International Women’s Day

Baroness Amos Excerpts

Friday 8th March 2024 Lords Chamber

[Baroness Amos (Lab)]

My Lords, I thank the Minister for opening today’s important debate. I also say how much I am looking forward to the maiden speech by the noble Baroness, Lady Casey. I have long been an admirer of her work, her determination, her advocacy, and the way that her work has really made a difference in people’s lives—so thank you.

Today and this debate give us an opportunity to reflect, to pause and to remember the women who lost their lives in pursuit of equality for women, those women who are in the midst of war and conflict, and those women who face sexual violence and general domestic violence as an everyday reality. It is also an important moment to celebrate and honour the achievements of women around the world.

In the short time available to me, I will speak not on international matters, as I generally do, but will touch on inequalities in our healthcare provision, particularly with regard to women’s health, more specifically black women’s health, which has a sustained and long-term impact on their well-being and quality of life, as well as a significant impact on our economy and on economic inclusion. I am extremely grateful to Dr Jenny Douglas, a senior lecturer at the Open University, with whom I have debated and discussed these issues over many years. She is a lifelong and passionate advocate for black women’s health.

There is a wealth of data out there from the WHO, the Institute of Health Equity, and the King’s Fund, on these health inequalities. They identify issues around life expectancy, premature death and disability, productivity losses, the direct cost to the NHS and other welfare services and reduced taxes. There are all these economic impacts, but let us always remember the well-being and welfare impact of these inequalities on women. These are significant consequences to our economy.

The Women’s Health Strategy was published in August 2022, and identified that:

“Although women in the UK on average live longer than men, women spend a significantly greater proportion of their lives in ill health and disability when compared with men. Not enough focus is placed on women-specific issues like miscarriage or menopause”—


although I welcome the recent guidance from the Equality and Human Rights Commission and also the work the Government have been doing in relation to this—

“and women are under-represented when it comes to important clinical trials”.

The report also states that

“while women make up 51% of the population, historically the health and care system has been designed by men for men”.

That still remains the case.

“This ‘male as default’ approach has been seen in: research and clinical trials, education and training for healthcare professionals”


and

“the design of healthcare policies and services. This has led to gaps in our data and evidence base that mean not enough is known about conditions that only affect women … It has meant that not enough is known about how conditions that affect both men and women impact them in different ways—for example, cardiovascular disease, dementia or mental health conditions. It has also resulted in inefficiencies in how services are delivered—for example, we know that many women have to move from service to service to have their reproductive health needs met, and women can struggle to access basic services such as contraception”.

Day after day, we hear from women who speak movingly about their experiences, women who do not feel well-served by our health system as it is.

In that strategy, although mention is made of black, Asian and minority women, the strategy does not really discuss the experiences of racism that black and Asian women experience. For example, a recent report by the Birmingham Race Action Partnership has significant data on this.

A specific example of where black and Asian women’s experience needs to be addressed is in relation to maternal deaths. Thankfully, these are very rare, but there are disparities with black and Asian women more likely to die during pregnancy, childbirth and in the year following childbirth than white women. The House of Commons Women and Equalities Committee’s report into black maternal health set out a number of reasons for ethnic disparities in mortality that are not fully understood. For example, pre-existing conditions, socio-economic factors, the quality of maternity care or the need for training on disparities. Black women at term are one and a half to two times more likely to have a stillbirth and four to five times more likely to die from complications in pregnancy and childbirth. There is an intersection with economic disadvantage, with women living in deprived areas having the highest maternal mortality rates.

Will the Minister say what progress has been made in implementing the recommendations in the Women and Equalities Committee’s report on black maternal health? That would go some way to tackling basic health inequalities and support women, particularly black and Asian women, to enable them to play their part in being active, healthy, major contributors to our society.