Oral Answers to Questions
Debate between Caroline Nokes and Maria Caulfield(1 month, 1 week ago)
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Caroline Nokes (Romsey and Southampton North) (Con)
The issue is not just the gender pay gap; there is also the gender pension gap, the lack of women on boards, and the importance of making sure that we have a pipeline of talented women at every level. Yesterday, I was with the community interest company, Women on Boards, and its clear message to the Minister is, “Please can we have more action and fewer initiatives, to ensure that we make real progress in getting women in our companies, at every level?”.
Maria Caulfield
We absolutely are taking action. We are planning to introduce the pay transparency pilot, because in high-paid jobs, salaries are often not advertised, and women end up being paid less than men for the same role. It is such action that will make a difference to women across the country.
International Women’s Day: Language in Politics
Debate between Caroline Nokes and Maria Caulfield(2 months ago)
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The Minister for Women (Maria Caulfield)
I start by thanking my right hon. Friend the Member for Basingstoke (Dame Maria Miller) for securing this important debate, and all hon. Members for their contributions. The use of language, particularly in politics, is such an important topic. Members have shared very personal experiences, including the hon. Member for Pontypridd (Alex Davies-Jones), my right hon. Friend the Member for Aldridge-Brownhills (Wendy Morton), the hon. Member for Newport West (Ruth Jones), and the hon. Member for Swansea East (Carolyn Harris), who has been criticised for her hair colouring. My criticism is that my hair looks like it was borrowed from my hon. Friend the Member for Lichfield (Michael Fabricant), so I share her frustration at that abuse.
Why does this abuse matter? My right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) put it very eloquently: it stops women from speaking freely, not just women in this place but women in our communities. At the moment, we have very toxic debates around issues such as biological sex, with people losing their jobs and facing prosecution just for wanting to have an honest debate. I am pleased that Members on all sides of the House have said this afternoon that it is important to have a sophisticated level of debate on very sensitive issues, but also about the general level of abuse that women face up and down this country. As the hon. Member for Bath (Wera Hobhouse) said, what is classed as banter by some people is very much abuse for others.
The hon. Member for Brent Central (Dawn Butler) always campaigns very hard on the issue of how abuse of women is reported in the media. We have met to discuss this, and I am frustrated that progress has been slow. I can assure her that I have met ministerial colleagues, but also the Domestic Abuse Commissioner, and I will follow up after this debate. It is really important that when women are murdered in our communities, it is not reported as a crime of passion. It has to be reported as it is: it is murder and abuse. That language makes a difference to how those crimes are then treated.
It is true—this was the focus of what my right hon. Friend the Member for Basingstoke set out—that the situation has an effect on our democratic accountability and who stands for election. We want more women, and more women from the real world, standing for election. However, the Fawcett Society found that 93% of women MPs said that online abuse or harassment has had a negative effect on how they act as Members of Parliament. It stops talented women coming forward for all parties, and we are losing good hon. Members. My hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) is one example of a woman leaving this place. We heard earlier in this parliamentary term from Rosie Cooper that the reason she stood down early was the abuse and threats she received. We have lost good Members such as her, which is very sad for Parliament.
We are potentially in an election year, so it is as important as ever that our language is measured—in this place, and in our political parties. Every single political party can play a role, and nobody standing for election should suffer intimidation for holding or aspiring to hold elective office. We have introduced measures to try to make the experience fairer. Since 2022, anyone who intimidates a candidate, campaigner or elected representative can be barred from elective office for five years. It is great that we are passing legislation like that in this place, but it needs to be enforced, because abuse is too often seen as something that just goes with the job. No one—not my hon. Friend the Member for Finchley and Golders Green (Mike Freer), nor my right hon. Friend the Member for Bournemouth East (Mr Ellwood)—should have their office burned or people protesting outside their home simply for representing their constituents.
The debate reflects the wider debate in society about violence against women and girls. Sadly, the hon. Member for Birmingham, Yardley (Jess Phillips), had to read out her list again this year, and one of the women she mentioned was my constituent Chloe Bashford, who was murdered in horrific circumstances in Newhaven. The hon. Member for Vauxhall (Florence Eshalomi) commented on two tragic deaths in her constituency of women who were also on that list. We have made significant progress, having published the tackling violence against women and girls strategy and the tackling domestic abuse plan, but that is not going fast enough. We all have a role to play, not just the Government; it is the role of all agencies, from the police to the courts, to absolutely make sure that femicide is taken seriously and dealt with when people come forward to give evidence and share their stories.
Our Domestic Abuse Act became law in 2021. That legislation is making a difference. Abusers are no longer allowed to directly cross-examine their victims in the family and civil courts, and victims have better access to special measures in courtrooms. However, conviction rates are still too low. We also supported the Protection from Sex-based Harassment in Public Act 2023, and the hon. Member for Bath brought in the Worker Protection (Amendment of Equality Act 2010) Act 2023, which addresses harassment in the workplace. That is for everyone, but we know that women are affected by that in more ways than most.
