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Public Health England Review: Covid-19 Disparities

– in the House of Commons at 10:37 am on 4th June 2020.

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Photo of Gill Furniss Gill Furniss Shadow Minister (Equalities Office) (Women and Equalities) 10:37 am, 4th June 2020

(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.

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

With your permission, Mr Speaker, I will make a statement.

As a black woman and the Equalities Minister, it would be odd if I did not comment on the recent events in the US and protests in London yesterday. Like all right-minded people, regardless of their race, I was profoundly disturbed by the brutal murder of George Floyd at the hands of the police. During these moments of heightened racial tension, we must not pander to anyone who seeks to inflame those tensions. Instead, 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.

On Tuesday, my right hon. Friend the Secretary of State for Health and Social Care confirmed to the House that Public Health England has now completed its review of disparities in the risks and outcomes of covid-19. 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.

I thank Public Health England for undertaking this important work so quickly. 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.

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. Taking action without taking the necessary time and effort to understand the root causes of those disparities only risks worsening the situation. 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.

Photo of Gill Furniss Gill Furniss Shadow Minister (Equalities Office) (Women and Equalities)

Thank you, Mr Speaker, for granting this urgent question. 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.

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?

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. 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.

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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. As I said earlier, 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.

Photo of Caroline Nokes Caroline Nokes Chair, Women and Equalities Committee, Chair, Women and Equalities Committee

The Race Disparity Unit is now in the Cabinet Office and at the heart of Government. My hon. Friend is right to say that it needs all the available data to make the correct recommendations. 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.

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

My right hon. Friend is right, and I thank her for that question. 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.

Photo of Joanna Cherry Joanna Cherry Shadow SNP Spokesperson (Justice and Home Affairs), Shadow SNP Spokesperson (Justice), Shadow SNP Spokesperson (Home Affairs)

I wish to reassure Scotland’s BAME communities that the SNP takes this issue very seriously. 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.

It was good to hear the Prime Minister agree with my right hon. Friend 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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

On Public Health Scotland having different results from Public Health England, we are finding this in a range of reports and it is one reason why we are not rushing to recommendations. 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.

Photo of Richard Fuller Richard Fuller Conservative, North East Bedfordshire

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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, 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.

Photo of Rachael Maskell Rachael Maskell Shadow Minister (Digital, Culture, Media and Sport)

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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.

Photo of Marco Longhi Marco Longhi Conservative, Dudley North

As a former employer, and as a new employer in this place, I am acutely aware of the impact I can have on the welfare of my employees. Will my hon. Friend therefore say how important it is to engage with employers in the work that she does?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

That is a very good point, and I thank my hon. Friend for his question. Engaging employers as well as employees will be essential. Professor Kevin Fenton of PHE has already undertaken extensive stakeholder engagement on this issue, and I intend to assist him in continuing that excellent work. I also intend to ensure that this approach continues to cover other factors such as age, sex, geography and deprivation.

Photo of Fleur Anderson Fleur Anderson Labour, Putney

The Spanish flu epidemic led to huge, widescale social reform, and this report points to the need to do the same. 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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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.

Photo of Helen Hayes Helen Hayes Shadow Minister (Cabinet Office)

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

I thank the hon. Lady for raising the case of Belly Mujinga. I am extremely saddened and shocked by what I have read about her death. I understand, contrary to what the hon. Lady says, that British Transport police are not taking further action in Belly Mujinga’s case because senior detectives are confident that the incident at Victoria station did not lead to her contracting covid. Nevertheless, this was an appalling incident, and frontline workers like Ms Mujinga deserve to be treated with respect at work, especially during this challenging time. 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.

Photo of Selaine Saxby Selaine Saxby Conservative, North Devon

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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.

Photo of Alison Thewliss Alison Thewliss Shadow SNP Spokesperson (Treasury)

As I said to the Secretary of State for Health and Social Care earlier this week, 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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

I must push back on some of what the hon. Lady said. It is wrong to conflate all black people with recent immigrants and assume, which is what she just said, that we all have to pay a surcharge. That is wrong. I am a black woman who is out to work. My employer—[Interruption.] 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 in the press. I go back—[Interruption.] I go back to what I said in my original statement. It is not right for us to use confected outrage. We need courage to say the right things, and we need to be courageous in order to calm down racial tensions, not inflame them just so that we have something to put on social media.

