Mental Health Bill [ Lords ] (Ninth sitting)

Natasha Irons Excerpts

Committee stage
Tuesday 24th June 2025 Public Bill Committees

Brought up, and read the First time.

[Natasha Irons (Croydon East) (Lab)]

I beg to move, That the clause be read a Second time.

The new clause seeks to ensure that if a patient dies while in detention under the Mental Health Act, an independent inquiry into their death will be required. Unlike deaths in prison or police-related deaths, deaths while a person is detained under the Mental Health Act are not automatically investigated independently. Currently, if a person dies while detained under the Act, the trust responsible for their care should carry out an internal investigation into their death to find out what happened and whether lessons can be learned. Those investigations, known as serious incident investigations or root cause analysis, do not have any independent oversight and can vary a lot from trust to trust.

Inquest, the only charity in England and Wales providing expertise on state-related deaths and their investigation, has found that the current system for investigating such deaths is not fit for purpose. In its statement to the Lampard inquiry, it outlined an anonymised case from 2010 in which there was a stark contrast between the findings of the NHS trust that investigated the death of a patient detained under its care and the inquest that took place two years later. The trust found very few failings in care, whereas the jury at the later inquest were critical of the patient’s treatment, which directly led to their death. The question we must ask ourselves is why we would allow deaths while in detention under the Mental Health Act to be investigated by those in charge of custody, when deaths in any other setting would not be. We do not allow the police to judge their own actions if a death occurs in custody, so why should it be any different for those detained under the Mental Health Act?

[Josh Dean (Hertford and Stortford) (Lab)]

My hon. Friend is making a fantastic speech. In the really dire circumstances of a death in detention, we are dealing with the most difficult and, for family members and loved ones, the most devastating circumstances. Given that, does she agree that it is important to make sure that the circumstances are reviewed thoroughly and independently?

[Natasha Irons]

My hon. Friend is absolutely right. This is about transparency and providing answers for the families of patients when the very worst happens.

Independence has allowed investigations into deaths in places of custody to improve significantly. As outlined by the independent advisory panel on deaths in custody, patients detained under the Mental Health Act now have the highest mortality rate across all places of custody. Indeed, the rate is three times higher than in prisons, when taking into account estimates of time in custody and the number of people in each setting. Behind each of these tragedies are families who have unanswered questions and who have had to fight to find out what happened to their loved ones, and vulnerable people who should have received better care.

In my constituency, there is the story of Catherine Horton, who died in 2017 while in the care of the South London and Maudsley NHS trust. The inquest into her death found that the risk assessment was not properly updated, with no formal risk assessment conducted, and no care plan on her arrival or while at the facility. There is also the story of Tia Wilson, who died in 2021 in the care of the same trust. The inquest into her death found that there were multiple failures in managing her risk, which contributed to her death. Then there is the story of the brother of one of my constituents, who absconded from his care, went missing, and was later found dead in a wooded area a stone’s throw from her home.

For each of those cases, we know that internal reviews will have taken place and assurances of improvements will have been made, and yet issues with risk assessments remain and families are left pushing for answers. This is not unique to south London; the internal review process is failing to deliver the necessary improvements across the country. Without embedding independence into the process, we risk undoing a lot of the good work that the Bill seeks to achieve. Adding independence into the investigation of these incidents where the very worst things happen gives trusts a genuine space to learn the lessons. It would improve patient safety and provide families with the transparency they need.

Although we must all acknowledge the incredible work that trusts do across our country to provide care for people at their most vulnerable, we must also provide a proper framework for challenge and improvement. The new clause is an opportunity to treat the deaths of people detained under the Mental Health Act with the same seriousness and care as deaths in other custody settings, to embed transparency, and to make the meaningful improvements that all patients deserve.

[Stephen Kinnock]

I am very grateful to my hon. Friend for bringing this issue to the Committee. I thank her for her powerful speech, which drew on specific experiences of people who have been through very terrible and tragic processes. I have discussed some work on the broader issue of quality of care, but this is a vital issue, and I reiterate how grateful I am to her for enabling us to discuss it on the public record. We recognise that there have been too many incidents of poor-quality and unsafe care, which sometimes result in tragedy. I hope my hon. Friend is reassured by the measures we are taking to support providers of mental health care to improve the quality of their services. We have carefully considered her new clause, and I am afraid that we do not think this needs to be addressed through the Bill.

