Covid-19 Vaccine: Take-up Rates in London

Siobhain McDonagh Excerpts

Tuesday 9th March 2021 Westminster Hall

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

May I begin by making it clear that I am not here to raise criticism for criticism’s sake? I am here because I understand how imperative it is that the vaccine programme is successful. Although I welcome the scale of the programme and the number of vaccinations delivered, I am extremely concerned about the vaccination take-up in my constituency, and the inconceivable decision to open the two new vaccination centres miles away from the NHS declared low take-up wards of concern.

Let me briefly explain the geography. The borough of Merton is split in two: Mitcham and Morden, and Wimbledon. Merton’s inequalities in health are stark, with an eight-year difference in life expectancy between parts of Mitcham and parts of Wimbledon. The Minister will be aware of Tudor Hart’s inverse care law—that the areas in the greatest health are then statistically more likely to receive better health services.

Look no further than Merton. When the state-of-the-art Nelson health centre was opened in one of the wealthiest, richest wards of Wimbledon, Mitcham received the “Wilson portacabin”. When lateral flow testing was introduced at community pharmacies, they were opened everywhere but Mitcham. When a decision was made to relocate acute hospital services—guess what? The proposals moved them miles further away from the most deprived areas, with the statistically worst health. While many of these decisions are baked into decades of inequality, the location of a vaccination centre is a decision for here and now.

Here is the state of play: there are two centres in Merton; one in Wimbledon and one in Mitcham. However, take-up of the vaccine across the borough has varied significantly and, as ever, the devil is in the detail. Merton has 25 middle and lower layer super output areas. Of the 12 with the highest vaccination take-up rates, 11 are in Wimbledon. In all 12 Wimbledon areas, over 93% of over-70s have received their first dose. Compare that with Mitcham and Morden, where seven of the 13 areas are still below 90%, and Mitcham West, where the vaccination take-up was just 81%. That means that one in five residents have been offered, but not accepted, the vaccine.

I recognise the breadth of factors as to why this could be, and that accessibility of the vaccination centre is only one. However, it is a significant one, particularly given that, of the two new large-scale vaccination centres that are set to open in Merton, both are in Wimbledon—two centres, miles away from the wards with the lowest take-up areas, which also have statistically lower levels of car ownership. Are we not supposed to be breaking down barriers, rather than throwing up even more?

I am not calling for Wimbledon to lose their services, but the Minister must surely see the absurdity of this decision.

[Sir Christopher Chope (in the Chair)]

I will have to limit the last two speakers to three minutes each. If they have not seen it, there should be a countdown clock at the top of their screens to help them keep to the time limit.

Covid-19

Siobhain McDonagh Excerpts

Monday 22nd February 2021 Commons Chamber

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

I will use my short time to emphasise the critical importance of accurate information on local surge testing. At 5 o’clock on 1 February, the Health Secretary announced that the South African variant of coronavirus had been discovered in part of my constituency and that all residents of the CR4 postcode would be tested. By 5.15 pm, my inbox was full. The actual area being tested, Pollards Hill, covers a quarter of the postcode, but residents in Mitcham, Lavender, Cricket Green, Longthornton, and even Colliers Wood and part of Tooting, all rightly expected that they too would be tested. They heard terrifying warnings that they must stay at home, using tins at the back of the cupboard, despite no additional national lockdown rules applying.

Uncertainty spread rapidly right across CR4. Schools prevented vulnerable and key worker children from attending; nurseries and childminders closed; key workers stayed at home; Hotpoint refused to visit homes and repair washing machines, and Boots in Sutton refused to do eye tests for CR4 residents. People felt they were under house arrest even though they were not in the area to be tested.

While I sincerely thank each and every Pollards Hill resident who took a test—and I am grateful for the extraordinary operation conducted thanks to local volunteers, the New Horizon Centre, the NHS and Merton Council staff—I cannot stress more strongly to the Minister the importance of clear and accurate communications from the Government.

I also say to the Minister that people will take a test only if they can afford to self-isolate. Some 70% of people who should be self-isolating are not doing so. That is not just a chink in our armour but a gaping hole in our defence. Those on low incomes and in insecure work often cannot do their job from home and, quite simply, they will not get paid unless they go to work. In order to take a test, they need to be confident that they will have the money to feed their family and pay their bills.

The more people spreading the virus, the more cases we have; the more cases we have, the more families who lose a loved one and the longer the lockdown and its consequences continue. A successful track and trace system is vital if the road map outlined today is to be met—and Minister, everybody wants it to succeed.

