Public Health

Caroline Nokes Excerpts

Wednesday 6th January 2021 Commons Chamber

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

I welcome the opportunity to contribute. We have heard a great deal of consensus across the House. We know that there is a terrible toll on people—on our constituents—and every Member who votes in favour of these regulations does so with a heavy heart, balancing the impacts carefully and with the recognition that the measures must be for a minimum period of time, reviewed frequently and carefully monitored.

We have heard from many speakers about the impact on children. My right hon. Friend the Member for Harlow (Robert Halfon) highlighted the terrible impact that the loss of social interaction during lockdown is having on young people and their mental health. I was pleased to hear from my right hon. Friend the Prime Minister today that getting schools back is an absolute priority. It must be. Teachers, parents and schoolchildren themselves have reached out to me, asking that I highlight their worries, as have those in the early years sector, who feel that they have not been taken with the Government and have been neglected in the announcements over the past few days.

Back on 12 November, I called for teachers to be prioritised for vaccination. I recognise that there are competing calls from all key workers, but I make a particular case for those working in special schools, where there is a very great need and where it is hardest for children to understand the importance of social distancing.

Equally, there must be vaccination for domiciliary care workers who are employed by charities or are working independently. This afternoon, Age Concern Hampshire has highlighted to me its worry that those workers will go unvaccinated.

The death toll among those with learning difficulties has been horrific. The hon. Member for Lewisham, Deptford (Vicky Foxcroft) highlighted the work that the Women and Equalities Committee did on that issue in our report on the impact of covid on those with disabilities. The commitment to rolling out information in a manner that can be easily understood, whether it is Easy Read, large print, Braille or British Sign Language, has been inadequate. As a result, the people who need the most help have had an information gap. That is not good enough. Gov.uk still does not have a BSL translation, when there are apps that could do it quickly, easily and relatively cheaply.

It is not just those with learning difficulties who have not been given enough information. Members of Parliament have this afternoon asked for additional details about the agreed schedule of vaccine delivery and the approach to the equation between numbers vaccinated and the consequential lifting of restrictions. People have shown a willingness to comply with massive restrictions, but they want to understand the exit strategy. Early years providers want to know that they are as valued as primary schools. Golfers want a clear explanation of why a walk with their partner with no clubs is fine, but one with their clubs is not.

People are not fools. The science is difficult and graphs can be bewildering, but Ministers need to give us transparency and honesty—that is the key.

[Mr Deputy Speaker (Mr Nigel Evans)]

I call Karin Smyth by video link. [Interruption.] You are on mute, Karin.

Covid-19 Update

Caroline Nokes Excerpts

Monday 14th December 2020 Commons Chamber

[Matt Hancock]

The right hon. Gentleman has made a typically wise intervention ahead of the decision making on Wednesday as to the wider tiering decisions for the rest of the country.

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

The Minister for Care has today indicated that there are 12,500 retired GPs and nurses seeking to help with the roll-out of the vaccination programme. My constituent David is one of them. He is 67 years old, fit and well and keen to do his bit, but the system that he has to log on to in order to apply keeps timing him out. I know that my right hon. Friend is an absolute whizz with apps. Please can he make sure that this one works for people like David?

[Matt Hancock]

I am thrilled at the number of former clinicians who have come back to support this. In fact, I met some of them when I went to Milton Keynes to see the vaccine being injected. I will look into the little whizzing box that is preventing my right hon. Friend’s constituent from applying.

Obesity: Covid-19

Caroline Nokes Excerpts

Tuesday 10th November 2020 Westminster Hall

[Caroline Nokes (Romsey and Southampton North) (Con)]

It is a pleasure to serve under your chairmanship, Mr Davies, and I add my congratulations to the hon. Member for Strangford (Jim Shannon).

We have had an important and interesting debate. I would like to follow what my hon. Friend the Member for Stoke-on-Trent Central (Jo Gideon) said by stating that we need to look at the issue holistically. This is not just a health problem; it is also an education problem and a Department for Work and Pensions problem.

