Black Maternal Healthcare and Mortality

Baroness Harman Excerpts

Monday 19th April 2021 Westminster Hall

[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.

Coronavirus

Baroness Harman Excerpts

Monday 9th March 2020 Commons Chamber

[Matt Hancock]

An awful lot of companies and other employers are taking these steps. Teleconferencing is usually cheaper and also better for the environment than travel, so there are good reasons to use it anyway.

[Ms Harriet Harman (Camberwell and Peckham) (Lab)]

The Secretary of State made it clear in his answer to the urgent question that parliamentary accountability is fundamental—that is evidenced by so many Members on both sides of the House rising to raise myriad issues —yet despite that acknowledgment we are hearing reports that after Easter the House might be suspended until September. Will he give an undertaking that that will not be the case? Will he recognise that, as a big organisation of 650 MPs and thousands of staff, we can play our part in containment without opting for the nuclear option of closing down accountability altogether? Other measures could be considered, such as using Westminster Hall on a UQ basis, so that we have continuous accountability for what the Government are doing through Parliament, albeit in a different form.

[Matt Hancock]

I have not seen those specific reports, but I know that the House of Commons Commission met this morning. Parliamentary accountability is incredibly important. I will be doing all that I can to ensure that Parliament stays open through this process, and that we follow the clinical advice on how that can happen so that we keep that parliamentary accountability. It is a decision for the House, but my position and that of the Government is clear.

Oral Answers to Questions

Baroness Harman Excerpts

Tuesday 6th February 2018 Commons Chamber

[Mr Hunt]

I will happily do so.

[Ms Harriet Harman (Camberwell and Peckham) (Lab)]

The Secretary of State will be aware of the importance of King’s College Hospital to my constituents. In 2009, it was rated “excellent” and one of the top hospitals in the country; now it is missing its A&E waiting time targets and a key cancer treatment target, there has been a fourfold increase in the number of cancelled operations, and it is in special measures. The Government must take some responsibility for that. They must not wash their hands of it. Will they step up to the plate and help King’s by, for instance, giving it the resources that it needs?

[Mr Hunt]

Let me reassure the right hon. and learned Lady that we do not wash our hands of any trusts that go into special measures. The point of the special measures regime is to highlight where Government intervention is necessary. I know the right hon. and learned Lady will agree that a huge amount of very fine treatment happens at King’s every single day, but it is having profound issues in relation to the management of its finances and some of its waiting times, which is why we are doing everything we can to support it.

King’s College Hospital

Baroness Harman Excerpts

Tuesday 16th January 2018 Westminster Hall

[Ms Harriet Harman (Camberwell and Peckham) (Lab)]

It is a pleasure to follow the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), who made a thoughtful contribution to which I look forward to hearing the Minister’s response.

I thank my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) for introducing this debate. She has proved herself a real champion for her constituents. She fully recognises and champions King’s College Hospital, which many of her constituents need to use and where many others work. She is my constituency neighbour, and my constituents find themselves in the same situation. King’s is enormously important. It is an organisation of international excellence but also of local necessity. It sits at the heart of GP, primary care and social care services, and of mental health care services, both at the Maudsley Hospital and in the community. It is a pivotal part of the local community.

I will confine my remarks to two key points. The first is about the tenor of the debate. I hope Members do not treat King’s like a recalcitrant teenager who has overspent their allowance, or argue that its managers, chair or board are somehow profiting or salting away public money into offshore tax havens. King’s is doing its very best, in good faith, and all its people want to provide the very best service they can. That must always be at the heart of our debates. A tone of blaming King’s sometimes creeps in, but we should be grateful to it and thank it. On the deficit, it may be inconvenient for the Government to see figures with “King’s” written next to them going in a particular direction, but they should understand what is going on there, not tell King’s off as if it is at fault. It is doing one thing, and one thing only: trying to provide the very best care to people who use its national specialties, to regional referrals and to local people who need it. Let us always start on the footing that it is doing its best and that we are grateful to it for that.