Covid-19

Siobhain McDonagh Excerpts

Tuesday 12th January 2021 Commons Chamber

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

I had arranged a speech about schoolchildren’s access to the internet, but as I was sitting here waiting to speak, I decided that I wanted to say to the House, to the Minister and to you, Mr Deputy Speaker, that I have become increasingly alarmed at comments from Ministers, and comments in the papers and the rest of the media in the past few days, driving the message that people are not following the rules. This has been in order to make people feel bad about themselves. However, when I look at the places in London that I know have the highest rates of coronavirus, I see a straight line to poverty. I suggest to the Minister that if we actually want to drive down rates further, we have to give more support to people to self-isolate if they are contacted by Test and Trace and told that they have been near somebody who has got coronavirus. If we want to encourage carers and support workers to take up lateral flow tests, we have to give them the support to do it. Who wants to know that they have got the virus if they cannot afford to take the time off work? If the choice is feeding three children by going to work or ignoring those uncomfortable symptoms, I suspect I know the decision that most of us would make.

The boroughs in London that have the highest rates are those with the worst housing, where there is a family in every room, where they share a bathroom with people they do not know. What do we do for those people to ensure that they are in a position to self-isolate? I understand that in New York the way they drove rates down was by providing people who did not have it with the money, the hotel room, the food—they even offered to walk their dogs!—to encourage them to self-isolate.

Rather than the siren calls against people who are doing their best, what we need to do as a Government and as a society is say to people, “Go and get the test. We will help you to have your time off work. We will help you to treat your symptoms, because we want to put an end to the virus.” No help to them means increasing rates for all of us.

--- Later in debate ---

[Jo Churchill]

I thank my hon. Friend, and I would say a couple of things. Of course I will take that away and mention it to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi). I would also reiterate the Minister for Health’s comment to my hon. Friend during his opening speech that if at first we do not succeed, we will try, try and try again. It is really important that people feel secure, and that it is not just one hit. If someone has missed their appointment—there may be valid reasons why people cannot get there—we will keep trying over and over again to ensure that as many people can receive the vaccination in as swift a time as possible, because ultimately that is how we will be safe.

Many people mentioned how brilliant pharmacists and their teams have been. We are starting to roll out the vaccine to community pharmacists through the pharmacy network over the course of this week, and building up next week. Many people also mentioned supply. This is a process of driving more and more capacity into the system to make sure that as we build a system—from the mass vaccination sites, in one of which the mum of my hon. Friend the Member for Hazel Grove is working, cascading down through our communities and into more rural sites—those in care homes can get vaccinated without having to leave their care home. This is about making sure we are using GPs and pharmacists across our network, and mobilising the armed forces, who, as we heard in this place earlier today, have been absolutely at the forefront of making sure we get kit such as PPE to the right place, and have been out there helping with testing and helping with the vaccine roll-out. This has been a national effort and a team effort.

[Siobhain McDonagh]

Could the Minister comment on the supply of something fundamental: oxygen? I wrote to the Secretary of State on Saturday about supplies of oxygen to Epsom and St Helier trust, which had a specific problem, but it is not solely Epsom and St Helier—in London, a number of intensive care units are under great pressure and are worried about running out of oxygen.

[Jo Churchill]

I refer the hon. Lady to the in-depth answer on exactly that point that my right hon. Friend the Secretary of State gave during Health and Social Care questions this morning, when he said that there is no national shortage of oxygen in the system. He explicitly outlined the challenges and what is being done to mitigate them.

Pharmacists are being brought online, as are many other parts of our system, including all the staff working hard behind the scenes to keep vital services going and to keep people safe. I reiterate that all front-facing health and social care staff in category 2 can access vaccines, including all dentists and their teams; I think nurses and optometrists were the other professions mentioned during the course of the debate.

We are entering a critical period in our fight against this virus. As my hon. Friend the Member for Milton Keynes North (Ben Everitt) said, there are challenging days ahead—we are not there yet. We are dealing with a new, more transmissible variant of this virus that risks overwhelming our NHS, so we had to put in place these tough but vital rules to slow the spread of the virus. I know how hard these rules have been, not only for those we are asking to follow them but for most of us—it goes to our very core. We did not come into politics to stop people doing things.

Independent Reconfiguration Panel

Siobhain McDonagh Excerpts

Thursday 19th November 2020 Commons Chamber

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

I have lost count of the number of times that I have spoken in this House about the future of St Helier Hospital. Time and again, the hospital has been hurled head first into turbulence, with countless consultations coated in fancy branding repeatedly asking my constituents whether they want their hospital to keep its A&E, critical care and maternity services. The latest plan—almost laughably named “Improving Healthcare Together” proposes to downgrade both Epsom Hospital and St Helier Hospital, moving all acute services south to leafy, wealthy Belmont. The purpose of this debate is to look at whether the Independent Reconfiguration Panel was actually independent when it came to a decision not to look into these proposals.

