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Trespass
(3 years, 7 months ago)
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Peter Bone (in the Chair)
I remind hon. Members that there have been some changes to normal practice in order to support the new hybrid arrangements. Timings of debates have been amended to allow technical arrangements to be made for the next debate. There will also be suspensions between each debate. I remind Members participating physically and virtually that they must arrive for the start of the debate in Westminster Hall. Members are expected to remain for the entire debate.
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Katherine Fletcher (South Ribble) (Con)
I beg to move,
That this House has considered e-petition 300139, relating to trespass.
It is an honour to serve under your chairmanship, Mr Bone. I have demonstrated that not all talents are distributed equally, as I have managed to pour water all over my speaking notes. If there is any disintegration of these words, I beg your forgiveness.
This debate is about how we access the countryside, how much we value it and what laws should govern that access. The petition proposes changes to legislation currently going through Parliament. In short, it asks that we do not criminalise trespass. Before its closure in September last year, the petition had been signed by 134,932 people, 185 of whom are from my own fabulous patch of South Ribble.
In seeking to represent fairly the different sides of this complex debate, I met a number of individuals and organisations to hear their views. I am particularly grateful for their time and expert insight. My sincere thanks go to the petition’s originator, Guy Shrubsole; Gemma Cantelo, representing the views of the Ramblers; Abbey Kirkby, for sharing her thoughts from the Traveller community; as well as George Dunn, from the Tenant Farmers Association; Sam Durham, from the National Farmers Union; and Andrew Gillett, from the Country Land and Business Association.
With those thanks over, let me take a step into the detail of this debate. My right hon. Friend the Minister has stated that the Government
“made a clear manifesto commitment to act on the issue of unauthorised encampments and…remain determined to ensure police have the powers they need.”
As a result, the Police, Crime, Sentencing and Courts Bill introduces intentional trespass as a criminal offence. The “Don’t criminalise trespass” petition was set up by Guy as he has a series of concerns about unintended consequences for countryside lovers and those who seek to reside in it. In his view, criminalising intentional trespass could lead to, although not exclusively: prosecuting ramblers who stray from the path by accident—I am sure that is something that the Minister, the Chair and all of us in this room have done, although I confess that I am normally in possession of a mountain bike and a rucksack when issuing unfettered apologies for being in the wrong part of the countryside—preventing participation in wild camping, even for personal safety or enjoyment; limiting the right to peaceful protest; and forging new paths in the countryside. Guy is also keen to highlight the wider implications of criminalising intentional trespass on the lives of Traveller communities across the country.
Through an online survey, the Petitions Committee sought the opinions of affected groups and forums. A remarkable 84% of respondents felt that criminalisation of intentional trespass would have major or moderate effects on how they live their lives. Further conversations with representatives of the Ramblers regarding access and right of way suggest that they share similar concerns about the criminalisation of those who have become lost or strayed from the footpath. They argue that the likelihood of becoming lost with unkempt footpaths and limited signage—and, in my case, a lack of capability —inhibits visitors from venturing out and exploring our beautiful countryside. Discouraging rambling should not be a consequence of the legislation, and nor should be it threatened.
Respondents to the Petitions Committee survey also suggested that urban dwellers—I was most definitely one in my youth—include higher levels of minorities and the economically disadvantaged, who already have less access to outdoor spaces in England. They could be disproportionately affected through either the reality or the perception that they will be criminalised for accessing the countryside, and the petitioners feel extremely strongly that this should not be the case.
There were concerns that the proposed changes in the law would add further barriers to outdoor access. I am proud that we are a country with 140,000 miles of public rights of way, mainly founded through public footpaths and bridleways. Such routes to access to the countryside, nature and wildlife are here to stay, and they are extremely important as an outlet for our educational, mental and physical needs. Like the petitioners, I use them regularly on my bike and on foot, and I would be deeply concerned if new legislation were to deter others from enjoying the beauty of England—north or south.
Many robust concerns were raised about the unintended consequences of the legislation. Crucially, such opinions were mirrored in the conversations that I have had with rambler groups, farmers and landowners. During those discussions, it became clear that at the heart of the debate is a key phrase: “to intentionally reside”. It many cases, a lost walker has no intent to reside unlawfully on a farmer’s field. When discussing this further, Guy’s experience of wild camping in Dartmoor is a potential model. Stays there are restricted to a maximum of two nights, which prevents a camper from establishing intent to reside, and arguably they are at no risk of committing trespass by that account.
The legislation that sparked the petition is aimed at tackling illegal encampments, where visitors occupy land and do not leave when asked. In representing the petitioners, I felt it appropriate to speak to those whom the legislation seeks to support. Within my constituency of South Ribble, there have been a series of trespass issues for landowners. As trespass is currently a civil offence, returning access to landowners’ property can be a lengthy process with temporary results. According to my local landowners who have reported back to me, the current reprimands for trespass do not equal the financial and environmental cost. Despite the focus on unauthorised encampments, petitioners are concerned that under the proposed changes to the law, there is a real possibility that the legislation will be manipulated to criminalise participants in wild camping, mountain biking and rambling who get lost. I look forward to hearing from the Minister what he can do to assuage the extremely valid concerns.
Representatives of the National Farmers Union, the Country Land and Business Association and the Tenant Farmers Association were keen to highlight that farmers and landowners are delighted to share the countryside with others, as long as visitors are respectful. That means steering clear of livestock and crop production, and adhering to the countryside code. However, they were keen to speak to the points in the petition. In their view, instances of trespass with residency have become a larger problem, with the use of intimidation, violence and environmental destruction being reported to them. They felt that current legislation is not a useful tool to prevent such issues. In order to best prevent and discourage intentional and destructive trespass, it seems logical to them to make it a criminal offence.
I discussed these points with Abbie from Friends, Families and Travellers during a really brilliant conversation. She expressed the importance of not associating certain behaviours with all members of the Traveller community. Given the authorised Traveller sites in South Ribble, I must wholeheartedly agree with her. She recognised a persistent problem with unlawful encampments, but she has huge concerns that further legislation compounds the inequalities experienced by the Traveller community. The Bill strengthens police powers, including the ability to seize a vehicle, for example. For those in the Traveller community, that could mean the seizure of their home and possessions. The number of lawful sites in which the Traveller community can reside is limited, so Abbie and the petitioners argue strongly that improved site provision, not further legislation, is key to preventing issues. On behalf of the Traveller community, she says quite clearly: “Don’t criminalise trespass.”
Owing to the delay caused by covid, since the petition’s inception and our meetings, the Police, Crime, Sentencing and Courts Bill—the subject of the petition—received its Second Reading in the House of Commons on 16 March. The Bill contains provisions on unauthorised encampments, including the creation of an offence
“relating to residing on land without consent in or with a vehicle”.
My understanding is that that phrasing is intended in part to address the concerns raised by the petitioners. The new offence has been phrased in such a way as to ensure that the right of ramblers and others to enjoy the countryside is not affected. Despite that, under the definition provided, a bicycle could constitute a vehicle, which could put me and my haphazard mountain biking at risk. The inclusion of bicycles in the definition has been highlighted as a concern of many of those who have signed the petition. I look forward to hearing the Minister’s response to those points.
The petitioners are worried about the introduction of a barrier to their access to the wonderful British countryside, and about the idea that it would put others off accessing our bridleways and footpaths for recreation and enjoyment, good mental health, and engagement with nature—all those amazing things. Although farmers and landowners are experiencing difficulty with unlawful encampments, with which they believe the current statute cannot assist, they are mindful of the unintended consequences of legislation.
The Traveller community have concerns about their way of life, and about being judged by the actions of a minority, which is a concern shared by the petitioners. I repeat my grateful thanks to all those who signed the petition, and to those who took the time to meet me in the run-up to the debate. I look forward to hearing colleagues’ responses on this difficult and nuanced subject. The petition says, “Don’t criminalise trespass”, but is that the same as residing on land without consent in or with a vehicle?
Andy Slaughter (Hammersmith) (Lab)
It is a pleasure to be before you in Westminster Hall, Mr Bone. I thank the Petitions Committee for facilitating the debate, which has come slightly later than we envisaged—it was due to take place in January. If anything, it is now more relevant, as the hon. Member for South Ribble (Katherine Fletcher) said.
We have had Second Reading of the Police, Crime, Sentencing and Courts Bill, and we heard the arguments put forward then. I must compliment the hon. Lady on putting forward a balanced argument, but in her effort to do that, what shone through was how strong the arguments are on the side against this wholly unnecessary provision, which is being included in the Bill for reasons on which I will speculate in a moment.
There is no reason for the provision. If the petition had not been closed, as they are after six months, I am sure that we would by now have had many more than the 135,000 signatures. Lots of groups are threatened by the criminalisation of trespass: ramblers, who have been mentioned; off-road cyclists; canoeists; wild campers; those who are forced to live in a vehicle because of homelessness or other circumstances; and those who care about and want access to the countryside.
In their response to the consultation on the Bill, the Government have implied that many of those groups are not the target. Two questions spring from that. First, the Government have not persuaded anyone. As the Ramblers said in the briefing for this debate, the legislation is vaguely drafted and many of the proposals are unclear in both scope and reach, which risks criminalising activities such as wild camping when accessed by a motor vehicle or bicycle, as well as the legitimate right to protest. The Bill would allow the police to take action on an officer’s suspicion that someone might intend to reside. It would give the minority of landowners who might wish to make the countryside a hostile place for those seeking to enjoy it for recreation a powerful new tool to deter users. The potential for abuse of the legislation is obvious and significant. The Bill would send a signal that the countryside is not an open resource that is accessible to all, but a place of complex rules and regulations, with criminal sanctions for breaching them.
If the Government did succeed in so limiting the Bill by a further amendment in Committee or at a later stage, the issue of who is primarily the target would become clearer: Gypsy and Traveller communities, and those who adopt a nomadic lifestyle through choice or necessity. I say this regretfully: I can only reach the conclusion that it is a rather nasty racist little attempt to attack minority ethnic communities already suffering severe discrimination, and other socially marginalised groups. I will repeat something I said when speaking about the Bill on Second Reading, that
“no family willingly stops somewhere they are not welcome, and which has no running water, waste disposal or electricity”—[Official Report, 15 March 2021; Vol. 691, c. 88.]—
and where they will be harassed.
The reason for unauthorised encampments is the lack of authorised sites, be they permanent or transit sites. The number of permanent or transit sites on aggregate has gone down over the past ten years by several hundred, and by over 8% in total. Gypsies and Travellers are among the most marginalised and discriminated against groups in the country. Their outcomes in health, education and life expectancy are the worst of any ethnic minority group, and proper provision is simply not made. There are 354 transit pitches across the whole of England, and only 29 local authorities provide them. If there is nowhere to go that is of an authorised nature, then what alternative is there but to use unauthorised sites? There are 1,696 households on the waiting list for pitches, with only 59 vacant pitches on permanent sites and 42 on transit sites.
In responding to the petition, the Government said:
“The law of trespass is largely one of common law, with the courts developing the law and resolving disputes based on the circumstances of the case. However, following the ‘Powers for Dealing with Unauthorised Development and Encampments’ consultation in 2018, it was clear”—
clearly it was not clear, because most people opposed the provision responding to that consultation—
“that action is needed to address the sense of unease and intimidation residents feel when an unauthorised encampment occurs.”
That is an insidious piece of text. First, it is good that the control of trespass is brought up by the common law over the centuries. Secondly, there is plenty of legislation on the matter, notably the Criminal Justice and Public Order Act 1994. That legislation was seen as draconian at the time, and this goes much further. Over the past two decades, law enforcement and nomadic communities have tried to make the current law work by guidance, negotiation and compromise. The police Bill strips away all of that experience and sets up confrontation, arbitrary use of power, and the threat of arrest, imprisonment, loss of home and perhaps of families. For what purpose? So that the Home Secretary can indulge in a bit of dog-whistle politics.
If people think I am exaggerating, I chaired a seminar earlier today, organised by the all-party parliamentary group on Gypsies, Travellers and Roma, to hear the real-life experiences of Gypsies and Travellers, and to hear from their advocates in the Friends, Families and Travellers movement who were loyally supporting those communities. They all do an excellent job. We heard stories of Traveller families who had booked official caravan sites, only to be turned away on arrival. The racism of Pontins in refusing access on the grounds of ethnicity is far from rare.
Without access to legal sites, where are families supposed to go? Under the current law, there was at least a chance of negotiating an organised departure, and the discretion lies with the police whose guidance says that only where there is “damage”, “abusive behaviour” or multiple vehicles should precipitous action be taken. Under the new law, we apparently need to address the sense of “unease” that local residents might feel, an “intention to reside” or the likelihood of causing “damage, disruption or distress”.
Has there ever been a law so disingenuously or vaguely worded? It is clear why, because in their frequently answered questions, the Government give the explanation that “strengthened police powers” and the new offences
“could also deter unauthorised encampments from being set up in the first instance.”
This is designed to frighten people into taking no action at all. It is designed to attack the principles of nomadic life, which the Government have already attacked by changing the definition of what Gypsies and Travellers means.
If the legislation is passed unamended, it will have a rough ride in the courts. It is already clear that it violates important principles of the Human Rights Act and the Equality Act 2010. No one with any sense supports this unnecessary and vindictive provision—certainly not the police. Only 21% of police organisations responded positively to the proposals and the consultation, while 94% called for more site provision.
I know that other Members are waiting to speak and that I have taken my allotted time. I simply say to the Minister that this is the time to consider what changes will be made to the detail of the Bill. Part 4 adds nothing useful to the current law. It will do huge damage to relations between settled communities and Gypsies and Travellers. It will put the police in an extremely difficult position. It will suck in whole groups of other people who, whether this is the intention or not, are also severely worried about the consequences. Let us have a sensible and mature rethink and let us drop these invidious proposals now.
