An Avoidable Crisis (The Lawrence Review)

Date
October 27, 2020
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Recommendation 1: The Government must go further and set out an urgent plan for tackling the disproportionate impact of Covid on ethnic minorities this winter

Despite being aware of the disproportionate impact of Covid-19 on the UK’s Black, Asian and minority ethnic communities, the Government has not done enough to protect people ahead of the second wave or account for the significant disparities we’ve seen. As the country now faces rising Covid cases, hospital admissions, and deaths, the need for this action could not be more urgent.

The Government should set out a wider package of immediate measures to tackle the disproportionate impact of Covid on Black, Asian and minority ethnic people. This should include further steps to protect frontline staff and improve public health communication.

Recommendation 2: A national strategy to tackle health inequalities

The 2010 Marmot Review set out six policy objectives to reduce health inequalities. Ten years on no action has been taken and the recently published updated Marmot Review has argued that many Government policies have run counter to its recommendations.

The Government should implement a national strategy to tackle health inequality as a matter of urgency. This strategy should be implemented in tandem with communities, and should include:

  • Clear ministerial accountability and clear targets to close the gaps in negative health outcomes, such as the difference in mortality between Black and white women in pregnancy and childbirth
  • Targeted public health action to help reduce instances of conditions such as diabetes and cardiovascular disease
  • A review of clinical training to ensure all ethnicities get the best medical care
  • Improved training for all health and care staff to tackle racism, challenge any unconscious bias and ensure good understanding of cultural differences
  • Targets to improve the diversity of NHS governance, with clear ministerial accountability
  • Improve the Workforce Race Equality Standard so that managers and the boards are held to account for a failure to make progress
  • Support for every Trust to develop their own race equality strategy
  • Steps to address racial inequality in mental health services, to ensure provision is widely accessible and support is culturally appropriate. Action should also be taken to address inequality in the detainment of people in crisis under the Mental Health Act
  • A commitment to engage with staff on how the lessons from the pandemic can be applied to the future of the NHS

Recommendation 3: Suspend ‘no recourse to public funds’ rule during the pandemic and initiate a review

The Government should suspend ‘no recourse to public funds’ for the duration of the Covid-19 pandemic, and conduct a review of the impact of NRPF on public health and health inequalities.

Recommendation 4: Ensure Covid-19 cases from the workplace are properly recorded

Under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) employers are legally required to report cases of diseases and deaths caused by occupational exposure.

However, employers have been advised by the Government not to register many occupational cases or deaths during the pandemic because it claims contact with the public is not "sufficient evidence" they could have resulted from the virus. [1]

As well as making it harder to track and tackle the spread of the virus, this will potentially deny workers and their families clarity, closure and justice. It will also undermine the Government's efforts to understand the impact on Black, Asian and minority ethnic communities, who are among those more likely to be exposed to the virus at work.

The Government should confirm that employers have a duty to report occupational infections of, and deaths from, Covid-19 in line with RIDDOR requirements. It should further take action to increase awareness of these requirements and call on the Health and Safety Executive to take action against employers failing to comply with them.

Recommendation 5: Strengthen Covid-19 risk assessments to ensure consistency and to give workers more confidence

All employers with more than five staff are required to produce written risk assessments and employers with over 50 staff are expected to publish their risk assessments on their own website. However, many employers failed to publish risk assessments on their websites despite having staff working onsite.

The Government should introduce a legal requirement that employers publish their Covid-19 risk assessments on a central Government portal, giving staff greater confidence in their safety at work.

Recommendation 6: Improve access to PPE in all high-risk workplaces

The Government should advise employers in high-risk settings that they should provide PPE for staff where a risk assessment requires it. The Government should also advise employers that they must provide PPE which is appropriate for all staff, for example for those who wear hijabs, turbans or have beards for religious reasons.

Recommendation 7: Give targeted support to people who are struggling to self-isolate at home

The Government should urgently work with local authorities to co-produce a package of resources to enable them to identify and support people who may not be able to self-isolate. This should include those with no recourse to public funds.

The Government should also review its current financial support package for those who need to isolate to ensure it supports all those who need help. No one should be forced to choose between isolating or putting food on the table.

If the Government or local authorities plan to provide a system of parcels of food and essential amenities during the second spike of Covid-19 then it must build into the contracts measures to ensure these are culturally appropriate and meet the dietary needs of all of our communities.

Recommendation 8: Ensure protection and an end to discrimination for renters

The Government should urgently bring forward emergency legislation to protect renters in this crisis, and ensure that its Renters Reform Bill includes measures to tackle racial discrimination in the private rental market.

