Oral Answers to Questions
Debate between Maria Caulfield and Abena Oppong-Asare(5 months ago)
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Abena Oppong-Asare (Erith and Thamesmead) (Lab)
The Care Quality Commission now says that almost two thirds of England’s maternity services are rated inadequate or requiring improvement in safety, up from 55% last year. The Government have been told time and time again to recruit more midwives, and to value midwives so that they do not want to leave the profession in the first place. As a result of ministerial failure, mothers—especially those from black and ethnic minority groups—do not get the safe, good-quality maternity care that they deserve. What is the Minister’s plan to properly improve maternity care?
Maria Caulfield
The hon. Lady may not have listened to my first answer. We have increased the number of midwives—it is up 14% since 2010—and increased the number of midwifery training places by 3,650. We have also introduced a maternity support programme that is providing intensive support for the 32 trusts that are going through it. The hon. Lady may want to speak to her ministerial colleagues in Wales, where Labour runs the health service, because Healthcare Inspectorate Wales recently issued an immediate improvement notice to Cardiff and Vale University Health Board for its maternity services.
IVF Provision
Debate between Maria Caulfield and Abena Oppong-Asare(6 months, 1 week ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
It is a pleasure to serve under your chairmanship, Mr Robertson. I thank the hon. Member for Jarrow (Kate Osborne) for tabling this important debate, and all Members across the Chamber for their contributions. It has been a positive debate—a good example of putting politics aside and debating how to do the right thing. While I am not denying the challenges for the LGBT+ community raised by the hon. Member, I want to highlight that the Government have brought in major changes over the years with the introduction of same-sex marriage, and the transformation of the management of HIV with the roll-out of opt-out testing and PrEP treatment.
I am pleased to announce that, following the advice from the Advisory Committee on the Safety of Blood, Tissues and Organs, the Government will be introducing secondary legislation to allow the donation of gametes by people with HIV who have an undetectable viral load; we will be introducing that as soon as we can. We will also be addressing the current discriminatory definitions of partner donation, which result in additional screening costs for female same-sex couples undergoing reciprocal IVF; again, amendments through statutory instruments will be introduced as soon as possible.
Those are some of the measures that we have been working on, but I absolutely understand from what I have heard today that there are many issues still to be dealt with, and I welcome the hon. Member for Jarrow holding my feet to the fire to deliver change. Hopefully some of these updates will provide reassurance. This is a priority area, which is why IVF, fertility, and particularly same-sex access to IVF, were in the first year of the women’s health strategy, and it is why we are not going to wait for the 10 years of the strategy to introduce the changes.
To be clear, the Government are implementing a policy that no form of self-financed or self-arranged insemination is to be required for same-sex couples to access fertility treatment. I acknowledge that is taking a little while to be rolled out across the country. Hon. Members, especially the hon. Member for Pontypridd (Alex Davies-Jones), have spoken about infertility a lot. We absolutely recognise that it has a serious effect on individuals and couples, which is why it is a priority—particularly for the women’s health strategy.
As the hon. Members for Strangford (Jim Shannon) and for Livingston (Hannah Bardell) pointed out, I can only speak on the provision of IVF in England, but I am very happy to work with colleagues in the devolved nations of Scotland, Wales and Northern Ireland to achieve a consistent approach. Although we are dealing with the inconsistencies in England, if we are a United Kingdom, these matters need to be addressed across all four nations and I am not precious about stealing best practice from other parts of the UK.
In our call for evidence for the women’s health strategy, women told us time and again that fertility was a key issue and that they felt very frustrated about the provision of, and access to, fertility treatment. Colleagues have made a number of important points which I will respond to in turn, but it has been recognised that there has been unequal access to IVF in England since the treatment was introduced; that is why this is such an important issue. There is resistance in some parts of the country to the changes the Government want to make, but I think we will be able to make progress on them.