David Simmonds (Ruislip, Northwood and Pinner) (Con) [V]
It is a pleasure to serve under your chairmanship, Mr Bone. As we consider the important matter of illegal encampments and unauthorised access to land, may I commend my hon. Friend the Member for South Ribble (Katherine Fletcher) for her eloquent and balanced introduction to the debate? It is important that I be clear from the outset that I and my constituents strongly support the introduction of tougher measures to protect land and property from trespass, whether it belongs to private individuals or the taxpayer in the form of central Government or local authorities.
I pay tribute to the work of Councillor John Warmisham, the Labour leader of the UK delegation at the Congress of Local and Regional Authorities in the Council of Europe, who has led work for many years at an international level to improve the way in which human rights law, as administered by local authorities and regional governments, treats Gypsy, Roma and Traveller people. His work has been very important in informing my thinking on the subject and my approach to the petition today.
There seems to be no evidence that the proposed strengthened measures would deter anyone from lawful access to private land. Ramblers, walkers and riders do not see their legitimate and time-honoured access restricted by what the Government propose. It is very clear, as my hon. Friend the Member for South Ribble said, that powers to prosecute are triggered only in circumstances where someone is present where they have no right to be, and when they refuse to leave when asked.
In my constituency, on the edge of London, we have many popular walking and rambling paths, mountain bike routes and bridleways. The users of these amenities, many of which are maintained by private landowners as part of the good husbandry of their holdings, should have no fear that they will be negatively impacted. It is also clear that the law in Scotland might offer a model to consider, and I know that the Government have been consulting on that. Trespass is a criminal offence, but legitimate use of the property is included. Other Members may disagree with that, but that is the legal interpretation that I saw in the briefing note. I look forward to being enlightened.
Many communities have suffered significant blight from unauthorised encampments for too long. I live opposite a green space owned and maintained by the London Borough of Hillingdon, and it was the subject of one such incursion. Like many people across the country, other residents and I were treated to the sight of people defecating publicly opposite our homes, with rubbish strewn around and extensive vandalism. Normal activities such as children’s football, outdoor exercise and dog walking all had to stop while the legal process was followed.
Once that notice was served, I watched alongside those other residents as campers gathered all the glass that they had accumulated during their stay, smashing it to fragments and scattering it across the whole area, to maximise the harm and inconvenience that their illegal incursion caused the community. When they finally departed, they left a massive clean-up job and, for that season, a bill in excess of £300,000 for council tax payers to meet. I speak from personal experience when I say that the measures are long overdue.
Some will argue that legitimate lifestyles are at risk of being criminalised. I wholly disagree. Not one moment of what I witnessed was legitimate. Both the settled and the temporary residents of local caravan sites, which are made available for public use, would agree, because they pay council tax to clear up that kind of mess, too. Breaking into other people’s property, causing misery and stress at a massive cost is simply unacceptable. It is not a lifestyle; it is straightforward criminality, and it must be robustly dealt with when it occurs.
Clearly, there is a balance to be struck. At the moment, the balance weighs too heavily against the landowner and the taxpayer, and in favour of the small minority of criminals who choose to exploit the fact. It is absolutely right that the Government take heed of the concerns of communities across London and the rest of the country, and enact the measures.
Margaret Greenwood (Wirral West) (Lab) [V]
It is a pleasure to serve under your chairmanship this afternoon, Mr Bone. I am pleased to have the opportunity to speak in this important debate.
I would like to begin by paying tribute to the more than 134,000 people, including 149 of my constituents, who signed the petition “Don’t criminalise trespass”. The petition set out that the Government’s manifesto stated that the Conservative party
“will make intentional trespass a criminal offence”.
It pointed out that it is
“an extreme, illiberal & unnecessary attack on ancient freedoms that would threaten walkers, campers, and the wider public.”
It expressed concern that that would, among other things,
“Criminalise ramblers who stray even slightly from the path …Criminalise wild camping, denying hikers a night under the stars”.
The petition shows great strength of feeling on this issue, which is part of our great tradition in this country of securing access to the countryside through protest. We have an incredibly important tradition of accessing the great outdoors, and are richly blessed with the diversity of landscapes that we can enjoy. That tradition is in activities such as walking, cycling, kayaking and mountaineering; it is in the activities of brownies, girl guides, cubs and scouts, and it is in our culture through the poetry of Wordsworth and the paintings of Turner, to name just two of the many artists and writers who have found inspiration in the power and grandeur of the natural world.
We have wonderful national parks, such as Snowdonia, the Lake District and the Peak District. The last one became the first national park in the UK almost exactly 70 years ago, on 17 April 1951. Our national parks give us access to breath-taking coastal scenery, such as that in Pembrokeshire, the south downs and the North York Moors. In my constituency, there is Caldy Hill, Thurstaston Common, Irby Hill and Harrock Wood, all owned and cared for by the National Trust, which does such an important job preserving such areas for the benefit of local people and visitors.
When we reflect on all that we have to enjoy, it is important to consider the invaluable work of individual conservationists, campaigners and protest groups that have delivered such riches to us, and have ensured that we can access those beautiful places. I am thinking of people such as Beatrix Potter, who bought large tracts of land in Cumbria specifically to preserve the landscape, and who left 4,000 acres of countryside to the National Trust, as well as 14 farms, when she died in 1943. Millions of people enjoy that countryside, in what we know as the Lake District national park.
Hundreds of ramblers from Manchester and elsewhere took part in the mass trespass on Kinder Scout in 1932. Knowing our history is important: the mass trespass is widely credited with leading the Labour Attlee Government to pass legislation in 1949 to establish the national parks, playing a part of the development the Pennine Way and many other long-distance footpaths, and securing walkers’ rights over open country and common land in the Countryside and Rights of Way Act 2000. In 2007, Lord Hattersley described it as
“the most successful direct action in British history.”
In January this year, a number of organisations—including the Campaign to Protect Rural England, Friends of the Earth and the Ramblers Association—wrote to the Home Secretary, arguing that making trespass a criminal offence is
“an extreme, illiberal and unnecessary attack on ancient freedoms.”
They warned that
“It would send a signal that the countryside is not an open resource accessible to all, but a place of complex rules and regulations, where stepping off a public path could lead to a criminal sentence.”
Recently, the Government published their Police, Crime, Sentencing and Courts Bill, and Labour opposed it on Second Reading. The proposals in part 4 of the Bill, on unauthorised encampments, create a new offence of
“residing on land without consent in or with a vehicle”.
However, more than 250 civil society groups are still concerned that the Bill threatens our right of access to the countryside, as they made clear in their letter to the Home Secretary and the Secretary of State for Justice last month. Liberty has pointed out that the provisions of the Bill will
“impact access to the countryside and affect the enjoyment of British land for recreational activities.”
Can the Minister tell us how the Bill is consistent with the Government’s commitment to
“opening up the natural world”,
as they stated in their 25-year environmental plan? The countryside should always be accessible to everyone and it is incredibly important that we follow in the tradition of those who have gone before us to secure rights of access.
The petition that is the subject of today’s debate also raises important concerns that legislation making intentional trespass a criminal offence could impact on Gypsy, Roma and Traveller communities, and I have to say that I was very shocked by the comments of the previous speaker. The Bill includes a new criminal offence of trespass with the intent to reside; until now, trespass has been a civil offence. The National Police Chiefs Council and the Association of Police and Crime Commissioners have stated quite clearly that
“trespass is a civil offence and our view is that it should remain so”
and that
“no new criminal trespass offence is required”.
Why have the Government ignored that viewpoint?
The charity Friends, Families and Travellers has warned that making trespass a criminal offence would push Gypsies and Travellers into the criminal justice system merely for existing nomadically. It has pointed to an absence of places where Gypsies and Travellers are permitted to stop or reside. One of my constituents wrote to me to say that she is
“from one of the many Gypsy, Traveller and nomadic communities who will be directly and harmfully affected by the criminalisation of trespass put forward in the Bill.”
She said that
“We need more sites and stopping places where Gypsies and Travellers are allowed to be. Nobody should be made a criminal or punished for living a nomadic way of life.”
What is the Minister’s response to my constituent? What would he say to her about how this Government are treating Gypsy, Traveller and other nomadic communities?
The petition also raises concerns about the Government’s proposals to
“clamp down on peaceful protest, a fundamental right and essential part of our democracy”.
Numerous organisations have drawn attention to how the Bill threatens the right to peaceful protest. Three years ago this month, many of us gathered to see the unveiling of the first statue of a woman in Parliament Square, which was of the suffragist Millicent Fawcett. She holds a banner that reads, “Courage calls to courage everywhere”. That unveiling was an historic moment for us democratically.
Protests and demonstrations have forged positive change in our country over generations, whether they were the actions of the suffragettes tackling the grotesque injustice of women not even having the right to vote, or, more recently, the actions of anti-fracking protesters who set up camp at places such as Preston New Road in Lancashire. The actions of those campaigners helped to achieve a moratorium on fracking, and now the Government say that fracking is over in the UK.
The numerous demonstrations for employment rights that have been spearheaded by the trade union movement have been crucial in furthering the rights of working people, and the protests of people up and down the country against the Conservative Government’s plans to privatise the national health service continue, showing the passion with which people believe in a national health service that is paid for through direct taxation and free to all at the point of need.
Without people being able to gather and show their opposition to issues of social injustice and attacks on the environment, the Government would feel as though they could do whatever they pleased. No Government should ever be given that opportunity. It is as important now as it has ever been to make it clear that we demand the right to protest. Any attempt to curtail that right strikes at the heart of our democracy.
Catherine West (Hornsey and Wood Green) (Lab)
It is a pleasure to serve under your chairmanship, Mr Bone, and to contribute to this important debate. It is also a pleasure to highlight the 600 signatures from Hornsey and Wood Green on the petition—clearly my constituents are concerned about their ability to go about in and enjoy the great outdoors.
We are blessed with parks and walks in Hornsey and Wood Green, but none as lovely as being outside London and enjoying a quiet walk. During the pandemic the desire to be outdoors has been heightened because of the impact of the loneliness of coronavirus on mental health. It has been lovely for our friends and families to walk in and explore the countryside. I hope that the Government will have a rethink on the matter, and I note a number of campaigns and newspaper articles calling for that. The Ramblers Association, which is a well established group, is one of those calling for a rethink so that we can fully enjoy the outdoors—particularly in the summer months as we go towards another year, possibly, of holidays at home—without the fear of being told we are trespassing.
The proposals risk putting a stop to some of the walks that we enjoy so much, with landowners closing off swathes of remote countryside. Furthermore, some local authorities do not look after paths and maintain tracks; the measures will be a disincentive to them when it comes to doing that and showing signage. The enjoyment of a walk can be slightly spoiled by getting lost, which can lead to trespass, and that can happen if local authorities do not look after paths well. I hope that the Minister, who, of course, has a background in local government, will take note and perhaps send round a little note to local government leaders asking for paths to be looked after, so that there is not a risk of trespass and so that people can walk with proper signage, and enjoy their ramble.
I emphasise that there are some naturalists who desire to carry out wildlife surveys. Some scientists have warned that the measure we are debating could prevent some of the basic science through which we get our love of science and nature. It cannot be stressed enough how vital it is for people to have access to nature and the open countryside.
Sales of camping equipment have soared, which is great for the economy. British Canoeing has had a 40% jump in membership and our national parks have had huge numbers of visitors. I am not sure whether the Government have yet got round to implementing Labour’s suggestion, from the last manifesto, of bringing in some more national parks; but certainly the experience of camping and visiting a national park should not be underestimated.
I want to highlight concerns about some of the debate on Second Reading. It was disheartening when Member after Member stood up to criticise, in demeaning terms, the Gypsy and Traveller community going about their travelling, and some of the challenges that that community faces. Statistics show us that the Gypsy and Traveller community is probably the one most discriminated against in Europe. It was dispiriting to hear, in this wonderful Parliament, Member after Member having a go at that community on Second Reading. That is not what the House of Commons should be about.
The police have made it clear that they believe that the powers they have are sufficient—75% of police responses to the proposals show that they believe that. Additionally, 84% did not support the criminalisation of unauthorised encampments, and 65% said that lack of site provision was the real problem. In my view, some of the problem with policing is the closure of 50% of police stations since 2010 and the drop in the number of police. Hundreds of police have been taken off the street since 2010 and that is the real problem with much of policing. In particular, some schools say that they miss the friendly bobby on the beat who drops in. A lot of that policing in schools has disappeared from the budget, and that is a real pity. That is the sort of issue that we want to get down to—not high-level mudslinging at minority communities.
I urge the Government to pull back from what is a dangerous, illiberal and unnecessary step. If they really want to protect landowners, Ministers should heed the calls from the police and campaigners to provide access to well-maintained walking paths and sites for Travellers, rather than continuing down this thinly veiled attack on rights and livelihoods, which will deny so many the chance to explore our beautiful countryside.
Barbara Keeley (Worsley and Eccles South) (Lab) [V]
I am glad to speak in this debate with you in the Chair, Mr Bone. This debate is important and timely as we await the Committee stage of the Police, Crime, Sentencing and Courts Bill. The proposals around the criminalisation of trespass are deeply concerning, and I want to focus today on an area of them. There is real concern that these proposals will have the effect of deterring people from accessing the countryside for recreation.
We have seen during the pandemic that access to green space and the countryside is central to promoting people’s physical and mental wellbeing, but access to green space has too often been the preserve of a small number of more privileged groups. Over the past year, we have begun to see a broadening of access as more people seek out green spaces and visit the countryside. It is vital that this is promoted, rather than suppressed. I am concerned that the provisions in the Bill could deter people who seek to access green spaces for entirely legitimate reasons.
Key to the issue is the provision that allows people to be stopped by the police if they are suspected of intending to reside on land without consent. This power is so broadly defined that it could cover people on wild cycling trips who intend to camp on open land such as moors or hillsides. It would give the small number of landowners determined to discourage public access to the countryside a powerful tool to make it a hostile place.
