Eye Health: National Strategy

Florence Eshalomi Excerpts

Wednesday 17th May 2023 Westminster Hall

[Marsha De Cordova]

My hon. Friend makes a really crucial point about special schools and about ensuring there is enough capacity to support children who have complex needs with sight loss. What is really troubling is that, in many instances, sight loss is not always picked up, so having specialist ophthalmologists in schools is crucial. There absolutely should be no way of reducing that provision—in fact, we need to build capacity.

To respond to the current crisis in eye healthcare, the Government must commit to a national eye health strategy for England, as set out in my Bill. The strategy would include measures to improve eye health outcomes, remove the postcode lottery of care, reduce waiting times, improve patient experiences, increase the capacity and skills of the workforce, and make more effective use of data, research and innovation. An eye strategy would ensure that, regardless of where someone lives, they can have access to good-quality eye healthcare, which would address eye health inequalities and ensure that there is more equity of access to eye care among different communities and people who are more at risk of sight problems but who may not be accessing NHS sight tests.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

I thank my hon. Friend for making such an important speech. I pay tribute to the staff in the eye health department at St Thomas’s Hospital in my constituency. Figures show that 650,000 people are on waiting lists in England and that 37% have waited for more than 18 weeks. If the Government had a strategy, would that not address the postcode lottery my hon. Friend highlighted?

[Marsha De Cordova]

I thank my hon. Friend, who highlights the fantastic eye care department at St Thomas’s Hospital. She is absolutely right: my strategy already sets out how to address the backlogs in eye healthcare, and the Government could just say, “Yes, we are going to take it on, reduce those backlogs and address the workforce issues.”

Ensuring that we have equity of eye health must also include people who are homeless and those with learning disabilities, as my hon. Friend the Member for Lewisham East (Janet Daby) mentioned. A strategy would focus on five areas. The first is the eye health and sight loss pathway, which outlines the care and support for those diagnosed with loss of vision. A pathway would focus on the physical and emotional impact of being diagnosed with sight loss. Research has shown that blind and partially sighted people are likely to experience poor mental health outcomes, such as depression and anxiety, in their lifetimes. As part of the pathway, more emphasis should be placed on the provision of non-clinical community support, which would complement the work of community optometrists, ophthalmologists in hospitals and rehabilitation officers. Where is the plan to improve non-clinical and community support as part of the eye health pathway?

The second area the strategy would aim to improve is collaboration between primary and secondary care, and it would emphasise integrated care systems to ensure timely and accurate referrals. Demand for eye care services is expected to increase by 40% over the next 20 years, so we need to pay more attention to joining up care to meet future demand. Some of the burden on hospitals from that increased demand could be eased through more investment in high street community optometrists and by changing the way services are commissioned, to make more use of resources and infrastructure in our communities.

Two million people attend NHS accident and emergency services each year with an injury to or disease of the eye, and over 65% of those cases could have been treated in primary care optometry, which is not only more accessible but saves money—it costs less. Despite that, only 23 out of the 42 integrated care boards commission a minor eye condition service, or MECS, consistently. Five have no MECS provision at all—patients must attend a hospital eye service either via their GP or A&E. That is unfair and inequitable, and it is a waste of NHS resources to have patients go to A&E when they could access something in the community, which is easier for the patient, improves outcomes and saves us money.

Covid Pandemic: Testing of Care Home Residents

Florence Eshalomi Excerpts

Wednesday 1st March 2023 Commons Chamber

[Helen Whately]

On the first point about the use of public health advice, the hon. Lady is wrong; all decisions were informed by public health advice. On her request about the public inquiry, that inquiry is independent of government, so I cannot do what she asks.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

To reiterate the point that my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) just made, every time there is a statement, every time there is a revelation, every time such an issue is raised, whether in this House or in the press, it triggers trauma for many people who have not healed from losing their loved ones, who were not able to go to funerals, and who were not able to seek closure. I hope that the Minister will reflect on her response in that context.

To come back to the public inquiry, Covid-19 Bereaved Families for Justice said that the revelations show why the inquiry must allow the bereaved families to

“be heard in the hearings and for our lawyers to cross-examine key people”—

including the former Secretary of State, the right hon. Member for West Suffolk (Matt Hancock)—

“so we can get full answers to our questions in the right setting instead of having to relive the horrors of our loss through exposés.”

Does the Minister agree?

[Helen Whately]

As I have said, we are talking about, very sadly, people’s lives being lost—people’s mothers and fathers, grans and grandpas, sons and daughters, and sisters and brothers. We should always remember the genuine and real human cost, as well as all those who worked in health and social care looking after dying people and who had a traumatic time themselves.

On the trauma that the hon. Lady talks about, it is Labour Front Benchers who have asked the urgent question and made this conversation happen in this forum rather than in the context of a public inquiry, which might encourage a more reasoned form of debate. I hope she will have noticed that my tone fully appreciates the points that she makes, but it is not for me to dictate who will give evidence to the public inquiry.