The panel is a little known but hugely important body that provides checks and balances to the plans of one of the most powerful institutions in our country: the NHS. The NHS employs as many people as the red army, and some would argue that it is built around the same command and control principles—that is, decisions are made and everyone is expected to row in behind them. Communities are hugely affected by proposed NHS changes. As such, their representatives in local government have the power to consider whether they agree with a hospital reorganisation. If they do not, they can refer it to the Secretary of State, who has the power to refer it to an independent panel of experts.

In the case of the “Improving Healthcare Together” programme, my argument is not that the chair of the panel, Professor Sir Norman Williams, is not a man with a hugely important and successful medical career who has brought benefits to thousands, or that he has not made a huge contribution to the NHS. My argument is simply that he could not be regarded as independent, and that through his involvement as a member of the board of St George’s Hospital—which will be profoundly affected by these changes—he should have recused himself. We know that in public life not only do we have to do the right thing; we have to be seen to do the right thing. I will argue that Sir Norman could not be regarded as independent because his connection is far from “tangential”.

Let me turn first to the plans themselves. The programme proposes to turn St Helier Hospital into a glorified walk-in centre, removing its A&E, maternity services, children’s beds and critical care. Some 62% of beds would be lost from the area where health is poorest and life expectancy shortest. The programme’s own analysis unsurprisingly reveals the indisputable link between deprivation and the need for acute services, but ignores the fact that 42 of the 51 deprived areas in the catchment are nearest to St Helier. It is a slap in the face for expectant mums in my community.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on securing this debate. Does she agree that although moving beds to a nearby hospital may make sense on paper, to ask expectant mothers to add a lump of time to their journey makes no sense, and that community-led care is essential and should be kept in the community?

[Siobhain McDonagh]

I agree with the hon. Member.

In the plan, it is assumed that mothers in my area want home births. That is a discriminatory assumption that is completely against their right to choose. It takes maternity services away from the mothers who are most likely to deliver a low-weight baby and mothers who are less likely to want a home birth. It also breaks up the continuity of care, with pre and post-natal services being delivered at one hospital and the birth at another.

The programme ignores the intrinsic link between old age and life expectancy in pointing to the higher number of elderly people in Belmont when deciding where need is greatest. The sobering reality is that Mitcham has a far lower life expectancy than Belmont—nine years lower, in fact. There are more elderly residents in Belmont because, quite simply, its residents live longer. To experts, it is yet another example of the Tudor Hart law, or the inverse care law as it is also known: the understanding in health academia that the areas in greatest health receive the most health investment. Or as my mum, herself a nurse, would say, “Much gets more.”

The reality is that the Minister and his Department are being asked to commit £500 million of scarce NHS resources to move acute services to one of the richest and healthiest areas in London, at the expense of one of the most deprived. Surely the Minister can see that that is wrong, if not from a health perspective, then from a financial one. The plans require 22% more capital than the option of rebuilding where health needs are greatest. Improving St Helier would have a higher return on investment, posing far less risk with a significantly lower capital requirement. Our economy is being decimated by the virus. Can the Minister not see that this proposal goes completely against Treasury guidance and value for money?

This was a devastating decision before the pandemic, but have we learned nothing from coronavirus? How can it possibly make sense for south-west London to come out with fewer acute beds and fewer intensive care units than before? Surely the decision to place the only intensive care unit on the same site as a cancer hub now has to be questioned. I do not dispute the extraordinary work of the Royal Marsden or challenge whether it requires an intensive care unit, but these plans were formed long before the pandemic was known about and have to be reassessed in the light of it.

The programme’s own impact assessment in January warned that any unplanned event such as a pandemic could challenge the resilience of the proposed reconfiguration. It described this situation as “unlikely” and yet, astonishingly, just five pages of analysis have been produced on the pandemic’s impact on the plans. It is the wild west, where everything proceeds full steam ahead, no matter the evidence presented—evidence that cannot be dismissed.

We now know that people from black and ethnic groups are most likely to be diagnosed with coronavirus, more likely to require admission to an intensive care unit once in hospital, and up to twice as likely to die than those from white British backgrounds. We know that black women are five times more likely to die in childbirth than white women, and more likely to require neonatal or specialist care baby units. We also know that 64 of the 66 areas with the highest proportion of BAME residents are nearest to St Helier, and that half of those are in the bottom two quintiles of deprivation, increasing their likely reliance on acute services.

It is indisputable: these proposals would negatively and disproportionately impact BAME residents, deprived communities and expectant mums in my constituency. It is no wonder that when they were put out to public consultation, tens of thousands of residents voiced their disapproval, with overwhelming opposition to the downgrading of St Helier. It was also clear from the public response that if these plans went ahead, many residents would not travel to inaccessible Belmont, but would head instead to St George’s—a hospital that is already under immense pressure, with an A&E in the bottom quartile for safe standards.

