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Public Health England Review: Covid-19 Disparities
04 June 2020
Lead MP
Kemi Badenoch
Debate Type
Ministerial Statement
Tags
TaxationEmployment
Other Contributors: 42
At a Glance
Kemi Badenoch raised concerns about public health england review: covid-19 disparities in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Government Statement
The Minister of State, Department for Digital Culture Media and Sport and Equalities commented on the racial tensions due to recent events in the US and protests in London. She highlighted the importance of understanding the impact of COVID-19 on BAME communities accurately. Public Health England (PHE) has completed its review confirming that being from a BAME background is a risk factor for higher diagnosis rates, even after accounting for age, deprivation, region, and sex. The Government will be reviewing their actions to lessen disparities in infection and death rates of COVID-19 and commission further data research through the Equalities Hub to clarify the reasons for gaps in evidence highlighted by the report.
Gill Furniss
Lab
Sheffield Brightside and Hillsborough
Question
The MP questioned the lack of recommendations in Public Health England's review, the absence of views on discrimination and racism from the review, the need for structural racism recognition, action to address socioeconomic inequalities, a plan for employers' BAME workforce risk assessment.
Minister reply
Kemi Badenoch acknowledged the importance of understanding disparities and their drivers but emphasised that recommendations would come after wider dissemination and discussion. She noted that some data needed is not routinely collected.
Caroline Nokes
Con
Romsey and Southampton North
Question
The MP inquired about the involvement of various departments in addressing BAME communities' issues, including Work and Pensions, Transport, and Education.
Minister reply
Kemi Badenoch confirmed that equalities are a cross-governmental responsibility, not confined to the Equalities Office.
Question
The MP inquired about Scotland's BAME communities' assurance and asked for action on no recourse to public funds policies and lowering sick pay thresholds.
Minister reply
Kemi Badenoch noted different results from Public Health England's report and mentioned extensive actions taken by the UK government, such as protections against evictions, mortgage holidays, and support measures. She also clarified access to statutory sick pay for individuals with no recourse to public funds.
Richard Fuller
Con
North Bedfordshire
Question
Sensitivity to disproportionate risk is greater when the leadership of institutions includes representation of those most at risk. That is an issue for corporations such as Transport for London and Govia Thameslink Railway, where there has been a lack of BAME representation in leadership roles. Will my hon. Friend look into how the Government can promote diversity in the leadership of our leading institutions?
Minister reply
I thank my hon. Friend for that question, which makes an important point. We do want to see diversity in leadership across institutions in this country, and I will be looking into it as Equalities Minister. Professor Kevin Fenton has been asked to lead on the review.
Rachael Maskell
Lab Co-op
York Central
Question
In 2010, Professor Marmot published a report highlighting structural inequalities predisposing the poorest to worse health outcomes. A decade later, these inequalities have grown. The PHE report has now highlighted fatal consequences of this inequality. Even today, low-paid workers are exposed to the greatest infection risks. Will the Minister pause the easement plan until a full mitigation plan is in place to address these inequalities?
Minister reply
It is important to reiterate that any easing of restrictions is being made in conjunction with scientists and experts. Employers must make risk assessments for their staff so they are not unduly exposed to the virus.
Question
As a former employer, I am acutely aware of my impact on employee welfare. Will my hon. Friend say how important it is to engage with employers in her work?
Minister reply
Engaging employers as well as employees will be essential. Professor Kevin Fenton has already undertaken extensive stakeholder engagement, and this approach will continue.
Fleur Anderson
Lab
Putney
Question
The Spanish flu epidemic led to huge social reforms. The report points to the need for similar action today. Almost three quarters of health and social care staff who have died due to covid-19 are from black and ethnic minorities. Why does the review fail to mention occupational discrimination faced by BME healthcare staff, which has been highlighted by the British Medical Association and the Royal College of Nursing?
Minister reply
This is not the end of the process; it is the beginning. We will continue to look at other factors such as age, sex, geography and deprivation in future work.