Future of the NHS

Florence Eshalomi Excerpts

Thursday 23rd February 2023 Commons Chamber

[Kate Osborne]

I will address my hon. Friend’s point in my remarks. This Government’s ideological commitment to the free market has led them to force through more and more privatisation of our national health service. Some Government Back Benchers are talking openly about moving to an Americanised healthcare system in which people are priced out of healthcare, and they have even mentioned it in this Chamber. We have seen corrupt contracts for cronies, and friends of the Government making millions while people suffer. The Government have allowed the private sector to run rampant, taking hundreds of billions out of the NHS budget over the last 10 years.

It is as if the Government are on a mission to destroy the NHS as we know it. They have even performed smash-and-grab raids on hospital repair budgets, taking £4.3 billion away and leaving hospitals crumbling, leaking and falling apart at the seams. Fifty per cent. of trusts now have structural issues with leaks, collapsing floors, raw sewage and unsafe wards.

American news agency CNN said last week:

“Britain’s NHS was once idolized. Now its worst-ever crisis is fueling a boom in private health care.”

The number of people paying privately for operations is up 34% in 2022. If that trend continues, it will embed a two-tier service in our NHS and price many people out of healthcare. My constituent Christine was referred to a private health company by her GP, while another constituent, Ray, was told that he could no longer get a service from the NHS and that he would need to pay privately, at a cost of £50. Ray said to me:

“As I am 74 years old and rely on my state pension it makes it very difficult for me in the current economic climate to pay this amount. Having paid national insurance contributions for 50 years, I don’t understand. Why do I have to pay again?”

I look forward to receiving a response for Ray from the Minister.

Ray is correct, of course. As Nye Bevan said:

“No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”

As with any crisis, companies step in to exploit the situation and make money.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

I thank my hon. Friend for making such a powerful speech on a really important issue. A fantastic GP surgery in my constituency, the Waterloo Health Centre, is closing because the landlord is selling to a private developer. Many people who have used that GP service for decades are now worried about where they will register. A number of people across the country are waiting to register with NHS GPs, and waiting lists continue to grow. Does she agree that that is another example of the private sector coming in and making it really difficult for our NHS system?

[Kate Osborne]

Yes. We have all seen for ourselves and heard from our constituents how difficult it is to get an appointment, and the private profiteers are driving that.

--- Later in debate ---

[Matt Hancock]

No, that is not right. There are record numbers in training, and the opening of the new medical schools that were put in place by my right hon. Friend who is now Chancellor of the Exchequer is another Conservative achievement in that space.

However, given the record numbers of nurses and doctors, the record numbers of training places, the record numbers of GPs coming out of training places and the record funds going into the NHS, there is still a record-scale problem. I do not at all deny the scale of the challenge, but that challenge demonstrates to me the vital importance of reform of the NHS—we cannot support its long-term future without supporting reform. My experience of the NHS and of being Health Secretary tells me that the single most important thing that has to happen for the NHS to be as effective as possible in the future is the widespread and effective adoption of the use of technology and data, so that the NHS can be more efficient, giving clinicians back—as Eric Topol put it when he launched his review in 2019—“the gift of time”.

The inefficiency of the NHS because of poor use of data leads to appointment letters being sent out that arrive after the appointment date has passed. Who gets a letter these days for an appointment, anyway? We all use modern technology instead.

[Florence Eshalomi]

Will the right hon. Member give way?

[Matt Hancock]

I will in a moment.

That inefficiency means that different parts of the NHS cannot talk to each other, and indeed cannot talk to social care. It means that a person can end up going into hospital for a serious procedure, but their GP will not know that they have had that procedure, because they went in urgently rather than through that GP. It means that there are people right now who go into an NHS hospital and find that their records, which are on paper, cannot be adequately analysed. Service provision is worse as a result, which directly impacts people’s health. The poor use of data is the No. 1 factor holding back the effective use of the resources that we put into the NHS—not only the cash but, crucially, the staff. They find it deeply frustrating that they have to work with these terrible IT systems when every other organisation of any scale in this country, or in any developed part of the world, uses data in a much more efficient, effective and safe way.

[Matt Hancock]

I will make one final point before I give way to the two hon. Members who are seeking to intervene, which is that the inefficiency in the NHS is best exemplified by its ridiculous continued use of fax machines. Those machines are totally inefficient and completely out of date, and are also terrible for privacy and data protection, because one never knows who is going to be walking past the fax machine. When the Minister sums up, I would like him to set out what he is doing to not just get rid of those fax machines—I tried to do it and made some progress, but did not manage to finish the job—but, more importantly, drive the use of high-quality data, data analytics and digital systems throughout the NHS. Investment in that is the single best way to ensure that all patients can get the service that they need.

[Florence Eshalomi]

To bring the right hon. Member back to the point he made about digital data and making sure that patients are accessing services, I hope he will agree that for a number of my constituents, and probably his constituents as well, access to the internet is a luxury that they cannot afford. A number of people I represent cannot afford a monthly broadband connection because they are choosing between heating their home and paying their rent. They do not have monthly broadband, so they cannot log on to book online appointments; they want to see a GP, but they cannot.

