(7 months, 1 week ago)
General CommitteesIt is a pleasure to serve under your chairship, Dame Caroline. I am concerned, however, that this matter is not being debated in the main Chamber.
The renaming of NHS medical assistant roles to physician associate and anaesthesia associate is confusing the public by blurring the clear distinction between doctors and other professionals who do not have medical physician qualifications and training. In response to a British Medical Association survey last month, 30% of patients said that they had no idea that they were not seeing a doctor, and 90% of doctors believe that the shift has been dangerous for patients.
According to at least two coroners, including the Chief Coroner, and the British Medical Association, the use of associates instead of fully qualified physicians has contributed to the avoidable deaths of patients who were misdiagnosed. Emily Chesterton from Salford, who was 30 years old, and 25-year-old Ben Peters both died after being sent home by physician associates who diagnosed emergency health issues as a calf strain and a panic attack, respectively—in Mr Peters’s case, despite a history of heart problems. Ms Chesterton’s family said that she was never aware that she had not been seen by a doctor.
The use of associates has been the subject of dangerous scope creep. One physician associate told a podcast that he was performing basic brain surgery and “learning on the job”. Another hospital—in Leicester, as it happens —congratulated a nurse practitioner on being the first to perform a heart operation unsupervised. According to NHS campaigners, such non-medical roles are being used and expanded to cut staff costs and to fill vacant places as part of overall cost-cutting in the so-called integrated care service programme, which is the US accountable care system under a different name. A deliberate system of incentives ensures that the NHS and its regional providers will keep cutting the corners of what used to be a comprehensive, state-funded service, turning it into something that business can profitably provide.
The plan to regulate these non-medical roles through the General Medical Council adds to the dangerous confusion. It has been opposed by both the Royal College of General Practitioners and the British Medical Association. For the safety of patients and the proper functioning of the NHS, I urge the Committee to oppose the draft order. Instead, the titles of these roles should revert immediately to the previous titles, physician assistant and anaesthesia assistant. The NHS workforce plan must put doctors into doctor roles and unambiguously distinguish between medically qualified roles and other roles. As the British Medical Association has recommended, the Government must regulate those assistant roles through the Health and Care Professions Council, so that patients and their families are fully aware of who is treating them and how qualified they are.
(1 year, 7 months ago)
Commons ChamberThe first thing that needs to be said in this debate is that its title gives a false impression: “mismanagement” creates an impression that the Government have been doing their best to manage the NHS well but have failed to do so, whereas in fact the emergency in our NHS is the result of 13 years of deliberate policy decisions by the Conservatives. A staff shortage of 133,000 that has only grown in recent years is not “mismanagement”. A shortage of almost 40,000 NHS nurses is not “mismanagement”, especially not when the Government knew there was a huge shortfall and decided anyway to end the nurses’ bursary and make already-underpaid nurses pay a fortune to train while inflicting annual real-terms pay cuts on staff across the NHS.
Consistently allowing staffing numbers to remain far below safe levels is a decision, not something that was just badly managed, as was the intentional fragmentation of the NHS and the Health Secretary’s decision, along with the Government in 2012, to end statutory responsibility to provide a safe and fit health service. Cutting thousands of beds and millions of annual bed days in the NHS is a wrecking strategy—even more clearly so when it continued during the pandemic. It is part of an ideological push towards a rationed system that is more profitable for private providers and in which the NHS is in perpetual crisis not because of demand, but because beds, staff, hospitals and services have been intentionally slashed below the demand that was there. Even the current push to a so-called “integrated care system” is acknowledged by the King’s Fund and others to be, in reality, based on a US accountable care system that is designed to withhold treatment in order to cut costs and share the profits with private providers.
It is vital to be clear that the NHS is not merely collapsing; it is in a state of induced coma. There is not enough time in this debate to properly list all the damage that Conservative Governments have done to our health service in the past 13 years—and all in the full knowledge of what the consequences would be for those who need the NHS and who work in it and the deaths that it would cause.
The scale of this intentional damage is so great that playing around the edges with a little more cash that will end up in private company accounts—let alone talk of one-off payments to NHS staff who now rely on food banks—is just PR. The solution to all this is not better management; the only solution to 13 years of fragmentation and hollowing out is a return to the NHS’s original principles: a publicly owned, properly funded national healthcare service free to all.
