Black Maternal Health Awareness Week

Bell Ribeiro-Addy Excerpts

Tuesday 29th April 2025 Westminster Hall

[Bell Ribeiro-Addy (Clapham and Brixton Hill) (Lab)]

I beg to move,

That this House has considered Black Maternal Health Week 2025.

It is a pleasure to serve under your chairship, Ms Furniss. Before I get to the crux of this debate, I want to begin by saying that the UK is one of the safest countries in the world for a woman to give birth. I say that at the outset not to diminish the importance of this debate, but to move beyond that platitude—because in the sixth largest economy in the world, this should be one of the safest places to give birth. It is important that we move beyond that and focus on the real and persistent inequalities facing black and minority ethnic women in maternity care. While I am sure it is not the intention to focus on that, it can give the impression that, because the UK is broadly safe, the negative experiences of some women are exceptional and not matters that require significant Government attention. When we detail some of the harrowing experiences of women and hear that response, it can feel as though our concerns are being minimalised, so I hope the Minister will appreciate that I have got that part out of the way. While the UK is among the safest places to give birth, it is by no means perfect, and for many women it is deadly. As always, it is vital to lay out the current state of affairs.

The disparities in maternity care are evident not only in maternal mortality statistics, which show that black and mixed heritage women are three times more likely to die during pregnancy or childbirth as white women, and Asian women twice as likely, but in many other areas. Miscarriage rates are 40% higher in black women, and black ethnicity is now regarded as a risk factor for miscarriage. MBRRACE-UK’s 2023 comparison of care for black and white women who have experienced stillbirth or neonatal death found that the majority of all significant issues were identified in antenatal care for 83% of black women, compared with 69% of white women; 67% of black mothers and babies had a major or significant issue related to pathology, compared with 46% of white mothers and babies; and 75% of black parents and 66% of white parents had significant issues identified during the follow-up or reviews of their and their baby's care.

Public Health England’s 2020 report found that prematurity is a major cause of long-term infant morbidity. Black mothers, particularly those of black Caribbean background, are twice as likely to give birth before 37 weeks. In Five X More’s “Black Maternity Experiences Report 2022”, 27% of the 1,340 survey respondents felt that they received “poor” or “very poor” care during pregnancy and labour, and postnatally. Forty-two per cent of the standard of care during childbirth was “poor” or “very poor”, and I sincerely hope that the findings of Five X More’s next survey, which is currently under way, will show some improvement here.

According to Bliss, many babies born to black mothers require specialist care after birth, particularly due to preterm birth or full term complications, yet significant inequalities persist in neonatal care, admissions, the quality of care received, and outcomes after discharge. Poor care received at such an early stage of life can have critical consequences and lead to long-term health complications for black babies and deepen trauma for their families. Post-natal mental health disparities are also significant; UK studies show that women from black, Asian and minority ethnic backgrounds are more likely to suffer from common mental health disorders, yet are less likely to access treatment.

[Afzal Khan (Manchester Rusholme) (Lab)]

The Caribbean and African Health Network CIC report reveals that the perinatal mental health services lack spaces where black women can feel safe, seen and supported. Does my hon. Friend, and indeed the Minister, agree that more inclusive, high quality and personalised care is required to meet the needs of all women in maternity care?

[Bell Ribeiro-Addy]

I thank my hon. Friend for his intervention; he is absolutely right. I re-emphasise the point that black, Asian and minority ethnic women are more likely to suffer from common mental health disorders, yet are less likely to access treatment. According to MBRRACE-UK’s “Saving Lives, Improving Mothers’ Care” report from last October, deaths from mental health-related causes accounted for 34% of deaths occurring between six weeks and a year after the end of pregnancy. It is vital that all those who experience pregnancy and childbirth receive mental health support, even if they do not necessarily present as struggling with their mental health; but that is especially true of black, Asian and minority ethnic women, who are more likely to have a negative experience during pregnancy and childbirth. Some of these women’s experiences are deeply traumatic and scarring, and can lead to several mental health problems. Despite that, they are less likely to access mental health support, so they are left to try to recover mentally from the experience on their own.

That disparity exists beyond pregnancy and childbirth, and even before conception. According to the Human Fertilisation and Embryology Authority, black women are 25 times less likely to access fertility treatment, and NHS-funded in vitro fertilisation cycles among black patients decreased from 60% in 2019 to 41% in 2021. Black and Asian patients aged 18 to 37 had the lowest IVF success rates compared with white patients in 2020-21, and non-white groups also struggled to access donor eggs, with 89% of egg donors being white, 4% Asian, 3% of mixed heritage and only 3% black.

During the International Women’s Day debate, I highlighted the latest MBRRACE-UK data, which showed a statistically significant increase in the UK’s maternal death rate in the years 2020 to 2022, even when excluding deaths caused by covid-19. Put plainly, more women and babies of all races are dying in the UK now than in the past two decades. This is incredibly worrying, and it means that black women, who often face the worst care, are likely to experience even further deterioration.

When I was researching the latest statistics and figures for this debate, it became increasingly apparent that the data on racial disparities in maternity care is limited and scattered. The data I have cited comes from a collection of reports by various medical bodies and advocacy organisations. Racial disparities are often identified as part of broader studies but, as far as I know, to date there has been no comprehensive medical study dedicated exclusively to racial disparities in maternity care and outcomes, despite the statistics consistently showing how bad things are becoming.

The Lancet’s recent study on maternal mortality and MBRRACE-UK’s reports do include racial breakdowns, but they are based on the data that they have, not the data that they need. A single, dedicated study is yet to be conducted. The lack of comprehensive research makes it incredibly difficult to see a full picture of what is happening, so I hope that the Minister will address that point and highlight what the Government are doing to get a clearer picture of the state of maternity care.

