Written questions by Ribeiro-Addy.

What steps his Department is taking to help support local maternity services to tackle racial disparities; and whether his Department monitors the compliance of these services with guidelines on (a) equality and (b) anti-discrimination.

The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services by making care more personalised and equitable. A key objective within the plan is to reduce inequalities for all in maternity access, experience, and outcomes, seeking to improve equity for mothers and babies. As part of the plan, all local areas have published Equity and Equality Action Plans, which set out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and those living in the most deprived areas. Equity and Equality Action Plans are published online to ensure public accountability. NHS England has published technical guidance to monitor compliance and to determine the success measures that are used to monitor the outcomes and progress in achieving the key objectives of the plan. The guidance is available at the following link: https://www.england.nhs.uk/long-read/three-year-delivery-plan-for-maternity-and-neonatal-care-technical-guidance/ The Department is also considering what longer term action can be taken to tackle disparities in outcomes and experiences for black, Asian, and minority ethnic women. This includes working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change.

What steps his Department is taking to help ensure that Black, Asian, and other minority ethnic women receive equitable access to high-quality maternity care in (a) areas with significant health inequalities and (b) other areas.

It is unacceptable that there are such inequalities for women and babies. It is a priority for the Government to make sure that all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity. The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services by making care more personalised and equitable. A key objective within the plan is to reduce inequalities for all in maternity access, experience, and outcomes, to improve equity for mothers and babies. As part of the plan, all local areas have published Equity and Equality Action Plans, which set out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and for those living in the most deprived areas. Trusts are also implementing Version 3 of the Saving Babies Lives Care Bundle, which provides maternity units with guidance and interventions to reduce stillbirths, neonatal brain injury, neonatal death, and preterm birth. The Department continues to work closely with the NHS as it delivers these initiatives.The Department is also considering what longer term action can be taken to tackle disparities in outcomes and experiences for black, Asian, and minority ethnic women. This includes working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change.

What steps his Department is taking to help reduce the impact of (a) housing, (b) income, (c) access to education and (d) other social determinants of health on maternal health outcomes for ethnic minority women.

The Government is committed to addressing the stark inequalities for women and babies, so that everyone can receive the high-quality care they deserve regardless of their background, circumstance, or ethnicity.The Department is working with NHS England, other Government departments, and the wider sector to identify and embed the right actions and interventions that will help deliver improvements. For example, we are working closely with the Ministry of Housing, Communities and Local Government to develop non-statutory guidance to support the implementation of Awaab’s Law from October 2025. This law introduces additional hazards, such as excess cold, which increase health risks for pregnant women, as well as for unborn and born children.To find new ways to tackle maternity disparities, the National Institute for Health and Care Research, funded by the Department, launched the first challenge on maternity inequalities in March 2024. Over the subsequent five years, funding of up to £50 million will be made available to develop research and evidence that will drive action to reduce maternity inequalities and improve outcomes for women.

What steps his Department is taking to ensure that culturally competent (a) midwifery and (b) obstetric training is available in the NHS; and how his Department assesses the effectiveness of these steps.

It is a priority for the Government to make sure that all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity. To deliver this, it is important that those working in maternity and neonatal services receive the required training needed to deliver culturally competent care. While it is the responsibility of employers in the health system to ensure that their staff are trained to the required standards to deliver safe and effective treatment for patients, NHS England is taking steps to ensure that maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and through provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Over 15,400 maternity staff have completed the e-learning module, which supports staff to better understand and meet the needs of diverse communities. NHS England has also embedded equity-focused leadership development through the Perinatal Culture and Leadership Programme. All 150 maternity and neonatal units in England have participated in the programme. No assessment has been made on the effectiveness of these steps.

What steps his Department is taking to (a) ensure that data collection on maternity care outcomes is disaggregated by ethnicity and (b) reduce gaps in this data.

Data on a woman’s ethnic background is routinely collected by services at multiple points throughout maternity care. This data is used to disaggregate reporting of adverse outcomes, like maternal mortality, by ethnicity. Differences by ethnicity are also reported as part of the Care Quality Commission’s annual survey, which asks a sample of pregnant women and new mothers about their experience of National Health Service maternity services.NHS trusts are incentivised to collect this information through the Maternity Incentive Scheme, which is a financial incentive program designed to enhance maternity safety within NHS trusts. Safety Action 2 of the Maternity Incentive Scheme incentivises trusts to submit digital information, including ethnicity data, to the Maternity Services Data Set.The levels of completeness are high, and gaps are rare. 95% of women who gave birth in 2023/24 had their ethnic background recorded.

