Children’s Mental Health Week 2024

Abena Oppong-Asare Excerpts

Tuesday 30th January 2024 Westminster Hall

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

It is a pleasure to serve with you in the Chair, Mr Pritchard.

Let me start my remarks by praising my hon. Friend the Member for Tooting (Dr Allin-Khan). She is a true champion for the nation’s health. She works tirelessly to highlight mental health issues, especially those among children. In my unbiased way, I have seen how she has operated as an MP and as an NHS emergency doctor, as echoed by some of my colleagues, and she commands huge respect on these issues, so I wish to congratulate her, as others have, both on securing the debate and on her excellent speech.

I also wish to thank hon. Members who have contributed to this debate. My hon. Friend the Member for Bolton South East (Yasmin Qureshi) said that this was not just a moral case, but an economic case, especially as children grow into adults and continue to be negatively affected. My hon. Friend the Member for York Central (Rachael Maskell) talked about the impact on the mental health workforce and the fact that there needs to be clear leadership in this area. She called for a 10-year mental health strategy along with a parent strategy.

I am delighted to be marking Children’s Mental Health Week, which starts on 5 February. This is its 10th year. It is organised by Place2Be, which deserves great thanks for all the work that it does to support children’s mental health. I also congratulate its chief executive, Catherine Roche, and its president and founder, Dame Benny Refson. These are strong women leading the way. This year’s theme, “My Voice Matters”, goes to the heart of the issue. Every child matters. Each child counts no matter who they are, what their parents do, what their race or religion are, or where they live. Every child must know that their voice matters. We need a system that listens to every child. We know that our child and adolescent mental health services are in a severe state of crisis—they are at breaking point.

Last May, we read reports in The Guardian that the number of children in mental health crisis in England was at a record high. NHS data collected by the excellent YoungMinds charity revealed more than 3,500 urgent referrals for under-18s in May, three times higher than the same month in 2019. The number of children and young people undergoing treatment or waiting to start care also reached new highs, with record open referrals to children and young people’s mental health services. This month, The Independent newspaper revealed that NHS figures show that a record 496,897 under-18s—nearly half a million—were referred by GPs to child and adolescent mental health services at the end of November last year, up from 493,434 the month before.

More children than ever with anxiety, depression and other serious mental illnesses are waiting, for longer than ever, in anguish. We know that the causes are complex: social disintegration, harmful social media, bullying, worries about the climate and anxiety about the future. As has been mentioned, covid was a real game changer. Secondary school pupils across the UK experienced significantly higher rates of depression and social, emotional and behavioural difficulties—overall, the worst mental wellbeing—during the pandemic. An Oxford University department reported that cases of depression among secondary school pupils aged 11 to 13 rose by 8.5% during the pandemic compared with a 0.3% increase among the same cohort before covid, that girls’ mental health deteriorated more than that of boys during the pandemic and that girls were also more likely to find the return to full-time schooling difficult. This is a generation in pain, so when we use the word “crisis”, we mean it.

The Oxford University research highlighted something else that is really important: the students who were most resilient during the pandemic were those with plenty of social interaction and support, including a supportive school environment, along with good relationships at home and a friend to turn to for support during lockdown. That is why the centrepiece of Labour’s plan for children’s mental health is the introduction of specialist mental health support for children and young people in every school. That will mean that every child in the school will have someone to talk to, someone to listen to, someone to offer support and someone to prove that “My Voice Matters”. It will go alongside recruiting thousands more mental health staff to cut waiting lists and ensure that more people can access treatment. Labour will create an open-access mental health hub for children and young people in every community. We will focus on prevention, early diagnosis, early intervention and timely treatment near where people live. It simply cannot be right that young people travel miles and wait for months to see a specialist. We know that mental illness is best tackled early and that it seldom gets better as the wait goes on longer. Prevention is not just socially just but, as has been mentioned, economically efficient. It saves young lives and it saves money. The next Labour Government will pay for this move by abolishing tax loopholes for private equity fund managers and tax breaks for private schools. That is social justice.

That promise sits alongside the many other measures in Labour’s child health action plan—a plan that adds up to a comprehensive mission to create the healthiest generation of children ever. That is why, when we meet again for Children’s Mental Health Week in early 2025, after the ballot papers have been filled in at the general election, we hope that we will have a new Government and a fresh start for children’s mental health.

I once again thank my hon. Friend the Member for Tooting for securing this important debate.

Excess Death Trends

Abena Oppong-Asare Excerpts

Tuesday 16th January 2024 Westminster Hall

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

It is a pleasure, as always, to serve under your chairship, Sir Gary. I congratulate the hon. Member for North West Leicestershire (Andrew Bridgen) on securing this important debate on trends in excess mortality. I also congratulate all hon. Members who have spoken in this lively debate.

The phrase “excess deaths” refers to the difference between the actual registered number of deaths, and the expected number of deaths, based on data from previous years. Recording and understanding such trends is important for any Government of this country, because through that lens we discover areas of growing irregular activity, and we can use that information to tackle issues and improve the lives of our families, our constituents and everyone in this country.

It is sad that excess deaths appear to have increased in recent years. Although there is a range of estimates from different bodies, they all point to an increasing trend. Life expectancy in the UK has also fallen to its lowest level in a decade. Male life expectancy is down 38 weeks from its pre-pandemic peak, and female life expectancy is down 23 weeks. Those worrying trends reinforce the need for us to understand what is happening and what we can do to turn them around.

However, it is important to tackle the claim by the hon. Member for North West Leicestershire that there is a causal link between the covid-19 vaccines and excess deaths in this country.

[Paul Girvan (South Antrim) (DUP)]

Will the hon. Lady give way?

[Abena Oppong-Asare]

I am afraid I have limited time.

The Opposition have stated clearly, and I confirm again, that we believe vaccines are the most effective public health intervention in relation to coronavirus and health in general. It is clear from extensive independent research that the covid-19 vaccines have been and continue to be extremely successful at preventing deaths. Sadly, there have been extremely rare cases of people suffering side effects that are possibly linked to the vaccine, but the data does not suggest that there is a link between that and the large increase in excess mortality in recent years. However, when serious side effects do occur, it is right that individuals and their families should have access to the vaccine damage payment. I encourage anyone who has a side effect from any vaccine to use the yellow card system and to report the side effect to their general practitioner.

It is wrong, however, to consistently link the observed excess deaths to covid-19 vaccines. Like my right hon. Friend the Member for Knowsley (Sir George Howarth), I have concerns that making that link not only stokes fear and misinformation, but distracts the public conversation away from other health concerns of critical importance.

[Philip Davies]

Will the hon. Lady give way?

[Abena Oppong-Asare]

I normally would, but I have limited time, and I really want to explain the Opposition’s thoughts. Although I disagree with hon. Members on this issue, I am pleased that we are discussing the topic today, because as I have mentioned, we face increased excess deaths and a wider health crisis across the country.

The primary cause of excess mortality has, of course, been covid-19. The pandemic was one of the most profound events of our lifetime, and in the UK, hundreds of thousands of people died, and millions were extremely ill. In fact, there are perhaps 2 million people still shielding because of their clinical vulnerability to the virus. I am sure that we all know who some of those individuals are.

The Opposition have made the case over many years that the Government and our health system were not fully prepared, and were far too slow to act throughout the crisis. It is vital that we learn lessons from the pandemic, and take steps to strengthen our resilience for the future. That is why it is so important that the covid-19 inquiry receives the support that it needs: to ensure that mistakes are not repeated.

The Government have named several other reasons, apart from the pandemic, for the increase in excess deaths in recent years.

[Mr Philip Hollobone (Kettering) (Con)]

On a point of order, Sir Gary.

[Abena Oppong-Asare]

These include high flu prevalence, a strep A outbreak, an increase—

[Sir Gary Streeter (in the Chair)]

Abena, we have a point of order; I am so sorry. Philip, it had better be a point of order.

--- Later in debate ---

[Sir Gary Streeter (in the Chair)]

That is entirely a matter for the Opposition spokesman, but thank you for the point of order.

[Abena Oppong-Asare]

There is an increase in conditions such as heart disease, diabetes and cancer. As a number of Members have mentioned, the Government say that they are attempting to reduce excess deaths through more health checks, as part of their major conditions strategy. We in the Opposition welcome all efforts to improve the health of our country and tackle these issues, but we must have a Government who will build an NHS and a healthcare system that is there for the public when they need it.

[Mr Hollobone]

Will the hon. Lady give way?

[Abena Oppong-Asare]

I am afraid not; I really want to explain our concerns, and what the Opposition will do.

Unfortunately, through 14 years of Conservative mismanagement, the country has seen the Government do the exact opposite. On patients being seen on time, the situation continues to get worse; so many key NHS targets are being missed. The Prime Minister promised last year to get NHS waiting lists down by 2024, yet this month, waiting lists remain sky high at 7.6 million—400,000 higher than he promised. One year on, that is another pledge missed by the Prime Minister and this Government, and it leaves so many families waiting for urgent care across the country.