There is no one driver of the racial disparities in maternity care and outcomes. The causes are multifaceted, but overwhelmingly they are the result of a combination of structural racism, unconscious bias, gaps in culturally competent care and socioeconomic inequalities. The first two are incredibly important to highlight. Without acknowledging that the NHS has an issue with institutional racism and unconscious bias, we cannot address the problem. Those issues feed into the quality of care being delivered for black mothers and their babies. The inaccurate and dog-whistle assumptions around black women’s pain tolerance, for example, can lead to women being denied pain medication during childbirth, or misbelieved when raising concerns about pain felt that signals a severe medical condition. Those beliefs are not taught in medical school or during training, yet so many black women have come across a nurse, midwife or doctor who holds them. They are a direct result of institutional racism in the NHS and have a direct impact on the care that women receive.

It is important to note that, although racial disparities in maternity care are experienced regardless of class, occupation, education or geography, socioeconomic inequalities are still a very important factor in determining health outcomes and experiences. Women living in the most deprived areas have a maternal mortality rate more than twice that of women living in the least deprived areas. Black and minority ethnic people are 2.5 times more likely to be in relative poverty and 2.2 times more likely to live in deep poverty.

The combination of socioeconomic inequalities and institutional racism in the NHS is having a dual impact on black mothers’ experiences of maternity care and health outcomes. Much of the previous Government’s work to improve maternity care was focused on co-morbidities and socioeconomic drivers of poor health. Indeed, it is crucial that those areas are addressed, but without looking at the structural racism and unconscious bias in the NHS, the problems will persist.

I want to recognise the campaign groups that are pushing the issue up the political agenda. In the absence of concrete Government or NHS action, advocacy groups have stepped in to offer their solutions and recommendations. Where they can, they also offer alternative care and training. First—always first—I commend Five X More, which established Black Maternal Health Awareness Week in 2019. Its work empowers black women to make informed decisions during pregnancy, and it advocates for systemic change. It is currently conducting its second national survey, building on its impactful 2022 research.

Five X More is calling for a measurable Government target to end racial disparities in maternal death, a commitment that the Labour Government support but have yet to implement. I hope that the Minister will confirm today whether such a target will be set, how it will be measured and when we can expect it. Five X More also advocates for mandatory annual maternity surveys focused on black women’s experiences, compulsory anti-racism and cultural competence training for all maternity professionals, and improved data collection on ethnicity and outcomes.

[Natasha Irons (Croydon East) (Lab)]

I thank my hon. Friend for securing this important debate. Given the complexities and interchangeable disparities that affect maternal health for black women, does she agree that without a national target or framework we are doomed to make the same mistakes again and again? This travesty needs to end, because no mother or child’s health outcome should be determined by the colour of their skin.

[Bell Ribeiro-Addy]

My hon. Friend is absolutely right. These figures have been circulating for decades, but it was only after a successful parliamentary petition launched by Five X More that we first debated them in the House. We are now five or six years on and we are still in the same situation. Things have to change.

I will continue to pay tribute to the amazing groups that have been pushing for decades to put the issue on the agenda. Mimosa Midwives is another remarkable group that offers culturally safe, continuous maternity care. It campaigns for a culturally appropriate care model in the NHS and for inclusive training in midwifery education to reflect diverse maternal experiences, because much of our medical training remains centred on white women.

The Motherhood Group is a social enterprise supporting black mothers with peer-led services, training workshops and national campaigns. Its annual black maternal health conference brings together researchers, clinicians and service users to tackle disparities. It also launched the Blackmums app to connect mothers navigating similar challenges.

Other charities such as Bliss, Tommy’s, Birthrights and the Royal College of Midwives also highlight racial disparities in their broader efforts to improve maternity care. Where the Government and the NHS have fallen short, they have taken the time to campaign and to step in.

I will, however, acknowledge the positive steps that the new Government and the NHS have taken. In response to my written parliamentary questions last month, the Government outlined some ongoing measures. Every local maternity system must now publish an equity and equality action plan that sets out tailored actions to reduce disparities, especially for ethnic minority women and those in deprived areas. I welcome the roll-out of version 3 of the Saving Babies’ Lives care bundle, which aims to reduce stillbirth, neonatal death, pre-term birth and brain injury.

Maternal medicine networks are being established to ensure equitable access to specialist care for women at heightened risk. Those efforts are supported by the NHS equality, diversity and inclusion improvement plan, which was launched in 2023. That plan requires NHS organisations to tackle workforce discrimination, improve leadership accountability and foster an inclusive, harassment-free environment. I am also pleased to note that NHS England is developing a respectful and inclusive maternity care toolkit to support inclusive and culturally competent practice. Those are all really welcome developments, but much more is needed.

I will close with four questions for the Minister. First, will the Government commit to a statutory inquiry into racial disparities in maternity care, including testimony from affected families and frontline providers? Secondly, will the Government fund dedicated research into the medical complications disproportionately affecting black women during pregnancy and childbirth? Thirdly, will the Government commission a review of maternity training across all medical professions, to better equip practitioners in recognising complications and symptoms in black women and babies? Finally, do the Government acknowledge the presence of systemic racism within the NHS? If so, what steps are being taken to confront and eliminate it? It is good that in the past few years, the House has taken the time to acknowledge these issues and allow us to debate them, but even though the Government stated in their manifesto that a target will be set, we now need to see action. We cannot continue to see gaping inequalities in maternal outcomes.

--- Later in debate ---

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Ms Furniss. I, too, congratulate the hon. Member for Clapham and Brixton Hill (Bell Ribeiro-Addy) on securing this important debate today. As she said in her opening speech, the UK enjoys some of the best outcomes in the world when it comes to maternity health, but there is always more work to be done to improve our outcomes further. I hope we can all agree that equal access to the best care, for all across our society, should always be our target. That should be based on excellence across the board as standard.

We are considering Black Maternal Health Awareness Week, which is part of National Minority Health Month, and I welcome the opportunity to discuss this topic and exchange views with colleagues from across the House. Colleagues will know that as a clinician myself, I am always guided by data when assessing current healthcare practices and new policy proposals. A 2023 report by the maternal, newborn and infant clinical outcome review programme found that in the period from 2019 to 2021, 241 UK women died during pregnancy or up to six weeks after the end of pregnancy. That equates to a rate of 11.7 women per 100,000 giving birth. Each of those cases represents a tragedy for the woman and baby involved and their family and loved ones, and we must do all we can to prevent them.

