Black Maternal Healthcare and Mortality

Janet Daby Excerpts

Monday 19th April 2021 Westminster Hall

[Janet Daby (Lewisham East) (Lab) [V]]

I am pleased to be speaking today on such an important but also disturbing issue. I commend my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for sharing such a personal, moving story that is so relevant to the debate.

Every death in maternity is a tragedy, but it is wrong that we are having to speak on the issue of black women dying during pregnancy or soon after giving birth in the UK. It is unacceptable that the disparity exists between women from different ethnic backgrounds. It is most distressing that when a mother dies, a child or children are left motherless, not to mention the loss to their partner or spouse and to the wider community. Too many unanswered questions need to be asked, and too many changes need to be made, and that is why we request that the Government work with the NHS to improve maternal health outcomes of black women, women of mixed heritage and Asian women.

As we have already heard, compared with white European women, black women in the UK are four times more likely to die in pregnancy and childbirth, women of mixed heritage are three times more likely to die, and Asian women are two times more likely to die. African women are 83% more likely to suffer a near miss in childbirth, and black Caribbean women are 80% more likely to do so. That is all happening in the UK. It is shameful and outrageous. How and why is it happening? It is a huge concern regarding equality of care. Why are non-white women’s experiences so different compared with those of white women? Change needs to happen, and it is this Government’s responsibility to make the change happen.

These babies are 121% more at risk of stillbirth. Their life chances are limited before they are even born. Do these little black lives matter? I think they do, and I know that many Members in this Chamber agree with that. Immediate interim changes and safeguards need to be put in place now for these vulnerable women to protect their lives: the lives of the mothers and children.

I call on the Government to implement the recommendations in the Joint Committee on Human Rights report on black maternal health, “Black people, racism and human rights”, to ensure that all health professionals record and identify those who are most at risk of poor outcomes, so that protective factors are implemented. I also call on the Government to ensure that there is increased support for at-risk pregnant women. I ask the Secretary of State for Health and Social Care to introduce a plan and target to improve maternal outcomes for black women. Professor Maggie Rae, president of the Faculty of Public Health, has said:

“This year’s coronavirus pandemic has brought this disparity even more starkly to the fore, and we must not lose sight of the actions that are required to address systemic biases that impact on the care we provide for ethnic minority women.”

World Social Work Day

Janet Daby Excerpts

Thursday 18th March 2021 Westminster Hall

[Janet Daby (Lewisham East) (Lab) [V]]

I thank the hon. Member for Ruislip, Northwood and Pinner (David Simmonds) for having secured this significant debate. I am not used to being so high up on the call list, but I very much appreciate it.

For as long as I have been involved in children and family social work, I have only ever known children’s services to be under immense pressure. I say this because unless a person is part of this area of work, the crucial role of children and family social work can be easily misunderstood, and not enough politicians understand children and social services. That is probably why there are so few of us taking part in this afternoon’s debate, which is disappointing. These services have been undervalued and not invested in for many years; they have been cut year on year.

I became a children and family social worker in 1995. I first worked in the emergency duty team, then went on to work with children in need before moving to work in a looked-after children’s team. The red tape and bureaucracy have increased, and the majority of social workers’ time is spent at the office, completing reports and filling in forms, as legislative and policy changes have been made. Obviously, those changes have often been in the best interests of the child, but they have meant that social workers have been increasingly kept away from spending more time with the child.

In my seven years’ experience of working for a local authority, there were five reorganisations. This can be really distressing for staff—having to be re-interviewed and, in many cases, seeing their posts being deleted, changing, or even moving buildings. When support is removed and cuts are made to admin posts or specialist workers’ posts, all of this adds to the caseload of the social workers. Where social workers’ posts are cut, caseloads increase, and what is often overlooked is where the children are in this: the child is supposed to be paramount, but less time is spent with the child.

All of this needs to be rethought, and there needs to be a whole new way of thinking about how to do children and family social work. Every time the Government make cuts to local authorities and the NHS, children’s service provision is affected—the cut is passed on to the child. Fewer social workers and managers and increased caseloads mean less time and less interaction with the child, and less support for them and their families. Cuts also mean a lack of resources and longer waiting lists, causing delays.

I have nothing but admiration for social workers—children and family social workers and social workers across social care sectors within our society. They have one of the most highly stressful jobs. They must be valued, and to value them we must invest in them.

