Black, Asian and Minority-Ethnic Women: Maternal Mortality Rates

Question

14:49:00

Asked by

To ask His Majesty’s Government what plans they have to reduce the maternal mortality rates of Black, Asian and minority ethnic women, and to reduce the mortality rates of their babies.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper, and declare my interests as set out in the register.

My Lords, I first pay tribute to the noble Baroness for her work with the Muslim Women’s Network, and for her excellent campaigning to end appalling inequities in women’s experiences across the country. Interventions such as enforced continuity of care for the most deprived and initiatives to tackle racism are key. However, further, urgent action is required. This Government are committed to closing the black and Asian mortality gaps and to ensuring safe and compassionate care for mothers and babies alike.

I thank the Minister for her comments. A number of maternity reports tell us exactly what is contributing to the poor outcomes for minority-ethnic women and their babies. Will the Government bring the recommendations in those reports together to ensure that hospital trusts and medical professional bodies follow them? Will the Minister consider appointing a maternity commissioner, because it would save lives?

I certainly agree with the noble Baroness that the maternity landscape is extremely crowded; there have been a number of reports and inquiries, along with investigations. I shall look very closely with officials at the recommendations from those reports as well as those that are forthcoming. With regard to an independent commissioner, I feel that there is general agreement about what the issues are, and the most important priority is to take action. Of course, in reviewing what is going on, as I am now in this post, I will consider all suggestions, and that includes the one from the noble Baroness.

My Lords, I also thank my noble friend Lady Gohir for her continuous campaign. I declare an interest having been involved in these matters in Tower Hamlets for some 40 years. I congratulate the Minister on her ministerial role. When she seeks to consolidate these matters and take the best course of action, will she ensure that she looks at the reports that have been on the shelves at the Royal London Hospital trust for the best part of 40 years?

I thank the noble Baroness for her kind remarks and good wishes. Certainly, all reports will be considered because we will look for what works.

My Lords, sickle cell disorder affects mainly people whose heritage is from Africa, the Caribbean and Asia, and the Sickle Cell Society’s report, No One’s Listening, shows that people with sickle cell experience discrimination when they engage with the NHS. We know that black and Asian women are four times more likely to die in childbirth. Can the Minister assure the House that NHS maternity units have the right level of training, staffing and systems to support safe care for expectant mothers living with sickle cell? I declare an interest as a patron of the Sickle Cell Society.

The noble Baroness is quite right to draw the House’s attention to the important matter of sickle cell. We look to specialist midwives to assist us in this. I have been asked for a particular assurance and it is correct that the noble Baroness seeks that. I shall be pleased to look into it to be able to come back to her in much greater detail.

My Lords, the previous Government introduced the first ever UK women’s health ambassador, who can help to co-ordinate the complex changes that are needed to reduce the mortality rate for black, Asian and minority-ethnic women and their babies. Can the Minister commit to continuing to support the ambassador’s work?

I pay tribute to the noble Baroness for her work promoting good health for women and girls, and I look forward to working with her and with other noble Lords across the House. One of the first calls that I made was to the women’s health ambassador and I will certainly look to her to drive forward the change and improvements in patient safety and patient experience that we desperately need.

My Lords, while I welcome the Minister’s commitment to look at all the recommendations that have been around for a pretty long time, and it is frustrating that action has not been taken, can she give a commitment that once she has considered those recommendations, and if there is a plan of action, she will report to the House on what that plan is likely to be?

I will indeed be very pleased to report back to your Lordships’ House on this matter. It is something that greatly concerns me, because it cannot be acceptable that women go into childbirth, which should be a happy and safe occasion, and perhaps come away with trauma, and in some cases families experience death as well. We cannot have a situation like that. I have been very moved by the stories I have heard and will commit to working to put improvements in place, and to sharing that with noble Lords.

My Lords, I welcome the Minister to her place. I look forward to working constructively with her as we did when our roles were reversed. Has she read the report by Sands, the baby loss charity? It gave examples of Asian parents being dismissed as either being too anxious or exaggerating their claims, while black parents were stereotyped as feisty or dramatic by some NHS staff. When I was a Minister, a young female civil servant told me about her friend, a young Afro-Caribbean lady whose baby died during birth. When she tried to get the records for what happened that evening, she was told that they had somehow magically disappeared. She was being gaslighted. We know that the majority of NHS staff are highly dedicated but, when we hear stories such as this, what does the Minister believe should be done to tackle the culture of cover-up and gaslighting by that small minority of NHS staff?

I thank the noble Lord for his kind remarks; I am very pleased to see him again across the Dispatch Box. The duty of candour is extremely important in all this. Racism in this area is not just towards mothers and families; as the noble Lord said, it is also towards staff. Clearly, we need to tackle this for both patients and staff. The patient’s voice is key. Even at this early stage, it is quite clear to me that women, and people of black, Asian and minority-ethnic heritage, are not being listened to. We will bring forward plans to put this right. As part of the report to which I referred earlier, I will be glad to update the House in this regard.

My Lords, I declare my interest as set out in the register. Given the complexity of the causes of these unacceptable mortality rates, what is the Minister’s department doing to ensure that there is a cross-government approach to ending the maternal mortality gap?

My noble friend is quite right: this is a cross-government matter. There are complex reasons why black, Asian or minority-ethnic people are suffering far worse than those who are white. They include socio-economic factors such as deprivation and health inequalities being felt across the whole range. It is not going to be possible to solve this without cross-government co-operation. I look forward to working with my ministerial colleagues to put it right.

My Lords, I too welcome the Minister’s commitment to addressing this very serious issue. As other noble Lords have mentioned, there have been numerous reports over the years from different trusts highlighting the crisis in maternity services. Training will help, but we hear constantly that a shortage of maternity nurses in many trusts is leading to such situations. The noble Baroness also mentioned that women are simply not being listened to. This has come out in many reports. Will she ensure that women’s voices are heard when they are in labour and giving birth, as they are the experts about their own bodies?

I can say yes to the noble Baroness on the second point, because if we do not listen to patients, we will not get it right. The Government are committed to training more midwives and health visitors and to incentivising continuity of care, as well as to making sure that the National Health Service is focused on tackling inequalities that can be described only as shocking. I absolutely agree about training, but we also need leadership and a determination from the top to put this right, as well as practical plans.