My second point is that we need always to concentrate—I do not mean this in a cheesy way—on actual people. I baulked when I heard the Prime Minister talk about cancelled operations being “part of the plan”. Please, let there never be a plan with cancelled operations as part of it. Let us think of the situation for people. For anyone who has an operation booked, there are all sorts of things around that operation. Quite apart from the fact that it screws up their confidence and courage, they have to get time off work and, if they have a young family, their mother-in-law might have to book time off work, too, so that she can come and stay when they go in to have their operation.

An operation looks like one little entry in the Department of Health computer, but for the individual concerned, quite apart from the psychological effect of gearing themselves up for an operation and then finding it cancelled, everything is organised around it. We must not mess people’s lives around by assuming that cancelling an operation, of all things, is normal and can be used as a management tool. I hope that the Minister says that that is not at all what the Prime Minister meant, and that we will not manage our hospitals by booking operations and then cancelling them.

We must remember the human impact of longer waiting lists and cancelled operations. Someone’s hip replacement operation being postponed might be the thing that ultimately causes their job to be given to someone else. They might take sick leave and then take more, and their manager might finally say, “We’ve tried our best, but we just can’t carry on like this. We’re going to have to get somebody else in.” People lose their jobs while they are waiting for hospital treatment. Prompt treatment allows people to get on with their lives. An elderly person who is waiting for a cataract operation, for example, will not go out much, because they cannot see. They will not have the confidence to go out and meet their friends. If the operation is heavily delayed, by the time they have it they may have lost their social circle, lost what they do and become de facto housebound. For every single person who has to wait or whose operation is cancelled, there is a human cost. It is important to focus on that.

There is also the question of accident and emergency. I have watched the TV programmes and have visited King’s A&E on numerous occasions. The odd person is there just because they want to spend four hours sitting somewhere, but most people are there because they have had an accident or they have an emergency. They might have tried to find somewhere else to be seen, but they are there, and they are worried. They are often in pain, and they often have worried relatives with them. We must not drift back to the situation we had before 1997 under a Tory Government. I remember that well. People routinely spent all night on trolleys in King’s accident and emergency. I know what that situation was like, and we must not drift back to it. That would be really unfair on people. In this day and age, when much of the hospital has been rebuilt, we should not go back to that situation.

I hope the Government recognise people’s concerns. I hope that they are generous not just with their money but with their commitment to King’s; that they help it to go forward; and that they do not talk euphemistically about savings. Everyone knows what cuts are—cuts are when more people are coming through the door and there is less money per person. I thank Bob Kerslake for his work as chair, and I am disappointed that, because of the circumstances, he felt he could not stay on. I will meet the new interim chair shortly, but I hope that everyone at King’s—the staff, the management and the chair—feels that the Government are on their side and want to help them sort out the situation rather than blame them, make an example of them and talk about King’s as if it is anything other than the wonderful hospital we believe it is.

King’s College Hospital Foundation Trust

Baroness Harman Excerpts

Tuesday 12th December 2017 Commons Chamber

[Ms Harriet Harman (Camberwell and Peckham) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the resignation of Lord Kerslake as chair of the King’s College Hospital NHS Foundation Trust.

[The Minister of State, Department of Health (Mr Philip Dunne)]

I would like to begin by paying tribute to Lord Kerslake, whom I have met in his role as chair of King’s, which he has served with great commitment for two years during a period of significant challenge. While we may differ on some matters of policy, this should not blind us to the service that he has given to the NHS.

The context of Lord Kerslake’s departure from King’s is the very real financial challenges faced by the trust and the way in which these have or have not been addressed. A number of other trusts have similar challenges, but none has deteriorated as far or as fast as King’s, especially in the past few months. This is why it was placed into financial special measures by NHS Improvement yesterday.

There has been a consistent pattern of financial projections by the trust that have not been met during Lord Kerslake’s tenure as chairman. In 2016-17, a planned deficit of £1.6 million deteriorated over the year to an actual deficit of £59.6 million. For the current year, a budget deficit of £38.8 million was agreed in May. At month 5, the chairman confirmed to NHS Improvement that the trust was on track to meet this deficit, but by October there had been significant deterioration in the trust’s position, with a projected deficit of £70.6 million at October—£32.l million worse than planned. NHS Improvement was informed last week that this had deteriorated further to a mid-case projection of a deficit of £92.2 million, which would be £53.4 million worse than the original planned deficit. Indeed, Lord Kerslake indicated that the final position could be even worse.