For someone starting in their role as a social worker, it is about supporting families to be healthy, to be happy and to stay together as well as is possible, though sometimes that is not possible. I remember the case of a complex and lovely young person; I had been her social worker for more than three years, but when she turned 16, I was told I had to transfer her to the young persons’ team. She protested vehemently and was vile to me verbally due to the loss, but I completely understood. I knew she was hurting and did not want that level of separation. That is a concern because as legislators we should be flexible. We need to have her and other children’s best interests in mind, and sometimes that means being flexible with our services and ensuring they are not lost while we are focusing on what is best for our institutions or sometimes for the team.

There was another boy I worked with; he was five years old and I worked with him for three years. I remember when I became the senior social worker, he said to me, “If you are becoming the senior social worker, does that mean you’ll still be my social worker?” His case shows the lack of flexibility sometimes within the service. I should have been able to carry on being his social worker, and he should have had continuity of the support he was enjoying at that time. Social services should not be built around institutions; they should be built around the child. We need to ask us ourselves whether the welfare of the child is really paramount, or whether we need to rethink how we do children and families social services. We really need to get this right, because we want children in need and in care to grow up to be well adjusted and to have a bright future.

As I have already stated, the social work profession has always been under immense pressure, but the pandemic has made that even worse. The social work profession is in crisis. Working conditions have got worse compared with what I knew them to be before. The British Association of Social Workers found that 77% of social workers who responded to the survey on working through covid-19 felt that the lockdown restrictions had made it much harder to safeguard adults and children. Many respondents felt there was a definite increase in people being referred to social services. Capacity was already stretched, but the past year has brought it to breaking point. Social workers must be protected from burning out. They have valuable views on how services can be transformed for the better, and they must be part of framing a more effective service for the future.

There were also calls for more capacity to focus on tackling violence against women and girls. That issue has come up in the public spotlight after the tragic events of the past few weeks, but it is something social workers are constantly dealing with. Social work practice frameworks must reflect the areas in greater need of attention, and local social services must have the ability to specialise in the problems affecting their communities—for example culture-specific discrimination or gender-based violence.

With problems in staff retention and growing caseloads, social services remains in crisis. Earlier this week, on the Justice Committee, I spoke to the chief executive officer of the Children and Family Court Advisory and Support Service, who said that we need to rethink and to reinvest in children’s services. I absolutely agree with her.

Covid-19

Janet Daby Excerpts

Monday 22nd February 2021 Commons Chamber

[Janet Daby (Lewisham East) (Lab) [V]]

I am grateful to speak in today’s debate. I extend my thanks to healthcare staff and volunteers up and down our country for their invaluable help with the roll-out of the vaccine. I say that especially to everyone at Downham healthcare centre in my constituency, where I saw the roll-out in action, and it was managed superbly.

In this debate, I will raise concerns about the position of the NHS. The NHS is in crisis. Intensive care units are still overflowing with seriously ill patients who have coronavirus. Doctors are having to make crucial decisions, and many patients with other illnesses are not able to have their appointments.

Prior to the pandemic, I spoke in the Chamber—physically, not virtually—about the nursing shortage. Before covid hit, the shortage of nurses was 100,000, and it was getting worse due to the lack of Government funding for student nurses and the uncertainty for nurses coming from the EU to live and work in the UK. We still have an enormous lack of nurses in hospitals, and there is also a lack of care staff to work in care homes.

Existing staff are overworked and underpaid, and the pandemic has exposed the decline in our health services after a decade of Tory cuts. Furthermore, areas of NHS hospital services are being privatised and given to private contractors, when the work can be done just as well by NHS staff when the money is reinvested into the NHS.

The National Audit Office has shown that the total accumulated debt of NHS providers was almost £11 billion in March 2019. While the Chancellor announced a 10-year plan for NHS support in January 2019, not all healthcare professionals have found this adequate. There are no plans to cover the cost of workforce training and expansion and, crucially, the cost of public health work.

It is purely the efforts of all those staff in the NHS—the doctors, nurses, porters, cleaners, cooks and administrators —that have kept and keep our NHS going, but they need more. We need a health service that is thriving and not struggling to survive. We need a long-term recovery plan that closes the financial holes, and we must prioritise mental health services, which are known as the poor relative to the NHS. Mental health services and CAMHS are needed more than ever as the country begins to recover from the effects of the pandemic, and I truly hope that the Health Secretary and his Ministers are listening to what needs to change and will act on it.

