Black, Asian and Minority-Ethnic Women: Maternal Mortality Rates
Baroness Benjamin Excerpts(5 months ago)
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Baroness Merron (Lab)
I thank the noble Baroness for her kind remarks and good wishes. Certainly, all reports will be considered because we will look for what works.
Baroness Benjamin (LD)
My Lords, sickle cell disorder affects mainly people whose heritage is from Africa, the Caribbean and Asia, and the Sickle Cell Society’s report, No One’s Listening, shows that people with sickle cell experience discrimination when they engage with the NHS. We know that black and Asian women are four times more likely to die in childbirth. Can the Minister assure the House that NHS maternity units have the right level of training, staffing and systems to support safe care for expectant mothers living with sickle cell? I declare an interest as a patron of the Sickle Cell Society.
Baroness Merron (Lab)
The noble Baroness is quite right to draw the House’s attention to the important matter of sickle cell. We look to specialist midwives to assist us in this. I have been asked for a particular assurance and it is correct that the noble Baroness seeks that. I shall be pleased to look into it to be able to come back to her in much greater detail.
NHS Dentistry
Baroness Benjamin Excerpts(2 years, 11 months ago)
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Lord Kamall (Con)
As the noble Lord will know, anyone can have access to an NHS dentist—they do not have to be registered with the practice in question—and when they are unable to find a practice, they can ring 111 to get information. In addition, over 700 urgent dental care centres remain open across the country.
Baroness Benjamin (LD)
My Lords, dentistry is facing an unprecedented challenge. We will not overcome the enormous backlog of treatment and the rising wave of dental staff leaving the NHS unless dentists have a seat at the table and a voice when commissioning decisions are made which affect them and the millions of patients they treat, especially children, for whom tooth decay is the number one reason they are admitted to hospital. Will the Minister tell us whether and how dentists will be represented in the new integrated care systems?
Lord Kamall (Con)
I thank the noble Baroness for that question. Following the Bill there has been a debate about the integrated care system—both the integrated care boards, and who should be there as a right, and the integrated care partnership, which works with local authorities and others, including place-based organisations and primary care organisations. We hope that they will all have a voice via the ICP.
Covid-19
Baroness Benjamin Excerpts(4 years, 3 months ago)
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Lord Bethell (Con)
The noble Baroness asks three extremely perceptive questions. With regard to the science of testing at airports, a huge amount of work is being done on this, and I pay tribute to the work of the scientists at SAGE, who have, I think, published several papers on this matter.
The number that sticks in my mind is SAGE’s estimate that of those infected who pass through an airport only 7% would be captured by what is called day zero testing—a tiny proportion. That uncomfortable and inconvenient statistic holds us back from doing what we would love to do—it just does not work. We are looking at seven-day testing, eight-day testing and 10-day testing. This is a lot about risk management: there is a risk curve. I would be happy to share a copy of the SAGE report, which is public, that shows that curve.
The noble Baroness is right to raise quarantine implementation: it is a cause of concern. Quarantine is critical to the effective implementation of our epidemic management. It is a trust-based system. Anyone who has read the papers will know that that trust-based system is under pressure. We are keeping it under review and will be looking at whether it needs to be updated.
Baroness Benjamin (LD) [V]
My Lords, it has been widely acknowledged that Covid-19 has disproportionately affected the black, Asian and other diverse communities, with many dying—especially men. There is also a high risk of suicide among these groups. Sadly, I personally know of two people who have taken their lives because they could not cope with the uncertainty of the future. What measures, therefore, are the Government putting in place to ensure that suicide prevention is a government priority and that this group receives the support it needs to face the Covid-19 pandemic?
Lord Bethell (Con)
My Lords, on behalf of the House I pass on our sympathy to the noble Baroness, Lady Benjamin, for her experience with the friend who committed suicide. It is a touching story and we feel sorry them.
Suicide is important for this Government and we have a number of programmes that address it. One of the peculiar aspects of the epidemic is that the mental health tsunami that we were all braced for and deeply concerned about has not manifested itself in the way we thought it might. There is currently no evidence that the suicide rate has increased in any way. We keep a careful eye on this. When a major epidemic such as this happens, we worry that it will have a huge impact, particularly on the young—particularly young girls—and those groups, such as BAME, who may feel that the prevalence is higher in their community. To date, however, the statistics suggest that we are blessed by having avoided harsh effects so far.