--- Later in debate ---

In regard to the creation of a new body to investigate deaths under the Act, we are concerned that the patient quality and oversight landscape is already overly cluttered and fragmented. That is why we have asked Dr Penny Dash to make recommendations on whether greater value could be achieved through a different delivery model. We will shortly be seeing the results of her review. I once again thank my hon. Friend for this important discussion, and I hope she is content to withdraw her new clause.

[Natasha Irons]

I thank the Minister for his comments. The cluttered and chaotic way in which we investigate these things is part of the problem, so I am glad to hear that there is a wider review of how we streamline the process better for patients, because we are seeing mistakes repeated over and over again. I am content to withdraw the new clause, but I would be grateful if the Minister would meet me to discuss the wider plans in this area and how I can support that work and take it forward.

[Stephen Kinnock]

I would be more than happy to meet my hon. Friend. It is also worth mentioning the independent advisory panel on deaths in custody report, which she mentioned. We are considering that carefully, so we should include it in our discussions.

[Natasha Irons]

I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 26

Use of restraint and restrictive intervention

“(1) The Mental Health Act 1983 is amended as follows.

(2) In Part II (Compulsory Admission to Hospital and Guardianship), after section 7, insert—

‘7A Use of force in connection with admission for assessment or treatment

(1) A relevant organisation that operates a hospital must appoint a responsible person for the purposes of this section.

(2) The responsible person must—

(a) be employed by the relevant health organisation, and

(b) be of an appropriate level of seniority.

(3) The responsible person must keep a record of any use of force by staff who work in that hospital against a person (“P”) who—

(a) has been admitted for assessment or treatment under sections 2 to 5 of this Act; or

(b) is on the hospital premises and is at risk of detention under this Act.

(4) The Secretary of State must by regulations provide for the risk factors to be considered under subsection (3)(b).

(5) A record kept under this section must include—

(a) the reason for the use of force

(b) the place, date and duration of the use of force

(c) whether the type or types of force used on the patient formed part of the patient's care plan;

(d) the name of the patient on whom force was used;

(e) a description of how force was used;

(f) the patient's consistent identifier;

(g) the name and job title of any member of staff who used force on the patient;

(h) the reason any person who was not a member of staff in the hospital was involved in the use of force on the patient;

(i) the patient's mental disorder (if known);

(j) the relevant characteristics of the patient (if known);

(k) whether the patient has a learning disability or autistic spectrum disorders;

(l) a description of the outcome of the use of force;

(m) whether the patient died or suffered any serious injury as a result of the use of force;

(n) any efforts made to avoid the need to use force on the patient; and

(o) whether a notification regarding the use of force was sent to the person or persons (if any) to be notified under the patient's care plan.

(6) The responsible person must keep the record for three years from the date on which it was made.

(7) The Secretary of State must ensure that, at the end of each year, statistics are published regarding the use of force by staff who work in hospitals under the conditions set out in this section.’”—(Jen Craft.)

This new clause would require hospitals to record information on all incidents in which force is used against patients with mental disorders, in line with the reporting currently required in mental health units, including force against those at risk of detention for assessment or treatment. It would also require the Government to publish annual figures on the same topic.

Brought up, and read the First time.

[Jen Craft (Thurrock) (Lab)]

I beg to move, That the clause be read a Second time.

I will speak briefly to the new clause, which was tabled by my hon. Friend the Member for Sheffield Hallam (Olivia Blake). Its aim is to close a loophole in the current framework by which use of restraint is recorded. Currently, the use of restraint is governed by the Mental Health Units (Use of Force) Act 2018, which mandates that where force or restraint is used in a mental health unit, that must be recorded and reported. There are, however, a number of patients who are treated outside mental health units and therefore do not fall within the scope of the Act. My hon. Friend the Member for Sheffield Hallam has spoken about the issue, to which her attention was particularly drawn in the context of the treatment of patients with eating disorders. This happens quite often, either where there is a shortage of beds in a mental health unit or where the patient in question has co-occurring physical health conditions that require treatment outside such a unit.