The potential for abuse of this legislation is obvious. The impact of this measure on trespass would be to create an image of the countryside as a place governed by complex rules and regulations, with criminal sanctions for breaching them. This will particularly deter people who already have more negative experiences of the criminal justice system, especially people from diverse communities who already face more structural barriers to accessing the countryside. The end effect of these proposals is likely to be fewer people accessing the countryside.
The Government have claimed that they want to do more to promote access to nature for everyone, but their actions say otherwise. From a delayed Environment Bill that makes no firm commitments on access to nature, to this retrograde proposal that could actively deter people from getting out into the countryside, we are seeing a Government that are putting up barriers, rather than breaking them down. If the Government choose to criminalise trespass, they would also be completely out of touch with the public mood. More people are visiting the countryside and green spaces due to covid-19. Visits to parks and green spaces have doubled in the past 10 years, and more people are taking part in outdoor activities.
Despite this, the number of people who spend little or no time in natural spaces is still too high. Evidence shows that access to good-quality green space such as parks, woodlands, fields and allotments varies greatly depending on where people live. The most economically deprived areas often have less available public green space, meaning that people in those communities have fewer opportunities to reap the benefits to their health and wellbeing. I join the Ramblers and other groups in urging the Government to reconsider and to drop these damaging proposals, so that people are free to enjoy the countryside without the threat of criminalisation hanging over them.
Mary Kelly Foy (City of Durham) (Lab) [V]
It is a pleasure to serve under your chairmanship this afternoon, Mr Bone. It is with great sadness that I speak to the House on this subject again—it seems that when it comes to Gypsy, Roma and Traveller communities, the Government never learn. The Police, Crime, Sentencing and Courts Bill contains many authoritarian measures, but none so pernicious as those aimed at GRT communities.
I was saddened to come across the most awful racism on Twitter this week in relation to the Channel 5 programme “Here Come the Gypsies!” It was sickening to read the way in which people were displaying their prejudices, many without any challenge, but of course there is a political context to this hatred. As we know, the Police, Crime, Sentencing and Courts Bill includes measures to
“Strengthen police powers to tackle unauthorised encampments, where trespassers cause distress and misery to local communities and businesses.”
Of course, as Members have mentioned, the criminalisation of trespass is a direct attack on the nomadic lifestyle of many Gypsies and Travellers. Police forces across the country have specifically asked not to be given these powers on trespass, as they realise that such powers attack the lifestyles of groups who are often voiceless and who do not have a choice over where to stop.
When the measures to criminalise trespass were consulted on by the Government, over 90% of police bodies said that the provision of additional legal sites for encampments, rather than additional criminal powers, should be the approach taken by the Government, so why are seeing this unthinking and vicious anti-Traveller legislation once again? It starts from a lack of education: politicians and legislators do not understand and, worse still, do not try to understand the problems faced by Gypsy, Roma and Traveller communities trying to balance their nomadic traditions with the need for services and the constant hostility wherever they settle. At the heart of this is a form of racism.
I know it has been said before, but there is a reason why anti-Gypsy, Roma and Traveller prejudice is called the last acceptable face of racism. It is because politicians do not stop and think before they paint whole communities as the problem, as perfectly demonstrated by the hon. Member for Ruislip, Northwood and Pinner (David Simmonds) a few moments ago. Communities all over the country have issues with rubbish, antisocial behaviour and small-time criminality. Nobody should excuse such behaviour or pretend that it does not exist, but we have a racism problem whereby one section of our society is blamed and targeted relentlessly, and others are excused or ignored. The double standard of that targeting should be scrutinised, not fuelled, by this House.
We should be honest about what this is: a political attack on Gypsy, Roma and Traveller communities. It is kicking a community that has very few self-defence mechanisms at its disposal. The key thing is that there are other solutions. Abbie Kirkby of Friends, Families and Travellers has said:
“The Government should not imprison people, fine them and remove their homes for the ‘crime’ of having nowhere to go. Another way is possible. Through negotiated stopping and by identifying land where Traveller sites can be built, councils can ensure nomadic families have a safe place to stop, save money on evictions and improve relations between travelling and settled communities.”
Giving all people dignity and respect is a fundamental duty for anyone who calls themselves an anti-racist or who understands the concept of human rights. It is easy to scapegoat a community—sometimes it is done unconsciously, but it is just as damaging—and all because we do not take the time to listen, understand and find solutions. Tony Benn once said:
“The way a Government treats refugees is very instructive because it shows you how they would treat the rest of us if they thought they could get away with it.”
The same could be said for the way in which our Government treat the Traveller community. That is our challenge: if we want to live in a decent, respectful and fair society, we should think about what that means in practice and look for the answers that are already out there in the provision of adequate sites, services and facilities.
Olivia Blake (Sheffield, Hallam) (Lab) [V]
It is a pleasure to serve under your chairmanship, Mr Bone. I speak not only as someone who supports the right to roam freely, but as a Sheffield MP standing in a long and proud tradition of Sheffielders who fought for the right to roam. Many constituents have contacted me about this issue, with 713 signing the petition and many others emailing me about today’s debate.
Our debate on the petition is well timed, although delayed. It takes place between two dates that are important to my city and my constituency, and which have significance for the whole country. The first date fell on Saturday 17 April, which marked the 70th anniversary of the Peak District national park, which was the first such park in the UK. The foundations of the park were built by my constituent Ethel Haythornthwaite, who was born in 1894. After falling in love with the beauty of the countryside surrounding our city, she founded the Sheffield Association for the Protection of Local Countryside, which would later become the Peak district and South Yorkshire branch of the Campaign to Protect Rural England. Throughout her life, she directed a host of campaigns to defend the use by everyone of the green spaces in and around Sheffield.
The second important date is this Saturday, 24 April, which will be the 89th anniversary of the Kinder Scout mass trespass mentioned by my hon. Friend the Member for Wirral West (Margaret Greenwood), one of many regular trespasses into moorland estates organised by workers from northern industrial towns and cities, such as the Sheffield Clarion Ramblers. Before the founding of the national parks, these workers were forced to trespass because moorland estates were privately owned by the landed gentry. Their demand was simple: that everyone should be able to access the moors. In 1945, their efforts were recognised when a Government were elected who shared the views not only of Ethel but of the Kinder trespassers as well. Ethel was actually appointed to the National Parks Committee and helped the new Government to deliver the National Parks and Access to the Countryside Act 1949.
Ministers now propose to turn back the clock and make trespass a criminal offence. They attack not only the right to roam but the right of the Gypsy, Roma and Traveller community to live as they wish. If the Government were serious about addressing unauthorised encampments, they would increase funding for more legal sites and more places to legally stop, not pass new laws that attack an already persecuted community and force more people into our criminal justice system. We should look to extend our right to green spaces, not deter people from accessing our precious countryside, nor should we criminalise those whose culture is based around the right to roam.
As a Sheffield MP, I am proud to stand on the shoulders of Ethel Haythornthwaite, the Sheffield Clarion Ramblers and the Kinder Scout trespassers in demanding that everyone should enjoy, as Ethel put it, the “peace, freedom, solitude, excitement” that comes with the escape into the clean air and the gradual return to nature.
Martin Docherty-Hughes (West Dunbartonshire) (SNP) [V]
It is good to see you in the Chair, Mr Bone. I hope that you and the Clerks are well in these difficult times. I thank those who brought forward the petition, and I am grateful to those Members who opened the debate, which I will now respond to on behalf of the Scottish National party. There will of course be those who ask why I am participating in the debate, given that the trespass in England and Wales comes under the remit of the UK Parliament. However, the debate also relates to the police Bill, which will have ramifications for Scots law.
May I first of all, if you will forgive me, Mr Bone, clarify some points on the law in Scotland? At this moment in time, trespass in both England and Scotland is a civil wrong but not a criminal act. I can say on behalf of my party that, if we are re-elected to government in May, we will certainly not bring forward any legislation at Holyrood to follow the police Bill, which seeks to criminalise trespass, at least from our perspective. I also highlight that it seemed as if some points made during the debate suggested that all members of the Gypsy and Traveller community, owing merely to their being members of those ancient and historic communities, commit criminal acts. My own window was smashed at the weekend, and I can tell hon. Members that it was certainly not by members of the Gypsy and Traveller community; it was clearly by somebody who probably had too much wine in the sun at the weekend during a global pandemic. I do not assume for one minute that it was a member of the Gypsy, Roma and Traveller community. These extraordinary statements are entrenched in a lot of the narratives and debates and discussions we have had over the last couple of months leading up to the police Bill and debates on it in Parliament. It has been quite horrific to hear some of the dreadful instances of racism and bigotry that our Gypsy, Traveller and Roma communities face.
That is not to say that things are in any way perfect in Scotland, in terms of reflection, but there has been an opportunity to learn and to move forward. That is for all parties, I have to say, and not only in the Scottish Parliament; before the break-up of the last Session of the Holyrood Parliament, my colleagues in local government, through the Convention of Scottish Local Authorities, co-signed Scotland’s national plan for the Gypsy and Traveller community. That was signed by my colleagues, the Minister the Minister for Older People and Equalities, Christina McKelvie, and Councillor Kelly Parry of COSLA. The aim has been to secure political support across all parties so that they work together to improve the lives of Scotland’s Gypsies and Travellers; and to formally recognise the right to travel.
There has been a commitment to finding ways to map and, where possible, reopen traditional and, as I often say, ancient stopping places across the nation of Scotland, used since at least the 12th century. The Scottish Government and COSLA, representing all parties, announced a shared commitment with Police Scotland to work together to challenge discrimination and promote equality for Gypsies and Travellers—people who have been economically, socially and politically excluded from our country. That has been brought forward with a package of investment—up to £20 million, announced through the action plan—and critically for the issue of housing, they are linking it to Scotland’s national housing strategy, to ensure that Gypsy and Traveller communities, whether living on official or new sites or in their nomadic lifestyles, have access to that investment.
We have even recently seen here in Scotland some rather unfortunate terminology from the UK Government’s party and the way in which some of its members have utilised the debate to marginalise, yet again, the Gypsy and Traveller community in Scotland. I am glad that no one else here is participating in the use of that type of language.
Will the Minister consider that this may be an opportune time to reflect on what is happening in Scotland? I am referring to the right-to-roam legislation and the working with the Gypsy and Traveller community. As Members from across England have already mentioned, there is a requirement not only to invest in existing sites, but to open up England’s ancient and historic Traveller sites, which are as much a part of England’s heritage as any other element of it. It is very important, I think, that that should be done. Will the Minister recognise the recommendation not to criminalise trespass? Because of the existing legislation, police forces across not only England but Wales and Scotland say that there is no need for new legislation.
There is also a requirement to understand infrastructure. I happen to be the Member of Parliament for West Dunbartonshire, in which are found the national park headquarters for Loch Lomond and the Trossachs. I am afraid we have to say that the vast majority of trespass, vandalism and the lighting of fires has never traditionally been by the Traveller or Gypsy community; it has been by those of us who went out and utilised that lovely part of the world. Through the right to roam and working with people, working with communities, the national park as a body has reduced those elements: fires, litter and antisocial behaviour. It has done so by ensuring that we work together. I hope that the Government and the Minister will reflect on the lived experiences and also the policy experiences across these islands, and I look forward to hearing their answers.
Sarah Jones (Croydon Central) (Lab) [V]
It is a pleasure to serve under your chairmanship, Mr Bone. I want to begin by thanking everyone who signed the petition and all the individuals and organisations that have spent a lot of time, in the various consultations and processes around this issue, giving their views. It is clear that there is a very strong community of organisations, from all kinds of backgrounds and interests, that are coming together to give their view and to oppose what the Government are seeking to do. I thank those individuals and organisations.
I thank the hon. Member for South Ribble (Katherine Fletcher), who I thought gave a very balanced view, as my hon. Friend the Member for Hammersmith (Andy Slaughter) said; and I thank my hon. Friend, who is so principled and so practical in everything that he says—I hope that the Minister was paying close attention. Indeed, I thank all colleagues who spoke in the debate. We have heard about both the importance of keeping our countryside open as much as possible for as many people as possible and about the other side of this issue, which is the prejudice and harm that the legislation will do to the Gypsy, Traveller and Roma communities. That was very well articulated by several hon. Members, including my hon. Friend the Member for City of Durham (Mary Kelly Foy), who made a really powerful case. I thank everyone for their contributions.
As we have heard, over 140,000 people signed the petition against the Government’s proposals. That is not surprising, given the moral and practical problems that the Government are introducing with the proposals. The Petitions Committee’s online survey was really interesting and asked petitioners for their views. As has been said, over 84% of respondents told the Petitions Committee that
“the criminalisation of trespass would have a ‘major’ or ‘moderate’ effect on how they live their lives as they do today…Many respondents were concerned that criminalising trespass could increase pre-existing tensions, mistrust, and lack of understanding between their local community and Travellers. There was consensus that more needs to be done to provide authorised sites for Travellers.”
As I mentioned, a broad coalition—from the NSPCC to Liberty, from the Gypsy, Roma and Traveller communities to the Ramblers Association, and from the police to Shelter—is united in the view that the proposals put forward by the Government would be wrong and unhelpful and would go against our basic rights. The Police, Crime, Sentencing and Courts Bill is designed to criminalise the act of trespassing when making an unauthorised encampment. What is proposed in the Bill on the trespassing of unauthorised encampments is deeply concerning and unnecessary. As one of the responders to the Petitions Committee’s survey put it:
“The criminalisation of trespass will simply exacerbate an already fraught relationship. Gypsies and Travellers will still camp but there’ll be more prosecutions, more distrust, more public money spent on legalities”.
Other people who have a nomadic lifestyle have told me that they feel that they will no longer be able to live on the road in the way that we have seen in this country since the 16th century, and that the Bill risks criminalising their way of life. Failure to comply with a police direction to leave land occupied as part of an unauthorised encampment is already a criminal offence, but the proposals create a new offence of residing on land without consent in, or with, a vehicle. The broad way in which the definition is drafted seems to capture the intention to do this as well as actually doing it—the intention can be criminalised as well—with penalties of imprisonment of up to three months or a fine of up to £2,500, or both. The loose drafting of the wording in the legislation invites problems with its interpretation, and it is simply not fair to put that on the police. If someone were to drive in a car, park it and walk somewhere in order to wild camp beneath the stars, what does “with a vehicle” cover in the legislation? How far away from the vehicle would the campers have to be in order to escape carrying out a potential criminal offence?