Health Protection (Coronavirus, Restrictions) (Leicester) Regulations 2020
Baroness Benjamin Excerpts(4 years, 5 months ago)
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Baroness Benjamin (LD) [V]
My Lords, the coronavirus pandemic has exposed deep inequalities in our society. It has caused so much pain, death and suffering in areas across the country. This is evident in Leicester, where many families are from minority communities with low-level incomes and are reportedly working in unacceptable sweatshop conditions. Many are also living in cramped housing conditions, which is having a huge impact on their children’s mental and physical well-being. The report from Public Health England in June stated that the Government must:
“Ensure that COVID-19 recovery strategies actively reduce inequalities caused by the wider determinants of health to create long-term sustainable change. Fully funded, sustained and meaningful approaches to tackling ethnic inequalities must be prioritised.”
When Ministers placed new restrictions on Leicester a few weeks ago, it came after weeks of warning from local authorities of major gaps in the Government’s Covid-19 policy. One of the gaps was the pillar 2 testing system. The data from these tests was received very late by Leicester authorities. Local authorities and communities need much clearer information and answers, because by not knowing they cannot prepare.
Leicester has a high number of diverse communities, so why was more not done in anticipation of a second outbreak of Covid-19? Worryingly, that situation could be replicated in other areas and is a huge cause for concern. If long-term sustainable preventive measures are not put in place to avoid major problems in the future, further outbreaks are likely to occur in other parts of the country. So what long-term action do the Government propose to counteract these threats, ensuring that people are better paid, have improved working conditions and better access to housing and healthcare? What short-term measures are being used to communicate public health messages such as social distancing, in Leicester and other communities such as Oldham, to ensure that people are aware of the Covid regulations imposed? Prevention is better than cure, and never before has that been so important to deal with this pandemic.
The Deputy Speaker (Lord Faulkner of Worcester) (Lab)
I now call Baroness Gardner of Parkes. Is she there? No? Then I call Lord Bhatia.
Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020
Baroness Benjamin Excerpts(4 years, 5 months ago)
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Baroness Benjamin (LD) [V]
My Lords, it is widely acknowledged that black, Asian and ethnically diverse people have been hardest hit by the Covid-19 pandemic. They have experienced higher levels of depression and anxiety throughout the crisis. They have had greater mortality and infection rates than other groups, as well as fears about catching Covid-19. They are also more worried about unemployment and access to food, and they suffer more financial stress than other groups. We know that Bangladeshis are twice as likely to be affected. Many live in the most deprived areas, with high levels of poverty and cramped conditions with no gardens, and they face immense difficulties in home-schooling their children, which has a detrimental impact on those children’s futures. Recommendation 7 in the Beyond the Data report states:
“Ensure that COVID-19 recovery strategies actively reduce inequalities caused by the wider determinants of health to create long term sustainable change.”
What are the Government’s plans to get these regulations’ messages out to this group of vulnerable people to protect and reassure them?
Covid-19: BAME NHS Staff
Baroness Benjamin Excerpts(4 years, 7 months ago)
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Lord Bethell
I reassure the noble Baroness that we have a large amount of data—although we could do with more and better. The collection of death certification data, for instance, has already improved dramatically and we are working hard to ensure that the evidence is there to inform our policy-making.
Baroness Benjamin (LD)
My Lords, the coronavirus crisis has exposed the fact that the majority of NHS BAME healthcare staff—including Filipino workers, who are often forgotten—hold junior positions and are therefore more likely to find themselves on the front line in the fight against Covid-19; many have lost their lives doing so. After this crisis, what will the Government do to encourage the NHS to develop better career paths and promotion initiatives for its BAME staff?
Lord Bethell
The noble Baroness is entirely right. We owe a huge debt of gratitude to those BAME staff, whether black Afro-Caribbean or Filipino, who have put their lives at risk on the front line. It is a wake-up call; we should always be thinking about how we can accelerate opportunities for all members of staff. Those who start at the lower ranks should be given whatever opportunities are available to progress to a higher rank. The noble Baroness is entirely right that this puts a spotlight on our commitment to those groups. I completely endorse her point.
Queen’s Speech
Baroness Benjamin Excerpts(4 years, 11 months ago)
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Baroness Benjamin (LD)
My Lords, almost 10 years ago in this House my maiden speech highlighted my lifelong mission to ensure that children’s well-being is at the heart of society’s thinking. So, as we start a new decade under a new Government, it is appropriate to ask: what are we, in government and in Parliament, doing to champion children’s well-being in everything we do—in every policy and initiative and every new piece of legislation? If we make children our number one priority, it will save the Treasury billions of pounds in the future because childhood lasts a lifetime. So let us put children first—it is a no-brainer.
Over the last decade we have seen childhood change rapidly, thanks to the rise of the internet, so in protecting children’s well-being we must look at the new risks they are exposed to and how we can protect them. Just like the legal requirement to wear a seatbelt in a car and the ban on buying alcohol under the age of 18, the internet should now come with appropriate safeguards.
