Before I start the debate, Madam Deputy Speaker, let me say that I am delighted that you were able to pay tribute to all of our Doorkeepers and, in particular, to Trevor, on his last day here.
I beg to move,
That this House has considered Baby Loss Awareness Week.
I am personally very pleased that this debate is being held in Government time, having participated in last year’s debate on baby loss. It was one of the most moving experiences I have had in this Chamber, as Members from both sides of the House gave expression to their own experiences. That helps to send a signal outside this place of the significance that we accord this, not just within the Department of Health and the NHS; Members of this House sympathise with the many members of the public who go through such experiences. It does this House a good service when Members who feel able to do so place on the record their own experiences. It is right and important that we continue to raise awareness of the devastating impact of baby loss.
I wish to restate at the outset this Government’s commitment to providing high-quality bereavement care and to reduce the numbers of babies who are lost too soon through miscarriage, stillbirth or other causes such as sudden infant death syndrome. I pay tribute to all those who are sharing their personal experiences this week. In particular, I thank my hon. Friends the Members for Eddisbury (Antoinette Sandbach) and for Colchester (Will Quince), who are in the Chamber today, and all members of the all-party parliamentary group on baby loss, which they co-chair, for achieving so much in raising awareness during this past year.
I wish to update the House on some of the initiatives that the Government and the NHS have put in place since last year’s debate to improve safety, reduce stillbirths and other adverse maternity outcomes and improve bereavement care. I believe that all hon. Members support the ambition of the Secretary of State to halve the rates of stillbirth, neonatal and maternal deaths and brain injuries that occur during or soon after birth by 2030, and to achieve a 20% reduction in rates by 2020.
Shortly after the debate last October, the Secretary of State launched the safer maternity care action plan, which set out additional support for the maternity and neonatal services working to achieve that ambition. The plan set out a range of initiatives on five themes. First, there is a focus on leadership, with the establishment of local, regional and national maternity safety champions to promote professional cultures, teamwork and continuous improvement. Every trust with maternity services has pledged to appoint a maternity safety champion, and 88 out of the 134 trusts that provide maternity services now have named leads.
Secondly, there is a focus on learning and best practice. This includes the Saving Babies’ Lives care bundle to reduce stillbirths, which was launched by NHS England in March 2016. Saving Babies’ Lives brings together four elements of care that are recognised as evidence-based and/or best practice: reducing smoking in pregnancy; risk assessment and surveillance for foetal growth restriction; raising awareness of reduced foetal movement; and effective foetal monitoring during labour. The Department has also funded Sands and Best Beginnings to develop and promote the “Our Chance” campaign to give parents knowledge and confidence to maximise their chances of healthy outcomes.
Thirdly, there has been a focus on multi-disciplinary teams with an £8.1 million maternity safety training fund, which is designed to ensure that staff have the skills and confidence they need to deliver world-leading safe care. All 134 trusts with maternity units have now received funding and are implementing training packages. Many of those are being delivered by the charity Baby Lifeline, which I met this morning to learn some of the benefits that this training is bringing to improving safety, reducing error, and helping patient outcomes.
I visited Leeds teaching hospital a couple of weeks ago and heard from midwives about their multi-disciplinary training programme “Deliver me safely” in which they and doctors undergo training together in the recognition that human factors can contribute to harm in maternity systems. These simulations focus on situational awareness and team interactions, challenging some cultural hierarchical attitudes, which I am afraid can be prevalent in parts of the NHS, and encouraging everybody to speak up if they have safety concerns.
Lastly, there has been a focus on innovation, with the launch of a maternity safety innovation fund of £250,000, which has supported 25 local maternity services to create and pilot new ideas, and of the national maternal and neonatal health safety collaborative to build local capability in quality improvement and to provide structured support for local teams. One example of this is the safer films project at the University Hospitals Coventry and Warwickshire NHS Trust, which is developing staff training films, using headcam devices to show interactions with clinicians from the mother’s perspective. The patient’s view of the drills undertaken around her allows clinicians to look back at the impact that their activity, including how they communicate with women and their partners, has on the patient.
Just last month, the Secretary of State hosted a roundtable with 25 key partners across the health system to discuss evidence and current NHS clinical practice on supporting women to have safe births. There has been an enthusiastic response to the Secretary of State’s ambition, with a range of initiatives developed by national and local NHS organisations, royal colleges and charities. We will continue to work with our partners to align these initiatives with the work of the maternity safety action plan. I am happy to report that we are on track to achieve our 2020 ambition. The stillbirth rate in England has fallen from 5.1 per 1,000 births in 2010 to 4.4 in 2015. The neonatal mortality rate was 2.6 deaths per 1,000 births in 2015, down 10% from 2.9 in 2010.
I would like to touch briefly on the importance of learning from when things go wrong in clinical care. Many parents I have spoken to have made it clear they want maternity and neonatal services to learn from the deaths of their babies so that other families do not have to go through the experience of losing a much-loved and wanted child if that can be prevented. Recent publications from the Royal College of Obstetricians and Gynaecologists and MBRRACE-UK—Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK—found that some local reviews of stillbirths and neonatal deaths were of poor quality. Input from parents or independent experts is not routinely sought, and there is insufficient information to understand the quality of care provided.
To improve the quality of those reviews and to learn from them, the Department of Health, together with the Health Departments in Scotland and Wales, has funded the development of a national standardised perinatal mortality review tool to support systematic, multidisciplinary reviews of the circumstances and care leading up to every stillbirth and neonatal death. The tool, which will be available at the end of this year, will also support clinicians to talk with parents about the care review and how they can contribute to the process.
Last month, I laid the draft health service safety investigations Bill in Parliament. This Bill will take forward the work of the current independent healthcare safety investigation branch, which came into operation last April. Under the proposals, HSIB will have far-reaching access so that it can investigate serious safety incidents or risks to patient safety; help to develop national standards on investigations; and provide guidance and training to improve investigative practice across the health service.
Earlier this year, we also consulted on proposals to introduce a system of consistent and independent investigations for all instances of severe avoidable birth injury, along with access to ongoing support and compensation for eligible babies through an administrative scheme. The public consultation into a rapid resolution and redress scheme for severe avoidable birth injury concluded at the end of May, receiving more than 200 responses. We are currently in the process of listening to people’s views, and we aim to publish a formal response soon.
Turning to bereavement care, a clear message that we heard last year, particularly from my hon. Friends the Members for Eddisbury and for Colchester and the hon. Member for Kingston upon Hull North (Diana Johnson), who I am pleased to see with us this evening, was about the need for a bereavement care pathway to ensure that all families experiencing baby loss receive the highest quality of care, no matter where they live.
Since last year’s debate, the Department has funded Sands to deliver a national bereavement care pathway. I am delighted that 11 wave 1 pilot sites were announced yesterday. I know from the experience of my friends and colleagues that care in bereavement is best described as patchy. In some cases, I could use a less flattering adjective. There is no doubt that we need to do more to raise the training of staff and the facilities available to look after families who go through a bereavement in a hospital setting, and indeed to provide care and support to those who suffer loss outside a hospital setting. That is an important initiative.
Earlier this year, Sands, NHS England and the London maternity clinical network published a new maternity bereavement experience measure. That tool aims sensitively to enable parents whose baby has died to feed back about the care they received. It also aims to support services to learn from the experiences of bereaved parents and identify where local improvements may be needed.
Sands is also working on a project for NHS England on the role of the bereavement midwife. The project will make recommendations for the remit of the role of the bereavement midwife and give guidance on the support structures required around the role.
Since 2010, the Government have invested £35 million in the NHS to improve birthing environments, including better bereavement rooms and quiet spaces at nearly 40 hospitals to support bereaved families. Whenever I visit maternity units, I ask to see the bereavement suite. I am always impressed by the quality of the suites, by the feedback from families and staff alike and by how the commitment of many families who have gone through such terrible loss has often led to them raising funds to help to create better bereavement facilities in hospitals.
I commend the Minister for his excellent speech. I am sure that he will join me in congratulating Forever Stars, which is exactly the sort of charity that he has described. It was started by two of my constituents, who sadly lost their baby, Emily, who was stillborn. They have raised about £200,000 for two suites. A third is on the way, and they are now fundraising for counselling services for the siblings of babies who have not survived.