The major concern that the Opposition have with this part of the Bill, and that is articulated in the petition, is that it is clearly targeted at Gypsy, Roma and Traveller communities, and such criminalisation could breach the Human Rights Act 1998 and the Equality Act 2010. When the powers in the Criminal Justice and Public Order Act 1994 were first debated in Parliament, it was stated that the powers were intended to deal with “mass trespass”. In the new Bill, however, even a single Gypsy or Traveller travelling in a single vehicle will be caught by the offence. What constitutes
“significant damage, disruption or distress”
is subjective, particularly as there needs to be only one vehicle, and what constitutes the intention to cause
“significant damage, disruption or distress”
is even more subjective. That is in part why the measures to increase police powers on unauthorised encampments are not backed by the police, as we have heard. When Friends, Families and Travellers researched the consultation responses that the Government received, it found that 84% of the police responses did not support the criminalisation of unauthorised encampments.
In her opening speech, the hon. Member for South Ribble quoted the Minister as saying he wants to ensure that the police have the powers they need. Actually, they believe that they already have the powers they need. Senior police are telling us that the changes in the Bill relating to unauthorised encampments would only make matters worse. They would add considerable extra cost to the already overstretched police and risk potentially breaching the Human Rights Act.
The views of the National Police Chiefs Council and the Association of Police and Crime Commissioners were clearly put in their joint submission to the 2018 Government consultation.
They state:
“Trespass is a civil offence and our view is that it should remain so. The possibility of creating a new criminal offence of ‘intentional trespass’…has been raised at various times over the years but the NPCC position has been—and remains—that no new criminal trespass offence is required. The co-ordinated use of the powers already available under the Criminal Justice and Public Order Act 1994 allows for a proportionate response to encampments based on the behaviour of the trespassers.”
Why are the Government determined to lock up Gypsies and Travellers against even the advice of our own police?
The police already have extensive powers in the Criminal Justice and Public Order Act 1994 to move on unauthorised encampments. As of January 2020, just 3% of Gypsy and Traveller caravans in England were on unauthorised encampments. Some 419 of those caravans were on sites not tolerated and 275 were on tolerated sites. Police and campaigners tell us that the evidence is not there for these new powers to be necessary at all and that many more authorised encampment sites should be provided instead. In their joint response to the Government’s consultation on unauthorised encampments, the Association of Police and Crime Commissioners and the National Police Chiefs’ Council called for the shortage of transit sites and the lack of accommodation provision to be addressed.
In a ministerial statement on 8 March 2021, the Home Secretary stated:
“As of January 2020, the number of lawful traveller sites increased by 41% from January 2010.”—[Official Report, 8 March 2021; Vol. 690, c. 22W.]
Friends, Families and Travellers has pointed out that
“this is a gross misrepresentation of the facts.”
It says that the 41% referred to by the Home Secretary is in fact
“an increase in transit provision and the Ministerial Statement fails to include this key component of referencing ‘transit’.”
That amounts to about 101 additional transit pitches, which is 10 a year over 10 years, whereas the number of permanent pitches has gone down by over 500 since 2010. Friends, Families and Travellers goes on to say:
“This misrepresentation of the figures leads people to believe there has been a much greater increase in site provision than there has. In fact, the Government published figures show there has been an overall 8.4% decrease of pitches on local authority Traveller sites.”
The Government should be focusing on ensuring that local authorities have the resources they need to provide more space for Traveller communities to legally reside. By taking an enforcement approach to addressing the number of unauthorised encampments, they are overlooking the lack of site provision. Friends, Families and Travellers notes:
“There are other solutions to managing unauthorised encampments, such as negotiated stopping, whereby arrangements are made on agreed permitted times on stopping and to ensure the provision of basic amenities such as water, sanitation and refuse collection.”
The Conservative party manifesto commitment and the Government response to the consultation refer to littering as a problem. Why do the Government not consider providing more authorised camping sites with proper refuse facilities? If a family are asked to move on, where are they supposed to go if there is no authorised encampment in their area? Why do the Government think that confiscating someone’s home, putting them in prison and fining them is the answer?
The legislation that the Government seek to introduce would cause harm to Gypsy and Traveller communities for generations and threaten their very way of life. It is impractical, misleading and adds nothing useful to the law that already exists to tackle problems such as rubbish and antisocial behaviour, which we all abhor and which the Government claim they seek to address. I urge the Government to rethink these harmful proposals.
This debate has been a good opportunity to raise concerns about the forthcoming Bill, which we will discuss in more detail in Committee. I end by asking the Minister to answer the following questions in his response. Can he provide an update on the progress of the national strategy to tackle Gypsy, Roma and Traveller inequalities, which was announced by the Government in June 2019? We have heard nothing since then. Under the provisions in the Police, Crime, Sentencing and Courts Bill, what would happen to a Traveller family in a single vehicle who are residing on a highway and have nowhere else to go?
Can the Minister clarify the Home Secretary’s claim that there has been a 41% increase in site provision? Can he confirm that that applies only to transit provision and that permanent site provision has significantly decreased? Can he confirm that the provisions in the Police, Crime, Sentencing and Courts Bill on unauthorised encampments are not in breach of the Human Rights Act 1998 and the Equality Act 2010?
Will the Minister look at different approaches, such as that of the Welsh Labour Government, who have placed a legal duty on local authorities to ensure that the accommodation needs of Gypsies and Travellers are properly assessed and that the needs for pitches are met? As an example of the current lack of provision for Gypsies and Travellers, only eight of 68 councils in south-east England have identified enough land in their areas for Travellers to live on. Will the Minister tell us where those Gypsy and Traveller families, who will otherwise be criminalised, are supposed to go?
Finally, does the Minister agree with the multiple concerns raised by the police, and what is he doing about them? What is he doing to ensure that the Bill, if passed, does not damage our rights as British people and cause more harm than good?
The Minister for Crime and Policing (Kit Malthouse)
It is a great pleasure to appear under your beneficent hand on this beautiful spring day, Mr Bone. As I am sure colleagues are aware, the debate was convened on the strength of an online petition submitted on 5 September last year. Since then, the Government have published our response to the public consultation “Strengthening Police Powers to Tackle Unauthorised Encampments”, and we have introduced the Police, Crime, Sentencing and Courts Bill, which sets out our measures to introduce the new criminal offence. I am grateful to my hon. Friend the Member for South Ribble (Katherine Fletcher) for her introduction to the debate, and to all hon. Members who have participated.
I understand that those who signed the petition were primarily concerned about the impact that the new offence might have on the ancient freedoms of walkers and the wider public to access the countryside. As somebody who represents 220 square miles of beautiful chalk downland in the northern part of Hampshire, I am pleased to be able to say that those who wish to enjoy the countryside, including in my constituency, will not be prevented from doing so by the offence. We made that clear in our response to the consultation, and the clauses currently before Parliament set out the circumstances in which the new powers can be used.
Our proposals, which were included in our manifesto, are aimed squarely at unauthorised encampments. For many of our constituents, and for landowners, those cause damage, destruction or distress, as well as causing significant cost to local authorities. Residents often feel helpless as their local amenities are damaged or disrupted, and for some councils, such as in Birmingham in 2016, with £700,000 of clean-up costs, the bills can be huge. I have seen that repeatedly in my own constituency.
It is only right, then, that the Government seek to protect citizens and strike a balance for those who are adversely affected by unauthorised encampments. The measures that we are introducing in the Bill will give the police the powers to bring an end to the misery caused by some unauthorised encampments. The new criminal offence will apply where a person who resides on land with a vehicle causes significant damage, disruption or distress and does not leave when asked to do so. That means that the powers will not apply to people camping in tents in the countryside or to others who inadvertently stray on to private land.
The Government have also amended the Criminal Justice and Public Order Act 1994, which gives police the power to direct people away from land in the first instance when they are causing lower levels of harm, disruption or distress. We will broaden the types of harm that can be caught under that provision to include physical damage to the land and non-physical damage, such as damage to the environment, which includes excessive noise and litter. Disruption includes an interference with a person’s ability to access any facilities located on the land or otherwise make lawful use of the land, or with a supply of water, energy or fuel. Offensive conduct, such as threats or abuse, is also covered. We will also increase from three months to 12 months the period for which trespassers directed away from the land must not return. We will enable police to direct people away from land that forms part of a highway.
I reassure hon. Members again that those who wish to access the countryside to walk, hike, climb or cycle—as many of us love to do—will not be caught by the measures. We all have the right to enjoy the beautiful national parks and green spaces that this country has to offer, and we will be able to continue to exercise that right, even when the Bill is passed. I am sure that that will come as welcome relief to those clubs, associations and individuals who have taken the time to write to their MPs or the Home Office about the issue.
Andy Slaughter
Will the Minister explain why he thinks that the organisations that he indicates, such as the Ramblers Association, whose comments I read out, are not at all persuaded by the Government’s view? Will he, the Minister for Policing, address the police’s concerns? They do not believe that the provisions are sensible. Will he also address what the shadow Minister, my hon. Friend the Member for Croydon Central (Sarah Jones), said about equalities and human rights law? He must be familiar with the leading cases of Chapman v. UK and Bromley v. Persons Unknown. Does he think he will face legal challenges if this goes through?
Kit Malthouse
I will come on to many of those issues later in my speech if the hon. Gentleman will be patient.
We received significant support in the consultation for some of these measures. Some 94% of local authorities that responded to the consultation supported one or more of the proposed amendments. The Criminal Justice and Public Order Act, to which the hon. Gentleman referred in his speech, will extend the powers of the police to direct trespassers away from land.
During the passage of the Bill, I hope we will be able to reassure the groups that have perhaps taken alarm at these measures that they will not be affected. Let us remember that there is the lock that significant harm and disruption must be under way and that people must be residing with a vehicle, so this does not cover ramblers, who, presumably, are without a vehicle—I am not sure whether a canoe counts as a vehicle or indeed whether one can reside in a canoe. Therefore, those who are wild camping or enjoying the countryside will be unaffected. Hopefully, that will come as a relief.
I now turn to the impact on Traveller communities set out in the petition statement. The legislation is not anti-Traveller and it would be wrong to portray it as such. We know that a small minority of people in unauthorised encampments cause harm, disruption and distress, but the vast majority of Travellers are law-abiding citizens, and unauthorised sites can often give an unfair and negative image of their communities. Enforcement will obviously not be based on ethnicity. Rather, anyone who causes significant harm, disruption or distress under the specified conditions and who refuses to leave when asked to do so will be caught by the offence. The Government want to ensure fair and equal treatment for all travelling communities. Settled and travelling communities should be able to live side by side harmoniously, and indeed integrate. We hope that the clear rules and boundaries that we are putting in place will facilitate that. The police are fully trained, and we expect that their actions will continue to be compliant with equality and human rights law.
The Government remain committed to developing a cross-Government strategy, as mentioned by my shadow, the hon. Member for Croydon Central (Sarah Jones), to tackle the inequalities faced by Gypsy, Roma and Traveller communities. We are also committed to supporting the provision of Traveller sites via the new homes bonus. This provides an incentive for local authorities to encourage housing growth in their areas and rewards net increases in effective housing stock, including the provision of authorised Traveller pitches.
In addition, the £11.5 billion affordable homes programme will deliver a wide range of affordable homes to meet the housing needs of people in different circumstances and different housing markets, and will include funding for new Traveller pitches. Data shows that we have seen an increase in the number of caravans on authorised sites from 14,498 in July 2010 to 20,043 in July 2019, showing that this locally led planning system works. We expect that local planning authorities should assess the need for Traveller sites in their areas and make provision accordingly. Local authorities are best placed to make decisions about the number and location of such sites locally, having due regard to national policy and local circumstances.
Finally, I note that the e-petition refers to the impact that the new offence will have on clamping down on peaceful protest. Of course, the right to protest is a fundamental human right and is central to our democracy. Although the new offences do not apply to protests, we are introducing other measures in the Bill that will enable the police to better manage highly disruptive protests, striking a better balance between the rights of protestors and the rights of others to go about their business unhindered.
Kit Malthouse
I will not. I hope this Chamber is reassured that the measures the Government are taking are right, balanced and measured. We are delivering on one of the manifesto commitments that we were elected on. I commend the Government’s response to the e-petition.
Katherine Fletcher
What an interesting debate. We have heard from passionate enjoyers of the countryside, including from the city of Sheffield—I particularly enjoyed the description of Manchester and Sheffield as one city with a massive park in the middle of it. That is how much the countryside is valued on both sides, and what has come across very clearly in the contributions of the hon. Members for Wirral West (Margaret Greenwood), for Hornsey and Wood Green (Catherine West), for Worsley and Eccles South (Barbara Keeley) and for Sheffield, Hallam (Olivia Blake) is the idea that access to the environment is a fundamentally British right, provided that we stick within the rules of the countryside. I was delighted to hear that.
We have also heard some powerful testimony about the harms that illegal encampments can cause from my hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds), to give him his full title. It was very obvious that the acts of that minority of individuals are a cause of personal pain to him, as well as—being a serving council officer—a significant financial disruption.
We heard from the hon. Member for Hammersmith (Andy Slaughter) about how important it is to make sure we have a complete lack of discrimination and the extra sites to provide for a unique part of our heritage, which as one Member mentioned—forgive me, I have forgotten which—has been part of our lives since the 16th century. The hon. Member for City of Durham (Mary Kelly Foy) made a hugely important plea to ensure that we always bear in mind that racism, in all forms, is abhorrent. I am quite happy with that, as I am—on a personal note—with the fact that so many Members from urban constituencies have attended this debate to talk about something that is fundamentally about access to the countryside, such as the wonderful areas within South Ribble and those within the Minister’s constituency.
