209. Claire Coutinho

0:06Well behaved women rarely make history. Bloody difficult women do. As Claire Coutinho reminded me in the course of our conversation, she was the youngest person to enter cabinet since I think Pitt the Younger. She also had an incredibly scary near-death experience when she gave birth to her first child about a year ago. It's an astonishing scrape with death. As she says, she was swirling towards the plug hole for two weeks. It's quite a listen. Welcome to Difficult Women.

0:59Claire Coutinho is a proud, successful second generation immigrant. Although, of course, we don't call you that, Claire. Your parents came to the UK from India in the 70s. Your late father was an anaesthetist. Your mother is a GP. Now, I know that you were also captain of the maths team. You went to a top South London private school, JAGS, then up to Oxford to read a very brainy combined degree of maths and philosophy. You did a stint in the city then you took a 70 % pay cut to work in a right-leaning think tank. Then you went from policy to politics and entered Parliament in 2019. Have I got all that right so far?

1:42Yes, that's broadly right, thanks. Broadly. Okay, what was broad? I know, accuracy is very important because apparently you're very nerdy. I think when people start talking a bit and listing what you've done in your career, you slightly switch off though. So I think probably it was just my get out clause in case something wasn't accurate. For some reason, in the way that women are identified by a male, like I am Boris's sister, you've been identified throughout your career and compared to Rishi Sunak as the sort of female Rishi Sunak. You did in fact work for him. He appointed you as the youngest member of his cabinet, where you served for just under a year, I think, until all the wheels came off.

2:24Can we start with that? Do you think that in this country we insist on putting women into boxes and neat labels on them? And how do you feel about that? I think it is difficult for people to cope with nerdy women. often I think you know you have to sort of either wear spectacles or you know do something quite niche so I do think it's a much more obvious trope which is a sort of young very smart man and if you think about tv shows or films that very hyper intelligent man is is is something that people can reach for in their minds or have a few examples so I think very very mathsy women are not as sort of normal or well represented.

3:10But I think in terms of the comparisons with Rishi, I mean, firstly, we are both small, Indian, short, nerdy people. And whose parents worked in the NHS. His parents worked in the NHS. So there is some similarities there. I mean, obviously, you know, as soon as you delve deeper than that, there's big differences. But I can see why on the surface level, people could see some similarities for sure. And do you think that's why he was sort of drawn to you and he wanted you to be on his team? Oh, absolutely. I take it as a compliment because I think not only having that sort of background, the parents and public service, so the right leaning nature that you get from second generation Indian immigrant households as well.

3:52I think that is a culture of aspiration and, you know, standing on your own two feet and working hard and doing all of those things. So I think there was a similar value set there. And then, yes, I always enjoyed working with him, you know, similar sense of humour and work ethic. And, you know, I really respected him. I thought he was a decent guy. And he was tipped to become Prime Minister and did. You've also been tipped to become Prime Minister. Is that something you would aim for? I hope so, by the way. Who's tipping me? I've not seen these tips. Well, apparently you are tipped to be... Is that my mum?

4:26You were the future once. Yeah, your mum. I love what I do. I cover the energy brief and I cover the equalities brief. And essentially, they're two subjects, which I think there's a lot of bad thinking in. And my role has been to come in and break down some of the myths and to say some of the things that we weren't allowed to say. And that's what I love doing. Actually, I've loved the contrarianism of also coming in and having a proper look at what people are saying in an area and working out what's true and not true and I think that's what suits me very well I think you know those jobs at the very top I think of Rishi being prime minister or all of the other people that I've seen in those roles so much of it is diplomacy that's really not my strength so I like doing what I'm doing now.