What assessment he has made of the potential impact of racial disparities in maternity care on the mental health and wellbeing of women from ethnic minority communities.

The Government recognises that women from ethnic minority backgrounds may face unique challenges when it comes to maternal mental health, and that perinatal mental health difficulties commonly affect both women and men, and can adversely impact parent-infant relationships.Significant progress has been made to ensure that women experiencing moderate to severe and complex perinatal mental health problems can access specialist perinatal mental health services. For example, mental health services are now available for women who have pre-existing mental health needs prior to their pregnancy, as well as for those who experience mental health difficulties during or as a result of their pregnancy or labour. This is delivered through specialist perinatal mental health services, maternal mental health services, and Mother and Baby Units. Work is also ongoing to modernise the Mental Health Act so that it is fit for the 21st century, redressing the balance of power from the system to the patient, and ensuring that people with the most severe mental health conditions get better, more personalised care.No overall assessment has been made on the potential impact of racial disparities in maternity care on the mental health and wellbeing of women from ethnic minority communities.

What steps he is taking to ensure that ethnic minority women are adequately represented in research on maternity care.

The Department commissions research through the National Institute for Health and Care Research (NIHR). The NIHR’s Research Inclusion Strategy 2022-2027 sets out how NIHR will become a more inclusive funder of research and widen access to participation in clinical trials for under-represented groups, such as pregnant women and ethnic minorities. In addition to these priorities, the NIHR will specifically consider intersectionality, recognising that multiple social identities overlap to exacerbate the experience of inequities.In March 2024, the NIHR launched a £50 million ‘Challenge’ funding call for research to tackle inequalities in maternity care, bringing together experts from across the country into a new consortium. The research carried out by the consortium will focus on inequalities before, during, and after pregnancy, and will identify specific areas where measurable improvements can be made.Furthermore, the NIHR is currently funding two studies focussed on ensuring ethnic minority women are adequately represented in research on maternity care. The first aims to co-produce a toolkit or guidance which can be used to improve the inclusion of women from ethnic minority backgrounds in maternity research. The second aims to develop a guide to support research nurses and midwives to effectively communicate maternal and neonatal healthcare research opportunities to back women.The NIHR continues to welcome funding applications for research into any aspect of maternal health, including research on improving the representation of women from ethnic minority backgrounds in research on maternity care.

What information his Department holds on the (a) number and proportion of maternity services that use tailored interventions to address the specific needs of ethnic minority groups and (b) effectiveness of tailored interventions in reducing racial disparities in maternal health outcomes.

No national data is collected on the number, proportion, and effectiveness of maternity services that use tailored interventions to address the specific needs of ethnic minority groups. It is, however, expected that all local areas fully implement their Equity and Equality Action Plans, which set out tailored interventions for tackling inequalities for women and babies from ethnic backgrounds and for those living in the most deprived areas.

What steps he is taking to help tackle racial disparities in maternal mortality rates.

It is unacceptable that there are stark inequalities for women and babies, and it is a priority for the Government to make sure all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity. This includes taking action before women reach maternity care, as well as after they go home, with action focusing on improving both women’s experiences and outcomes.The Government is committed to setting an explicit target to close the maternal mortality gap. We are ensuring that we take an evidence-based approach to determining what targets are set, and that any targets set are women and baby-centred.The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services by making care more personalised and equitable. A key objective within the plan is to reduce inequalities for all in maternity access, experience, and outcomes, seeking to improve equity for mothers and babies.As part of the plan, all local areas have published Equity and Equality Action Plans, which set out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and those living in the most deprived areas. Trusts are also implementing Version 3 of the Saving Babies Lives Care Bundle, which provides maternity units with guidance and interventions to reduce stillbirths, neonatal brain injury, neonatal death, and preterm birth. The Department continues to work closely with the NHS as it delivers these initiatives.Maternal Medicine Networks have also been established across England, which provide expert care to women with complex medical conditions before, during, and after pregnancy. To address inequalities in maternal outcomes, networks should put pathways in place to ensure equal access to specialised care for all women, and that referral criteria reflect the increased vulnerability of women from ethnic minorities and those who are socially deprived.The Department is considering what longer term action can be taken to tackle disparities in outcomes and experience for black, Asian, and minority ethnic women. This includes working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change, both immediately, and in the future.