I congratulate my right hon. Friend and thank her for drawing that to the House’s attention. That is one of the most significant examples of fundraising for such suites that I have come across. I pay tribute to the family involved and to the efforts to raise funds for the counselling of siblings, who go through a traumatic experience as well.
I conclude by reiterating that the Government are fully committed to reducing the number of babies who die during pregnancy or in the neonatal period, and to providing support for bereaved families.
I am delighted to participate in what is now the annual debate on Baby Loss Awareness Week, although, sadly, the only reason why such a debate and such a week of remembrance are necessary is to mark the 3,500 babies stillborn each year across the UK, with one in three of those stillbirths occurring at full-term. That of course does not take into account the babies who die within a year of birth.
All the experts, including Professor Jim Thornton, Professor of Obstetrics and Gynaecology at the University of Nottingham, agree that
“For an otherwise healthy baby to die undelivered near term is, with hindsight, an easily avoidable event. Research to make it avoidable in practice is a priority.”
That is why debates such as this, and any and all measures to highlight stillbirth, are vital.
Although the UK’s stillbirth rate has fallen slightly in recent years, it remains unacceptably and stubbornly high. For too long, this taboo was left in the shadows, too difficult, too upsetting to talk about. As politicians, we all know, what is not discussed, what is not acknowledged, is not addressed and, if not addressed, it cannot be improved. We in this House have been and will continue to work to break that deafening silence. That is our duty on behalf of all those trapped in the isolating silence of grief. Some of us in the Chamber today have experienced that silence first hand.
I think back to 9 June 2016, when I had a Westminster Hall debate on stillbirth, which was hugely emotional, not just because of my own experience but because of the realisation that so many of our babies have been lost over generations, with parents isolated in grief, as this was something that was never talked about in our society, except in whispers. However, since 2016 we have come quite a way. The all-party group on baby loss has done so much to ensure that the issue stays firmly on the agenda. Gradually, as a society, we are becoming more willing to acknowledge this awful event, which affects 3,500-plus babies every year in the United Kingdom, with all the devastation, grief and fallout that it inevitably brings.
Since 2016, I have been in contact with a number of stillbirth organisations such as Sands and Safer Births UK—in fact, too many to mention. Early on, I became convinced that if we accept the analysis of the experts, such as Professor Jim Thornton and others, that for an otherwise healthy baby to die undelivered near-term is, with hindsight, an easily avoidable event—why would we not accept what the experts tell us?—then surely it makes sense to have full investigations when otherwise healthy babies do die undelivered near-term. One third of babies across the UK who are stillborn die at the end of the pregnancy. One in three—this is something that requires serious attention.
That is why last year I asked both the Secretary of State for Health in the United Kingdom Government and the Cabinet Secretary for Health in Scotland, Shona Robison MSP, to instigate coroner inquests in England and fatal accident inquiries in Scotland when stillbirths at full term occurred in an otherwise healthy baby. I appreciate that such processes are expensive, complicated and difficult, but if we consider the lessons that could be learned—what has been missed, what was overlooked and what could have prevented the loss of a baby so close to birth—that can inform good practice and improve the care for future babies. Logically, the need for inquests or fatal accident inquiries would surely diminish gradually over time, as fewer babies would be lost. Of course, we would not just be preventing the loss of babies late in pregnancy either; the lessons learned would inform practice and improve it across the whole maternity service at any and every stage of pregnancy.
When I lobbied for that, I was told by some that it was simply not doable—that I should spend my efforts improving practice in other areas of maternity care: surely it would be best to focus on, for example, ensuring minimum and consistent standards of care across the board. Well, yes and no. The minimum and consistent standards of care that everybody in this Parliament seeks should be embedded in improvement and research, and the use of coroner inquiries and fatal accident inquiries could be a hugely important part of that. It is not an either/or question.
I am hugely heartened by the fact that, after an initial refusal, the Cabinet Secretary for Health in Scotland, Shona Robison MSP, has agreed that the Crown Office in Scotland should investigate whether there could be fatal accident inquiries for babies lost late in pregnancy. Such a move is not about bringing prosecutions but about learning lessons, informing practice and making sure that when our children are about to be born but something goes wrong, we find out why and use that knowledge to make other babies safer.
Make no mistake: this is a monumentally significant step forward, which has largely been ignored by the mainstream media. I do not know why, but it means that so many who would be comforted by it may not even know that it has happened. However, the significance of this development cannot be overstated. If, after consideration, the Crown Office in Scotland decides for whatever reason that this measure cannot be implemented, at least we will know where we are. We will know what obstacles we are dealing with and can set about removing them. I am also convinced that this measure will mean that fewer of our babies die. When that is shown to be the case, I am hugely optimistic that a similar measure will be adopted in England. That, I feel, has been a huge step forward in the 16 months since my first debate on stillbirth. Credit must also go to the campaigners who have worked hard to achieve this.
This coming Sunday, 15 October, is Pregnancy and Infant Loss Remembrance Day and also would have been my wee boy’s eighth birthday. It is very important that his death, and the deaths of all the babies who have been lost, should not have been in vain. The campaign goes on, so that other babies do not have their lives ended before they even begin.
My hon. Friend is giving an excellent and emotive speech, and she is conveying an important message about inquiries. Does she agree that it is also extremely important that early miscarriage is well researched? I know from my own experience of early miscarriage that when it happens, people say, “It’s just natural, and there is nothing that can be done.” But the more we look into it and research the causes, the more we can prevent that grief.
I absolutely agree with my hon. Friend. If we start our research at the end of pregnancy and work back the way, I think we will be able to spot things much earlier in pregnancy as we learn the lessons that were missed at the end.
No parent should have to bury their child without knowing or understanding why they did not live. That is what drives me on, and I know it drives on many of us who are taking part in this debate. The tragedy of the loss of so many of our babies is that it does not have to be this way. To change that must be, in the words of Professor Jim Thornton, our “priority”.
It is a pleasure to follow the hon. Member for North Ayrshire and Arran (Patricia Gibson). I thank you, Mr Deputy Speaker, and the Leader of the House for going above and beyond to secure this important debate this week, as part of Baby Loss Awareness Week. It is particularly important that the debate should be held this week.
I did not come into politics to be a baby loss campaigner. Like several of my all-party group colleagues, tragic circumstances led me to campaign to bring about change on this issue. Those circumstances occurred three years ago this Thursday, which makes this week all the more poignant. We, as politicians, have the best job in the world, and I would challenge anyone who says that Back Benchers cannot get things done. Politicians do not always have the best reputations—some of that is deserved, and some less so—but I would refer any sceptics to the work of the all-party group on baby loss.
This place is amazing, and if we use it correctly on a cross-party basis we can achieve great things. We can get things done. We can bring about positive change that will make a difference and affect people’s lives. The all-party group was established, and exists, to reduce miscarriage, stillbirth and neonatal death, and to ensure that we have world-class bereavement care and support for those who suffer the tragedy of losing a child.
I commend the hon. Gentleman, the hon. Member for North Ayrshire and Arran (Patricia Gibson) and those who will follow for their contributions in the Chamber. The hon. Gentleman is, like me, a person of faith. We are talking about losing small children or miscarrying; my mother miscarried a number of times, my sister miscarried and the young girl who works in my office miscarried on two occasions, and what sustained all of them was their faith. Does he agree that at such times, when people are in difficult circumstances, it is important that they have someone from a faith or religious background to call on? Does he also agree that it is important that hospitals have rooms where bereaved parents can spend time together, reflect and call on someone greater than us?
The hon. Gentleman makes some very good points, and he is absolutely right that bereavement suites play a very important role, as do hospital chaplains. I say that as a man of faith, but I know lots of people who have been through this tragic experience and who are not of faith. Nevertheless, the hospital chaplain came to talk to them—not about God, and not about religion—and sat there, listened, and allowed them to come to terms with the tragic event that had just happened. The chaplain gave them the time that they needed, and which medical professionals do not always have. It is a really important role, and chaplains are a credit to the NHS.
We now have some ambitious targets when it comes to tackling stillbirth and neonatal death. I applaud the Government for their commitment to bringing about a reduction in stillbirth and neonatal death of 20% by 2020— I recognise the Minister’s efforts to make us aware of the steps that will be taken to achieve that—and 50% by 2030. Those targets are very much to be welcomed. Even if we are to achieve those targets—let us be clear: it would be absolutely fantastic if we could achieve a 50% reduction in stillbirth and neonatal death by 2030—that statistic would still mean thousands of babies dying every year. Tens of thousands of parents—
The debate stood adjourned (Standing Order No. 9(3)).
