Public Health England Review:
Covid-19; BAME and Disparities
Dr. Mozammel Haque
People
from Indian, Bangladeshi and Pakistani communities had a significantly higher
risk of living. Baroness Doreen Lawrence, Labour’s new race relations adviser,
who is heading an investigation, said, “Black, Asian and minority ethnic
communities have long been disadvantaged by the social and economic injustice
which still exists in our country.”
“There
is a clear and tragic pattern emerging by the pandemic’s impact on these
communities which must be better understood,” she said.
The
Public Health England Report was published. Opposition parties were demanding
to publish immediately the findings of the inquiry into why black and minority
ethnic groups have been disproportionately affected by coronavirus.
The
report was commissioned to analyse how factors such as ethnicity, obesity and
gender can affect people’s vulnerability to Covid-19. Health bosses sought
‘insight’ after it was reported that deaths among BAME communities were disproportionately
high. Analysis by University College London has found BAME people are two to
three times more likely to die from Covid-19 than the general population.
Announcing
the Review’s launch in early May, the Health Secretary Matt Hancock, said, “we
recognise that there has been a disproportionately high number of people from
black and ethnic minority backgrounds who have passed away, especially among
care workers and those in the NHS.”
BAME
campaigners and activists urged the UK government to address health and
economic consequences. A Covid-19 race equality strategy must be launched
across Whitehall in the wake of growing evidence of inequalities amid the
pandemic, a coalition of BAME campaigners, peers, academics and religious
leaders has said, according to a report published in The Guardian on 27
May 2020.
Dr.
Zubeida Haque, the interim director of the Runnymede Trust, said: “There is
well-documented evidence of racial disparities not only in in the pre-existing
disparities leading to Covid-19, as well as the outcome of Covid-19, but also
how BAME people have been treated by authorities during Covid-19.”
“I
think we are aware that not only do racial disparities exist in Covid-19
deaths, we are also aware that there are racial disparities in people’s social
economic, housing and labour market status as well but also acutely aware that
during Covid-19 there have been racial inequalities in the way BAME people have
been fined by police using their Covid-19 powers. There have been some cases of
disproportionate use of force against black people during the lockdown,” said
Dr. Zubeida Haque, reported by the Guardian on 2 June 2020.
PUBLIC HEALTH ENGLAND REVIEW:
Covid-19 Disparities
(Urgent Question): To ask the Minister for Women and
Equalities if she will make a statement on the Public Health England review of
disparities in risks and outcomes related to the covid-19 outbreak.
The Minister for Equalities, Kemi Badenoch said, “we must
work together to improve the lives of people from black and minority ethnic
communities. It is in that spirit that we approach the assessment of the impact
of covid-19 on ethnic minorities. If we want to resolve the disparities
identified in the PHE report, it is critical that we accurately understand the
causes, based on empirical analysis of the facts and not preconceived
positions.
Speaking about the Public Health England Review, the
Equalities Minister said, “The review confirms that Covid-19 has replicated,
and in some cases increased, existing health inequalities related to risk
factors including age, gender, ethnicity and geography, with higher diagnosis
rates in deprived, densely populated urban areas. The review also confirmed
that being black or from a minority ethnic background is a risk factor. That
racial disparity has been shown to hold even after accounting for the effect of
age, deprivation, region and sex.”
She also mentioned, “I know that its findings will be a
cause for concern across the House, as they are for individuals and families
across the country. The Government share that concern, which is why they are
now reviewing the impact and effectiveness of their actions to lessen
disparities in infection and death rates of covid-19, and to determine what further
measures are necessary.”
The Equalities Minister also said, “It is also clear that
more needs to be done to understand the key drivers of those disparities and
the relationships between different risk factors. The Government will
commission further data research and analytical work by the Equalities Hub to
clarify the reasons for the gaps in evidence highlighted by the report.”
“That is why I am taking this work forward with the Race
Disparity Unit in the Cabinet Office, and the Department of Health and Social
Care, and I will keep the House updated,” she mentioned.
.
