NHS Staffing Levels

Kate Osamor Excerpts

Tuesday 22nd November 2022 Westminster Hall

[Kate Osamor (Edmonton) (Lab/Co-op)]

Thank you for calling me to speak, Mr Hollobone. It is a great pleasure to be part of this important debate, and I thank my hon. Friend the Member for Wirral West (Margaret Greenwood) for securing it and for setting the dire scene in the NHS.

I will use my speech to talk about when I was a practice manager before I became an MP, and I want to speak about the way in which racism and discrimination affects the wellbeing of black and minority ethnic staff. Some 22.4% of NHS staff in England are from BME backgrounds, so they are disproportionately represented in the NHS but are under-represented in senior leadership. If we want an acceptable level of NHS staffing, it is crucial that racism and discrimination against staff from BME backgrounds is properly challenged.

Earlier this year, the BME Leadership Network published the “Shattered Hopes” report, which was based on surveys and roundtables of staff, revealing results that were shocking to read. It found that more than half of BME NHS leaders have considered leaving the NHS in the last three years because of their experiences of racism, and that colleagues, leaders and managers were a more common source of racist treatment than members of the public, which is truly shocking.

I want to provide the Minister with some recommendations, which I hope he will be able to address in his summing up. First, it goes without saying that the Government must give a pay rise to doctors, nurses and all staff in the NHS that is at least above the current rate of inflation, to protect their standards of living and to ensure the retention of staff. Secondly, we must ensure that bursaries for nursing students are restored so that more people—particularly those from more disadvantaged backgrounds—can access training. Lastly, the Government need to provide a renewed commitment to ensure that the NHS delivers on its commitment to combat institutional racism alongside tackling health inequalities.

We need an expanded training programme to truly tackle discrimination within the NHS. Without that commitment, countless staff will have no choice but to quit working for the NHS.

Menopause

Kate Osamor Excerpts

Thursday 9th June 2022 Westminster Hall

[Kate Osamor (Edmonton) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Robertson, I believe for the first time. I congratulate my hon. Friend the Member for Swansea East (Carolyn Harris) on securing this important debate and on all the campaigning she has done to raise awareness about the barriers women face when accessing HRT prescriptions. There is certainly a lot more work to be done, including on the interaction between black and Asian women and healthcare professionals.

For the last 10 years, I have experienced a multitude of symptoms, including hot flushes, memory loss, fatigue and poor sleep, but I just thought it was this job—boo hoo—so I used the lockdown to press the reset button. I thought, “If I do my bloods, maybe I can find out what is wrong with me.” My doctor did not advise me to do my bloods, but I thought I would use my own agency, so I turned up and said to my doctor, “This is what I want to do,” and my doctor said, “Okay, go and do your bloods. Let’s see what’s wrong with you.” Bear in mind that for the last 10 years, I have been experiencing different symptoms intermittently, but my doctor did not join the dots for me, and did not explain or say, “Possibly, Kate, this is what you’re going through.” What came back from the bloods was that I was pre-diabetic—another menopause symptom, but my doctor looked at my results and said, “You are pre-diabetic. You need to change the way you are eating and possibly you will be okay and will not become diabetic.”

This was not what I was expecting to find out. I was trying to find out why I was having all the other symptoms, but the bloods showed up different symptoms. I used lockdown and the time I had to reset the button and turn my food habits around and, fortunately, I was able to take my body back to where it should be. I am no longer pre-diabetic and I did not become diabetic— I was really happy about that—but my GP did not explain to me that the persistent symptoms were related. If I am honest, it was not until I watched Davina McCall’s recent TV show on menopause that I connected the dots.

I grew up, as many of us in this room did, watching Davina on “Big Brother” and all her other shows. She is relatable, she is fun—she is like a friend I have never met. She is a trusted voice. Her view and her vulnerability made me look at the symptoms she was presenting and made me think, “Okay, that could be me.” I was not alone. So many women I have spoken to watched the same show and said that Davina turned on the light for them. I thank her for that.

I then had to go on to speak to my GP. Now I had the information I needed, which I had not been given before, and I had the agency to tell my GP, “This is what I want.” We had a long discussion and my GP offered me antidepressants. Many women may have taken that option, but I know, from watching Davina’s show, that it is an option that a lot of women were being offered. I could have taken the antidepressants, not knowing that it was almost like a barrier put up to stop women getting HRT. I listened, we had a little discussion and my GP agreed to give me HRT. I should not have had to have that conversation and I feel really sorry for those women who do not get past that barrier, accept the antidepressants and just carry on existing, taking the antidepressants but not dealing with the symptoms.