Motion made, and Question put forthwith (Standing Order No. 15),
That, at this day’s sitting, proceedings on the motion in the name of the Prime Minister relating to Baby Loss Awareness Week may be proceeded with, though opposed, until 9.00pm.—(Andrew Stephenson.)
Question agreed to.
Main Question again proposed.
The fact that we have some really ambitious targets is to be applauded, and I welcome the Minister’s update on the Government’s position on those targets. Even if we achieve a target of about 50%, however, that would mean that between 2,500 and 3,000 babies will still die every year. We must ensure that the parents, grandparents and wider family members have a support network. That is why the all-party group was established very much on the basis of bereavement care, and our focus very much remains on bereavement care.
My hon. Friend mentioned support networks, and I want to draw attention to the Crowborough birthing unit in my constituency of Wealden. It does fantastic work with mums and dads, and siblings, to make sure everyone can go through the process either of having a healthy baby or, if they have such a tragedy, of losing a child.
My hon. Friend gives a great constituency example. Maternity units up and down this country have the most incredible provision and offer the most incredible compassion and care. In fact, we have some of the best provision in the world. Tragically, however, that is not replicated all across the country, and there is regional variation. I will come on to what we need to do to address that a little later.
To return to bereavement, the very first debate, which I led in this House back in November 2015, was about bereavement care. It specifically looked at bereavement suites in maternity units, and that was very much the focus. I am pleased to say that the theme of this Baby Loss Awareness Week is bereavement.
This week, we have seen something incredible, something truly groundbreaking—the result of over a year of work —which is the establishment of the national bereavement care pathway. The pathway has been developed by a number of charities and professional organisations, with the support of the Department of Health and the all-party group on baby loss. It has primarily been developed to improve the quality of bereavement care experienced by parents and families at all stages of pregnancy and, indeed, baby loss up to 12 months. The objective of the pathway is to ensure that all bereaved parents are offered equal, high-quality, individualised care that is safe and sensitive.
The national bereavement care pathway was launched yesterday in 11 pilot sites, and the plan is to roll it out nationwide over the next year. This has been an incredible exercise in collaborative working. I want to pay tribute to Sands, all the baby loss charities and organisations that have made an input, NHS trusts, the Department of Health and all the parents who have fed in their experiences. It is not easy for them to talk about their loss, and the evidence of all the parents who have talked about their tragic experience will improve care for very many others up and down the country. I also pay tribute to a former colleague, Ben Gummer, who, when he was the Minister with responsibility for care quality, pushed so hard for this and worked so hard to make it happen.
Yes, it is important that we push the Government to address the UK’s high stillbirth and neonatal death rate, but the support that we give bereaved parents is just as important, if not more so. We need to make sure that they have the support that enables them to have the time and the space in which to grieve. We know that going through this most traumatic of experiences can often lead to mental health issues—such as depression and post-traumatic stress disorder, about which there is growing evidence—whether they appear weeks, months or sometimes even years later. The number of couples that separate after losing a child is still very high, and that comes with huge social costs. Putting in place the right level of high-quality, consistent bereavement care is not just the right thing to do for parents; it should be part of our push to improve mental health care nationwide.
On the pathway for bereaved parents, may I raise a particular type of bereavement that is unusual but does, unfortunately, happen? On 4 August, my constituent Craig Renton went into hospital with his wife Heidi for her to have a caesarean. Sadly, she died during the caesarean, and although their baby was born, she also died 15 hours later. Within the space of 15 hours, the happy couple expecting the birth of their daughter were no more, and my constituent Craig, who came to see me, had lost both his wife and his first and only child. In such a situation, the bereavement care needs to be designed particularly carefully if it is to deal with two bereavements in one day.
My hon. Friend raises a most tragic case, and I know I speak for everybody in the House when we send our condolences to Craig in what must have been a hugely emotional and traumatic experience. My hon. Friend is absolutely right when he says that the point of the national bereavement care pathway is to ensure that care, although consistent, is individualised and patient-centred. That means that when there are unique sets of circumstances—I would say that was a unique set of circumstances—the care package and the bereavement support are unique to match them.
I could never, ever truly express my thanks to the nurses at the Rosemary suite, a specialist bereavement suite at Colchester General Hospital, for the care and support that my wife and I received just three years ago, but I want to ensure that every grieving parent receives the excellent, high-level support that we did. I truly believe that the new national bereavement care pathway is an important step to making that a reality. I am really proud to co-chair the all-party parliamentary group on baby loss and I know that the work that we are doing on a cross-party basis is really important and is changing lives up and down the country.
Finally, I want to send a message to bereaved parents up and down the country that together we will break the silence on baby loss.
I want to make sure we all get equal time on this. Can I suggest that Members speak for up to eight minutes, so that everybody gets equal time? It is a very important day, it is a very emotional debate, and I want to make sure we get fairness right across the Chamber.
I speak as someone who has not lost a child, but I remember what happened when I was working in Lebanon and was four months pregnant with my son. We had discussed the risks of going to Lebanon when I was pregnant and we thought I would only be there a few months; even if I was here there would be nothing that could be done, so I was not adding to the risk. But when I suddenly saw blood, all of a sudden I realised how paltry that word “miscarriage” is. I understand that we are predominantly talking about babies who have been lost later, but that term “miscarriage” sounds like “misstep”—like a bump in the road—and by four or five months, particularly once you have had that little ultrasound picture, which you thought was going to be the first of a whole lifetime of photographs, you realise you have already bonded with the bulge that means you need elasticated waistbands and is giving you heartburn or keeping you up at night, or even, a bit later, starting to kick the living daylights out of you at three in the morning. So I think it is really important, as my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) said, that we think of those who are slightly outwith this debate. That is something that we must try to bring over to medical staff as well.
I acknowledge the discussion about bereavement midwives, and we always need champions and leaders when, trying to raise awareness, but as someone who has worked in breast cancer for over 30 years, I can tell the House that having a grumpy old surgeon and then sending the lady to the breast cancer nurse, who would be nice to her, is not a solution. In fact, with all midwives, all doctors, it only takes one person to turn the knife and make that heartbreak worse.
I had a friend who had three miscarriages before she successfully had two rather wild and lively boys—something for which I am sure she gives thanks every day. On her second miscarriage, a routine scan at 16 weeks revealed that the heartbeat had stopped. They thought she would miscarry, but she did not. The period between then and when she underwent surgery meant she knew she was carrying her own dead baby. That was really difficult. At the scan that made the diagnosis, she was simply sent back out to the waiting room after a couple of minutes. She was sitting there surrounded by women with their bumps discussing their plans, while she waited for almost half an hour to be taken into a room and just given leaflets. There is no point in having one person who knows how someone should be supported: every single member of every single team, from antenatal, perinatal and right through to early paediatrics, needs to know the language, the body language, the timing and the support that someone might need.
The number one thing as a doctor is to try to reduce the number of deaths. Scotland actually had higher perinatal, stillbirth and neonatal figures. About five years ago, there was a big discussion in the profession in Scotland saying that it needed to be tackled. It was not enough simply to collect data—whether the Scottish perinatal mortality data, which go back to 1977, or, now, in MBRRACE-UK. The cases had to be looked at. Regardless of whether that is done through a fatal accident inquiry, it must be done by the clinicians. As surgeons, we carry out morbidity-mortality meetings every couple of weeks to discuss cases that have gone wrong in a very open and frank way. We learn from them. Often, we will suddenly see a pattern that makes us want to change. Since 2013 in Scotland, our perinatal figures have dropped by 34%—a third—our stillbirth rate has dropped by 26% and neonatal has dropped by over 50%. That is what can be done if every single case is discussed.
Believe me, Scottish Members here know that the geography of Scotland makes providing perinatal care really difficult and challenging. It is easy to identify the difficult case with a past history of diabetes or a huge wain and a small pelvis, but any delivery can go wrong. One challenge we face, which is not faced in so many areas in England, is how to get people off our islands and how to cover hundreds of miles, yet we have managed to bring the figures down.