I was particularly struck by the comments of the hon. Member for Strangford: we cannot use fat shaming and stigma to force people to lose weight. Over the summer, we learned from the Prime Minister’s brave words about his own battle with covid, his own unwellness and how that had been exacerbated by his weight. It might be easy from Downing Street to recruit the services of a personal trainer, but that is not open to everybody; we have to find routes to enable individuals to empower themselves to take control of their own wellbeing—whether that be through exercise and diet, or through receiving the emotional and mental support they need.

We all know that weight is not just a physical issue—there is an inextricable link between food and the way people feel about themselves. It is critically important that the support services are there to dig into that and to find the best routes, because we all know it will be an individual journey for each and every person.

I have to admit that the Prime Minister inspired me throughout lockdown; I made sure my “covid stone” was in the right direction, but for many that was not the case. It has been demonstrated that people have put on weight, and as we go into another lockdown there is real anxiety about the impact on people’s wellbeing.

I keep banging on about wellbeing—people think that I have gone all airy-fairy and am about to break out the crystals and the twinkly music—but the reality is that mental, physical and emotional wellbeing are all linked. Just yesterday, I was at Focus Fitness in Southampton talking to the personal trainers, who are all operating over Zoom in a covid-secure way. They made the point that there has to be a wellbeing approach that reaches across all generations and socioeconomic groups, and that we must find routes to help the poorest in our society embrace these initiatives as well.

Many people have mentioned cooking. During half-term, I was at the community pantry based at Romsey Community School, where we were talking about the Connect4Summer courses that were run over the summer and the half-term courses. They bring families together and give them ingredients, recipes and those basic cooking skills, which are so important. What really struck me was that the pantry gives away fruit and veg—there is a free bag of fruit and veg that people can take. I asked, “Why are people not taking it unless it is free?” I was told that it was because people did not know how to cook with it.

The point is absolutely crucial. I was blessed, in that my mother taught me how to cook reasonably well, but I know that I am lazy and do not have the time to cook properly from scratch. Lockdown enabled me to hone some of my cooking skills, but we have to make sure that those who are time-pressured—who in some cases are working two or three jobs—also have the ability to pick up that bag of vegetables and know they can cook something nutritious, quick and, mostly importantly, tasty.

I turn to the comments from the hon. Member for Bath (Wera Hobhouse). I have a lot of sympathy with what she said about calorie counting. Some of the major chains such as Costa Coffee and McDonald’s have been advertising calorific values for years, yet the trajectory has been in the wrong direction: we are still getting fatter. In many instances, the battle has already been lost the minute a person walks through the door. Regardless of what the indication of calories on a menu is, people are in the wrong place to be making healthy choices.

It is important that we make labelling really straightforward. There is less than two seconds between someone picking up something in a supermarket and putting it in their trolley. That is no time to be inspecting the calorific fat and salt levels, so traffic lights or whatever mechanism makes things quick and easy have to be the way forward. People also have to have the skills to cook the healthier choices.

We have seen a rush over the last few days: the national media have been talking about how to lose a stone before Christmas and how to drop a dress size. Yet again, this is appearance-based, with little understanding that the issue is about people’s long-term wellbeing. I recognise that in some instances diets do not work and people will engage in yo-yo dieting, but in other instances they do. We have to find a way to empower people to make the lifestyle choices to bring about sustainable long-term differences to their way of life.

I think I have covered everything that I wanted to in a very limited time, but I look forward to the Minister’s coming up with some practical solutions as to how we can make a real difference to the people in our constituencies who need the most help, the most encouragement and the most support.

Covid-19 Update

Caroline Nokes Excerpts

Tuesday 10th November 2020 Commons Chamber

[Matt Hancock]

Yes, it will be a huge task. The NHS is leading on it, and of course the NHS reaches all parts of this country. As for the flow of the future doses that we have secured, the only one that is in immediate prospect is AstraZeneca. It would be wonderful to hear the same sort of results soon for AstraZeneca that we heard from Pfizer yesterday. After that, it is next summer before the next vaccine candidate comes on stream, so the focus of the roll-out plan at the moment is on delivering the Pfizer and AstraZeneca projects if they pass the safety test.