Why does Sir Norman have a conflict of interest? Because this is a reorganisation of a neighbouring trust that will have a profound impact on St George’s. That is a case that the board of St George’s has rightly and successfully fought, very publicly, so much so that in a letter in March this year, the chief executive of St George’s made it clear that support for the plans was contingent on her hospital receiving capital investment for a new emergency floor to take account of the increased number of emergency care patients that it would receive. That is the kind of change that requires the full consideration, scrutiny and involvement of the board and the most senior staff. I can think of a number of words to describe that relationship: conditional, connected and dependent, but certainly not “tangential”.

In July this year, Merton Council saw these plans for what they are and used its power to call them in for review by the Department of Health and Social Care Independent Reconfiguration Panel. By its name and nature, it is an independent panel of health experts who can cast a fresh, impartial eye for the Secretary of State. The chair of the panel is Professor Sir Norman Williams, who until 30 September 2019 was a long-standing board member at St George’s Hospital. Naturally, I presumed that that conflict of interest would be recognised and he would step aside from judging this proposal. Unfortunately, he did not, with his connection to the plans described as “tangential” and

“not relevant to his role in independently formulating a response”.

This evening, I ask the Minister to consider just how tangential that connection is. In April 2016, Sir Norman became a board member at St George’s, and board meeting minutes and papers reveal that the reorganisation was debated time and time again. The papers from one of his first board meetings in June highlighted the requirement for service change and reconfiguration in south-west London. In March 2017, the chair discussed the upcoming board-to-board meeting with Epsom and St Helier, which would provide an opportunity to discuss the development of joint renal services. Fast forward to October, and the board’s attention was on a joint letter signed by the CEO of St George’s about the importance of considering the future of their hospitals with any reconfiguration at St Helier.

The issue came to the board again in December, following Epsom and St Helier’s indication that it needed to change its clinical model. By the following November, the impact of the proposals on St George’s was so clear that the chair of the board, Gillian Norton, wrote to the programme directly on behalf of her board, including Sir Norman:

“Senior staff within St George’s have spent significant amounts of time over the last 3 months engaging with both the programme team and colleagues in other providers to work through the impact on providers of the shortlisted options…The board agreed that I need to write to you now, formally, to set out these concerns…I understand that a key principle of how programme process has been agreed is that there is no formal requirement to take account of the impact on other providers. I find this difficult to understand in any event given we are a health system but particularly so in the context of the SWL Health and Care Partnership and the expectation that we will work collaboratively.”

I found this letter so extraordinary, after fighting this reorganisation for 23 years, that I wrote back to the board and the chair. Naturally, this issue rightly remained high on the board’s agenda. The papers for the board meeting of December 2018 show concerns from St George’s finance and investment committee about the lack of options explored by Epsom and St Helier, and agreement that the trust should feed this back to the programme. By January 2019, the chief executive spelled out to Sir Norman and the board:

“Any changes to the current configuration of services at Epsom and St Helier are likely to impact St George’s, and it is important these are factored into any future proposals.”

She again used her notes at the February board meeting to state:

“While the location of the new facility is yet to be decided, it’s clear that there are significant estate issues at both Trusts that need to be addressed through capital investment.”

Time and again, the programme was brought to Sir Norman and the board’s attention—in April, in May and in June. This would be a landmark decision for St George’s Hospital. It is completely understandable that it had their full attention.

In July 2019, the programme released the impact assessment on St George’s. It is utterly inconceivable that someone as diligent and respected as Sir Norman would not have been aware of this, particularly as senior staff at his trust had helped produce it—a document released just months before he became chair of the Independent Reconfiguration Panel. That Sir Norman was so heavily involved in these proposals is no criticism. He was rightly fulfilling his responsibility as board member of a hospital that would be heavily impacted by these proposals. He declared his role to the other Independent Reconfiguration Panel members, explaining that he had even had recent discussions with senior consultants at Epsom and St Helier through his role as chair of the national clinical improvement programme. All public office holders are subject to the seven principles of public life, one of which is objectivity. But how could Sir Norman be objective? How could he even appear to be so? In public life, it is important not only to be objective, but to be seen to be objective.

My community has fought tirelessly for St Helier, and the least we expect is transparency, honesty and objectivity from the top. Astonishingly, the panel instead considered that there was nothing more than tangential connections, irrelevant to Sir Norman’s role in independently formulating a response for the Secretary of State. Tangential! If there is any doubt over how interconnected the hospitals are, then be aware that the chair of St George’s also became chair of Epsom and St Helier in 2019. Conveniently, it was on the very same day that Sir Norman became chair of the Independent Reconfiguration Panel. Surely the Minister can see that there is nothing tangential in the evidence that I have laid out today. Not only did Sir Norman already know about the proposals before he was asked independently to judge them, he must have known them inside out, having faced them repeatedly at board level and in conjunction with a whole host of the key personnel involved. It was tangential to the tune of millions of pounds of investment on which his former hospital’s support is contingent.