Restraint is used regularly and often on patients with eating disorders, by which I mean restraining them to force them to eat, but there is currently no mechanism by which its use must be recorded. If a patient, particularly a young person, who is in hospital but is not in a mental health unit is subject to this restraint, which may be deemed necessary to preserve life and in their best interests, there is currently no mechanism by which that is recorded.

Mental Health Bill [ Lords ] (Sixth sitting)

Natasha Irons Excerpts

Committee stage
Tuesday 17th June 2025 Public Bill Committees

[Dr Shastri-Hurst]

My hon. Friend makes a pertinent point. We all know, from our casework or personal experiences outside of this place, about the pressures on the Courts and Tribunals Service. Mental health tribunals are not exempt from that pressure. Changing the timeframe on which tribunals operate, and the frequency with which reviews take place, will inevitably increase the burden on the service. Therefore, although these changes are broadly welcome, it is important that we are cognisant of their impact on the resources that will be required, the number of judges and wing members that will be needed, and of course the hard standing of the court and tribunal infrastructure that will need to be made available. Other issues, such as those around the digitalisation of the service, will also need to be addressed.

Clause 31 will recast the regime for automatic tribunal referrals, replacing the prior six-month structure with the concept of “a relevant period”. For detained patients, referrals will now occur at three months, then 12 months, and annually thereafter. For community patients, they will occur at six months, then 12 months, then annually. Most significantly, hospital managers will be under a new duty to refer a case when no review has occurred in 12 months, regardless of whether an application has been made. That is a sound reform.

The clause will introduce coherence to a previously fragmented system, and establishes a minimum standard of legal oversight. The inclusion of a backstop provision—that no individual should go more than 12 months without review—is essential. In a system in which patients may not always have the means or capacity to apply for a review themselves, it offers a critical safety net. Clause 31 will also repeal section 68A of the 1983 Act, which has become unwieldy and duplicative. By streamlining the referral process, the Bill enhances legal clarity and administrative efficiency, but I would caution that the increased complexity of the new timeframes may require significant training of those responsible for their implementation.

Clause 32 will provide for restricted patients who are subject to deprivation of liberty conditions. It goes further than clause 30 by imposing mandatory referral duties on the Secretary of State. Under the clause, a tribunal must be convened after 12 months, every two years thereafter, and at four years if no review has occurred. Crucially, the clause also codifies the tribunal’s powers. It may now vary or impose conditions, including those that constitute a deprivation of liberty, provided that they are necessary to protect the public from serious harm and are no more restrictive than hospital detention. That clause introduces a principled, proportionate framework for balancing public protection with patient liberty, and avoids vague or discretionary use of such powers.

Finally, clause 33 will apply the same principles to restricted patients not subject to deprivation of liberty orders. Such individuals, although under fewer constraints, are none the less subject to significant legal orders. The new requirement for a tribunal review at two years, and every four years thereafter, ensures that oversight is regular and non-discriminatory.

All four clauses are united by a clear objective to rationalise tribunal access, enhance procedural safeguards and bring the Mental Health Act into alignment with modern standards of fairness and proportionality. However, I will close with a caveat: rights without resourcing are hollow. If we are to place greater demand on the tribunals service, and to rely on it as the guardian of liberty for thousands of individuals, it must be adequately funded, staffed and supported. Legal representation must be accessible. Tribunal members must be properly trained. Hospital managers must be equipped to meet their new responsibilities.

With those reservations, I broadly welcome clauses 30 to 33 as a necessary recalibration of our mental health law. They reflect the dignity of the individual, the demands of public safety, and the enduring principle that no one should be deprived of liberty without fair or timely review.

[Natasha Irons (Croydon East) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Harris. I rise to speak in support of clauses 30 to 33. I echo many of the remarks of the gallant and learned hon. Member for Solihull West and Shirley, but I will try not to go over too much of the same ground.

These clauses seek to provide clarity and improvement in access to the tribunal process, both for patients detained under the Mental Health Act and for those on conditional discharge, and seek to implement key recommendations from the independent review. Section 66 of the Act is amended to extend the period in which a patient detained under section 2 can apply to the tribunal from 14 days to 21 days. Clause 30 also allows for auto-enrolment in a hearing, reducing that time from six months to three months. It clarifies that conditional discharge patients are included in this package, so they also have the right to have their treatment reviewed at a tribunal. Providing for auto-enrolment simplifies the system for people who, as the hon. Member mentioned, are perhaps not in the best position to make administrative decisions and fill in the paperwork to apply to a tribunal.