I will draw my remarks to a conclusion there. I hope the petitioners feel that we have done them justice with today’s debate, and let them draw their own conclusions from what the Government and Opposition spokesmen have said. Thank you, Mr Bone; it has been a pleasure to serve under your chairmanship.
Question put and agreed to.
Resolved,
That this House has considered e-petition 300139, relating to trespass.
Black Maternal Healthcare and Mortality
(3 years, 7 months ago)
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Sir Gary Streeter (in the Chair)
Welcome, everyone, to this important debate. I remind hon. Members that some changes have been made to normal practice, to support the new hybrid arrangements. Timings of debates have been amended to allow technical arrangements to be made for the next debate. There will be a suspension between each debate. I remind Members participating physically and virtually that they must arrive for the start of debates. Members are expected to remain for the entire debate.
I remind Members participating virtually that they are visible at all times, both to one other and to us in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks’ email address. Members attending physically should clean their spaces before they use them and before they leave. I would also like to remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall.
Before I call Catherine McKinnell to move the motion, I must say that we have 12 Back-Bench speakers. We normally allow 10 minutes for each Front-Bench speaker. If Catherine speaks for about 10 minutes, that should allow for in the region of four minutes for each Back-Bench speaker. I will not impose a formal time limit, but I ask everyone to try to deliver your speech within four minutes. That would be most helpful.
Catherine McKinnell (Newcastle upon Tyne North) (Lab) [V]
I beg to move,
That this House has considered e-petition 301079, relating to Black maternal healthcare and mortality.
It is an honour to speak under your chairmanship, Sir Gary. I am also honoured to open this debate on behalf of the Petitions Committee and the more than 187,000 people who signed the petition organised by campaigners Tinuke Awe and Clo Abe.
The petition highlights the shameful fact that in 21st-century Britain, the colour of a woman’s skin affects how safe she and her child are during pregnancy and birth. That is one of the starkest examples of racial health inequalities in this country. As Tinuke and Clo have pointed out, the latest data show that black women are more than four times more likely than white women to die during pregnancy or in the six weeks after giving birth. Women from Asian backgrounds are twice as likely as white women to die during pregnancy. To put that into context, I should state from the outset that the UK is one of the safest countries in the world to give birth. Deaths during pregnancy are very rare. I am sure the Minister will reiterate that in her response.
Around one in 10,000 pregnant women dies every year from causes related to their pregnancy. Every single one of those deaths is a tragedy, but they are a very small proportion of all pregnancies. The situation has also improved slightly over the last 10 years. Those figures mask the underlying, long-standing and shocking inequalities in maternal mortality, yet we do not have a base of research and evidence to fully explain their root causes and to point the way forward. There is still no Government target to eliminate the gap. That needs to be addressed urgently.
What do we know about women who die during or shortly after pregnancy? Pregnancy alters the way the body works. Two thirds of all pregnant women who die fall victim to complications such as heart disease or the care they receive while pregnant. Most do not die during childbirth itself. Dr Christine Ekechi, co-chair of the race equality taskforce at the Royal College of Obstetricians and Gynaecologists, points out that black women are more likely to have pre-existing health conditions that lead to greater risks during pregnancy. However, she also highlights that the obvious question to ask is why black non-transmissible health issues such as cardiac disease and high blood pressure are more prevalent in the first place. If it is a result of existing social and economic inequalities, that must be addressed.
Across all ethnicities, most pregnant women who die have complex medical needs, but leading maternal health researchers such as Professor Marian Knight have expressed concerns that our health and social care system is just not set up to deal with that complexity. Clinics are often based at different hospitals, requiring separate appointments. Communication between them does not seem to happen in the way it should. Women are often expected to juggle other childcare and work commitments while attending myriad appointments at a range of different institutions. Not all women have the same support and security at home and at work, and the system does not account for that.
Accounts have shown that the symptoms that pregnant women present with are too often dismissed and attributed to pregnancy itself, when they could be indicators of serious underlying medical complications. Pregnant women from all backgrounds report not being listened to despite the fact that that is crucial to the physical and mental wellbeing of both mother and child. Professor Knight points to what she calls the “constellation of biases” that black and Asian women are subject to. Those range from lack of listening, learning and nuance around women’s backgrounds and the most appropriate care, to micro-aggressions, all the way to completely unacceptable race-related perceptions such as the entirely unsubstantiated notion that black women have higher pain thresholds. If pregnant women are not being listened to and their symptoms are not taken seriously, or if they feel that they will not be, that is a recipe for tragedy.
It is important that public awareness of that issue has finally begun to increase, which is in no small part thanks to the work of such campaigners as Tinuke and Clo and the initiatives that they have launched, such as Black Women’s Maternal Health Awareness Week, which was first held last September, and the petition that we are debating. More women are now coming forward with their experiences, and five times more have shared their stories. One woman recounted:
“As soon as the second midwife was on shift she just seemed to have one goal in mind and that was delivering my baby as soon as possible, she didn’t seem to care about easing any part of my pain or reassuring me for the many worries I had at the time—she rushed my labour along and as a result almost cost me my sons life.”
Another said:
“I already seemed like that hyper-emotional black woman worried about nothing and I let that silence me. I really wish in this moment I expressed my concern or spoke up, because I honestly couldn’t have fathomed that what happened next would come.”
The reaction on social media to Channel 4’s recent “Dispatches” documentary was also very telling. One Twitter user said:
“For many Black women ‘The Black Maternity Scandal’ on Ch 4 is sadly not shocking or eye opening at all. Not being listened to in times of pain has become far too normal and it has to change.”
Another wrote:
“For many of us Black and Brown women, this felt like the first time our stories and traumatic, hurtful experiences got a small hearing on national TV.”
Pregnancy can be a special and exciting time, but it can also be exhausting and terrifying. For any woman to have to spend it not being listened to or not receiving the most appropriate care because of the colour of her skin is nothing short of appalling, so it is unsurprising that there is now an increasingly vocal consensus on the urgent need for more research and evidence, and for firm commitments from the Government and the NHS to end the scandal. We need to address the under-researching of health issues that black women face, and get a clear picture of the data on maternal deaths among different ethnic groups. Many different ethnicities are grouped together under broad categories, which risks missing cultural nuances, misrepresenting experiences and leading us to the wrong conclusions.
Maternal deaths are just the tip of the iceberg. For every woman who dies, many more will have severe pregnancy complications, and there is evidence of disparities between ethnic groups in that respect, too. However, the number of those cases and the impact on their families and lives is not recorded. Lack of research on those so-called near misses is a gap in the knowledge base that must be urgently and proactively corrected.
Tinuke and Clo are asking MPs to act by signing up to the Five X More black maternal health pledge, which I know many colleagues who have spoken today have already supported. One of the asks is that the Government implement the recommendations of the Joint Committee on Human Rights, including the introduction of a firm target to end the disparity in maternal deaths. I would be grateful if the Minister would tell us whether the Government agree with the Joint Committee on Human Rights, the chief midwifery officer and the petitioners that such a target must be put in place. It would also be useful to know whether the Government intend to address the data gap in medical research in the upcoming women’s health strategy.
I want to end by quoting what Tinuke said in an interview with The Guardian last year:
“In 1991 when my mum gave birth to me she was at greater risk of dying. In 2020 when I gave birth to my daughter that risk had increased and I was five times more likely to die…I’ll be damned if my daughter, whenever she decides to give birth, is 25 times more likely to die.”
That truly is a source of shame for this country, which is why today must mark the day that future generations start to look back and wonder how on earth this situation was ever tolerated for so long.
Ms Harriet Harman (Camberwell and Peckham) (Lab)
I thank the members and Chair of the Petitions Committee for choosing this subject for debate. My constituency contributed the second highest number of signatures to this petition, which reflects the concerns of both black and white people in my constituency.
It is particularly tragic when a new mother dies. She will die early in life, leaving behind a newborn or other children. Everyone in maternity services wants maternity care to be a properly resourced and highly professional team. A black woman is four or five times more likely than a white woman to die during childbirth or shortly thereafter, and nobody wants that to be the case. It is a dreadful situation and it must be addressed. I have four proposals for the Minister. I know that she understands this issue very well, having worked in the health service. She cares about it, so I look forward to hearing her response.
First, the monitoring must be clear and publicly accessible. The publication of covid statistics has provided a real example of this. It has shown how, when information needs to be brought into focus and targeted at the public and everybody in the health service, the regular and consistent publication of statistics can enjoin us all in a public effort. Coherent statistics must, therefore, be published.
Secondly, as my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) has said, we must have a target to end this black maternal mortality gap, with milestones set for progress year by year. The Joint Committee on Human Rights, which I chair, heard evidence from the chief midwifery officer that there is a great deal of concern about this issue but no targets have been set. We know that the NHS works to targets and to milestones. Good intentions are not enough.
Thirdly, we have to reduce health inequalities—this is a general but important point—and income inequalities, which mean that if someone is black they are more likely to have a low income, and if they are on a low income they are more likely to have poorer health.
Finally, we must recognise that this is not just about the health status of the mother; it is also about the delivery of care. We have to face up to a difficult truth. Polling by the Joint Committee on Human Rights found that 60% of black people felt that they were not likely to get equal care in the NHS, and 78% of black women felt that the NHS would not give them equal treatment. For white people, those are shocking statistics, particularly as so many black women and men play such a crucial part in providing NHS services. Those figures are based on the experiences and expectations of black women in a society where black people are not treated equally.
This is a matter for the consideration not only of everyone in every part of our society, but of everyone in every part of the NHS and everyone involved in maternity care. Like the Chair of the Petitions Committee, I hope that this debate will mark the start of rapid and transparent progress towards ending this egregious inequality.
Kate Osamor (Edmonton) (Lab/Co-op) [V]
It is an honour to serve under your chairmanship, Sir Gary. First, I congratulate Tinuke and Clo, the co-founders of Five X More, on working tirelessly to change black women’s maternal health outcomes, and on putting forward this petition, which gained over 187,000 signatures.
The racial disparities in maternal mortality rates are completely unacceptable. A black woman is four times more likely than a white woman to die in the UK due to pregnancy or childbirth. Just think about that—that is four times as many women passing away well before their time, and four times as many families suffering the pain and grief of losing a loved one.
It is not just those women who have sadly died who have been victims of this disparity. Research by the Nuffield Department of Population Health has shown that women of black African and black Caribbean heritage are, respectively, 83% and 80% more likely than white European women to suffer a near miss of maternal death. That reflects, and is the consequence of, the wider disparities in care, which countless women have recounted from their experiences. As well as the socioeconomic inequality that disproportionately affects black people, a study by MBRRACE-UK showed that only 29% of women who died during pregnancy and childbirth were deemed to have received good care, with improvements in care being judged to have potentially made a difference to the outcome in 51% of those cases—evidence that there are clearly improvements to be made.
The attention shone on this issue in recent months, and highlighted by the sheer number of people who have signed the petition, must be used as a spur for the Government and the NHS to develop a clear action plan. Furthermore, it highlights the damaging nature of the Government’s recent race report, which sought to sideline almost any suggestion that racism could be a factor in the different outcomes experienced by people in Britain today. Racism is not just a perception or historical experience, as Tony Sewell wrote in his foreword to the recent report.
This is not about a chip on our shoulder; it is about addressing the real inequality of black maternal mortality rates, which result in women unnecessarily passing away. It is a disparity that requires the Government to take seriously racial and ethnic disparities. Therefore, what we are asking today, and what the campaigners have been asking the Government to do, is to listen and to really take the data seriously. I hope the Minister will introduce an NHS target to end this disgusting disparity.
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.
Sarah Owen (Luton North) (Lab) [V]
It is a pleasure to serve under your chairship, Sir Gary. I thank the right hon. Member for South West Surrey (Jeremy Hunt), the Chair of the Health and Social Care Committee, for asking me to respond on behalf of the Committee. Too often our Parliament is viewed as old, with blind spots on issues such as the health inequalities that affect black people, and black women in particular, so I am grateful to each of the nearly 200,000 people who signed the petition.
We have already heard that black women in the UK are four times more likely to die during pregnancy or childbirth than other women, and up to twice as likely to experience a stillbirth than white women. This is not coincidence or fluke. We see in the available data and in people’s experiences how health services, designed disproportionately by non-black people, fail to meet the needs of black people. It is an institutional problem.
The Select Committee is currently looking into the safety of maternity services in England. The brilliant Tinuke and Clo from Five X More came to speak to us and share their experiences, and I thank them for leading this petition and for their campaigning work. Clo told the Committee that there needs to be greater investment to understand the huge disparity in health outcomes for black women. We currently do not collect data on near misses, morbidity, illnesses or poor outcomes for black women. I hope the Minister announces some changes to that.
Clo also told us that only once we uncover the experiences of black women going through maternity services and set targets to do better will we have better outcomes for all black women. The same sentiment was echoed when I met Mars Lord, a doula and birth activist working on the Black Mums Matter Too campaign, which is not only highlighting the shocking inequality facing black women and their children relating to maternal mortality, but taking action to save lives. Mars is working with Peppy Baby, which gives black birth parents free expert support, delivered remotely via an app.
In my own constituency, I have been doing my best to support my constituent Ernest Boateng. His wife, Mary Agyeiwaa Agyapong, sadly lost her life to covid-19. Mary was pregnant, and a nurse at Luton and Dunstable University Hospital in my constituency. Shortly after undergoing a C-section, Mary sadly died. I have been so moved by Ernest’s resolve and commitment over the last year to seek answers and to make sure that no other family faces such a tragic loss in the same way. I presented Ernest’s petition for greater protections for pregnant women during the pandemic to Parliament earlier this year. This is hugely important, especially as 55% of pregnant women hospitalised during the first months of the pandemic were from black, Asian and minority ethnic backgrounds.