5:15I suppose you can also have more fun and be a bit more lippy in opposition because you're not actually writing the legislation yourself I mean you obviously can can help write the legislation because you you have a vote and you're an MP but um you are you having more fun in opposition than you did in government I'm certainly enjoying the freedom and candor I don't know if that comes across but uh nobody checks what you say anymore so does anyone care what you say well I mean that's that's probably the downside trying to make people care about what you're talking about I mean I'm lucky in that I think my briefs have been highly relevant and if you take something like energy there's a big debate in the country about net zero for example so for me it's been a good mix of being able to be in government look behind the scenes particularly in a department I think it's quite broken if you think about how we're doing energy in this country it's clearly not working so I spent a lot of that brief time I had in government going through how they were making decisions, what was coming down the tracks.

6:18And having seen all of those things, I've come out into opposition, I can talk about it freely. So in some ways, for me, that's worked quite well. Well, let's start with energy and net zero, which was a Tory policy. I now think that you've resiled and the Tory party has resiled from net zero. You've said that Ed Miliband is, you know, a religion, like it's like a religious cult for him. But it's, It's causing unnecessary expense for British householders. And we've got to drill baby drill. Is that about right? The problem with net zero is it's played upon people's emotions about the environment.

6:56So I think protecting the environment is a very conservative thing. You know, we have a deep principle that we want to hand on the good things in life down to the next generation. And net zero promised to be doing that. You know, this is what's going to solve climate change. We need to play our part in a global challenge. and actually when you look behind the scenes of what we're doing that is not what it's doing what it's doing is giving control to civil servants and government to make decisions across every single part of the economy adding huge amounts of costs which have driven down emissions in the UK but that's in part by driving our businesses out of competitiveness so they've moved abroad So what you're doing is shutting down industry in the UK, importing those goods from places around the world, which often have dirtier systems.

7:46So all you're doing is actually adding to global emissions, but making your own country poorer. And that's the problem that I've got with net zero. It's not the ambition to protect the environment, but actually it's what it's achieving instead. What would Ed Miliband say to that? So for Ed Miliband, he's not really a politician. He is more of a preacher. He's kind of a religion's cult leader when it comes to net zero. He says, you know, we've got to keep doing this. And if we do this, everybody will follow our lead. And the point that I've made him and what I found when I was Secretary of State is countries around the world did not want to follow our lead.

8:22They weren't coming up to me saying, how have you achieved this emission reduction? They were saying, why is your electricity so expensive? You know, why is your industry leaving? that's the thing that they worry about because actually preaching to people doesn't convince them prosperity does. Why is our electricity so expensive in a nutshell? So if you look at electricity now the wholesale price where you're actually paying for the fuel is now a minority on your bill. The majority of your bill is all of these fixed costs and that comes from these extra costs of renewables and it also comes from the fact that generally it's very expensive to build energy infrastructure here and so the idea which Ed Miliband says is that everything is to do with gas is just simply not true it's actually all of these other fixed costs coming down the line that okay what he's saying is your energy bill is this high because the it's based on the price of gas which is set globally so the gas price is set in Europe but your wholesale price is now 40 % of your bill so that's that's where your gas price comes in 60 % of the bill are other things so if you look at what energy experts some of them by the way powerful advocates for renewables what they've said in the last couple of months is that even if gas were to go to zero people's bills would still be going up by 2030 even if the gas price okay that is genuinely insane I'm so glad we covered this it's genuinely so yeah so should we be leaving gas aside if we got more of our energy supply from our own reserves in the north sea would bills come down so the north sea is about security of supply and that comes into it of course because we are in you want to have we're seeing exactly exactly so the the three things that i think you need to do at the moment is you need to build a lot of nuclear.

10:15Nuclear's got the most secure supply chain. If you look at renewables, there can be some benefits to renewables. But where are you getting all your renewables kit from? China. Huge amounts of the renewable supply chain dominated by China. So that's a big concern in a world that's getting more dangerous. If you look at oil and gas, yes, it is affected by that European price. But you still are going to need it. So if you're going to need it, you should get as much as possible from Britain. The point when I say, you know, this is about security of supply the point you want to ask yourself is if you are going to need oil and gas in the years ahead which even the climate change committee says we're going to need you know 25 of our energy needs in 2050 will come from oil and gas if you are going to need it where do you want to get it from do you want to get it from the us do you want to get it from norway do you want to get it from qatar or do you want to get it from the north sea with all the jobs and the tax revenues it's a no-brainer of course it's a no-brainer and the other thing that people need to realise is the North Sea isn't just about oil and gas.