Order. I must ask hon. Members to keep one eye on the clock. I know that it is difficult when you are reading notes, but you really must watch the clock.
(3 years, 3 months ago)
Commons ChamberThe legislative programme outlined in the Queen’s Speech lacks the ambition, depth and understanding needed to address the many health, poverty and social inequalities facing the residents, communities and families of Leicester East.
There is nothing in this legislative programme to save Leicester General Hospital from being downgraded. Our NHS staff and care workers are exhausted and there are nearly 5 million people in the UK waiting for NHS treatment. Rather than investing in our NHS, the proposals actually cut services, including hard-working staff. NHS staff and social care workers deserve much more support than they are currently getting, including a 15% pay rise instead of the insulting 1% real-terms pay cut offered to nurses.
We should all be very worried about the new powers granted to the Health and Social Care Secretary to accelerate the privatisation of our NHS. The Government want more profit and less care. I urge them, rather than downgrading Leicester General Hospital, selling off its land and extending NHS privatisation, to reverse their strategy and properly fund all hospitals in Leicester and across the UK.
On planning, the Government want to give more powers to property speculators and developers while delivering less genuinely affordable housing. The Royal Institute of British Architects has already warned that the Government’s plans could lead to
“the next generation of slum housing”.
On overcrowding, there are pockets of my constituency close to Leicester General Hospital where populations of 2,000 live in areas of 60,000 square meters. Hon. Members may not know what that equates to. It means that each person has an average of 32 square metres of space, which is equivalent to a box bedroom. The UK average is 3,676 square metres of space per person, more than 100 times the space afforded some people living in Leicester East. There is nothing in the Government’s legislative programme to address that stark inequality or to provide the health services that such overcrowded populations need. Rather than making it harder to build homes fit for working families, the Government must properly fund local authorities such as Leicester City Council and rapidly increase the construction of council housing and genuinely affordable family-sized homes.
On jobs and tackling poverty, I was proud to join the picket line in solidarity with workers at SPS Technologies in Barkby Road, in Leicester East, who bravely took strike action, with Unite the union, against their employer’s appalling fire and rehire employment practices. Well, we won. This form of solidarity will now be needed across the country, because the Government have failed to outlaw these exploitative practices.
Endemic wage exploitation in Leicester’s garment industry continues apace, with workers still being paid as little as £3 per hour, while the retail brands make super-profits, profiting with impunity from the exploitative sweatshop labour of workers in Leicester and worldwide. Factories compete to supply at the lowest price possible, and 60% of garments end up in landfill within a year. In addition to strengthening powers of the unions, collective bargaining power and workers’ rights, we need a garment trading adjudicator, similar to the Groceries Code Adjudicator, to ensure that payment terms for suppliers are fair, that wages are paid at a legal rate and that employment is secure. We need a more sustainable and ethical fashion industry and an end to zero-hours contracts and throwaway fashion.
The wellbeing of our entire planet and our health relies on our using the post-pandemic recovery to mitigate the existential threat of climate change with a radical green new deal to rebuild the country in the interests of people and planet.
(3 years, 4 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Sir Gary. I congratulate the campaign group Five X More, and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) on securing this hugely important debate, as well as the nearly 200,000 UK residents who signed the petition. The debate could hardly be more important, as it shines a light on a devastating and long-neglected area of institutional racism.
The latest UK data shows that black women are five times more likely to die in pregnancy, or up to six weeks after giving birth, compared with white women, yet there is no target to end that. This difference has almost doubled since 2011, with a 121% increased risk for stillbirth and a 50% increased risk for neonatal death, but there is no target to end this. It is not true that black women are superhuman. They do not have a higher pain threshold.
The maternal mortality for women from Asian backgrounds is double that for white women. There is also a concerning increase in the maternal mortality rate for women from mixed ethnic backgrounds, who now have a three times higher risk compared with white women, yet there is no target to end any of this. There is no doubt that health disparities within maternity care settings have been amplified by the coronavirus pandemic. Indeed, African, African-Caribbean, Asian and minority ethnic women made up 56% of all pregnant women hospitalised in the early months of the pandemic.