I have written to the Minister multiple times to ask her to meet Ernest. He is the father of two children, and his one-year-old, little Mary, will never get to meet her mum. He is campaigning to make things better and safer for other expectant parents, but sadly every time I have asked, the Minister has responded that she is too busy to meet me and Ernest, so I use this opportunity to ask for even just 20 minutes of her time. I am sure that she will stand up and say the right things, and I know that her heart is in the right place. I am more than happy to assist, if she is willing to listen to the experiences of Ernest, so that no family has to face the devastating loss that his has.
Bell Ribeiro-Addy (Streatham) (Lab) [V]
It is a pleasure to serve under your chairmanship, Sir Gary. I start by paying tribute to Tinuke and Clo from Five X More, who have been leading the charge in calling for action on black maternal health. Black women are four times more likely to die in pregnancy and childbirth—we have heard that many times today, and we will probably hear it some more, but I really want it to hit home. We know this, but we have no target to end it.
During my own pregnancy, it was not hard to find instances where, as a black woman, how I was perceived or believed drastically impacted the care I received, from complaints about how I was feeling to being denied scans. We know that black women are perceived to experience less pain. We know this, and we have no target to end it.
Things went from bad to worse for me. I was swollen. My blood pressure would get so high that I would feel dizzy and my nose would bleed. My doctor eventually had me rushed to the hospital for further tests and scans, and I was admitted to the hospital with pre-eclampsia. My last conversation with the consultants was harrowing. They said that my pregnancy had become very dangerous and there were only two outcomes: my child would die, or both myself and my child would die. My diagnosis was too late for any intervention, and simple steps—which I soon found were simple things such as taking aspirin—were no longer an option for me. The consultants’ advice was for a late termination and a delivery to save myself. They also explained that my condition was deteriorating so quickly that I would immediately have to nominate someone to make the decision for me if I should become unconscious.
Some 83% of women of African origin, like myself, and 80% of Caribbean women suffer a near miss in pregnancy and childbirth. Not only do we not have a target to end this, but we do not have information about the health issues that black women go on to face. I did not have to make this decision, because a scan scheduled the day after that meeting showed that my baby’s heart had stopped beating. I was induced, and after something like 18 hours of labour, she was born. As a person of faith, even then, I still had faith that maybe the doctors were wrong and everything would be okay, but she did not move, she did not cry, and there was no miracle. Black babies have a 50% increased risk of neonatal death, and a 121% increased risk of stillbirth, like my own daughter. With figures like that, I wonder how much of a chance she really had. We know this, and we have no target to end it.
When I talk about this, I am asked how long ago it was and how far along I was. I just want to say that when any woman loses a baby, however her pregnancy ends—miscarriage, stillbirth, or even an abortion if she had to have one—it is not for anyone else to quantify how much pain she must feel, as if to decide how much empathy to show, and it is certainly not for them to decide how much care she should be shown.
I would like people to stop blaming black women—that is all I have heard in response to some of the messages that have been put out. So often, black women are viewed as the problem, but we could be the solution if people would just listen to us, respect us and care for us. We are not a lump of comorbidities—some of us who go on to have these tragic experiences did not even have any comorbidities. We are black women who have decided to bring life into this world, and that choice has become a matter of life and death and health. The inequality we face is not our fault. Inequality is an institutional and political outcome—an institutional and political choice—and it is the duty of the Government to end it, not to outsource responsibility and blame those who are suffering.
In the US, they have just had a Black Maternal Health Week, and $200 million were put towards ending this disparity in training clinicians. In the UK, we have a Government who have ordered reports saying that institutional racism does not exist. So when the Minister responds today, I do not want to hear what the Government think is wrong with women who look like me; I want to hear what they will do to protect women who look like me, and the children we have. I want to hear that this Government realise that if they are not part of the solution, they are part of the problem, and I want them to acknowledge the institutional racism that we face and to have a target to end it. The colour of a woman’s skin should have no bearing on whether she or her child live or die.
Abena Oppong-Asare (Erith and Thamesmead) (Lab) [V]
It is a pleasure to serve under your chairmanship, Sir Gary. I thank my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) for bringing this e-petition debate on black maternity healthcare and mortality before the House. I also thank Tinuke and Clo, the founders of the Five X More campaign, who have been fighting to get this issue taken seriously.
Other Members have touched on these heartbreaking and stark statistics, but they bear repeating: black women are four times more likely to die during pregnancy or up to six weeks postpartum, women of mixed heritage are three times more likely to die, and Asian women are twice as likely to die. Each loss of life is a tragedy, and that disparity is unacceptable. It needs to be understood and it needs to change.
I also want to mention the Royal College of Obstetricians and Gynaecologists’ term “near misses”. The numbers of women who survive childbirth and are left with long-term morbidity are currently not recorded, but are part of a wider health picture. They must be taken into account. For the past year, covid has exacerbated many of these issues. In fact, even when other factors such as age, obesity and location were taken into account, black and Asian women are more likely than white women to be hospitalised. We need to understand why that is the case, because the statistics can only tell us so much. A commitment to looking into how and why that is the case is urgently needed. I am sure that all of us in the debate today would welcome that.
These tragic deaths are part of a wider picture, a story of health inequality, with black women facing disparities when it comes to stillbirths, cancer diagnoses and outcomes, and access to fertility treatment, among other things. We must recognise that disparities in health outcomes are driven by social factors—poverty, education and housing—as well as discrimination. None of that is new. It is not earth-shattering. It is not changing, either. That simply is not good enough. So we need action, and we need action now.
The Government must commit to a target to reduce the disparity in mortality rates. The Government must support Five X More pledges, including the recommendations relating to black maternity health in the report “Black people, racism and human rights” produced by the Joint Committee on Human Rights. There needs to be a full and independent review that seeks to end the disparity once and for all. The NHS must commit to robust data collection to aid the understanding of these outcomes. For a start, we need to move beyond the term BME. When women are dying, it is not good enough use data catch-all terms. We need to do more to deliver a workforce that reflects the diversity of the communities it serves.
On a final and quick point, I have not mentioned “no recourse to public funds”. That is, of course, the huge elephant in the room when it comes to health outcomes. Some women face costs of £7,000 or more for essential maternity care. These are the very women who are at risk of increased mortality. It is time for that practice to end.
Janet Daby (Lewisham East) (Lab) [V]
I am pleased to be speaking today on such an important but also disturbing issue. I commend my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for sharing such a personal, moving story that is so relevant to the debate.
Every death in maternity is a tragedy, but it is wrong that we are having to speak on the issue of black women dying during pregnancy or soon after giving birth in the UK. It is unacceptable that the disparity exists between women from different ethnic backgrounds. It is most distressing that when a mother dies, a child or children are left motherless, not to mention the loss to their partner or spouse and to the wider community. Too many unanswered questions need to be asked, and too many changes need to be made, and that is why we request that the Government work with the NHS to improve maternal health outcomes of black women, women of mixed heritage and Asian women.
As we have already heard, compared with white European women, 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 to die, and Asian women are two times more likely to die. African women are 83% more likely to suffer a near miss in childbirth, and black Caribbean women are 80% more likely to do so. That is all happening in the UK. It is shameful and outrageous. How and why is it happening? It is a huge concern regarding equality of care. Why are non-white women’s experiences so different compared with those of white women? Change needs to happen, and it is this Government’s responsibility to make the change happen.
These babies are 121% more at risk of stillbirth. Their life chances are limited before they are even born. Do these little black lives matter? I think they do, and I know that many Members in this Chamber agree with that. Immediate interim changes and safeguards need to be put in place now for these vulnerable women to protect their lives: the lives of the mothers and children.
I call on the Government to implement the recommendations in the Joint Committee on Human Rights report on black maternal health, “Black people, racism and human rights”, to ensure that all health professionals record and identify those who are most at risk of poor outcomes, so that protective factors are implemented. I also call on the Government to ensure that there is increased support for at-risk pregnant women. I ask the Secretary of State for Health and Social Care to introduce a plan and target to improve maternal outcomes for black women. Professor Maggie Rae, president of the Faculty of Public Health, has said:
“This year’s coronavirus pandemic has brought this disparity even more starkly to the fore, and we must not lose sight of the actions that are required to address systemic biases that impact on the care we provide for ethnic minority women.”
Naz Shah (Bradford West) (Lab) [V]
It is a pleasure to serve under your chairmanship, Sir Gary. May I associate myself with all the comments that have been made? I commend in particular my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for the courage and bravery with which she spoke.
The disparity of maternity care outcomes in England is already well known. Black women are four to five times more likely than white women to die during pregnancy, birth and the postpartum period, while our Asian women, most of whom are from Pakistani and Bangladeshi backgrounds, are two to three times more likely than white women to die during those periods. Those statistics have been known for many years, but in the last 20 years or so they seem to have gone the wrong way and got worse.
We must find out why black and south Asian women and their babies are more likely to die. In addition, we need to find out why black women and then south Asian women are most likely have an emergency C-section. Why are black women and then south Asian women most likely to have excessive bleeding? Are those factors contributing to their deaths? Are those women receiving the right care at the right time? We need to look further into all those questions, because most of the deaths are likely to be preventable.
Why do racial and ethnic variations in health outcomes occur? The Government’s latest report suggests that institutional or structural forms of racism just do not exist, and that, in fact, they are just in our minds, or they are narratives pushed by groups that lobby on racism. I would be really grateful if the Minister explained why, if there is no racism, those disparities exist.
I am co-chair of the all-party parliamentary group on Muslim women, which is currently conducting research to find out about Muslim women with babies and maternity care, so that lessons can be learned to mitigate existing inequalities. Muslim women are from diverse ethnicities, and in the UK they are mostly from black and south Asian backgrounds, but we wanted to take an intersectional approach to find out how overlapping factors, such as ethnicity and faith, could affect their healthcare. The aim is to find out why those women have poor health outcomes, and to understand their perspectives and experiences of the healthcare during and after pregnancy. The findings of the inquiry are set to be published in the autumn.
This debate signifies just how important such an inquiry is, so I will end by expressing my gratitude to the whole team in the APPG on Muslim women, to the Muslim Women’s Network UK, and to all colleagues across the House who raise this important issue.
Claudia Webbe (Leicester East) (Ind) [V]
It is a pleasure to serve under your chairmanship, Sir Gary. I congratulate the campaign group Five X More, and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) on securing this hugely important debate, as well as the nearly 200,000 UK residents who signed the petition. The debate could hardly be more important, as it shines a light on a devastating and long-neglected area of institutional racism.
The latest UK data shows that black women are five times more likely to die in pregnancy, or up to six weeks after giving birth, compared with white women, yet there is no target to end that. This difference has almost doubled since 2011, with a 121% increased risk for stillbirth and a 50% increased risk for neonatal death, but there is no target to end this. It is not true that black women are superhuman. They do not have a higher pain threshold.
The maternal mortality for women from Asian backgrounds is double that for white women. There is also a concerning increase in the maternal mortality rate for women from mixed ethnic backgrounds, who now have a three times higher risk compared with white women, yet there is no target to end any of this. There is no doubt that health disparities within maternity care settings have been amplified by the coronavirus pandemic. Indeed, African, African-Caribbean, Asian and minority ethnic women made up 56% of all pregnant women hospitalised in the early months of the pandemic.
Discrimination is ingrained in the social, political and economic structures of our economic system. According to the Office for National Statistics, key workers are more likely to be from black, Asian or minority ethnic communities, to be women, to be born outside the UK and to be paid less than the average UK income. These inequalities are grounded in class inequality and reflect the severe racial disparities in our economy. African, Asian and minority ethnic women are also more likely to be in insecure work, which can leave them without basic maternity rights and more exposed to discrimination when it comes to hospital treatment.
That said, we cannot ignore the issue of racism and implicit racial bias in our healthcare system, which can negatively influence diagnosis and treatment options provided by clinicians, including pain management, and indirectly affect medical interactions, through loss of patient-centredness in treatment and the removal of patient autonomy. That has a corrosive effect on trust in services, which creates a downward spiral of healthcare outcomes.
The demonisation and mistreatment of migrants and those with unsettled status must also end. Migrant women with insecure status face charges of £7,000 or more for NHS maternity care, which can deter women from accessing essential services. The Government cannot be serious about reducing maternal health inequalities unless they abolish the “no recourse to public funds” policy.
There is also a significant gap in the medical research community, contributing to disparity of access in the UK. Latest figures show that 0.7% of professors employed at UK universities are black. In 2018, there were just 25 black British female professors in UK universities. Much more must be done to invest in research and researchers who can help combat those unacceptable health inequalities.
I finish by saying how callous, how cruel and how ignorant the Government’s recent race and ethnic disparities report is in the context of this debate. The Government’s crusade to deny the existence of institutional racism means that the disproportionate suffering of pregnant women of African, Asian and minority ethnic backgrounds is ignored. This must change. The UK Government must urgently set a target to abolish racial disparity to combat maternal mortality, so that we can all hold them to account and work towards long-lasting change.
Wera Hobhouse (Bath) (LD)
I am grateful that we are debating this important petition today and pay tribute to the women who have bravely shared their stories, from those involved in the “Dispatches” documentary to the Five X More campaigners to some of my own constituents in Bath.
The disparity in maternal health outcomes between black and Asian women and white women is one of the most frightening elements of systemic racism in today’s society. The statistics revealed in the MBRRACE report should shock and horrify us all. It should go without saying that health outcomes should never be determined by race, but for too many women this is the awful reality when accessing healthcare. One of my constituents said:
“I have two dual heritage daughters. As things stand, they are three times more likely to die during pregnancy and childbirth than my white friends’ daughters.”
Another wrote to me to share her concern that her race affected the way she was treated.
She felt she was not properly informed about the options open to her, her concerns were not taken seriously, and she could not say no when she felt uncomfortable.