It is absolutely right that, even if we drop the mortality rate further, there will be children who are lost. We must not stop trying to do that and we must support people, in particular those whose babies are born and require extra neonatal care in a special baby unit. We know they have a higher incidence of post-natal depression. We know that, naturally, mothers who lose a child will have an increased incidence of post-natal depression. If we can get all our teams to try to get it right all the way through and support them, then maybe we can tackle both problems.
Thank you for calling me, Mr Deputy Speaker, although I have to say it is not a pleasure to speak in today’s debate. It is absolute torture for many of the speakers who have chosen to share their experiences with the House. It is, however, a pleasure to follow the extremely knowledgeable speech, as ever, of the hon. Member for Central Ayrshire (Dr Whitford). It is so good to hear the good news from Scotland about the real developments that have come from investigation into what happens when things go wrong.
I am most grateful to business managers—even if I am quite close to some of them—for allocating time during Baby Loss Awareness Week, and to all those who organised the extension of today’s sitting. It is a testament to the way the House has changed. I am grateful that you, Mr Deputy Speaker, have chosen to be in the Chair after your traumatic experiences last year listening to us. We are most grateful to all those who have enabled this debate.
It is fair to say that maternal safety keeps me awake at night. Issues with the maternity unit at Horton General Hospital in my constituency sadly continue. It is good to see my hon. Friend the Member for Witney (Robert Courts) in his place. I do not know what keeps him awake at night. Indeed, I do not know whether he is kept awake at night. If he is, I suspect his young son probably has something to do with it, but I also know that he worries as much as I do about the future of the unit. The uncertainty goes on. My hon. Friend, other campaigners and I are not giving in. I remain convinced that the current situation is unsafe. Significant numbers of transfers are taking place during labour. Babies have been born at the side of the road and in ambulances. Mothers and their babies are not getting the sort of care that is safe, kind and close to home, which is what everybody in the Chamber wills them to get.
Out of this morass sadly comes some dreadful casework. I have noticed that when something goes wrong, the shutters come down in the health service. Hospitals are on the defensive from the beginning and legal teams are called in. In one of the saddest cases I have had to deal with over the past year, Oxford University Hospitals NHS Foundation Trust responded by saying that it would not meet me or the family in question without legal representation. My attempts to ensure that there was a full and external review of the case by MBRRACE-UK, for example, were stalled for months. This is simply not acceptable. Families, along with most of us, are motivated by a burning desire to ensure that what happened to us will not happen again. They are not interested in compensation except where that is necessary for looking after a desperately sick child. They are motivated by change in practice.
Sir Charles Pollard, the former chief constable of Thames Valley police, has been working tirelessly on producing restorative solutions in the justice sector—that is my background—and increasingly in the health sector, where the needs of all parties, including families, doctors and staff, are crucial. Constructive conversations can be had in carefully controlled environments. I think, particularly after having a lengthy conversation with my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), that it is important to find a new language. We do not want to apportion blame to anyone in any way, unlike in the justice sector. Finding a new language would be good for families and for staff, who are often traumatised by a loss on their watch.
There have been some exceptional speeches on this sensitive issue. I am not sure whether my hon. Friend is aware that my private Member’s Bill—the Civil Partnerships, Marriages and Deaths (Registration Etc.) Bill—includes a clause to give coroners the power to investigate late-term stillbirths. Extraordinarily, that is currently not available to them. Many parents who have gone through difficult stillbirths where the circumstances are unclear would like an independent assessment of what went wrong so that everybody can learn from the situation. I am sure my hon. Friend will support that.
I will most certainly support that.
The hon. Member for North Ayrshire and Arran (Patricia Gibson) made an excellent speech in which she mentioned inquests and fatal accident inquiries. I do not know why so many of us involved in this debate are lawyers; it is very strange. These are, of course, very sensitive legal issues. We are talking about when a person becomes a person—things that we have not spoken about in places such as Parliament or the courts, and perhaps should have done, over the years. We have allowed a body of law to grow up that does not fit current requirements. Even though restorative solutions are great, inquests may also be appropriate and may also act restoratively. They do not have to be legalistic. They can be inquisitive, which is why inquests came into being. Inquests and, in Scotland, fatal accidents inquiries, have an important part to play in preventing stillbirths and neonatal deaths.
Today is World Mental Health Day, so it is particularly appropriate that we are talking about the bereavement care pathway in Baby Loss Awareness Week. As we have heard from other hon. Members, the pathway is very good in places but variable in others. We are making progress but we need to do more to ensure consistency, and I know the Minister is on top of this. The Care Quality Commission does not currently ask sufficiently in-depth questions about the quality of bereavement care on offer, but I am encouraged by the constructive conversations I have had with it on behalf of the all-party parliamentary group on baby loss recently and am hopeful that we will have real progress to report this time next year.
I would like to end on a high. Petals opened its new bereavement counselling service in Banbury yesterday, in the Horton General Hospital, and I was very pleased to be there. It offers bereaved families six sessions per couple. That might not be enough, and it certainly might not be appropriate for mothers and fathers to be seen together, but the evidence shows that what it does is of very real value and that its outcomes are valuable and beneficial to the couples who use its service. Lots of charities do similar work, as is clear from our well-attended APPG meetings.
We might not enjoy these debates, but they have begun to change both perceptions and the law, and I am grateful to the Minister and the previous Member for Ipswich for all their work. I would like to finish by congratulating us all.
I am grateful for the opportunity to take part in this important debate, which allows us to play our part in Baby Loss Awareness Week.
In terms of how we talk about it day to day, pregnancy and childbirth are for many people times of joy and celebration: a new addition to the family, a celebration of new life, the hopes and dreams—and laughter and tears—that a new baby can bring to a family. It is all the more difficult, therefore, when a family suffers the loss of a baby. These issues— miscarriage, stillbirth, death in infancy—are less commonly spoken about for a range of reasons. I note that the hon. Member for Central Ayrshire (Dr Whitford) referenced miscarriage. I know from speaking to family and friends that the loss is felt acutely, but too often, perhaps, society trivialises it. To the mother and family, it is the loss of a baby—an unborn baby—and the hopes and dreams that go with it. When that is taken away, privately it can be very difficult. Some do not tell their family and friends straightway, so the grief takes place in a very private and unspoken way. Others break the news, and it is heart-breaking to have to so shortly after sharing the good news of the pregnancy. I know that that can be particularly difficult for families and women.
The pain and loss that follow from the loss of a child can be acute. I know that families admire the many improvements made and I recognise that much work has been done, but I also know that more must be done to enhance services, including bereavement services, and the support for perinatal and post-natal mental health. I know from speaking to many women that the support services are simply not there at this very difficult time. It is not right, for example, that many women continue to be placed in and around maternity wards, surrounded by new mothers, parents and joy, at a time when they are grieving. Having to listen to the conversations, hearing the cries of new-born babies, while suffering their own personal loss, makes it all the more difficult for them and their families. It is not right that a woman who has suffered miscarriage after miscarriage, often when a child is much longed for, is required to sit in an out-patients maternity ward with heavily pregnant and joyful mothers-to-be. Very often women are left there for half an hour or an hour watching those families and feeling the pain of their loss—sometimes loss after loss—very acutely. It is not right either that families are left without adequate bereavement care.
I want to raise a number of short points. First, our perinatal and support services must improve, not just following baby loss or miscarriage, but in relation to women’s mental health. The way in which we understand the human mind, mental health and trauma has changed and advanced year on year, but I think that, for too many of the people who go through this experience, those services are not advancing at the same pace and they need to catch up.
Secondly, we need to look at statutory and support services for bereaved parents as a matter of urgency. Like many people, before I started to speak to parents, I had assumed that these issues would be dealt with compassionately by employers, schools and statutory agencies, but it became clear that that was not always the case. There is a good basis for the introduction of enhanced statutory protections for bereaved families, to ensure that they are given the time that they need to try to heal and move forward with their lives.
Thirdly, I think it would be remiss of us not to refer to the health of mothers, infant mortality and miscarriage rates all over the world. There is no doubt that improvements can be made, and that they can be made throughout the United Kingdom as well. I welcome the commitment that has been made in that regard, but in too many countries, there are still appalling rates of infant mortality and appalling statistics about the health of mothers and what happens during childbirth. I know that most of those who campaign on the issue here will have the same interest in trying to improve services for women throughout the world. Those in the poorest areas often suffer incredibly during childbirth, and there are still very high levels of infant and mother mortality in such places.