[Matt Hancock]

Of course, it is critical that people do not have to use a computer to access a universal service. Many people will never use a computer in their lives, but the fact of the matter is that well over 95% of us use technology every single day. We can get enormous gains through the use of technology, which allow us to give better provision to the tiny minority of people who do not use technology. The point that the hon. Lady makes is absolutely valid, but it is no argument for not using data and digital services effectively. On the contrary, we can make it easier for the very small minority of people who cannot, will not or cannot afford to use digital technology by using data more effectively for the rest of us.

One example that shows this can be done is the vaccination programme, which was built on a high-quality data architecture. People could book their appointment, choosing where and when to get vaccinated—where else in the NHS could they do that? They should be able to do it everywhere in the NHS. Hardly anybody waited more than 10 minutes for their appointment; it was one of the most effective and largest roll-outs of a programme in the history of civilian government in this country, and we started with the data architecture. We brought in the brilliant Doug Gurr, who previously ran Amazon UK, to audit it and make sure that it was being put together in a modern, dynamic, forward-looking way. It was brilliant, so anybody who says that data cannot be used more effectively is fighting against history.

Of course, a tiny minority of people did not use the IT system to get vaccinated. That was absolutely fine, because that high-quality data system meant that everybody else could, leaving resources free for people who either needed to be phoned or needed a home visit in order to get the vaccine.

--- Later in debate ---

[Liz Twist (Blaydon) (Lab)]

First, I congratulate my hon. Friend the Member for Jarrow (Kate Osborne), my constituency neighbour, on securing this debate, which is hugely important. I listened to the former Secretary of State for Health, the right hon. Member for West Suffolk (Matt Hancock), speaking about data and so forth, and there are clear points there, but I want to focus on the experience that my constituents, my family and my friends have of the NHS. Let me declare an interest in this debate as a Unison member and a former Unison health representative, which I am glad to say hugely informs my interactions on this subject.

There has never been a more urgent need to talk about our NHS. All of us from across the House regularly attend drop-ins with cancer charities and other medical charities, and they tell us about the situations that they face and the backlogs. We all make arguments about those things, but we cannot just see them in isolation: we cannot look just at cancer figures or mental health figures; we need to look at the NHS as a whole system and at how we can make it better.

I want to refer to some of the figures after 13 years of Tory Government. We know that satisfaction with the NHS is at a 25-year low of 36%. That is a drop from 70% in 2010, when Labour left government. Some 7.2 million people are waiting to start planned NHS treatment, which is nearly three times the figure when Labour left power. Before the pandemic, the number was already 4.6 million, so this is not just a covid-related issue, though covid clearly made things difficult—the figure was increasing anyway. Just 80% of patients with an urgent GP referral for suspected cancer saw a specialist within two weeks, which means that more than 42,000 people wait too long.

[Florence Eshalomi]

I thank my hon. Friend for making such a powerful speech, and I declare that I am also a proud member of Unison. Cancer Research UK recently held a drop-in session in Portcullis House, and I must say I was quite surprised to see the statistics for my constituency. We have a world-class hospital quite close to a world-class cancer treatment centre, but even in my constituency of Vauxhall over 300 people have missed the 14-day window and have been waiting longer. Does she not think that this is a big issue right across the country and something the Government need to get a grip on?

[Liz Twist]

I most certainly agree that that is a shocking figure. We need to make sure that we are really addressing all those issues very urgently. Those cancer waits are really important for what happens when undertaking treatment and the possibility of cure, so we really need to get on top of that.

When we look at accident and emergency, which has been much in the news, we see that 11,000 patients died after waiting more than 11 hours in A&E in 2021-22. The Government have just changed the target to 76% of patients waiting less than four hours in A&E by March next year, but we really need to return to the original target. Just changing the figures does not mean that people get better or that fewer people die; it means that the figures have been changed, and people understand that. My constituents know that.

More than 1.5 million people are waiting for key diagnostic tests such as MRIs, which is an increase of 95,500 from this time last year, whereas in May 2010 just 536,262—actually, that still sounds like a big figure—were waiting for key diagnostic tests. We need to get better, not worse, at doing these things.

One in seven people cannot get a GP appointment when they try to do so. All of us know, as constituency MPs, that one of the issues people consistently raise with us is that they are unable to get appointments in a timely fashion, so something that needs seeing to now is perhaps only seen to in a few weeks’ time. That is despite the really heroic efforts by a lot of our GP practices and surgeries, and the staff working in them, to try to make sure that people can get the advice they need when they need it. We know there is a shortage of GPs. Just in my constituency, people talk to me about that regularly. I regularly discuss with the NHS and with the new integrated care boards what is happening in that area, and things are really difficult for us at the moment.