Vaccine Roll-out

Janet Daby Excerpts

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

I am delighted that my hon. Friend is volunteering in a vaccination centre; that is terrific. This is a big national effort, and he is playing his part. Some 49,000 vaccinations had been done in Nottinghamshire as of 17 January. Clearly we still have to do more, but we are making very significant progress. As I said, the rate-limiting factor is the amount of supply that we get into the country, rather than, for instance, the enthusiasm of GPs in the NHS or, indeed, the number of volunteers who have stepped forward such as my hon. Friend.

[Janet Daby (Lewisham East) (Lab) [V]]

A constituent of mine, Mr Clive Tombs, recently reached out to me regarding the crisis facing the London ambulance service. He told me that no one he knows in the service has had a vaccine, despite their being on the frontline of exposure to the virus. At the same time, we have seen pictures of ambulances lined up for hours waiting to get into A&E departments. Clive suggested that, with some co-ordination from the Department, arrangements could be made for ambulance staff to receive vaccines from hospitals while they are waiting in the queue—if there is a surplus and to prevent wastage. Has the Secretary of State considered that possibility? Does he agree that that is a humble suggestion from Clive when, in fact, frontline ambulance staff should be prioritised for the vaccine?

[Matt Hancock]

Frontline ambulance staff absolutely are and should be prioritised for the vaccine. They are in category 2, and we have to make sure that that happens. I will take away Clive’s idea, work on it and get back to the hon. Lady to see what progress we can make.

Covid-19: Dental Services

Janet Daby Excerpts

Thursday 14th January 2021 Commons Chamber

[Janet Daby (Lewisham East) (Lab) [V]]

Thank you, Mr Deputy Speaker. I congratulate my hon. Friend the Member for Putney (Fleur Anderson) on securing the debate. She has been a persistent advocate for dental care during the pandemic.

We are all aware of the widespread impact of the coronavirus pandemic. A&E departments are overwhelmed, intensive care units have been described as warzones, and essential operations, for example on cancer patients, are being postponed at great cost. In the midst of the sprawling crisis, the effect on dentistry has been overlooked. People have not received the essential dental care that they need, and dental practices have experienced crippling blows to their finances during the pandemic.

The Association of Dental Groups has found that dental practices in England suffered from an average of 45% losses in 2020. Dentists are crying out for Government support, but the Chancellor’s recent announcement applies only to the hospitality and retail sectors. Dental practices will receive no grants and no business rates exemption. The Government need to act so that it does not have a negative effect on our economy.

The ADG found that 35% of business owners expect to employ fewer staff next year, with some planning redundancies. We will lose practices from our high streets, and communities will be deprived of the care that they need. That needs urgent Government intervention and attention. The Department of Health and Social Care must work with other Departments to provide business support grants and relief. Additionally, dentists are still not acknowledged to be critical care workers in this lockdown—a matter that has already been mentioned by other Members, and that the Secretary of State needs to review. Patients have also had to—

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. Sorry, Janet; 4.42 pm has been reached. I do apologise. We move on to the Front-Bench contributions. I call Alex Norris.

Long Covid

Janet Daby Excerpts

Thursday 14th January 2021 Commons Chamber

[Janet Daby (Lewisham East) (Lab) [V]]

I thank the hon. Member for Oxford West and Abingdon (Layla Moran) for arranging this important debate, which I hope will raise awareness of the issue, and cause the Government to reassess the rate of sickness benefit and to invest in research.

Long covid can affect anyone who has caught the virus. It is another one of those invisible illnesses that people cannot see, and many still do not know it exists. Constituents, friends and family have reached out to tell me of their physical and mental struggles with long covid. Persistent breathing problems and coughing, fatigue, dizziness, chest pains and insomnia are some of the things that have been mentioned to me. Even getting a diagnosis has been challenging, with people having to go through all manner of scans and tests. The lack of explanations and solutions has led to support groups being created online, where people with long covid can connect with one another and share their difficulties. But not everyone has online access and not everyone is able to communicate their experiences. Low public awareness of long covid leaves sufferers feeling even more isolated. I would be grateful to hear from the Government how they will raise the profile of this illness.