A recent report from Barnardo’s—I declare an interest as a vice-president—found that cyberbullying had impacted on the mental health of 79% of children aged 11 to 15, and 78% had accessed unsuitable or harmful content through social media. This can have a devastating effect on children’s physical, mental and emotional health and well-being. I welcome the Government’s commitment to making the internet safer for children, but we need to see urgency.
Will the Government set out a clear timetable for the progression of the online harms White Paper, and guarantee that this will achieve effective regulation? There is overwhelming research to show that stumbling across pornography online can have a devastating impact on young children’s long-term mental health. The BBFC’s research shows that many children, some as young as seven, have stumbled across “aggressive” and “violent” pornography, with graphic content such as gang rape just one click away from every child online. Will the Minister explain why the Government have delayed bringing into force legislation that could have put in place an age gate to prevent children accessing this material? The BBFC says that it is good to go; it could still implement the Digital Economy Act. Section 3 is still on the statute book. Why has this Act not been brought into force to protect our young children’s mental health and young, innocent minds?
The Government originally said that they planned to bring in this legislation because they calculated that 1.4 million UK children see pornography every month. Why do the Government need to wait until we have a fully “coherent” approach to addressing all harmful content online, which could take years?
The Government committed in the Queen’s Speech to an online harms Bill and the concept of a duty of care, but that is just a concept. We already have practical legislation on the statute books, and the BBFC is ready to implement it immediately. The age-verification industry and the adult industry are also prepared to introduce age verification to prevent access for under-18s if the law is brought into force now. We can start tackling commercial pornographic services straightaway, then address the issue of social media in the longer term. I urge the Government—I plead with them—to take action now, to show common sense and compassion and implement the Digital Economy Act for the sake of the next generation.
Every child deserves to be protected from harm, whether on our streets or online. It is our responsibility to put in place protective factors. The Government have set out their agenda for the future of our children, which should be applauded. But what is missing? What is essential to pull everything together and give a clear indication that this Government prioritise children? The answer is a Cabinet-level Minister, with specific responsibilities for children and for the work carried out across multiple government departments to promote children’s well-being. This is very different from a Secretary of State for Education or Health. It is an appointment that could transform the way government oversees children’s issues. Let us do it. For the next decade, let us prioritise children, their well-being, and their futures. Let us make the UK the best place in the world for children to grow up.
Queen’s Speech
Baroness Benjamin Excerpts(5 years, 2 months ago)
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Baroness Benjamin (LD)
My Lords, children should not be able to see pornography. Sadly, there was no mention of this in the Queen’s Speech, but the Government need to act now to ensure this. It should be added to the same category as the introduction of seat belts and banning smoking, as mentioned by the noble Lord, Lord Young of Cookham.
I have been campaigning for over eight years to try to prevent childhoods being damaged by pornographic content. Eventually, in 2017, the Digital Economy Act was successfully passed to impose age verification controls to prevent children stumbling across and accessing pornography online. Last month, on 5 September, I wrote to the Secretary of State, Nicky Morgan, asking her to confirm the Government’s commitment to bringing in this legislation as early as possible. I never received a reply. But, shockingly, last week in her Written Statement she said that there would be no commencement order for this regime because of the “objective of coherence”, and that it would all be dealt with under online harms at some unknown date. That day was used to bury bad news, and I wept thinking of the consequences.
I have had concerns about the many delays in bringing in this legislation, such as the Government not notifying the European Commission of the BBFC’s guidance on age verification arrangements, which was an avoidable and unforgivable blunder. Interestingly, I was also told in confidence back in January that there were those in influential positions who did not want this legislation to happen. But I had faith in the Government that they would not let our children down.
By the Government’s own statistics, every month that passes, 1.4 million children access pornography. Therefore, every month this regime is delayed, millions more children will stumble across pornography. We are talking about violent sexual content, gang rape, real and close-up images of sexual acts, all just one click away because there are no age restrictions. The results of this cause children as young as four to be excluded from nursery school because of their sexual actions towards other children. Recently, a father contacted me to tell me how traumatised his eight year-old daughter, who loves horse-riding, was, after she typed in the word “stallion”.
Pornographic content is traumatic for children to watch and can directly impact on their adult relationships, including their understanding of consent and their long-term mental health. How can this Government justify any delay in preventing children facing this trauma on the grounds of “coherence”? Any new legislation is years away. But even if it was months, why wait? I visit Rye Hill prison in Rugby, which houses over 680 sex offenders. Many tell me that they wish they had never seen pornography as children. It has destroyed their lives.
