Black History Month

Debate between Marie Goldman and Ben Coleman

Thursday 23rd October 2025 Commons Chamber

[Ben Coleman (Chelsea and Fulham) (Lab)]

My remarks will be influenced by my membership of the Health and Social Care Committee, and by the fact that I am the vice-chair of the all-party parliamentary group on black health. Also, like my hon. Friend the Member for Leyton and Wanstead (Mr Bailey), I have the pleasure of being a trade envoy: for Morocco and francophone west Africa. We share a great interest in that continent.

I will focus my remarks on health. When we talk about health and black people, very often we talk about the huge improvement in recognition of one outstanding person: Mary Seacole, who is now just talked about as a nurse who did wonderful things in the Crimea. She has reached the august stage of not just being referred to as “the black Florence Nightingale”; she is now referred to in her own right, but it took an immensely long time for that to happen.

The hon. Members for East Grinstead and Uckfield (Mims Davies) and for Aberdeen North (Kirsty Blackman) referred to the contribution made by the Windrush generation. The history of the national health service and of our country’s black community are intertwined. The people who came on Windrush and other boats, and the successors to them, are now retired and are served by the national health service, but the people who came after them are still the bedrock of the national health service. They provide the majority of the care that we all expect to receive, but we know that their contribution has not always been well rewarded.

There is still a huge issue today regarding how well the national health service serves people of colour—how well it serves black people. That was brought home to me quite starkly by one of the most challenging things that has confronted any of us in our recent history: the covid pandemic. As a cabinet member for health and social care in a London council at the time, I would see the vaccination figures every week among people of different socioeconomic backgrounds. Consistently, people from an African-Caribbean background would be the least likely to be vaccinated; they would be the most reluctant.

A lot of people were saying things like, “Oh, this is just because they are prey to misinformation or have irrational fears. All we need to do is put them in front of people of religion, or footballers, and it will change everyone’s mind.” I found that slightly odd, so I talked a lot to people to try to understand why it was happening. I should say that I went to a London comprehensive school with people who were black, white and from all sorts of backgrounds. I have always been aware of racism, but I thought that things had got a lot better. From talking to black people about covid and their feelings about the NHS, I realised that things were really not as good as I had liked to pretend to myself.

The situation was not driven by a need to educate people or make them aware; the problem was that there was a lack of trust in the NHS, and it did not come from nowhere. If people consistently get less good access to care, less good treatment and less good outcomes, it is not surprising that when they are told, “Trust us, we’re the NHS,” they say, “Well, you haven’t always obviously had my best interests at heart, so forgive me a certain amount of reluctance to do so.”

We have a very serious problem in our country of people getting less good healthcare simply because their skin colour is different, which is completely absurd—it sounds very childish of me to put it in that way, as it is so ridiculous—and what I saw during that time on the council made me think, “How do we address it? How do we create the trust that we need everybody in this country to have equally in the NHS?” Our Select Committee is trying to grapple with those questions in different ways. The hon. Member for Chelmsford (Marie Goldman) mentioned the issue of black maternal health. She is right that maternal health services are a huge problem.

The Health and Social Care Committee recently undertook an inquiry into how to improve black maternal health services. I will talk a little bit about it, because I think what we came out with provides a bit of a road map for transforming the NHS’s treatment of black people across the board, and for improving services across the board. We started by confronting the shocking fact that a black woman is 2.3 times more likely than a white woman to die during pregnancy or childbirth, or in the post-natal period. As a slight aside, the figure used to be even worse; it used to be almost five times. It has only got better because everything has got worse for white people as well. There is a huge problem in maternity services in this country generally, but the disparity still remains: black women are 2.3 times more likely to die than white women—in 2025, in one of the richest countries in the world.

We heard repeatedly that the disparity was not the result of social factors, biology or other things; it was simply racism—it was not direct, not overt, not thought through, but racism was one of the core drivers of the disparity. The statistic that black women are 2.3 times more likely to die than white women is not just a statistic, because behind every number is a woman who did not come home to her family; a child left to grow up without their mother; and a partner, parent or a friend left devastated by a death that was preventable.