Although this framework and these changes are necessary to bring clarity and autonomy back into people’s healthcare, it would be good to hear from the Minister about how we will support patients throughout these processes as we learn about the different timelines. How will we ensure people can access this change in the system and understand what they are entitled to under this new provision?

[Dr Evans]

Clauses 30 to 33 deal with the tribunal access and automatic referrals of patients detained or conditionally discharged under the Mental Health Act. Let me begin, again, by welcoming these provisions, which seek to improve safeguards, ensure timely oversight, and extend the rights of individuals, particularly those under deprivation of liberty conditions in the community. These are serious matters of liberty and I acknowledge the Government’s intention to modernise and strengthen protection. Nevertheless, it is important that we look carefully at how the clauses operate in practice. I will take each in turn.

Clause 30, on tribunal application periods, will make important changes to when patients can apply for the tribunal. First, it will extend the time that patients detained under section 2 of the Act have to apply from 14 to 21 days. This is a welcome change. We know that the first few days in hospital are incredibly disorientating, so allowing patients a bit more time to seek legal advice is entirely sensible.

Secondly, the clause will reduce the period for patients detained under section 3 to apply from six months to three. I can understand the logic of that, given that clause 29 also shortens the initial detention period, but is there any reason for choosing that mark? Is there any evidence that the three-month window will still allow patients to have sufficient time and support to exercise their rights?

Thirdly, the clause will introduce new provisions for conditionally discharged restricted patients, setting out different application timeframes depending on whether the patient is subject to conditions amounting to deprivation of liberty. Those under the deprivation of liberty safeguards will be able to apply between six and 12 months after discharge and then every two years. For those not under such conditions, the window begins at 12 months. That reflects the impact of conditions on a person’s liberty, and I recognise that distinction, but can the Minister clarify how patients will be informed about which track they are on? That will be fundamental to exerting their rights. Will any guidance be issued to ensure consistency? Will patients have access to advocacy or legal advice at this point?

On clause 31, automatic tribunal referrals are a crucial safety net for those who for whatever reason do not exercise their right to apply. The clause introduces a new framework of relevant periods after which the hospital managers must refer, as we have heard. For section 2 patients, it will be three months. For section 3 and CTO patients it will be three months, then 12 months and every year thereafter. Significantly, the current three-year review period for many detained patients is reduced to one year.

The clause marks a substantial increase in oversight, which I support, but it also raises practical questions. Given that we have put these backstops in place, have the Government made any estimate of how many extra tribunals will be needed and how much extra work they will generate? The Minister was kind enough to say that there were four hours of clinical work involved in doing the plans, but I do not think we have yet heard how much work the Government estimate that the tribunals will take.

More importantly, what support is being provided to ensure that the tribunal system can meet that increased demand? I am particularly concerned that the benefits of these reforms may not be felt if backlogs or delays undermine the safeguards they are intended to deliver.

--- Later in debate ---

[Stephen Kinnock]

I understand and recognise my hon. Friend’s concerns, but we can rattle through all the different forums where feedback can be captured: the CQC, the trust boards, the patient and carer race equality framework, Healthwatch England and all the other informal channels in the mental health ecosystem. Our view is that adding another layer into all that would in the end be counterproductive. That is the Government’s position.

[Natasha Irons]

The Minister mentioned the complex network of ways in which patients can give their feedback; perhaps the aim of the clause is to try to simplify that and, as my hon. Friend the Member for Thurrock mentioned, make it a bit more direct and immediate after treatment. Are there any plans to simplify the process in another way? The complex cobweb that the Minister described is perhaps the reason why the patient voice is not always captured and utilised in a way that we would want if the services that people rely on are to be improved.

[Stephen Kinnock]

My hon. Friend raises an important point. I do worry about the list of different organisations and agencies throughout the system, and not just in mental health—so many parts of the system have had layer upon layer of bureaucracy added in. That is one of the reasons why we are abolishing NHS England: we want to try to find greater simplicity and clearer channels of communication.