NICE is reviewing its fertility guidelines, taking account of the latest evidence of clinical effectiveness. These will be published next year and we will be working with NHS England to implement these guidelines in England quickly and fairly. I am told that they will end regional variation and create a compassionate and consistent fertility service across England, but that does not mean that we cannot improve services in the meantime.
As has been set out, integrated care boards are now responsible for delivering IVF services. They were previously determined by CCGs, but from July last year the 42 ICBs across England are now responsible. Since the ICBs were created, we have seen a levelling up of IVF provision in many. Where CCGs have come together, ICBs have often adopted the higher rate of provision, rather than the lowest level. That is to be welcomed, but by no means does it mean that the level of provision is where we want it to be. Some, but by no means all, ICBs, including in north-east London and Sussex—I declare an interest as a Sussex MP—are now fully compliant with the current NICE guidelines and the provision of three cycles. Others are improving their integrated offer, but some ICBs have kept their pre-existing local offer. That is not good enough, and we are aiming to tackle it.
Abena Oppong-Asare
What conversations has the Minister been having to make sure that ICBs are currently being updated to be as robust as possible?
Maria Caulfield
I will go through that. One of the first things we have done is to be transparent about what is being offered. We have asked every ICB—the whole 42—to detail their provision. We are now publishing that on gov.uk, so if ivf.gov.uk is entered, the table will come up. That illustrates the number of cycles offered by every ICB, the age provision, the previous children rule and what funding is offered for cryo-preservation. That is not just to say, “This is what’s on offer” so that women and couples can see what is available in their area; it is also the start of the process of holding ICBs’ feet to the fire—and for local MPs to be able to say, “Look, they’re offering free cycles in Sussex; why are we not offering that in our local area?”
Abena Oppong-Asare
The Minister may be about to get to this point, so I apologise if I have intervened too quickly. In terms of transparency, it is great that the Minister is publishing the data, but what are the Government doing to make sure that more work is being done by ICBs to provide a better—or adequate—service, given that publishing data does not require them to take any action?
Maria Caulfield
As the hon. Lady will know, it was only last year that we published the women’s health strategy. IVF was front and centre of that—the first year priority. Getting that information is the first step, and then we are able to look at the ICBs that are not offering the required level of service, have those conversations about why and have a step change to improve the offer. That is just one tool in our box to fulfil our ambition to end the postcode lottery for fertility treatment across England.
Colleagues have also raised the issue of lack of information about IVF, both for the public and healthcare professionals. We are working closely with NHS England to update the NHS website to make IVF more prominent, and also with the royal colleges to improve the awareness of IVF across healthcare professions. One area we are dealing with is that of add-ons, which the hon. Member for Pontypridd (Alex Davies-Jones) and my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) addressed. As part of our discussions with the HFEA, it now has the add-on rating system, so that people can see what percentage difference an add-on would make and make an informed choice about whether they want to do that as part of their IVF treatment.
I have also just received the HFEA’s report about modernising the legislation, with particular regard to its regulatory powers. That will cover the provision of add-ons, and I hope to be able to respond to the report as quickly as possible. We are making really big changes to some of the issues that have been holding back IVF for a long time. I know that for many people this is not quick enough, but I reassure hon. Members that progress is being made.
For female same-sex couples and same-sex couples across the board, I know that this is a really important matter. I took the position that it was unacceptable for female same-sex couples to shoulder an additional financial burden to access NHS-funded fertility treatment. On the transparency toolkit now on the gov.uk website, we can easily see which parts of the country are asking for six cycles of self-funded insemination, for instance. In Cambridgeshire and Peterborough it is 12 cycles, in Bristol and north Somerset it is 10. As the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) said, that is exactly the information we need so that we can tackle the issue head-on and directly with the ICBs. Indeed, one of our key commitments in the women’s health strategy was to remove this injustice once and for all. We were hoping to do that completely in the first year; it will in fact take us a little longer, but it will not take us 10 years.