Lastly, I want to take a moment to recognise all the parents and families who have suffered loss in this way. I think that it will be an incredible tribute to those families, and to the loss that they have suffered, if we go on striving to create world-leading services in both bereavement and childcare.
I feel extremely humbled to be able to speak in the debate. Let me start by paying tribute to my hon. Friends the Members for Colchester (Will Quince), for Eddisbury (Antoinette Sandbach) and for Banbury (Victoria Prentis), as well as all members of the all-party group. They have shone a much-needed light on the issue of baby loss, its effect on parents, and the need for action. They have not only pushed for change, but helped to achieve it. On behalf of everyone who has ever suffered, I take this opportunity to say thank you.
We must also pay tribute to the medical professionals who work day in, day out to prevent baby loss and deal with it, and to organisations such as the Royal College of Obstetricians and Gynaecologists, as well as charities such as Sands. They play an important role in developing programmes and reviewing the care provided for expectant and bereaved parents.
Baby loss is not a regional or even a national problem, but an international one. It affects people in all our constituencies, and hurts and devastates families in Wiltshire and throughout the country. It has touched my own family. My grandma experienced the loss of her first-born in 1948 when the child was breached. Tragically, the ambulance reached her too late. The months after that were probably the hardest that she experienced in her life, and I heard about them when I was growing up. Like other women in the same situation, she struggled with the ordeal of having carried the baby and prepared for its birth, only to lose that child as soon as it arrived. Devastated and receiving no help, my grandmother suffered a period of depression.
That is the story of the strongest, most no-nonsense woman I have ever met in my life. She was a woman full of grit and strength, yet she had no help in her time of need, and even the strongest among us do need help. My grandma is long passed and now in heaven, but I think that she would want me to share her story, and to ask the question: why, after so many, many years, are the rates of baby loss still so high? The most recent review of stillbirths and neonatal deaths in the UK reports that of 782,720 births in 2015, 3,032 were stillbirths and 1,360 were neonatal deaths. Yes, there has been a reduction since 2013, but the number remains higher than those in comparable European countries.
I am proud that the Government have taken action to address maternity care and set an ambitious target, which I think is bold and moral, to halve stillbirth rates by 2030. Now we must all work together to ensure that we meet that target by keeping the subject on the agenda. I hope that debates such as today’s will help to serve that purpose so that 69 years from now, when another MP is standing here, they are not saying the same thing.
I think that my grandmother would also ask why, 69 years on, we have failed to improve our bereavement care to a satisfactory and appropriate level. Bereavement care, as has been pointed out, is the focus of this year’s Baby Loss Awareness Week. Bereavement care is vital, both for psychological and emotional support, and for advice and signposting. Since 2010 we have invested £35 million in the NHS to improve birthing environments, including better bereavement rooms in 40 hospitals. We need that for every hospital and facility. The current guidelines vary far too much between setting and service. In addition, most of the frameworks are guidelines, and they are not mandatory, or indeed monitored, in all areas. That is why the Government’s work to create a national bereavement care pathway is so important. That will reduce the variation in the quality of bereavement care provided by the NHS so that residents in Wiltshire get the same care as those in, say, London or Manchester. That is essential.
One can only imagine how harrowing and devastating the loss of a baby must be. I think that the courage that Members have displayed by sharing their experiences in this House is remarkable. Bereavement care must be of a high quality, consistent, individualised and available across the UK. It is time that we achieved that so that, as I have said already, we do not look back in 69 years’ time and again ask why we are not doing more for those in need.
It is estimated that today about 15 babies in the UK will die before, during or shortly after birth. Today let us not only remember those who have suffered and the babies they have lost, but pledge to work together, across parties, to support the Government’s work and ensure that nobody faces a postcode lottery when it comes to baby loss. We need to determine what should be the level of bereavement support and ensure that it is consistent across the country so that parents receive what they deserve if they tragically lose a child.
I pay tribute to the hon. Members and their constituents who have shared their deeply personal stories. It must be very difficult to talk about the loss of a child. We are indebted to all those who have had the courage to talk about their experiences, both this evening and previously. I remember watching the debate last October and being struck by the speech made by my hon. Friend the Member for Lewisham, Deptford (Vicky Foxcroft), who is in the Chamber tonight. She said then that it was the most difficult speech she had ever had to write or deliver, but it mattered enormously that she did so. Her speech, as well as those of other Members, many of whom are here tonight, demonstrated that Parliament was willing to talk about this most painful issue.
It was a few weeks after that debate that I met my constituents Jack and Sarah Hawkins, whose daughter Harriet was born dead at Nottingham City Hospital on 17 April 2016. Jack and Sarah were convinced that Harriet’s death was the result of a mismanaged labour, but their concerns were not listened to by hospital staff; they were told that a post-mortem had found that Harriet’s death was caused by an infection and
“to try to move on”.
Jack and Sarah are both health professionals, so they knew that there was no evidence of an infection. They were sure that their healthy, full-term baby had died due to mistakes in Sarah’s care, and they were not prepared to be dismissed. The debate in this House helped to give them the confidence to get in touch and seek my advice and support, but it is thanks to their courage and determination that Harriet’s death is finally the subject of a proper external investigation. But the loss of their much-wanted daughter, and the circumstances surrounding it, have had an absolutely devastating effect on every aspect of their lives. Last week, they spoke to the media about Harriet’s death and the failures of care during Sarah’s labour, and many Members may have seen, heard or read their story. I will not attempt to do justice to it now, but others will be able to look it up online if they want. Jack and Sarah are calling for a change in the law to enable coroners to investigate stillbirths and hold inquests into the deaths of babies after 37 weeks’ gestation. That is the particular issue that I want to discuss today.
Under the Coroners and Justice Act 2009, a coroner has a duty to investigate certain deaths, but current legislation means that a stillborn child is not classed as a deceased person, so the coroner cannot investigate even when a healthy full-term baby has died during labour and the parents wish the coroner to do so. I welcome the Minister’s confirmation that the standardised perinatal mortality review tool is being rolled out across the country, but will he also support calls to broaden coroners’ jurisdiction so that they are able, at the request of parents, to investigate a stillbirth? Hospitals’ internal review processes should involve parents and should answer their questions about why their baby has died, but when those questions are not answered, the coroner can play a vital role not just in providing answers—important though that is—but in identifying preventable deaths, and ensuring that lessons are learned and mistakes are not repeated. Such a change to coronial law would bring England and Wales in line with Northern Ireland, where a landmark legal ruling in 2013 held that a coroner
“can carry out an inquest into the death of a stillborn child that had been capable of being born alive.”
It is clear from several contributions this evening that there is cross-party support for such a change. I particularly welcomed the contribution of the right hon. Member for Broxtowe (Anna Soubry). She is not in the Chamber now, but she assured me that the change has her support, for which I am thankful. I hope that the Minister will deal specifically and positively with this suggestion when he responds to the debate.
There is nothing that I can do to take away the pain of Harriet’s death for Jack and Sarah, as much as I wish I could, but I think that they would gain some comfort if their experience helped to prevent other parents from suffering in the same way.
It a pleasure to follow the hon. Member for Nottingham South (Lilian Greenwood). I know exactly how Jack and Sarah feel, because it was the burning desire to see change that motivated me and many others in the all-party parliamentary group on baby loss to work not only to reduce the number of neonatal deaths and stillbirths, but to consider how we can improve things for parents.
When we set up the APPG, saying that we wanted to achieve huge cuts in the number of families affected by all these issues and to put in place a bereavement care pathway seemed to be setting rather a large challenge. I pay enormous tribute not only to Members of this House—it has been a cross-party effort—but to parents and health professionals, who have risen to the challenge set by the APPG and the Department of Health. In a way, I can provide some comfort to a number of Members who have spoken today about miscarriage, for example, because the national bereavement care pathway, which was launched yesterday, in effect addresses loss from conception to up to one year post-birth. That is quite groundbreaking in a number of ways. Pilot schemes in 11 hospital trusts are developing specific pathways to address early miscarriage, late miscarriage and stillbirth, and for those in the very unfortunate situation of having to terminate because of foetal abnormality. I have been encouraged by the willingness of parents to come forward and talk about their experiences as part of the development of these pathways and to share their loss with medical professionals, including the Royal College of Obstetricians and Gynaecologists, and the Royal College of Midwives. There has absolutely been cross-working and buy-in for this change.