What is more, we are so far behind on critical health challenges. As the hon. Member for Easington (Grahame Morris) mentioned, on cancer mortality, thousands are needlessly dying because of slow and late diagnosis, combined with delays to urgently needed treatment. Cancer waiting time targets are consistently being missed, and some of them have not been met for over a decade—a leading cause of avoidable deaths in England. It is urgent that we swiftly tackle this crisis. That is why Labour has committed to improving cancer survival rates by hitting all NHS cancer waiting time targets, and to ensuring early diagnosis within five years, so that no patient waits longer than they should.

When it comes to the NHS and the health of our nation, Labour offers a different plan. We are fully committed to delivering a mission-driven Government who will cut NHS waiting times and build our NHS, so that it is there for the people when they need it. That includes measures such as delivering 2 million more appointments and operations a year at evenings and weekends.

[Miriam Cates]

Will the hon. Lady give way?

[Abena Oppong-Asare]

It means doubling the number of scanners, so that patients with conditions such as cancers are diagnosed early.

[Karl MᶜCartney]

Will the hon. Lady give way?

--- Later in debate ---

[Abena Oppong-Asare]

And it includes ensuring that ambulances get to people in time to save lives, not when it is too late. We will also tackle the wider health inequalities that mean that life expectancy is much worse in our country’s poorest regions, through our focus on intervention and a shift to community care.

Just last week, we announced our detailed child health action plan to reverse the plummeting health outcomes for our children. Through specific measures, targeting waiting lists, mental health, dentistry and more, we will ensure that that we have the healthiest generation of children ever. That area of concern has been echoed by a number of Members during this debate.

I will conclude by restating the Opposition’s concerns about increasing excess deaths in recent years. Covid-19 was the most significant threat that our public had faced in over 100 years. It is vital that we all learn lessons from that profound event and make sure that mistakes like this never happen again. It is critical that we understand other trends in the excess mortality seen across the country, and that we build our NHS as a healthcare system that invests in prevention—because prevention is key—and that is there for the public when it is needed.

I look forward to hearing from the Minister on the issues that have been raised, and about how we can tackle rising excess deaths across the country.

International Men's Day

Abena Oppong-Asare Excerpts

Tuesday 21st November 2023 Westminster Hall

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

It is a pleasure to serve under your chairship, Mr Davies. I know that you have done a lot of work in this area, having secured the first International Men’s Day debate in 2015.

I congratulate the hon. Member for Don Valley (Nick Fletcher) on securing the debate, and I thank him for championing this important issue and for his work with the APPG on issues affecting men and boys. He spoke powerfully about how suicide impacts on men and took us on the journey of Tommy’s life to talk about how he had been affected.

I am pleased to close this important debate for the Opposition and to have the opportunity to speak on International Men’s Day and mark the occasion in Parliament. I begin by thanking several hon. Members who have spoken. The hon. Member for Strangford (Jim Shannon) talked about Northern Ireland and highlighted the slow diagnosis of prostate cancer. He also talked about loneliness in rural areas.

I thank the right hon. Member for Basingstoke (Dame Maria Miller), who said that she wants all services to work for women and men. Both the hon. Member for Strangford and the right hon. Member for Basingstoke talked about how the use of language and perceptions sometimes have an impact on how men and women are treated, giving the example of the words “man up”.

My hon. Friend the Member for Walthamstow (Stella Creasy) talked about images of fatherhood that are used in ways that we would not like to replicate, about how the mental load of parenting is often something that mothers do, and about equal parental leave.

The hon. Member for Truro and Falmouth (Cherilyn Mackrory) has done a lot of work as the co-chair of the all-party parliamentary group on baby loss. I thank her for sharing her personal story again; she has been a trailblazer in this area. She talked about how the tragedy of baby loss has a long-standing impact on fathers as well as mothers, which is not always talked about. She also talked about making sure that there is adequate space for fathers at maternity wards.



As the name indicates, International Men’s Day is a worldwide celebration of the positive contribution that men bring to their families and communities. It is only fitting for me to thank all the incredible men who inspire and uplift others and promote a fair and inclusive society for all. I know that I have a number of male allies and that I would not be in this place today if they had not played a key role in supporting me. However, this annual event is also a crucial moment when the public come together to say that our men and boys face extreme challenges. These include the high rate of male suicide, shorter male life expectancy, falling educational standards among boys compared with that of girls, and so much more. We must also not neglect to mention the shocking inequalities that often leave minorities and the least privileged men in our society most vulnerable. Those are big challenges, but ones where progress can and must be made.

Figures on men’s mental health in the UK continue to show that suicide is the biggest cause of death in men under the age of 50. The Minister may remember that, in my first Health questions in my current Front-Bench role, I raised the issue of men aged 45 to 49, who are at most risk of suicide. However, we know that suicide affects the young as well.

Although it does not always come down to one factor, men can face specific life events that may increase their risk of suicide, including the breakdown of relationships, loneliness, unemployment, alcoholism and financial difficulties. Some of these contribute to the sad fact that the poorest in our society are more than twice as likely to die from suicide compared with the wealthiest. It is also important to mention that young black men are around three times more likely to present with suicidal risk. Research has found that gay, bisexual and trans men are even more prone to poor mental health, substance misuse and self-harm. I hope we can all agree that much needs to be done to support men who are struggling in crisis, because around three quarters of the deaths from suicide each year are men. As has been mentioned, men are less likely to seek help. If they do not seek help, they are less likely to get the help they need.

I want to commend a few charities doing fantastic work in this space by providing community support, especially for middle-aged men. They include James’ Place, the Men’s Sheds Association, Andy’s Man Club and Second Step’s Hope Project. I also want to mention Tommy’s, raised by the hon. Member for Truro and Falmouth.

Although suicide is extremely complex, it is preventable. The Opposition believe that we must shift towards a system that focuses on prevention. The high rate of suicide is a haunting indictment of a lack of early intervention and support. For example, it is shocking that patients across England waited a total of 5.4 million hours in A&E while experiencing mental health crises last year. It is further shocking that 1.8 million people are on the NHS waiting list for specialist mental health treatment, and those numbers are growing only higher.

A Labour Government will treat mental health as seriously as physical health. Our mission will be to get the rate of suicide down. If we are privileged to get into Government, we will do that within our first term. Our plan will also include recruiting more than 8,500 more mental health professionals to cut waiting times for treatment. We will provide access to specialist support in every school and every community. We will open mental health hubs for young people. Labour has a plan and mission to build an NHS that is fit for the future and there for when people need it.

I turn to the many concerning disparities in men’s physical health. It is important to note that men have a shorter life expectancy, as has been mentioned, with one in five dying before the age of 65. We know that those deaths could be prevented by diet and lifestyle changes. Men are disproportionately affected by heart disease, and more men than women are overweight or obese.

As with mental health inequalities, when comparing life expectancy, there is a stark inequality between the most and least deprived areas of the country. In England’s most deprived postcodes, life expectancy for men is 73.5 years compared with 83.2 years in the least deprived areas. Despite that, men are still less inclined to seek help or advice from medical professionals, and therefore do not get the help they need. Without regular health check-ups, serious issues can go untreated for longer, and sometimes it is too late.

When instances of cancer are 21% higher for men than for women, we know how important early intervention can be. We also know about the well-recognised high rate of prostate cancer among black men. When the cancer is detected, patients must get the treatment they need, yet year after year, the Government have failed to meet the cancer waiting-time targets. Missing target times means missing lifesaving cancer treatment.

We need a strategy that is focused on early intervention and ensures that people receive the care and support they need. Instead, the Government have chosen to cut public health budgets substantially across the country. A Labour Government will invest in a bigger than ever expansion of the NHS and look to improve the cancer survival rates within five years by hitting all NHS cancer waiting times and early diagnosis targets, so that no patient waits longer than they should.

We will also tackle the stark health inequalities faced by disadvantaged groups. We have committed to a fit for the future fund to arm the NHS with state-of-the-art equipment and new technology to cut waiting times. That means doubling the number of CT and MRI scanners and getting people diagnosed earlier.

Of course, we cannot discuss men’s health without looking at boys’ performance in education. In basic terms, boys perform worse than girls by the end of primary school, with 70% of girls reaching the expected standard in maths. The disparity is even more acute among those from disadvantaged backgrounds, with disadvantaged white boys being the least likely group to go to university. Children only have one chance at education, and reducing those disparities with early intervention will make outcomes better.

I will conclude by repeating what I said at the start of my remarks. While we have spent most of today’s debate on the areas of most important concern, this occasion should also be a moment of celebration. It may be obvious to say this, but we all know that men—including you, Mr Davies—provide an invaluable contribution to our families, communities and society. This occasion should be one of appreciation as well as awareness, and I am glad to have had the opportunity to contribute to this debate.

Menopause

Abena Oppong-Asare Excerpts

Thursday 26th October 2023 Commons Chamber

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I congratulate my hon. Friend the Member for Swansea East (Carolyn Harris) on securing this important Backbench Business debate; I am sure we all agree that she has been a fantastic champion on this issue. I would also like to thank my hon. Friend the Member for Bootle (Peter Dowd) for opening the debate. I can say with certainty that he did this debate justice, talking powerfully about the concerns of my hon. Friend the Member for Swansea East, as well as referencing where improvements need to be made and the newly launched “Manifesto for Menopause” by the menopause APPG. They have done fantastic work.