We must not underestimate the importance of a fresh eye. One of the leaders of these plans, Daniel Elkeles, formerly led the infamous “Shaping a Healthier Future” plan, which proposed similar hospital downgrades in north-west London, wasting £76 million over eight years before the Treasury finally put a stop to it.

I draw to a close now. I must say that I respect the Minister. He found time to meet me in the summer when his time must have been so scarce. I explained my reasoning for calling this debate to his office last week so that he could come prepared. I am not trying to catch him off guard. I am asking that he steps away from party politics and recognises that this connection is indisputable rather than tangential. If an independent panel was asked to review the plans, the panel must be independent. I am asking that he consults his Treasury colleagues on why the most expensive option is being chosen at a time of such economic turmoil. I am asking that he reflects on the powerful shoes he is in and the unique opportunity he has to help to close health inequalities in an area where they are so stark. Surely that would make any Health Minister proud of his work, and maybe then we really could improve health together.

Baby Loss: Covid-19

Siobhain McDonagh Excerpts

Thursday 5th November 2020 Westminster Hall

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

I beg to move,

That this House has considered the effect of the covid-19 outbreak on people experiencing baby loss.

It is a pleasure to serve under your chairmanship. Before I start, how should I address you—Chair?

[Siobhain McDonagh (in the Chair)]

However you like—it will not be the worst thing I have ever been called.

[Cherilyn Mackrory]

This is now the fifth year the House has marked Baby Loss Awareness Week—as with many things, covid-19 caused some delay, as Baby Loss Awareness Week took place a month ago—and I am pleased and grateful that we are here today. It is extremely encouraging and moving that right hon. and hon. Members have ensured that this important issue has been debated often in recent years, helping to deliver an unmistakable message outside this place about its importance in Parliament, the Department of Health and Social Care and the national health service. Most importantly, that sends a message to bereaved families, letting them know that there are people in this place who truly understand how it feels.

Please forgive me for telling my story today, in as much detail as I dare. It is important to me that my baby’s short story helps to shine a light on what is a really dark situation for many people. “I can see straightaway that something isn’t right”—those are the words that broke my heart and changed my life forever. It was 3 January 2019, and my husband and I were at the routine 20-week scan for our second baby. My first pregnancy had been healthy and straightforward and resulted in our fabulous daughter. At age 42, I had been slightly anxious about my 12-week scan, but happily all tests had come back clear. My midwife encouraged me to birth again at our midwife-led centre, and I was keen to stay healthy in order to do just that.

We had celebrated a low-key but cosy Christmas and new year with family and friends. I felt content and reassured by my kicking baby and wondered what the following year would bring. Three days later, we went for our 20-week scan and would receive the terrible news from the sonographer that our baby had an extremely severe form of spina bifida. I lay on the couch and grabbed my husband’s hand tightly. Tears stung my eyes—not unlike now. When I glanced at him, his eyes were watering, too. We did not dare believe what had just happened.

Just over an hour later, we were sitting in the office at our main hospital, the Royal Cornwall Hospital in Truro, with a wonderful consultant and an incredibly kind bereavement midwife. We were met at reception and taken to a small room and brought some tea. I just knew this was not going to end well, but I did not know what to expect. I was checked again, and any hope we had was extinguished by a slow and silent shake of the head. But my baby was still kicking. So started the most traumatic weekend of my life to date.

We had no idea what would happen next. Our world had started to swim and spiral away, and neither of us knew what questions we should ask.

--- Later in debate ---

[Sarah Owen (Luton North) (Lab)]

I thank and pay tribute to the hon. Member for Truro and Falmouth (Cherilyn Mackrory) for securing this important debate, and also for speaking with such bravery and honesty. It is a real inspiration—she has done Lily proud.

Coronavirus has impacted every part of our lives, often in ways that we did not think or expect. We took things for granted little things, such as holding the hands of loved ones who are in pain or upset, or even those across the political divide. When restrictions were put in place in hospitals for visitors, fathers, partners and support networks in relation to scans for expectant mums, I was not surprised to receive pleas from women in Luton who were saying that they really needed somebody there to support them through their scans and neonatal appointments.

That is especially important to people who have had difficult pregnancies or miscarriages or who have suffered baby loss in the past. Not every scan is one of joy, and the time before a scan can be an incredibly anxious, nervous one, full of dread. Holding someone’s hand during that time is incredibly important. That is why I am so pleased to say that, having worked closely on this issue, the fantastic team at Luton and Dunstable University Hospital was one of the first to enact the new guidance allowing visitors to come to scans with expectant mothers.