Through the development of the code of practice and the consultation process, simplifying and clarifying the system will be a key objective. Adding another layer would have the opposite effect. But my hon. Friend makes an important point, which will definitely be a part of the process of consultation and development of the guidelines and code of practice. On the basis of those answers, I recommend that we do not adopt the clause.

Mental Health Bill [ Lords ] (Second sitting)

Natasha Irons Excerpts

Committee stage
Tuesday 10th June 2025 Public Bill Committees

[Jen Craft]

I rise to share a few brief reflections. I appreciate that the intent behind amendment 25 is to make sure that the relevant training is in place. I assume that the hon. Member for Guildford has in mind something similar to the Oliver McGowan training provided across hospital trusts, which mandates that all healthcare providers spend a certain amount of time training with someone who has lived experience of autism and of learning disabilities, in order to make sure that the very different ways in which people with autism or learning disabilities might present do not overshadow what they are attending hospital to demonstrate. Particularly for mental health, we all know that diagnostic overshadowing can be fairly significant. In a locked setting, someone with a learning disability or autism may be unable to demonstrate behaviours that show they are improving or getting better, which can undermine the care they receive.

I would just question whether primary legislation is the best vehicle by which to provide for this. We have spoken at length about how the NHS workforce plan and the 10-year plan are coming forward. I wonder whether this would be better placed within that wider framework. Training could be taken forward either as part of continual professional development, or for medical professionals at the start of their career.

[Natasha Irons (Croydon East) (Lab)]

On the point about training in the round for NHS staff, or any staff dealing with someone in crisis, might it be about taking a more contextual safeguarding approach that relates to not just the one setting? I agree with the point about looking at the 10-year plan, and making sure that mental health training is provided for all staff, because we know that people can present in very different ways, in many different contexts across the health system.

[Jen Craft]

I think there is a concern about having a prescriptive mandate in primary legislation, rather than using a vehicle that could implement real change. Again, I would welcome the Minister’s thoughts on how to ensure that those working in a mental health environment have sufficient training on learning disabilities and autism. We need to make sure that those with a specialism in learning disabilities and/or autism are present and people have access to them, so that things like diagnostic overshadowing do not continue to occur.

Oral Answers to Questions

Natasha Irons Excerpts

Tuesday 6th May 2025 Commons Chamber

[Karin Smyth]

My hon. Friend is right to campaign on behalf of her constituents to make sure that more services are delivered in communities. We want to see services brought out of hospital and into local communities. It is up to the ICB to decide how those are commissioned, but we will certainly make sure that, as part of our commitments under our 10-year plan, we see more of those sorts of services working together in neighbourhoods.

[Natasha Irons (Croydon East) (Lab)]

6. What plans he has to reform NHS health and social care services.

[The Secretary of State for Health and Social Care (Wes Streeting)]

People deserve the very best health and care. Our plan for change is already bringing waiting lists down. Our 10-year plan for health will set out how we improve access and make the three shifts that I described earlier, so that the NHS is fit for the future. At the same time, we are rebuilding adult social care now and for the future. Baroness Casey’s independent commission has launched, and it will set out through its work how we will create a national care service. All that is made possible thanks to the investment decisions taken by the Chancellor in her Budget. That investment was opposed by the Conservative party, which shows that only Labour can be trusted to invest in and modernise our NHS.

[Natasha Irons]

Last week, the Centre for Young Lives published a report on the state of mental health support for children and young people across England. It outlines that despite an ongoing crisis in mental health among young people,

“There remains a 55% treatment gap”

between adult and children’s mental health, and that

“fewer than 10%...of ICBs have a dedicated strategy”

for supporting children’s mental health. Will the Secretary of State consider strengthening statutory guidance for ICBs to ensure they assess the local need of children and young people, publish treatment gap data on an ongoing basis, and create joined-up, community-based mental health support for our young people?

[Wes Streeting]

Young people’s mental health is a priority for this Government. That is why we set out in our manifesto our commitment to making sure that mental health support is available in every primary and secondary school in the country. We have walk-in mental health services in every community, and we invest in the mental health workforce, so that we can cut waiting times. I am also working closely with the Secretary of State for Education to make sure that our education and health services work together, so that children get the very best start in life, and so that we look after mind, body, soul, aspiration and futures.