Labour Party MP from Sheffield, Brightside and
Hillsborough, Gill Furniss said, “On 2 June, Public Health England published
its long-awaited review of disparities in the risks and outcomes of covid-19
for BAME communities. The review confirms what we already know: racial and
health inequalities amplify the risk of covid-19. It found that those from BAME
backgrounds were more than twice as likely to die from covid-19 than white
people, and that BAME healthcare workers are at particular risk of infection.
These lives matter, and it is time for the Government to take action on the
devastating impact that this virus has had on BAME communities.”
She mentioned, “Public Health England’s review fails to
make a single recommendation on how to reduce those inequalities, protect
workers on the front line, or save lives. That is despite the fact that its
terms of reference include to “suggest recommendations” for further action.
Will the Minister urgently explain why the review failed to do that? The
Government have said that the Race Disparity Unit will publish recommendations
on the findings from the review. When will those recommendations be published,
alongside a plan for their implementation?”
Labour Party MP Gill Furniss also said, “More than 1,000
individuals and organisations supplied evidence to the review. Many suggested
that discrimination and racism increase the risk of covid-19 for BAME
communities.”
Copyright@The Guardian
She asked, “Will the Minister explain why those views were
not included in the review? Does she accept that structural racism has impacted
the outcomes of covid-19? Does she agree that it is now time to address
underlying socioeconomic inequalities facing BAME communities, and will she
confirm that the Government will take action to do so? BAME workers on the
frontline of this crisis are anxious for their lives. Will the Minister listen
to Labour’s demands to call on all employers to risk assess their BAME
workforce? Coronavirus thrives on inequality, and there is no more important
time to tackle racial injustices in our society and save lives during this
crisis. It is now up to the Government to take action and show their commitment
that black lives matter.”
The Equalities Minister replied, “It is imperative that we
understand the key drivers of those disparities, the relationships between
different risk factors, and what we can do to close the gap. That way, we will
ensure that we do not take action that is not warranted by the evidence. The
hon. Lady is right: Public Health England did not make recommendations, because
it was not able to do so. Some of the data needed is not routinely collected,
but acquiring it would be extremely beneficial.”
She also mentioned, “I will be taking forward work to fill
the gaps in our understanding, and review existing policies or develop new ones
where needed. It is important to remind ourselves that this review was
conducted in a short period, and it sets out firm conclusions. As the author of
the report said on Tuesday night, there is a great deal of background and
detailed information that we think will be helpful. It is not easy to go
directly from analysis to making recommendations, and we must widely
disseminate and discuss the report before deciding what needs to be done.”
Conservative MP Caroline Nokes asked, “Will she reassure
me, from the heart of Government, that this will not just be a matter for the
Equalities Office or for the Department of Health and Social Care, but that it
will include the Departments for Work and Pensions, for Transport and for
Education? In all those areas we might expect to see real commitment to action
that will make lives better for our BAME communities.”
The Equalities Minister replied, “Equalities are not
something that happens in the Equalities Office; equalities happen across
Whitehall. Every Department has responsibility to ensure that it makes the right
policies for all the people who are impacted by the activities that are carried
out, and I will continue to work with them on that.”
SNP MP from Edinburgh South West said, “On 20 May, the
Scottish Government published Public Health Scotland’s preliminary analysis,
which suggested that the proportion of BAME patients among those seriously ill
with covid is no higher than the proportion in the Scottish population
generally. However, the Scottish Government are treating those findings with
caution, given the findings in England and Wales. Further work is under way to
deepen understanding of the risk factors and improve analysis.”
She questioned, “It was good to hear the Prime Minister
agree with my right hon. Friend the Member for Ross, Skye and Lochaber (Ian
Blackford) yesterday that black lives matter. However, actions speak louder than
words and some Government policies impact more strongly on BAME communities.
What action will the UK Government take to review their no recourse to public
funds policies, given that the Prime Minister revealed that he was unaware that
thousands of people are locked out of available support due to those rules? In
addition, why will the UK Government not lower the earnings threshold for
statutory sick pay, which is forcing people in BAME communities out to work
when it is not safe for them to be working?”