The data does, as has been mentioned, also show that women from black backgrounds face a mortality rate much higher than the average; it is equal to 37.2 per 100,000. Women from Asian backgrounds also face a higher rate, at 17.6 per 100,000. Clearly, those figures present a pretty stark picture, but we must exercise care in the interventions that we make, and balance our desire to solve the problem with ensuring that we do that in a way that resolves the problem without risking creating others.

At the outset, it is crucial to ask what the Government are doing to understand the specific causes of these outcome disparities, because if we understand the causes, we will be better able to manage and treat them. The Kirkup and Ockenden reports have already been mentioned. What are the Government doing to ensure that those recommendations are fully implemented, and to develop a strategy to ensure that all women have the opportunity for a safe pregnancy and birth? What kinds of data held by the NHS and the Department of Health and Social Care might cast light on other demographic, economic or geographical patterns that contribute to these numbers, which we may be able to help to resolve?

We know that the most significant factor in predicting death during the maternity period is a pre-existing medical condition, and we know that disparities exist in the incidence of some pre-existing conditions that are relevant between some ethnic groups in the wider population. For example, a 2018 research paper in the American Journal of Kidney Diseases found that rates of heart disease were 20% higher among the black community than those from white backgrounds, and rates of stroke were a remarkable 40% higher. Do the Government know how the rates of pre-existing conditions among ethnic groups are influencing the figures on maternal health, and how are they going to work to reduce the risks of such conditions among these groups to try to improve the care not just during maternity, but during the whole of black ladies’ or ethnic minority ladies’ lives?

Maternal mortality itself arises from a number of conditions and causes. In the period from 2019 to 2021, for example, 14% of maternal deaths were attributed to cardiac disease, 14% to blood clots, 10% to sepsis and 9% to epilepsy or stroke. What are the Government doing to understand the prevalence of those conditions among ethnic groups, how the conditions can be prevented, how they can be identified in black women—indeed, in all women—how they can be better treated to save lives, how they can be better managed to save lives, and what research can be done to ensure that they are, if possible, prevented?

Socioeconomic deprivation has also been mentioned, and it is important to consider the impact of deprivation. In the period from 2019 to 2021, 12% of women who died during pregnancy or in the year afterwards were at severe and multiple disadvantage. That included, in particular, women who had suffered mental health conditions or domestic abuse, or had a history of substance abuse. How do the Government understand these factors and their influence on mortality rates, and what are they doing to help to resolve those issues?

Closer to home, in February 2022 the NHS Race and Health Observatory published “Ethnic Inequalities in Healthcare: A Rapid Evidence Review”. The authors of that report noted:

“Tackling poorer care and outcomes among ethnic minority women and babies continues to be a focus within the…NHS England and NHS Improvement Maternity Transformation Programme Equity Strategy, which includes pledges to improve equity for mothers and babies and race equality for staff.”

The Government’s abolition of NHS England risks placing that ongoing programme of work, like many others, in jeopardy. Will the Minister tell us the current status of the maternity transformation programme and the implementation of the equity strategy under the NHSE and DHSC reorganisation? How is that work being prioritised, given the many other demands on the Department’s time and resources—not least from the reorganisation—that might previously have been spent on improving care?

The previous Government improved the number of midwives per baby and made progress towards the national maternity safety ambition of halving the 2010 rate of stillbirths, neonatal maternal deaths and brain injuries in newborn babies. When will the Government set out their ambition for the next decade? The Labour Government promised more than 1,000 new midwives in their manifesto last year. Will the Minister update us on how many of those 1,000 midwives are now working for the NHS?

The Minister for Care recently stated that the 41 maternal mental health services are now live and will be active in every integrated care system by the end of 2025-26. How will the Government ensure that access to those services can continue when ICSs face such high cuts in funding?

Colleagues have mentioned the possible influence of systemic racism or unconscious bias in maternal outcomes. The NHS has an employed population of 1 million, and it is likely that some bad apples will be found within that overwhelmingly brilliant staff cohort, but I dispute that the NHS overall is a racist organisation. I work in the NHS—I should declare that interest—and I have not seen evidence of structural racism.

The Royal College of Obstetricians and Gynaecologists reported that, as of 2024, 45% of obstetric and gynaeco-logical doctors identify as of a black, Asian or minority ethnic background, and 26% of births were to women of black or other minority ethnic backgrounds. Figures for midwives are harder to assert, because they are collated with nursing staff, but the proportion among nurses is 22%.

[Bell Ribeiro-Addy]

I just want to check whether the hon. Lady understands that structural racism is about not the number of people within an organisation, but the way the organisation is set up and treats different people. Does she understand that having a high proportion of ethnic minority people does not necessarily mean that an organisation such as the NHS—which, I might add, in its senior levels is run by people mostly not from ethnic minorities—does not discriminate against people in a certain way?

[Dr Johnson]

I understand the hon. Lady’s point. I do not dispute that some women, men, boys or children have awful experiences at the hands of bad apples. That will happen within any organisation of that size—the NHS employs more than 1 million people. That is wrong and should be rooted out; it is absolutely clear that that should stop. However, I work in the national health service, and I think the vast majority of people who go to work in it do so to care for the patients in front of them as best they possibly can. Care should be provided on the basis of clinical need and should not be affected by the ability to pay or by any other socioeconomic, ethnic or other demographic data. Although I accept the point that some individuals will have experienced poor care, which is reprehensible, I do not think that is the majority situation by quite some margin. I think most people receive extremely good care in the NHS, and care that is delivered on the basis of their clinical need, not the colour of their skin.

[Bell Ribeiro-Addy]

Does the hon. Lady accept that, given that she is not of an ethnic minority and has not looked at the information given by a number of women from ethnic minority backgrounds who have experienced this, she is not really in a position to say that what they say they experienced does not exist?

[Dr Johnson]

That is not what I said.

--- Later in debate ---

[Bell Ribeiro-Addy]

I am just challenging her point. Just because for one or two reasons she may not have seen any institutional racism in the NHS, that does not mean it does not exist. Further, the figures for black maternal mortality are the same in the United States, which has a completely different healthcare system from ours, but they are not the same in countries in Africa or the Caribbean, where black women are the majority. Does she see why that can point only to institutional racism? It is a completely different healthcare system in United States. The only difference is that we are both living in societies where institutional racism is known to be a problem.