Black Maternal Health Awareness Week

Natasha Irons Excerpts

Tuesday 29th April 2025 Westminster Hall

[Bell Ribeiro-Addy]

I thank my hon. Friend for his intervention; he is absolutely right. I re-emphasise the point that black, Asian and minority ethnic women are more likely to suffer from common mental health disorders, yet are less likely to access treatment. According to MBRRACE-UK’s “Saving Lives, Improving Mothers’ Care” report from last October, deaths from mental health-related causes accounted for 34% of deaths occurring between six weeks and a year after the end of pregnancy. It is vital that all those who experience pregnancy and childbirth receive mental health support, even if they do not necessarily present as struggling with their mental health; but that is especially true of black, Asian and minority ethnic women, who are more likely to have a negative experience during pregnancy and childbirth. Some of these women’s experiences are deeply traumatic and scarring, and can lead to several mental health problems. Despite that, they are less likely to access mental health support, so they are left to try to recover mentally from the experience on their own.

That disparity exists beyond pregnancy and childbirth, and even before conception. According to the Human Fertilisation and Embryology Authority, black women are 25 times less likely to access fertility treatment, and NHS-funded in vitro fertilisation cycles among black patients decreased from 60% in 2019 to 41% in 2021. Black and Asian patients aged 18 to 37 had the lowest IVF success rates compared with white patients in 2020-21, and non-white groups also struggled to access donor eggs, with 89% of egg donors being white, 4% Asian, 3% of mixed heritage and only 3% black.

During the International Women’s Day debate, I highlighted the latest MBRRACE-UK data, which showed a statistically significant increase in the UK’s maternal death rate in the years 2020 to 2022, even when excluding deaths caused by covid-19. Put plainly, more women and babies of all races are dying in the UK now than in the past two decades. This is incredibly worrying, and it means that black women, who often face the worst care, are likely to experience even further deterioration.

When I was researching the latest statistics and figures for this debate, it became increasingly apparent that the data on racial disparities in maternity care is limited and scattered. The data I have cited comes from a collection of reports by various medical bodies and advocacy organisations. Racial disparities are often identified as part of broader studies but, as far as I know, to date there has been no comprehensive medical study dedicated exclusively to racial disparities in maternity care and outcomes, despite the statistics consistently showing how bad things are becoming.

The Lancet’s recent study on maternal mortality and MBRRACE-UK’s reports do include racial breakdowns, but they are based on the data that they have, not the data that they need. A single, dedicated study is yet to be conducted. The lack of comprehensive research makes it incredibly difficult to see a full picture of what is happening, so I hope that the Minister will address that point and highlight what the Government are doing to get a clearer picture of the state of maternity care.

There is no one driver of the racial disparities in maternity care and outcomes. The causes are multifaceted, but overwhelmingly they are the result of a combination of structural racism, unconscious bias, gaps in culturally competent care and socioeconomic inequalities. The first two are incredibly important to highlight. Without acknowledging that the NHS has an issue with institutional racism and unconscious bias, we cannot address the problem. Those issues feed into the quality of care being delivered for black mothers and their babies. The inaccurate and dog-whistle assumptions around black women’s pain tolerance, for example, can lead to women being denied pain medication during childbirth, or misbelieved when raising concerns about pain felt that signals a severe medical condition. Those beliefs are not taught in medical school or during training, yet so many black women have come across a nurse, midwife or doctor who holds them. They are a direct result of institutional racism in the NHS and have a direct impact on the care that women receive.

It is important to note that, although racial disparities in maternity care are experienced regardless of class, occupation, education or geography, socioeconomic inequalities are still a very important factor in determining health outcomes and experiences. Women living in the most deprived areas have a maternal mortality rate more than twice that of women living in the least deprived areas. Black and minority ethnic people are 2.5 times more likely to be in relative poverty and 2.2 times more likely to live in deep poverty.

The combination of socioeconomic inequalities and institutional racism in the NHS is having a dual impact on black mothers’ experiences of maternity care and health outcomes. Much of the previous Government’s work to improve maternity care was focused on co-morbidities and socioeconomic drivers of poor health. Indeed, it is crucial that those areas are addressed, but without looking at the structural racism and unconscious bias in the NHS, the problems will persist.