The Equalities Minister replied, “It is important to note
that the PHE review did not take into account other factors such as
comorbidities. On no recourse to public funds, we have taken extensive action
to support those with recourse to public funds. The range of such actions
includes: protections for renters from evictions; mortgage holidays for those
who need them; support for those who are vulnerable and need assistance with
access to medication and shopping; the coronavirus job retention scheme; and
the self-employed income support scheme. Those with no recourse to public funds
do have access to statutory sick pay, which the hon. and learned Lady
mentioned. Furthermore, if an individual has been working in the UK and
sufficient national insurance contributions have been made, they may be
entitled to claim contributory employment and support allowance. We have also
allocated £750 million of funding for charities, which are providing vital
support to vulnerable people at this difficult time.”
Richard Fuller Conservative MP said, “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, in particular, Govia Thameslink Railway, given what
happened to Ms Mujinga. It is an issue for the NHS, where although there has
historically been an over-representation of black and minority ethnic people
among employees, they have been under-represented in the leadership of the NHS.
In this instance, it is a case for the leadership of PHE, as I believe that not
one of either the chief executive or his direct reports is drawn from the BAME
communities. Will my hon. Friend look into how the Government can promote
diversity in the leadership of our leading institutions?”
The Equalities Minister Kemi Badenoch replied, “We do want
to see diversity in leadership across institutions in this country, which is
one reason why we asked Professor Kevin Fenton, who is a black surgeon, to lead
on this review. This issue is close to my heart, and, as a black woman who is
Equalities Minister, I will be looking into it as well. I can definitely take
this forward and examine what is happening across our institutions.”
Labour/Co-op MP Rachael Maskell said, “In 2010, Professor
Marmot published his report on how structural inequalities predispose the
poorest to the worst health outcomes. We know how race inequality is entwined
with that. A decade on, the inequalities have grown. The PHE report has now
highlighted the fatal consequences of that. Even today, low-paid workers are
exposed to the greatest infection risks, and lockdown easement is reinforcing
that. Will the Minister pause the easement plan until a full mitigation plan is
in place to address these inequalities?”
The Equalities Minister Kemi Badenoch replied: “It is
important to reiterate that any easement plan is being made in conjunction with
scientists. The Government have reviewed and explained guidance extensively
across all sorts of occupational areas. It is important that employers make
risk assessments for their staff so that they are not unduly exposed to the
virus.”
Labour Party MP from Putney, Fleur Anderson said, “Almost
three quarters of health and social care staff who have died as a result of
covid-19 are from black and ethnic minorities. Why does the review fail to
mention the occupational discrimination faced by BME healthcare staff, which
has been highlighted by the British Medical Association and the Royal College
of Nursing and needs urgent attention?”
The Equalities Minister Kemi Badenoch replied: “Again, it
is important to remember that the purpose of the review was to look at specific
factors. There are other factors that we will continue to look at. This is not
the end of the process; it is the beginning of the process. I am going to take
the information from the first stage, and that will be part of the work we will
carry out in the programme. It must be said that we are working round the clock
to protect everyone on the frontline during this pandemic for as long as it is
required, and that will include BAME staff on the frontline.”
Labour Party MP from Dulwich and West Norwood, Helen Hayes
said, “Belly Mujinga died tragically from coronavirus after being spat at while
at work at Victoria station. She was at increased risk as a result of her
ethnicity and underlying health conditions. Thousands of BAME frontline workers
recognise the risks that Belly faced as the same risks that they continue to be
exposed to, and her appalling death must lead to change. There must be justice
for Belly Mujinga and her family by way of meaningful action to stop
unnecessary BAME frontline deaths now. When will the Government instruct
employers to put in place the comprehensive protections that are needed for all
BAME staff and other vulnerable workers who need protection to stop them dying
now?”
The Equalities Minister Kemi Badenoch replied “We know that
there are a high number of BAME individuals working in healthcare, social care
and transport, and it is vital that we understand more about their experiences
during the next piece of work I am taking forward. It is important to reiterate
that the Government have already done what the hon. Lady said, which is to
ensure that employers know that they must risk-assess their employees before
they put them out to work. We will continue to reiterate that message.”
