Black Maternal Health Awareness Week

Michelle Welsh Excerpts

Tuesday 29th April 2025 Westminster Hall

[Michelle Welsh (Sherwood Forest) (Lab)]

It is a pleasure to serve under your chairship, Ms Furniss. I congratulate my hon. Friend the Member for Clapham and Brixton Hill (Bell Ribeiro-Addy) on securing today’s important debate. She has highlighted that black women often receive a worse standard of care and that their risk of maternal death is three times higher than for white women.

The situation in Nottinghamshire demonstrates why change must happen quickly. As some in the Chamber will know, there is currently an independent review into maternity services at Nottingham University Hospitals NHS trust, led by Donna Ockenden. I first called for this review when I was a councillor after my experience of giving birth to my son in 2020. I knew then, as I know now, that women accessing services at NUH do not always receive the care they deserve, nor are they listened to when they raise concerns. Ahead of today’s debate, I reached out to Donna Ockenden and her team for their perspective on black maternal health in Nottinghamshire so that I could highlight it here today.

When the Donna Ockenden review was established in Nottingham two years ago, the Nottingham University Hospitals trust could not share a single named contact within the black community, nor did the trust have any meaningful engagement with the many groups across Nottinghamshire. It had no way of reaching into groups of black women who might have been affected by poor maternity care. The translated resources provided by the trust were also very limited. It is therefore unsurprising that trust between black communities and Nottingham University Hospitals trust was at an all-time low.

As Donna Ockenden rightly emphasised to me, that only increased the risk that women and their families would disengage from vital health services and be unable to give informed consent to treatment through their maternity programme. I am pleased to say that the review’s work so far is leading to some improvements in the NHS, and I believe it is important to acknowledge that progress even if there is still so much further to go.

Since the review began, Donna and her team have met many community groups across Nottinghamshire and attended numerous church services and meetings in the majority black-led churches. They have also appeared on the famous Kemet FM, a local community radio station that focuses on the music, wellbeing and culture of Nottingham’s African and Caribbean communities, broadcasting across the east midlands and the Caribbean.

Following that outreach, many black families have come forward to the review, and community engagement has strengthened as the review has progressed. I am pleased to report that these learnings are shared with the trust in bimonthly learning and improvement meetings, although it has taken years to build that relationship with local communities and to establish trust. That is essential not only in providing safe care that is reflective of the population’s needs, but in ensuring that the voices of black women are no longer ignored. It is clear that there had been little or no communication for so long.

However, it is important to acknowledge that not every trust has a Donna Ockenden. They do not have somebody reaching out to black communities and black women to find out what is happening and how they are affected by health services.

I know that the last 14 years have had a hugely detrimental impact on maternity services across the country. The only way we can begin to fix them is by tackling the underlying issues in the culture of the NHS. It is important to note, as I have just said, that not every NHS trust has a Donna Ockenden and the level of scrutiny that happened in Nottingham.

As the newly elected chair of the all-party parliamentary group on maternity, I am committed to working with the Government on a health strategy for maternity services that recognises how inequalities have a huge impact on the care that people receive. I therefore urge the Minister to ensure that the experiences of black women are at the heart of any forthcoming maternity strategy, and that trusts are strongly encouraged to engage with communities so that their voices are no longer ignored. If inequalities are to be addressed, we require a national framework and a maternity strategy that is fit for the future.

--- Later in debate ---

[Dr Johnson]

I think we have both made our positions clear. I accept that some people will have received poor care and that the people who delivered that poor care need to be hauled over the coals. They need to be called out for what they have done and we must ensure that such care does not happen again. But I do not accept that the NHS is a racist organisation.

Another issue is language barriers. It is well recognised that it is difficult for people who have a language barrier to access health services. Can the Minister tell us what the Government are doing to help with that? In recent years in my medical career I have seen improvements in the delivery of language services, but when I was a more junior doctor an appointment needed to be booked in advance and an interpreter had to attend in person. Sometimes they were available and sometimes they were not. Sometimes other members of staff or family members would be used to interpret, which is a poor standard of care, relatively speaking.

[Michelle Welsh]

Is it possible for the hon. Member to highlight what part of the NHS she worked in? The reported experiences of interpretation and translation nationally are very different from what she is describing, which does not reflect the factual accounts and certainly does not reflect what has been happening in Nottinghamshire.

[Dr Johnson]

I did the junior part of my medical career in Nottinghamshire. I am describing what happened in the junior part of my career, which is about 20 years ago now. My experience 20 years ago was that it was very difficult to get interpreters, and that the people used to interpret were not proper interpreters and not the appropriate people. That should not be happening.

The service is still not perfect, but over time we have seen translation services improve. Many hospitals have instituted new iPad systems where one can choose a country of origin or the language that the person speaks, and a dial-up system of interpreters working from home is used to provide an interpreting system. That is much better—it is more available to the patient than the services we had in the past, which required someone in person—but it is still not perfect. We still see areas across the country where those services and that interpretation are unavailable to people. How will the Minister ensure that women who have difficulties with the English language are able to access interpreters when they need them—not just for appointments, but for out-of-hours emergencies? That is when interpreters are most difficult to obtain, particularly for languages spoken by fewer people in the United Kingdom.

I want to ask about the Government’s plans. The previous Government instituted a three-year plan, which comes to an end next year. When will the Government produce the plan? They talked about their 10-year NHS plan, which they said they would produce in the spring. I believe we are in the spring now—if we look outside, it is a beautiful day; the flowers are out and the lambs have been born. Where is the plan that the Government promised? What targets are they going to set, and when, to improve maternity care for all women, and specifically for black women?