At the same time, there are huge numbers of nursing vacancies in the NHS, with 47,000 posts unfilled, according to the latest figures. Some 40,000 nurses and 20,000 doctors left the NHS in the past year, and only 7,000 of those people retired. Surely, we must agree that patients need care and the NHS needs staff, and that it must be a priority to resolve this situation. That is why I am so pleased to see that Labour has a plan to address those workforce issues, because those workforce issues are at the heart of the difficulties within our NHS. It is not problems with NHS staff or that people are not working hard; they are working hard and, if anything, really becoming burnt out.

--- Later in debate ---

[Rob Roberts]

I invite them to come to Wales and view the conditions in the north Wales health board, where only 62% of buildings are operationally safe and where the hard-working staff, including friends and family of mine, are working in impossible conditions. In England, one in 20 people—5% of them—have been waiting more than a year on waiting lists. In Wales, the number is one in four—25%. The NHS in Wales performs worse in virtually every measurable area than the English equivalent. Labour Members are not shouting any more—how interesting. Currently, only 51% of red call patients are responded to within the target eight minutes. These are the second longest ambulance wait times ever. Only 23% of amber calls, which include strokes, were reached within 30 minutes.

The hon. Member for York Central (Rachael Maskell) mentioned dentistry in an intervention. Only 7% of dental practices in Wales are accepting new patients. Where is the outrage? Where are the demands for better? For every one pound spent on healthcare in England, there is almost £1.20 available in Wales—it is not a money problem—but for markedly worse outcomes in all areas. Where is the outrage? Instead, the Leader of the Opposition, in a speech last year in Wales, described the Welsh Government as providing

“a blueprint for what Labour can do across the UK”.

Well, good luck to the rest of the UK if it chooses to install the right hon. and learned Gentleman into Downing Street next year on that basis.

I am not helping the discussion with these statistics at all. I am guilty of the very thing I always tell others not to do—to stop blaming people, stop trying to score silly political points, and stop wasting everybody’s time by saying that different Administrations are to blame. There is no prospect of an open debate on the actual issues—the real, fundamental problems—if all we focus on is finding blame. It is easy, it is lazy and it gets us nowhere.

The NHS across the United Kingdom is in difficulty. It is in difficulty in England, Scotland, Wales and Northern Ireland. It is not in difficulty for political reasons; it cannot be, because there are three very different Administrations running health services in all those parts of the UK, and the same problems occur in all of them. We need to ask why there is so much waste in the NHS and why there are nurses graduating from universities with degrees who—as the RCN agreed with me recently—cannot draw blood or insert a cannula into a vein. It is not their fault; as with everything, it is the systems that let them down—systems that mean that health boards across the UK spend hundreds of millions of pounds sending graduates on courses to learn the clinical skills that they were not taught on their degrees.

I commend the shadow Health Secretary for something he said recently. He said that he would be prepared to use private sector resources to bring down waiting lists faster. He asked the question: “How can I look someone in the eye as a prospective Health Secretary and tell them that I have a way to provide them with a better outcome, but my ideology is standing in the way of their recovery?” He was lambasted for that view from his side of the aisle but, while he and I will disagree about almost everything else, I have to say that my respect for him went up significantly with that intervention.

The NHS health boards across Wales are sending people to private facilities, which is costing hundreds of millions of pounds. I commend them, because it is all about outcomes. We get so caught up on process and procedure—on who does what, when—that we lose sight of the outcomes for people. One of my most hated phrases in politics is “political football”. It is used almost exclusively in discussions about the NHS, but the bottom line is that things such as the health service have to be run by political decisions; otherwise, who could be held accountable to the public? If we take decisions out of the hands of politicians, who should make them and how can they be held to account?

[Florence Eshalomi]

I thank the hon. Member for making—a speech. He says that this is a political issue. Does he agree, then, that his Government have failed politically by not getting around the table sooner to avert some of the strikes that we have seen up and down the country?

Draft Mental Health Bill

Florence Eshalomi Excerpts

Monday 27th June 2022 Commons Chamber

[Sajid Javid]

We of course want to ensure that children with mental health challenges, including eating disorders, get the support that they need. That is why during the pandemic—just last year—we put in an additional £79 million specifically for children’s mental health services. That is providing many thousands more children with that support.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

The Bill’s focus is on individuals who are sectioned under the Mental Health Act, which is important, but I refer the Secretary of State back to the issue of waiting times raised by many Members. In December, I spoke to my constituent who was concerned about the welfare of his child who suffers from an eating disorder. At every stage, it has impacted his mental health. Despite the local services, this child is still waiting, six months on, just to see a specialist. The limited staff available cannot cope. What is the Secretary of State doing now to address the issue so that we do not see more young people suffer?

[Sajid Javid]

We are putting in record amounts of new investment, with newer services. During the pandemic, we established for the first time a national 24/7 all-age mental health helpline. I would like to make that permanent, beyond the pandemic. When it comes to NHS talking therapies, I mentioned earlier that some 1.25 million people were seen last year. We aim to get that up to 1.9 million over the next couple of years. When it comes to waiting times, the hon. Lady is right that there is a waiting time for high-intensity mental health services, and the NHS is of course working to bring that down. For low-intensity mental health services we have managed to bring the median waiting time down to 14 days nationally.