What steps he is taking to reduce disparities in maternity care outcomes for Black, Asian, and Minority Ethnic women.

It is unacceptable that there are stark inequalities for women and babies, and it is a priority for the Government to make sure all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity. This includes taking action before women reach maternity care, as well as after they go home, with action focusing on improving both women’s experiences and outcomes.The Government is committed to setting an explicit target to close the maternal mortality gap. We are ensuring that we take an evidence-based approach to determining what targets are set, and that any targets set are women and baby-centred.The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services by making care more personalised and equitable. A key objective within the plan is to reduce inequalities for all in maternity access, experience, and outcomes, seeking to improve equity for mothers and babies.As part of the plan, all local areas have published Equity and Equality Action Plans, which set out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and those living in the most deprived areas. Trusts are also implementing Version 3 of the Saving Babies Lives Care Bundle, which provides maternity units with guidance and interventions to reduce stillbirths, neonatal brain injury, neonatal death, and preterm birth. The Department continues to work closely with the NHS as it delivers these initiatives.Maternal Medicine Networks have also been established across England, which provide expert care to women with complex medical conditions before, during, and after pregnancy. To address inequalities in maternal outcomes, networks should put pathways in place to ensure equal access to specialised care for all women, and that referral criteria reflect the increased vulnerability of women from ethnic minorities and those who are socially deprived.The Department is considering what longer term action can be taken to tackle disparities in outcomes and experience for black, Asian, and minority ethnic women. This includes working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change, both immediately, and in the future.

What steps he is taking to improve access to culturally appropriate maternity care for women from diverse ethnic backgrounds in (a) urban and (b) rural areas.

Taking action to tackle racism experienced by both staff and patients is essential to providing safe services for everyone. It is right that the National Health Service takes proactive steps to address prejudice and discrimination where it exists across the NHS workforce.NHS England is ensuring maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and the provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Equity-focused leadership development is being embedded through the national Perinatal Culture and Leadership Programme.In June 2023, NHS England published an Equality, Diversity and Inclusion Improvement Plan, which sets out targeted actions to address prejudice and discrimination in the NHS workforce. The plan seeks to increase accountability for all leaders in delivering improvements, and to create an environment that eliminates the conditions in which bullying, discrimination, harassment, and physical violence at work occur.For maternity services specifically, all local areas, including those in urban and rural areas, are required to equip staff to provide culturally competent care through their local Equity and Equality Actions plans, such as by providing appropriate training to staff for their local population.   NHS England is also developing a respectful and inclusive maternity care toolkit which aims to improve access, experiences, and outcomes for service users and to support staff to provide culturally sensitive care.

What data his Department collects on the (a) racial and (b) ethnic backgrounds of women experiencing adverse maternity outcomes; and how that data is used to inform policy on maternity care services.

Monitoring and utilising data and evidence is crucial to making evidence-based improvements to our maternity services. Data collected on the ethnic backgrounds of women experiencing adverse maternity outcomes can help identify areas that require targeted interventions and improvements in maternal and neonatal care. Monitoring the incidence and rate of adverse outcomes is a crucial step in implementing evidence-based strategies to preventing and mitigating such incidents.Data on a woman’s ethnic background is collected by services at various points on her maternity journey. National Health Service trusts are incentivised to collect this information, and levels of completeness are high, with 95% of women who gave birth in 2023/24 having had their ethnic group recorded. This information is used to identify differences in care pathways and outcomes experienced by women from different ethnic backgrounds.For example, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) reports the shocking disparity in maternal mortality rates for black and Asian women compared with white women. MBRRACE-UK has also performed a confidential enquiry into the care of black and Asian women who have experienced a stillbirth or neonatal death. These reviews include recommendations for improvements in clinical processes and policy that may reduce ethnic inequalities in adverse maternity outcomes.Monitoring the experiences women have of different aspects of maternity care is also crucial. The Care Quality Commission conducts an annual survey that asks pregnant women and new mothers about their experience of NHS maternity services. The 2024 survey found that women who reported their ethnicity as ‘Indian’, ‘Pakistani’ and ‘any other White background’ reported poorer experiences of maternity care, specifically around not feeling listened to and not receiving help during their antenatal and postnatal care. These insights inform local and national interventions.