King’s is receiving substantial financial support from the Department of Health. During this financial year, the trust is receiving £135 million of support to maintain frontline services. That is the second highest level of support across England. Both the level of deficit and the speed of deterioration are unacceptable, as I am sure all hon. Members will agree. Although no trust or hospital is an island, it is right that those charged with leading it should take responsibility for such results. The chief financial officer and chief operating officer both resigned last month, and, as we know, Lord Kerslake left on Sunday.

The trust will now receive even more support with the appointment of a financial improvement director. The organisation will be required to implement a plan to improve its finances, which will be closely monitored by NHS Improvement. On top of special measures and subject to due process, NHS Improvement intends to appoint Ian Smith as a new and experienced interim chair for King’s to take control of the organisation’s position.

[Ms Harman]

Does the Minister not realise that the problem at King’s is not the leadership, any more than it is the growing number of patients or the dedicated staff? The problem at King’s is that there is not enough money. He shows no recognition of the fact that over the past two years, King’s has already cut £80 million—double the rate that other hospitals have had to cut—and taken on an ailing trust to help out the wider NHS. King’s is now being told that it has to make even further cuts. How can it keep its A&E waiting times down, prevent waiting lists from growing and continue to meet cancer targets if it goes on to make further cuts?

Will the Minister face up to the fact that problems caused by lack of money are simply not going to be solved by blaming the leadership? King’s is an amazing hospital and a specialist world centre of research, which is also there for local people. It was there after the Grenfell Tower fire and the terrorist incidents we have had in London. Is it too much to ask the Government to recognise the reality of the situation and pull back from imposing further cuts, which will make patients suffer? No amount of changing the faces at the top will make that difference. It is the Minister’s responsibility.

[Mr Dunne]

The right hon. and learned Lady said on the radio yesterday,

“just because they’re the regulator, when these judgments have to be made, doesn’t mean that they are actually right”.

I have to ask her about that, in the light of the comments made by NHSI, the regulator. I will give her a couple of quotes. Jim Mackey, who was until recently the chief executive of NHSI, has said:

“Honestly, I don’t think they have in my time hit a single set of their re-forecasted numbers”.

The current chief executive, Ian Dalton, has said that no other trust in the country

“has shown the sheer scale and pace of the deterioration at King’s”.

This is not just about the numbers; it is about the way in which the trust is managed.

Hospital Services (South London)

Baroness Harman Excerpts

Tuesday 22nd January 2013 Westminster Hall

[Ms Harriet Harman (Camberwell and Peckham) (Lab)]

I thank my hon. Friend for giving way and I join the hon. Member for Dartford (Gareth Johnson) in congratulating her on securing this debate.

On the impact on neighbouring hospitals, my hon. Friend will be aware of the importance—not only to local people but to London as a whole—of King’s College hospital. Is she also aware that the effective closing of maternity and A and E services at Lewisham hospital will hit like a tidal wave at King’s College hospital, because of the numbers of people involved. The health service estimate is that the number of people at King’s College A and E will increase by 45%. The staff at King’s College A and E do a very good job, but they will not be able to cope with a 45% increase in patients. The additional emergency admissions from that increased number of people at A and E will create such a strain on in-patient beds that the proposal is that in-patients—non-emergency admissions—will have to be shipped off to Farnborough hospital, which is an hour away on a bus and a train from Camberwell.

As for maternity services, the situation is even more pronounced, with a 54% increase envisaged in the number of women giving birth at King’s College hospital. The staff there simply cannot cope with that increase. At the moment, many women are turned away and told to go—guess where?—to Lewisham hospital.

[Dr William McCrea (in the Chair)]

The right hon. and learned Member for Camberwell and Peckham (Ms Harman) will know that interventions must be short. Certainly, however, the point she makes is well made.