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.

Covid-19 Vaccinations: 12 to 15-year-olds

Florence Eshalomi Excerpts

Monday 13th September 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful for my hon. Friend’s important question, and I thank her for the work she has done and continues to do on the vaccination programme. All I would say to her is that I think it is important that the Government accept the final decision—the unanimous decision—of the four chief medical officers for England, Scotland, Wales and Northern Ireland, and offer the vaccine. Of course, parental consent will be sought, but it is only right that we offer the one-dose vaccine to 12 to 15-year-olds as per the advice received today.

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

I thank the Minister for the statement. I have highlighted many times in this Chamber the low take-up among some communities, specifically our black and minority ethnic communities. They are the same communities that will be hesitant about their children coming forward. They will be the same communities, if the vaccines have to be administered in school, that will make sure their children do not go to school that day. So I want to know what additional support and information—in different languages and reaching out to those communities—there will be to properly inform them so that they can make the decision about whether or not their children are vaccinated.

[Nadhim Zahawi]

I am grateful for the hon. Lady’s question. Actually, on her final sentence about proper information, I think it is important not to stigmatise any parent whatsoever. It is right that we supply the information, and there will be an extensive information programme that the school-age vaccination team will deliver and work on with schools. The Minister for School Standards, who is sitting on my left, and his team, whom I have to commend, have been engaged throughout today in making sure that that information does get through to parents to make that decision.

Covid Vaccine Passports

Florence Eshalomi Excerpts

Wednesday 8th September 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful for my hon. Friend’s thoughtful question. There is great difficulty with knowing at what stage we feel confident that the virus has transitioned from pandemic to endemic. We have now entered a period of equilibrium with the virus because of the success of the vaccination programme. The upward pressure on infections is obviously schools going back. The downward pressure on infections will be the booster programme and mitigating policies like the one we are debating. The Government certainly do not see this as a long-term power grab to restrict people’s liberties.

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

I feel I should try to help the Minister by thanking him for the regular briefings on vaccination uptake over the recess, which was very helpful to me in terms of encouraging a number of people from the BME communities to take up the vaccine. However, this policy is not going to work in Vauxhall. A number of businesses that have been hampered over the last 18 months want to get back. A number of those businesses are fearful of the looming rent increases for private commercial tenants. A number of businesses are fearful about the backlog of business rates that they have to pay. We are now probably going to ask those same businesses to pay to implement this policy. I want to go back to the issue raised by my hon. Friend the Member for Feltham and Heston (Seema Malhotra): what funding will be available to those businesses and when will they receive it?

[Nadhim Zahawi]

I am grateful for the hon. Lady’s kind words about the engagement that we have maintained throughout the vaccine deployment programme. We will continue to do so, by the way, as we enter the booster programme, which, in some weeks, will hopefully break all records that we set in phase 1 of the vaccination programme. I think what is more detrimental to businesses in Vauxhall is having to open and shut, and open and shut again. The reason for this policy is to sustain their ability to trade, and hopefully trade profitably.

NHS Update

Florence Eshalomi Excerpts

Wednesday 21st July 2021 Commons Chamber

[Helen Whately]

May I say how good it is to hear that my hon. Friend’s area has taken up the jab so strongly, so that so many people are having the protection of both doses of the vaccination? We know that it does not mean that they definitely will not get covid at all, but we know that their risk of hospitalisation, serious consequences and indeed death is that much lower from being vaccinated. Of course, it is important that those who have yet to be vaccinated but who are eligible still come forward; there are more people still to come forward. If my hon. Friend thinks that there is anything specific that we could do further in his constituency, I hope that he will let me or the Minister for Covid Vaccine Deployment know.

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

I join my hon. Friends the Members for Tooting (Dr Allin-Khan), for Hackney South and Shoreditch (Meg Hillier), for York Central (Rachael Maskell) and for Warrington North (Charlotte Nichols) in expressing my dismay at the Minister’s statement, which outlines nothing for the many NHS staff—including the hard-working staff across the bridge from this House, at St Thomas’ Hospital in my constituency—who still have not seen the pay rise that they deserve. Our NHS staff have been working tirelessly for more than a year on the frontline; they are exhausted. They have experienced exceptional levels of trauma and crisis for a prolonged period. Recent research by King’s College London found that intensive care staff reported PTSD, severe depression and anxiety. They need support over the coming years. Will the Minister outline what steps the Government are taking to work with our NHS staff in order to support them to deal with the mental health fallout from the pandemic?