We were encouraged to be optimistic, so I want to be optimistic against that stark background. I think things can improve if we want them to improve. The Committee made a number of recommendations on maternity care. They are specific, but as I say, I think they have some universal applications. I will share them, and suggest how each can apply to the NHS more broadly to tackle racism, so that everyone gets equal care, no matter who they are.

First, we heard some really strange things. For example, we heard evidence about black women being told by both black and white doctors, “Oh well, you’re black. You can cope with more pain, can’t you?” It is incredible that people are still having that said to them. Other problems include symptoms not necessarily being identified —things like skin rashes and pre-eclampsia discolouration —because doctors and nurses are not properly trained to understand the differences in skin colours, and how to recognise these problems in black people as opposed to white people.

The Committee simply thinks that it would be useful if we had mandatory anti-racism training. That is not training against being racist; it is training in cultural competency, understanding differences—they could be colour differences or cultural differences—and respecting all patients, not just some. Surely it is the job and the fundamental duty of anyone in public service to be there for everybody, not just some people. We would like the training to be not just mandatory but informed by lived experiences, not by assumptions. At the time some people said to me, “Let’s just get people in front of churchmen and churchwomen and then they’ll take the covid vaccine.” It must not be those sorts of assumptions; we must actually listen to people and understand their lived experiences in order to tackle unconscious bias and racist assumptions.

The good news is that there is a model for this that works. Last night I was at a really interesting presentation by the Caribbean & African Health Network on something called the black health improvement programme. It was commissioned by the Greater Manchester Health and Social Care Partnership to address the health inequalities that were exposed by the covid pandemic, and it is now operating in Greater Manchester and Enfield. It offers GPs culturally appropriate education and training, informed directly by talking to the community. It covers institutional racism, health inequalities and lived experiences, and it is grounded in reality. We need to look at that and learn from it. We must scale up such programmes for use across the whole NHS.

[Marie Goldman]

The hon. Member speaks very powerfully and knowledgeably, in particular about maternity services. I note with interest the maternity services review being kicked off by the Government at the moment. Does the hon. Member agree that many of the changes he is suggesting could be implemented right now and that we do not need to wait for the outcome of that review before we get started?

[Ben Coleman]

The hon. Member makes a very good point. I will run through a few more proposals from the maternity report, but they will not surprise Members; they are not radical or new. What would really be radical and new would be if one of these reports— I think I have read at least six reports about black people getting less good treatment from the NHS—had their recommendations implemented. That would be radical. We on the Health and Social Care Committee are looking forward to the Government’s response to the report and are hoping to see the recommendations implemented. If they are implemented for maternity care, we hope that they can be applied more broadly.

The maternity services development fund has sadly been slashed from £95 million to £2 million. The money has been given to integrated care boards to parcel out, but they are all facing 50% admin cuts, so maternity services will have to compete with every other local priority. We need dedicated ringfenced budgets, and we need budgets for areas where there are specific racial health inequalities, such as conditions that affect some people more than others because they are black. I am thinking of fibroids, for instance, and sickle cell awareness, which I will come to in a minute.

I turn to another thing that is essential in the NHS. The Health and Social Care Committee was glad to have the new chair of the NHS, Dr Penny Dash, in front of us being interviewed before her appointment. She said that one thing that is really important to her is data, data, data—and I agree. However, the extraordinary thing is that ethnicity data collection in the NHS is not very good. But it is not impossible to do. There was some work done on assessing disparities in maternal morbidity outcomes. It was almost complete in March 2023 under the previous Government, but when the Committee asked Ministers in June 2025 how it was going, we were told that it was good news and that it was still being developed and was expected within less than three years. That means it will have taken potentially six years to complete something that was meant to be almost finished. This is very slow and unacceptable progress.