[Dr Johnson]

I think we can both agree that any examples of racism are reprehensible and should be rooted out and that, in the examples given, people are speaking truthfully of their perceptions and what they have experienced. No one is denying the experiences of individuals or groups who have experienced poor care and that that poor care should stop. I just do not think that that suggests the NHS itself is a racist organisation, because I do not believe that it is. That is our point of difference. I think the staff who work in the NHS are overwhelmingly not racist. They want to care for people on the basis of clinical need to the very best of their ability, regardless of any ethnic minority status.

[Bell Ribeiro-Addy]

I did not say that the people in the NHS are racist; I said the NHS has a problem with institutional racism. I hope the hon. Member will accept that there are distinctions between those two things.

[Dr Johnson]

I think we have both made our positions clear. I accept that some people will have received poor care and that the people who delivered that poor care need to be hauled over the coals. They need to be called out for what they have done and we must ensure that such care does not happen again. But I do not accept that the NHS is a racist organisation.

Another issue is language barriers. It is well recognised that it is difficult for people who have a language barrier to access health services. Can the Minister tell us what the Government are doing to help with that? In recent years in my medical career I have seen improvements in the delivery of language services, but when I was a more junior doctor an appointment needed to be booked in advance and an interpreter had to attend in person. Sometimes they were available and sometimes they were not. Sometimes other members of staff or family members would be used to interpret, which is a poor standard of care, relatively speaking.

--- Later in debate ---

[Bell Ribeiro-Addy]

I thank all Members present in this afternoon’s debate for their thoughtful and balanced contributions. It is not very often in the House that we are generally in agreement, so I am heartened to be joined by Members from different political backgrounds calling for us to improve the state of maternity care.

I was grateful for the intervention from my hon. Friend the Member for Manchester Rusholme (Afzal Khan), who talked about the lack of spaces where black women feel supported and the importance of increasing those for all women in maternity care. My hon. Friend the Member for Croydon East (Natasha Irons) pointed out the need for a national target and framework to challenge these issues. My hon. Friend the Member for Sherwood Forest (Michelle Welsh), the chair of the APPG on maternity, gave a fantastic speech on the significant concerns about the quality and safety of maternity services in the Nottingham University Hospitals Trust. She made very important points on tackling the underlying issues of culture within the NHS. I was also pleased to hear the Liberal Democrat spokesperson, the hon. Member for Chichester (Jess Brown-Fuller), rightly pointing out that this disparity is a national scandal. We are at risk of normalising these issues, and it is so important that we continue to challenge them. Although I do not agree with the shadow Minister on much, she made a very good point about language services.

I thank the Minister for her response and for detailing the steps that the Government are taking to tackle this. I know that the Government have committed to setting a target to end racial disparities in maternity care, and I was pleased to see it as a manifesto commitment, but at times, it can feel as though the issue is being kicked into the long grass, as the target has not yet been set. We are looking forward to that, and there are several campaigns watching the debate this afternoon that will have rejoiced when they heard that the Government have committed to setting a target. Like me, however, they continue to wait in eager anticipation to hear what it is. I hope the Minister will take that on board, and that we will not wait too much longer for the target to be announced.

Should there be a national inquiry into maternity services, we would hope that black maternal health would be considered as a clear element of the problem, with stand-alone recommendations on what should be done to tackle the disparities. That would be extremely important. I also thank the Minister for acknowledging the need for anti-racism training, that systemic racism exists, and that there are various things that we must do to tackle it. One of the worst things that can happen to women in this situation is being gaslit into thinking that their experiences did not happen. Women not being listened to purely because of what they look like, where they are from and their ethnic origin, is causing so many problems and even leading to deaths. We must acknowledge them and, instead of burying our heads in the sand, tackle issues of racism and discrimination in our health service.

Finally, I thank all the campaigners listening to the debate today again for their hard work and tireless campaigning. Many of the women in the campaign are involved because of their own experience in maternity care or that of a loved one. Many who have dedicated their time to campaigning on the issue do so because they do not want anybody else to go through what they did. It can be exhausting to re-live past traumas and continue to push the cause, but it is through their hard work that we are having the debate today and that we have a Government willing to address the issues.

In my opening remarks, I mentioned the worrying findings from the recent MBRRACE-UK report, which revealed that the overall maternal death rate is increasing. That is outrageous. That should be alarming to all of us and should spur us into action. I say this each time we have this debate: improving the state of maternity care for black and ethnic minority women and babies will improve the overall quality of maternity care for all mothers and babies. I hope we can agree that that is certainly worth doing.

Question put and agreed to.

Resolved,

That this House has considered Black Maternal Health Week 2025.

HIV Testing Week

Bell Ribeiro-Addy Excerpts

Thursday 13th February 2025 Westminster Hall

[Bell Ribeiro-Addy (Clapham and Brixton Hill) (Lab)]

It is a pleasure to serve under your chairpersonship, Dr Allin-Khan. I congratulate the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) on bringing forward this important debate and on the work he continues to do with my hon. Friend the Member for Vauxhall and Camberwell Green (Florence Eshalomi) on the APPG.

While we will spend most of this afternoon’s debate speaking about the goal to end new HIV transmissions by 2030, I feel it is important to recognise just how far we have come in our understanding of HIV and treatments for it, and in our education and awareness raising. We have seen so much progress in the fight against HIV since the 1980s crisis. Although there is still a way to go, it is through open discussions, such as the one we are having today, that we have been able to reduce the number of HIV cases in the UK down to an estimated 113,500. But it is thought that 4,700 people are unaware that they are living with HIV, and that is why it is vital that we continue to push to increase testing. We know that when caught early HIV is treatable and that the quality of life of those living with HIV is far better than it was back in the ’80s. Unknowing carriers risk not only not getting the treatment they need or getting it too late, but unknowingly infecting others. Testing is easy, quick and can save lives.