As we know, with coronavirus everything is always under review. I really hope that the Government continue to support trusts in enabling that to happen as long as is humanly possible, because it is important. It is not like the films on TV when someone sees two pink lines and then suddenly the film fast-forwards to the very large woman buying lots of baby clothes and then screaming for a couple of minutes, and out pops the baby. For many people, that is not the reality of pregnancy. It is not that simple. Miscarriage and baby loss are part of the pregnancy journey that are often just not talked about. Yet, a quarter of all pregnancies end in miscarriage. If we are to end the stigma, the silence and sometimes the shame, we need to be open and honest.

The first time I miscarried, I was at work. I knew that something was not right, so I booked myself a scan during lunch break. I was by myself then, and they told me that there was no heartbeat. To be honest, what happened next was a bit of a blur, but I still remember the emotional and physical pain as if it was yesterday. I will be perfectly honest: a miscarriage is not like a period. It is incredibly physically and emotionally painful. The second time, we were further along. I was not alone for that scan. It did not make the news any easier, but I cannot describe the difference it made to have my hand held, gently squeezing support to one another.

During these losses, and throughout the pregnancy of my wonderful rainbow baby—the term for a baby born after miscarriage or baby loss—my friends and family were there every step of the way, and held me close to get me through those dark times. But my fear is for all those women who no longer have that support. That is exactly why I urge the Government to hold out for as long as they can to ensure that visitors can come to the scans of expectant mums, and to tackle the cause of the doubling of stillbirths during this lockdown.

I want to pay tribute to the Miscarriage Association. Without its support, I know that myself and thousands of women would still have struggled, and struggled alone. Social media is often a cesspit; but I have to say, for any woman who has miscarried, or is pregnant following miscarriages or baby loss, the Miscarriage Association’s website and forums on Facebook are an oasis of comfort, information and understanding. During this time, I know that we cannot hold the hands of everyone we want to. There are women out there, associations, charities and hospitals doing their best to get us through, and I hope the Government listen to their concerns and work with them so that no woman endures baby loss alone and so that women are no longer an afterthought throughout this pandemic.

[Siobhain McDonagh (in the Chair)]

I have been here 23 years and I have never seen a Doorkeeper distributing tissues to Members during a debate—I thank him. I am sure this is going to be a harrowing debate. There is a limit of about seven and a half minutes on speeches so that everybody can tell us their story.

--- Later in debate ---

[Angela Richardson (Guildford) (Con)]

It is a pleasure to serve under your chairmanship, Ms McDonagh. I congratulate my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) on securing such an important debate, on her moving contribution and on her strength and courage in sharing her story about her loss of baby Lily.

This year will be remembered as a difficult year for so many people, but particularly for those who have lost loved ones—especially a much-longed-for baby. I rise to speak today because my difficult year in relation to baby loss was 2003, which coincided with the SARS outbreak. Stopping in Singapore for a couple of days in February 2003, on our way to introduce our first-born to her New Zealand grandparents, my husband, our baby daughter and I became very ill with a high temperature and a continuous cough. Only a few days later, our baby was coughing up blood and we were straight into A&E, where she was treated for pneumonia for several days. We were not counted in any official statistics, and we were not tested. It could have been any other type of virus that was prevalent at the time, but it was an illness that knocked us for six. It is the most ill I have ever been in my life. I was so ill that I was not well enough to care for my baby. I went on to miscarry in June, September and December of that year.

Although my personal experience is anecdotal, and correlation is not causation, the timing of my experience got me wondering—as we are discussing the effects of long covid and any viral illness—whether a lingering heightened immune response has any bearing on an increased incidence of miscarriages. I would be interested to know of any scientific research, either historical or under way now, that links this issue with repeat miscarriages.

I know that my year of grief was a fundamental tipping point in my life and caused me to re-evaluate everything I thought I knew, believed, cherished and held dear. Being an immigrant to this country, I understand a little about isolation: I have not had time to build extensive networks, and I do not have the deep roots that many people who have grown up here have. I did have my National Childbirth Trust group, and I will never forget how blessed I was that I was busy hosting our regular gathering when I started contracting at 14 weeks, two weeks after we had announced to everybody that we were pregnant again. One friend scooped up my daughter and took her home to look after her, and the other took me to the local doctor. She was with me when my waters broke. Then she took me to A&E and stayed with me through a difficult labour and delivery. I was not prepared for many things, including my milk coming in afterwards—or that, years later, I would have flashbacks.

I asked for a test to be done on that particular miscarriage, because it was further along than the other two. Unfortunately, I received a note from the consultant a couple of weeks later to say that they had not done the test and that the foetus had been taken to be incinerated. As hon. Members have said, it leaves people left wondering what they have done wrong. What could have been done differently? Not having answers is probably one of the most difficult things. I can only imagine how difficult it is for families who have had to endure this situation through lockdown conditions. We need to ensure that support is in place for such families.