Discrimination is ingrained in the social, political and economic structures of our economic system. According to the Office for National Statistics, key workers are more likely to be from black, Asian or minority ethnic communities, to be women, to be born outside the UK and to be paid less than the average UK income. These inequalities are grounded in class inequality and reflect the severe racial disparities in our economy. African, Asian and minority ethnic women are also more likely to be in insecure work, which can leave them without basic maternity rights and more exposed to discrimination when it comes to hospital treatment.
That said, we cannot ignore the issue of racism and implicit racial bias in our healthcare system, which can negatively influence diagnosis and treatment options provided by clinicians, including pain management, and indirectly affect medical interactions, through loss of patient-centredness in treatment and the removal of patient autonomy. That has a corrosive effect on trust in services, which creates a downward spiral of healthcare outcomes.
The demonisation and mistreatment of migrants and those with unsettled status must also end. Migrant women with insecure status face charges of £7,000 or more for NHS maternity care, which can deter women from accessing essential services. The Government cannot be serious about reducing maternal health inequalities unless they abolish the “no recourse to public funds” policy.
There is also a significant gap in the medical research community, contributing to disparity of access in the UK. Latest figures show that 0.7% of professors employed at UK universities are black. In 2018, there were just 25 black British female professors in UK universities. Much more must be done to invest in research and researchers who can help combat those unacceptable health inequalities.
I finish by saying how callous, how cruel and how ignorant the Government’s recent race and ethnic disparities report is in the context of this debate. The Government’s crusade to deny the existence of institutional racism means that the disproportionate suffering of pregnant women of African, Asian and minority ethnic backgrounds is ignored. This must change. The UK Government must urgently set a target to abolish racial disparity to combat maternal mortality, so that we can all hold them to account and work towards long-lasting change.
(3 years, 7 months ago)
Commons ChamberWe now have the bare minimum of a national lockdown that should have happened weeks ago. The evidence was clear. The continuous delay and failure to follow the science and to take a zero-covid approach means that we now have more people with covid-19 in hospitals than at the peak in April 2020. Tragically, recent figures put us at well over 1,000 daily deaths due to coronavirus in the UK. In comparison, South Korea has recorded fewer deaths from coronavirus throughout this entire pandemic. Indeed, in one day the UK has recorded more deaths than the total covid-19 fatalities in all of Taiwan, New Zealand, Thailand and Australia, despite those countries having a combined population of nearly twice that of the UK’s.
This was not inevitable, but a devastating political and ideological choice. My city of Leicester has been under lockdown or enhanced restrictions for longer than any other area in the UK. No household has been allowed to visit another household since March 2020. That means no hugs. There are individuals and businesses in my constituency of Leicester East that have had no financial support since March 2020. They are on their knees. The Government must stop blaming the public and urgently look at the gaps and provide adequate support for everyone in our community, which they have so far repeatedly failed to do. The numbers are not going down in parts of my constituency because factories are open for non-essential garment manufacturing. Close the factories. Give people the means to stay safe.
At every stage of the crisis, there has been dithering and delay. Any common-sense actions by our Government have come far too late. Tragically, that will have cost an unimaginable number of lives over the past year. It is so infuriating to see the Government and, indeed, much of the media blame the public for the spike in cases. It was not the public who introduced a failed and confusing tier system. It was not the public who just weeks ago threatened schools with legal action for taking steps to protect their pupils and staff. It was not the public who promised a five-day Christmas free-for-all.
Unlike with previous lockdowns, this time the Government cannot waste the sacrifices of people in Leicester and across the UK. They must ensure that everyone has the means to isolate. Statutory sick pay must be increased to a living wage level and made available to all workers. Furlough must be fixed, so that no one receives less than the minimum wage. NHS and public service wages must be increased. The notion of cutting universal credit must be abandoned and, instead, it must be increased permanently.
The mortgage holiday, the eviction ban and support for renters must be further extended and strengthened. The 3 million excluded and left behind must be supported and given access to the business grant. The hospitality sector, including the wedding industry, must be properly supported. Undocumented migrants must be given status now. Student rents must be returned, and university tuition fees and debts cancelled.