11:13Downstream you've got chemicals, you've got plastics, you've got all of these other things that we take for granted in a modern economy and those industries in Britain are dying and we are going to be relying on all these basic goods, you know, from countries from around the world who have much more polluting systems than our own. So none of that makes sense. If you're saying we're doing all of this in the name of climate change, none of that adds up. And how frustrating is it not to be in cabinet putting this case and being in opposition when your opposite number is a cult leader rather than a politician?

11:55Well, it's obviously frustrating to see what Ed is doing to the system because the thing that he's doing is signing up to contracts which are now 20-year contracts and so for anybody who's an energy nerd they're looking at these contracts that he's putting onto the system and all of you know he's shutting down the North Sea at the moment he's making all of these changes which are very hard to reverse so it's yes it's frustrating no break clauses no get out clauses of these 20-year contracts it's it's incredible they're incredibly uh tightly written but But when you look at something like the North Sea and you know, I've been to Aberdeen, I've met those people who are losing their jobs.

12:32And you think that countries around the world would die to have the North Sea. It's such an amazing resource. And we have someone in government willfully shutting it down. It makes you want to tear your hair out. But then my job is to shine a light on that and hold them to account. Hasn't Michael Gove, who comes from Aberdeen, who edits The Spectator now, asked you to do a big cover story on this yet? So he hasn't actually, but I have spoken at their conference. I have spoken at their conference multiple times. And I think they had a editorial. Tory conference. Spectator conference. They do an energy conference.

13:09You can get your invite next year, I'm sure. NFI. I don't think it's that exclusive. I can get you in, though. I'm sure I can get you in. Thank you. But yes, they've done some great work, actually. Because Michael's, you know, one of the reasons he was Brexit-y is because he said that the European fisheries policy put his dad's fishmongers out of business. He must be hoping that the Aberdeen, which is an oil and gas town as well as a fishing town city, is going to be nuked, literally nuked. Well, I'm sure he is. I can tell you who definitely is the people of Aberdeen. I mean, I went and I took a Vox Pop and just walked around the streets of Aberdeen and asked them what they thought of Ed Miliband and the plans they had around the North Sea.

13:58And they were scathing. They were scathing, very polite, but scathing in that way that Aberdonians can be. Can you do the accent? I absolutely will not do the accent. No, nor will I. I'll direct people to my video feeds so I can go and see the actual video. But they were furious because, you know, you can just feel it in the town. You talk to taxi drivers. They're not getting the business. you go to restaurants and they're not getting the business. You've got grandparents who are worried about their grandkids, you know, either not getting jobs or being made redundant. And for what? Just so we can import more oil and gas from Norway, from the very same basin we could be drilling ourselves.

14:37Put like that, Claire, it seems absolutely self-defeating and self-destructive.

15:01you also hold the shadow equalities brief i do um a recent guest on this podcast has been baroness kishwa faulkner who had her own um uh ding dong i think with bridget phillips and labor Labour's position on the Supreme Court's decision that biological sex was more important than gender identity. Is this the kind, is this all in your wheelhouse? And do you think that we've seen a shift? I do. I do. I think Kishwa has been incredibly brave. She was, like Kemi was as well, one of the women at the beginning who stood up and said something we all take for granted now, which was very hard to say at the time, which was trans women are not women.