I thank those who have contributed to today’s discussion. It has been particularly uplifting to see male colleagues also speaking in the debate. It is important that we all discuss this issue and that it is not just on the shoulders of women to raise it. As the hon. Member for Walsall North (Eddie Hughes) said, our role as MPs is to inform people, and particularly men, who have a powerful role to play in providing the support that is needed. He also talked about the phs Group, which has been doing great work on this issue.

I thank my hon. Friend the Member for Bradford South (Judith Cummins), who highlighted really well the fact that menopause is not just a women’s issue but a health issue for everyone. My hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) talked about how companies can play a role by ensuring that employees are supported through the menopause and about Labour’s plans for the workforce. He highlighted the fact that over half of the workforce are women, and with one in 10 women leaving work because of the menopause, we need to do more to retain their skills. The hon. Member for Bath (Wera Hobhouse) powerfully explained how women have to fight before symptoms are taken seriously, and the hon. Member for Strangford (Jim Shannon) talked about how his wife went through menopause and how it is important to understand this issue at home. I thank him for sharing his personal story.

As we all know, for far too long women’s health has been a marginalised issue, and when it comes to women’s health, the issue of menopause is critical. It affects every woman, yet time and time again, we in this country have neglected doing the right and obvious thing: to support women experiencing the menopause. I will not be presenting any groundbreaking information today, since all Members present are aware of the inadequate quality of care and support that women currently receive. For instance, there is the staggering finding—which has been highlighted —that nearly one in 10 women must consult their GP on 10 separate occasions before receiving proper guidance and support regarding the menopause. Of those women who did eventually receive treatment, 44% waited at least one year, and 12% waited more than five years. I am sure Members agree that those statistics are staggering.

One in 10 women have quit their job because of menopause symptoms, despite the fact that menopause affects every woman. As my hon. Friend the Member for Swansea East has mentioned on previous occasions, although women are 51% of the UK population, only 59% of medical schools included mandatory menopause education in their curriculum. Further important findings were released last week by Menopause Mandate reinforcing the inadequacy of support. Those findings confirm that not only do nearly all women experiencing the menopause find that the symptoms have a negative impact on their quality of life, but the vast majority face negative experiences at their GP and significant barriers at work. The finding that only 24% of women have a positive experience at their GP is surely a damning indication of how much further there is to go.

I warmly welcome the release of the manifesto by the APPG on menopause and the important words that have been spoken by Members today. It is one step further in this positive campaign, and in the work my hon. Friend the Member for Swansea East has done to put the menopause on the map and act on an issue that has been in the shadows for far too long. She is a trailblazer, and I am privileged to have the opportunity in my new brief to work more closely alongside her on these issues and make sure we realise many of the changes she has been fighting for. Education on the menopause is the first important step towards progress: when seeing our GP, we rely on their knowledge and guidance, yet too often, we hear stories of women who go to their GP again and again without proper diagnosis. Some women have said that it is a gamble whether their individual doctor prescribes them the treatment they need, which has been echoed in some of the contributions to this debate.

It is therefore essential that we seek to improve the education and training of healthcare professionals across the NHS with regard to the menopause. As well as looking at those who are training now, we must look at those who are currently practising—those whom we currently rely on to diagnose and assist the millions of women experiencing the menopause today. Furthermore, as with all health concerns, early detection is essential. When it comes to menopause, early detection can prevent much unnecessary pain and suffering. That is why Labour has been so focused on making our health and care services deliver a prevention first revolution that would support our NHS, our economy and, importantly, women. If we fail to progress on awareness, early detection and prevention, we are surely failing at the first hurdle.

Turning to the availability of hormone replacement therapy products, I want first to commend the progress that has been made, and again praise the work of my hon. Friend the Member for Swansea East. It was her private Member’s Bill and her determined campaigning which, two years ago, saw the Government finally commit to reducing dramatically the cost of HRT prescriptions for women in England. I commend her on not giving up—on raising awareness and constantly pushing for change on this issue. It is also important to acknowledge the positive steps we are introducing, with a dedicated page on the NHS website for women’s health. I hope this becomes an invaluable source for women to access the latest information and advice on menopause, HRT and all women’s health issues.

But while progress has been made on access to HRT, the Minister will surely be aware that women face an HRT postcode lottery, and, as with so many health issues, those in the most deprived areas are least likely to receive support. It is important that we tackle the structural inequalities that contribute to poor health for disadvantaged groups.

Additionally, we must not forget the serious failures that have led to the continued shortage of HRT drugs. Women seeking to access HRT are still being failed by the system, with drugs unavailable and alternatives out of reach. This has left so many women with debilitating symptoms, extending unnecessary pain and suffering. Education and informing clinicians are no good if we do not also improve access to HRT and end shortages. As my hon. Friend the Member for Swansea East has said, it is a very bad sign when only 14% of the 13 million women experiencing the menopause in this country are getting treatment. I hope the Minister can update the House on the Government’s actions on ensuring that shortages of these essential treatments do not happen again and improving access to HRT for women.

Fundamental to progress for women experiencing menopause would be progress for women in the workplace. As my hon. Friend the Member for Oxford East (Anneliese Dodds) has announced, a Labour Government would advance this issue by bringing in menopause action plans for large employers and publishing guidance for small businesses to support women suffering with menopause symptoms. These important steps are part of our plans for a new deal for working people and will make Britain work for working women. These reforms will give hope to women and significantly help all who work so hard to hold their jobs and care for their children and families while experiencing the challenges and symptoms of menopause. This is the right thing to do for these women, but it is also good for employers and the economy as a whole.

It is a tragedy that one in 10 women experiencing menopause leave their jobs and 14% reduce their hours due to lack of support in the workplace. That means hundreds of thousands of women are reducing their hours, giving up promotions or quitting their jobs because of the menopause. Labour is on the side of these women, wherever they work, and unlike the Government, we have committed to take the required action. Does the Minister not agree they are failing women in the workplace and damaging the economy as a result?

I finish by praising all who took part in the menopause revolution in our country. I am sure the whole House will agree that not only has this revolution begun but that it will continue to grow. Central to the revolution is my hon. Friend the Member for Swansea East, whom I congratulate again on championing this cause. If we get this right, the difference we can make for the millions of menopausal women will be life-changing, benefiting them and all future generations of women, so that no woman has to suffer in silence again.

IVF Provision

Abena Oppong-Asare Excerpts

Tuesday 24th October 2023 Westminster Hall

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

It is a pleasure, as always, to serve under your chairship this morning, Mr Robertson. I congratulate my hon. Friend the Member for Jarrow (Kate Osborne) on securing this important debate, and thank her for championing such an important issue so eloquently today. She talked about the barriers that LGBTQI+ couples face to having children, particularly being priced out, and the fact that while the guidance is good, more work needs to be done.

I thank Megan and Whitney for sharing their hard-hitting story, along with many others who have done so much work to ensure that we are informed about these challenges. I know that there was an urgent briefing yesterday on IVF provision. I am sure everyone will agree with me that this has been a good debate, and that it is clear that a number of changes need to be made for the sake of equality and fairness.

I also thank the hon. Member for Cities of London and Westminster (Nickie Aiken), who has clearly done a lot of work in this area, for talking about the barriers that individuals may face in the workplace when undergoing IVF treatment. She mentioned businesses signing up to the fertility workplace pledge. The hon. Member for Strangford (Jim Shannon) spoke about how the IVF process was impacting his constituents and, as always, gave a helpful picture of the situation in Northern Ireland. I also thank my hon. Friend the Member for Pontypridd (Alex Davies-Jones) for sharing her personal story and for her work on the private Member’s Bill, the Fertility Treatment (Transparency) Bill.

As we all know, becoming a parent can be a special and rewarding time for many people. It is the start of an exciting journey into parenthood and a time to celebrate new life. However, as we have heard, there are many challenges that women and families face when conceiving and many challenges in the way of those who seek NHS fertility treatments. As my hon. Friend the Member for Jarrow powerfully said, the challenges—both financial and emotional—for LGBTQ+ couples are so much higher. IVF is one of several techniques available to help people become pregnant. This medical procedure has transformed countless lives, providing hope and the possibility of parenthood to those who might otherwise never experience it.

While IVF is a celebrated medical advancement, the lack of accessibility and the inequality of provision in England and across the UK are issues that cannot and should not be ignored. The National Institute for Health and Care Excellence is responsible for making recommendations about who should have access to IVF treatment on the NHS in England. The current guidelines for England recommend that IVF should be offered to women under the age of 43 who have been trying to get pregnant for two years, as has been mentioned. The exact NICE recommendation is three full cycles for women under 40 and one full cycle for women aged 40 to 42. While in some areas women under 40 can access three cycles of IVF, in other areas they are offered one or even none.

For example, in 2020, the British Pregnancy Advisory Service used freedom of information requests to find out that 86 clinical commissioning groups—now ICBs—funded only one cycle of treatment. More concerningly, it found that three CCGs in England did not provide any funding for IVF services at all. In fact, only 23 CCGs funded three cycles as recommended by NICE.

Unsurprisingly, the provision of IVF services across England, as pointed out by my hon. Friend the Member for Jarrow, has been described as a postcode lottery. I am sure we all agree that this is not right, that the policies are unfair and out of date, and that they must be updated as soon as possible.