What steps he is taking to ensure that maternity healthcare professionals receive training on (a) unconscious bias and (b) culturally competent care.

Taking action to tackle racism experienced by both staff and patients is essential to providing safe services for everyone. It is right that the National Health Service takes proactive steps to address prejudice and discrimination where it exists across the NHS workforce.NHS England is ensuring maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and the provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Equity-focused leadership development is being embedded through the national Perinatal Culture and Leadership Programme.In June 2023, NHS England published an Equality, Diversity and Inclusion Improvement Plan, which sets out targeted actions to address prejudice and discrimination in the NHS workforce. The plan seeks to increase accountability for all leaders in delivering improvements, and to create an environment that eliminates the conditions in which bullying, discrimination, harassment, and physical violence at work occur.For maternity services specifically, all local areas, including those in urban and rural areas, are required to equip staff to provide culturally competent care through their local Equity and Equality Actions plans, such as by providing appropriate training to staff for their local population.   NHS England is also developing a respectful and inclusive maternity care toolkit which aims to improve access, experiences, and outcomes for service users and to support staff to provide culturally sensitive care.

What steps his Department is taking to (a) monitor and (b) reduce racial disparities in the (i) experiences, (ii) levels of satisfaction and (iii) care outcomes of women during (A) antenatal, (B) labour and (C) postnatal care.

Monitoring and utilising data and evidence is crucial to making evidence-based improvements to our maternity services. Data collected on the ethnic backgrounds of women experiencing adverse maternity outcomes can help identify areas that require targeted interventions and improvements in maternal and neonatal care. Monitoring the incidence and rate of adverse outcomes is a crucial step in implementing evidence-based strategies to preventing and mitigating such incidents.Data on a woman’s ethnic background is collected by services at various points on her maternity journey. National Health Service trusts are incentivised to collect this information, and levels of completeness are high, with 95% of women who gave birth in 2023/24 having had their ethnic group recorded. This information is used to identify differences in care pathways and outcomes experienced by women from different ethnic backgrounds.For example, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) reports the shocking disparity in maternal mortality rates for black and Asian women compared with white women. MBRRACE-UK has also performed a confidential enquiry into the care of black and Asian women who have experienced a stillbirth or neonatal death. These reviews include recommendations for improvements in clinical processes and policy that may reduce ethnic inequalities in adverse maternity outcomes.Monitoring the experiences women have of different aspects of maternity care is also crucial. The Care Quality Commission conducts an annual survey that asks pregnant women and new mothers about their experience of NHS maternity services. The 2024 survey found that women who reported their ethnicity as ‘Indian’, ‘Pakistani’ and ‘any other White background’ reported poorer experiences of maternity care, specifically around not feeling listened to and not receiving help during their antenatal and postnatal care. These insights inform local and national interventions.

What steps he is taking to ensure that maternity services (a) are free from racial discrimination and (b) effectively meet the needs of women from all ethnic backgrounds.

Taking action to tackle racism experienced by both staff and patients is essential to providing safe services for everyone. It is right that the National Health Service takes proactive steps to address prejudice and discrimination where it exists across the NHS workforce.NHS England is ensuring maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and the provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Equity-focused leadership development is being embedded through the national Perinatal Culture and Leadership Programme.In June 2023, NHS England published an Equality, Diversity and Inclusion Improvement Plan, which sets out targeted actions to address prejudice and discrimination in the NHS workforce. The plan seeks to increase accountability for all leaders in delivering improvements, and to create an environment that eliminates the conditions in which bullying, discrimination, harassment, and physical violence at work occur.For maternity services specifically, all local areas, including those in urban and rural areas, are required to equip staff to provide culturally competent care through their local Equity and Equality Actions plans, such as by providing appropriate training to staff for their local population.   NHS England is also developing a respectful and inclusive maternity care toolkit which aims to improve access, experiences, and outcomes for service users and to support staff to provide culturally sensitive care.