15:52Trans women are trans women. We must treat them with respect and compassion, but we shouldn't elide the difference between the two. And I do remember actually saying to your brother in 2019, when I was a very new MP, I got invited to go into Downing Street. A few other new MPs to meet the prime minister. And that was my bro. It was, it was your bro. and he raised this issue and said what do you think about it and I said I think you should say trans women are trans women and women are women and they're different and we can care about both but they're different and everybody else in the room said don't say that don't say that that's a terrible idea and what did you and what did he say and then I'll tell you something he says about it he I will say he was very thoughtful about it and he was also one of the people who started saying look we've got to care about sports and data and biological sex is real and he did it actually in a very compassionate way and I always thought that was credit to him um and I think we probably credit his wife Carrie for that who's been very you know a lot of her friends are LGBTQI plus or whatever they are and I think he's you know he she's much younger and probably educated him a bit but literally the other day I was with him and this the issue of trans came up and I said you You know, how did you do with it when you're in power?

17:16And he said, I would instruct my team to avoid the subject. And then he quoted that dodgeball line, duck, dip, dive, dodge. You know what I mean? And just dodge it. But you didn't dodge it. And you've said it. And Kemi says it. And Kishwa says it. The problem is, I think, when political leaders dodged the issue because they found it too hard, that may have worked. By the way, that may have been a joke. That may have been a joke. And I do think he did grip it towards the end. I remember personally seeing him say that in Parliament. He said biological sex is real. And it was a big moment. Yes, I remember that.

17:49And that's what I do give him credit for. But there were definitely political leaders. And we've all seen Keir Starmer and all the rest of it. All these people who did duck and dip and dive. And the problem with that is there are very real women who have suffered the consequences. So there was a nurse two years ago who was working on a night shift when a convicted paedophile prisoner came in who was a trans woman who she served with care and dignity. Her name was Jennifer Mellet, this nurse. And she refused to use pronouns while she was talking, while she was outside talking about medical needs of the patient.

18:31And she referred to the patient as a he. and the patient got very upset, racially abused her, called her the n-word multiple times and she said I'm really sorry I can't use those pronouns because I'm a Christian but I can use your chosen female name and continue to serve the patient with care and with dignity and the next day she was sanctioned and she ended up being suspended from work and she was almost sacked this year because of this issue and that's what happens downstream there are very ordinary people who are trying to treat everybody with compassion and dignity, but want to hold a line that they think biological sex is real.

19:08And because those leaders at the top didn't set out the truth clearly enough, they ended up being punished and they were put at risk. And that's why I think it is really important that Boris, when he did, and Kemi, who has been absolutely brilliant on this issue, took a stand and said the things which were difficult at the time and laid out what the truth was. Do you think it is easier now for people to make those distinctions between biological sex and gender identity as a result of the Supreme Court ruling and also as a result of these cases, also Sandy Peggy, who has won her case? But the NHS, as an institution, hasn't enacted the Supreme Court's ruling on biology across its hospitals and its other huge units, the biggest employer in this country.

20:00So even though the principle has been enunciated, I'm not sure the practice has necessarily followed. What's your view on that? So I would say the door has been opened. So the door has been opened so people feel like they can stay in certain quarters. However, the system has not changed. You had the Supreme Court ruling. It was very clear that biological sex is real. And yet all of these big organisations, the NHS is a prime example, but lots of other civil servants in government departments have not adopted the ruling. they've hid behind this fig leaf that they need to wait for guidance they don't need to wait for guidance the supreme court didn't change the law the supreme court confirmed the law they are currently breaking the law but what has been missing is the government has not instructed these public sector bodies to adopt the supreme court judgment they've been very timid and unsure about it um kishwa you mentioned earlier i think it's been extraordinarily courageous why hasn't As you said, dip, duck, dive.

21:07It's just a lack of courage. It's just a lack of courage. They have people in their base. They have people in the parliamentary party who do not want to see the Supreme Court ruling taken on. And actually some of the things that sitting MPs on the Labour front benches, or they might be Labour back benches actually, but sitting MPs have put out about the Supreme Court ruling. You don't need to do this yet. You have to wait for the guidance. It's factually incorrect. And it's left the situation whereby nurses who don't want to change in front of a trans female or trans woman nurse, not a trans female, trans woman nurse, are the ones who are told to go and change in the stationary cupboard while the trans woman nurse gets to use the women's changing room.