Helen Hayes
Lab
Dulwich and West Norwood
Question
Belly Mujinga died tragically from coronavirus after being spat at while at work. She was at increased risk due to her ethnicity and underlying health conditions. Thousands of BAME frontline workers recognise the risks that Belly faced as similar to their own. When will the Government instruct employers to put in place comprehensive protections for all BAME staff and other vulnerable workers?
Minister reply
I am extremely saddened by what I have read about Ms Mujinga’s death. The British Transport police are not taking further action because they are confident that the incident at Victoria station did not lead to her contracting covid. However, we will continue to ensure employers risk-assess their employees before putting them out to work.
Question
The report identified age as the greatest disparity. Can the Minister assure me that she is conscious of the sacrifices that older people are making and that she will do what she can to ensure that older people are treated equally?
Minister reply
People diagnosed who were 80 or older were 70 times more likely to die than those under 40. I agree with my hon. Friend and will be doing all I can.
Question
No recourse to public funds is a racist policy that forces black people and BAME backgrounds out to work due to lack of choice. Will the Minister abolish it now?
Minister reply
It is wrong to conflate all black people with recent immigrants who have to pay a surcharge. We must not try to merge issues for traction in the press but instead calm down racial tensions.
Question
This Public Health England analysis is based on incomplete data due to missing factors such as occupation and comorbidities. Why is this, given the undertakings from the Office for National Statistics two years ago regarding discrepancies in the way data was collected?
Minister reply
Public Health England did not have all the data it needed, including comorbidities, population density, public transport use, household composition and housing conditions. We will be looking at these factors in future stages.
Rupa Huq
Lab
Ealing Central and Acton
Question
The Black Lives Matter protest highlighted the issue that being black should not be a death sentence. Can we really look into our sons’ eyes and say we acknowledged it? Surely we need action, not just statements.
Minister reply
We cannot be seen to do box-ticking exercises but must address disparities and factors that can make outcomes worse for BAME individuals.
Question
How will the Minister ensure that everybody is treated equally, regardless of ethnicity?
Minister reply
All parts of the Government must take care to pay due regard to the equalities impacts of policy decisions in line with the public sector equalities duty and our commitment to promoting equalities.
Jason McCartney
Con
Colne Valley
Question
The MP joins in condemning the murder of George Floyd and recognises the contributions made by BAME workers during the crisis. He asks for immediate actions the Minister is taking to address these disparities.
Minister reply
The Minister agrees on the importance of acknowledging contributions from diverse communities but emphasises that rushed decisions might be wrong steps. She commits to a proper programme and a comprehensive review considering various studies.
Dawn Butler
Lab
Brent East
Question
The MP questions the completeness of the Public Health England report, criticising the Government's handling of structural racism reports previously. She raises concerns about delays in addressing social injustices.
Minister reply
The Minister rejects the criticism and clarifies that a review was commissioned to analyse factors affecting health outcomes from COVID-19, separate from stakeholder engagement which is ongoing.
Flick Drummond
Con
Stroud
Question
The MP asks if the report has gone far enough in examining issues such as age and ethnicity, comorbidities, socioeconomic factors, and multi-generational living.
Minister reply
The Minister acknowledges that the report is a first step but not comprehensive. She commits to further examination.
Zarah Sultana
Lab
Coventry South
Question
The MP argues for justice and demands a race equality strategy covering all Whitehall Departments to address underlying inequalities highlighted by the pandemic.
Minister reply
The Minister states that the Government is committed to eliminating disparities caused by the disease, addressing impacts across age and gender groups.
Sara Britcliffe
Con
Hyndburn
Question
The MP asks for assurances regarding recording of COVID-related deaths based on ethnic data and steps to ensure positive health outcomes for BAME communities.
Minister reply
The Minister commits to ensuring consistency in the collection of data across different boards.
Christine Jardine
Lib Dem
Edinburgh West
Question
The MP questions if there are reasons why certain individuals and stakeholder groups should not be included in the report, demanding full unredacted evidence from those involved.
Minister reply
The Minister reiterates that a quantitative review was commissioned to focus on key drivers of disparities. She assures future inclusion of stakeholder engagement.