All the child protection charities believed that this legislation is vitally important. Yet the Minister Matt Warman in the other place suggested that the NSPCC supported this decision. I cannot understand this claim, and I believe it should be withdrawn. I have here a letter sent on 2 October by John Carr, secretary to the Children’s Charities’ Coalition on Internet Safety, which includes Barnardo’s, the Children’s Society and the NSPCC, asking the Secretary of State to implement Part 3 of the Digital Economy Act “without further delay”. Let us not forget that the Digital Economy Act has provision for a review 12 to 18 months after entry into force. That is the time to consider “coherence”: to look at whether social media could and should be included once the regime has had the chance to be operational and to protect our children from this appalling content.
The world is watching us, and this decision potentially has ramifications far wider than the UK. We had the chance to change things for the next generation of children so that their first concept of sex is not at the age of seven, stumbling across images of violent sex acts on their computers. The argument that children are clever enough to get round the age gate is ludicrous. We are not talking about 15 year-old computer wizards but about six and seven year-olds inadvertently accessing porn. In addition, the idea that, as an alternative to age verification, we should teach children about porn at such a tender age is completely outrageous. The notion that the privacy of adult visitors to porn sites will be compromised is misleading and untrue. Personal data will not be shared with porn sites.
I therefore plead with the Minister to speak to the Secretary of State and ask her, as a moral duty, to reconsider her decision so we can see this ground-breaking child protection standard in place in the UK by the end of the year. Childhood lasts a lifetime, so let us ensure that all children’s innocence is protected for as long as possible.
NHS Dentistry Services
Baroness Benjamin Excerpts(5 years, 5 months ago)
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Baroness Blackwood of North Oxford
As I said in my previous answer, children’s oral health is better than it has ever been. This is not to say that there is any complacency or acceptance of where we are. We recognise that while access has significantly improved, there are still areas where NHS England needs to do more to meet local need. NHS England is responsible for helping patients who cannot find a local dentist. Those in that situation should contact NHS England’s customer contact centre for assistance. Things that are being done to improve this include the introduction of new nationally flexible commissioning, which can help national commissioners commission a wider range of services from dental practices, and the testing of a new, reformed dental contract, which we think will make the profession more attractive for new dentists.
Baroness Benjamin (LD)
My Lords, patients’ dental fees in England have been increasing at an unprecedented rate. These charges are discouraging patients from seeking treatment; they are made to think twice before treatment. Delayed treatment means that they end up seeking free help for dental pain from their GPs and the local A&E, piling huge pressures on other parts of the NHS. Will the Government take urgent action and start proper investment in NHS dentistry to end these extortionate dental fee increases?
Baroness Blackwood of North Oxford
The noble Baroness raises an important point. Patient charges are an important contribution to the overall costs of the NHS, and they were driven by some really difficult financial circumstances in the NHS, but she is right that it is critical that no one be deterred from seeking care by the cost. As part of this year’s uplist, the Government and the department have committed to looking further at evidence as to whether patients are being adversely impacted so that this can be taken into account in next year’s—and any future—decisions.
Children: Oral Health
Baroness Benjamin Excerpts(5 years, 9 months ago)
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Baroness Benjamin
To ask Her Majesty’s Government what plans they have to tackle the oral health problems of hard to reach children, especially those in deprived areas of the country, through the Starting Well Core scheme.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)
My Lords, Starting Well Core allows commissioners, where they identify local need, to establish schemes similar to the National Starting Well scheme, which runs in 13 high-need areas. Starting Well Core has a particular focus on children up to two years old; practices engage with a wide range of partners to promote the importance of early preventive care. Areas that have so far introduced the approach include London, the West Midlands, Shropshire and Staffordshire, Cheshire and Merseyside, and Greater Manchester.
Baroness Benjamin (LD)
My Lords, too many five to 10 year-olds in deprived areas undergo general anaesthetic in hospitals to have their decayed teeth removed. Starting Well Core is therefore a welcome first step towards ensuring that children are seen by a dentist, preventing them from developing decay at a young age. Unfortunately, this scheme contains no educational element, only posters and leaflets available at dental practices, seen by those already attending. There are no measures to get the hard-to-reach children through the dentist’s doors. How do the Government plan to encourage all carers to take their children to the dentist, even before their first birthday? Will they please introduce supervised tooth brushing in nurseries and primary schools to combat this epidemic?
Baroness Blackwood of North Oxford
The noble Baroness asks some very important questions. I am pleased to say that 77% of five year-olds now have no visible decay, compared to 69% in 2008, which is a welcome reduction. We accept, however, that while these figures represent a significant improvement, there are unacceptable inequalities in children’s oral health. She is right that the Starting Well Core scheme is operating in areas of high need and the crucial issue is how children are sign-posted to these practices. Practices are using a mix of advertising, linking with other health professionals and actively engaging with local communities in schools and shopping centres and at local events. I hope that she is reassured by this answer.