Black History Month

Debate between Ben Coleman and Calvin Bailey

Thursday 23rd October 2025 Commons Chamber

[Ben Coleman]

I am most grateful for the correction, Madam Deputy Speaker. It is interesting that my hon. Friend talks about doctors, because honestly there are not that many people in leadership positions in the NHS who are black, and that is another issue that needs to be addressed.

I have used the word “racism”—as we all have—in a way that is perhaps not easy to do everywhere. I have to say, when I first started becoming aware of the huge differences there are in how people are likely to experience health services depending on whether they are black or white, I did not feel at all comfortable using the word “racism”. Sometimes when people say “structural racism” when talking about racism, people will say, “I am not a racist!” but that is not what is being talked about, so it is very difficult to enter this conversation.

I remember when I was on the council I was once on a big Zoom call with 150 people to discuss the inequalities work we were doing. A black woman talked a lot about micro-aggressions, and I asked her, “When you are talking about micro-aggressions, aren’t you talking about racism?” She answered, “Yes, yes. But you can say that. I can’t.” So I think it is incumbent on people like me—a white middle-class gentleman of a certain age—to be allies, as many hon. Friends and hon. Members here are being, and to stand up and talk about these things and name them for what they are.

We can effect change. We can do the radical thing of implementing the change that is needed, but to do that we need to have leadership that wants to actually effect the change. We have found, sadly, that black women facing poor outcomes is shaped by systemic failings in leadership and accountability as well as in training and data collection. We need senior leaders to be held accountable for racial health inequalities. That means that they need to be aware of them, which means they need the data. We need Care Quality Commission inspections to specifically assess equity in care delivery. Trust boards should be specifically responsible for monitoring and addressing disparities, and performance metrics should include equity indicators. That all sounds terribly onerous, but it is not. It can become part of the normal way of doing things; it just has to be introduced at some point. As I said, these are not radical suggestions, but to do them would be radical.

Indeed, the really radical thing to do—this came out of the Committee—is just to listen properly to the women needing maternity services. I saw a terrible programme during covid where a woman was talking about her daughter, who was 20 and had gone to see her doctor. She was talking about being in immense pain. The doctor said, “Well, black women have differently shaped cervixes, so that is probably why.” She died in childbirth. That sort of thing happens all the time; we just do not talk about it all the time. It has to stop. We need to listen to black patients.

Black patients talking to us said, “I had pain. I reported pain and I reported symptoms—I just wasn’t believed.” Their concerns were dismissed. That pattern appears not just in maternal health services but right across healthcare.

[Mr Calvin Bailey]

My hon. Friend is making a powerful speech. It is important to highlight the simple things like listening to people, but we must also get over our inherent reluctance to speak about health inequities when we are speaking to each other. Prostate cancer, for example affects one in four black men, whereas it impacts one in eight white men, partly because we do not discuss the fact that it is more prevalent in black men and we need to conduct diagnosis much earlier. Does he agree that if you are a black man or you have a history of prostate cancer in your family, you should go and get a prostate prostate-specific antigen test as early as possible—as early as 45? I will not make reference to my own age or the fact that I have had a test myself.

[Ben Coleman]

I am grateful to my hon. Friend—my youthful friend—for that comment. I could not agree more. When I became aware of this problem back when I was a councillor, we instituted a programme to build trust within the black and minority ethnic community in the NHS. As a result, we had hundreds of conversations in the community with people from the NHS and with people of colour. One black gentleman, who I think was a little older than 45—he was probably not far from my own age—went and had a prostate test as a result, and it was found that he had prostate cancer. If he had not had the test, who knows what the situation would be these days. I therefore fully support my hon. Friend’s call for everybody to have prostate cancer tests. I have had one myself, and fortunately, like him, I think things are all right.

When we get feedback from patients, we need formal mechanisms for registering that—it should not be done in the typical ad hoc, amateur way—and we need to co-produce the changes with the people we are actually meant to be there for. Also, when people complain about discriminatory treatment, we need to consider that seriously, and the NHS needs to respond in a much more open-hearted, open-handed and open-minded way than I am told it often does. The Committee did the inquiry and came up with specific recommendations that affect black maternal health, but I think they spread right across the piece of black people not getting as good healthcare as they should, and as white people do.

I end on a specific example of something quite close to my heart because of friends: sickle cell disease. As we are talking about black history, I would like to pay tribute to Dame Elizabeth Anionwu, a wonderful woman and the UK’s first sickle cell nurse. She has done so much to educate me and other people and improve services in this country.

People may not know much about sickle cell if they are not black. It causes intense pain and organ damage. Crudely, cells get shaped like sickles, and it can cause strokes; it can even cause early death. It is often overlooked, mainly because it affects black and minority ethnic people.

Imperial College healthcare NHS trust is currently running a wonderful programme that serves my constituents in Chelsea and Fulham. It is one of only seven centres in the country piloting what is called a renal haematology triage unit, which is one of those sexy NHS titles, but it just means if a person suddenly get a crisis and needs to be seen swiftly, they do not have to wait for hours and hours in accident and emergency; they can get swift pain relief. That is vital for making sure that the problem does not get seriously dangerous seriously quickly. I went to visit it and talked to patients and staff. It is a terrific centre that has made a huge difference to people’s lives, as they are able to go to work and look after their children more easily. It is inspirational—but, sadly, it is a pilot. In the normal world, we do a pilot, we see if it works and, if it does, we try to find the funding long term. Often, in the NHS it means, “We have got a bit of money left over. What can we do?” or it means, “Let’s do a project for a few years and call it a pilot.” We need to keep the funding for those seven projects across the country, which are offering urgent, swift pain relief for people with sickle cell, after April. That is one thing that I am working on at the moment. We have to show everybody that they matter equally. We have to build trust.

So let us build trust, let us acknowledge the harm that has been done and let us do the work on training, comprehensive data and workforce issues. Let us name racism and tackle it head on. Let us listen to black patients and ensure that services for conditions such as sickle cell are as important to everybody as they are to just a few. We cannot change history—we can recognise it, as my hon. Friend the Member for Clapham and Brixton Hill (Bell Ribeiro-Addy), who has just left the Chamber, said—but we can change the future. We have the evidence and the recommendations. We know what needs to be done. I have not said anything new or anything that will have shocked the House. The only thing that is shocking is that there is often so little willpower to make the obvious and necessary changes that are needed. I will keep fighting for that to happen, and I hope that everyone in the Chamber will fight alongside me.