I want to tackle the important issue raised by my hon. Friend about the need to break down barriers for all couples. As Stonewall has highlighted in its campaign on this issue, LGBTQI+ couples face incredible financial costs to achieve the same outcomes as everyone else. While the women’s health strategy pledged to remove financial barriers for female same-sex couples in England, the statistics prove that little progress has been made. According to Stonewall’s research, only four of the 42 ICBs in England officially provide NHS funding for artificial insemination, and nine in 10 ICBs in England still require same-sex couples to self-fund at least six cycles of intrauterine insemination before they are eligible for IVF treatment on the NHS. As the Minister will know, that means that LGBTQI+ couples are forced to go privately and end up paying large sums of money—thousands or even tens of thousands of pounds— before they can access NHS fertility services.

I agree with the crucial point that the Government must commit to tackling inequality in access to NHS-funded fertility services. ICBs should ensure fair access to treatment for all, and ensure that individuals within the LGBTQI+ community, including lesbians, bi women and trans individuals, are not left behind but have the same access to NHS-funded care. However, sadly, going private is now not the last resort but the norm for all individuals in England. In recent years, fewer and fewer women can access IVF treatments on the NHS, with everyone else having to go private. In fact, the use of privately funded IVF cycles by patients across the UK aged 18 to 34 increased to 63% in 2021 from 52% in 2019. That coincides with a fall across the board in numbers of NHS-funded IVF cycles. It is a damning result, highlighting the lack of support available on the NHS for women in the UK. Women are being forced to go private, and parents and families up and down the country face the added financial burden.

The Government must acknowledge that one of the main reasons for the falling levels of provision has been the extraordinary waiting times that women face prior to starting treatment. As the Royal College of Obstetricians and Gynaecologists has shown, although waiting lists were growing too quickly before the pandemic, the impact of the pandemic has made the situation significantly worse. There is an urgent need to reverse the growth of NHS waiting lists in gynaecology, and to ensure that women can access high-quality, timely care and treatment. I know that the Minister and this Government have committed to tackling those extraordinary waiting times, and I hope that she can update us regarding their progress on this critical issue. We all know that the quicker women are seen, the better the outcome will be.

Another critical factor is non-clinical access criteria, where mothers and parents can be denied access to treatment because of their relationship status—as pointed out by my hon. Friend the Member for Jarrow—their body mass index, or the fact that one partner has a child from a former relationship. The women’s health strategy seeks to remove non-clinical access criteria to fertility treatment, and to address geographical variation in access to NHS-funded fertility services. We on the Labour Benches welcome that ambition, but we know, as do the Government, that it cannot be realised without providing the NHS with the staff and resources it needs. As part of the work, the Minister has said that her Department will work with NHS England to assess fertility provision across ICBs, with a view to removing non-clinical access criteria. Can she confirm the extent of her conversations with NHS England and update Members on the timeline for making the changes?

For far too long, women and their partners have faced unnecessary obstacles to accessing IVF treatment. The Government have had 13 years to address those problems. Instead, I am concerned that they have weakened standards for patients, who are paying more tax but getting worse care. On the important issue of provision of IVF treatment, I welcome the ambitions outlined in the women’s health strategy. I hope that, along with Megan and Whitney’s powerful story, the Minister has been listening to hon. Members, especially my hon. Friend the Member for Jarrow, who has made it clear that the reforms need to happen sooner rather than later.

I urge the Minister to assure us today that there will be full implementation of these aims, and to give us a timeline for when they will occur. I urge her to give us hope that there will be an end to the postcode lottery, and to the inequality in provision faced by so many individuals and partners across England and the UK.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I thank the hon. Member for Jarrow (Kate Osborne) for tabling this important debate, and all Members across the Chamber for their contributions. It has been a positive debate—a good example of putting politics aside and debating how to do the right thing. While I am not denying the challenges for the LGBT+ community raised by the hon. Member, I want to highlight that the Government have brought in major changes over the years with the introduction of same-sex marriage, and the transformation of the management of HIV with the roll-out of opt-out testing and PrEP treatment.

I am pleased to announce that, following the advice from the Advisory Committee on the Safety of Blood, Tissues and Organs, the Government will be introducing secondary legislation to allow the donation of gametes by people with HIV who have an undetectable viral load; we will be introducing that as soon as we can. We will also be addressing the current discriminatory definitions of partner donation, which result in additional screening costs for female same-sex couples undergoing reciprocal IVF; again, amendments through statutory instruments will be introduced as soon as possible.

Those are some of the measures that we have been working on, but I absolutely understand from what I have heard today that there are many issues still to be dealt with, and I welcome the hon. Member for Jarrow holding my feet to the fire to deliver change. Hopefully some of these updates will provide reassurance. This is a priority area, which is why IVF, fertility, and particularly same-sex access to IVF, were in the first year of the women’s health strategy, and it is why we are not going to wait for the 10 years of the strategy to introduce the changes.

To be clear, the Government are implementing a policy that no form of self-financed or self-arranged insemination is to be required for same-sex couples to access fertility treatment. I acknowledge that is taking a little while to be rolled out across the country. Hon. Members, especially the hon. Member for Pontypridd (Alex Davies-Jones), have spoken about infertility a lot. We absolutely recognise that it has a serious effect on individuals and couples, which is why it is a priority—particularly for the women’s health strategy.

As the hon. Members for Strangford (Jim Shannon) and for Livingston (Hannah Bardell) pointed out, I can only speak on the provision of IVF in England, but I am very happy to work with colleagues in the devolved nations of Scotland, Wales and Northern Ireland to achieve a consistent approach. Although we are dealing with the inconsistencies in England, if we are a United Kingdom, these matters need to be addressed across all four nations and I am not precious about stealing best practice from other parts of the UK.

In our call for evidence for the women’s health strategy, women told us time and again that fertility was a key issue and that they felt very frustrated about the provision of, and access to, fertility treatment. Colleagues have made a number of important points which I will respond to in turn, but it has been recognised that there has been unequal access to IVF in England since the treatment was introduced; that is why this is such an important issue. There is resistance in some parts of the country to the changes the Government want to make, but I think we will be able to make progress on them.

NICE is reviewing its fertility guidelines, taking account of the latest evidence of clinical effectiveness. These will be published next year and we will be working with NHS England to implement these guidelines in England quickly and fairly. I am told that they will end regional variation and create a compassionate and consistent fertility service across England, but that does not mean that we cannot improve services in the meantime.

As has been set out, integrated care boards are now responsible for delivering IVF services. They were previously determined by CCGs, but from July last year the 42 ICBs across England are now responsible. Since the ICBs were created, we have seen a levelling up of IVF provision in many. Where CCGs have come together, ICBs have often adopted the higher rate of provision, rather than the lowest level. That is to be welcomed, but by no means does it mean that the level of provision is where we want it to be. Some, but by no means all, ICBs, including in north-east London and Sussex—I declare an interest as a Sussex MP—are now fully compliant with the current NICE guidelines and the provision of three cycles. Others are improving their integrated offer, but some ICBs have kept their pre-existing local offer. That is not good enough, and we are aiming to tackle it.

[Abena Oppong-Asare]

What conversations has the Minister been having to make sure that ICBs are currently being updated to be as robust as possible?

[Maria Caulfield]

I will go through that. One of the first things we have done is to be transparent about what is being offered. We have asked every ICB—the whole 42—to detail their provision. We are now publishing that on gov.uk, so if ivf.gov.uk is entered, the table will come up. That illustrates the number of cycles offered by every ICB, the age provision, the previous children rule and what funding is offered for cryo-preservation. That is not just to say, “This is what’s on offer” so that women and couples can see what is available in their area; it is also the start of the process of holding ICBs’ feet to the fire—and for local MPs to be able to say, “Look, they’re offering free cycles in Sussex; why are we not offering that in our local area?”

[Abena Oppong-Asare]

The Minister may be about to get to this point, so I apologise if I have intervened too quickly. In terms of transparency, it is great that the Minister is publishing the data, but what are the Government doing to make sure that more work is being done by ICBs to provide a better—or adequate—service, given that publishing data does not require them to take any action?

[Maria Caulfield]

As the hon. Lady will know, it was only last year that we published the women’s health strategy. IVF was front and centre of that—the first year priority. Getting that information is the first step, and then we are able to look at the ICBs that are not offering the required level of service, have those conversations about why and have a step change to improve the offer. That is just one tool in our box to fulfil our ambition to end the postcode lottery for fertility treatment across England.

Colleagues have also raised the issue of lack of information about IVF, both for the public and healthcare professionals. We are working closely with NHS England to update the NHS website to make IVF more prominent, and also with the royal colleges to improve the awareness of IVF across healthcare professions. One area we are dealing with is that of add-ons, which the hon. Member for Pontypridd (Alex Davies-Jones) and my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) addressed. As part of our discussions with the HFEA, it now has the add-on rating system, so that people can see what percentage difference an add-on would make and make an informed choice about whether they want to do that as part of their IVF treatment.