Health and Social Care Leadership Review

Florence Eshalomi Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

The reason why the Department keeps that under review is that, although the pass has stopped and there is absolutely no prospect that I can see of its ever coming back into place, it is right that, as we wind things down and work on the digital resources, all things are looked at appropriately.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

On Thursday 19 May, I and a group of south London MPs met south London nurses from the Royal College of Nursing. They told us that they are tired. They told us that they are fed up. They told us that they are having to use food banks. They told us that they are seeing their salaries squeezed by the cost of living. They told us that they face bullying, intimidation and abuse at work. This was coming from staff members who work in our hospitals, including at St Thomas’s Hospital, in my constituency, which I know the Secretary of State has visited on many occasions.

There is a big gap—an omission—around this leadership issue in social care. We have big retention issues. There are more than 9,000 vacancies. Does the Secretary of State have a plan to address that big omission in health and social care, including retaining the people we need on the frontline?

[Sajid Javid]

The short answer is that, yes, the hon. Lady is right to talk about the importance of retaining and recruiting more nurses. When it comes to nurses’ pay, she will know that we gave a 3% rise last year when there was a freeze for the public sector workforce generally. This year, we will be listening carefully to what the independent recommendation is.

Special Educational Needs and Children’s Mental Health Services

Florence Eshalomi Excerpts

Wednesday 9th February 2022 Westminster Hall

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Ms Fovargue. I pay tribute to the hon. Member for Newbury (Laura Farris) for calling this important and timely debate. It is always a pleasure to follow the hon. Member for Cities of London and Westminster (Nickie Aiken). I agree with everything she said. Our young people are facing a mental health crisis. They need vital support and funding in our schools.

For my Vauxhall residents, the mental health impacts of measures to tackle covid-19 have been some of the hardest of the seismic effect of the pandemic. Since March 2020, people have had severe restrictions on who they can meet and where they can go. We have seen park benches taped up. As a mother of two young children, that was difficult for me as well. People have seen their friendship groups shrink. They have had to deal with being shut at home, not going out and not seeing loved ones. They have missed loved ones for many months. In some cases, they have missed those vital last minutes. That situation has taken a toll on all of us but, most importantly, it has taken a toll on our young people.

Schools develop vital skills in subjects such as maths and English, but for our young people they are also a place to make friends, solve conflicts and develop vital interpersonal skills that help us all to navigate our lives. Those skills are vital in developing mental health resilience in our young people.

The Health and Social Care Committee has found that 1.5 million children and young people under 18 will need new or additional mental health support after the pandemic. That places a tremendous strain on already stretched mental health provision. Although extra funding has been promised, too few children are getting the treatment they need.

Several hon. Members have highlighted the many difficulties that parents, carers and, most importantly, young people face in accessing SEND provision. I am sure the Minister is aware of the data on the disparity and the barriers that black and minority ethnic children and their families face in accessing that provision.

I went to visit Lansdowne School in my constituency last December. Lansdowne is a specialist school for young people with autism, communication difficulties and speech and language delay. On my visit, I spoke to the headteacher about the fantastic work teachers and carers did during lockdown, providing vital support for children with challenging needs. I also spoke to the head boy and head girl and said that, in return for their giving me a tour round their school, I would give them a tour round my workplace, here in Parliament. They had such smiles on their faces; they beamed with joy. I saw a mural that students have worked on with local artists. With the right support and funding, our young people with special educational needs will flourish. We have to believe in them.

For many young people with special educational needs, finding the right support is vital. I am proud that the National Autistic Society decided to open another school in my constituency, on Kennington Road—the Vanguard School. Unfortunately, because of the many lockdowns, we have not been able to have the official opening, which has been postponed three times. I hope that when that opening finally takes place, the Minister will come to visit this excellent school, which provides state-of-the-art services for young people with additional needs.

As chair of the all-party parliamentary group on knife crime and violence reduction, and through my work on youth violence, I see the effects of youth violence and mental health trauma faced by our young people. If we fail to tackle the mental health crisis among them, we will continue to see them develop lifelong problems and not have access to vital SEN provision. Most importantly, we may see some of those young people taken too soon. I urge the Minister to look at providing vital support in this area now.

Covid-19: Purchasing Effort

Florence Eshalomi Excerpts

Thursday 3rd February 2022 Commons Chamber

[Edward Argar]

My hon. Friend puts his finger on the issue absolutely. I mentioned in response to the hon. Member for Worsley and Eccles South (Barbara Keeley), who is no longer in her place, that a small proportion of this £8.7 billion went on PPE that did not meet the standard, and we continue to pursue those contracts and investigate them. However, my hon. Friend is right to say that the vast majority of this money purchased PPE that was delivered and is usable, and the difference in money reflects the fact that we bought at the height of a global pandemic, doing whatever was needed to get the supplies we needed. Of course, in the two to two and a half years since, that market has stabilised, with significantly more manufacturing also in this country.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

The Minister mentioned in his statement that the Government took these difficult decisions to keep the country safe. The hard-working staff in St Thomas’ Hospital in my constituency took the decision to come to work every day during this pandemic to keep the country safe. The Minister mentions that this is a value of accounting and it is not real money. Can he tell me: how much more could we have got for nurses for that £8.7 billion? My local nurses who are watching this statement are thinking that they could have done with that pay increase.