Covid-19 Update

Florence Eshalomi Excerpts

Tuesday 6th July 2021 Commons Chamber

[Sajid Javid]

My hon. Friend will know that the reason we have seen an increase in demand for A&E across the country is that many people have not been able to go to their GP in the usual way. Quite understandably, when their problem gets to a point that, in normal circumstances, it would not have reached, they go to A&E. That is what I meant when I talked earlier about the backlog of cases. Yesterday, I said that there are some 7 million people who, in normal circumstances would have come forward to the NHS either through their GP or in another way, but have not done so because of the rules and restrictions around the pandemic. Easing those restrictions will make a big difference.

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

More than a quarter of my Vauxhall constituents are aged between 20 and 29 and many of them have not had the chance to come forward for their second vaccine. Obviously, the lockdown restrictions that we are under will ease in two weeks’ time. This morning, the Secretary of State has confirmed that numbers are expected to rise after 19 July. He will be aware that a number of young people—one in eight—are still vaccine-hesitant. We know about the link between cases and hospitalisation and that the link is not broken. Young people are fearful of getting long covid, so can the Minister inform the House what specific resources are being made available through the NHS for those suffering with long covid?

[Sajid Javid]

The Government have made more than £90 billion of additional funding available to deal with the consequences of the pandemic. Much of that has gone to the NHS and other parts of the healthcare system, and it is helping in every aspect, including with those sadly suffering with long covid. Younger people are, of course, affected by the virus—no one could pretend otherwise—but the hon. Lady will know that they are less affected and impacted than older people in their communities. That is why older people have been the priority in the vaccination programme. One of the reasons that the date of 19 July was set was to allow every adult to get their first jab. Yesterday I announced the decision to shorten the time period between jabs from 12 weeks to eight weeks, so that some more people, including all the younger people to whom the hon. Lady referred, can get the full protection of a double dose by September.

Covid-19

Florence Eshalomi Excerpts

Tuesday 25th May 2021 Commons Chamber

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

I thank the Minister for his weekly updates, which I have found really helpful, and for his work on vaccine hesitancy across the black, Asian and minority ethnic community. I had my vaccine on 14 May at St Thomas’ Hospital—the same hospital that cared really well for our Prime Minister. The Prime Minister thanked those nurses, including Luis, who gave me my vaccine. But we saw that Jenny resigned from the NHS last week, so will the Minister use his will and his power to speak to the Treasury to get our hard-working nurses the pay they deserve?

[Nadhim Zahawi]

I am grateful for the hon. Member’s commitment in ensuring that we get the vaccine message out to harder-to-reach communities and for her work with me on the weekly meetings. We have delivered an increase to nurses. We await the outcome of the deliberations of the panel that will look at nurses’ pay, and then the Treasury will make an announcement in the usual way

Black Maternal Healthcare and Mortality

Florence Eshalomi Excerpts

Monday 19th April 2021 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Sir Gary. I thank the campaigners for bringing this really important issue to Parliament and for raising awareness on behalf of all women. Over 1,186 Vauxhall constituents signed the petition that has led to this important debate.

As the mother of two young children born just over the road from Parliament, at St Thomas’ Hospital, I know that giving birth should be one of the most natural and exciting experiences that any mother can have. I think back to my first pregnancy—the fear, excitement and mixture of emotions. Like many women from a black or minority ethnic community, I was not aware that I suffered from a disease called fibroids until I had my first maternal scan. That brought additional fear and anxiety around my childbirth, but for far too many women, pregnancy and childbirth can be complicated and dangerous. When I got pregnant, I also realised that I was a sickle cell carrier.

We have known for some time that maternal and perinatal mortality rates are significantly higher for women of black, Asian and mixed heritage and their babies. That is why we have to do everything we can to ensure that pregnancy and childbirth is as safe as it can be for all women in this country. We have the data. We know that the death rate in childbirth for black women is five times that for white women. In 2021, that cannot be acceptable.

To tackle the problem, we must first acknowledge the structural and institutional racism that exists in our healthcare system. We know that black and minority ethnic women are sometimes not listened to during the course of their care, and this can be subject to unconscious bias and microaggression. As a result, their symptoms are dismissed as normal during pregnancy, whereas they should be investigated a lot further.

The NHS is aware of the disparity, but it has no target to end it. I hope that by raising awareness of this issue, we will help to kickstart a national debate that will lead to the Government taking real action to address it. My colleagues have already asked the Minister to respond by looking at those key targets. We need to work with the NHS to implement the Joint Committee on Human Rights’ recommendations, which are clear. They are about reducing racial disparities in black and minority ethnic maternal health outcomes, and specifically about introducing those targets, so that we can measure those protections.

NHS Pay

Florence Eshalomi Excerpts

Wednesday 24th March 2021 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Hosie. I pay tribute to my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for securing this crucial debate and for her tireless efforts to ensure that our key workers get the fair pay they deserve.