Pursuant to the Answer of 11 March 2025 to Question 33570 on General Practitioners: Unemployment, which bodies hold data on the number of unemployed GPs; and for what reason that data is not held centrally.

While the General Medical Council register contains data on the number of qualified general practitioners (GPs), the National Health Service is not the is not the sole employer of GPs. They may choose to undertake private work, to work in other settings outside of general practice, for example, prisons or army bases, or to work abroad. Since the NHS only collects data on GPs employed through the NHS, unemployment figures are not available.

What assessment he has made of the potential impact of the proposed increase in the certificate of sponsorship fee on the adult social care sector; and if he will hold discussions with the Chancellor of the Exchequer on making more funding available to support the adult social care sector.

The Immigration and Nationality (Fees) (Amendment) Order 2025, laid on 21 January 2025, sets out increases to the fee maxima that applies to the Certificate of Sponsorship from £300 to £525. These changes were agreed via collective agreement. If fees increase as set out in the Explanatory Memorandum to this Order, an Impact Assessment will be produced by the Home Office.International recruitment has played a valuable role in helping grow the adult social care workforce. The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth and improve the retention of the domestic workforce. The Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.Adult social care is a central part of local government’s responsibilities. Decisions about the funding of all local government priorities will be taken in the round at the Spending Review.

If he will make an estimate of the annual cost of cannabis-related health conditions to the NHS.

The Department is committed to reducing the harm from all illicit drugs. Any illegal drug use, including cannabis, can be harmful, both from immediate side-effects and long-term physical and mental health problems. It can, for some, have a negative impact on their fertility. Cannabis use can contribute to and exacerbate existing mental health problems or can accelerate their development in people predisposed to mental health problems.No estimate has been made of the annual cost to the National Health Service specifically of cannabis-related health conditions or the impact of cannabis-related mental health conditions on NHS finances. An assessment cannot be accurately made because the data relating to cannabis and mental health related health conditions and admissions is presented across various settings. The diagnosis code for ‘mental and behavioural disorders due to use of cannabinoids’ does not include admissions to mental health hospitals or cannabis-related treatment occurring outside of a hospital setting.Dame Carol Black’s review of evidence related to drugs, published in February 2020, estimated the cost to the NHS of illegal drug use, not substance specific, at £431 million per annum. This includes admissions in secondary care, prison treatment and infectious disease. However, this figure does not include other NHS costs such as primary care or accident & emergency usage so will be an underestimate.

What recent assessment his Department has made of the potential impact of cannabis-related mental health admissions on NHS finances.

The Department is committed to reducing the harm from all illicit drugs. Any illegal drug use, including cannabis, can be harmful, both from immediate side-effects and long-term physical and mental health problems. It can, for some, have a negative impact on their fertility. Cannabis use can contribute to and exacerbate existing mental health problems or can accelerate their development in people predisposed to mental health problems.No estimate has been made of the annual cost to the National Health Service specifically of cannabis-related health conditions or the impact of cannabis-related mental health conditions on NHS finances. An assessment cannot be accurately made because the data relating to cannabis and mental health related health conditions and admissions is presented across various settings. The diagnosis code for ‘mental and behavioural disorders due to use of cannabinoids’ does not include admissions to mental health hospitals or cannabis-related treatment occurring outside of a hospital setting.Dame Carol Black’s review of evidence related to drugs, published in February 2020, estimated the cost to the NHS of illegal drug use, not substance specific, at £431 million per annum. This includes admissions in secondary care, prison treatment and infectious disease. However, this figure does not include other NHS costs such as primary care or accident & emergency usage so will be an underestimate.

What assessment he has made with Cabinet colleagues of the potential impact of proposed changes to the level of the certificate of sponsorship fee per worker on the adequacy of the funding settlement for adult social care announced in the Autumn Budget 2024.

The Immigration and Nationality (Fees) (Amendment) Order 2025, laid on 21 January 2025, sets out increases to the fee maxima that applies to the Certificate of Sponsorship from £300 to £525. These changes were agreed via collective agreement. If fees increase as set out in the Explanatory Memorandum to this Order, an Impact Assessment will be produced by the Home Office.International recruitment has played a valuable role in helping to grow the adult social care workforce. The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth and improve the retention of the domestic workforce. The Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.