By the time our second child arrived, I had been pregnant, almost continually, for 18 months. I have spoken openly about suffering from both perinatal and post-natal depression. The effects of baby loss are profound and long-lasting. The passage of time has softened my grief, and my mother always said you can’t put an old head on young shoulders, but if I can use today’s important debate to send a message to women who are coping with baby loss during this time of extra concern and difficulty with covid, I would say this: be kind to yourself, and be patient. Do not be afraid to ask for help from your frontline healthcare providers, and get any support that you need with mental health.

Taking the opportunity to tell our stories, as we are doing today, is a wonderful thing that women can do for each other. It lets others know that they are not alone, especially at this time, when we are more concerned about isolation and loneliness than ever before.

[Siobhain McDonagh (in the Chair)]

I apologise to the hon. Member for Sheffield, Hallam (Olivia Blake), but I am going to ask the Member speaking for the Scottish National party, the hon. Member for North Ayrshire and Arran (Patricia Gibson), to come in at this point, because she has to get on to a special flight. I apologise for not having told the hon. Member for Sheffield, Hallam in advance.

Testing of NHS and Social Care Staff

Siobhain McDonagh Excerpts

Wednesday 24th June 2020 Commons Chamber

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

We now know that coronavirus is not the great leveller. We know that it exacerbates social difference and the problems of health and social inequality. If someone is a black doctor, a black nurse, a black cleaner, a black paramedic or a black person in social care, they are more likely to contract and die of coronavirus than their white counterparts. We also know that if someone is a black man not in the health service, they are more likely to die from coronavirus. If someone is a black woman, they are more likely to die than their white counterparts. If they are taken to hospital, they are more likely to enter intensive care.

We know that it is not fair—it is not a balanced foundation. The Government have pledged to look into the issue with an inquiry, yet in nine days’ time, the NHS in my area intends to agree a plan that will move services away from black and ethnic minority areas to those that are whiter and more wealthy. When asked, “How can you do this without looking at coronavirus and its impact on the NHS?”, they said, “Okay, we’ll do the research, but we are not telling you about it.” Under pressure and embarrassment, they have produced their research: four pages, and not one word about the impact of coronavirus on black or ethnic minorities. There is no defence of their decision to take services away and no acknowledgement of the problem that exists. That is without even considering the fact that the black community in my constituency and around me in south-west London are more likely to have diabetes and hypertension, and black women are five times more likely to die in childbirth.

Do black lives matter? Perhaps we have to prove that they do. I ask the Minister directly: will she intervene to say that, yes, black lives matter, and that we need more than four pages that do not even give any acknowledgement of the problem that exists for black and ethnic minority people in our country and in my bit of south-west London?

Covid-19: BAME Communities

Siobhain McDonagh Excerpts

Thursday 18th June 2020 Commons Chamber

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

It is the pride of my life to represent the big, diverse constituency that I was born and brought up in, from those like my parents who came over in the ’40s to the newer communities from west Africa and Sri Lanka. Many of the children in those communities are doing well in our schools and will be the professionals of the future—as long as they manage to get through the circumstances in which they find themselves in overcrowded accommodation and houses in multiple occupation. As soon as we heard the advice about how to avoid getting coronavirus, we knew what would be the likely outcome. For those who do not have their own bathroom or kitchen but instead share them with four or five other families, the advice was impossible to follow.

It is not that I believe that people in positions of authority want to be overtly racist; I sincerely believe that they do not. However, even as we stand here, the health service in my area is ignoring the advice in the Public Health England evidence. There are plans to move the A&E, the maternity unit and all the acute services at St Helier Hospital further away into Sutton, in spite of the evidence that that takes them further away from BAME communities who are more likely to be dependent on them. The evidence is damning. Of the 66 lower output areas in the catchment with the highest proportion of BAME residents, just one is nearest to the proposed site in Belmont. Meanwhile, 64 of the 66 are nearest to St Helier, 32 of which are in the bottom two quintiles of deprivation, increasing their likely reliance on acute services.

The people running the programme know this; it just does not matter enough for them to want to do anything. Their own impact assessment states clearly:

“As higher densities of the BAME community and those with long term health conditions…live within areas in the highest quintile of deprivation, these groups may also be expected to be disproportionately impacted compared with others”.

But the programme carries on. Despite the overwhelming pressures facing the NHS, the programme’s consultation culminated at the peak of the pandemic. Yet the impact assessment states:

“A reduction in the number of hospitals providing…acute services could potentially have a negative impact on the resilience of services, if for example, there is an unplanned event…on the single major acute hospital site which may restrict service delivery. It is recognised that the likelihood of such a situation occurring is unlikely”.

It happened, we saw it, and it may come back again—and perhaps in an area with higher BAME density where the services will then be gone.

On 4 June, those at the programme confirmed that they will not have concluded their analysis of the impact of the pandemic on their proposals and that they have no intention of releasing the analysis they are undertaking. Their runaway train carries on full steam ahead, coronavirus or no coronavirus, no matter who dies or who does not; it is irrelevant, it is their plan and they are going to have it, come what may.