[Caroline Nokes (Romsey and Southampton North) (Con)]

My right hon. Friend is absolutely right to prioritise those working in the health sector for the roll-out of the vaccine, but will he also consider the important role that those working in the teaching profession and in childcare play? Their being in work enables children to be in school or in care and therefore allows their parents to be economically active.

[Matt Hancock]

Of course I understand the importance of that, hence we protected education and kept schools open as much as possible through this second peak. I pay tribute to schools, which have, in, very large part, stayed open. Some children have had to go home, and we are looking to see how we can use testing to reduce the need for children in bubbles to have to isolate if an index case has tested positive in a school.

Covid-19

Caroline Nokes Excerpts

Monday 28th September 2020 Commons Chamber

[Caroline Nokes (Romsey and Southampton North) (Con)]

I would like to start by paying tribute to all the fantastic public sector workers in the health service, our local authorities and the police, who have worked so hard during the pandemic so far, and of course have many months yet to face.

Over the past six months, we have learned that this pandemic impacts people’s physical, mental and financial wellbeing, and I wish to turn to each of those individually. I am a little disappointed that my the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), has left her place on the Front Bench, because I have been in correspondence with her over the past few months about the impact it has had on women seeking treatment for other conditions—specifically breast cancer patients who are perhaps waiting for reconstructive surgery. She has received a long list of written questions from me on that subject, highlighting that the delays are in some cases well over a year for women who have had drastic surgery for cancer and are waiting to have their reconstruction. One constituent who contacted me could not even get an appointment for a breast prosthesis, and there was no indication of when that date may come. It is imperative that our health service is protected from the worst ravages of this pandemic so that it can bring back in all those patients who are waiting for treatment.

Numerous constituents have contacted me about the issue of mental wellbeing. We are very blessed in Romsey to have an active community of choirs and orchestras. Everyone who contacted me from one of them has made the point that that activity is about their mental wellbeing. It is an opportunity to get out and do something that they find rewarding and that gives them social contact and a sense of community. I urge Ministers to think carefully about how restrictions on that sort of activity can lead, in the most extreme cases, to the tragic suicides that the hon. Member for North Antrim (Ian Paisley) mentioned. We are very conscious of the fact that the pandemic has had a terrible impact on people’s emotional and mental wellbeing, including all those 18-year-olds who have just disappeared off to university and found themselves in very difficult circumstances.

I also want to talk about the financial circumstances of companies up and down the country. I echo the comments of my right hon. Friend the Member for Epsom and Ewell (Chris Grayling) about the events industry. Just last week, I visited Beat the Street and Phoenix Bussing Services—the country’s largest supplier of tour buses. I was given a tour of Lady Gaga’s schedule tour bus. That company made the point that it has 66 buses laid up in its yard, each one of which represents an investment of half a million pounds. It has had a £24 million turnover each and every year apart from this one, and there is no end in sight. It is deeply concerned about what that will mean for its viability.

Some industries have worked brilliantly to address the situation they find themselves in and, indeed, to help. Polystar Plastics in Southampton, which is run by a constituent of mine, is now producing millions of PPE aprons—something it had never done before. Of course, it is looking for contracts and at how the Government’s tendering system will make sure there are opportunities for UK suppliers so that we do not maintain our dependence on those from overseas.

My right hon. Friend the Member for Basingstoke (Mrs Miller) mentioned people with disabilities. We waited far too long for the equalities impact assessment of the Coronavirus Act 2020. When we are asked to renew the Act in just a few days’ time, there will be a binary choice. On the Care Act easements, which only a handful of local authorities have used, we will be asked simply yes or no, not whether we can put a separate time limit on them or whether they are needed at all. On the easements to the Mental Health Act 1983, which have not been used, we will again be asked whether we accept the whole package and renew it. I argue—as the Women and Equalities Committee has—that there is no case to renew that carte blanche with another six-month extension. We need to drill down into which part of the Coronavirus Act are need and which parts could be repealed. I echo the comments that the hon. Member for Rhondda (Chris Bryant) made about that point.

