Disability Benefits Assessments

Debate between Marsha De Cordova and Gary Streeter

Tuesday 1st February 2022 Westminster Hall

[Sir Gary Streeter (in the Chair)]

I remind Members to observe social distancing. Before I call the Member to move the motion, I will make a short statement about the sub judice resolution.

I have been advised that the Government have applied to appeal the findings of the High Court on the lawfulness of the UK disability survey. Those proceedings are therefore live before the courts, under the terms of the House’s sub judice resolution. However, Mr Speaker has exercised discretion to allow reference to the issues concerned, given their national importance. Nevertheless, Members should remember that those matters are still before the courts, and they are encouraged not to discuss those legal proceedings in any detail.

[Marsha De Cordova (Battersea) (Lab)]

I beg to move,

That this House has considered disability benefits assessments and the Government’s health and disability green paper.

It is a pleasure to be here under your stewardship, Sir Gary.

I thank all right hon. and hon. Members who have come along today to debate this important issue, which affects many of our constituents. I thank all organisations that have supported disabled people and provided briefings for this important debate, including Z2K, Sense, Marie Curie, Mencap, the Royal National Institute of Blind People, the Multiple Sclerosis Society, the Cystic Fibrosis Trust, Rethink Mental Illness, the Young Women’s Trust, Scope and the Charities Aid Foundation.

I also say a special thanks to Citizens Advice Wandsworth, the South West London Law Centres and the Wandsworth food bank, which have supported people in my constituency. I pay tribute to the tens of thousands of disabled people who have been victims of the cruel and callous assessments for the employment and support allowance and the personal independence payment.

In the short time I have been an MP, I have raised the question of social security for disabled people on many occasions. The system should act as a safety net that is there to support each and every citizen in need, as envisaged by the Beveridge report of 1942, which was about strengthening the social contract for those facing hardship in our society by removing the five social ills. However, there is an ever-growing link between poverty and disability, and social security is no longer seen as a basic right.

Disabled people are usually in receipt of employment and support allowance, universal credit, disability living allowance or PIP. As is the case for ESA, disabled people claiming universal credit must undergo the work capability assessment in order to be found to have limited capability for work. PIP is designed to meet some of the extra costs of living with a disability. Since its introduction, however, almost half of those who were previously on DLA and were reassessed for PIP have either completely lost their award, or had it reduced.

--- Later in debate ---

[Sir Gary Streeter (in the Chair)]

Order. Marsha, before you respond, I remind everyone that interventions should be brief.

[Marsha De Cordova]

I thank my right hon. Friend for his intervention. He is absolutely spot on; it is so important that these decisions are got right first time around. I will come on to that issue later in my speech.

The overwhelming body of evidence shows that the assessment frameworks for both ESA and PIP are not fit for purpose. They use a series of points-based, functional descriptors and a tick-box approach. PIP looks at an individual’s ability to carry out a series of everyday activities relating to daily living and mobility, and the WCA is supposed to test someone’s capability for work, based on various activities. Its main flaw is its failure to include real-world factors, and it takes no consideration of how carrying out work could affect a particular person’s health. For example, I heard from one person who was asked to touch their toes, no matter how much pain they were in or how such an activity relates to their doing work.

For more than a decade, there has been a growing mistrust of assessors as a result of the errors in reports, and many people do not feel that they are being treated fairly. Research by Demos revealed that WCA assessors assume that people are not telling the truth or are exaggerating their condition, and many people report being treated as if they are making a fraudulent application.

Black Maternal Healthcare and Mortality

Debate between Marsha De Cordova and Gary Streeter

Monday 19th April 2021 Westminster Hall

[Marsha De Cordova (Battersea) (Lab)]

It is a pleasure to serve with you in the Chair, Sir Gary. I am grateful to my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) for leading the debate on behalf of the Petitions Committee. I also congratulate the formidable campaigners Tinuke and Clo, the founders of the Five X More campaign, who got the petition debate in Parliament today. The petition received more than 180,000 signatures. It is not before time that such a huge injustice is finally receiving the attention it deserves.

We have heard some powerful contributions from right hon. and hon. Members this evening, including my right hon. and learned Friend the Member for Camberwell and Peckham (Ms Harman), the Chair of the Joint Committee on Human Rights. Just last year, the Committee published its report “Black People, Racism and Human Rights”, which contains shocking findings, particularly that the care that many black people receive is unequal to what is given to white people. I urge the Minister to accept all the recommendations of that report.

My hon. Friend the Member for Edmonton (Kate Osamor) highlighted, as others have done, the choice made in the report of the Commission on Race and Ethnic Disparities to sideline the institutional and structural racism that exists across society, but more so in the health service. My hon. Friend the Member for Streatham (Bell Ribeiro-Addy) made a powerful contribution sharing her lived experience. I thank her for doing so, but also for her tireless campaigning on the issue. She has been brave, and I thank her for that.