I am encouraged that the change is being supported by the Department of Health. Pilots are taking place so that lessons can be learned, with the outcome of those lessons applied before things are rolled out more widely and nationally. As somebody who sat in a room with white walls and a sofa that was not anything like a bereavement suite, I know at first hand, as do so many parents who have not been in such facilities, that when one visits a hospital such as Medway Maritime Hospital, which has the most extraordinary facilities, one can see that change is coming. The improvement and change in the past year has, to my mind, been something that I and many professionals did not imagine would happen as quickly as it has and in the way that it has.
I would absolutely support the hon. Member for Nottingham South if she proposed a ten-minute rule Bill to try to effect the change in coronial law that she spoke about. I myself will introduce a ten-minute rule Bill tomorrow on the regulation of foetal dopplers. I will expand on that point tomorrow, but the false reassurance they provide to parents can increase the risk of stillbirth. I know that my hon. Friend the Member for Colchester (Will Quince) put forward a Bill in the last Parliament that has now been taken up by my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake), and it is due to have its Second Reading on 20 October. There are therefore methods to effect change in this Parliament, and I know that the hon. Member for Nottingham South would find great support in the House for her constituents if she tried to effect the change that they propose. I know that I will be trying to get the Minister’s support tomorrow on the subject of foetal dopplers.
This is Parliament at its best. We are listening to constituents. We understand where there has been a failure in the system, and there is no doubt that the statistics show we need to make changes in this area. I am delighted that the Government have accepted that quickly and have therefore set ambitious targets. The chief executive of my local hospital, the Leighton Hospital, which has an award-winning maternity unit, was able to say to me that they had had 14 fewer deaths this year. That means 14 fewer families in my local areas going through the loss that so many in this House and outside it have seen. At the same time, I should say that the Countess of Chester Hospital is under investigation in relation to 15 baby deaths. There are concerns about care in relation to eight of them. So the perinatal mortality tool is crucial, as is the investigation of these incidents, in order that those lessons are learned, that good practice is shared and that professionals are honest with parents where something has gone wrong; they need to admit that and learn from it so that it does not affect other families. Let us get that open culture; the Health Secretary has talked openly about the need for no-fault investigation, and the need to learn from that culture is incredibly important. The hon. Member for Ellesmere Port and Neston (Justin Madders), who speaks for the Opposition on this matter, will know of the particular importance of that, because the Countess of Chester serves his area too and this directly affects all our constituents.
I say to the Minister that the huge progress that has been made is encouraging. The charities and colleges yesterday spoke about the great enthusiasm and drive that has come from working collaboratively together. If we can take that and use it, the progress we are starting to make can carry on. We can roll it out into the difficult areas. We know that they exist, so let me mention just two. First, we know that there are big issues in respect of minority ethnic groups that go beyond the hospital setting, often relating to factors in the environment. Those issues fall outside the Department of Health’s remit, but wider working will need to be done to examine how those factors can be addressed and whether or not public health issues arise in their regard.
The second area involves general practitioners. I sent out a freedom of information request to every clinical commissioning group in England, and less than 50% of them provide any form of bereavement counselling, whatever the death. So even not in relation to child loss, a lot of CCGs simply are not commissioning support in the community. Those CCGs have relied on provision from the acute sector, and the next piece of work from the all-party group will need to be on how we take the lessons learned from the acute sector into the primary care sector, because that will end up benefiting not just those who have lost a child, but those who have suffered a loss.
The other sector that provides so much of the bereavement care, such as the service I helped open yesterday, is of course the charitable sector. Would my hon. Friend like to comment on whether CCGs should be encouraged to join that sector in funding bereavement counselling, such as that provided by Petals, in the future?
My hon. Friend makes a good point, and she can probably guess that the reason for my freedom of information request was to put pressure on not only my local services, but services more widely. There is expertise out there that we can build on, but bereavement touches everybody and this Government’s focus on mental health gives us a real opportunity to approach death in a way that minimises its mental health impacts, which can be severe. We can roll out elsewhere the way in which the Department of Health is leading on baby loss and working together with the third sector. This year’s Baby Loss Awareness Week therefore perhaps has a message of hope that has not been present in the past two such debates we have had.
I am very grateful to be called to speak in this debate. I took part in the debate last year and was very moved by the contributions. I am pleased that we have such excellent speakers again today. I wish to pay tribute to the all-party group for the wonderful work that it has done, and to say to the Government that their record of making improvements and investing in this area is to be applauded.
I am having to stand here again because I wish to speak about my constituents, Mike and Tina Trowhill. Members may remember that I spoke about them last year. Many years ago, they lost their little boy, William, who was then cremated. They were told that there were no ashes, but 20 years later they found that there had been ashes and that they had been scattered without the family’s knowledge. Mike and Tina started to ask questions, and it became clear that they were not the only family that this had happened to. It now appears that there are about 70 families in the Hull area who share their experience. The ashes of those babies may have been left on the shelves of the funeral director’s offices. There was one instance of a baby being cremated, with no indication of an undertaker being used. Nobody seems to know quite how that happened.
When this all came to light, I went to see the council, because I knew that there had been similar instances in Shrewsbury and Scotland and that there had been inquiries about what had happened in those areas. It was on 27 March 2015 that I went to the council with Mike and Tina and we asked whether we could have an inquiry into what had happened to these 70-odd families. It took three and a half months for the council to say that no, it was not willing to do that. I felt that there was an injustice here and that these families needed to know what had happened to their babies’ ashes.
In February 2016, I went to see the right hon. Member for Surrey Heath (Michael Gove), who, at that time, was Secretary of State for Justice. He wrote a letter to Hull City Council, which said:
“My fellow Secretaries of State at the Department of Health and the Department for Communities and Local Government have agreed with me that there is a need for an historic investigation into the practices relating to infant cremations in the Hull area, and we have today jointly written to the Chief Executive of Hull City Council asking him to commission this. We have suggested that the Hull investigation should have terms of reference similar to those of the Emstrey inquiry.”
I was very grateful to the right hon. Gentleman for that. He met my constituents and was incredibly compassionate and understanding. It is really important to see a politician showing such kindness. However, unfortunately, Hull City Council said that it did not need to hold that inquiry and there was a change in Justice Secretary. Without any reference to me, Tina or any of the other families, the Ministry of Justice decided not to pursue the issue with Hull City Council. It accepted that Hull had done everything it needed to do and that everything was fine. I was not told that. I only found it out because the council told me that it was no longer considering holding an inquiry. I was livid and, as Members can imagine, my constituent was completely dismayed. She has now formed a group with the other families called Action for Ashes in Hull.
The families were absolutely dismayed, as their hope of getting the answer to what had happened was snatched away from them. However, the new Justice Secretary did write to Hull City Council, suggesting that it might like to meet the Action for Ashes group. The council refused to do that, saying that it was not willing to meet the group, but that it would meet me, Tina and one other parent. We had that meeting on 24 March 2017. I specifically asked for the full investigation that it said it had carried out to be published so that we could see what it had actually done. That took four months. On 25 July, my constituent Tina was given 27 minutes’ notice that the report was about to be published and given to the press. It was not sent to any of the other parents who were in the group.
A 22-page internal report was produced by Hull City Council, but so many questions still needed answering—questions, as I said at the outset, about why babies’ ashes were left on the shelves of funeral directors and why families were told there were no ashes in the first instance. None of that was properly addressed, and there was no investigation into the role the NHS had played or into the independent funeral directors who had been involved. The report also looked at just 2% of the cremations that had been carried out in the area, whereas, in Shropshire, the Emstrey inquiry looked at 100%—it combed through all the records. In Hull, the report looked only at the families who had come forward and self-identified.
A year on from the last time I raised this issue in Parliament, Hull City Council still believes it has done everything it needs to do, despite families saying they still have not got the answers they need. I still do not understand why, in Shrewsbury and Scotland, an inquiry was appropriate, but one is not appropriate for the people I represent. There have never been clear answers and explanations about what happened. One Conservative Member made the point that there seems to be a fear that this will turn into a legal dispute and that there will be an opportunity for compensation. That is not what these families want; they just want to know what happened, why they were told things that were not true, and who knew what when. It is that basic information that they are still seeking.