Black History Month
Debate between Maria Caulfield and Abena Oppong-Asare(6 months, 2 weeks ago)
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The Minister for Women (Maria Caulfield)
I am grateful to be able to contribute to this Adjournment debate to mark Black History Month. I congratulate the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) on what has been a marathon afternoon for us both. It is lovely to finish the afternoon by responding to such an important debate.
As Minister for Women, I was pleased to see that one of this year’s themes for Black History Month is “celebrating sisters”. That gives us a chance to recognise the important contribution that black British women have made in the story of this nation. From individuals such as Mary Seacole, a trailblazing nurse who served during the Crimean war, to women from the Windrush generation who helped rebuild this country after the second world war, these pioneering women fought for civil rights and equality, playing an essential role in shaping the diverse and inclusive nation we are today.
As a Government, we are committed to ensuring that Black History Month is, as the hon. Lady said, not a once-a-year event and that schools are equipped to teach black history all year round. How our past is taught is crucial to ensuring that every pupil, regardless of their background, feels a sense of belonging to this country. We also want to celebrate the fact that our country is more diverse than ever before. According to the 2021 census, 18% of people in England and Wales are now from an ethnic minority group, compared with just 14% in 2011. Integration is also increasing, with the mixed- ethnicity population in England increasing by 40% in 10 years; 2.4 million households are now multi-ethnic.
Abena Oppong-Asare
According to some of the latest data, contained in a report produced recently by the newspaper the Voice in conjunction with Cambridge University, although we are seeing more diversity, especially in communities, there are concerns about the way people feel. May I urge the Minister to look at the report and think about what action can be taken in that regard?
Maria Caulfield
I have not seen the report, but I shall be happy to look at it, because the question of how people feel is important, in terms of both their experience and how it shapes their future.
It would of course be naive to say that tolerance and inclusion are the universal experiences of everyone who lives here, which is why, in July 2020, the then Prime Minister established the Commission on Race and Ethnic Disparities. We published our response to the Commission, “Inclusive Britain”, in March last year. That response sets out a groundbreaking action plan to level up the country, with three clear aims: to build a stronger sense of trust and fairness in our institutions—the hon. Lady touched on that, in relation to maternal health in particular —to promote equality of opportunity, encouraging aspiration and empowering individuals to reach their full potential; and to encourage and instil a sense of belonging to a multi-ethnic United Kingdom that celebrates its differences while embracing the values that unite us all.
The landmark “Inclusive Britain” strategy sets out 74 actions to tackle entrenched ethnic disparities in health, education, employment, policing and criminal justice. The strategy aims to increase trust and fairness, promote equality of opportunity, nurture agency, and foster a greater sense of belonging and inclusion. In April we published an update for Parliament, setting out the excellent progress we had made in delivering our ambitious strategy. This is a cross-Government approach, and we have delivered a number of changes already. There is new guidance from employers on how to use positive action in the workplace. We have published our ambitious schools White Paper, and provided targeted support for pupils who need it the most. We have established an Inclusion at Work panel to promote fairness in the workplace, and we are improving the stop and search process through new training for police officers. All of that will make a difference to the lives of black communities. Eighteen months on, we have already completed more than half those 74 actions, and we are proud to be delivering on our promises to all our citizens.
Abena Oppong-Asare
I appreciate that the Government are taking steps to try to address this issue, but given that this is the 75th year of the Windrush generation, I should like to hear more about what they are going to do for, in particular, those who have contributed so much to the NHS, have worked in Transport for London, and have helped our public sectors in general. They are being massively left behind, and the compensation scheme has not moved forward at all.
Maria Caulfield
The hon. Lady raised that point in her speech. We want to make sure that this is a fair scheme. The Home Office has reduced the time taken to allocate a claim for a substantive casework consideration from 18 months to less than five months. However, I fully understand the points that the hon. Lady has made, and I am happy to raise them with Home Office colleagues, because we fully understand the frustration and the upset that has been caused.