Closing the gap between maternal health outcomes for white women and for women of colour must be a priority for the Government. It is not enough merely to recognise the disparity; we need a specific target to dramatically cut the rate of maternal deaths among black women. I urge the Minister to ensure that targets are in place to halve the disparity in the next five years. We need more and properly funded investigations into maternal death, with recommendations that are actioned. We need national accreditation for those who provide language support in maternity care, and we need to look at health outcomes for those new mothers who have no recourse to public funds because of insecure immigration status.
On top of that, if we are serious about eliminating maternal health inequalities, we must tackle the inequalities that exist in all areas of society. We know that the pandemic has made all inequalities much worse. Women from ethnic minority backgrounds made up 56% of all pregnant women having to go to hospital in the early months of the pandemic. Women from ethnic minority backgrounds are more likely to be key workers, giving them an increased risk of contracting the virus. They are more likely to be in insecure employment, which leaves them without basic maternity rights. They are at risk of higher exposure to discrimination and poor treatment at work, affecting their mental health. Once again, I urge the Treasury to look at Maternity Action’s proposals for amending the furlough scheme. It would allow employers to claim 100% of the cost of maternity suspension for women who are over 28 weeks pregnant, or pregnant women with underlying health conditions—we have heard today that underlying health conditions make it much more risky for pregnant women from different ethnic backgrounds.
I hope that the powerful personal stories shared by so many brave women will spur urgent action from the Government. We need to listen to black women, to ensure that pregnancy and childbirth are safe for all.
Helen Hayes (Dulwich and West Norwood) (Lab) [V]
It is a pleasure to serve under your chairmanship, Sir Gary. I pay tribute to Tinuke and Clo for their vital work campaigning on black maternal health under the banner Five X More . I also pay tribute to my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for sharing her devastating experience so bravely and powerfully.
The statistics on maternal mortality are truly shocking. Skin colour should have no correlation with maternal health, yet in the UK, black women are over four times more likely than white women to die during pregnancy or childbirth; women of mixed heritage are three times more likely; and Asian women are twice as likely. What is even more shocking is that the gap has been widening—not for a short period of time, but for more than a decade.
The factors contributing to maternal mortality rates are complex and multiple. Social and economic factors have a strong influence on underlying health. Pressures such as insecure work, low income and fear of losing employment force some women into unsafe situations. Implicit racial bias in healthcare can lead to assumptions being made and some women not being listened to. The extent to which women are listened to, respected and empowered throughout pregnancy and childbirth has a vital bearing on ultimate outcomes.
The most shocking aspect is that every organisation concerned with maternal mortality says that more research is needed to understand why black women are at greater risk of death. After a decade of increasing black maternal health disparity, we still need more action to understand why there is such appalling racial healthcare inequality, so that action can be taken to stop it. That means better data collection, clear and measurable targets, and more funding for research.
We have to ask why those appalling statistics have been of so little concern to the Government that they have failed to undertake any major inquiry or fund significant research. There is a gender and ethnicity gap in medical research, and that must change. The Government must now commission an independent review of the ethnic disparity in maternal mortality, looking in detail at the data and capturing the lived experience of black women, Asian women and women of mixed heritage.
I want to highlight in particular some of the things that are known and on which action could be taken right away to make a difference, even as further research is commissioned. We know that women from black and Asian backgrounds are more likely to be key workers in frontline roles and physical roles such as social care. Many of those women are on low pay and in insecure work. Maternity rights and health and safety protections at work must be extended to all women, whatever their employment status or job role. It must not be the case that fear of losing pay or losing work forces pregnant women to risk their health, either through the work itself or through being unable to attend essential healthcare appointments.
The barriers to accessing healthcare that face some black and Asian women, particularly asylum seekers and women with no recourse to public funds, must be removed. In maternity care, relationships really matter. Women’s experiences during pregnancy and childbirth are far too inconsistent across the country, but often, the best care is delivered by community-based midwifery teams, working across both community and hospital settings and enabling women to get to know and trust the midwives who will eventually deliver their babies. Dealing with a birth is not like other forms of healthcare. Women in childbirth should feel that they are equal partners with midwives, doctors and the wider professional team to deliver their baby safely.
Finally, the racial disparities in maternal health further serve to underline the nonsense of the report by the Commission on Race and Ethnic Disparities. That report straightforwardly denies the lived experience of many black people and people of colour living in the UK. Addressing structural racism, shown so clearly in the health data we have been discussing today, must start with listening to and taking seriously the experiences of black people and people of colour in the UK, not denying those experiences. That report will not even help to get off the blocks the work that needs to be done to iron out and remove racial disparities in maternal health.
Kim Johnson (Liverpool, Riverside) (Lab) [V]
It is a pleasure to serve under your chairship, Sir Gary. I, too, would like to begin by thanking the Five X More campaign for raising awareness and bringing this important debate to Parliament, and my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for her bravery in sharing her devastating story with us all tonight.
I am a black mother of twins and I had a very positive experience, but sadly, too many black women are dying needlessly in childbirth. In today’s historic debate, we have already heard incredibly personal and heartfelt stories, and I pay tribute to my sisters’ strength and bravery in sharing their experience to help to bring about change.
The rate for black mothers dying during or just after childbirth is five times that of white mothers in the UK; and black babies have a 121% increased risk of a stillbirth. It is estimated that for every instance of maternal mortality, there are 100 severe maternal morbidities or near misses. Behind every one of these statistics is a story, and behind every one of these mothers who dies is a group of women who had a near miss.
The report by the Joint Committee on Human Rights, which was published last year, highlighted the lack of an NHS target to end this obscene disparity and urged the Government to introduce one. I call on the Government today to rectify that urgently and set ambitious targets to address and eliminate these inequalities, including to halve the number of black maternal deaths by 2023.
The 2019 MBRRACE-UK report revealed that almost all those who died during or after pregnancy had multiple issues such as mental or physical health problems or were victims of domestic abuse or were living in a deprived area. More than half of those who died were overweight or obese. Black women are more likely to have conditions that can put them at greater risk, including cardiac disease, diabetes and high blood pressure. We must ask the deeper question of why black and Asian women are more likely to have those pre-existing health conditions in the first place. There is no specific genetic connection between all black people. Many of these pre-existing conditions are non-communicable diseases that are driven by social determinants of health, such as poverty, education and housing. Women living in the most deprived areas were three times more likely to die than those living in more affluent areas. Social services were involved in the lives of 20% of the women who died.
We are now a year into a pandemic that has laid bare the pervasive health inequalities that exist in our country. We have seen clearly that race, class, housing, education, income and employment all directly define someone’s chances of survival. More than half of pregnant women admitted with covid-19 in the first two months of the pandemic were black, Asian or from another minority ethnic group. Black women have been eight times more likely to be admitted to hospital as a result of coronavirus. These inequalities are widening and will become more profound as deprivation and disadvantage continue to be fuelled by the pandemic and women continue to suffer.
The recent Sewell report, backed by the Government, who allegedly had a hand in doctoring its findings, had the gall to assert that structural racism no longer exists as a dominating force in Britain today. The figures and the stories that we have heard today tell a very different story, so will the Minister go back to the Government and appeal to them to rectify the report, given the undeniable evidence we have heard today? This must be a turning point. The Government must commit today to a national strategy to tackle health inequality, which must include a road map and a timeframe for the eradication of the racial injustice in maternity care.
Anne McLaughlin (Glasgow North East) (SNP) [V]
I am happy to speak under your chairmanship today, Sir Gary, although what we are discussing is a very unhappy set of circumstances. I thank Five X More for the petition and the debate, and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) for leading it. I confess—I know I am not alone in this—I knew very little about this subject until hearing from Five X More , and I am someone with a long-term interest in racial inequality, so I thank it sincerely. Many hon. Members have spoken powerfully today. I pay particular respect to the courage of the hon. Member for Streatham (Bell Ribeiro-Addy).
In the UK, almost 800,000 women give birth every year. That is 800,000 interactions with their national health service, making childbirth the No. 1 reason for engagement with the NHS. For a large proportion of women, it is their first adult contact with health services, and maternity care should be a unique opportunity to mitigate some of the factors that perpetuate health and social inequalities. I have no doubt that for many it is, regardless of ethnicity. I also have no doubt that the vast majority of healthcare workers care deeply about the people they work with. This debate is more about the system itself and the structural inbuilt inequalities.
We are hearing through heartbreaking testimony and alarming reports that these inequalities are very much there, putting black mothers and babies at a significantly higher risk of maternal and perinatal death. It is worth repeating again and again that black women are four times more likely to die during pregnancy or shortly after giving birth than white women. Women from mixed-race backgrounds are three times as likely and Asian women twice as likely. Most alarming to me is the fact that this inequality and disparity in maternal and newborn health has been highlighted for several years, yet there is still no target to end this. Why on earth not?
I want to pay tribute to MBRRACE-UK for the work that it has done in the confidential inquiry into maternal deaths. There is a coldness to research and statistics that often lets us forget what MBRRACE-UK points out: behind each number is a mother, a father, a baby, a family and a community left devastated by these events. Five X More has published a comprehensive list of suggestions for the Government to act on, as many hon. Members have noted today. I will note just one: the advice to listen to the voices and experiences of black women. Listen!
Maternity Action notes that a reason for the disparity, as the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) has noted, is that migrant women with insecure status face charges of £7,000 or more for essential NHS maternity care. That will clearly deter lots of these women from attending for care. Maternity Action has rightly called for an end to no recourse to public funds rules, as others have today. The rules exclude some migrants from access to top-up payments such as housing benefit, universal credit, child benefit and other critically important benefits. Many working people are paid so little that they require those top-ups just to survive, but many migrant women with work visas and jobs and others with limited leave to remain do not have the right to what is considered essential for everybody else.
Finally, Maternity Action and others are calling for a welfare safety net for all pregnant women. I will add to that by talking about how important universality can be. In Scotland, there is universal access to free prescriptions, but even more relevant to this debate is universal access to the baby box. It is not a poor baby’s box, but a “welcome to the world” baby box. It is free to all new parents and is based on the Finnish model, which has a proven record of decreasing infant mortality. The box includes essential items for a baby’s first weeks and months, and it provides a safe space for babies to sleep near their parents. However, one of the most important aspects of the baby box is that it brings women in touch with healthcare workers before and after the baby is born. Those workers can then support the mother and baby.
Every baby should be born with an equal start in life, and the SNP Government are exploring even more ways in which the baby box can be used to promote women’s health and support mental health. I mention the baby box not to say that Scotland does everything so much better than the rest of UK, but it is something that I would love to see the rest of the UK adopt. It is not just about health and being in touch with health services; it is about the psychological impact of the Government telling people, particularly migrants to this country, that their babies are welcome and loved. So much work was done on ensuring that it was not seen as a poor baby’s box that, in 2019, 47,000 baby boxes were delivered to new parents in Scotland—a 93% uptake. That is what happens when there is universality.
As we know, the mortality risk from covid-19 among ethnic minority groups is twice that for white patients, and that is after potential confounding factors such as age, sex, income, education, housing tenure and area deprivation have been taken into account. A recent report found that black pregnant women are eight times more likely to be admitted to hospital with coronavirus, and Asian women are four times more likely. There is simply no hiding from this issue. If we are to fully understand race and health, we have to fully understand the role of ethnicity and racism in our society—the everyday acts of discrimination, the unconscious and implicit biases, and the cultural and structural racism that we are now being told does not exist.
I do not have the time or expertise to delve deeply into this issue, so I am glad that others are speaking about it. One of those is Dr Christine Ekechi, who is the spokesperson for racial equality at the Royal College of Obstetricians and Gynaecologists. She said:
“it’s important for us to acknowledge that we are still humans, and so there are lots of things that can operate at a conscious level, but there are many things that operate at a subconscious level.”
Dr Ekechi has suggested that we need more diversity in healthcare systems and that healthcare professionals should check themselves for whatever biases they may have. I expect the vast majority would want to do that, and we should be supporting them. It is one of the things that we will be looking at on the all-party parliamentary group on unconscious bias, because it does exist. We should be finding ways to help people unravel their biased thinking, because it has a massive impact on people’s lives.
I want to add to some of what others have said about the Commission on Race and Ethnic Disparities report. Rather than focusing on structural inequalities, it attempted to explain them by talking about economics, geography and family units. Academics have accused the report of cherry-picking data to reach predetermined conclusions. They say it is littered with mistakes and selective quoting, in an attempt to tell us that
“the British discourse on race is obsessed with victimhood when it should be celebrating progress.”
That is not surprising, given that the author has already said many times in the past that he does not believe structural inequality exists, but it also chimes with a growing trend among Conservative politicians to claim that there is no such thing as structural racism in the UK. However, even the Prime Minister now seems to be distancing himself from the report, saying recently:
“I’m not going to say we agree with every word.”
For those who may not know and who may be watching, if we say the health service is structurally racist, it does not mean that it is populated by racists. It means that the way it is structured is for white people and that it takes into consideration their needs—culture, language, health trends and so forth—with very little flexibility to take account of anyone else’s. We need to change the structures and make them more flexible, which is what this debate is calling for. After all, our NHS is not a national white person’s health service; it is supposed to be for everybody equally.
This is a moral issue. As Alexandre Dumas wrote:
“Moral wounds have this peculiarity—they may be hidden, but they never close; always painful, always ready to bleed when touched, they remain fresh and open in the heart.”
I will end with the words of Amy Gibbs, the chief executive of Birthrights:
“A lot of black and brown people in the birthing world are understandably frustrated by calls for more research when what’s needed is action.”
I think she is right. We need to act now. No more endless research: let us just do something about this.
Marsha De Cordova (Battersea) (Lab)
It is a pleasure to serve with you in the Chair, Sir Gary. I am grateful to my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) for leading the debate on behalf of the Petitions Committee. I also congratulate the formidable campaigners Tinuke and Clo, the founders of the Five X More campaign, who got the petition debate in Parliament today. The petition received more than 180,000 signatures. It is not before time that such a huge injustice is finally receiving the attention it deserves.