Liam Fox
Con
North Somerset
Question
The MP highlights significant gender disparity in COVID-19 deaths and asks for resources to understand the causes and tackle them.
Minister reply
The Minister agrees that understanding gender differences is crucial, noting potential factors such as behavioural and occupational risks and biological differences.
Ben Lake
PC
Ceredigion Preseli
Question
The MP raises concerns about racial disparities in prison populations where BAME communities are disproportionately represented.
Minister reply
The Minister acknowledges the concern and offers to provide more information on Welsh prisons after further discussion with officials.
Felicity Buchan
Con
North West Norfolk
Question
The MP discusses the concept of levelling up beyond north-south divides, focusing on inequalities within urban areas.
Minister reply
The Minister affirms the Government's commitment to levelling up across regions and nations, including addressing challenges posed by COVID-19.
Kevin Brennan
Lab
Cardiff West
Question
The MP points out overt pregnancy discrimination for self-employed women under the Chancellor’s support scheme.
Minister reply
The Minister acknowledges the complexity of HMRC data collection and suggests alternative schemes to help impacted individuals.
Nicola Richards
Con
Macclesfield
Question
The MP asks for further investigation into factors like underlying health conditions and employment types that affect disproportionate effects on BAME communities.
Minister reply
The Minister commits to looking into those factors.
Scott Benton
Lab
Blackpool South
Question
In Blackpool, the life expectancy for the poorest is 20 years below the national average. The PHE report indicates that deprived communities have been disproportionately affected by covid-19, supported by a high local infection rate. Does my hon. Friend agree it's imperative to reduce health inequalities between rich and poor?
Minister reply
Yes, we will closely examine the health inequalities aspects of the report as part of ongoing work.
Chris Bryant
Lab
Rhondda and Ogmore
Question
The Rhondda has one of the highest death rates per 100,000 people in the country. Being poor means an early death by some 20 years compared to richer parts due to low wages, unsafe labour conditions, meagre benefits and reliance on food banks. Surely we must learn from coronavirus that key workers should be paid properly.
Minister reply
We agree with the hon. Gentleman's point and are putting forward policies to address these issues in both short-term and long-term contexts.
Nusrat Ghani
Con
Sussex Weald
Question
Lack of leadership and transparency at PHE and NHS England has exposed barriers for BAME health workers, including death rates and unequal access to personal protective equipment. How will the Government hold these institutions accountable?
Minister reply
We are addressing these concerns sensitively without undermining frontline workers' efforts.
Stephen Timms
Lab
East Ham
Question
Does the Minister agree there are additional barriers for BAME communities to access key services, and will she press her colleagues to suspend the ‘no recourse to public funds’ restriction during this crisis?
Minister reply
We understand difficulties faced by failed asylum seekers and continue providing free accommodation to those who would otherwise be destitute.
Question
The Race Disparity Unit supports Departments in driving change where disparities are found. Will the Minister ensure the unit is dedicated to understanding how to close the gap in respect of coronavirus?
Minister reply
Yes, we need to look at a range of areas and Members should write to us if there are specific issues they want us to address.
Question
'No recourse to public funds’ reinforces structural inequalities that the Black Lives Matter campaign is trying to call out, leaving constituents destitute. Will the Government review this situation and allow people to get the support they need?
Minister reply
We do not conflate black people with those who do not have any recourse to public funds.
Question
Many BAME people in Bolsover constituency are proud of their contribution to the health service and care system. Does the Minister agree they have made a fantastic contribution?
Minister reply
Absolutely, we welcome their contributions as key workers.
Question
People look to this House to set an example on hand-washing and social distancing. Will Members in the House set an example for BAME communities?
Minister reply
Members must demonstrate that they agree with guidance and follow rules.
Maria Eagle
Lab
Liverpool Garston
Question
Research shows diagnosis rates are higher in deprived, densely populated urban areas. Does the Minister accept that we must research disparities to address them effectively and allocate resources accordingly?