Abena Oppong-Asare
It is great that the case workload has been reduced, although it needs to be speeded up. However, I want to ask about the Wendy Williams review, which has been in place for some time. Is the Minister able to give us any firm commitments on its full implementation and any timescales applying to that?
Maria Caulfield
I am not able to give a firm commitment from the Dispatch Box this afternoon, but I can update the hon. Lady, and I shall be happy to write to her with some firm timelines after the debate.
I understand that Windrush is a particularly sensitive area, but I reassure the hon. Lady that we are making progress across the board, particularly on the school curriculum. Our model history curriculum will help pupils to understand the complex nature of British history and their place within it.
The hon. Lady touched on maternal health, and the evidence and statistics show that women from black, Asian and working-class backgrounds have poorer maternity outcomes, which is why I am so pleased that we set up the maternity disparities taskforce. My co-chair Wendy Olayiwola is a trailblazing black woman, and she follows the fantastic Professor Jacqueline Dunkley-Bent, who transformed how maternity services respond to black women in particular.
We established the taskforce in February 2022 to tackle disparities for mothers and babies, and our work is currently focused on pre-conception health and wellbeing because our understanding is that disparities are often bedded in by the time a woman is pregnant. The way to reduce those disparities is to ensure that women have help and support before getting pregnant, as that is the best way to ensure a safe outcome during pregnancy and birth.
The taskforce met in September, just a few weeks ago, and we are bringing together experts from across the health system, including some of the charities that the hon. Lady talked about, to explore and consider interventions. We are looking at setting up a pre-conception toolkit, and those charities, including Five X More, are feeding in what they think will make the greatest difference for women across the board. We know from their testimony that previous poor experience of healthcare services often prevents black women from engaging with healthcare services in future. It is important that we break down those barriers and change black women’s experience of NHS services.
Our Online Safety Bill will soon become law, allowing us to hold social media companies to account in clamping down on online racist abuse. This is just a taste of the work we have done and will continue to do to make sure the inclusive Britain commitments are implemented.
The hon. Lady touched on a meeting back in 2022. I was not the Minister at the time, but I am happy to follow up and let her know the outcomes. If it has not been actioned since that meeting, I will follow it up.
I am grateful for the points raised by the hon. Lady throughout this debate. I share some of her concerns, particularly on maternity services, and we are committed to trying to transform the statistics to make sure that black and Asian women in particular, have better maternity outcomes.
Across the board, the Government are committed to continuing to work towards a society in which every individual, regardless of their background, has the opportunity to succeed. We are not there yet, as the hon. Lady so eloquently pointed out, but I have every confidence that the decisive action we are taking as part of our inclusive Britain strategy will help us to achieve that goal.
Question put and agreed to.
Oral Answers to Questions
Debate between Maria Caulfield and Abena Oppong-Asare(6 months, 2 weeks ago)
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Abena Oppong-Asare (Erith and Thamesmead) (Lab)
The House of Commons Library says there has been no statistically significant change in the rate of suicides in England since 2015. Suicide remains the biggest killer of men under 50 in the UK. Why has it taken so long for the Government to bring forward a strategy, and why do they continue to drag their feet over reform to the Mental Health Act? Can the Minister give the House a firm timetable today?
Maria Caulfield
The hon. Lady is not quite right in her statistics. Just before covid we had seen a 20% reduction compared with two decades ago in suicide levels in England. She might be interested to know that in Labour-run Wales suicide rates are higher than in England, and its suicide prevention strategy expired last year. Mental health has been demoted on the shadow Front Bench, too, as we saw from the resignation of the hon. Member for Tooting (Dr Allin-Khan) when the role of shadow mental health Minister was removed from the Opposition Front Bench.
International Women’s Day
Debate between Maria Caulfield and Abena Oppong-Asare(1 year, 1 month ago)
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Maria Caulfield
Yes, absolutely. That is why we need a cross-Government approach. We need to work with the Home Office and the Ministry of Justice team so that we have a united voice.