Maternal Mental Health

Michelle Welsh Excerpts

Wednesday 5th February 2025 Westminster Hall

[Michelle Welsh (Sherwood Forest) (Lab)]

I thank my hon. Friend the Member for Aylesbury (Laura Kyrke-Smith) for securing the debate—I am so sorry about her friend Sophie.

Maternity services in this country are in a dire state. In Nottinghamshire, this has been exacerbated by the fact that we have had the largest maternity scandal in NHS history. We have seen at first hand how women have suffered from some of the worst care and treatment imaginable; in many, if not most, cases they were left with little or no support and support was lacking or sparse.

I had a traumatic pregnancy and a traumatic birth. My son was born in the first week of the first lockdown. Despite having an emergency C-section due to not having been listened to, I was sent home in less than 24 hours. I was left alone and abandoned by the health services. The mental health situation that I faced does not go away—it never leaves you—but I am one of the lucky ones.

I do not wish to say much more, other than that maternal mental health provision will be fixed only when we fix our maternity services, and our maternity services start by supporting women before they are even pregnant. To get to the point where women do not go home feeling that they have done something wrong, that their situation is all their fault, and that they are useless and not capable of being a mother, we have to fix our system for how we care for women and babies.

World AIDS Day

Michelle Welsh Excerpts

Wednesday 27th November 2024 Westminster Hall

[Michelle Welsh (Sherwood Forest) (Lab)]

I thank my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) for securing this important debate. All the words we have heard today have been poignant and impactful.

I want to speak about the impact of AIDS on women. In the UK, women make up a third of people living with HIV and just over a third of new HIV diagnoses. It is crucial that any strategy for AIDS does not forget women and their unique experiences of this disease. Often, women with HIV are some of the most disadvantaged members of society. The Terrence Higgins Trust estimates that almost half of women living with HIV in the UK live below the poverty line. It also estimates that over half of women living with HIV have experienced violence because of their HIV status. I spoke earlier today in a debate on tackling violence against women and girls, and this is yet another opportunity to highlight the actions we need to be taking to ensure that women in the UK do not have to live in fear.

I also want to raise the importance of women getting tested for HIV, as it can often feel like there are too many barriers in place. We have made great strides in the treatment of the disease; it is vital that women can also access those treatments.

It is also important to raise the fact that often, black, Asian and ethnic minority women face worse outcomes and experiences in our healthcare services than white women. That will no doubt also be seen in how those women access HIV care.

I will finish by saying that we must strive so that all those living with HIV are able to do so with freedom from HIV secrecy, knowing that they are accepted and that HIV is not a label, and are free to pursue their dreams, faith and relationships free from stigma and discrimination.

[Sir Mark Hendrick (in the Chair)]

I thank hon. Members for their brief contributions and for giving time for the Front Bench speakers.

Respiratory Health

Michelle Welsh Excerpts

Thursday 14th November 2024 Westminster Hall

[Michelle Welsh (Sherwood Forest) (Lab)]

I thank the hon. Member for Strangford (Jim Shannon) for bringing forward this important issue. Lung diseases are sadly prevalent in my constituency of Sherwood Forest. Diagnosis is often slow and prognosis is often devastating. Health inequalities in my constituency are stark, with people in the south of Nottinghamshire living an average seven and a half years longer than those living in the north of my constituency. Significant work across Nottinghamshire is being done regarding the diagnosis of lung cancer, and rightly so, but there are serious gaps in pathways for those suffering from lung diseases such as pulmonary fibrosis.

Pulmonary fibrosis is a devastating disease, and its impact is felt acutely by those affected. I know at first hand that this relentless and often rapidly progressing condition drastically changes the lives of the people affected and their loved ones. They face a daily struggle of breathlessness, constant fatigue and the immense mental toll of facing a terminal illness with very limited treatment options. Simple tasks such as walking across a room become an enormous challenge.

Yet pulmonary fibrosis lacks a focus that it desperately needs. Many people receive their diagnosis far too late, partly because the symptoms are often mistaken for less severe respiratory issues, and long waits for access to specialist care and life-extending treatment are very common. The disparities in access to these life-enhancing resources are unacceptable and must be addressed. Health inequalities play a significant role in accessing pulmonary fibrosis care, with those coming from a socially deprived background and living further from one of the few specialist centres likely to die sooner. I welcome the Secretary of State’s call for more specialist care to be available closer to home, as the current situation is particularly problematic for pulmonary fibrosis.

I welcome the work of the national charity Action for Pulmonary Fibrosis in bringing together the community to implement a new pathway to improve many of the issues, and I hope the NHS will continue to focus on the implementation of that work. We have the opportunity to redesign services in a way that better aligns with local population needs and therefore enhances patient outcomes. I place on the record my thanks to those in the Nottingham University Hospitals NHS trust who work in respiratory care, particularly the lung nursing team, the healthcare assistants and Dr Saini, who are working endlessly to improve both diagnosis and prognosis. I know that at first hand, as sadly my father suffers from this cruel disease, and I have subsequently met many other sufferers and their carers.

People with idiopathic pulmonary fibrosis are often misunderstood, as it has no known identified cause. They often feel lost and always feel ignored. The work to improve healthcare systems for pulmonary fibrosis requires collective effort, and I hope that today’s debate will pave the way for significant strides forward in how we address this heartbreaking disease so that those suffering are heard and understood.