The NHS is desperate to help these patients, but it needs help from the Government to do this. The Government need to ring-fence funding for research into the illnesses and find treatments. People with long covid also often find their ability to work seriously affected. The economy suffers from this section of the workforce being incapacitated. Sick pay is £95.85 per week. My constituent’s rent in a shared home is £900, with bills, each month they are short of more than £500, and their situation is not dissimilar to that of others, which means that the sickness pay rate is inadequate.

Another constituent asks me:

“How much longer is our society going to keep treating people with illness as a burden? How long are people going to face such hard decisions just to keep living?”.

Although I cannot give my constituent all the answers they need, I, along with colleagues today, call on the Government to recognise this illness, commit to reassessing the sick pay rate, and fund research treatments to cure and help sufferers with long covid.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I realise that a number of colleagues have not been able to get into this debate. As I have said, we had a very short time for it. The Front Benchers have agreed to speak for less time than they normally would, and I now call the Scottish National party spokesperson, Neale Hanvey.

Public Health

Janet Daby Excerpts

Wednesday 6th January 2021 Commons Chamber

[Janet Daby (Lewisham East) (Lab) [V]]

I am grateful to be able to speak in today’s debate. I start by extending my deepest sympathy to my staff member, Ruzina, who today lost her mother to coronavirus. Words cannot describe the devastation that this virus has caused to so many.

There are so many concerns that I have about the impact of the Government’s handling of this pandemic, and there are too many pressing issues in Lewisham East to mention, but today, I would like to raise the crisis facing our ambulance services. I have been speaking with a constituent of mine, Mr Clive Tombs, who is a technician in the London ambulance service. Mr Tombs told me of the sheer stress levels that he and his colleagues are experiencing. As the secretary of his branch of the GMB union, Mr Tombs speaks not just for himself, but for thousands of members serving the capital.

Staff sickness in the ambulance service is at an all-time high. Mr Tombs estimates that around 6,000 staff across the service are off sick, the majority with covid-19. He has lost colleagues to the virus and other colleagues are hospitalised. Many others are understandably suffering from declining mental health after seeing the very worst of the impact of this virus and the impact which it is having on our people. Post-traumatic stress disorder is also becoming commonplace.

Phone operators are having to play God in choosing who among the hundreds of callers will get an ambulance. Mr Tombs also speaks of the relentless shifts that those in the ambulance profession are working. Those on the frontline are working 12, 13 and sometimes 14-hour-long shifts, and all too often, they do not get a rest or a break before starting their next demanding shift. We cannot expect our ambulance service to work all hours of the day and night, providing high-quality care, thinking quickly, making smart decisions and putting themselves in danger, without having enough time to rest. I would be grateful to hear from the Secretary of State for Health and Social Care on this issue.

Many of us have been distressed by images over the Christmas period of ambulances piling up outside hospitals, particularly in London. Every one of those ambulances has someone who is in urgent need of medical care and, for some of them, their lives depend on it. A&E departments are not able to keep up with the level of demand, so ambulances, with patients in them, have to wait for hours upon hours—up to 11 hours, Mr Tombs says. They wait on trolleys that provide them with little comfort and are meant only for short use. Staff sit with them in vehicles but struggle to provide safe ventilation in the cold weather. There is no access to a toilet or a washbasin in an ambulance. None of us would like to imagine our parents, partners, elderly neighbours or loved ones suffering on an ambulance trolley waiting to be admitted. What is more—

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. Sorry, Janet, your time is up. I apologise.

Covid-19 Update

Janet Daby Excerpts

Monday 14th December 2020 Commons Chamber

[Matt Hancock]

We are always open to finding new ways to protect the economy as much as possible and bring the virus under control. I share my right hon. Friend’s desire to get it under control and to keep it under control until a vaccine can make us safe, but unfortunately this is no longer just a problem among school-age children in Waltham Forest and north-east London, which it has been until the last week’s data. The case rate among the over-60s in Waltham Forest is now over 250 and we are seeing that rising over the last week. We are also seeing rising admissions to hospital.