[Edward Argar]

The hon. Lady will know that I have not said that this is not real money; I have said that what has been published here in the accounts is what is required for an accounting purpose. The PPE was purchased, and that was done at the height of a global pandemic and at extremely inflated prices, because every country was desperately seeking to acquire the PPE that was needed. That situation has stabilised over the past two years and PPE can now be purchased for a much, much cheaper rate. Again, I make no apology for our purchasing this PPE to protect these very nurses, who did an amazing job in her local hospital, from the effects of covid.

Vaccination Strategy

Florence Eshalomi Excerpts

Wednesday 12th January 2022 Commons Chamber

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

I pay tribute to the hard-working staff at St Thomas’ Hospital in my constituency, who have helped many Members of this House to receive their booster jab, and to the many volunteers throughout Vauxhall. The Minister outlined that 90% of people have had their first dose and over 80% their second. With the emergence of omicron, we have seen that unless everyone is vaccinated, we are not safe. We are not safe until everyone is safe, but around the world there are still places where people are not receiving vaccines. Will she outline what work the Government are doing to make sure that there are enough vaccines globally to ensure equitable access for everyone?

[Maggie Throup]

I also pay tribute to the staff at St Thomas’ Hospital. I visited the vaccination centre there and was really impressed by the way it is set up, with the paediatric side as well, and by all the volunteers who were there making sure that everyone felt comfortable about going forward. Some of the people there had thought for quite some time about taking the plunge and getting their first dose, so I thank the staff for their work.

The hon. Lady makes a good point when she says that we are not safe until everyone is safe. I reiterate our commitment to COVAX, not just through donating vaccines but financially as well. Just over a year ago, the first AstraZeneca vaccine jab in the world was given to a gentleman in Nottinghamshire. As a result of our collaboration with Oxford University and AstraZeneca, those jabs continue to be delivered at cost throughout the world. That is a really good outcome of the Government’s investment.

Sickle Cell Treatment

Florence Eshalomi Excerpts

Wednesday 8th December 2021 Westminster Hall

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Mrs Miller. I pay tribute to my right hon. Friend the Member for Wolverhampton South East (Mr McFadden) for securing this important debate and for his tireless work as the chair of the APPG on sickle cell and thalassaemia. I would also like to reflect on the work of the late hon. Member for Southend West, who was a former officer of the APPG, on sickle cell and to say how much poorer we are today without his contribution, which I know would have been well received by all of us.

This debate is quite personal for me. Reading through the report about Evan’s lack of care and the failings brought back many memories. My late mother suffered from sickle cell anaemia, which is a disease that does not discriminate. My late mum was one of 12 children—same mum and same dad—but she was the only child who had full-blown sickle cell. Some of my aunts and uncles had the trait. I found out that I had the trait when I got pregnant with my daughter, who is now six years old. I went on to have a healthy daughter and a healthy son. My daughter has the trait, but my son does not. That shows how sickle cell can affect anybody.

Reading through some of the failings in Evan’s care—or lack of care—made me, as my late mother’s principal carer, remember some of the issues we encountered in the 1990s. As a young child, I had to learn about diamorphine, co-codamol, penicillin, folic acid and the large variety of painkillers that sickle cell patients have to take. I knew how important it was for my mum to have access to oxygen when she had shortness of breath, and to hear that Evan had to call 999 from his hospital bed to get oxygen, in 2019, and to see sickle cell patients failed so badly, breaks my heart.

My mum had two oxygen units at home; that is how severe her sickle cell was. I know that for many sickle cell patients this time of year is so difficult and that they have to make sure that they are wrapped up warm because, once they start getting cold, that pain gets into their bones. I spent many nights rubbing my mum’s legs and back, trying to help her relieve the pain. I know how important it is to make sure that when the ambulance arrives, the symptoms are properly outlined so that when she arrives at A&E she is prescribed with the right drugs, not paracetamol.

I know how to describe the searing pain that sickle cell patients face when they are going through a crisis, with doctors and some nurses looking at them with a blank expression because they do not understand. My mum used to describe that pain to me as someone chiselling at her knee, her bones and her joints. That is why patients need that strong pain medication, not because they are addicted to painkillers. Calling sickle cell patients addicts is totally wrong.

I know how important it is to ensure there is access to good quality housing and that patients who suffer from sickle cell have time off for appointments. I know how timely it was—a matter of life and death—that my mum got the blood transfusions she needed. This 21-year-old boy was failed. With the right level of care and support, sickle patients can lead a fulfilling life. My mum went on to have three healthy children—I am one of three girls—and thankfully, she saw her granddaughter before she died in 2015, when she was 60. Evan will never have that chance. He will not have a chance to start a family, his parents will not have a chance to see their grandchildren, and he will not have a chance to fulfil his life ambitions. Why? Because he was failed by the doctors and nurses who should have helped him. That area has a high prevalence of sickle cell patients, so why did they not know what to do? Those doctors and nurses should be caring for sickle cell patients, regardless of their race.

