Women’s Health Outcomes

Lord Boateng Excerpts
Thursday 8th July 2021

(3 months, 1 week ago)

Lords Chamber

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Department of Health and Social Care
Baroness Bennett of Manor Castle Portrait Baroness Bennett of Manor Castle (GP) [V]
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I thank the noble Baroness, Lady Jenkin of Kennington, for securing this debate—a timely update a year on from the brilliant report of the noble Baroness, Lady Cumberlege, as the noble Baroness, Lady Bottomley of Nettlestone, just said.

Today’s debate led me to look back over our debates on the Medicines and Medical Devices Bill, during which the Government conceded, after Scotland led the way, on a patient safety commissioner for England. We were promised then that serious consideration was being given to the report’s other recommendations to support victims of disastrous medical procedures and to prevent future avoidable damage. I follow the noble Baroness, Lady Walmsley, in pointing out that the victims of sodium valproate, pelvic mesh implants and Primodos are still waiting. The First Do No Harm report concluded that thousands of lives were ruined because officials failed to listen to female patients. I hope we might hear some good news on that issue from the Minister.

In three minutes, there are many issues I could cover, but I want to extend the conclusions of the noble Baroness, Lady Cumberlege, to broader issues. I note that women wait longer to be diagnosed for many conditions, including cancer, and that heart disease in women is more likely to be misdiagnosed. Mental health is likely to be the diagnosis for a wide range of conditions that have a clear physical cause, often discovered only after many years of suffering.

I note too that intersectionality is at sometimes deadly and always damaging play here, and that women from BAME backgrounds and the LGBTIQA+ community are more likely to report poor treatment from their GP and receive inadequate support from services.

In the brief time left to me, I thought I would focus on an area still getting far too little attention and, like so many others, that is being exacerbated by the Covid-19 pandemic. That is musculoskeletal disorders. I point the House to the excellent briefing for this debate from the Chartered Society of Physiotherapy, which covers that as well as many other important issues. I should perhaps declare a personal interest here, having relied over many decades on physiotherapists to keep me going and repair damage wrought on the sporting field and in the workplace.

As I read that briefing’s recommendations on preventing musculoskeletal problems through access to occupational health physiotherapy, I thought of some women I met in Sheffield working at picking up baskets for a major supermarket’s home delivery service from midnight to dawn. I heard from them how physically challenging it was and how tough it was in the chiller and freezer sections.

We have to think about the many women who are doing what is often a double shift in the home with child and elder care. They also suffer musculoskeletal damage from that, and would greatly benefit from musculoskeletal first contact physiotherapists in primary care being available to all.

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

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

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

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

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

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

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