The disastrous costly reliance on the private sector must be abandoned. The Government should not facilitate profit making from free school meals. It is wrong to profit from childhood hunger.
(3 years, 7 months ago)
Commons ChamberAs announced today, Leicester will move into tier 4. This is a city that has been in lockdown for longer than most. In Leicester we have not been allowed to meet inside any household since the start of the first UK lockdown—that is 10 months.
The Home Secretary was dangerously wrong to claim that the Government have been ahead of the curve throughout the pandemic. There can be zero doubt that on every major strategy the Government have got this wrong. The Government have lost control of the virus. Today there have been 50,023 new covid cases and 981 deaths. On 1 August, deaths from coronavirus had fallen to almost zero. We were at a crossroads. The Government should have opted for a zero covid strategy. Germany invested €500 million in improving schools’ ventilation. China brought plexi-screens into classes. Italy carried out randomised testing of pupils. In England, with no disrespect to our teachers, headteachers and excellent teaching unions, we put some sticky yellow tape on the floor, claiming that that meant distancing in the classroom would be sufficient to scare off the virus. The Prime Minister visited a school in the county of Leicestershire and proclaimed that students’ classrooms were safe. Within days of his visit, a positive infection had been confirmed.
The Government had a choice. Their own SAGE experts told them that opening schools would push the R rate above 1. Indeed, this week SAGE explicitly told the Government to close schools. In the first wave alone, 148 education staff died of coronavirus, according to the Office for National Statistics. In the second wave, deaths of teachers have continued to mount. History will judge us harshly for ignoring teaching professionals and scientists when they warned us to close schools.
The Government acted in the way they did because they perceived themselves to be putting wealth before health. It did not matter to them that African, Asian and minority ethnic people or the poor were more than twice as likely to die from coronavirus. As long as the City of London kept trading, they thought it was a price worth paying. What the Government have failed to grasp is that health is wealth. It was a false choice. By pursuing a zero covid approach, they could have crushed the R rate right down and bought time to implement a proper randomised testing system. They could have invested in online learning and proper equipment, including the internet, so that students could study from home.
Most of all, the Government should have trusted NHS professionals to run the test and trace system. By handing £12 billion of coronavirus contracts to people linked to the Tory party, they put donors first. Public Health England and local NHS bodies are ideally placed to conduct test and trace, and the Government failed to include them.
There is still time to save many thousands of lives, go further than the tiered approach, which at best gives rise to divide and rule, and implement a zero covid approach and a national lockdown. Yes, close schools and keep them closed. Listen to the science and give people the full financial support to stay safe, including the 3 million excluded. We are only as safe as the most vulnerable among us. Give status now to all undocumented workers.
The recently announced vaccine approval is inspiring news for all. Where politicians have failed, scientists have stepped up. The Government must now ensure that those most at risk get the vaccine first, which obviously means care home residents and NHS staff, but it should also include the minimum-wage workers who are getting us through this pandemic. A Deliveroo rider has more right to the vaccine than Etonian billionaires.
We must also make sure that African, Asian and minority ethnic communities and the poor are given fair access to the vaccine. We know that the elderly are most at risk from the virus, yet more than 70,000 Indian and Pakistani grandparents live with school-age children. The Government would be willing to place these communities at risk by reopening schools. I implore the Government to change direction before many thousands more lives are lost.
One last thing, Mr Deputy Speaker—
No, sorry. The time limit is the time limit.
(3 years, 9 months ago)
Commons ChamberAmid a deadly second wave and record-breaking numbers of covid-19 infections, it is important to act for change. The virus is continuing to rise. The measures put in place are not working. Time is running out. My constituency of Leicester East knows this only too well as our city has been under enhanced restrictions and/or lockdown longer than any other area in the UK, yet our numbers are continuing to rise.