I hope very much that come next year—I hope there will be a debate again, because this is an important issue, which we need to discuss each year—I do not have to come here and say, “I am still fighting to get a local authority to display the kindness and compassion this group of people truly deserves.” I am staggered that I am still having to fight this case, because it is absolutely obvious that an internal investigation is not sufficient. What we need is to have some fresh air in this case and to have someone independent come in, look at all the records and ask the families about what happened. That seems to me the best way forward, the kindest way forward and the way we will actually get justice and truth for these families finally.
Let me start by saying how grateful I am to everybody who secured the extension of today’s business so that we have the opportunity to pay tribute to the families who have suffered the unimaginable loss of a child and to the professionals who provide irreplaceable care and support throughout a journey that no parent ever wants to take, and, in Baby Loss Awareness Week, to break the silence for bereaved parents, as the strapline for this year’s campaign says.
I also pay tribute to the APPG and to my hon. Friends the Members for Banbury (Victoria Prentis), for Eddisbury (Antoinette Sandbach) and for Colchester (Will Quince), and to other Members from across the House, including the hon. Member for North Ayrshire and Arran (Patricia Gibson), who have spoken with such courage, dignity, passion and determination, enabling us to deal with this issue in a very open and honest way and to really move things forward. The hon. Lady was right to say that if we do not talk about things, nothing ever happens, and I commend everybody for telling their stories.
I want to tell two stories today, one of which I told in my debate in Westminster Hall before the recess, and which focused on bereavement support for employees. It is about a young guy in the west of Scotland, who was recently married and looking forward to becoming a dad for the first time, but whose son died at three days old. He received a phone call from his employer the day after his child’s death to say that because his son was dead and there was no baby, there was an expectation that he did not need the remainder of his parental leave and was therefore expected to come back to work the next day. The hon. Member for Belfast South (Emma Little Pengelly) is so right that there is an assumption that people are kind and decent and deal with things compassionately, but the truth in too many cases is that that is not the case.
The second story I want to talk about is about a family in my constituency, and it means a lot to me because it is the story of my office manager, whose daughter Rebecca died of TB meningitis. She had spent the last three months of her life in the Institute of Neurosciences in Glasgow’s children’s hospital. After several failed operations on her brain, her parents were told that there was no hope and that their daughter would die—their daughter, who had previously been fit and well and full of life, would die of a disease not usually associated with a first world, developed country. For the last three weeks of her life, she was transferred to Robin House, which is a most incredible children’s hospice run by Children’s Hospices Across Scotland in Balloch, near Loch Lomond.
The staff of Robin House gave Rebecca, her parents and the rest of her family a week devoted to giving her what I believe is called a “good death”. I am not sure there is ever such a thing, but in these circumstances perhaps that is the right term. It was a week where nothing else mattered, where the tasks that made an impossible situation in the hospital worse, like having to cook, do the laundry, travel, find a car parking space and look after other children, were all entirely dealt with. Rebecca died on 2 December 2009 in the arms of her parents, in a double bed that had been installed in her room from another part of the hospice, because no task was impossible for the staff of Robin House. Indeed, their support for Rebecca’s family continues several years on.
It is important to recognise that for the charities across the UK no task is impossible for the babies, children and parents they look after—from Bliss and its vision to give every baby born prematurely and sick in the UK the best chance of survival and quality of life, to Sands, which offers support to anyone affected by the death of a baby, the Miscarriage Association and its work offering support to anyone affected by miscarriage, and Together for Short Lives, whose mission is to secure the best quality of life and the best end of life for children who have short lives. In parents’ hours of need, absolutely nothing is insurmountable for both the paid staff and the volunteers in these organisations.
As we have heard, however, experiences outside the specialist palliative care environment can vary wildly. Hospital facilities do not always lend themselves well to the purpose of grieving. Not all health boards have dedicated bereavement rooms. They do not all have dedicated staff available. They do not all have rooms where parents can leave the noise and “life” of the hospital environment, which can make things so much harder and painful because it is so impersonal and sterile. Not all hospitals provide night-time accommodation for parents. Rebecca’s mum regularly slept in hospital coffee rooms overnight simply because there were not the facilities on the ward for her.
After death, when families are left devastated—some of them may have lost or given up their job and devoted themselves to being the sole carers for a sick child for many months or possibly years—the support we as a society give them to grieve can make the difference between whether they are able to rebuild their lives or not. Someone said to me that when your child dies you are shattered and, like a smashed vase, you can put the pieces back together but you are never the same as you once were; you are never truly whole again. You may find a way to function in society, but you are not coping; you are never coping. The grief can come on almost randomly and indiscriminately and it can be overwhelming. We must acknowledge the fact that the psychological consequences of grieving for a child are lifelong. It is not something that will ever leave you.
I am talking today not with a list of statistics or data because this is not a debate for pie charts or graphs. It is more about trying to reinforce the message of Baby Loss Awareness Week, to break the silence for bereaved parents who need support, to break the silence to promote the outstanding work of charities such as CHAS, CLIC Sargent, the Rainbow Trust, Bliss and the many charities across the UK that have come together for Baby Loss Awareness Week, and, most importantly, to break the silence for children like Rebecca so they are never forgotten.
Following on from the very moving and courageous speeches by hon. Members about Baby Loss Awareness Week, I rise as someone whose own family members have suffered from the trauma of baby loss. Stillbirths and neonatal deaths affect so many in our community, including in my Slough constituency. The son of my very good friend Councillor Madhuri Bedi was born prematurely. He had strep B, which gave him brain damage. The family had to make the harrowing decision to switch off his life support machine only one day into his precious life. As they remarked, there is very little awareness and not enough support. That is something that we all need to work towards.
I commend the excellent work done by so many individuals, campaigners and hon. Members, on a cross-party basis. I also pay tribute to members of the all-party parliamentary group on baby loss.
On that point, will my hon. Friend join me in welcoming the recommendations in the updated clinical guidance from the Royal College of Obstetricians and Gynaecologists, which include the recommendation that all pregnant women should at the very least be provided with an information leaflet on group B strep, as a tool to raise awareness and prevent what he has just described?
I fully concur with my hon. Friend and thank her for her intervention. In that regard, I would very much like to pay tribute to hon. Members in the all-party group. I look forward to joining them tomorrow to provide whatever little support I can.
It is wonderful to see the advances made and also the pledges made by the Minister, whether on maternity safety champions, funding for safety and training at hospitals or the national bereavement care pathway. I for one most sincerely hope that he and the Government will continue in this endeavour to ensure that we make further advances and minimise the trauma suffered by so many.
It is a pleasure to follow the hon. Member for Slough (Mr Dhesi), who talked very touchingly about his own family experiences when they were affected by this terrible issue. It is also a privilege and an honour to speak in this debate in Baby Loss Awareness Week. Obviously it is humbling to hear all the different stories from fellow Members and parents on these Benches—they are such harrowing stories—and the bravery with which they are able to communicate them and raise this issue.
This is the most harrowing thing that can happen to any parent. I speak as a parent of four children, one of whom is about to reach his 21st birthday, but this is a fear that will never leave any of us, whatever age our children are. Although we got to four children, we had a number of mishaps and miscarriages along the way, and the hope for those affected is that as more children come along the way, that pain eases a little bit.
It is a pleasure to have the opportunity to introduce my own private Member’s Bill to deal with some of these issues—actually, I have merely been passed the baton by my hon. Friend the Member for Colchester (Will Quince), who has done so much work on this. My private Member’s Bill would allow parental bereavement leave. We heard an incredible story from my hon. Friend the Member for East Renfrewshire (Paul Masterton), who talked about an employer who would not let somebody affected by this terrible tragedy have time off work. That is absolutely outrageous, but the reality is that in those circumstances—the death of a child—there is no statutory requirement for an employer to let staff have time off. I cannot imagine the distress that that must cause people affected by these terrible tragedies—tragedy upon tragedy—or how terrible the effect must be on the workforce of that employer, with everybody having to hear about it.