21:55that's that's what's happened as a result of a failure to enact the ruling or the government to tell institutions that they should enact the ruling exactly and what we've had and we've seen this i think in in lots of different ways is the equality act has created this sense that there's a hierarchy of diversity and it's people in positions of power who've decided who sits where in this hierarchy. And what happened is trans women were put above women. So the needs of the trans women had to be fully accepted. So everything, you know, they wanted access to single sex spaces, you know, they wanted people to use certain pronouns, all of that had to be completely adopted, even where it eroded the rights of women.

22:41Now, we all know in a society, what you have to get is a balance of rights between people so that everybody can enjoy the freedoms and the privileges and the same penalties as everybody else in the best way possible so we can all rub alongside each other. What you can't have is one group who gets all of their demands given into at the risks of another. Speaking of the NHS, you had your son, Raphael, a year ago or so. Now he's a year old, isn't he? He is. And you were very vocal about the experience you had and it wasn't a sort of NHS catastrophe by any means and we're not going to talk about it in those terms.

23:34But it sounds like a very scary experience. And why did you want to talk about it? And what would you like people to take away from the story, which I'm going to ask you to tell, the gory birth story of Claire Coutinho? By the way, you're only 40, so you can have many more gory birth stories. Come back and tell us some more soon, I hope. Um, so, well, what happened was I have a very rare condition called, uh, acute fatty liver, which affects pregnant women. I should start by saying, I think it's a terrible name to give a condition that affects pregnant women. You know, you're vulnerable, you're feeling larger, and then they tell you you've got a fatty liver.

24:24Um, but it's a, it's a very rare condition. And what, what happens is in the later stages of pregnancy, your body starts shutting down. and you go into multiple organ failure. And that's what happened to me. So I went in to have an elected C-section. On schedule? No, it was early. So Raph had come early. When you say he'd come, did you... So I was getting labour pains. Okay, so you went in for a C-section. And so off we went into the hospital. And they weren't sure whether they could fit me in, because if you go in for elected C-section, they have to make sure there's no other sort of medical emergencies.

24:58if you've not gone in the right date. Luckily they fit me in because if they hadn't I would probably be dead. So it's great that they did that and then he came out that was day one and the doctor said any minute now you'll hear him breathing and I was there and my husband was there and we just didn't hear anything for 15 minutes and our hearts sort of stopped. I couldn't see anything. My husband could see that he was sort of blue. They were trying to get him to breathe and after 15 minutes we heard a cry and off they whisked to the NECU, so the baby specialist unit. So we had quite a scary first 24 hours but then he was fine.

25:41So we got all the checks done, they'd been worried about oxygen going to his brain so whether he might have some problems for life but they said no actually everything looks fine, we were absolutely thrilled. I got to see him at about 10pm in the evening and it was heaven perfection. It was only for about half an hour but we were all going to be fine so that was great. Then the next day at about sort of early evening I started suddenly getting very sick. I was swelling up, I threw up, I was getting increasingly delusional and it's a very odd thing especially for someone who is usually in control of faculties I could feel myself getting delusional so they would ask me what my date of birth was and I would give them my phone number and you know it's not right or I remember a doctor asked me to count the months back and I started with December and then I said melembra, philembra, philembra like I was looking at everybody's faces and I was like that's not right so I could feel that something was happening with my brain and then they whisked me off to the high dependency unit and after that I spent another sort of almost two weeks in hospital sort of circling the drain but luckily.

26:57Circling the drain. Circling the drain. Circling the drain between life and death. It was yeah I was in a coma I was put in an induced coma at one point and I was very close I was very close so I went into multiple organ failure me and my husband were preparing ourselves for the worst. I obviously just desperately wanted to spend as much time with my baby as possible because he was still not with me and I was thinking this might be the last few hours we have together um but luckily after a couple of weeks I turned a corner and then it felt like a miracle we we all went home and here we are I'm sorry it's it's so traumatic just to hear it what it must have been to go through it and not to did did they bring the baby to you in the NICU?