We have heard some powerful contributions from right hon. and hon. Members this evening, including my right hon. and learned Friend the Member for Camberwell and Peckham (Ms Harman), the Chair of the Joint Committee on Human Rights. Just last year, the Committee published its report “Black People, Racism and Human Rights”, which contains shocking findings, particularly that the care that many black people receive is unequal to what is given to white people. I urge the Minister to accept all the recommendations of that report.
My hon. Friend the Member for Edmonton (Kate Osamor) highlighted, as others have done, the choice made in the report of the Commission on Race and Ethnic Disparities to sideline the institutional and structural racism that exists across society, but more so in the health service. My hon. Friend the Member for Streatham (Bell Ribeiro-Addy) made a powerful contribution sharing her lived experience. I thank her for doing so, but also for her tireless campaigning on the issue. She has been brave, and I thank her for that.
More importantly, my hon. Friend the Member for Vauxhall (Florence Eshalomi) highlighted some of the issues related to underlying health conditions in her own experience of being diagnosed with fibroids and also of being a sickle cell carrier. I also urge the Minister to listen to my hon. Friend the Member for Luton North (Sarah Owen), to give 20 minutes of her time to her and her constituent and to hear their experiences.
I also want to mention the contribution of my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes), who highlighted the fact that we need to focus more on issues relating to research. Unless we do the work, we will not move forward and bring an end to this crisis.
As we have heard, it is absolutely shameful that black women continue to be four times more likely to die in childbirth and pregnancy than white women. That inequality has existed for decades, with little action being taken to address it. [Interruption.]
Sir Gary Streeter (in the Chair)
Order. Does any Member present have to go to vote physically, or is everyone on a proxy vote? If everyone is happy, let us continue.
Marsha De Cordova
Last week I met campaigners, obstetricians, midwives and black, Asian and ethnic minority women with lived experience of maternal health complications. They were very clear that socioeconomic determinants such as income, housing and occupation and comorbidities only partially explain the inequalities affecting black maternal health. It is absolutely clear that structural racism is a driver of disparities in treatment, and it is a missed opportunity that the Commission on Race and Ethnic Disparities chose to sideline that important issue. I hope the Minister will choose to ignore and reject that view.
Black and Asian women, and their partners, regardless of their socioeconomic status, are not being listened to, not being respected and not being cared for. When they voice pain or concern during pregnancy or childbirth, they are branded as “aggressive” or “angry”, while dangerous stereotypes about “strong black women” mean that black women are often not offered the same treatment as white women.
It is outrageous that racist myths about black women having higher pain thresholds than other women continue to affect their treatment. Meanwhile, the lack of cultural competency in medical training means that complications experienced by black women are not spotted early enough. For example, black women have shared accounts of how their anaemia was not picked up soon enough because of the colour of their skin.
So I ask the Minister what action she is taking to tackle structural racism and to build trust in maternity services for black, Asian and ethnic minority mothers and their partners and for healthcare professionals, including midwives, as many have shared their experiences of occupational discrimination, as was highlighted in the Public Health England report last year. I would really like the Minister to address this issue. Additionally, cultural competency and unconscious bias training is an essential part of ending these inequalities, so will she commit to improving training in the health service and in medical schools?
We are all aware of the importance of data, which as we have heard is central to closing the maternal mortality gap. Many mothers and medical professionals have shared accounts of how pregnant women are recorded as being white if they do not disclose their ethnicity, meaning that it is difficult to track complications. Therefore, the recording of data is essential, so will the Minister commit to ensuring that all maternity services record the specific ethnicity of all mothers?
It is clear that fatalities are just the tip of the iceberg, with many women speaking of the near-misses and poor treatment they have experienced. I have heard from many medical professionals that data on near-misses could easily be made available, but it is not being. Will the Minister therefore commit to collecting and publishing data on maternal near-misses by ethnicity, and, if so, can she set a timeline for that commitment, with some clear milestones?
Midwives consider the continuity-of-care model as a way to help bridge some of these inequalities. A 2016 study found that women who see the same midwife throughout their pregnancy are 16% less likely to lose their baby. The NHS standard contract for 2019-20 stipulated that 35% of women will be booked on to a continuity-of-care pathway by March 2020. Can the Minister confirm whether that target was met? Can she also say what is being done to meet that target in the NHS long-term plan, which aims to provide continuity of care for 75% of black, Asian and ethnic minority women by 2024?
Before I close, I want to mention how the hostile environment is exacerbating this problem, as mentioned by my hon. Friends the Members for Erith and Thamesmead (Abena Oppong-Asare) and for Dulwich and West Norwood. Charging for maternity services and no recourse to public funds conditionality mean that many women are either becoming indebted as a result of their pregnancy or are turning away from health services all together for fear of being reported to the Home Office. Many women subject to charging are destitute and unable to pay, and three of the 209 women whose deaths were investigated in the 2019 MBRRACE-UK report were affected by charging for NHS maternity care. Does the Minister agree that charging women for maternity care is cruel and dangerous during this pandemic?
I want to make it clear that black maternal health and mortality is an avoidable inequality, and it is scandalous that the Government have not yet set a target to end this injustice in the NHS long-term plan, so will the Minister commit to doing so today? The NHS long-term plan sets many targets for other issues, so why not for black maternal health?
Let me be absolutely clear that a Labour Government would be committed to ending the crisis in black maternal health and mortality, and that the Government must take urgent action now. We need a national strategy to tackle health inequalities as a matter of urgency, which must include a target and a commitment to end the mortality gap between black, Asian and ethnic minority women and white women and to tackle structural racism once and for all, not deny its existence. We cannot afford for this not to be a priority.
The Minister for Patient Safety, Suicide Prevention and Mental Health (Ms Nadine Dorries)
I thank all Members of the House who have taken the time to attend and speak in today’s debate, and particularly the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) for having secured the debate. Along with everyone else, I also thank the co-founders of the Five X More campaign, Clo and Tinuke, for their incredible work. Their petition to Parliament has generated a huge amount of interest and support, and their work to improve maternity mortality rates and healthcare outcomes for black British women is inspiring and brings this deeply important issue the attention it deserves.
Every woman deserves to have safe care, to feel that her voice has been heard and to be an informed decision maker in her own care. The NHS is one of the safest places in the world to have a baby. Few women in the UK die during childbirth. Between 2016 and 2018, 217 out of 2.2 million women died during, or up to six weeks after, pregnancy from causes associated with their pregnancy. That equates to 9.7 maternal deaths per 100,000 pregnancies. We also know from the MBRRACE-UK maternal mortality reports that some of these deaths could have been prevented. Sadly, evidence shows that, currently, there remains a more than fourfold difference between maternal mortality rates among women from black ethnic backgrounds and among white women in England. There also remains an almost twofold difference between women from Asian ethnic backgrounds and white women. Those disparities are worrying and must be addressed, and I have heard all of the calls to do that today.
However, let me address the points that have been raised by speakers today—many of which have been raised repeatedly—beginning with the right hon. and learned Member for Camberwell and Peckham (Ms Harman). We need to fundamentally understand why this issue occurs and why we have these disparities. The statistics tell only part of the story: the lived experiences of black women need to be understood, appreciated and heard for us to really gain an understanding of the full picture. I think it was the hon. Member for Liverpool, Riverside (Kim Johnson) who read out some of the reasons for these disparities that are given in the report. As we know, and as we could tell from that report and from the list that she read, which was just the tip of the iceberg, the reasons are incredibly complex.
That is why, last month, I announced that the Government are embarking on the first women’s health strategy for England. That strategy is, first and foremost, about listening to women’s voices. The call for evidence that launched on International Women’s Day seeks to understand women’s experience of the health and care system, and we have already seen an incredible response to it. Many thousands of women across the country have come forward to share their experiences through the online survey, which takes just a few minutes to complete, so I will unashamedly make another call in this debate for any woman who has not yet completed the online survey to do so.
However, women from black and other ethnic minority groups are under-represented in the responses we have received so far, and today’s debate has reiterated just how important it is to ensure that the health and care system is listening to women of all backgrounds. I encourage any woman listening to this debate, and in particular women from black and ethnic minority groups, to come forward and have their voice heard. By better understanding women’s experiences, we can ensure that the health system truly meets the needs of women as they should be met. The complaint that women’s voices are not heard—that women are not listened to and are spoken down to in the healthcare sector—is a common one across the board from women, and was highlighted in Baroness Cumberlege’s recent “First Do No Harm” report.
Disparities in maternal mortality rates among women from different ethnic groups have been well documented for many years. The numbers are just not acceptable, and the Government are committed to reducing those inequalities. The charity Five X More has campaigned to make the NHS commit to a target to reduce inequalities and close the current gap in maternal mortalities. There are considerable limitations on producing an England-level indicator of maternal mortality by ethnicity. Many Members raised that point. The fact is that maternal deaths are rare, even among women from black ethnic groups. Because of the very low numbers, even a large reduction in mortality rates for a particular ethnic group would not necessarily be attributable to a genuine improvement in the quality of care.
Marsha De Cordova
The issue is that there is a need for a target. When a target is set, work can take place towards a reduction. The Minister says it might be difficult to record the figures by ethnicity. Could she explain why it would be difficult?
Ms Dorries
I will go further and explain what we are hoping to do to make a difference. We know that for every woman who dies, 100 women have a severe pregnancy complication or a near miss. That has been mentioned a number of times. When that woman survives, she will often have long-term health problems. Disparities in the number of women experiencing a near miss also exist between women from different ethnic groups. Because near misses are more common than maternal deaths, we can investigate those disparities at local and regional level, to better understand the reasons for disparity, to assess local variation and to identify areas with less disparity and, hence, best practice.
Wera Hobhouse
Is it not clear from everything we hear that black women and women from ethnic minorities feel that the health system does not communicate appropriately, so they do not understand all the choices available to them? Is that not a way of getting to the bottom of what is going wrong?
Ms Dorries
That is certainly one of the many issues highlighted in the report, but it is not the only one. We have commissioned the policy research unit in maternal and neonatal health and care at the University of Oxford to undertake research into the disparities in the near misses, and to develop an English maternal morbidity outcome indicator. The research will explore whether the indicator is sufficiently sensitive to detect whether the changes made to clinical care are resulting in better health outcomes. Five X More called for that in its list of 10 requests.
We are putting the research in. We have found a way to look at the research in order to make the differences that need to be made. We can do that by examining the near misses. What happened in those cases and in those women’s experiences? What went wrong? Do the women feel that they were not listened to? Was it a matter of treatment? Was it a lack of understanding? We need to understand that by looking at the near misses. The research is being undertaken, but it will take some time. Hopefully, when that is reported, we will be able to make progress on the issue of setting targets.
This Government are no strangers to setting targets. On the very sad issue of baby loss, we set a target to reduce neonatal stillbirth and neonatal mortality rates by 20% by 2020. We have reached almost 25%. We have smashed that target and are still pushing forward to improve that situation even more. We are not afraid of setting targets, but when we are setting them we have to know how to achieve better outcomes. The hon. Member for Battersea (Marsha De Cordova) mentioned continuity of carer. She is absolutely right about those figures. We know that continuity of carer works incredibly well, particularly for black women and women from ethnic minorities. Having the same midwife throughout the process of pregnancy makes a huge difference. That is being rolled out across the country. I am sure that the hon. Lady has spoken to the chief midwifery officer, who is a huge supporter of the policy. We are continuing to roll it out and make progress with it. It has been slightly more difficult during the 12 months of the covid pandemic, particularly because many trusts did not continue with home births.
We are not afraid of setting targets, however. Setting targets in maternity units is what we are about, to make them safer places in which to give birth and in order to reduce both neonatal and maternal mortality rates, but we need to do the research on the near misses, to understand what the problems are. We cannot set targets until we know what we are trying to achieve through those targets and what we need to address. Five X More has asked for that research to be done. It needs to be done, and it will be done.
We are committed to reducing inequalities and to improving outcomes for black women—we work at that daily. I established the maternity inequalities oversight forum to focus on inequalities so that we in Government understand what the problems are. The forum also brings together experts from across the UK—we have met MBRRACE-UK and Maternity Voices—who have done their own research and studied this problem, to hear their findings and recommendations. Professor Jacqueline Dunkley-Bent, the chief midwifery officer for England, is leading the work to understand why mortality rates are higher, to consider the evidence on reducing mortality rates, and to take action to improve the outcomes for mothers and their babies.
NHS England is working with a range of national partners, led by Jacqueline Dunkley-Bent and the national speciality adviser for obstetrics, to develop an equity strategy that will focus on black, Asian and mixed-race women and their babies, and on those living in the most deprived areas. The Cabinet Office Race Disparity Unit has also supported the Department of Health and Social Care in driving positive actions through a number of interventions on maternity mortality from an equalities perspective. The Royal College of Obstetricians and Gynaecologists has established—
Sir Gary Streeter (in the Chair)
Order. Will the Minister kindly leave two minutes for Catherine McKinnell at the very end?
Ms Dorries
I will end there, but if any hon. Members wish to speak with me about the work we are doing and the research we have undertaken with Oxford University, we are happy to share more. I say in response to the hon. Member for Luton North (Sarah Owen) that very few personal meetings have taken place, but I would be happy to meet her and her constituent.
Sir Gary Streeter (in the Chair)
Thank you very much, Minister. It is very important that Catherine McKinnell has the final word.
Catherine McKinnell [V]
Thank you, Sir Gary. I thank the Minister for her response, and everybody who has contributed to the debate, which has been very moving and powerful, and also very painful. I thank in particular my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for sharing such a powerful personal story.
I hope that the debate has helped to raise awareness and understanding of why the issue must be urgently addressed, and I hope that we have done justice to the passionate and powerful campaigning of Clo and Tinuke. I know that they and we all want to see change, so I hope that the Government and NHS leaders have heard that call today. I urge the Minister to meet those who are affected, to continue to listen and to ensure that data continues to be collected and that changes are made to put an end to the five times more statistic for good.
Question put and agreed to.
Resolved,
That this House has considered e-petition 301079, relating to Black maternal healthcare and mortality.