Many black women experience menopause disproportion- ately. Many black women I speak to say that there is no point going to the GP. It is not something we discuss in our community; it is not something that is passed down to us. We are encouraged to be strong, as black women. We are encouraged to carry the family and to sort out our problems privately. That is not a slight on the community—it is about how we hold ourselves together—but as individuals in the community, at times we need the support when we do go to the doctor. That could be to have antidepressants, but in this instance it is to talk about HRT. That is something we do not do.

I am standing up in Parliament to say, “Let’s talk about it. Let’s have that discussion. Let’s help each other and let’s think about the next generation, who will be able to say, there is the blueprint and these are the things that we should be looking for, and when they come up we will go to our doctor and have agency and have strength.” We should do that, rather than being quiet and thinking, “My mother never spoke to me about this and my aunties never spoke to me about it, so it must be something to do with my job or my partner or my friends or whatever”. It is something that is part of every woman, whether they are black, white or Asian.

I also want to say that black women’s voices are less likely to be heard or shared in the media. Black women are less likely to appear in media campaigns. In the menopause landscape, we do not exist. We need to be heard. Our experiences are really important. The next generation need a reference point.

As I said, in our community we are taught to be strong. Slogans like “Black Girl Magic” are associated with strength and glamour, against all odds, which is fantastic, but trying to live up to that all the time puts a lot of pressure on us. We need a wider discussion as a community, but we also need the media and health professionals to get involved, to reach out to us and to explain, “These symptoms appear at a certain age and if they do, this is what you should do.” The media and companies should be looking for black women to front their campaigns to ensure that women feel that there are relatable faces and voices. Yes, here we all know Davina McCall, but not everyone knows Davina—I should not say that; Davina might not be happy. On a serious note, when someone is young and looking up to people, they want to see faces that look like theirs—that is really important. If the Black Lives Matter movement showed us anything, it showed the globe that all lives matter. We should work together.

Do not get me wrong, there are some fantastic black and Asian British women who are raising menopause awareness. There is Karen Arthur, who runs the Menopause Whilst Black Instagram account; she also has a podcast where she shares black women’s stories of menopause. There is Dr Arif, the family GP who specialises in women’s health—she is a bit of a celebrity now. Dr Arif says:

“NHS practitioners are not trained in menopause. They often don’t realise you can have menopausal symptoms during perimenopause, or have symptoms and still have your period. And that there’s no blood test that can reliably tell you if you’re perimenopausal as hormones fluctuate. That’s a barrier to all women.”

Today I want to take this opportunity to look forward, based on my own experience, to how we can be better and more productive in the relationships between black women, GPs and advertising. All women need to be included in the menopause debate. Let’s be honest: if any other issue had been found to cause one million people to leave the labour market, cause problems with sleeplessness, anxiety, brain fog and countless other overlooked symptoms, and impose an unacceptable and unappreciated burden, then the tabloids would be in overdrive. It is a basic issue of equality in the workplace, and should be treated as such. There should be endless debates and significant Government legislation needs to be passed.

A study earlier this year by Koru Kids found that a quarter of women going through the menopause feel unhappy at the lack of support on offer. Many are likely to be the next workers to drop out of the labour market. While employees can claim some protection through existing legislation, such as the Equality Act 2010, clearly it is falling short. There remains no legislation which expressly puts obligations on employers to ensure they provide necessary adjustments for women going through the menopause. Therefore, I would like to make a few recommendations to the Government.

First, legislation should be passed ensuring women going through the menopause are protected in the workplace in the same way that other protected characteristics are, such as those that exist around pregnancy and maternity discrimination. Workplace menopause policies should be made mandatory. Many employers already recognise the importance of bringing in a menopause policy, but need a little nudge. The Mayor of London announced City Hall’s policy on International Women’s Day this year, which Unison helped develop. That policy includes tackling discrimination and stigma around menopausal symptoms, as well as introducing temperature-controlled rooms and flexible adjustments to the workday to accommodate symptoms. Leading examples should be admired, yet progress remains too slow across the board and the best way to enforce minimum standards is by statutory change.

