2021

(3 months, 2 weeks ago)

Lords Chamber

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Department of Health and Social Care
Lord Boateng Portrait Lord Boateng (Lab) [V]
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My Lords, thanks are due to the noble Baroness, Lady Jenkin, for all she has done for women’s health. She mentioned pregnancy. Black women in the UK have higher rates of morbidity and mortality related to pregnancy and childbirth than any other section of the community. They have worse outcomes too for breast and cervical cancer. Black women of Afro-Caribbean origin are less likely to consult health professionals regarding symptoms of perinatal depression. The British Journal of General Practice gives as the perceived reasons for this a lack of compassion in healthcare workers and a lack of culturally sensitive staff. I hope the Minister will address how training is going to address these issues.

Reference has been made to Covid. In a study of maternal death in the course of the Covid pandemic, it was revealed that 88% of the deaths investigated in the report Saving Lives, Improving Mothers’ Care were from black and ethnically diverse groups. I hope the Government will ensure that, in learning the lessons of Covid, the impact of ethnicity and racism is taken into account. The Royal College of Obstetricians and Gynaecologists has called on the Government to take action on racial disparities and on the Government’s own racial disparity audit and the extent of the real problem it reveals. What action is in fact being taken in that area?

Black and south Asian ethnic-minority women suffer a double whammy of gender and ethnicity. They suffer a real disadvantage in their access to healthcare and of positive outcomes. There is an issue—we cannot ignore it—of unconscious bias. This leads to adverse behaviours. It leads also, I am afraid, to adverse outcomes. We need to address this in training and continuous professional development.

The absence of black and ethnic-minority women in all too many clinical trials reveals an equally important issue, as well as a stereotyping of south Asian women as somehow more likely to suffer pain and of black women as non-compliant. If you are a black or Asian woman, you are more likely to find yourself locked up in a secure ward. You are less likely to have treatment by way of talking therapies. We know that we need partnerships with women’s organisations; we need to listen better to women, especially black women, and we need resources. All these things are necessary if we are to translate good intentions into action that makes a real difference for women in general and black and ethnic-minority women in particular.

Baroness Nicholson of Winterbourne Portrait Baroness Nicholson of Winterbourne (Con)
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I welcome this important debate on women’s health. I congratulate the noble Baroness, Lady Jenkin of Kennington, and thank her profoundly for her deep and permanent commitment to the health and welfare of girls and women.

Like her, I have worked overseas and on the ground as a volunteer on violence against girls and women and, specifically for this debate, on raped and tortured female victims. Indeed the noble Baroness, Lady Bull, and I were working on that together only 10 days ago for Yazidi victims. I seek our Government’s ongoing commitment to the plight of these most special girls and women, both here and in the war-torn nations where I work, above all others. These heavily damaged survivors of continuous rape by different but always violent males deserve the very best of surgical and general healthcare.

My praise for our NHS staff and volunteer rape crisis centre teams in Britain, all of whom treat raped girls and women with outstanding care and sensitivity, is unbounded. However, the natural growth of social concern for difference and our proper national commitment to greater inclusion has led to the appointment of natal males to tend to acutely female needs, such as intimate care for mentally challenged in-patient girls, and to lead staff posts in rape victim settings. I believe the noble Baroness will join me in examining these breaches of customary dignities afforded to women whose capacity is either limited since birth, accident or illness or has been compromised by rape or other indignities. Should they not be care for, nurtured and helped to live by fellow females? Common sense and parental requests suggest they surely should, yet that is not the case today. I urge the Minister, for whom I have the highest respect, to pay heed to research and take steps to correct this situation.

Lord Brooke of Alverthorpe Portrait Lord Brooke of Alverthorpe (Lab)
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My Lords, I join others in expressing my gratitude to the noble Baroness. She is a great campaigner and is prepared to reach out across all Benches. That is much required with the problems we face.

I think I am probably the first to mention football, but I mention Denmark and congratulate it on the work it does with women. Denmark ranks the highest in the whole world in presenting a community in which women have equality; it respects and does not abuse women. Women are treated as well as men at work and in health terms. It is a great country and should be proud of what it has done.

We could learn a lot from Scandinavia about how we treat each other, and in particular how we treat women. Look at what Denmark does with justice—restorative rather than punitive justice, which we engage in so much in this country. Do noble Lords know that Denmark does not fill its prisons? In fact, it invites neighbouring countries with a surplus of prisoners to send them to Denmark. That is because of the way it approaches its problems.

Similarly, we find that Denmark deals with issues we have here, where women are abused because of alcohol—that and a whole range of other topics were mentioned earlier—in a quite different way. We really ought to learn that we should visit others and invite them here to try to help us with some of our problems. Basically, I think it does so well because, as in other Scandinavian countries, the inequality in wealth is so minimal by comparison with what we experience. We cannot run away from that.

My noble friend Lord Rooker and the noble Baroness, Lady Greengross, raised Sir Michael Marmot’s continuing work on inequality and the need to get incomes and salaries closer together, in the way that we had 30 or 40 years ago. This is fundamental to health and so many aspects of what happens in society. I look to the Minister to see whether the Government are doing work on it.

This morning I listened to Nadine Dorries talk on a Zoom exercise about the coming review. There have been 112,000 responses to the strategy. Like others, I look forward to seeing whether something positive comes out of it and that we have attached to it a firm action programme.

Like others, I spoke on the great report from the noble Baroness, Lady Cumberlege, but when is the action coming? What are the Government going to do with that? When will we see the action programme presented to the House?