The APPG’s report highlights the many failings that took place. I will not go into it, as many Members have highlighted it, but it is important that we listen to its clear recommendations. The fact is that our communities, not just in London but right across the UK, are becoming more diverse, and we have to make sure that the people going into the health system now understand this disease. We are going to see more diverse communities, and this is not just about black, Asian and minority ethnic people in London, but about BAME people right across the country. Our population will continue to be diverse, which is something we should celebrate, but those people will be scared, not wanting to move to and live in areas where this disease is not understood. That understanding existed at King’s College Hospital where my mum was cared for, and at Guy’s and St Thomas’ in my constituency now, but there were times when my mum would be scared to visit family members in other parts of the country because she did not know whether, if she came into a crisis, she would be understood if she had to go into hospital.

Sickle cell patients should not be scared to travel and leave their areas, but basic things that should be available to everybody are being denied them. I thought the days of patients not being believed about their pain threshold—being told that they should come back, or that they should go and buy paracetamol over the counter—were over, but all those things seem to be happening now, so this issue is really important. I hope that the Minister will respond to the critical recommendations in this report with a clear action plan. No one should be failed in the way that Evan has been failed. No one should have to die because they suffer from sickle cell.

Black Maternal Health Week

Florence Eshalomi Excerpts

Tuesday 14th September 2021 Westminster Hall

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I pay tribute to my constituency neighbour, my hon. Friend the Member for Streatham (Bell Ribeiro-Addy), for her powerful opening speech and for the work that she has been doing to lead on this really important issue.

The theme for this year’s Black Maternal Health Awareness Week is “changing the narrative”. We have to change the narrative. There is a call for a sea change in the outcomes for black women during pregnancy, and in finding ways to empower black patients to advocate for their health. We have known for years that women of black, Asian and mixed heritage face significantly higher maternal and prenatal mortality rates, and that women from black and minority ethnic backgrounds discover many conditions during their pregnancy. I discovered that I had fibroids at my first maternal scan during my first pregnancy. As an expectant mother, that brought a level of fear and anxiety—what would happen to me and my baby? In most cases fibroids can be unharmful, but in a small number of cases they can cause complications for the growth of the child and for both mother and baby during labour.

Unfortunately, we know that black and minority ethnic women are sometimes not listened to during the course of their pregnancy, and that there can be unconscious bias as a result of the structural inequality and institutional racism in our healthcare system. As my hon. Friend the Member for Streatham highlighted, Professor Knight suggests in the MBRRACE-UK report that a number of black and ethnic minority people face microaggressions, which means that symptoms can be indicative of complications that are missed, and that they are not given the attention they need. The “changing the narrative” campaign helps to empower black women to make their voices heard on this issue. It is crucial that their voices are listened to, and that their experiences are heard. I pay tribute to Five X More for the vital work that it has been doing to lead the campaign and, most importantly, to get the Government to listen to the many voices of the black and Asian women who are suffering in this area.

As a mother to two young children, who were born just across the river at St Thomas’ Hospital, this issue is close to my heart and those of many of my constituents in Vauxhall. More than 1,000 Vauxhall residents signed the petition urging the Government to pay close attention to this issue and to improve health outcomes and maternal rates for black women in the UK. Compared with white European women, black African women in the UK are 83% more likely to suffer near-misses in childbirth, and black Caribbean women are 80% more likely to do so. My two children were very stubborn and did not want to come out; in the end, they had to be evicted by C-section. My first pregnancy was fine: I was induced, it did not work, so the C-section was the next day. My second pregnancy did not go so well. Having gone through a C-section, I did not want that again. I tried to explain to the doctors that my body did not respond to induction and that if they just gave me time, the baby would eventually come out. Everything did not go to plan and I was rushed to theatre for an emergency C-section.

Panic, fear and the unknown, added to the fact that they had not been able to contact or locate my husband, meant my body froze and rejected the epidural. I heard the doctor’s words that I would have to go under general anaesthetic. I asked, “What? I am going to be put to sleep and you are going to deliver this baby. What if I don’t wake up?” I was lucky because I did wake up, after many hours. A number of black women are not as lucky; they do not wake up. It is important that we listen to black women and the experiences of all women, because they know their bodies best.

During the debate earlier this year, alongside the petition in April, the Minister would not set a target around black maternal health:

“We cannot set targets until we know what we are trying to achieve through those targets and what we need to address.”—[Official Report, 19 April 2021; Vol. 692, c. 172WH.]

We know that black women in the UK are four times more likely to die in pregnancy and childbirth; women of mixed heritage are three times more likely; and Asian women twice as likely. Those statistics paint a clear picture of the problem we need to solve. It is now five months since we last discussed this issue in the House. I have one question for the Minister: what research has been done to set the target, so that we can measure the progress to end this disparity? If none, what steps is she taking to gather the data urgently to tackle this problem as soon as possible? One death is far too many. It is important that we listen to those women and address this issue urgently.