Secondly, the Government should take a proactive approach to promoting best practice on workplace policies. The Government should work alongside the TUC, which has produced a series of recommendations for employers. Those include: awareness training for all staff; risk assessments; and a confidential point of contact for women in their workplace for problems arising due to the menopause.

Lastly, flexible working should be made the default for all workers, unless there are reasons why it is not possible. Sadly, the employment Bill was not included in the Queen’s Speech, which is a great shame for all workers —especially those who are going through menopause. Without that right, many workplaces will continue to fall short on making reasonable adjustments, and women will continue to feel their health suffer as they are forced to work hours that do not meet their health needs. These changes are a necessity if we aspire to have a truly equal workplace.

Sickle Cell Treatment

Kate Osamor Excerpts

Wednesday 8th December 2021 Westminster Hall

[Kate Osamor (Edmonton) (Lab/Co-op)]

Thank you for calling me to speak, Mrs Miller. It is a pleasure to serve under your chairmanship, although “chairship” is a better word. I thank my right hon. Friend the Member for Wolverhampton South East (Mr McFadden) for securing this important debate and for setting out a strong argument.

First, our thoughts must be with Evan Smith, who tragically died at North Middlesex hospital in my constituency. Owing to a determination to prevent further tragically avoidable deaths, the sickle cell and thalassaemia all-party parliamentary group must be given huge credit for putting together the hugely important “No One’s Listening” report on the failures in sickle cell care, and for producing an extensive and thought-through list of recommendations.

It has clearly been found that although the details of Evan’s case are particularly distressing, this is not just an individual failing of one hospital but the reflection of widespread shortcomings in care and a lack of institutional knowledge, which have led those with sickle cell to be fearful of receiving secondary care and of attending hospitals. Indeed, North Middlesex hospital is situated in an area with a large black population and, compared with the average hospital, it should have been adept at caring for sickle cell patients. Evidence of the dismissal of the pain of sickle cell patients sadly tallied with what has been highlighted by other studies of the disparities regarding the treatment of black people by healthcare staff, such as by Five X More, which has done work on black maternal health.

I wholeheartedly endorse the recommendations made in the all-party group’s report, and I want to highlight a number of those recommendations. First, the North London Partners integrated care system, within which my constituency and North Middlesex hospital fall, should develop a concrete plan to improve sickle cell care and share lessons learned from across the country. North Middlesex hospital should also engage with Betty and Charles, the parents of Evan Smith, regarding an appropriate memorial for their son.

I urge the Government to tackle the report’s recommendations with the seriousness that they deserve. Knowledge of sickle cell among healthcare professionals must be improved by mandating that universities should provide training in sickle cell as part of the curriculum, and healthcare in England should develop a mandatory e-learning module for staff treating sickle cell patients in high-prevalence areas.

The standard of care must be improved by developing individualised care plans for sickle cell patients, with copies passed to the patients and all their carers. NHS trusts should develop action plans to ensure compliance with the clinical guidelines to deliver pain relief to sickle cell patients within half an hour.

Finally, the NHS Race and Health Observatory should undertake a study of sickle cell care, examining how racism affects the experiences of patients, and the prioritisation that sickle cell patients are given compared with those experiencing other conditions. While sickle cell patient advisory groups are flourishing, they should be given the resources they need to have an oversight of sickle cell services across all hospitals. There is a lot of work to be done, but the way forward has been set.

I want to add that North Middlesex hospital has a unit for people who have sickle cell, so what happened to Evan should not have happened. The A&E experience for all patients who have sickle cell needs to be looked at with urgency. Thank you for listening.

--- Later in debate ---

[Maria Caulfield]

The hon. Member makes a good point. Most patients are probably young, of working age, and have to pay for their prescriptions, but around 89% of all community prescriptions are not paid for—they are free at the moment—and for those with long-term conditions, such as sickle cell, there are the prepayment certificates covering prescriptions for around £2 per week, no matter how many items they have to order. If, say, someone needed three items, that gives a saving of around £228 per year. I know that that does not give free prescriptions, but it is an existing system that patients are often not told about, and it can offer huge savings. I am happy to discuss that with the hon. Member after this debate.

I want to reassure colleagues that a huge amount is being done by the Department to improve the treatment of sickle cell patients. Clear and positive work is under way. It is quite new and innovative, and we hope it will make a difference in a very short space of time. There are still gaps in the provision of services.