Conservative Party MP from North Devon, Selaine Saxby said,
“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
as far as possible?”
The Equalities Minister Kemi Badenoch replied:” Yes. The
largest disparity found was by age. People diagnosed who were 80 or older were
70 times more likely to die than those under 40. My hon. Friend is right, and
that is something I will be doing.”
SNP MP from Glasgow Central, Alison Thewliss said, “it is
one thing to say that black lives matter and quite another to force black
people and people from BAME backgrounds out to work who have no choice other
than to go to work because they have no recourse to public funds. No recourse
to public funds is a racist policy. Will she abolish it now?”
The Equalities Minister replied: “This House has done
everything it can to make sure that I am following the guidelines and that all
of us are. It is absolutely wrong to try to conflate lots of different issues
and merge them into one, just so that it can get traction.”
Labour Party MP from Ealing Central and Acton, Dr. Rupa
Huq, said, “Anyone in Westminster yesterday could not have failed to notice the
Black Lives Matter protest, inspired by Minneapolis. The placard that sticks in
my mind most said: “Being black should not be a death sentence. The Minister
talked about having courage and being a black woman herself.
Copyright@muslimnews.co.uk
Dr. Huq asked, “She and I are both BME parents. Can we
really look into our sons’ eyes and say we acknowledged it? Surely we need
action. It is not good enough. When will we see a detailed plan, with
deliverables, objectives, dates and buy-in from all our diverse communities, so
that this does not just look like a box-ticking exercise?”
The Equalities Minister Kemi Badenoch replied: “I agree
that we cannot be seen to be doing a box-ticking exercise, but we also should
not just accept statements such as “being black is a death sentence” in this
country. It is not true, although it is true there are disparities and other
factors that can make outcomes worse. Let us look at that, but let us not in
this House use statements such as “being black is a death sentence”. Young
people out there hear that, do not understand the context and then continue to
believe that they live in a society that is against them, when actually this is
one of the best countries in the world in which to be a black person.”
Labour Party MP from Coventry South, Zarah Sultana, said, “The
coronavirus does not discriminate, but the system in which it is spreading
does. Higher rates of poverty, overcrowded housing, precarious work and jobs on
the frontline mean that if you are black or Asian you are more likely to catch
the virus and to be hit worse if you do. “Black lives matter” is not a slogan.
We are owed more than confirmation that our communities are suffering; we are
owed justice.”
“Will the Minister commit to a race equality strategy
covering all Whitehall Departments, so that we can rebuild by tackling the
underlying inequalities and systemic injustice that coronavirus has so brutally
laid bare?” she asked.
The Equalities Minister Kemi Badenoch replied: “All I can
say to the hon. Lady is that the Government are doing every single thing they
can to make sure we eliminate the disparities that we are seeing because of
this disease. We must remember that, as we talk about different groups, there
are many other groups that have been impacted based on age and even based on
gender. We are looking at all of that. I am not going to take any lessons from
the hon. Lady on race and what I should be doing on that. I think the”
Conservative MP from Blackpool South, Scott Benton, said, “Blackpool
contains some of the most deprived neighbourhoods in the whole of England, and
in some of those communities the life expectancy for the poorest is 20 years
below the national average. The PHE report makes it explicitly clear that
deprived communities such as those in my constituency have been
disproportionately affected by covid-19, a fact that is supported by our high
local infection rate.”
“Does my hon. Friend agree that it is imperative that the
Government redouble our efforts to reduce health inequalities between the
richest and the poorest?” he asked.
The Equalities Minister Kemi Badenoch replied: “Yes,
absolutely. We will look very closely at the health inequalities aspects of the
report. That is part of the work that I am going to be carrying forward.”