Photo of Maria Miller Maria Miller Conservative, Basingstoke

Every death in this pandemic is a tragedy, and we have to know how to better protect the most vulnerable, yet this Public Health England analysis is based on incomplete data for ethnic minority groups, because it does not include two key factors—occupation and comorbidities—in the deaths among ethnic minority groups. Why not, particularly given the undertakings given by the Office for National Statistics to the Women and Equalities Select Committee two years ago, when we did a report into the race disparity audit and when it was acknowledged that there were huge discrepancies and inconsistencies in the way data was collected for ethnic minority groups? Can the Minister address this?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

My right hon. Friend is absolutely right. I would have hoped to see more, but I understand that Public Health England did not have all the data it needed. Some of the things not present included comorbidities, population density, public transport use, household composition and housing conditions. That is why it is important that I take this forward. All the things she has listed are things we will definitely be looking at in the next stages.

Photo of Rupa Huq Rupa Huq Labour, Ealing Central and Acton

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. 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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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.

Photo of Rob Butler Rob Butler Conservative, Aylesbury

The report on disparities in the risks of contracting covid-19 is extremely concerning, so how will the Minister ensure that everybody is treated equally, regardless of ethnicity?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

We are considering the experiences and circumstances of people across society so that, while the UK will be changed by this experience, we can emerge stronger and more united. 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.

Photo of Jason McCartney Jason McCartney Conservative, Colne Valley

I join the Minister in her utter condemnation of the horrific murder of George Floyd. Black lives do matter! Does the Minister agree that the UK should be very proud of the huge contribution BAME workers have made during this crisis, both as key workers and in the health service? With that in mind, following this review, will she say once again what immediate action she is taking to address these disparities?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

My hon. Friend is absolutely right. In a time of crisis and great worry for many of us, it has been heartening to see different communities working together hand in hand and people acknowledging the huge contributions people from BME backgrounds have made to this country? As I have said, however, we must take the right action; we must not rush into doing the things people are asking for if it turns out they are the wrong steps to take but look right. It is not about optics; it is about doing the right thing, and that is why we are not rushing. We will have a proper programme. We will look at all the studies that have come out, not just the Public Health England one, and produce an appropriate set of recommendations that have the confidence of various communities.

Photo of Dawn Butler Dawn Butler Labour, Brent Central

The PHE report has no third-party submissions. Where are the missing submissions and will the Minister place them in the House of Commons Library? The Government have a reputation for whitewashing reports and hiding from the consequences of structural racism. The Minister says she is not going to rush. In 2016, the Conservative Prime Minister said she would tackle the burning injustices in society. What happened? Where is the social injustice office that was promised in 2016? There is not rushing, and then there is taking your time and avoiding the issue. The Windrush report was delayed and edited, and some parts were deleted. That is a worrying trend of this Government. The PHE report essentially says that there is nothing internal about why black, Asian and minority ethnic people are dying of covid at twice the rate of their white counterparts. There is nothing internal. That means that it is external, and it is accelerated by this Government.

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

I utterly reject what the hon. Lady has said. With permission, Mr Speaker, I think I need to clarify some confusion that seems to have arisen. The Government commissioned a review to analyse how different factors can impact on people’s health outcomes from covid-19. That is what was published this week. Separately, PHE has been engaging with a significant number of individuals and organisations within the BAME community over the past couple of months to hear their views. That was not a part of this. A lot of people think that that is something that should have been in the report. We will be building on, and expanding on, that engagement as we take this work forward, but that is different from the report that we have commissioned.

Photo of Flick Drummond Flick Drummond Conservative, Meon Valley

I have read the report and I do understand that it has been rushed, but it does raise a number of issues, such as the effect of age and ethnicity. Further examination is also needed of other issues such as comorbidities, socioeconomic issues and multi-generational living, which is the case in Italy too. Does the Minister feel that the report has gone far enough?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

The short answer is no. The report is a welcome first step, but it certainly has not gone far enough. We will take it to where we think it needs to get to.

Photo of Zarah Sultana Zarah Sultana Labour, Coventry South

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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 Government have a record to be proud of. We will wait and see the outcomes of the following steps in the recommendations.

Photo of Sara Britcliffe Sara Britcliffe Conservative, Hyndburn

What assurances can the Minister give my constituents in Hyndburn and Haslingden that the Government are recording covid-related deaths based on ethnic data? What steps is she taking in support of the NHS to ensure that BAME communities have the same positive health outcomes as all other communities?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

This goes back to the point I made about making sure that everyone is treated equally. We need to look at some of the data that is being collected to make sure there is consistency across the board. That is something that has come out from the different reviews undertaken on this issue and we will continue to work on that.

Photo of Christine Jardine Christine Jardine Liberal Democrat Spokesperson (Home Affairs), Liberal Democrat Spokesperson (Women and Equalities)

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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.

Photo of Liam Fox Liam Fox Conservative, North Somerset

One of the biggest disparities in deaths from covid is the gender difference. The standardised mortality rate among men is 781 per 100,000; among women, it is 439 per 100,000. Across all communities, we are talking about fathers, brothers, sons, husbands, partners and friends. This affects the whole country. Will my hon. Friend ensure that resources are given to understanding why this gender difference is there and how we can tackle it in the future? I am sure that one thing the whole House can agree on is that all lives matter and they all matter equally.