We know that testing among men who have sex with other men is high. This is incredibly encouraging, but we must do more to increase testing among heterosexual men, heterosexual and bisexual women, and the trans and non-binary community. The stereotype that HIV is only something that affects men who have sex with men is not true. In fact, the increase in infections in 2023 was attributed to sex between men and women, with a 35% increase among heterosexual men and a 30% increase among heterosexual women.

We should be doing more to encourage testing among all groups. That means greater investment in local and community-based public health initiatives, so I am pleased that the Government are investing in local government public health. I am particularly pleased to hear about the £38 million that is being awarded to my borough of Lambeth, which will go a long way towards supporting people with HIV, preventing HIV and funding other public health initiatives that the borough runs.

My hon. Friend the Member for Dartford (Jim Dickson) spoke about the important role that councils play, and it is a crucial role indeed. They encourage testing and are well-poised to target the right communities and areas to increase awareness, and they can tailor messaging in the way that is needed. The work of local councils and community-based organisations has really helped to increase testing rates and reduce stigma. It has also helped to ensure that as many people as possible know their HIV status, and the recent round of Government funding will continue supporting that work.

I hope to see more from the Government on the international front. We must actively look to support international efforts to stop HIV transmissions, especially at a time when President Trump is running his reckless review of American aid and has put the future of the US President’s Emergency Plan for AIDS Relief in the balance. Any credible attempt to end HIV transmission must include a global response. When it comes to ending HIV transmission, we are not an island. Ending new cases here will only last for so long if we are not contributing to efforts to end them abroad. Where the US is stepping down from efforts to tackle global HIV transmissions, we should be stepping up.

As it stands, we are already not on track to reach our target of ending new cases by 2030, but I hope that today we will hear insights from the Minister on the steps the Government are taking to increase testing and to end new cases in the UK and abroad. As I am sure other hon. Members do, I eagerly await the Government’s new HIV action plan in the summer.

Endometriosis: Women in the Workplace

Bell Ribeiro-Addy Excerpts

Wednesday 15th January 2025 Commons Chamber

[Gill Furniss]

I thank the right hon. Member for that intervention, and I absolutely agree. I pay tribute to you, Madam Deputy Speaker, and to the right hon. Member for the efforts he has put in over many years.

Stigma and a lack of awareness by employers means that reproductive health conditions can have a significant effect on women’s experiences at work. It is almost impossible to remain at work when suffering from chronic pain and the mental toll that these conditions cause.

[Bell Ribeiro-Addy (Clapham and Brixton Hill) (Lab)]

I thank my hon. Friend for the fantastic speech she is making. Endometriosis UK, which provides the secretariat of the all-party parliamentary group on endometriosis, of which I am the chair, released a report last year that found that 47% of women had visited their GP 10 or more times with symptoms prior to diagnosis. Many of those women are likely to face issues with getting time off work to attend these appointments, or experience some form of disciplinary action because of it. Does my hon. Friend agree that being understanding and tolerant about the number of appointments needed to secure a diagnosis is critical to being an endometriosis-friendly employer, and that, ultimately, we need to take steps to ensure that the process does not take several years and so many appointments?

[Gill Furniss]

I thank my hon. Friend. The average length of time taken is now eight years, which is not good.

Many women feel unable to speak openly about endometriosis as they would other conditions, as if it were something to be ashamed of. Research shows that 23% of women take time off work because of period health issues while 80% lie about reasons for absence if they are related to periods. Having said that, endometriosis is not just about periods; it is a whole-body complaint. I do not think there is an organ in the body up to the chest that has not been found to be affected by what is a crippling disease.

World AIDS Day

Bell Ribeiro-Addy Excerpts

Wednesday 27th November 2024 Westminster Hall

[Bell Ribeiro-Addy (Clapham and Brixton Hill) (Lab)]

I thank my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) for bringing forward this crucial debate. I will start by commending campaigners and activists who have worked tirelessly to ensure that we have international awareness of HIV and AIDS.

The legacy of racism surrounding the AIDS pandemic casts a long and enduring shadow for communities such as mine in Lambeth, and indeed across Africa and the Caribbean. Although the impact of the virus and our understanding of it has evolved, the legacy of racist attitudes towards AIDS continues to have consequences for black communities in the healthcare system. HIV-related racism and stigma increases vulnerability to infection in black communities, and those who are HIV-positive are less likely to come forward to be tested or to access treatment and health services.

Last year, more than one in three HIV diagnoses in Lambeth was classified as late, meaning that the immune system had already suffered damage. Across England, 44% of diagnoses are late and women are 51% more likely to receive such delayed diagnoses. Early detection saves lives, offering effective treatment that ensures that those living with HIV can lead long and healthy lives and not pass on the virus once it is suppressed.

People who are not infected are still at high risk because HIV stigma can prevent them from accessing information and education. Cultural taboos linked to sex and sexually transmitted diseases in black communities can also have an impact on people’s access to HIV prevention and education, which directly increases the vulnerability of those who are not infected.

Racist assumptions around HIV and AIDS have also had consequences in other areas of the healthcare system. As recently as 2021, the NHS had a discriminatory blood donation ban on black donors due to flawed science around HIV. The ban had a direct impact on sufferers of sickle cell, an illness that predominantly affects black communities. Treatment is dependent on blood transfusions, particularly for a rare blood group such as Ro, which is common in black people.

The legacy of those rules has resulted in a reluctance among the black community to come forward and donate blood. That is why I commend the work done by organisations such as the Terrence Higgins Trust, which makes a concerted effort to combat outdated and discriminatory policies and all the damage that they cause. I could not allow this opportunity to pass without mentioning the new Brixton blood donation centre in my constituency, which is opening in a few weeks. I extend an invitation to the Minister, and all Members, to come and visit the new clinic and to open their veins and donate. It is so important that we challenge the misgivings around blood donation and encourage people to donate.

Ending new HIV cases is not just a medical issue; it is a social justice issue. We have to challenge the racism and discrimination that prevents individuals from accessing care, education and support.

Oral Answers to Questions

Bell Ribeiro-Addy Excerpts

Tuesday 23rd July 2024 Commons Chamber

[Wes Streeting]

I welcome the hon. Lady back to her place. We worked constructively on the Opposition Benches together and, regardless of the size of the Government’s majority, we intend to work constructively with her on this side of the election, too. By extension, I congratulate her colleagues on their election. I have discovered that I have 72 new pen pals, all sitting there on the Liberal Democrat Benches, and they have been writing to me about a whole manner of projects. My colleagues and I will get back to them.