I have also just received the HFEA’s report about modernising the legislation, with particular regard to its regulatory powers. That will cover the provision of add-ons, and I hope to be able to respond to the report as quickly as possible. We are making really big changes to some of the issues that have been holding back IVF for a long time. I know that for many people this is not quick enough, but I reassure hon. Members that progress is being made.

For female same-sex couples and same-sex couples across the board, I know that this is a really important matter. I took the position that it was unacceptable for female same-sex couples to shoulder an additional financial burden to access NHS-funded fertility treatment. On the transparency toolkit now on the gov.uk website, we can easily see which parts of the country are asking for six cycles of self-funded insemination, for instance. In Cambridgeshire and Peterborough it is 12 cycles, in Bristol and north Somerset it is 10. As the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) said, that is exactly the information we need so that we can tackle the issue head-on and directly with the ICBs. Indeed, one of our key commitments in the women’s health strategy was to remove this injustice once and for all. We were hoping to do that completely in the first year; it will in fact take us a little longer, but it will not take us 10 years.

Covid-19 Vaccine Damage Payments Bill

Abena Oppong-Asare Excerpts

2nd reading
Friday 20th October 2023 Commons Chamber

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I congratulate the hon. Member for Christchurch (Sir Christopher Chope) on securing Second Reading of the Bill. I thank the right hon. Member for Tatton (Esther McVey) and the hon. Member for Shipley (Philip Davies) for participating in the debate. I have listened attentively to the issues they raise.

I will begin by setting out Labour’s position on the matter. We believe that the covid-19 vaccine is safe and effective. It has saved countless lives, not only in Britain but across the globe. Over the course of the pandemic, over 230,000 people across the UK died with covid-19. Therefore, it is important we do not understate that getting a vaccination has been, and continues to be, the single most effective way to reduce deaths and severe illness from covid-19.

[Andrew Bridgen (North West Leicestershire) (Reclaim)]

rose— Members from across the House will be aware that all vaccines go through extensive and ongoing testing procedures. The covid-19 vaccines went through multiple stages of clinical trials before being approved. [Interruption.] The vaccine has met strict independent standards for safety, quality and effectiveness.

[Andrew Bridgen]

On that point, will the hon. Lady give way?

[Abena Oppong-Asare]

I will not.

[Mr Deputy Speaker (Sir Roger Gale)]

Order. It is entirely up to the hon. Lady whether she gives way or not, but Members should not walk into the Chamber three quarters of the way through a debate and then seek to intervene.

[Abena Oppong-Asare]

It is important for me to set out Labour’s position on the matter. Without the vaccine and the work of scientists, volunteers and NHS staff, we would not have been able to end the lockdowns and return to our daily lives. I am sure we all agree on that. Therefore, the shadow health and social care team remain extraordinarily grateful to all those who have worked so hard to build and roll out the vaccines across the UK.

However, while the covid-19 vaccination programme has been hugely successful, there have been some extremely rare cases of people sadly suffering side effects and deteriorating health with possible links to covid-19 vaccines. While serious and adverse events are rare compared to the number of doses administered, when they do occur, they can have unexpected and life-changing implications.

It is therefore right that our healthcare system and this Government do all they can to improve the diagnosis and treatment of those who have suffered from this. The yellow card scheme already collects and monitors information on suspected safety concerns, and a dedicated team of scientists reviews information to monitor the vaccine roll out. I encourage everyone to keep using that scheme, to ensure that information can be collected.

Where vaccine damage tragically occurs, it is right that individuals and families can access the vaccine damage payment scheme. It is important that that scheme is fit for purpose and that the Government act to make that happen. There have been reports of operational delays within the vaccine damage payment scheme. Those reports suggests that hundreds of people have been waiting over 12 months for an outcome, with some waiting more than 18 months.

In fact, following a question about the VDPS earlier this year, the Prime Minister vowed to improve the scheme, so I will be interested to hear from the Minister about the Government’s response to tackling those delays. Will the Minister confirm that the Government believe that the scheme is fit for purpose and whether they plan to update it? Will the Government assure us that the NHS Business Services Authority has the capacity to process applications to the VDPS in a timely manner? I urge Ministers to meet and engage with affected individuals and their families to look at ways to improve diagnosis and treatment and at how claims under the VDPS can be addressed more quickly.

[Sir Christopher Chope]

On that point, will the hon. Lady give way?

[Abena Oppong-Asare]

I will, but the hon. Member has spoken at length already.

[Sir Christopher Chope]

I am grateful to the hon. Lady for giving way. Does the Labour party believe that the vaccine damage payment scheme is fit for purpose, or does it not believe that?

[Abena Oppong-Asare]

As I have said, I have asked the Minister to meet members of the families who are directly affected to see whether there are ways to improve the scheme, and how that could be addressed more quickly. That is the best step forward, and we need to listen to individuals regarding tailored support and where it needs to be improved.

Finally, it would be remiss of me not to join colleagues in calling out the scourge of vaccine misinformation. Getting a vaccine is so important, especially for those who are most vulnerable. We must ensure that all vaccine misinformation is debunked, and that the most important message, that the vaccine is safe and effective, is shared. I hope the Minister will echo my remarks on the danger of misinformation. Getting a vaccination is too important for the health of this nation—indeed, this world—to be playing fast and loose with the facts. Although the Opposition do not support the Bill, we hope that the Government will tackle the issues that I and other hon. Members have raised, and address whether further action is required.

Birth Trauma

Abena Oppong-Asare Excerpts

Thursday 19th October 2023 Commons Chamber

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I thank the hon. Member for Stafford (Theo Clarke) for securing this important debate. I know that she has worked hard to raise this issue both in the Chamber and through her work outside it. I want to express my deep admiration of her for sharing in public such a moving story about a terrifying experience. That takes a lot of courage.

I thank my hon. Friend the Member for Canterbury (Rosie Duffield) for her kindness and congratulate her on her work on the newly launched all-party parliamentary group for birth trauma. I know that it will be successful and productive. I thank the hon. Member for Moray (Douglas Ross) for sharing his personal story and being an ally. He rightly said that it is shameful that this is happening in 2023, and that is linked to what my hon. Friend the Member for Canterbury said about how her friends and family have to name-drop her before they can get the support that they deserve. I thank the hon. Members for North Shropshire (Helen Morgan) and for Truro and Falmouth (Cherilyn Mackrory), too, for sharing their stories. I also thank the mothers with experience of this issue who are watching in the Chamber, and organisations that are working really hard on the issue.

This has been a very constructive debate. As we have heard, birth trauma is a difficult experience for anyone, but it has been in the shadows for far too long. It is right that we are speaking about it today and making it clear to the Government and all Members of the House that there is progress to be made. Pregnancy, birth and becoming a parent can be a special and rewarding time for many people. It is the start of an exciting journey into parenthood and a time to celebrate new life. However, it is clear that, at a moment of such importance and sensitivity, when complications occur the right support does not always follow. The statistics on maternity outcomes lay bare the problem that we face. The level of support is down, satisfaction is down, and confidence and trust in the system is down.

The Care Quality Commission’s “Maternity survey 2022” reported that women’s experiences of care had deteriorated in the last five years. The proportion of women contacting a midwifery team who were given the help that they needed during antenatal care dropped from 74% in 2017 to 69% in 2022. As for postnatal care, only 70% of mothers were “always” given the help that they needed when contacting a midwifery or health visiting team, a fall of nearly 10% since 2019. The downward trends continue: less than half—just 45%—said that they could “always” get support or advice about feeding their babies during evenings, nights or weekends, down from 56% in 2017, and just 59% said they were always given the information and explanations that they needed during their care in hospital, down from 66% in 2017.

What those statistics show is that mothers do not have full confidence in our system, and things are only getting worse. It is therefore not surprising to hear that, according to the Birth Trauma Association, between about 4% and 5% of women who give birth develop a post-traumatic stress disorder: that is about 30,000 women a year in the UK. The symptoms include flashbacks, nightmares, and extreme anxiety that make daily life immensely challenging. This is a shocking and sad indictment of the current system and shows how much more needs to be done.

We should also not forget the vast health inequalities that exist across Britain. We should all be aware of the fact that women in the nation’s most deprived areas are 3.5 times more likely to die from an avoidable cause than those in the least deprived areas, and the fact—mentioned by my hon. Friend the Member for Canterbury —that maternal mortality among black women is currently almost four times higher than it is among white women. That is why Labour’s mission sets an explicit target to end the black maternal mortality gap. The pandemic, of course, exacerbated those existing inequalities, particularly among the most vulnerable women in our society. As we heard from the hon. Member for Stafford and my hon. Friend the Member for Canterbury, the feelings of anxiety, helplessness, and fear that those with birth trauma endure are traumatic for all, but for women also to know that they are more at risk because of their race, their income or where they live is shocking, sad and wrong.

