Black History Month

Caroline Nokes Excerpts

Thursday 23rd October 2025 Commons Chamber

[Ben Coleman]

My hon. Friend makes a strong point, and I could not agree more. There is some data out there. Hospital trusts collect data each year on how their staff are feeling about a whole range of things. I looked at my local hospital trust’s data and one question it asks is: “Do you feel that you have suffered more discrimination this year from patients and from colleagues and managers?” I have not looked for a couple of years, but sadly the last time I looked it was getting slowly worse.

This is definitely an issue. If people are foolish enough to think that somebody’s skin colour is going to affect their ability to do their job properly, it makes it more difficult for staff to provide care to the whole population. Black NHS staff need to have safe working environments. They encounter racism, and they should not. It is interesting that you talk about doctors—

[Madam Deputy Speaker (Caroline Nokes)]

Order. The hon. Member means “he” not “you”.

[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.