The final piece I want to address is the role of the media, given the upcoming election. It is really important that debates and votes in this place are reflected fairly. One example is the sewage vote, which was an attempt to end the use of sewage outflows in this country. We Conservative Members voted to dismantle our sewage system and have a long-term plan to end sewage discharges, but that was often portrayed in the media as voting against stopping any restrictions on sewage, which has resulted in multiple death threats and abuse for Conservative Members. When journalists ask why MPs are abused so much, I would say that journalists’ language, and the way that they portray what happens in this place, is as important.
Caroline Nokes
I will not get the Minister to say this, but I will say it for her. Can we also look at those who write Commons sketches? I am particularly thinking of Quentin Letts, who is a bit prone to going after people like me for being too pony club posh, and my hon. Friend the Member for Gosport (Dame Caroline Dinenage) for having pink nail varnish. The list is endless, and it is never about what we say, but about what we look like.
Maria Caulfield
Absolutely. We need to remind each other that we all have a role to play—not just MPs but wider society. The fundamental issue is that if female MPs are being targeted and harassed, that will be reflected for women up and down this country; if it is seen as okay to target elected representatives for what they look like or what they say or how they vote, that will be reflected in wider society. There is a democratic system in this country: if people are not happy with who represents them, they go to the ballot box and they decide. What is not acceptable is for Members of Parliament, local councillors, police and crime commissioners, Members of the Senedd, the Scottish Parliament, the Northern Ireland Assembly and others, even down to school governors, who are taking difficult decisions, which would have been taken long before if they were easy, to be intimidated in how they vote. If that is tolerated, violence against women and girls will be tolerated, perpetuated and accepted too.
I thank everyone for such a positive debate. We have got to speak up, we have got to stand up and we have got to take part and not let the haters win.
Black Maternal Health Awareness Week 2022
Debate between Caroline Nokes and Maria Caulfield(1 year, 6 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
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.
Oral Answers to Questions
Debate between Caroline Nokes and Maria Caulfield(1 year, 10 months ago)
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Caroline Nokes (Romsey and Southampton North) (Con)
Endometriosis South Coast does brilliant work supporting women suffering from endometriosis, but it is seeking reassurance from the Minister that, when the women’s health ambassador is appointed, she will be a real champion for those affected by this condition and other women-only conditions that are so impactful on their to continue work. Can the Minister update the House on when the women’s health ambassador will be announced, given that we have been expecting the post since December?
Maria Caulfield
I can reassure my right hon. Friend that the women’s health ambassador will be key in driving change, not just by raising awareness and confidence among women in coming forward for help, but by improving the services women receive, and she will have to wait only days, rather than weeks, before we release the name.
Cumberlege Report
Debate between Caroline Nokes and Maria Caulfield(2 years, 2 months ago)
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Maria Caulfield
I will come to that point. The Government have apologised on behalf of the health and care sector for the time it took to listen and respond. We are doing more than apologising: we are changing the healthcare system so that it responds to women in a much better way.
As the hon. Gentleman has just raised the issue of redress, I will touch on it now. It is not just these cases where it is often difficult for patients to get redress and compensation. I gave evidence to the Health and Social Care Committee this week on the issue of clinical negligence. This week, we announced a fixed recoverable costs scheme, meaning that, for low-value claims, we can speed up the claims process, reduce legal costs and ensure that, whatever clinical negligence they have experienced, patients are able to get compensation as quickly as possible. The findings of the Cumberlege report highlight mesh, Primodos and sodium valproate. However, across the board, it is very difficult for patients to get redress, regardless of the clinical negligence they have suffered.
Caroline Nokes
I do not want to be too difficult, but I do not think it is any excuse to say that because it is difficult for everyone to get compensation, we should not try here.
Maria Caulfield
Specifically on Primodos, there is pending litigation so it is difficult for me to comment while that is in progress, but, depending on the outcome, the Government will respond to that.
Caroline Nokes
I will go for valproate, because there is not pending legislation about that. Have I understood the Minister correctly? Is she saying that if the Primodos case is successful, the Government will review it, and the women who have had mesh implants or who are the victims of sodium valproate will not be expected to have to go down that legal route?
Maria Caulfield
If I touch on the points in my response, hopefully I will be able to reassure colleagues on the progress being made.
Oral Answers to Questions
Debate between Caroline Nokes and Maria Caulfield(2 years, 5 months ago)
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Caroline Nokes (Romsey and Southampton North) (Con)
One of the times that women most engage with healthcare services is when they are pregnant. My constituent Michelle, a qualified midwife, has contacted me, talking specifically about the importance of retention in midwifery and highlighting the crisis that she says there is. What is my hon. Friend doing to make sure that qualified, experienced midwives stay working at the frontline where we need them?
Maria Caulfield
I thank my right hon. Friend for raising this important issue. Maternity care is a top priority for the Government, and earlier this year NHS England announced a £95 million recurrent funding package to support the recruitment of 1,200 midwives and 100 consultant obstetricians. Maintaining both the skill mix and the numbers is key to retaining experienced midwives, who often have to take the pressure when there are staff shortages.