Recommendation 9: Raise the local housing allowance and address the root causes of homelessness

The Government should raise the local housing allowance to the level of local average rents, to ensure low-income households are not forced into debt eviction and homelessness during the crisis. The Government’s homelessness and rough sleeping strategy must address the causes of homelessness among Black, Asian and minority ethnic communities, and put forward a strategy to address the root causes of housing inequality, including the supply of good quality, secure affordable housing.

Recommendation 10: Urgently conduct equality impact assessments on the Government’s support schemes to make sure Black, Asian and minority ethnic people are able to access the support they need

The Government has failed to conduct and publish equality impact assessments for its economic support packages. The Government should urgently conduct and publish equality impact assessments of all Covid-19 business support schemes. The audit should include but not be limited to the Coronavirus Large Business Interruption Loan Scheme, the Self Employment Income Support Scheme, the Bounce Back Loan Scheme, the Job Support Scheme and the Job Retention Scheme.

Recommendation 11: Develop and implement a clear plan to prevent the stigmatisation of communities during Covid-19

The Government must develop a clear plan, in conjunction with local authorities, to combat stigmatisation of communities during the Covid-19 crisis. The plan should include action to address the increase in hate crime and scapegoating seen during the pandemic, including online. As part of this plan the Government should provide clear guidance on the application of the law on inciting racial hatred, and political leaders should issue a joint statement to condemn any attempt to pit communities against each other.

Recommendation 12: Urgently legislate to tackle online harms

The Digital, Culture, Media and Sport Select Committee has warned that Covid-19 has ‘’exacerbated online harms before the machinery to deal with them has been put in place’’. The Government needs to take this issue seriously and must urgently bring forward its much-delayed Online Harms Bill. [2]

Recommendation 13: Ensure everyone can access Covid-19 communication

The Government should remove linguistic, cultural and digital barriers to accessing public health information including accessing testing, use of the track and trace app and other health and care services. The Government should work with all relevant bodies including faith and community groups to identify effective channels to disseminate information and provide support to local authorities to deliver it on the ground. Communication must have the trust of all communities and be tailored to different communities.

Recommendation 14: Collect and publish better ethnicity data

The Government should take immediate action to implement the PHE recommendation to “mandate comprehensive ethnicity data collection and recording as part of routine NHS and social care data collection systems”. [3]

The Government should also ensure all appropriate data collected and released by Government and public bodies is disaggregated to include a demographic breakdown, which enables analysis of particular intersections of ethnicity with other characteristics, such as age or religion.

Part of this will require building trust with communities. The Government should support targeted outreach and consultation activities alongside trusted community leaders to make clear the purpose of data collection to mitigate the perception of risk.

Recommendation 15: Implement a race equality strategy

If we are to tackle the scourge of racial inequality, we need action not reviews from Government. This means the development of a race equality strategy, as called for by the Equality and Human Rights Commission, developed with Black, Asian and minority ethnic communities and with the confidence of all those it affects.

Any strategy should:

  • Ensure all departments and public bodies conduct race audits and produce a roadmap to improve the recruitment, retention and progression of Black, Asian and minority ethnic people
  • Support the implementation of the public sector equality duty to ensure proper compliance
  • Have a strong mechanism for parliamentary accountability and clear milestones to measure success, including related to disparities outlined in previous Government reviews

Recommendation 16: Ensure all policies and programmes help tackle structural inequality

When the Government and political parties develop policies and programmes, racial equality must be a positive aspiration, not an afterthought or a tick-box exercise. Equality impact assessments should be used much more effectively to shape and inform policy, and policymakers should seek to tackle structural racism with their decisions. The Government should also enact section 1 of the Equality Act, which requires public bodies to reduce inequalities that result from socio-economic disadvantage.

Recommendation 17: Introduce mandatory ethnicity pay gap reporting

The publication of ethnicity pay gaps should become mandatory for firms with more than 250 staff, to mirror gender pay gap reporting. The Government has been consulting on this change for years but has failed to make any progress.

Recommendation 18: End the ‘hostile environment’

The Government’s ‘hostile environment’ policies have had far reaching consequences for migrants and the UK’s Black, Asian and minority ethnic population – far beyond the stated intention of the policies. The Government must commit to stopping the ‘hostile environment’, and reform our immigration system so that it is fair and effective.

Recommendation 19: Reform the curriculum to fight the root causes of racism

The Government, working with the Devolved Administrations, should launch a review into the diversity of the school curriculum to ensure it includes Black British history, colonialism and Britain’s role in the transatlantic slave trade. The school curriculum should include and inspire all young people.

Recommendation 20: Take action to close the attainment gap

The Government should implement a national strategy with clear targets to close the attainment gap at every stage in a child’s development, enforced through an independent body, such as the Children’s Commissioner.

End structural racism

Promoted by David Evans on behalf of the Labour Party, both at Southside, 105 Victoria Street, London SW1E 6QT.