I finish with a plea for mothers—expectant women who cannot have their partners attend a scan or antenatal appointment with them. I accept that that is a local decision made by individual trust, but we need to find ways to support mothers who face horrendous decisions and want their partner by their side or, worse, go into a scan expecting good news and receiving bad. If the message has not gone out loudly enough from the Department of Health and Social Care that trusts must help them, it should now.

Coronavirus

Caroline Nokes Excerpts

Tuesday 15th September 2020 Commons Chamber

[Matt Hancock]

The hon. Gentleman is right: we spoke over the weekend and worked hard to get those mobile testing units into the Rhondda, where there is a significant outbreak. It showed the effectiveness of people working together to deliver solutions. I do absolutely acknowledge the challenge, but I also urge everybody to ensure the message gets through to people in the Rhondda and across the country that tests are available. I use these figures to demonstrate that hundreds of people in every constituency are getting tests. I want people across the country to know that we understand there are challenges and are working incredibly hard to fix them but that tests are available.

[Caroline Nokes (Romsey and Southampton North) (Con)]

My disabled constituent Ian Kenny has been trying to get a home test since 8 September. He cannot drive so he cannot get to a test centre. He has symptoms but has been told there are no home tests available. Until he can prove he does not have covid, he cannot access the hydrotherapy he needs or go back to work. What reassurance can my right hon. Friend give Dr Kenny that he will be able to get a test? He speaks today of prioritisation and difficult choices, but disabled people living in their own homes must be a priority and must not be forgotten.

[Matt Hancock]

Absolutely, and I will of course be happy to look into the case in detail. Such cases, where there is a clinical need, should be at the top of the prioritisation. We have set out the prioritisation and will continue to update it to make sure it matches the latest science. My right hon. Friend has made her point and I will make sure the matter is looked into.

Coronavirus Response

Caroline Nokes Excerpts

Monday 20th July 2020 Commons Chamber

[Matt Hancock]

There is undoubtedly a challenge in respect of people who have not come forward during lockdown and are presenting now with severe mental health problems. I am working on that with both the NHS and the Royal College of Psychiatrists. There is good news: for non-pharmaceutical treatments, there is evidence that they are better done by telemedicine. Psychiatry can be better done by telemedicine, which helps, but obviously that does not help at the most serious end of cases of mental ill health, and that is something we are working very hard on.

[Caroline Nokes (Romsey and Southampton North) (Con)]

I am sure it will come as no surprise to my right hon. Friend that some of the solutions come from Southampton. I commend Synairgen’s work on the treatment it is producing. I wish to ask my right hon. Friend specifically about vaccinations. It is crucial not just that we put the anti-vax argument to bed but that he provides reassurance to those who might be anxious about a vaccination for covid. Can he provide any information on what plans he has for a reassurance programme?

[Matt Hancock]

Yes—we are planning to provide exactly the reassurance that my right hon. Friend seeks, in two ways. First, the essential point is that we will not approve a vaccine until we are clinically confident that it is safe. We would never approve a vaccine unless we were clinically confident that it was safe.

Secondly, we will also have a communications campaign. To answer a point that was raised earlier but to which I did not respond at the time, we have already published a plan for the order in which people will have access to the vaccine, starting with the most vulnerable. In essence, it consists of going down by age through those with comorbidities and health and social careworkers. We have to make sure that we reassure people and that we assure them that we are doing the roll-out in a clinically valid way.

Finally, on Southampton, my right hon. Friend is an assiduous representative of the environs of Southampton. When Southampton is doing well, Romsey is undoubtedly part of Southampton. In this case, Southampton is doing very well; let us hope that it continues.

Independent Medicines and Medical Devices Safety Review

Caroline Nokes Excerpts

Thursday 9th July 2020 Commons Chamber

[Ms Dorries]

The hon. Gentleman makes an interesting point about cancer trials. He may have heard the recent announcement that one of the Nightingale hospitals is to be used for processing cancer diagnoses. I believe that cancer treatments have started again, but I will come back to him with further information because this is not really in the scope of the report.