More importantly, my hon. Friend the Member for Vauxhall (Florence Eshalomi) highlighted some of the issues related to underlying health conditions in her own experience of being diagnosed with fibroids and also of being a sickle cell carrier. I also urge the Minister to listen to my hon. Friend the Member for Luton North (Sarah Owen), to give 20 minutes of her time to her and her constituent and to hear their experiences.

I also want to mention the contribution of my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes), who highlighted the fact that we need to focus more on issues relating to research. Unless we do the work, we will not move forward and bring an end to this crisis.

As we have heard, it is absolutely shameful that black women continue to be four times more likely to die in childbirth and pregnancy than white women. That inequality has existed for decades, with little action being taken to address it. [Interruption.]

[Sir Gary Streeter (in the Chair)]

Order. Does any Member present have to go to vote physically, or is everyone on a proxy vote? If everyone is happy, let us continue.

[Marsha De Cordova]

Last week I met campaigners, obstetricians, midwives and black, Asian and ethnic minority women with lived experience of maternal health complications. They were very clear that socioeconomic determinants such as income, housing and occupation and comorbidities only partially explain the inequalities affecting black maternal health. It is absolutely clear that structural racism is a driver of disparities in treatment, and it is a missed opportunity that the Commission on Race and Ethnic Disparities chose to sideline that important issue. I hope the Minister will choose to ignore and reject that view.

Black and Asian women, and their partners, regardless of their socioeconomic status, are not being listened to, not being respected and not being cared for. When they voice pain or concern during pregnancy or childbirth, they are branded as “aggressive” or “angry”, while dangerous stereotypes about “strong black women” mean that black women are often not offered the same treatment as white women.

It is outrageous that racist myths about black women having higher pain thresholds than other women continue to affect their treatment. Meanwhile, the lack of cultural competency in medical training means that complications experienced by black women are not spotted early enough. For example, black women have shared accounts of how their anaemia was not picked up soon enough because of the colour of their skin.

So I ask the Minister what action she is taking to tackle structural racism and to build trust in maternity services for black, Asian and ethnic minority mothers and their partners and for healthcare professionals, including midwives, as many have shared their experiences of occupational discrimination, as was highlighted in the Public Health England report last year. I would really like the Minister to address this issue. Additionally, cultural competency and unconscious bias training is an essential part of ending these inequalities, so will she commit to improving training in the health service and in medical schools?

We are all aware of the importance of data, which as we have heard is central to closing the maternal mortality gap. Many mothers and medical professionals have shared accounts of how pregnant women are recorded as being white if they do not disclose their ethnicity, meaning that it is difficult to track complications. Therefore, the recording of data is essential, so will the Minister commit to ensuring that all maternity services record the specific ethnicity of all mothers?

It is clear that fatalities are just the tip of the iceberg, with many women speaking of the near-misses and poor treatment they have experienced. I have heard from many medical professionals that data on near-misses could easily be made available, but it is not being. Will the Minister therefore commit to collecting and publishing data on maternal near-misses by ethnicity, and, if so, can she set a timeline for that commitment, with some clear milestones?

Midwives consider the continuity-of-care model as a way to help bridge some of these inequalities. A 2016 study found that women who see the same midwife throughout their pregnancy are 16% less likely to lose their baby. The NHS standard contract for 2019-20 stipulated that 35% of women will be booked on to a continuity-of-care pathway by March 2020. Can the Minister confirm whether that target was met? Can she also say what is being done to meet that target in the NHS long-term plan, which aims to provide continuity of care for 75% of black, Asian and ethnic minority women by 2024?

Before I close, I want to mention how the hostile environment is exacerbating this problem, as mentioned by my hon. Friends the Members for Erith and Thamesmead (Abena Oppong-Asare) and for Dulwich and West Norwood. Charging for maternity services and no recourse to public funds conditionality mean that many women are either becoming indebted as a result of their pregnancy or are turning away from health services all together for fear of being reported to the Home Office. Many women subject to charging are destitute and unable to pay, and three of the 209 women whose deaths were investigated in the 2019 MBRRACE-UK report were affected by charging for NHS maternity care. Does the Minister agree that charging women for maternity care is cruel and dangerous during this pandemic?

I want to make it clear that black maternal health and mortality is an avoidable inequality, and it is scandalous that the Government have not yet set a target to end this injustice in the NHS long-term plan, so will the Minister commit to doing so today? The NHS long-term plan sets many targets for other issues, so why not for black maternal health?

Let me be absolutely clear that a Labour Government would be committed to ending the crisis in black maternal health and mortality, and that the Government must take urgent action now. We need a national strategy to tackle health inequalities as a matter of urgency, which must include a target and a commitment to end the mortality gap between black, Asian and ethnic minority women and white women and to tackle structural racism once and for all, not deny its existence. We cannot afford for this not to be a priority.