The hon. Lady is right that this is not just about the new hospitals programme, important though that is; the condition of the whole NHS estate is poor. In fact, backlog maintenance, the direct cost of bringing the estate into compliance with mandatory fire safety requirements and statutory safety legislation, currently stands at £11.6 billion. That is the legacy of the last Conservative Government.

[Bell Ribeiro-Addy (Clapham and Brixton Hill) (Lab)]

11. If he will take steps to help increase the number of accommodation units available for parents whose babies have been admitted to neonatal care units.

[The Minister for Secondary Care (Karin Smyth)]

I congratulate my hon. Friend on her re-election and thank her for raising this important issue. It is not right that three out of four parents are not able to stay with their critically ill baby overnight at such an important point in that new relationship. NHS England recently concluded a review of neonatal estates. It is in the early stages of analysing the findings, which will be used to inform the next steps. We are all determined to support parents to be involved in every aspect of their baby’s care.

[Bell Ribeiro-Addy]

I congratulate my right hon. and hon. Friends on their re-elections and on taking their places. Recent research from the charity Bliss showed that when a baby receives neonatal care, their parents are routinely expected to leave them in hospital overnight for weeks or even months at a time. Its research found that for every 10 babies who need to stay overnight in neonatal care, there is only one room available for a parent to stay with them. How will the Minister ensure that the existing guidance about facilities for families is followed, and how will she ensure that trusts can access the resources they need to stop the separation of babies and their parents?

[Karin Smyth]

My hon. Friend is absolutely right that the separation of babies and their parents at that time is not acceptable, and about the shocking state of the estate, as we have just heard. We will look at the findings of the NHS review very quickly, and I will be happy to get back to her on those specific points.

Oral Answers to Questions

Bell Ribeiro-Addy Excerpts

Tuesday 23rd April 2024 Commons Chamber

[Andrew Stephenson]

Thanks in part to the sterling work of my hon. Friend, monthly average patient recruitment to commercial clinical trials is almost five times the figure it was back in June 2023. That is hugely positive, but there is clearly more to do in this space.

[Bell Ribeiro-Addy (Streatham) (Lab)]

For over a decade, the Camberwell dialysis unit has provided high-quality NHS care to patients in south London, so my constituents were shocked to hear that these services are to be outsourced to Diaverum, a multinational for-profit health corporation, which has already had one of its clinics rated inadequate and put into special measures. Does the Minister accept that privatising the NHS bit by bit has disastrous implications for care, and will he listen to patients in my constituency and commit to maintaining our NHS dialysis provision?

[Andrew Stephenson]

That sums up the usual contradiction on privatisation between Labour Front Benchers and Back Benchers. Any service changes should be based on clear evidence that they will deliver better patient outcomes. In Lambeth, patients who receive dialysis at the new site in Brixton will receive care in a significantly improved environment with brand new facilities, in a great example of an innovative public-private partnership. NHS England has established the renal services transformation programme to reduce unwarranted variation in the quality of access to renal care.

Hospice Funding

Bell Ribeiro-Addy Excerpts

Monday 22nd April 2024 Commons Chamber

[Sally-Ann Hart]

I agree. It is important to point out that most hospices do not want 100% funding from the Government because they need the flexibility to do what they want. Fundraising is a really important part of the local community effort, bringing people together, but when the dependence on fundraising is so vast we might need to intervene to provide extra funding.

End of life care is an essential service that so many of us will need, but the situation is made worse by inflationary pressures and rising demand. We have an excellent ICB in Sussex—NHS Sussex, led by Adam Doyle—which has highlighted that hospices are recognised as having become increasingly fragile in recent years, due to a lack of resilience in their funding model, which is heavily reliant on gifted income alongside NHS grants.

[Bell Ribeiro-Addy (Streatham) (Lab)]

Royal Trinity Hospice in my constituency supports people across central and south-west London to live and die well. Next year it will cost it £19 million to deliver care for its around 2,500 patients and support for their nearly 1,000 loved ones—a 20% on-year increase. Meanwhile, the NHS funding that it receives will decrease in real terms to 24% of the costs of running its services. Does the hon. Member agree that the Government should commit to maintaining the funding levels that hospices such as Royal Trinity require to ensure that people receive the quality of end of life care and the dignified death that they deserve?

[Sally-Ann Hart]

This is the point of the debate: to work out what sort of funding models we need. ICBs also need to be given the freedom to assess the priorities in their local areas, but I take that on board.

We have eight hospices across Sussex, and in 2019 seven of them formed the Sussex hospice collaborative—partnership working to ensure that the hospices’ combined resources can be used to maximise the impact, reach and cost-effectiveness of their activities. NHS Sussex works closely with that collaborative arrangement, which has supported the ability to have collective conversations. In January, the APPG on hospice and end of life care published a report on Government funding for hospices. The inquiry found that despite the introduction of a legal requirement for integrated care boards to commission palliative and end of life care, ICB commissioning of hospice services is currently not fit for purpose, and the value that hospices provide to individuals in the wider health system is at risk.

Hospice funding has historically not risen in line with inflation, which has been brought starkly to light during the periods of high inflation in recent years. Costs to keep palliative services running have increased rapidly over the past few years, but that is not reflected in the Government funding that hospices receive to deliver the services, which has increased by only 1% each year on average.

NHS Workforce

Bell Ribeiro-Addy Excerpts

Tuesday 6th December 2022 Commons Chamber

[Bell Ribeiro-Addy (Streatham) (Lab)]

The importance of this debate should not be understated because the NHS is in a dire state, and that is largely the result of a severe staffing crisis. Other than the generally inept economic policies we have seen from the Government, there is no denying that the Brexit deal has had a direct impact on staffing numbers, and that chronically low pay and poor working conditions have resulted in an exodus of staff leaving the NHS to work in the private sector, work abroad or leave the healthcare profession entirely.