--- Later in debate ---

[The Minister for Patient Safety, Suicide Prevention and Mental Health (Ms Nadine Dorries)]

It is a great pleasure to serve under your chairmanship for the first time, Mr Hollobone. I thank all Members who have taken the time to attend the debate, in particular the hon. Member for Streatham (Bell Ribeiro-Addy), who I have heard speak before about her experience on this issue. I think she is incredibly brave to campaign and highlight the issue in the way she does. I thank her for her thoughtful considerations. I know that she is holding my feet to the fire as well as the Department’s, and that is a huge assistance in pushing the agenda forward within the Department of Health and Social Care.

I stand responding to the debate as a brand new grandmother of 18 days. The delivery was not uneventful, and the baby arrived early, which is a similar story to that of the hon. Member for Vauxhall (Florence Eshalomi) at St Thomas’. Having given birth myself three times, I understand in a very raw way the pressures that all women experience, and I lived through just two weeks ago how emotional and incredibly frightening it can be when things do not go to plan.

This is the second annual awareness week we have had to highlight the disparities for black women in maternal health outcomes in the UK.

[Florence Eshalomi]

Congratulations to the Minister, it is always a joy to see more children and grandchildren. I am still getting to grips with motherhood with my four-year-old and six year-old. The statistics clearly show that the maternal death rates, and negative experiences, of black and Asian women are higher, but this does not negate the fact that some white women also go through similar experiences. Does the Minister agree that improving the maternal health outcomes of one group will improve the outcomes for all groups?

[Ms Dorries]

The hon. Lady is absolutely right. I am very proud of the work that we have done in the Department of Health and Social Care, and in the NHS, to improve maternal outcomes for everyone, particularly over the last few years. The statistics speak for themselves. However, I will focus on the issue of black women and maternal health, because there is a great deal that we have done since the hon. Member for Streatham had the last debate. I am looking forward to informing her about the work that has been undertaken since then. I thank her for instigating this debate, and I hope that she continues to hold our feet to the fire. It is important that people do raise this issue, as she does, as often as possible in Parliament.

In response to the incredibly articulate speech by my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), it is right to raise the report by the Health and Social Care Committee, which I will respond to next week. A number of the questions that have been asked today will be included in that response, so I will not steal my own thunder—I will wait to provide a response next week.

I thank the co-founders of the Five X More campaign, Clotilde and Tinuke, and all the health care professionals and organisations who campaign to raise awareness of this week. I have visited Tommy’s maternity unit three times now, and the hon. Member for Streatham is right to raise the point that the majority of staff, doctors and midwives are black. I am incredibly impressed with the way that Tommy’s addresses this issue; they are pioneers in addressing maternity inequalities and outcomes, and they do fantastic work. I pay tribute to Tommy’s, and all hospitals, who I know are putting their weight behind reducing maternity inequalities and outcomes—Tommy’s is certainly at the forefront of that work. My granddaughter was born at Chelsea and Westminster hospital, so I thank them too—they are pretty amazing as well.

This debate comes a few days before this year’s World Patient Safety Day; the theme this year is safe maternal and new born care. It provides an opportunity to mark the progress made across the system in improving outcomes and safety, but also to recognise that further work is needed. At its best, NHS care offers some of the safest maternal and neonatal outcomes in the world. However, the disparities that exist between black and white women in pregnancy and childbirth experiences are unacceptable. I am committed to both reducing this disparity in health outcomes, and improving the experience of care.

We cannot beat around the bush any longer on some of the reasons why we experience these inequalities. They are complex, and there is no one answer as to how we can address this subject. Personal, social, economic and environmental factors all play a part; we must address the causes of disparities to improve outcomes and experiences of care. I was delighted that last week NHS England and NHS Improvement published their equity and equality guidance, which responds to findings that maternal and perinatal mortality show worse outcomes for those in black, Asian and mixed ethnic groups. They invested £6.8 million in the guidance to improve equity and equality action plans, and implement targeted and enhanced continuity of care.

We know that pregnancy lasts around 40 weeks. However, when a woman walks into a hospital to give birth, those 24 or 48 hours—however many hours she is in hospital—are not what wholly contributes to her experience of the healthcare sector, or her outcome. A lifetime approach is needed to address some of the reasons why some women are more at risk of poorer outcomes than others. We know that there are many health issues that contribute to poorer outcomes in pregnancy, including alcohol, obesity and smoking. The chief medical officer recently published a report that showed that, in some of our seaside towns, 25% of women are smoking at the beginning of pregnancy. I think the figure was that 22% were still smoking by the end of their pregnancy. There are inequalities and health disparities that we really need to address.

For that reason, we have established the newly formed Office for Health Improvement and Disparities, which launches on 1 October, to target those health disparities, including racial and ethnic disparities in health, and to improve pre-conception health to support women to be in their best health throughout pregnancy.