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

That is absolutely correct; I agree with my right hon. Friend. At the risk of sounding clichéd, this is a Government that we want to work for everyone, but it is not yet fully clear what drives the differences in outcomes between males and females. Some could be driven by risks of acquiring infection due to behavioural and occupational factors—again, that is something that the PHE review was not able to look at—or by differences in how women and men develop symptoms and biological and immune differences. However, my right hon. Friend is absolutely right; this is something that does need to be looked into further, and we are actively working on that.

Photo of Ben Lake Ben Lake Plaid Cymru, Ceredigion

Twenty per cent. of all reported cases of covid-19 in prisons across England and Wales have been recorded in Welsh prisons, despite the fact that Welsh prisons hold just 6% of the total prison population. We know that a disproportionate number of those in the Welsh prison system are from black, Asian and minority ethnic communities. What plans do the Government have to work with the Welsh Government to address that racial disparity and the health implications arising from it for BME communities?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

I thank the hon. Gentleman for his question. As he will know, the review was by Public Health England. I have not seen the Welsh figures that he talks about, but if he writes to me separately, I think I might be able to provide some more information after speaking to officials.

Photo of Felicity Buchan Felicity Buchan Conservative, Kensington

We talk a lot about levelling up, but normally in the context of the north versus the south. As my hon. Friend knows, in our cities—in particular in London—we have huge inequalities. Will she assure me that we will look out for all those left behind?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

My hon. Friend is right. Levelling up is not just about north and south; it is going to cut across lots of different areas. Responding to the challenges of covid-19 specifically does not mean that the Government have forgotten that. We remain committed to a levelling up of every region and nation, and even within regions and nations of the UK, and that can still be a critical part of how we get back to normal.

Photo of Kevin Brennan Kevin Brennan Labour, Cardiff West

Earlier, the Minister said that equalities is something that happens across Whitehall. Self-employed women, including BAME women, who have had maternity leave in the last three years lose out under the Chancellor’s covid-19 self-employed income support scheme. That is overt pregnancy discrimination, pure and simple, by the Minister’s Government. What is she doing to rectify it?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

The Government have introduced an unprecedented scheme of packages to help all those people financially impacted by covid-19. As the hon. Gentleman knows, we are using average earnings data based over the last three years. That does mean that some groups are impacted, but because of how Her Majesty’s Revenue and Customs collects information, that is not necessarily something that we can address. That is why we have other schemes in place, which people hopefully should be able to access.

Photo of Nicola Richards Nicola Richards Conservative, West Bromwich East

The recent report does not include recommendations for people with underlying health conditions or by employment type. Will the Minister commit to looking into those factors further so that we can properly address the causes of the disproportionate effects of covid-19 on BAME communities?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

Yes, is the short answer. We can look at that.

Photo of Scott Benton Scott Benton Conservative, Blackpool South

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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.

Photo of Chris Bryant Chris Bryant Chair, Committee on Standards, Chair, Committee on Standards, Chair, Committee of Privileges, Chair, Committee of Privileges

I commend 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.

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

I do not think anyone in the House can disagree with what the hon. Gentleman just said, and I do agree with him. We are putting forward policies to address some of these things. We are looking at some things in the short term that relate specifically to coronavirus, and he and I can have conversations about medium to long-term interventions in future.

Photo of Nusrat Ghani Nusrat Ghani Conservative, Wealden

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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.

Photo of Stephen Timms Stephen Timms Chair, Work and Pensions Committee, Chair, Work and Pensions Committee

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

I refer the right hon. Gentleman to the answer that I gave earlier. 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.

Photo of Tom Randall Tom Randall Conservative, Gedling

The Cabinet Office Race Disparity Unit supports Departments in driving change where disparities are found. Will the Minister ensure that the unit is dedicated to understanding how to close the gap in respect of coronavirus?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

Yes, my hon. Friend is absolutely right. We need to look at a whole range of areas. I go back to what I said earlier about this being not the end of the review process but the beginning. I urge Members from all parties, if there are areas that they want us to look at, to please write to me so that we can make sure that we include them.

Photo of Patrick Grady Patrick Grady SNP Chief Whip

Does the Minister not understand that “no recourse to public funds” reinforces the various structural inequalities that the Black Lives Matter campaign is trying to call out? It is not leaving my constituents looking for mortgage holidays; it is leaving them destitute. That is not just unequal; it is inhumane. So will the Government please review this situation and allow people to get the support that they so desperately need?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

I will repeat the point I made earlier: we should not conflate black people with people who do not have any recourse to public funds. It is a very—I am not going to say the words “disingenuous argument”, Mr Speaker, but I do think that this is something that we need to be very clear about and not muddy the waters in terms of what is going on.