I want to recognise the campaign groups that are pushing the issue up the political agenda. In the absence of concrete Government or NHS action, advocacy groups have stepped in to offer their solutions and recommendations. Where they can, they also offer alternative care and training. First—always first—I commend Five X More, which established Black Maternal Health Awareness Week in 2019. Its work empowers black women to make informed decisions during pregnancy, and it advocates for systemic change. It is currently conducting its second national survey, building on its impactful 2022 research.

Five X More is calling for a measurable Government target to end racial disparities in maternal death, a commitment that the Labour Government support but have yet to implement. I hope that the Minister will confirm today whether such a target will be set, how it will be measured and when we can expect it. Five X More also advocates for mandatory annual maternity surveys focused on black women’s experiences, compulsory anti-racism and cultural competence training for all maternity professionals, and improved data collection on ethnicity and outcomes.

[Natasha Irons (Croydon East) (Lab)]

I thank my hon. Friend for securing this important debate. Given the complexities and interchangeable disparities that affect maternal health for black women, does she agree that without a national target or framework we are doomed to make the same mistakes again and again? This travesty needs to end, because no mother or child’s health outcome should be determined by the colour of their skin.

[Bell Ribeiro-Addy]

My hon. Friend is absolutely right. These figures have been circulating for decades, but it was only after a successful parliamentary petition launched by Five X More that we first debated them in the House. We are now five or six years on and we are still in the same situation. Things have to change.

I will continue to pay tribute to the amazing groups that have been pushing for decades to put the issue on the agenda. Mimosa Midwives is another remarkable group that offers culturally safe, continuous maternity care. It campaigns for a culturally appropriate care model in the NHS and for inclusive training in midwifery education to reflect diverse maternal experiences, because much of our medical training remains centred on white women.

The Motherhood Group is a social enterprise supporting black mothers with peer-led services, training workshops and national campaigns. Its annual black maternal health conference brings together researchers, clinicians and service users to tackle disparities. It also launched the Blackmums app to connect mothers navigating similar challenges.

Other charities such as Bliss, Tommy’s, Birthrights and the Royal College of Midwives also highlight racial disparities in their broader efforts to improve maternity care. Where the Government and the NHS have fallen short, they have taken the time to campaign and to step in.

I will, however, acknowledge the positive steps that the new Government and the NHS have taken. In response to my written parliamentary questions last month, the Government outlined some ongoing measures. Every local maternity system must now publish an equity and equality action plan that sets out tailored actions to reduce disparities, especially for ethnic minority women and those in deprived areas. I welcome the roll-out of version 3 of the Saving Babies’ Lives care bundle, which aims to reduce stillbirth, neonatal death, pre-term birth and brain injury.

Maternal medicine networks are being established to ensure equitable access to specialist care for women at heightened risk. Those efforts are supported by the NHS equality, diversity and inclusion improvement plan, which was launched in 2023. That plan requires NHS organisations to tackle workforce discrimination, improve leadership accountability and foster an inclusive, harassment-free environment. I am also pleased to note that NHS England is developing a respectful and inclusive maternity care toolkit to support inclusive and culturally competent practice. Those are all really welcome developments, but much more is needed.

I will close with four questions for the Minister. First, will the Government commit to a statutory inquiry into racial disparities in maternity care, including testimony from affected families and frontline providers? Secondly, will the Government fund dedicated research into the medical complications disproportionately affecting black women during pregnancy and childbirth? Thirdly, will the Government commission a review of maternity training across all medical professions, to better equip practitioners in recognising complications and symptoms in black women and babies? Finally, do the Government acknowledge the presence of systemic racism within the NHS? If so, what steps are being taken to confront and eliminate it? It is good that in the past few years, the House has taken the time to acknowledge these issues and allow us to debate them, but even though the Government stated in their manifesto that a target will be set, we now need to see action. We cannot continue to see gaping inequalities in maternal outcomes.

Oral Answers to Questions

Natasha Irons Excerpts

Tuesday 7th January 2025 Commons Chamber

[Wes Streeting]

Yes, I or the Minister of State for Health would be delighted to meet the hon. Member. She is right to describe the scale of challenge in urgent and emergency care. Of course, there are other challenges in east Kent, particularly in maternity services, which I am acutely aware of too, and I would be delighted to work with her to help solve some of those challenges in her community.