I would like to start with one of the most undervalued groups in our NHS, which is the first that most of us meet in modern Britain—the midwife. The Royal College of Midwives has estimated that it has an existing and long-standing shortage of more than 2,000 midwives, and that for every 30 who are trained, NHS England loses 29. Vacancies for nurse positions are estimated to be at an all-time high, with a survey at the start of the year finding that 57% of nursing staff across healthcare settings are thinking about quitting or actively planning to quit their jobs.

With figures such as these, we cannot blame existing staff for wanting to leave or blame others for not wanting to fill these vacancies, particularly when we see the TUC’s estimates that, since the Conservatives took office in 2010, midwives have had a total real-terms pay cut of £5,657, nurses’ pay is down by £4,310 in real terms and the pay of all doctors is down by about 7.4%. We cannot forget the thousands of non-medical staff, who are often overlooked, but are integral to keeping the NHS running. Cleaners, security guards, porters and other important workers have, along with other NHS staff, faced real-terms cuts in pay since 2010.

Is it any wonder that the NHS waiting list has now tipped to over 7 million? When we hear of the scale of the vacancies, can we really be surprised that some A&E patients are left waiting for over 12 hours, or that ambulances are repeatedly failing to meet their target response times? The staffing crisis in the NHS is having a dire impact on patient safety, and if we are going to tackle the NHS backlog, address the crisis in staff recruitment and retention, and bring the NHS back to the standard it should be, we first and foremost have to address pay. We cannot be gaslighting nurses by saying that they should drop their pay demands to send a message to Putin, which is absolutely ridiculous.

We have to pay nurses what they are worth, and if the Government were not aware of what they are worth, the pandemic should have shown them. We called them key workers because we could not do without them, yet the Government justify their pay by calling them low-skilled workers. There is no such thing as low-skilled work; there is only low-paid work. All work is skilled when it is done well, and our NHS staff are the best example of this. On the contrary, Ministers, who are paid multiple times more but who have shown little skill in running the country, if the cost of living crisis and the economic situation are anything to go by, are completely different. They get paid so much more, but we cannot see their sense of skill in running this country.

In the past year, a number of NHS personnel have been taking strike action against low pay, and nurses will be striking later this month for the first time in the Royal College of Nursing’s 106-year history, while ambulance staff have announced their strike today. If that does not show us the scale of the crisis facing workers in the NHS, I do not know what does. No one wants to have to take strike action, least of all the workers in our NHS, but the dire situation of chronic underpayment and poor conditions is leaving them no choice. This Government have left them no choice. When we have 27% of NHS trusts operating food banks for their staff, when one in three nurses is taking out a loan to feed their family and when NHS staff across the board are severely underpaid, of course they are at the point of saying that enough is enough.

No one goes to work for the NHS for the money, but it cannot be fair to expect people to live on poverty wages. If the Government want to address this crisis in recruitment and retention, they must get over this ideological aversion to paying public sector workers what they are worth. That means committing to a proper cost of living pay rise, and setting out plans to reverse a decade of real-term cuts in pay for our NHS workers.

Baby Loss and Safe Staffing in Maternity Care

Bell Ribeiro-Addy Excerpts

Tuesday 25th October 2022 Westminster Hall

[Bell Ribeiro-Addy (Streatham) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Hartlepool (Jill Mortimer) on securing this important debate.

The loss of a baby at any stage of pregnancy or after birth can be an incredibly painful experience for any parent. I pay tribute to everyone who has and will share their experience of baby loss in this Chamber. It takes a lot to relive that trauma, but I have heard that it means so much to everyone listening when we speak about such issues in this House. Sadly, when baby loss happens, people are often told, “It is one of those things” or “It just happens”. I remember being told in my grief that I was not the first woman that this happened to and that it was one of those things. It is heartbreaking that women continue to be gaslit in this way when we know that negative pregnancy and birthing experiences can drastically or even fatally change outcomes. We have to accept that it is not always “one of those things” and work to come up with solutions to end it.

I want to touch on two things. The first is a report conducted by Five X More—the black maternal health awareness campaign. It conducted the largest nationwide study of black women’s experiences of maternity services in the UK, and the results make for some shocking reading. The report will be presented to Parliament next Tuesday, and will be followed by a lobbying event by the campaign—where it will reiterate the call on the Government to set a target to address disparities and close the gap in mortality rates—to which all hon. Members have been invited. I put that request to set a target to the Minister again today.

The report encompasses the views of more than 1,300 black and black mixed-heritage women and their maternity experiences, including a number of black women who have experienced baby loss. As some will know, black women are four times more likely to die during pregnancy, labour or post partum; Asian women are twice as likely; and women of mixed heritage three times more likely. Black women are 40% more likely to experience a miscarriage, and black babies have a 50% increased risk of neonatal death and a 121% increased risk of stillbirth.

The Five X More report highlights all the negative interactions that women experience with healthcare professionals: feeling discriminated against in their care; receiving a poor standard of care, putting their safety at risk; and being denied pain relief. After experiencing negative maternity outcomes, 61% of the women surveyed reported that they were not even offered additional support to deal with the outcome of their pregnancy—something that, as we have heard today, is widespread. It is vital that we acknowledge these racial biases when we discuss maternity care.

To make maternity care safe for all patients, it is vital that the level of staffing and the treatment of staff is looked at. For every 30 midwives trained in this country, 29 are lost—what an indictment of the state of maternity services in this country. That is one of the reasons I am proud to support March with Midwives and the awareness it is trying to raise of the dire conditions midwives are facing. Midwives are overstretched, under strain and working in situations they know are unsafe, but pushing ahead anyway at a risk to their physical and mental health. They do not do it for the big bucks, but the least we can do is pay them decently—something that we know we are not doing.

All we ask from the Minister today is to address the pay conditions and shortages that midwives are facing. Everybody in this room owes their life or the life of one of their loved ones to a midwife. They deserve better, as do the women and babies they aim to care for.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Caroline Johnson)]

First, I thank all the Members who have taken the time to attend the debate and those who have spoken so openly about their own, and their constituents’, experiences and concerns. I particularly thank my hon. Friend the Member for Hartlepool (Jill Mortimer) for securing the debate and enabling us to have this important conversation.