People in Leicester East and across the country cannot afford to live below the minimum wage. Even before this crisis, more than half of the 40 million people in poverty in the UK were part of the working poor—suffering in-work poverty. Child poverty is off the scale due to a decade of austerity, extortionate rents and declining living standards. The Conservatives have overseen an unacceptable breakdown in our social contract in which a job no longer provides a route out of destitution. Yet now, during an unprecedented crisis, the Government are handing out poverty payslips and driving our residents into hardship. Will the Government today commit to ensure that no one receives less than a living wage throughout the remainder of this crisis? We are only as safe as the most vulnerable in our society, so, yes, local and regional authorities need funding to use their discretion to fully support undocumented workers and those on no recourse to public funds. Will this Government relax the barriers and grant status now to all undocumented workers, so that they can access much-needed social security benefit and not be destitute or desperate?
What makes this lack of support even more disgraceful is the billions that the Government have been willing to pay to private companies to oversee the disastrous test, track and trace system. The recent National Audit Office investigation into Government procurement has highlighted cronyism at the heart of Government. That has had a devastating impact on the spread of the virus in Leicester. In one week this month, the success rate of Leicester’s privatised contact system was just 55.5% and this has decreased by more than 5% on the previous month. That means that, in one week alone, nearly 700 Leicester residents who may have been exposed to the virus were not informed and therefore did not self-isolate. This is a Government who are frivolous when it comes to handing out public money to Tory donors or private companies, but penny-pinching when it comes to bailing out communities and the 3 million excluded, including the self-employed across the country.
As the representative of one of the most diverse areas of the UK, I am also especially concerned about the disproportionate impact of coronavirus on African, Asian and minority ethnic communities. Recently published research by the universities of Leicester and Nottingham found that black people were twice as likely, and Asian people 1.5 times more likely, to be infected with covid-19 compared with white—
One of the issues to emerge with covid is the apparent difference in rates and severity for different ethnic groups. To generalise, if someone is from a black, Asian and minority ethnic background, they are at greater risk when it comes to covid. This is accepted. But for some, it has been connected to an argument about discrimination—and this is actually coming from senior figures.
The chair of the British Medical Association appeared before the Health and Social Care Committee yesterday, so I took the chance to ask him about some of the views that he has expressed on this topic. Dr Nagpaul talked about “structural factors”, “differential attainment” and anecdotal evidence on PPE. I asked him several times whether he thought that the NHS was structurally racist. He would not repeat the term, but kept repeating that there were inequalities, and he said: “That’s what I am describing under that heading of racist”.
The NHS is probably the most diverse organisation in the country. It is doing heroic work to battle coronavirus. That effort has come from everyone within it, yet some regard the organisation as somehow racist. For me, this is personal, because both of my parents worked as nurses for our NHS in Peterborough.
Does the hon. Member not agree that the intensive care beds are filled today with covid-19 patients from African, Asian and minority ethnic backgrounds—back at levels seen during the first peak, despite earlier pledges from the Government to learn lessons and protect the vulnerable? What we need is change now.
I really do urge people not to make interventions, because it is going to prevent other people from speaking.
(3 years, 10 months ago)
Commons ChamberIt is hard to follow such optimism. I would begin by saying that the Government have lost control of the coronavirus, but that would not be entirely accurate, because at every step of this crisis, from a nonsensical herd immunity strategy to the initial lockdown delay, equipment shortages, care home neglect, contradictory messaging, a privatised testing crisis and much more, the Government have failed to adequately protect our communities.
My constituency of Leicester East has been in lockdown, or under significant restrictive measures, whether we call it tier 3, as it was then, or tier 2, as it is now, for over 100 days—to be precise, 106—at great cost to livelihoods, our businesses, our collective wellbeing and our mental and physical health. The Government are failing on lives and livelihoods. I therefore do not believe that they have ever had this virus under control, and I fear that the measures introduced this week will not be enough.
This catastrophe was not inevitable. Across the world, countries from New Zealand to China are returning to normality. I hope that you will forgive me, Mr Deputy Speaker, for saying that no city has borne a greater brunt of the Government’s failed approach than Leicester. Sadly, the Government have wasted the sacrifices of the British people, as we are now in a similar position to where we were in March. They spent £12 billion on a failed test and trace programme, which prioritises the enrichment of private corporations over the protection of our communities.
Rather than trust local health experts and the public sector, the Government have outsourced responsibility to corporate giants, which have consistently failed, with unacceptable contract rates as low as 50% or lower. My home city of Leicester is a prime example of the contrasting success of an underfunded local public health-led trace system. The success rate for our contact system is over 85%. The wasteful experiment of the private sector in our test and trace system must end.