[Caroline Nokes (Romsey and Southampton North) (Con)]

We have heard a great deal about my hon. Friend’s agenda for women, and I hope that the Women and Equalities Committee will have a chance to scrutinise it at some point.

I remember first meeting Emma Murphy and Janet Williams to talk about sodium valproate back in 2014. The Minister is absolutely right to point out what a valuable treatment it is, but it has massive dangers for pregnant women. She spoke of the pregnancy prevention programme, but there are drugs out there, such as Roaccutane, for which people cannot get the next month’s prescription unless they take a pregnancy test. Will she consider going further than the advice in the information that is given out to doctors and women and ensure that it cannot be given to pregnant women?

[Ms Dorries]

That is an interesting proposal. My hon. Friend has spoken about Roaccutane several times in the House. She makes an interesting comparison, and we will go away and look at it.

Coronavirus

Caroline Nokes Excerpts

Tuesday 7th July 2020 Commons Chamber

[Matt Hancock]

The use of face coverings that are not formal face masks is valuable, especially in some circumstances, and therefore it is mandated on public transport and has long been recommended in some shops. The use of masks, especially the high-end masks, should be reserved for those who need them in clinical settings. However, I am glad to say that the supply of PPE is now much, much more secure than it was a couple of months ago, which means that face masks are more readily and widely available and are increasingly used in non-clinical settings. The low-end surgical masks are the ones that would typically be used in a non-clinical setting. Nevertheless, face coverings are an incredibly important part of our armoury.

[Caroline Nokes (Romsey and Southampton North) (Con)]

People working in aesthetics—the professionals who tattoo on eyebrows for alopecia sufferers or tattoo on the nipples of cancer patients who have had reconstructive surgery—have been horrified to discover that they are categorised alongside strip clubs. Will my right hon. Friend please look at this issue urgently to understand how the NHS is referring patients to these people, who are still not allowed to open?

[Matt Hancock]

I will certainly look into the last point. However, that categorisation is not quite right. The beauty industry is an important industry in and of its own right. While we do still have restrictions in certain areas and categories, that does not mean that they should all be lumped in together. The beauty industry is an incredibly important industry and we will get it open as soon as it is safe to do so.

Covid-19: BAME Communities

Caroline Nokes Excerpts

Thursday 18th June 2020 Commons Chamber

[Caroline Nokes (Romsey and Southampton North) (Con)]

I congratulate the hon. Member for Brent Central (Dawn Butler) on having secured this important and timely debate. She picked up on several themes that I will probably echo, but she also spoke about voices, focusing on Marcus Rashford and Raheem Sterling—people who have used their voices effectively. In my speech, I will concentrate on the voices of BAME workers in our health service.

At the very start of the pandemic, we had a debate in this Chamber about the emergency covid legislation. I vividly remember receiving a briefing from the Equalities and Human Rights Commission that spoke about how the pandemic might affect different groups of people differently. It is interesting to read and review that briefing with 2020 hindsight. When it spoke of BAME communities, it mentioned their employment opportunities, including the likelihood that young BAME people in particular would be working in unsecure employment in the gig economy and on zero-hours contracts. What it did not speak about was their health.

I think that the death toll has shocked us all. But it is not only the death toll, is it? As the hon. Member for Brent Central highlighted, BAME people are more likely to be hospitalised. If hospitalised, they are more likely to end up in intensive care units. And if in intensive care units, they will be there for longer. As we have learnt over the course of the pandemic, all those things have a significant impact on people’s wellbeing going forward because the longer that someone is in ICU, the longer it will take them to recover and to return to their home, their family and their employment.

At the start of the pandemic, the Women and Equalities Committee launched an inquiry into the unequal impact of covid. That has now split into three separate inquiries looking specifically at: the impact on disabled people and their access to services; the gendered impact of covid; and—the inquiry that we have launched within the last couple of weeks and on which we have already taken significant evidence—the impact on our BAME community. As I said to Committee members last week before we had the first evidence session, “If there is one thing you can rely on from the Women and Equalities Committee, it is that our inquiry will come up with recommendations for the Government to act.”