In conclusion, I want to ask the Minister about two cases in my constituency. The first is that of Mr Salih Hasan, a cleaner at St George’s Hospital for the past 18 years. He worked for two outsourced contractors ISS and Mitie, but he was a part of the team at St George’s. Will his family be the beneficiary of the lump-sum payment for those who die of coronavirus in the NHS? The second is that of Mr Antwi, who worked for a private transport company in hospital transport. He died, leaving his family to pay for a funeral they could not be afforded. Surely, his family too should receive some of that fund.

Coronavirus Bill

Siobhain McDonagh Excerpts

2nd reading & 2nd reading: House of Commons
Monday 23rd March 2020 Commons Chamber

[Jonathan Ashworth]

My right hon. Friend makes an excellent point, and we are seeing it in my constituency. I have had complaints from constituents about exploitative profiteering, so I hope the Government will come forward with some proposals to stamp it out. It is an absolute disgrace that it is happening at this time of national crisis.

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

May I raise, once again, the issue of housing? Social isolation is great, but it is really difficult for people who happen to live with their family in one room in a deeply overcrowded shared house—sharing a kitchen and sharing bathrooms—as so many of my constituents do, particularly when the kids are off school. There needs to be some thought about letting them out in parks and stuff like that, because they do not have gardens.

[Jonathan Ashworth]

My hon. Friend makes an excellent point. I represent an inner-city seat, and I appreciate that her seat is on the outskirts of London but, none the less, our seats have similar demographics. I know full well that many, many families are living in cramped, small flats. There are intergenerational families living with elderly mums, elderly grandmothers and so on who have various comorbidities and who need to be shielded.

If we enter a situation in which we force people to stay at home, I hope the Government will look at how to support such families, because it is quite outrageous that, in many parts of the country—especially in London, but also in my constituency—there are flats with families of nine or 10 people sleeping on the floor, and so on, while property developers have flats standing empty. Why cannot we take over some of those empty flats to house some of these very vulnerable families and to help us get through this national crisis?

Oral Answers to Questions

Siobhain McDonagh Excerpts

Tuesday 10th March 2020 Commons Chamber

[Edward Argar]

My hon. Friend is absolutely right. It is indeed excellent news. As he will be aware, the public consultation process is under way. It would be wrong for me to prejudge that, but I encourage everyone to participate.

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

Does the Minister agree that it is important to spend taxpayers’ money well, and that to spend it on a site that is going to cost 20% more than St Helier—away from the people with the greatest health needs—is not the best way to spend public money?

[Edward Argar]

I gently say that I am not going to prejudge the outcome of the consultation, in which I am sure that the hon. Lady would encourage others to participate. Regardless of the outcome, I am sure that she would want to welcome the £500 million investment from the Government that will benefit her community and others.

Health Inequalities

Siobhain McDonagh Excerpts

Wednesday 4th March 2020 Commons Chamber

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

The £500 million promised by the Government for Epsom and St Helier University Hospitals NHS Trust provides the perfect opportunity to begin to address health inequalities in my part of south-west London. Instead, my local NHS has proposed moving services away from the most deprived areas to leafy Belmont, where life expectancy is longest. If that goes ahead, St Helier Hospital and Epsom Hospital will be downgraded, reducing two A&Es to one, with St Helier Hospital losing major A&E, acute medicine, critical care, emergency surgery, maternity services, in-patient paediatrics and child beds. That 62% reduction in beds would leave a shell of a hospital more accurately described as a walk-in centre.

Across the catchment of the trust, deprivation varies greatly. Given today’s debate, does the Minister agree that health inequalities must be at the heart of the decision on how to spend those funds? The key point is that of the 51 most deprived lower-layer super output areas in the trust’s catchment, just one is nearest to the chosen site. Meanwhile, 42 out of the 51 are nearest to St Helier Hospital. Any decision to downgrade St Helier, therefore, would exacerbate existing health inequalities. Rather than comparing deprivation by proximity to each of the three possible sites, it has been compared by CCG area, disguising the 76.5 year life expectancy of men in parts of Mitcham compared with the 84.4 year average in Wimbledon Park. The thousands of A&E attendances from the deprived areas in Croydon have been discounted, but the comparable number from prosperous Wimbledon have been included. The reality that the area of higher deprivation in the trust’s catchment area has, on average, a far higher attendance at A&E has been dismissed.

The Prime Minister’s amendment today states that the Government are committed to levelling up

“outcomes to reduce the health gap between wealthy and deprived areas”.

With just one month to go until the end of the St Helier consultation, the Government have a decision to make. Will much get yet more, or will the Government insist that vital services are left where they are most needed and any available funds are used to improve St Helier Hospital on its current site?