The following Answer to an Urgent Question was given on Thursday 4 June in the House of Commons.
“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 honourable 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 effects 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.”
My Lords, my criticism of the Government’s Answer is that even after the PHE review of disparities and risks and outcomes related to Covid-19 failed to include recommendations, the reply again talks about trying to understand the causes of disparities. Let us be clear: coronavirus thrives on inequality, and inequality thrives on inaction. Let us have no delay for research on causes but real action now to protect BAME people at risk from the virus. Will the Minister tell the House what actions the Government are taking to mitigate the very real risks BAME communities face right now?
My Lords, it is important that we understand the various drivers of the disparities and the relationship between different risk factors. It has been accepted that the report has some limitations; for example, the ethnicity analysis does not adjust for comorbidities such as the underlying health conditions of hypertension and obesity. It is imperative that we do the next stage of looking at the data and the connections to ensure that we fill in the gaps of understanding and developing new policies so that we act on a proper and scientific basis; otherwise, we risk making matters worse, which no one would want us to do.
New research today shows that more than half of pregnant women in hospital in the UK with coronavirus complications are from a black, Asian or minority ethnic background. Will the Minister commit to an urgent investigation into this?
My Lords, all aspects that are affecting black and minority ethnic people will be looked into by the Minister for Equalities. The Equalities Hub is now the central point to look at these matters. Action has been taken in relation to making sure that employers are risk assessing, including when employees are pregnant and could be at higher risk from the virus.
My Lords, the Public Health England report makes it clear that deprived communities are being disproportionately affected by Covid-19. Does the Minister agree that it is imperative that the Government redouble their efforts to reduce health inequalities between the richest and the poorest in society, fulfilling the Prime Minister’s levelling-up agenda? How might that be achieved?
My Lords, the PHE review indeed makes it clear that those who are in the most deprived neighbourhoods are more likely to die as a result of Covid-19 than those who are in more affluent areas. The Minister for Health outlined on 4 March that the Government are committed to levelling up and to looking at health inequalities, particularly in deprived neighbourhoods where we see early-onset diseases and avoidable mortality at their highest rates. The Government are committed to getting to the bottom of that and to acting upon it.
My Lords, Table 2.1 in the review shows that in the north-east a greater proportion of the excess deaths were due directly to Covid-19 than elsewhere. It also seems that our least well-off communities were the worst affected. I echo the calls of my noble friend Lady Hayter and the noble Baroness, Lady Pidding, for action to be taken on the basis of not just this report but all the other work that has been done on health inequalities, particularly by Professor Marmot and his review.
I assure noble Lords that the excellent work of Professor Sir Michael Marmot over the last 10 years or so will be reviewed and worked on by the Minister for Equalities, looking at all the different impacts and inequalities the virus has exposed in our communities.
My Lords, to judge the risks on both sides of this very difficult question we need precise information. I hope my noble friend will correct me if I am wrong, but I believe the statistics show that the 40,000 Covid deaths cover not only those who died from Covid as a primary cause but those who died with Covid as a secondary cause—in the same way that many men will die with prostate cancer but not necessarily from it. The distinction is crucial. Can my noble friend give a clear breakdown distinguishing between primary and secondary Covid deaths and say how many of those deaths would have been expected to occur within the next two years even without Covid? If she does not have that information, would she be kind enough to place it in the Library at the first possible opportunity?
My Lords, the Office for National Statistics has analysed the death certificates: on the death certificates where Covid is mentioned as a cause of death, over 95% had it as a primary or underlying cause. That does not exclude other underlying conditions; in March and April this year, over 90% of deaths from Covid had one other underlying health condition mentioned on the death certificate.