Yesterday we heard from Dr Chaand Nagpaul and Professor Kamlesh Khunti. I do not wish overly to paraphrase their evidence, but I only have six minutes so I really will have to. They both reiterated what can be found in the NHS England and NHS Improvement briefing on the disproportionate impact of covid—that BAME staff are over-represented in the lower grades of the NHS hierarchy, that there is not enough diversity in management structures, and that, as a direct result, BAME staff are worried to speak up when they do not have the right PPE. Those staff are not having their voices heard—or, worse, they are too scared to use their voices. That is Britain in 2020: BAME staff in the NHS are scared to speak up. We have to make sure immediately that channels are open for people to be able to do so, whether they work in the NHS or in other frontline roles such as bus drivers, retail workers and nursery assistants—the people without whom, to be blunt, our country would have ground to a halt over the course of the last 12 weeks.

The Committee heard from Professor Sir Michael Marmot, who did a review back in 2010. He refreshed his review in February this year—hard up against the start of the crisis.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The right hon. Lady makes a valid point about the NHS, in which there is not a great record on whistleblowing but at least many of those workers would be in regular jobs. Does she agree that there is a disproportionate number of black, Asian and minority ethnic people in insecure employment, for whom raising an issue could mean losing their jobs? They should not have to make that choice.

[Caroline Nokes]

The hon. Lady is absolutely right. That is why I specifically raised those who are working in transport and the gig economy, who do not have those routes. In the NHS they should at least be there; in some sectors, they do not exist in the first place.

We heard from the hon. Member for Brent Central some uncomfortable truths—issues that may be difficult for us to hear—but we cannot just listen and review; we must act. When I rather proudly told one of my constituents, as Chair of the Women and Equalities Committee, that we had launched an inquiry, her instant response was not great: it was, “Not another inquiry. Not another review. Please, can you come up with some action?” She was right.

The race disparity unit in the Cabinet Office was set up specifically to obtain data, but it needs to do more than just get data. It needs to be able to look at datasets and understand them—of course it does; we have to know where the structural inequalities lie—but it is of no use to accurately record a growing deficit, or perhaps a shrinking deficit. We have to have actions. We need policy levers to effect change, so that the young Caribbean boy in the constituency of the hon. Member for Brent Central has the same educational opportunities as the white girl in mine; so that the job opportunities and chances of progression in work—and that is absolutely key: it is about not just getting a job but getting a good job getting, a better job—are available whatever someone’s ethnicity; and so that someone’s ability to speak out when they do not have the right PPE is the same regardless of their gender, ethnicity, religion, age, sexuality or disability.

I cannot stand here and predict the outcome of my Committee’s inquiry—it would be wrong to do so—but I can predict that we will expect delivery from Ministers, not warm words, not more reviews and not more commitments to get better data. We want action and improvement.

Covid-19 is of course a novel virus and we have been forced to learn about it at pace, but it has highlighted health inequalities that are real and current: if someone lives in overcrowded, poor-quality housing, they are more likely to be negatively impacted; if someone is in frontline, public-facing work, they are more likely to be negatively impacted; if someone’s English is poor or they have learning difficulties, they will not be able to receive the important public health messages that they need; and if someone lives in multigenerational families, they are more likely to be negatively impacted, as are those whose work is insecure. Of course, a person may well have no choice but to carry on working at the height of a pandemic to feed their family. No one can be a careworker, a retail worker or a transport worker from the safety of their own home.

We have not had a public health crisis like this since the Spanish flu 100 years ago, and I do not know whether our generation will see another, but we cannot lurch to another crisis without having worked out how to risk-assess our frontline workers; without having established culturally intelligent ways to disseminate information; and without having empowered people in the workplace to voice their concerns and enabled the routes to redress.

I know that the Minister and her colleagues across Government will work hard on this issue. We heard last week from my hon. Friend the Minister for Equalities about the importance of the work that the race disparity unit is doing, but I urge the Minister present to come forward with what is actually going to happen, because that is what our BAME communities up and down the country wish to hear.