Labour Party MP from Rhondda, Chris Bryant, said, “I
commend the hon. Member for Blackpool South (Scott Benton) for what he has just
said, because it is what I was about to say—although I am not going to sit down
just yet, if that is all right. It is a simple fact that my constituency, the
Rhondda, has one of the highest death rates per 100,000 head of population in
the country, and therefore in the world. Being poor is certainly an early death
sentence—by some 20 years compared with richer parts of the country—and that is
because it is the people who are subsisting on poor wages, few hours and unsafe
labour in difficult working conditions, without proper protection, with miserly
benefits, with statutory sick pay that does not enable people to put food on
the table, relying on food banks, who are dying. Surely, one lesson that we
must learn from coronavirus is that we must pay our key workers properly so
that they can put food on the table and not rely on food banks.”
Conservative MP from Wealden, Ms. Nusrat Ghani, said, “The
lack of leadership and transparency in Public Health England and NHS England
has been shamefully exposed, with BAME health workers dying at a greater rate.
Covid has showed us what it means when these institutions are not equal, with
BAME workers saying that they did not have the same access to personal
protective equipment as their white colleagues and felt pressured to work on
the frontline. As both Public Health England and NHS England are independent,
how will my hon. Friend hold them to account?”
The Equalities Minister Kemi Badenoch replied: “My hon.
Friend is absolutely right to raise the concerns that we have been hearing
anecdotally. This is something that needs to be handled sensitively, because on
the one hand, we know that there are areas that need to be addressed, but on
the other hand, I do not want anyone to think that we are criticising NHS
workers for not looking after their own. It is something that needs to be
handled absolutely sensitively, but we are on top of it. I thank my hon. Friend
for raising that point.”
.
Labour Party MP from East Ham, Stephen Timms, asked, “Does
the Minister agree with the report that there are additional barriers that make
it harder for BAME communities to access key services? In particular, will she
press her colleagues to suspend the “no recourse to public funds” restriction,
which has prevented thousands of hard-working BAME families, many with children
born in the UK, from claiming universal credit during this crisis?”
The Equalities Minister Kemi Badenoch replied: “I know that
a lot of people are concerned about this issue, and we have taken extensive
action to support those with no recourse to public funds. We understand that
there may be difficulties for failed asylum seekers who cannot return home, and
we are continuing to provide free accommodation to those who would otherwise be
destitute. That is just another example of how the Government are looking at
these things intensely. We have not forgotten anyone.”
Labour Party MP from Slough, Mr. Tanmanjeet Singh Dhesi
said, “Almost three quarters of health and social care staff who were battling
this virus on our behalf but who subsequently died as a result of covid-19 were
black, Asian and minority ethnic, so I am hoping against hope that one of the
few positives to take from this national crisis is that those espousing hatred
against minorities and migrants will now be ignored, and that will lead to less
racism and greater community cohesion. Can the Minister explain why the Public
Health England review failed to mention the occupational discrimination faced
by BAME healthcare staff, which has been identified by both the British Medical
Association and the Royal College of Nursing?”
The Equalities Minister Kemi Badenoch replied: “Public
Health England did not necessarily have the data, because data is being looked
at from different quarters and different institutions have different data. That
data is something that I really want to see, because I think it will go some
way to explain the gaps, and I will be taking that forward to see whether we
can get the information out.”
Liberal Democrats MP from Edinburgh West, Christine Jardine
said, “The review, as we know, found that people of Chinese, Indian, Pakistani,
other Asian, Caribbean and other black ethnicity had between 10% and 50% higher
risk of death when compared to white British, yet only 11 of the 89 pages
explore the issue of racial inequalities in coronavirus deaths. We have also
heard reports that there is a chapter, referring to individuals and stakeholder
groups, which is not included. Can the Minister assure us that there is no
reason why the people she referred to as being dealt with separately should not
have been included in the report? Can she assure us that what we will see from
the Government is the full unredacted evidence from individuals and stakeholder
groups to address the imbalance in the evidence in this review?”
The Equalities Minister Kemi Badenoch replied: “Again—I
will repeat this point—it is important that we understand the key drivers of
the disparities. What we commissioned was a quantitative review. We want
to be evidence-led. Stakeholder engagement is important, but we do not want to
conflate the two things, and that is something that we will be taking forward
in the future.”
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