Black Maternal Health Week

Debate between Diane Abbott and Nadine Dorries

Tuesday 14th September 2021 Westminster Hall

[Ms Dorries]

The hon. Lady is absolutely right. I am very proud of the work that we have done in the Department of Health and Social Care, and in the NHS, to improve maternal outcomes for everyone, particularly over the last few years. The statistics speak for themselves. However, I will focus on the issue of black women and maternal health, because there is a great deal that we have done since the hon. Member for Streatham had the last debate. I am looking forward to informing her about the work that has been undertaken since then. I thank her for instigating this debate, and I hope that she continues to hold our feet to the fire. It is important that people do raise this issue, as she does, as often as possible in Parliament.

In response to the incredibly articulate speech by my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), it is right to raise the report by the Health and Social Care Committee, which I will respond to next week. A number of the questions that have been asked today will be included in that response, so I will not steal my own thunder—I will wait to provide a response next week.

I thank the co-founders of the Five X More campaign, Clotilde and Tinuke, and all the health care professionals and organisations who campaign to raise awareness of this week. I have visited Tommy’s maternity unit three times now, and the hon. Member for Streatham is right to raise the point that the majority of staff, doctors and midwives are black. I am incredibly impressed with the way that Tommy’s addresses this issue; they are pioneers in addressing maternity inequalities and outcomes, and they do fantastic work. I pay tribute to Tommy’s, and all hospitals, who I know are putting their weight behind reducing maternity inequalities and outcomes—Tommy’s is certainly at the forefront of that work. My granddaughter was born at Chelsea and Westminster hospital, so I thank them too—they are pretty amazing as well.

This debate comes a few days before this year’s World Patient Safety Day; the theme this year is safe maternal and new born care. It provides an opportunity to mark the progress made across the system in improving outcomes and safety, but also to recognise that further work is needed. At its best, NHS care offers some of the safest maternal and neonatal outcomes in the world. However, the disparities that exist between black and white women in pregnancy and childbirth experiences are unacceptable. I am committed to both reducing this disparity in health outcomes, and improving the experience of care.

We cannot beat around the bush any longer on some of the reasons why we experience these inequalities. They are complex, and there is no one answer as to how we can address this subject. Personal, social, economic and environmental factors all play a part; we must address the causes of disparities to improve outcomes and experiences of care. I was delighted that last week NHS England and NHS Improvement published their equity and equality guidance, which responds to findings that maternal and perinatal mortality show worse outcomes for those in black, Asian and mixed ethnic groups. They invested £6.8 million in the guidance to improve equity and equality action plans, and implement targeted and enhanced continuity of care.

We know that pregnancy lasts around 40 weeks. However, when a woman walks into a hospital to give birth, those 24 or 48 hours—however many hours she is in hospital—are not what wholly contributes to her experience of the healthcare sector, or her outcome. A lifetime approach is needed to address some of the reasons why some women are more at risk of poorer outcomes than others. We know that there are many health issues that contribute to poorer outcomes in pregnancy, including alcohol, obesity and smoking. The chief medical officer recently published a report that showed that, in some of our seaside towns, 25% of women are smoking at the beginning of pregnancy. I think the figure was that 22% were still smoking by the end of their pregnancy. There are inequalities and health disparities that we really need to address.

For that reason, we have established the newly formed Office for Health Improvement and Disparities, which launches on 1 October, to target those health disparities, including racial and ethnic disparities in health, and to improve pre-conception health to support women to be in their best health throughout pregnancy.

[Ms Abbott]

rose—

[Ms Dorries]

I will just finish the point on the office of disparities, because it is quite important. It is a huge step to establish an office that will actually deal with this particular issue. It will tackle inequalities across the country, and will be co-led by the newly-appointed deputy chief medical officer, Dr Jeannelle de Gruchy.

The office will be a vital part of the Department of Health and Social Care, and will drive the prevention agenda across Government to reduce health disparities. I hope the hon. Member for Streatham welcomes the establishment of this new body to tackle the top preventable risk factors for poor health, which include obesity, unhealthy diets, lack of physical activity, smoking and alcohol consumption. Equity and equality guidance will also be issued.

It is a huge step to look at those lifetime health experiences that contribute to what happens at the point of delivery and throughout pregnancy. Until we improve, and look at what happens before, using a lifetime view of health that includes women’s experiences of health throughout, then tackling what happens when they walk through a labour ward door will continue to be very difficult.

[Ms Abbott]

I think everyone present welcomes the establishment of the new office. The Minister has mentioned obesity, alcohol and smoking as risk factors in pregnancy; I take it she is not suggesting that the disproportionate outcomes we have for black women are because we are more likely to be obese, smoke or drink.

[Ms Dorries]

No.

[Ms Abbott]

I just wanted to get that clear.

[Ms Dorries]

Absolutely. The office will look at all pregnancies, and the negative contributing factors. I believe that one in four women—black and white women—who present in labour are obese. That has an incredibly high risk factor during labour, so it is to address inequalities across the board. My right hon. Friend the Member for Romsey and Southampton North mentioned socio-economic groups, and the disparities they experience: smoking, alcohol and other negative factors that contribute during pregnancy are across the board, and they need to be addressed. That is the reason why the office has been established.

The cessation of smoking during pregnancy was something we campaigned on a lot in the past. I have noticed, probably since we passed the legislation to ban smoking in many places, the emphasis has almost come off the importance of not smoking during pregnancy. The CMO’s report highlights that, in some areas of low socio-economic grouping, 25% of women are starting pregnancy smoking. That highlights the fact that we need to put more emphasis on, and focus on, those health disparities.