--- Later in debate ---

[Ms Nusrat Ghani (Wealden) (Con)]

It is a pleasure to follow the passionate speech of the hon. Member for Slough (Mr Dhesi). I first want to thank all NHS workers, who have done a tremendous job during this covid period. My speech will not be so friendly, so I want to start by thanking the Minister, who has been tremendous in supporting me in Wealden, where we have a particularly large care home system—I have a lot of older constituents. Regardless of the day of the week and the time of day, she has been incredibly responsive. Unfortunately, the rest of my speech will not be so flattering, so I will just crack on.

Like so many people in this country, I have lost loved ones to covid. I also have loved ones working on the frontline dealing with covid. We had the experience and network to highlight quite early on that we saw a pattern forming, but we were met with, “We don’t have the data”—it is 2020, and we do not have the data. I understand the argument that this is an unusual situation, and that we did not have the statistics to deal with this particular pandemic, but we do have data about how viruses spread. We also understand the long-standing institutional biases of NHS England and Public Health England, which have failed in their leadership, are unaccountable, and hide behind the catch-all, “We just don’t have the data.” It is shameful.

[Caroline Nokes]

Does my hon. Friend agree that we did not actually need data, given that we could open up the pages of any newspaper and see the photographs?

[Ms Ghani]

I agree with my right hon. Friend. That goes back to my earlier point: Public Health England needs far more functioning leadership.

Public Health England’s report says:

“It is clear from discussions with stakeholders the pandemic exposed and exacerbated longstanding inequalities affecting BAME communities in the UK.”

That is nothing new. Moreover, it confirms to me the wilful blindness of Public Health England and NHS England in addressing racial inequalities and their inability to put in place measures to address workplace risk and make sure that so many BAME staff were not exposed. In the time it took for Public Health England to review the disproportionate number of BAME deaths, another 17 doctors passed away. Sixteen of those were BAME.

What else do we know? We know that there is a significantly higher proportion of BAME healthcare workers in England across our health system; without BAME workers, there would not be a health system. We know that BAME workers are in lower-paid jobs and that they cannot work remotely. We know that BAME workers tend to work in high-risk areas, and that the families they go home to are high-risk individuals. It was a high-risk strategy, yet Public Health England and NHS England continued to expose high-risk staff to high-risk shifts.

We know that 94% of doctors who died were of a BAME background. In the biggest survey of its kind, ITV News asked the UK’s BAME healthcare community why they thought more of their BAME colleagues were dying than their white counterparts, and 50% felt that discriminatory behaviour played a role in the high death toll. One respondent described the treatment as “very unfair”, adding that “all BAME nurses” have been

“allocated to red wards and my white colleagues”

are “constantly in green wards.” Perhaps more worryingly, ITV found that 53% of BAME respondents said that they felt they could not comfortably raise concerns about deployment, so they risked their health as against their employment.

To me, that suggests that the problem is related not to covid but to long-standing institutional inequalities. I want to hear from the Minister a resolute commitment to hold Public Health England and NHS England to account, and to ensure that the recommendations are acted on, reviewed and assessed by the real workers on the frontline who are most at risk—by that I mean BAME workers—and that all the data, good and bad, is shared in good time. I hope that the Minister understands that I have very little confidence in particular in Public Health England.

As we champion our frontline key workers, we also need to give them confidence that we have their backs. Like all public workers, they want to do their jobs, but many are concerned that if there is a second wave of covid they will be risking their lives or their families’. The BAME community has already been severely hit. I am not sure that it could take a second wave. For BAME health workers to die at such a rate frankly amounts to negligence on the part of NHS England and Public Health England, but perhaps it is not that surprising. Their leadership boasts 46 individuals; yet only four of them are from BAME backgrounds.

The country was united in tackling covid, but Public Health England and NHS England let down BAME health workers. They have time to put the record straight. Either we are in this together or we are not. I hope that the Minister can confirm that the Department is committed to ensuring that Public Health England and NHS England will treat, manage and support all their staff equally, so that we do not see a second wave of disproportionate BAME health worker deaths.