Yesterday, along with the shadow Secretary of State for Health and Social Care, my hon. Friend the Member for Ilford North (Wes Streeting), I met representatives of the Maternal Mental Health Alliance. They welcome the roll-out of maternal mental health services in some parts of the country, focusing on those with mental health difficulties arising from trauma or loss related to childbirth, fear of childbirth, miscarriage, stillbirth, neonatal death, pregnancy termination and loss of custody whose needs are not currently met by other services. What concerns them is that these services are not available in every part of England. As the hon. Member for Stafford pointed out, there is significant variation in the support offered by the services that been rolled out so far, creating a postcode lottery for women, babies and families. The alliance is also concerned about the lack of sustainable funding for many services. These are fundamental services providing vital care for women; they are not luxury extras. We need to ensure that in all parts of the country, women who have experienced birth trauma and are struggling with their mental health have access to specialist support, and that there is continued funding in every area to meet the level of need that we know is out there. That is the alliance’s ask of the Minister.

I want to make it clear that I am not saying we do not appreciate the vast majority of our NHS and healthcare workers. Labour believes that the NHS is the backbone of our country, and will never abandon the founding principles of the NHS as a publicly funded public service, free at the point of use. However, as with so many other issues, this Government are presiding over a healthcare system that is going backwards rather than forward. It is the Government’s role to break down barriers and solve the difficult problems that we face, but it sometimes seems that those barriers are becoming higher and higher.

I want to raise with the Minister some concerns about the women’s health strategy. It lacks a plan to tackle the increasing waiting lists and a plan to enhance maternity care standards, and it fails to address the persistent staffing shortages. As my hon. Friend the Member for Enfield North (Feryal Clark) has said previously, it is plainly inadequate. The Royal College of Midwives told me this week that fundamental to delivering better maternity care is having enough midwives. The fact is that midwives are leaving the profession in droves, and the Government are failing to stop it happening. The Minister must tell us how she plans to keep the staff whom we currently have and ensure that the problems do not continue to worsen.

On top of those shortcomings, there is the problem that when a mother needs mental health support, the resources simply are not there. Midwives do not have the expertise or the time, and the result is that parents’ mental health is not being fully assessed. Overall, patients seeking mental health treatment spent more than 5.4 million hours waiting in A&E in 2021 and 2022. The reality is that patients are waiting or being overlooked rather than getting the support that they need. It is therefore no surprise that the deputy chief executive of NHS Providers has said that mental health services are over- stretched and understaffed, and that trusts are deeply concerned about the levels of unmet need. We need measures to address all these problems early.

Let me end by again congratulating the hon. Member for Stafford on securing the debate. I know it is not easy for her to share her story, and I hope she feels reassured that she has taken a significant step today in raising such an important issue.

Baby Loss Awareness Week

Abena Oppong-Asare Excerpts

Thursday 19th October 2023 Commons Chamber

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I congratulate the hon. Member for North Shropshire (Helen Morgan) and my hon. Friend the Member for Sheffield, Hallam (Olivia Blake) on securing this important Back-Bench debate to discuss Baby Loss Awareness Week. I thank all those who have spoken today on this important topic, including the hon. Members for East Worthing and Shoreham (Tim Loughton) and for Truro and Falmouth (Cherilyn Mackrory). I also take the opportunity to pay tribute to my hon. Friend the Member for Luton North (Sarah Owen), who has done a lot of work in this area and has shared her personal story of child miscarriage, and to my hon. Friend the Member for Sheffield, Hallam, who has been campaigning for over three years with Myleene Klass to secure changes. My hon. Friend is pleased that the Government have responded positively to the issues they have been campaigning on, which includes a trial of a graded model for sporadic and recurrent miscarriage care at Tommy’s in Birmingham.

I also pay tribute to members of the Baby Loss Awareness Alliance, including Sands, and all the charities involved in that work. They work together to drive through change and improvements in policy, research and bereavement care, and it is because of their great work that Baby Loss Awareness Week is such a great success each year. Furthermore, it is important to highlight the instrumental work of the all-party parliamentary group on baby loss. I applaud its work in supporting the establishment of the national bereavement care pathway, and its promotion of this debate and of Baby Loss Awareness Week in Parliament.

As Members may know, I am new to my role as the shadow Minister for women’s health and mental health. As such, I want to begin by sharing my deepest sympathies with all parents who have suffered the worst tragedy possible: the loss of their child. It is a privilege to have this opportunity to speak out, raise awareness and support change. Members may know a friend, loved one or constituent who has faced this terrible ordeal, and there is no more devastating experience. That is why this debate is so important. As previous speakers have highlighted, we must continue to stand up and champion the cause of Baby Loss Awareness Week to support families dealing with the grief of baby loss and to prevent it from happening in the first place. However, I want Members to know that, although I am new to this role, like so many I have long been an advocate of tackling the persistent issues that mothers in the UK face.

Constituents have shared with me their personal stories about their loss and the difficult grieving process that follows. I thank them all for sharing their stories to incentivise change. One constituent who lost her daughter said to me:

“My daughter matters. They all do.”

I want to share: “You are remembered, and you are missed.”

When it comes to the rate of mortality, it is good to know that levels have continually decreased in the last few decades. However, we will all be concerned that the rate of this decrease has slowed over recent years. Overall, the Government have set an ambition to halve the 2010 stillbirth rate in England by 2025. To meet this target, the rate would need to decrease to 2.6 per 1,000 births. Instead, last year the stillbirth rate for England was 3.9 per 1,000 births, so it will be important to hear from the Minister about her plans to accelerate our progress towards this target.

We also know that there remain significant geographical, racial and socioeconomic inequalities in these rates. For example, a few years ago NHS England reported that there was still a variation of about 25% in stillbirth rates across England. Office for National Statistics figures indicate that this geographical inequality persists. To be exact, the 2021 stillbirth rate for the 10% most deprived areas of England was more than twice as high as the rate in the 10% least deprived areas. That is 5.6 stillbirths per 1,000 births in the most deprived areas compared with 2.7 per 1,000 births in the least deprived. As Members would expect, the same shocking disparities occur in the neonatal mortality rate and the infant mortality rate.

Important work by groups already mentioned, such as Five X More, have highlighted that stillbirth rates for black babies are twice as high as for white babies, and neonatal death rates are 45% higher. It is therefore clear that there is still so much more work to be done in this area, and I urge the Government to address these inequalities and the calls for changes and improvements to the system. We must accelerate this decline in the rates and tackle the appalling health inequalities that our country faces.

As well as tackling that, we must commit to supporting parents and families as they face the difficult process of grieving. All families affected by baby loss must receive the best care and support as soon as possible. We know that the sooner they get it, the better that care is for them, yet access to bereavement support varies across the country. Although most NHS trusts in England have joined the national bereavement care pathway, Ministers should do everything possible to improve provision.

There has also been a longstanding campaign by Sands for access to well-resourced continuity of carer models to ensure consistency in the midwife or clinical team. That would provide care for a mother and baby throughout the maternity journey. However, the Government have dropped the target for most women to have access to continuity of care. Furthermore, severe staffing shortages mean women can no longer expect to see the same midwife from scan to delivery. On top of that, the Government have rejected the Women and Equalities Committee recommendation to set a target and strategy to end disparities in maternal deaths. The pace of progress in enhancing maternity services has been frustratingly slow. They must set clear targets to address inequalities in maternal and neonatal outcomes. By doing that, they could ensure the delivery of safe care to all mothers and their babies.

The Opposition welcome the long-awaited NHS workforce plan, which mirrors the commitment we have been calling for, and the next Labour Government will deliver on those aims. Alongside that, we will reform the NHS so that it is there for people when they need it. We want our NHS back on its feet and fit for the future. I therefore look forward to hearing from the Minister about what work she has been doing with the NHS, charities and all those campaigning for change, and I also look forward to hearing what the Department has been and will be doing to reduce baby loss and support those grieving.

Black History Month

Abena Oppong-Asare Excerpts

Thursday 19th October 2023 Commons Chamber

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I begin by saying that I find myself in an unusual situation today, as I have participated in a number of debates—this is my third—and it has been great getting to know the Minister a bit better. I thank Mr Speaker for selecting this important Adjournment debate and ensuring that we can once again debate Black History Month during the month of October.

Black History Month is an extremely important annual event, but I strongly believe we should be talking about black history week in, week out, and not just once a year. The theme of this year’s Black History Month is “Saluting our sisters”. I begin my speech, as I have done in previous years, by highlighting and celebrating a number of black Britons who have been under-appreciated and under-recognised in our national discourse. These black Britons are great Britons, and we should celebrate them as such. Again, I pay tribute to Akyaaba Addai-Sebo, co-ordinator of special projects for the Greater London Council, who organised the first recognition of this month in 1987.

With this year’s theme, I would like to highlight the crucial role that black women have played in shaping history, inspiring change and building communities. I have previously mentioned Mary Prince, who was the first woman to present an anti-slavery petition to Parliament and the first black woman to write and publish an autobiography. A petition was proposed to place a statue of her outside the Museum of London Docklands. To this day, there has been no statue.

I also pay tribute to some of Health Service Journal’s top 50 black figures who are leading the way in English NHS and health policy. Karen Bonner, one of a handful of acute trust chief nurses in the NHS, has been described as getting a great deal of attention for her “tremendous leadership” and “inspirational talks”. She has worked with Prostate Cancer UK to raise awareness of the disease in the black community. One in four black men will get prostate cancer in their lifetime. Black men are more likely to get prostate cancer than any other men, who have a one-in-eight-chance. We do not know why black men are more likely to get prostate cancer, but it is one of the easiest cancers to treat if detected early. It is good practice to have early testing and screening.