[Kate Osamor]

I thank the Minister for the update that she has just given us, but she has not said anything about the bottleneck in A&E. Patients arrive and they are not listened to and not believed. What work will the Government do on that area of hospital treatment?

[Maria Caulfield]

The hon. Member makes an excellent point. There are NICE guidelines on sickle cell, so I will ask departmental colleagues to look at how often they are not followed. The issue was raised about analgesia not being given within half an hour of someone presenting. That is in NICE guidance, and the guideline should be followed in A&E or other areas where patients are admitted. I am happy to look at the prevalence of that not happening and why not. Again, I think that a lot of it is not deliberate. Much of it is to do with the education of staff, who might be in busy A&E departments with lots of people in pain, and they might not realise the impact on a sickle cell patient who does not get analgesia in a timely manner.

Covid-19 Update

Kate Osamor Excerpts

Monday 6th December 2021 Commons Chamber

[Sajid Javid]

I believe that the UKHSA is carrying out some half a million tests, approximately, a day. In the light of some of the concerns around the omicron variant, with the need for greater testing, that testing capacity is being increased.

[Kate Osamor (Edmonton) (Lab/Co-op)]

The Nigerian high commissioner to London has called the inclusion on the red list of African countries, especially Nigeria, nothing short of “travel apartheid”. Omicron is classified as a mild variant, with no deaths and no hospitalisation, unlike the delta variant, so when will the European countries that have the delta variant be added to the red list? It is time for an international approach and not a discriminatory approach.

[Sajid Javid]

The only way our approach discriminates is in terms of the risk of the virus. The hon. Lady will know from the information that I have shared today and the Government have shared previously that the epicentre of this variant is southern Africa at the moment. The reason Nigeria has been included is that at least 21 cases in England are clearly linked to Nigeria, but we have also taken into account further reports such as Ghana having reported 25 cases linked to Nigeria. She will also understand that some countries do not have the same ability to test or sequence, and so we, with other countries, provide them with that support. It is right that whenever we have the data, we must act to protect British public health.

Black Maternal Healthcare and Mortality

Kate Osamor Excerpts

Monday 19th April 2021 Westminster Hall

[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.

Oral Answers to Questions

Kate Osamor Excerpts

Tuesday 6th October 2020 Commons Chamber

[Matt Hancock]

The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill) has committed to consult on the subject to make sure we get to the right outcome.

[Kate Osamor (Edmonton) (Lab/Co-op) [V]]

This Government have repeatedly refused to meet the group representing covid-19 bereaved families. I met the group last week, and they confirmed that they are not in litigation with the Government and never have been. They simply want to put across the concerns of thousands of people who have lost loved ones to coronavirus, so will the Minister now commit to meeting the group and hearing their concerns at first hand?

[Matt Hancock]

Of course I have met and continue to meet the families of those bereaved through coronavirus. With this particular group, I am afraid that when I last looked into it, they were in legal action—in pre-action protocol—with the Government, so I am advised that I should not therefore meet them.

Social Distancing: 2 Metre Rule

Kate Osamor Excerpts

Monday 15th June 2020 Commons Chamber

[Edward Argar]

The reason is that the current scientific advice is that the 2 metre rule significantly reduces the risk of transmission and we have not yet beaten this disease. That is why the Prime Minister has put in place this review—to consider not only the scientific and clinical evidence, but—exactly as my right hon. Friend would expect—the economic evidence and impact. It is right that it be done on the basis of a review and of evidence, but I hear his very clear plea that the sooner the better for the sake of businesses. I accept that.

[Kate Osamor (Edmonton) (Lab/Co-op) [V]]

During the lockdown, small businesses in my constituency have planned considerable changes to their business models in preparation for reopening in a way that is safe for employees and customers. That not only takes time but is an extra financial burden for small businesses, in particular. Will the Minister please confirm what extra financial support is readily being made available for understandably worried small and medium-sized enterprises to help cover the extra financial costs associated with reopening?

[Edward Argar]

The hon. Lady is absolutely right to talk about the amazing work that many of our businesses, large and small, have done to get themselves ready to reopen. I would encourage people, following the rules, the guidelines and the social distancing guidance, to get out there and support their local shops now that they have been able to reopen. As she will know, in recent weeks the Chancellor has put in place a significant package of support for businesses and individuals, and that is still there. It will obviously, as he has set out, taper in the coming months as the economy is able to reopen more fully. We have supported businesses throughout and we will continue to do so.