[Natasha Irons (Croydon East) (Lab)]

T7. The Family Dental Practice in my constituency has faced significant challenges caused by dental contracts introduced by the previous Government. The pilot scheme it took part in caused long-lasting operational financial damages to the practice. How will the Secretary of State support such practices, and will he consider measures such as rebasing the unit of dental activity targets to help them overcome these challenges?

[Stephen Kinnock]

My hon. Friend is absolutely right: the NHS dental contract simply is not working. We are working with the sector to reform the contract, with a shift to focusing on prevention and the retention of NHS dentists. We will deliver on our pledge to provide 700,000 more urgent dental appointments at the earliest possible opportunity, targeting areas that need them most.

Access to Primary Healthcare

Natasha Irons Excerpts

Wednesday 16th October 2024 Commons Chamber

[Natasha Irons (Croydon East) (Lab)]

Of all our public services, our NHS is the one that unites us the most. It is in the room that our children our born in. It is there when our parents get old and when we receive the worst possible news. It is there for us no matter who we are, what we do or what we earn. Our NHS belongs to us all. The previous Government inherited an NHS that was working, with the highest satisfaction levels and lowest waiting times in its history. The state of the NHS today, where 2.8 million people struggle to contact a GP every month, demonstrates their utter contempt not just for this precious institution, but for the people it serves.

There can be no greater example of the previous Government’s failure than the declining health of our young people. Last year, the number of under 18-year-olds on waiting lists for paediatric care in England soared to a record high of over 400,000. As Lord Darzi’s report shows, our children are some of the sickest in Europe, with the highest rates of obesity, diabetes, and poor oral and mental health. Under the previous Government’s watch, 40% of children lost regular access to a dentist, the number of children waiting more than 52 weeks for community health services hit 94% in just two years, and one in 5 children is estimated to have a mental health problem but is unable to access the right treatment.

The previous Government failed our children from head to toe. That is reflected in the experience of young people in my constituency, where they and their families wait months and sometimes even years for support. Parents are desperate for help, young people are desperate for healthcare and everyone is desperate for hope.

Labour has fixed our NHS before and under this Government we will fix it again. Following Lord Darzi’s report, the Prime Minister has recognised the need to change our health service, and has set out this Government’s intention for a 10-year plan to change our NHS. Our Health Secretary has already committed to putting in the extra resources we desperately need for primary care, including £82 million of investment to recruit 1,000 newly qualified GPS, and to finally reform the broken dental contract to get more dentists into the communities that need them.

Unlike the previous Government, we will fight for our NHS. We will not allow primary care services to continue to be overwhelmed. We will not leave patients rotting on waiting lists, and we will not let our children be the sickest in Europe. We will fix our NHS. We have fixed it before, and we will fix it again.

NHS: Independent Investigation

Natasha Irons Excerpts

Thursday 12th September 2024 Commons Chamber

[Wes Streeting]

I like the hon. Gentleman very much, but what audacity to criticise this Government for cleaning up the Conservatives’ mess. He fails to acknowledge the cost to the Exchequer and to patients in delayed and cancelled operations, appointments and procedures. More than £1 billion has been lost and more than 1 million appointments cancelled because of the Conservatives’ gross incompetence and failure to understand the difference—they are penny-wise and pound-foolish. That is why they have been sent into opposition and Labour has been trusted to clean up their mess.

[Natasha Irons (Croydon East) (Lab)]

There can be no greater example of the previous Government’s failure than the shocking outcomes for our children and young people, as Lord Darzi’s report highlights. Our children now have some of the worst health outcomes in Europe, with higher rates of obesity, diabetes and asthma, and poor oral and mental health. From head to toe, they have been failed. Will the Secretary of State ensure that the Government’s long-term plan for our NHS will give young people’s health the priority that it deserves?

[Wes Streeting]

I am delighted to see my hon. Friend in her place. She might be from the wrong side of the river, but she is absolutely right about the importance of prioritising children’s health. As the Prime Minister said this morning, it is shocking that the No. 1 cause of hospital admission among children aged between six and 10 is tooth decay. I was criticised by the shadow Secretary of State, who said that I called our children “short and fat”; she is more outraged by my calling out the scourge of childhood obesity that her Government fuelled than she is by the scourge of child obesity itself. That is why we will act and why the Conservatives failed.