I have a huge amount of sympathy for everybody affected by these decisions in Waltham Forest, but it is absolutely essential to get this under control now to protect the NHS from being overwhelmed in the future. We must break the inexorable link from cases now to hospitalisations in the future—and, sadly, deaths—by using the vaccine and by testing. Until we can have the vaccine fully rolled out and people inoculated by having their second dose, and until enough vulnerable people have had that second dose and have therefore become inoculated, unfortunately measures like this are necessary.

[Janet Daby (Lewisham East) (Lab)]

The Health Secretary is fully aware that hundreds of thousands of jobs have been lost during the pandemic, which continues to hit our economy. That means a vast number of families and individuals are diving into hardship. Having no heating and no hot water is what many residents across our country will face this Christmas, as they visit food banks. What discussions has he had with the Secretary of State for Work and Pensions with regard to reducing the rising level of poverty?

[Matt Hancock]

We are trying to support the economy as much as possible throughout all these difficult decisions. The extraordinary levels of financial support are a part of that, including the furlough scheme, which has now been extended to the end of March. I, of course, talk to my right hon. Friend the Work and Pensions Secretary regularly to make sure we take the action that is necessary in a way that supports people as much as possible.

Deaths in Mental Health Care

Janet Daby Excerpts

Monday 30th November 2020 Westminster Hall

[Janet Daby (Lewisham East) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Stringer. The circumstances of the debate are truly heartbreaking. I begin by extending my condolences to the family of the late Matthew Leahy and all families who have lost loved ones with mental illness at the hands of those who were supposed to protect them and care for them.

For many decades, mental health has not received enough attention or funding in comparison with physical illness. I draw attention to the mental health unit in Lewisham, which has already been viewed as not being fit for purpose—it was not built for people who have mental health problems—yet funding has never materialised for the changes needed to make it suitable for people with mental health problems. With the pressures of the pandemic, medical professionals are reporting more and more that people are suffering with mental illness due to economic hardship or loneliness, so it is clear there will be greater demand for mental health services over the next few years. It is imperative that we have well-functioning and well-funded mental health services to prevent needless deaths of the most vulnerable who are in need of those services. Medical professionals, the police and everybody around them also need support to be able to care for people with mental health illnesses. They need training, supervision and, most of all, not to be overworked. They also need to be able to debrief when they find things difficult.

I would like to raise the case of the late Kevin Clarke, from my constituency of Lewisham East, who sadly died following a mental health relapse. My condolences go out to his family, who are still bereft from the loss of Kevin, who, despite not posing an immediate threat to anyone, was handcuffed and placed in a leg restraint while telling the police that he could not breathe. In October, an inquest concluded that the officer’s restraint and supervision towards Kevin were excessive and sadly contributed to his death. However, the police were not the only professionals involved in his care. Other professionals were also in contact with him prior to this tragic incident.

A strategy of care needs to be in place for all mental health patients, one in which patients are listened to and family members are involved, so that loved ones can talk about preventative measures and their concerns, as well as contribute to the care plans that are needed. Mental health doctors, mental health nurses, social workers and care staff all need to work collaboratively with all professionals involved in keeping the most vulnerable people safe and secure, and to prevent these fatal, awful incidents of suicide or types of restraints leading to death. Change needs to happen.

[Graham Stringer (in the Chair)]

Hon. Members have either not turned up or taken less time than expected, so, unusually, I will increase the time limit for the last speakers to five minutes.

Covid-19 Update

Janet Daby Excerpts

Thursday 16th July 2020 Commons Chamber

[Matt Hancock]

Yes. My hon. Friend has raised this point with me, privately as well, about access to the data. It is incredibly important. We are constantly improving the data that is available because we are constantly getting better data. That is an important part of the work strand.

[Janet Daby (Lewisham East) (Lab) [V]]

We cannot praise enough carers, key workers and NHS staff during this pandemic, including, of course, in Leicester. My constituent Anthony Francis launched a petition for a national day of recognition for our NHS and key workers. He proposes 26 March, which was the first day of clap for our carers. The petition has reached over 100,000 signatures from across the country. Will the Secretary of State commit to this?

[Matt Hancock]

I will certainly look at it; it seems like a very interesting idea. I think that clap for our carers was an absolutely brilliant initiative. I love the fact that it was essentially a social initiative. It did not come from Government. We embraced it enthusiastically and all went out clapping, as did everybody, and a way to mark that permanently is something that I am absolutely open to.