Photo of Mark Fletcher Mark Fletcher Conservative, Bolsover

I have received many, many letters from constituents across the Bolsover constituency saying how proud they are of how many BAME people have contributed to our health service and to our care system. Does the Minister agree that they have made a fantastic contribution and that we should welcome that?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

Absolutely. We do welcome that. It is very heartening, as I said earlier, to see that communities all across the country are not just saying, but showing, how much we value the contribution that black and minority ethnic workers—key workers in particular—provide to our society.

Photo of Jane Stevenson Jane Stevenson Conservative, Wolverhampton North East

I am a very proud Wulfrunian and I am proud that many of my fellow Wulfrunians have roots all over the world. Does the Minister agree that people are now concerned about this report, and that we need to keep pushing hand-washing and social distancing? Does she also agree that it is up to Members in this place to set an example to the BAME communities?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

My hon. Friend is absolutely right and raises a very important point. People do look to this House to set an example across the country, and those of us in this House must not just demonstrate that we agree with the guidance, but show that we are following the rules as well.

Photo of Maria Eagle Maria Eagle Labour, Garston and Halewood

The research shows, among many disturbing findings about race disparities, that diagnosis rates are higher in deprived and densely populated urban areas, and that our great cities such as Liverpool have been hardest hit by the virus. Does the Minister accept that the reason why we must research covid disparities is so that effective action can be taken to address them? Will she undertake to ensure right now that the Government allocate resources to combat covid in such a way as to address these inequalities—she can do that now—rather than on a crude per capita basis that completely ignores the realities of who is hardest hit and why?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

We are distributing funds in many different ways. I have spoken to, for example, the mayors of combined authorities, and they have raised this issue with me as a Treasury Minister, and we will continue to look at it.

Photo of Paul Bristow Paul Bristow Conservative, Peterborough

The report does reveal correlations between the virus and certain other conditions. Diabetes is mentioned on around 20% of death certificates, but that rises to almost half of the certificates for black and Asian deaths. Does the Minister agree that these links with other health conditions—co-morbidities—need to be studied thoroughly?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

Yes, my hon. Friend is right. Within some medical circles, there is an expectation that when we do account for co-morbidities—I believe that there was an article in The Times which referenced the SAGE report—some of these differences do reduce to zero. That is why we are not rushing to take into account what one specific report is saying; we are looking at what has been said by all the different reports, such as the one from Public Health Scotland, to make sure that we find out exactly what is going on.

Photo of Wendy Chamberlain Wendy Chamberlain Liberal Democrat Spokesperson (International Development), Liberal Democrat Spokesperson (Northern Ireland), Liberal Democrat Spokesperson (Wales), Liberal Democrat Spokesperson (Scotland), Liberal Democrat Spokesperson (Cabinet Office)

I have received a great deal of correspondence from constituents who are rightly angry at the Government’s delay in publishing this report. Given the lack of recommendations, guidelines or action plan, will the Minister also now commit to establishing a post-covid-19 equality strategy to take forward work to develop policies to tackle health inequalities post covid-19?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

I think the hon. Lady is asking for what we are doing at the moment. That is what we are planning to do and that is what we will be looking into. On her accusation that the Government delayed this report, it is simply not true. We asked for a report for the end of May, and that report was brought before the House at the first available opportunity, Mr Speaker, which I am sure you will appreciate.

Photo of Alexander Stafford Alexander Stafford Conservative, Rother Valley

Health inequalities are also related to historical work conditions and industrial diseases, such as the high rates of silicosis and chronic bronchitis, as seen among some of my Rother Valley residents, many of whom are former miners. Does the Minister agree that these inequalities should be looked at as well in the context of the covid-19 outbreak?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

Yes, as I said before, there are a range of things that we will need to consider. We want to be evidence-led. I shall raise this with the various bodies, not just Public Health England, to make sure that, more than anything else, we are being led by the science.

Photo of Tan Dhesi Tan Dhesi Shadow Minister (Transport)

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

The hon. Gentleman is right. It goes back to what I said earlier. 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.

Photo of Mark Harper Mark Harper Conservative, Forest of Dean

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.

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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.

Photo of Andrew Griffith Andrew Griffith Conservative, Arundel and South Downs

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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.

Photo of Jo Gideon Jo Gideon Conservative, Stoke-on-Trent Central

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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 will never get tired of saying that. It is not something that I look at just in my equalities role, but also in my Treasury role, and I look forward to working with her on those issues.

Photo of Mary Foy Mary Foy Labour, City of Durham

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?

Photo of Kemi Badenoch Kemi Badenoch The Exchequer Secretary

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.

Sitting suspended.