Dr Jacqui Dyer is a director of Global Black Thrive and one of the key voices calling for the mental health system to recognise the different experiences of black, Asian and minority people. Yvonne Coghill assists organisations in working towards workforce race equality and is a special adviser to and board member of the NHS race and health observatory.

Marie Gabriel is one of the most experienced black NHS non-executives in the country. Dr Lade Smith, the president of the Royal College of Psychiatrists, is the first black woman to hold the role in the college’s 182-year history and only the fifth woman. I cannot mention all 50, but they are all inspiring. I suggest that everyone checks them out.

As well as paying tribute to under-acknowledged black Britons, I want to use the debate to highlight some of the inequalities that continue to affect black people in this country, which the Government must do more to address. First, there is black maternal health. I pay tribute to Five X More and the Motherhood Group for their outstanding campaigning on that. I am sure the Minister agrees that they have done so much to bring it up the political agenda. Their work has highlighted the stark disparities in outcomes that black women face when giving birth in this country. Black women in the UK are four times more likely to die while pregnant, while giving birth or as new mothers than white women. I commend Sandra, the founder of the Motherhood Group, for hosting the first ever black maternal health conference in the UK with the aim of rebuilding trust between the community and service providers and exploring the role of racism, human rights and structural change and how to engage effectively with black mothers.

I also commend the founders of Five X More, Clo and Tinuke, who held a women’s health summit to drive change. I am sure that the Minister saw the publication last week of the MBRRACE mortality and morbidity confidential inquiries report, which shows that there has been no change in the shocking statistics. Labour is committed to tackling that by training more midwives and health visitors, incentivising continuity of care and improving course content on the presentation of illness and pain among different groups. We will ensure that the NHS is squarely focused on tackling this shocking disparity. Put simply, giving birth as a black woman is considerably riskier than for women of other ethnicities. The Government know that that inequality exists, and now is the time for action.

I turn to another issue that affects black women and girls: the lack of specialist training for police and other agencies supporting black women who are victims of domestic abuse. I play tribute to Sistah Space, a domestic abuse charity supporting women of African and Caribbean heritage. It set up a petition to introduce Valerie’s law, which is named in memory of Valerie Ford, who was murdered by her former partner in 2014, alongside their 22-month-old daughter. She had previously asked the police for help after he ex-partner threatened to burn down their house with her in it. It was recorded only as a threat to a property.

While that story is shocking, sadly, it is not uncommon. Too many black women do not get the support they need because the police are not trained to spot and deal appropriately with domestic violence in black communities. That includes things such as missing signs of domestic violence on black skin, and the lack of cultural knowledge about how threats can be communicated. We need mandatory specialist training for the police and others on all that and more. I hope the Government will seriously consider that as part of a renewed focus on violence against women and girls, given recent events. I have raised this issue a number of times in Parliament, and was successful in getting a former Minister to agree to a meeting, following a debate on support for black victims of domestic abuse on 28 March 2022. That meeting took place, and a number of agreed actions followed. I met the representatives of the petition recently, who sadly informed me that nothing has followed since. I would be grateful if the Minister committed today that she or one of her colleagues will take up this matter as soon as possible.

[Jane Stevenson (Wolverhampton North East) (Con)]

The hon. Lady raises some incredibly important points. I have a large number of black constituents. What national efforts need to be made to achieve the things that she is setting out so clearly?

[Abena Oppong-Asare]

I thank the hon. Lady for her intervention and for the water. The Government can do a number of things, which I will come to.

I would like to bring the House’s attention to the largest ever survey undertaken for black Britons, carried out recently by The Voice newspaper and Cambridge University. I hosted the publication of the “Black British Voices” report in Parliament. The data I saw was shocking but not surprising. It showed that people had serious concerns about racism across education and the workplace. The report revealed that 41% of more than 10,000 black Britons surveyed identified racism as the biggest barrier to young black people’s education attainment. Of those surveyed, 95% believed that the national curriculum neglects black lives and experience. I am sure that Members agree that those statistics are alarming. Furthermore, fewer than 2% believed that educational institutions take racism seriously. In the light of the data, more work needs to be done to address those issues. I am worried about young black people growing up feeling that the system does not really work for them, particularly when looking at opportunities that may arise.

I want to talk about the 75th anniversary of the Empire Windrush’s arrival in Britain, when half a million people came to the UK after the second world war. It is important to reflect on the shameful Windrush scandal and assess what progress the Government have made to right the wrongs they have perpetuated. I am proud to represent a diverse constituency and to champion the contributions of the Caribbean community, but the Government’s treatment of the Windrush generation is one of the most shameful episodes in our post-war history. The Windrush generation were victimised under the hostile environment policy. People have been let down by the compensation scheme that was not fit for purpose and betrayed by the Government not implementing all the recommendations of the Wendy Williams lessons learned report. I have raised that with the Government a number of times and I am disappointed that there has not been a huge amount of progress in addressing it. I am proud that Labour will help to deliver justice for the Windrush generation by looking to overhaul the Windrush scheme and putting it outside Home Office control, and enacting all the recommendations of the Wendy Williams review.

I want to return to the asks that I made of the Government during the Black History Month debate last year. The first was for action to diversify the curriculum. As I have said previously, I want our children, whether they are black or white, in every corner of the country, to better understand our national history and culture. That includes talking about the good and the bad—the range of experiences that people have had. I am pleased by the progress being made by the Welsh Government; Wales has become the first UK nation to make the teaching of black, Asian and minority ethnic histories and experiences mandatory in the school curriculum. I believe that black history is British history and needs to be taught all year round.

My second ask was for the implementation of a race equality strategy and action plan. There has been much discussion about the inequality and structural racism in our country. The Government have done some work, particularly in relation to the Sewell report, which was seen as controversial, but they have not always been seen to go far enough in terms of concrete action. A race equality strategy and action plan, which is desperately needed, would cover areas such as education, health and employment, and should include specific proposals to address well-known inequalities such as the ethnicity pay gap, unequal access to justice and the impacts of the pandemic on black people. I support the Labour party’s policy on that.

In the current climate, as we come to a general election, I do not want any political party to see certain ethnic minority groups as a tool in culture wars. We need to make sure in the run-up to the election that everyone plays a role and that no one feels that they are being targeted because of their ethnicity. I am grateful, once again, for the opportunity to speak in this debate.

[The Minister for Women (Maria Caulfield)]

I am grateful to be able to contribute to this Adjournment debate to mark Black History Month. I congratulate the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) on what has been a marathon afternoon for us both. It is lovely to finish the afternoon by responding to such an important debate.

As Minister for Women, I was pleased to see that one of this year’s themes for Black History Month is “celebrating sisters”. That gives us a chance to recognise the important contribution that black British women have made in the story of this nation. From individuals such as Mary Seacole, a trailblazing nurse who served during the Crimean war, to women from the Windrush generation who helped rebuild this country after the second world war, these pioneering women fought for civil rights and equality, playing an essential role in shaping the diverse and inclusive nation we are today.

As a Government, we are committed to ensuring that Black History Month is, as the hon. Lady said, not a once-a-year event and that schools are equipped to teach black history all year round. How our past is taught is crucial to ensuring that every pupil, regardless of their background, feels a sense of belonging to this country. We also want to celebrate the fact that our country is more diverse than ever before. According to the 2021 census, 18% of people in England and Wales are now from an ethnic minority group, compared with just 14% in 2011. Integration is also increasing, with the mixed- ethnicity population in England increasing by 40% in 10 years; 2.4 million households are now multi-ethnic.

[Abena Oppong-Asare]

According to some of the latest data, contained in a report produced recently by the newspaper the Voice in conjunction with Cambridge University, although we are seeing more diversity, especially in communities, there are concerns about the way people feel. May I urge the Minister to look at the report and think about what action can be taken in that regard?

[Maria Caulfield]

I have not seen the report, but I shall be happy to look at it, because the question of how people feel is important, in terms of both their experience and how it shapes their future.

It would of course be naive to say that tolerance and inclusion are the universal experiences of everyone who lives here, which is why, in July 2020, the then Prime Minister established the Commission on Race and Ethnic Disparities. We published our response to the Commission, “Inclusive Britain”, in March last year. That response sets out a groundbreaking action plan to level up the country, with three clear aims: to build a stronger sense of trust and fairness in our institutions—the hon. Lady touched on that, in relation to maternal health in particular —to promote equality of opportunity, encouraging aspiration and empowering individuals to reach their full potential; and to encourage and instil a sense of belonging to a multi-ethnic United Kingdom that celebrates its differences while embracing the values that unite us all.

The landmark “Inclusive Britain” strategy sets out 74 actions to tackle entrenched ethnic disparities in health, education, employment, policing and criminal justice. The strategy aims to increase trust and fairness, promote equality of opportunity, nurture agency, and foster a greater sense of belonging and inclusion. In April we published an update for Parliament, setting out the excellent progress we had made in delivering our ambitious strategy. This is a cross-Government approach, and we have delivered a number of changes already. There is new guidance from employers on how to use positive action in the workplace. We have published our ambitious schools White Paper, and provided targeted support for pupils who need it the most. We have established an Inclusion at Work panel to promote fairness in the workplace, and we are improving the stop and search process through new training for police officers. All of that will make a difference to the lives of black communities. Eighteen months on, we have already completed more than half those 74 actions, and we are proud to be delivering on our promises to all our citizens.