It should be simple: if someone is contacted by NHS Test and Trace they must be provided with the material means to isolate. It does not matter what rules are set if no one in government is taking these matters seriously and if they are interpreting the rules to suit their own interests. The Government are not even following the advice of their own scientists, who make it clear what needs to be done to put the health of the nation first and protect lives.
(4 years, 2 months ago)
Commons ChamberFirst, I declare that I am a member of the Backbench Business Committee. I thank my hon. Friend the Member for Brent Central (Dawn Butler) for bringing this debate to the House today.
As the representative of Leicester East, one of the most diverse constituencies in the country, it has been extremely concerning to see the disproportionate impact of the coronavirus on African, Asian and minority ethnic communities. This was proven by the Government’s own report, which they shamefully published only after repeated pressure, and which does not outline any protective measures to deal with the disproportionate impact of covid-19. In a constituency like mine, which has a significant number of people from the affected communities, I worry about the processes of tracking, testing and so on, and whether that will be put right, because we can imagine what impact a second outbreak would have on such constituencies.
The Office for National Statistics has found that black people are 1.9 times more likely to die of covid-19 than white people, people of Bangladeshi and Pakistani descent are 1.8 times more likely to die, and people of Indian descent are about 1.5 times more likely to die. Those figures reflect the severe racial disparities in our economy.
We already know from a Resolution Foundation think-tank estimate that black, Indian, Pakistani and Bangladeshi employees experience an annual pay penalty of £3.2 billion. Analysis from Public Health England shows that once in hospital, people from African, Asian and minority ethnic backgrounds are also more likely to require intensive care. Those communities accounted for 11% of those hospitalised with covid-19, but 36% of those admitted to critical care.
Many have tried to dismiss the imbalance in deaths as being explained by cultural or even genetic factors. I have been dismayed by some of the information that has come through my inbox about what people need to do to tackle these genetic problems. Yet discrimination is not about that; it is deeply ingrained in the social, political and economic structures of our economic system. The scourge of institutional racism results in unequal access to quality education, unequal access to healthy food and unequal access to liveable wages and affordable housing, which are the foundations of health and wellbeing. That is the context in which the coronavirus crisis is operating. The virus itself may not discriminate, but our economic and social system certainly does.
Existing racial and class inequalities coupled with inadequate Government support mean that working-class communities, migrants and African, Asian and minority ethnic communities are at greater risk from exposure to covid-19. The severe racial disparities in our economy mean that those communities are more likely to fall through the cracks in the Government’s financial support and therefore more likely to be forced to work in unsafe conditions. A decade of cruel austerity has deepened the racial and class inequalities that exist in our society. Last year, a UN Human Rights Council special rapporteur reported on discrimination in the UK. We know that one of the grim findings was:
“Austerity measures in the United Kingdom are reinforcing racial subordination.”
NHS staff are at considerable risk from the virus, as we know. It is vital that we repay the extraordinary contribution of frontline workers with a permanent extension of migrant rights. That means an end to the hostile environment. That means shutting detention centres and ending them, and it means granting indefinite leave to remain to all NHS workers, to carers and to their dependent families. Recent reports indicate that migrant NHS workers and carers are still being charged for using the health service that they work in. That is despite the Government saying that they would end that.
As the inspiring crowds of protesters across the country have shown in recent weeks, it is crucial that we in the UK do not assume that we are immune from the disease of institutional racism. The failure of the Government to outline any protective measures, despite being evidentially aware of the disproportionate impact of covid-19, is yet another instance of the institutionalised neglect of African, Asian and minority ethnic communities.
Order. We have to move on; the time limit is up.
(4 years, 5 months ago)
Commons ChamberThe Spanish Government recently announced sweeping measures to take over private healthcare and to requisition products such as ventilators, testers and, indeed, facemasks. We have heard that, in the UK, the Prime Minister has ordered the NHS to acquire resources from the private health system to the tune of something like £2.4 million today. Will the Secretary of State outline measures that the Government will take to ensure that we put public health and public safety before private profit?