Let me take this opportunity to recognise the work of everyone who has been involved in Baby Loss Awareness Week. It is important that we make it easier to speak about pregnancy loss and enable people to have open conversations about their experiences, which in turn can help those who have experienced the tragic loss of a baby. I also take this opportunity to commend the work of the charities that provide excellent support to families experiencing baby loss, including all the members of the Baby Loss Awareness Alliance and the Lily Mae Foundation, which was mentioned by my hon. Friend the Member for Meriden (Saqib Bhatti).

As we take time to reflect, I want to acknowledge how difficult the loss of a baby is. Everyone’s grief will be different. It is a personal, individual process, which people will try to navigate in many different ways. Although it can be challenging to reflect on such tragic losses, this week provides an opportunity for people to remember, reflect, share and seek support and comfort from other people.

This is the seventh year in a row that a debate has been held to mark Baby Loss Awareness Week. I am honoured to take part as the new Parliamentary Under-Secretary of State at the Department of Health and Social Care and to work with everyone to continue making a difference in an area as vital as maternity and neonatal safety.

The independent review into maternity and neonatal services at East Kent Hospitals University NHS Foundation Trust, as mentioned by my right hon. Friend the Member for North Thanet (Sir Roger Gale), was published last Wednesday. I take this opportunity to extend my condolences to the families who suffered due to the care they received and express my gratitude to the individuals who were instrumental in establishing the review and to the inquiry team for carrying out the review to such a high standard. The Government and I take the findings and recommendations of that report extremely seriously, and I am committed to preventing families from experiencing the same pain in the future.

Our maternity safety ambition, as mentioned by my hon. Friend the Member for Hartlepool, is to achieve half the 2010 rates of stillbirths, neonatal and maternal deaths, and brain injuries in babies occurring soon after birth. Since 2010, the rate of stillbirths has reduced by 19.3%, the rate of neonatal mortality for babies born over 24 weeks gestational age has reduced by 36% and maternal mortality has reduced by 17%. However, it is important to note that there was an increase in the rate of stillbirths between 2020 and 2021. This increase occurred at the same time as the covid pandemic, and detailed work is going on to establish why that was the case. I reassure hon. Members that we remain committed to our maternity safety ambition.

Every woman giving birth has the right to a safe birth, and the Government and NHS England are committed to providing women with personalised and individual maternity care. The role of NHS staff in maternity services is critical to safe care for families, and I recognise all the great, hard work by teams across the country and thank them for it.

Members on both sides of the Chamber have talked about funding and workforce. NHS England has invested £127 million in bolstering the maternity workforce even further and in programmes to strengthen leadership and retention and provide capital for neonatal maternity care. We will keep that funding under review. That investment is on top of the £95 million investment made last year in the establishment of 1,200 more midwifery posts and 100 more consultant obstetrician posts. There are increasing numbers of midwifery and obs and gynae trainees.

I am grateful to the APPGs on maternity and on baby loss for producing their report into the maternity workforce, and I acknowledge the important themes in it. The hon. Member for Enfield North (Feryal Clark) raised the issue of retention. NHS England has established a nursing and midwifery retention programme, supporting organisations to assess themselves against a bundle of interventions aligned to the NHS people promise and it will use the outcomes to develop high-quality local retention improvement plans. In addition, in 2022-23 we made £50,000 available for each maternity unit in England to enhance retention and pastoral support activities.

[Bell Ribeiro-Addy]

Will the Minister give way?

[Dr Johnson]

I will not, because I have a lot of questions to get through in a really short time.

Many hon. Members talked about bereavement. In the difficult scenario of baby loss, we understand that bereavement care for women and families is critical. We continue to engage closely with the bereavement sector to assess what is needed to ensure that bereaved families and individuals receive the support that they need. This year we have provided £2.26 million of national funding to support trusts, expand the number of staff trained in bereavement care and directly support trusts to increase the number of days of specialist bereavement provision that families can access.

In the women’s health strategy, which hon. Members mentioned, published earlier this year, we discussed the introduction of pregnancy loss certificates for England. This will allow a non-statutory, voluntary scheme to enable parents who have experienced a pre-24 weeks pregnancy loss to record and receive a certificate to provide recognition of their baby’s potential life. The certificate will not be a legal document, but it will be an important acknowledgement of a life lost, and we hope that it will provide comfort and support by validating a loss.

We understand the impact of pregnancy and childbirth on mental health, especially for those affected by the loss of a baby, and we are committed to expanding and transforming our mental health services so that people can receive the support that they need when they need it.

As part of the NHS long-term plan, we are looking to improve the access to and quality of perinatal mental health care for mothers and their partners. Mental health services around England are being expanded to include new mental health hubs for new, expectant, or bereaved mothers. These will offer physical health checks and psychological therapy in one building.

Oral Answers to Questions

Bell Ribeiro-Addy Excerpts

Tuesday 19th April 2022 Commons Chamber

[Sajid Javid]

I share my hon. Friend’s concerns, which is why the NHS commissioned this review from one of our top paediatricians. It is already clear to me from her interim findings and the other evidence I have seen that NHS services in this area are too narrow; they are overly affirmative and in fact are bordering on ideological. That is why in this emerging area, of course we need to be absolutely sensitive, but we also need to make sure that holistic care is provided, that there is not a one-way street and that all medical interventions are based on the best clinical evidence.

[Bell Ribeiro-Addy (Streatham) (Lab)]

T5. Since February 2020 my local borough of Lambeth has seen a 14% drop in dementia diagnosis. That means people are not getting the support that comes from diagnosis. We also know that so far none of the announced £8 billion backlog funding has been dedicated to addressing the stagnation of diagnosis rates. Can the Secretary of State explain what exactly he is going to do to make sure that people get diagnosed on time?

[The Minister for Care and Mental Health (Gillian Keegan)]

The hon. Lady raises a very important question. We want a society in which every person with dementia and their families and carers receive high-quality, compassionate care from diagnosis through to end of life. We have provided £17 million this financial year to NHS England and NHS Improvement to increase the number of diagnoses. That funding was spent in a range of ways, including investing in the workforce to increase capacity in memory assessment services.