27:44So it was one of the hardest things actually so I should say I got tremendous medical care and I think if I hadn't had got the care that I had I'd be dead. It was very very lucky and so that being said the one thing which was really difficult was for me to see him and I remember a huge part of that time in hospital was me just desperately trying to see him and trying to work out how I could spend more time with him. And it ended up being the case that a senior consultant said, I'll wear the risk of, you know, this baby traveling around the hospital and then going to be with his mum. And I'm eternally grateful to that doctor because otherwise, for me, it was just...

28:31So did they... Was he in a crib next to you? The worst bit was when I was in intensive care because I had all of these wires in me. I was pretty immobile. and so they would wheel him in in a tub and I couldn't really touch him or hold him but I would sort of stare at him desperately and at that point I didn't really know where I was in terms of whether I was going to make it out or not so you were thinking gosh this might be my last few minutes of me sort of looking at you in this plastic tub.

29:15You asked me why I spoke about it. And the reason why I spoke about it was after I, you know, recovered and was coming back to work, and I told a few people sort of privately what happened, I realised that actually lots of people have these birth stories, I think women carry these horrible stories around with them. And often it's nobody's fault. Sometimes it really is the NHS's fault and you hear these terrible medical stories but often it's nobody's fault but women I don't think don't feel they can talk about it. Motherhood is meant to be complete perfection and total joy at all times and so they feel they can't talk about it and I thought you know if the least I can do is say this out loud then actually maybe other people feel that they can do the same.

30:03I think it's very healthy to talk about it. I think if you leave an NHS hospital with a live child and you're alive, you sort of feel you've been lucky. I mean, we've seen all the maternity reviews of how potluck it is, the care that a lot of people get. I mean, I'm not saying your story was definitely atypical because of your very rare condition. could the NHS have spotted your condition so I wondered that at the time because I was sick the month before and it's possible they could have but I think a lot of the symptoms that I was showing are quite common symptoms in late pregnancy bloating you know I was I basically I was really nauseous I had really bad acid reflux I was struggling to eat I was you know it's that kind of thing and that's that's not completely uncommon so I don't actually I'm not sure there's a world where it would have been picked up sooner although that would have been great because it is so unusual and you don't want to send you know women into hospital who are saying I feel uncomfortable and sick in my last month of pregnancy.

31:13Is there a test that they can do for fatty liver? So as far as I'm aware there's no tests that they could have done but what I will say is this is if you look at the maternal rate of sort of fatality in this country it's very very low so I think it's something like 0.02 % of women end up in intensive care like I did and 0.01 % of women die that is very very low but what we do have is a growing crisis in confidence and maternity services because you have seen such bad failures in some areas and the worry that I've got is women you know in those very vulnerable moments you know what it's like because you've done this multiple times you're huge this is one of the most important things that you're going to do in your life and the idea that women are sort of going into hospitals scared because they think they might be failed is just horrific to me um you know we're not having enough babies as it is and i don't want sort of fear of childbirth and i agree i mean i think part of the reason people stop absolutely I think we need to have more babies and we need to be confident that the NHS will give us the best care possible.

32:23Having said that, I've interviewed people who say that midwifery is disappearing as a profession because natural birth is now not as straightforward as it used to be. We're older, we're bigger, you know, it's just not. And so midwives are being phased out anyway. anyway in favor of doctors in favor of doctors yeah the whole business of birth is being medicalized because we're getting older and we're getting larger and there are comorbidities that you know older mothers have that when you were giving birth age 20 just didn't have or in your teens even because the average age of giving birth has gone up and up and up and up well it's interesting you say that because one of the things that i want to do and i'm looking at is is more work around why women are either not having more kids or not having kids at all because one of my biggest takeaways was I did this thing it almost killed me and if you asked me today would you do it again I would say in a heartbeat 100 % you know let's go let's go right now because Rafa and my son is the best thing that's ever happened to me he's the most joyful thing in my life I would give up every single thing in my life just to have had him and have had that go well.