Yesterday, we came together to reflect on the tragic events of the past year. We remembered the family members and friends we lost. We also paid tribute to those who cared for them. My constituency is home to the renowned St Thomas’ Hospital. That is the hospital that saved the life of the Prime Minister and the lives of countless other people during this pandemic. The hospital’s staff are now working hard to deliver the vaccine, while still maintaining the hospital’s regular services to the local community and to people from right across the country. I admit that I have a personal bias for St Thomas’ Hospital, as I received excellent care from the team there throughout my two pregnancies.

This past year has undoubtedly been one of the most difficult years for our NHS workers. They are physically and mentally exhausted. I recently had the pleasure of meeting the staff team at Saint Thomas’ when I was invited to speak at the Unison branch annual general meeting. I am proud to be a Unison member, and I am proud to have such an iconic hospital in my constituency. The staff team—including the dedicated nurses, security team, porters and junior doctors—told me about all the challenges they face while working day and night during this pandemic.

During the lockdown, I participated in the weekly clap for our carers, along with my son and daughter, because I genuinely wanted to show my appreciation. But clapping does not pay the bills. I know that, in some cases, nurses have to rely on food banks as they struggle to make ends meet. Many of my constituents who have been caught up in the cladding scandal are NHS key workers. They have been working long hours and making personal sacrifices to keep us safe, but now they face extortionate costs that they cannot afford.

A 1% pay rise is not a meaningful pay rise; after inflation, it is essentially a pay cut. It sends all the wrong signals to the NHS workers who have kept our country going during this dreadful pandemic. It is an utter betrayal by this Government not to give our NHS workers a bigger pay rise. The Prime Minister spent three nights in intensive care, on a ward for patients who needed specialist attention. He said afterwards:

“I can’t thank them enough. I owe them my life.”

Jenny and Luis stood by the Prime Minister’s bedside, watching him during the night. The NHS protected him. It protected us. Now is the time when we must protect it.

Covid-19 Update

Florence Eshalomi Excerpts

Tuesday 2nd March 2021 Commons Chamber

[Matt Hancock]

Coventry and Warwickshire have done an amazing job, and I was very pleased to see them top the ranks published on Thursday of the areas of England that have vaccinated the most. I congratulate my hon. Friend and his team.

On foreign holidays, we said in the road map that international holidays will not be allowed before 17 May. We are working with the global travel taskforce, which met this lunchtime, just before I came to the House. It is chaired by my right hon. Friend the Transport Secretary. I am on it, along with Home Office and Foreign Office colleagues and representatives from the travel industry—from the airlines, cruise ships and others. That will report by 12 April. Last year, international travel restrictions were about restricting the number of cases due to high prevalence elsewhere when the prevalence here was low. The challenge now is that we have to take into consideration the risks from variants of concern, which means that more understanding about the impact of vaccines on variants of concern, such as the one first discovered in Manaus in Brazil that we were talking about earlier, is critical to answering the question of when we will be able safely to reopen international travel.

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

I received some welcome news this morning that Lambeth’s local covid vaccination team is one of the highest performing teams in the country. Our local clinical commissioning group reports that 85% of people over 75 and 89% of residents in care homes have now been vaccinated. Here in Vauxhall, we have had to implement the surge testing operation in the past few days because a case of the South African variant was discovered locally. This is all down to the tireless efforts of our primary care workers, nurses, GPs, pharmacies and an army of volunteers. I am concerned, though, that despite this heroic effort, there is still some misinformation and vaccine hesitancy. Does the Secretary of State agree that more needs to be done to counter this misinformation and to support the vaccine roll-out and take-up among our black, Asian and ethnic minority communities?

[Matt Hancock]

Yes, I do. I want to add one more person to the long list of people whom the hon. Lady rightly thanked for their incredible work of getting take-up in Lambeth to as high as 85% among the over-75s, and that is her. She has played a personal leadership role, and I thank her and pay tribute to her for that. There is still much more work to do, and I hope that we can keep working together on it.

Covid-19: Vaccinations

Florence Eshalomi Excerpts

Monday 11th January 2021 Commons Chamber

[Nadhim Zahawi]

We work closely with the Welsh, Scottish and Northern Irish Governments on the programme and ensure that we deliver the vaccine volumes to them. Although we do not publish the exact quantities of vaccine for a variety of reasons—including that the whole world is looking to get more volume of vaccines and we do not want to disadvantage ourselves in any way commercially—I reassure my hon. Friend that all the devolved Administrations will have enough to be able to offer those four JCVI cohorts the opportunity to be vaccinated and protected by mid-February, at least with a first dose.

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

Teachers in Vauxhall are working tirelessly to manage the delivery of classrooms online as well as teaching the most vulnerable key worker children in our schools. The Minister highlighted earlier that he will prioritise those most likely to die and that he will keep teachers at the forefront of his mind. Can I please ask him why teachers and school staff on the frontline of the pandemic are not being protected? What is the timeline for getting them vaccinated?