Minister reply
We distribute funds in various ways and continue looking at issues raised by mayors of combined authorities.
Question
The report mentions correlations between the virus and other conditions, such as diabetes. Does the Minister agree these links with co-morbidities need thorough study?
Minister reply
Yes, we are looking at various reports to ensure evidence-led decisions.
Wendy Chamberlain
Lib Dem
North East Fife
Question
Given the lack of recommendations in the report, will the Minister commit to establishing a post-covid-19 equality strategy to tackle health inequalities?
Minister reply
We are planning and looking into this work but refute accusations that the Government delayed publishing the report.
Question
Health inequalities related to historical work conditions, such as silicosis and chronic bronchitis among former miners. Should these inequalities be looked at in context of the outbreak?
Minister reply
Yes, we will consider a range of issues and are evidence-led.
Tan Dhesi
Lab
Slough
Question
Three quarters of healthcare staff battling this virus who died were BAME. Can the Minister explain why the PHE review failed to mention occupational discrimination faced by BAME healthcare staff, identified by both the British Medical Association and the Royal College of Nursing?
Minister reply
Data from different institutions is being looked at; we aim to get information out to explain gaps.
Mark Harper
Con
Fittleworth
Question
May I draw to my hon. Friend’s attention the information published this week by the Care Quality Commission on 2 June, which highlighted the much higher death rate among people with learning disabilities, both from covid and non-covid causes? There was a 134% increase over the past year. I ask her to talk to her Health and Social Care Department colleagues about what that implies for access to testing for working age people in the care sector.
Minister reply
I am grateful to my right hon. Friend for that question. He raises an interesting point. We are aware that some of the risk factors associated with poorer outcomes are more prevalent in certain groups of the population, and that does include people with learning disabilities, so he is right to raise that, and I will speak to my colleagues in the Department of Health and Social Care on that issue again.
Andrew Griffith
Con
Arundel and South Downs
Question
All lives matter. They matter now and they mattered in March and April, when many of my constituents could not get a test when they needed one. Will the Minister talk to her colleagues about changing the attitude of Public Health England towards working with the private sector to mobilise testing capacity?
Minister reply
My hon. Friend is absolutely right. We need all hands on deck on this issue, and we definitely do not want silo working where people believe that only the public sector will be able to help sort the issue. We want them to be working hand in hand with the private sector. For other key workers—in supermarkets, heavy goods vehicle drivers and so on—we have seen that the private sector has done a fantastic job in helping us weather this crisis, and I would like to see more of that happening within the health space.
Jo Gideon
Lab
Stoke-on-Trent North
Question
The report identifies death rates in the most deprived areas as being more than double those in the least deprived. Does the Minister agree that growing capacity in community development is essential in ensuring equality of opportunity and levelling up in cities such as Stoke-on-Trent?
Minister reply
Yes, I do agree with my hon. Friend. I do not think there is anything further to add. Levelling up is a priority for the Government, and I look forward to working with her on those issues.
Mary Foy
Lab
City of Durham
Question
In February of this year, Professor Marmot published his review of health inequalities a decade after his original report. He made several recommendations, the first being for the creation of a cross-government, cross-party strategy led by the Prime Minister to address those health inequalities. Given that covid-19 has shown how far we are from achieving a fair and equal country, will the Minister say whether the Government will incorporate that recommendation as a key part of the recovery from coronavirus?
Minister reply
I am afraid I am not sure I have seen the specific report that the hon. Lady is referring to, but if she writes to me, I can give a much more comprehensive response than at the Dispatch Box. Without seeing the recommendation she is referring to, I am not sure I can fully comment, but I look forward to seeing that letter, and hopefully it will have things that we can include in there.
Shadow Comment
Gill Furniss
Shadow Comment
The shadow Minister criticised Public Health England's review for failing to make recommendations on reducing inequalities, protecting front-line workers, or saving lives. She urged the Government to take action on structural racism impacting the outcomes of COVID-19 and called for a plan to address socioeconomic inequalities facing BAME communities. Gill Furniss also demanded that employers risk assess their BAME workforce.
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