Abena Oppong-Asare
I appreciate the Minister’s generosity. I just want to put on record the work that Sistah Space has done—particularly in relation to Valerie’s law—for victims of abuse, especially black victims. The Minister’s predecessor started to do some work with me and with Sistah Space before the change of Government. Will she please continue that work?
Maria Caulfield
I shall be happy to do that, and we can certainly arrange to meet following this debate.
The shadow Minister was slightly dismissive of the groundbreaking Online Safety Bill. However, my right hon. Friend the Member for Chelmsford has reported that the UN special rapporteur on violence against women and girls has described it as world- leading. Many other countries are following our progress, and, indeed, may adopt similar legislation. The Bill will tackle criminal activity online. It will protect children from harmful and inappropriate content, and it aims to stop the rise of online misogyny. Several Members have mentioned the importance of that.
Let me say something about business. The UK is now successfully including gender provision in all the free trade agreements that we have made since leaving the EU. Our trade agreements with Australia and New Zealand, for instance, contain dedicated trade and gender equality chapters. That too is groundbreaking work. As for our domestic business focus, our taskforce on women-led high- growth enterprise was established last summer. I want to pay tribute to my hon. Friend the Member for Meon Valley (Mrs Drummond) for her work in the all-party parliamentary group on women and work, not just her work in pushing science, technology, engineering and maths for women, but the high-growth sector work she is doing. If we deliver more women with ambition, we will improve growth in our economy and also improve the outcome for those women as they thrive in the workplace.
We know that childcare is an issue. That is why we have spent more than £3.5 billion over the last three years on early education entitlement, and have increased the funding for local authorities to £160 million this year, £180 million next year and £170 million thereafter, to allow them to increase their payments to local childcare providers. I recognise the challenges and the cost that childcare imposes on families, but I also know how difficult it is for the providers to sustain their business model.
Turning briefly to women’s health, I am proud that in the past year we have published the first women’s health strategy for England. The hon. Member for Vauxhall (Florence Eshalomi) mentioned that in particular, and I am very keen that we make progress in that space, especially on maternity disparities. We have appointed Dame Lesley Regan as the first women’s health ambassador to lead that work. We announced yesterday that we are investing £25 million to roll out women’s health hubs across the country, providing a one-stop shop for women’s healthcare needs.
We will also level up IVF access to same-sex couples and across the board, ensuring consistent provision across the country, which does not currently exist. The HRT prepayment certificate will be launched from 1 April, cutting the cost of HRT by hundreds of pounds. We also aim to announce our pregnancy loss certificate later this summer, so that babies born before 24 weeks can be registered—an important issue for those parents who have lost babies. The major conditions strategy will look at long-term conditions such as heart disease, musculoskeletal conditions and dementia, the leading cause of death in women, which for too long have been ignored.
Finally, I want to touch on girls’ education, which it is a top priority for us in both our international commitment—we want 12 years of quality education for every girl, which is the best way to get girls and women out of poverty—and our domestic commitments. The Prime Minister in his first speech set out his ambition to ensure that all school pupils in England study some form of maths to the age of 18. My hon. Friend the Member for Thurrock (Jackie Doyle-Price) raised the issue of teaching materials in schools; the Prime Minister yesterday committed to a review of those and we will look forward to what that shows.
We need to get more women and girls into science, because, as my right hon. Friend the Member for Basingstoke said, despite getting more girls into STEM A-levels and on to undergraduate courses, we only see women making up 29.4% of the STEM workforce. That is why we are running our STEM Returners pilot; there are 75,000 people, mainly women, with experience and qualifications in STEM who are not working in the sector and who we want to see return to practice.
I hope that that showcases some of the work we are doing across the board. There are many challenges—we do not deny or shirk that fact—but we are making significant progress. In particular, domestically, on violence against women and girls, I hope that this time next year we will have a better story to tell.