[Abena Oppong-Asare]

I appreciate that the Government are taking steps to try to address this issue, but given that this is the 75th year of the Windrush generation, I should like to hear more about what they are going to do for, in particular, those who have contributed so much to the NHS, have worked in Transport for London, and have helped our public sectors in general. They are being massively left behind, and the compensation scheme has not moved forward at all.

[Maria Caulfield]

The hon. Lady raised that point in her speech. We want to make sure that this is a fair scheme. The Home Office has reduced the time taken to allocate a claim for a substantive casework consideration from 18 months to less than five months. However, I fully understand the points that the hon. Lady has made, and I am happy to raise them with Home Office colleagues, because we fully understand the frustration and the upset that has been caused.

[Abena Oppong-Asare]

It is great that the case workload has been reduced, although it needs to be speeded up. However, I want to ask about the Wendy Williams review, which has been in place for some time. Is the Minister able to give us any firm commitments on its full implementation and any timescales applying to that?

[Maria Caulfield]

I am not able to give a firm commitment from the Dispatch Box this afternoon, but I can update the hon. Lady, and I shall be happy to write to her with some firm timelines after the debate.

I understand that Windrush is a particularly sensitive area, but I reassure the hon. Lady that we are making progress across the board, particularly on the school curriculum. Our model history curriculum will help pupils to understand the complex nature of British history and their place within it.

The hon. Lady touched on maternal health, and the evidence and statistics show that women from black, Asian and working-class backgrounds have poorer maternity outcomes, which is why I am so pleased that we set up the maternity disparities taskforce. My co-chair Wendy Olayiwola is a trailblazing black woman, and she follows the fantastic Professor Jacqueline Dunkley-Bent, who transformed how maternity services respond to black women in particular.

We established the taskforce in February 2022 to tackle disparities for mothers and babies, and our work is currently focused on pre-conception health and wellbeing because our understanding is that disparities are often bedded in by the time a woman is pregnant. The way to reduce those disparities is to ensure that women have help and support before getting pregnant, as that is the best way to ensure a safe outcome during pregnancy and birth.

The taskforce met in September, just a few weeks ago, and we are bringing together experts from across the health system, including some of the charities that the hon. Lady talked about, to explore and consider interventions. We are looking at setting up a pre-conception toolkit, and those charities, including Five X More, are feeding in what they think will make the greatest difference for women across the board. We know from their testimony that previous poor experience of healthcare services often prevents black women from engaging with healthcare services in future. It is important that we break down those barriers and change black women’s experience of NHS services.

Our Online Safety Bill will soon become law, allowing us to hold social media companies to account in clamping down on online racist abuse. This is just a taste of the work we have done and will continue to do to make sure the inclusive Britain commitments are implemented.

The hon. Lady touched on a meeting back in 2022. I was not the Minister at the time, but I am happy to follow up and let her know the outcomes. If it has not been actioned since that meeting, I will follow it up.

I am grateful for the points raised by the hon. Lady throughout this debate. I share some of her concerns, particularly on maternity services, and we are committed to trying to transform the statistics to make sure that black and Asian women in particular, have better maternity outcomes.

Across the board, the Government are committed to continuing to work towards a society in which every individual, regardless of their background, has the opportunity to succeed. We are not there yet, as the hon. Lady so eloquently pointed out, but I have every confidence that the decisive action we are taking as part of our inclusive Britain strategy will help us to achieve that goal.

Question put and agreed to.

PANS and PANDAS

Abena Oppong-Asare Excerpts

Tuesday 12th September 2023 Westminster Hall

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

It is a pleasure, as always, to serve under your chairship, Mr Dowd, and it is my pleasure to speak for the first time in my new shadow ministerial role.

I congratulate the hon. Member for North East Fife (Wendy Chamberlain), and thank her for championing this important issue, which she has eloquently raised. She has previously raised it on a number of occasions, and has in particular talked about her constituent, the nine-year-old girl who I believe is still facing this incredibly challenging condition. The hon. Member spoke on behalf of her constituents today, as other people in the debate have. She has been a champion on the issue by talking about how the conditions affect people—from raising it in Prime Minister’s questions and her work on the all-party parliamentary group on PANS and PANDAS, to securing today’s Westminster Hall debate. I thank her for her work.

I also thank everybody who has contributed to the discussion. They have also spoken passionately about their affected constituents. For example, the hon. Member for North Devon (Selaine Saxby) talked about her constituent Jack. My hon. Friend the Member for Brentford and Isleworth (Ruth Cadbury) talked about the chronic lack of awareness and about how getting a diagnosis is key, which was echoed by the hon. Member for Aberconwy (Robin Millar). I commend the hon. Member for South West Bedfordshire (Andrew Selous) for his leadership in taking the time to circulate literature to GPs, who I am sure will find that information useful. I also echo what was said by my hon. Friend the Member for Wansbeck (Ian Lavery): this debate raises further awareness about the condition.

As hon. Members have mentioned, PANS and PANDAS are a set of conditions that result in an inflammation of the brain, which gives rise to an array of symptoms such as OCD, tics and dietary restrictions. It is a cruel condition that can affect a child overnight and out of the blue. The conditions are often misdiagnosed and blamed on bad behaviour or poor parenting. The symptoms can manifest suddenly and bring about profound life changes, as we know not just from the data but from the stories shared by hon. Members in the debate. I found it particularly concerning that as little as 10% of NHS doctors have heard of the condition. That means many children are being misdiagnosed and mistreated. The charity PANS PANDAS UK estimates that approximately 8,500 children experience the disorders. I send my sincere empathy to everyone who faces those challenges and all the families affected.

Those who need treatment and support face major barriers. There is currently no guidance for PANS and PANDAS written or endorsed by bodies such as the National Institute for Health and Care Excellence, NHS England or the royal colleges. As Members have mentioned, those barriers result in many families being forced to seek expensive private treatment to prevent further suffering.

Recent years have seen a number of important developments on the issue. In April 2021, the British Paediatric Neurology Association published a consensus statement that recognised the lack of high-quality scientific studies and urged

“further research so that robust treatment guidelines may be formulated.”

I would be grateful if the Minister could tell us whether she is aware of that and what engagement she has had with the British Paediatric Neurology Association on the matter. Late last year, the PANS PANDAS working group, in collaboration with the BPNA and others, began the process of developing standards of care, pathways and service models, which it hopes will assist all primary and secondary clinicians. The working group has also recommended that all NHS trusts develop a comprehensive cross-speciality and multidisciplinary team provision to support patients.

On top of that important work and collaboration is the effort made by campaigners to raise awareness of this issue. I thank all campaign groups, families, Members present and members of the public who have signed petitions or written to their Member of Parliament to bring this issue out of the shadows. Having heard from Members of different parties about the disease, the research and the stories of those affected, it is important that the Minister provides clarity about the Government’s position. She confirmed in an answer to a written question earlier this year that her Department had had no discussions with NHS England on the adequacy and consistency of treatment pathways for children living with PANS and PANDAS. Could she please confirm today that the situation has changed? It is also important to know what discussions are being held in the Department and with stakeholders on the development of care pathways for children and young people living with this condition. Finally, what steps is the Department of Health and Social Care taking to ensure that children and young people living with PANS and PANDAS receive effective, patient-centred care?

We must also consider the wider issues. The Government must acknowledge their failures over 13 years to support our health and care providers up and down the country. Patients face day-long waits in A&Es, a record number of workers are off sick, and millions are on waiting lists. In fact, not only are the Government failing on the Prime Minister’s pledge to cut NHS waiting lists, but they have presided over a disastrous decade of growing waiting lists and waiting times. Children suffering from PANS and PANDAS may have to wait many months for their first NHS paediatrician appointment. As stories from the PANS PANDAS UK charity have shown, that is exactly what is happening. Christopher’s parents say:

“The soonest NHS paediatrician appointment was 8 months away, so we arranged to see a private specialist who could help us. This was the best thing we ever did. We came away with answers to what was happening and a care plan, which our GP follows. At present we are still waiting for our first NHS paediatrician appointment.”

The reality is that we need a Government who will build an NHS that is fit for the future. Labour’s first goal is to deliver an NHS that is there when people need it. This includes doing all we can to get waiting lists down and getting people treated on time, just like under the last Labour Government. We have a 10-year plan for change and modernisation, which will include one of the biggest expansions of the NHS workforce in history. We also plan to put individual care and mental health treatment—an issue that has been in the shadows for too long—at the heart of our mission.

Labour’s approach will be different, especially for children and young people. A Labour Government will treat mental health as seriously as physical health. We plan to recruit over 8,500 more mental health professionals to cut waiting times for treatment. We will provide access to specialist support in every school, and every community will have an open-access mental health hub for young people. With Labour, more care will be delivered on people’s doorsteps, out of hospital and in the community. Most importantly, we will focus on prevention and a move towards transformational new technologies. It is Labour that has a plan and a mission to build an NHS that is fit for the future and there for people when they need it.