Most employers, of course, do not take that approach. I speak as an employer, both here—we are employers in this place—and in my life before Parliament. As an employer, we would not need the Government or anybody else to tell us to give people affected by this tragedy leave. Of course we would do that, and we would pay them whatever pay they were due. Sadly we cannot be that generous in our private Member’s Bill, but I encourage all Members please to attend the Second Reading debate on my Bill next Friday, to contribute and to make sure that we look at all the issues and circumstances. It is wonderful to hear that people are willing to share their circumstances, because it will help us to make sure that the legislation is in the right place.
The Bill would require all employers to provide at least two weeks’ leave for all staff affected by this kind of tragedy. I am delighted that the Government are supporting the Bill, which gives us a very good chance, given the extended time we have to get it through—unfortunately my hon. Friend the Member for Colchester was unable to get it through in the last Session because of time constraints. It fits very neatly with the Government’s pledge to enhance rights and protections in the workplace, so it is exactly where we need to be. Making sure that every employer provides such protections for people in their time of loss is the least we can do.
I thank my hon. Friends the Members for Colchester, for Eddisbury (Antoinette Sandbach) and for Banbury (Victoria Prentis) for their tremendous work in this area. Over the summer months, we have been working with employers, charities and unions to make sure that we get the legislation to the right place, as I am keen to do. The legislation will help bereaved parents not just of babies but of children all the way up to their 18th birthday.
I am sure that we all have touching stories from our own experience, or from constituents who have come to us. Some members of the all-party group will be familiar with Annika and James Dowson, and with Luke and Ruthie Heron. The Dowsons lost their little child, Gypsy, who was stillborn. The Herons lost Eli after 23 weeks and six days, but he managed to survive for another two and a half days. Had he not done so, their loss would have been classed as a miscarriage rather than a stillbirth. They are championing the need to look at the legislation in that regard, and Annika and James put all their efforts into raising money for a bereavement suite in Scarborough. There are some tremendous and touching stories of the hope that has come out of these tragedies. If the Bill eases the unimaginable pain of just one family, our collective efforts will be worthwhile.
I pay tribute to the bravery of the many people who have described very personal and moving experiences in the Chamber this evening. I have experienced this issue from a different angle, in a professional capacity. As a consultant paediatrician, I have been privileged to see many hundreds of babies come into the world. I can honestly say that the joy and the miracle of that event, in whatever circumstances, is not diminished by having seen it on numerous occasions.
As a junior doctor, one is fortunate to see many happy occasions when babies are born in good health and at full-term. As a consultant, one is called only when either the mum or the baby is in significant trouble. That might be when the baby is very premature, when the baby or mum is very sick—for example, following a road traffic accident or with sepsis, which we have heard about here before—or when the baby is, sadly, born without a heart rate.
I can remember occasions from my professional experience when I have had to give parents the news that nobody—I speak as a parent of three—ever wants to hear, and no doctor ever wants to give: that a baby or child is, sadly, going to die. I remember holding one particular infant in my arms, because his parents were not able to do so, as he passed away. There is no doubt that we need to do everything we can—NHS professionals work very hard every day—to make sure that that does not happen, but unfortunately it does. I welcome the Government’s target to reduce the incidence of stillbirth by 50% by 2030.
I want to talk about some of the changes that have been made during my career. I graduated as a doctor in 2001, and I worked as a consultant paediatrician in the NHS, particularly in neonatal care. A number of changes in neonatal care have led to improvements over this time. There has been an increasing centralisation of neonatal care, so that the smallest and sickest infants are cared for in areas of significant expertise. This has helped to reduce mortality, particularly for the smallest and sickest babies. It has also led to a need for transportation. A baby who is born in a small district general hospital may need to be transferred many miles—sometimes hundreds of miles—to a hospital that has the expertise to care for their particular problem. When I was a junior doctor, that meant the doctor who was on shift, such as me, getting into the back of a 999-called ambulance and taking the baby in an incubator to wherever they needed to go.
Over the past few years, that has changed considerably. We now have clinical networks and areas of the country are divided up into patches in which there is a dedicated clinical team, led by a consultant neonatologist, with nurses and doctors who have specialised in this area. In many cases, there is a dedicated ambulance, as well as helicopter transport, to come and retrieve babies from whichever hospital they are born in and to take them to such a centre of expertise. That has been a big improvement in the care we offer children during the time that I have been a doctor.
As was mentioned earlier, another thing we have done is to focus much more on the lessons that we can learn. As a doctor, the first infant I saw who died was a young boy whose death was, sadly, entirely preventable. There was an investigation and lessons have been learned, but that does not take away from the horror of the occasion. It was an awful experience for the family, and it was traumatic for everybody involved. As an introduction to being a junior doctor—although I took no responsibility for it all medically—it was very traumatic, as it was for everybody.
We now have regular meetings to look at the cases of children or infants who have died, suffered significant injury or become more unwell than we anticipated, and where any type of adverse event has occurred. Such cases are looked at in detail by a multidisciplinary team, which goes stepwise through the process from the child being conceived or being referred to hospital and asks what has happened, why it has happened, what could have been done better and what would have changed the outcome. Although we would like to prevent every case, the reality is that, while we will get closer to doing so, we will never prevent every death, in my view. We should, however, prevent every one that can be prevented, and I very much welcome the Minister’s statement about improving the way in which cases are reviewed and about making that a statutory requirement.
I welcome the contribution of my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) in relation to child bereavement leave. He is right to say that most employers, like him, are very flexible in dealing with people whose infant may be very unwell in hospital for several months at a time, but some are not, and that places an enormous pressure on such people. I also welcome the national bereavement care pathway. All the hospitals in which I have worked have had bereavement rooms and I think they provided good care to bereaved parents and families, although I know that that is not accepted as a universal statement.
Will the Minister look in detail at the evidence on group B streptococcal infections, and at any evidence relating to whether women should be screened for that in pregnancy?
The centralisation of tertiary neonatal services has been a good thing in making the survival outcomes for babies better. We are now focusing not just on survival but on improving the quality of life, particularly for pre-term infants, such as by improving ventilator settings so that their vision is improved and their lung function is better as they grow up. However, centralisation also has an impact on families. For example, for a baby born in my constituency, the nearest tertiary neonatal centre is Nottingham, and if it does not have a bed, they might be sent further afield to Sheffield, Leicester or Norwich. For people looking after older children at home—having to take them to school, for instance—trying to manage having a baby several hours’ journey away will have a huge impact on the family. It also has significant cost implications, and I not infrequently see parents, particularly in working families on low incomes, who are struggling with the financial implications of travelling to visit their desperately sick baby who is several hours away.
Overall, I think there have been many welcome announcements in this field today.
May I say how honoured and humbled I am to follow so many hon. Members on both sides of the House who have made moving speeches about their own experiences, and those with very deep professional knowledge, chief among whom are the hon. Member for North Ayrshire and Arran (Patricia Gibson) and my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson)? May I also thank all the members of the all-party group—we have heard from my hon. Friends the Members for Colchester (Will Quince), for Banbury (Victoria Prentis) and for Eddisbury (Antoinette Sandbach)—whose passion for and commitment to this most important of all causes really shines through, as I am sure everybody on both sides of the House agrees? I thank all those who have spoken today through their own pain, as well as all those constituents who have written to all of us to enable us to raise in the Chamber a cause that matters so much to them. If they did not write and share those very difficult stories, we would not be able to do half as much to help.
In my brief comments today, I shall give voice to concerns that my constituents have raised, and I want to support all my colleagues, on both sides of the House, who are working so hard to make change, reducing the number of deaths in these most tragic circumstances and providing help to parents when, regrettably, deaths do occur. I am very grateful to my hon. Friend the Member for Banbury for mentioning my little boy Henry. I am experiencing the joy of being a new father. I can only imagine the trauma that any parent would feel, having lost someone in those circumstances. There is no doubt that a greater trauma for a parent could not be imagined.
I shall take a brief look at the statistics. As has been said, this is a very human subject—not one for pie charts or statistics—but I think we ought to look at them, if only to consider how far we have to go, and how much more space we need to cover to get close to a situation where stillbirths, and births in labour and shortly afterwards, are reduced to the lowest possible level. One in four pregnancies will end in miscarriage; 200,000 mothers and their families are affected every year; 3,245 stillbirths were recorded in 2014 by MBRRACE-UK. In 46% of stillbirths, the causes are unknown. That is a horrifyingly high statistic, and it is vital that we continue—I am grateful for the Government’s efforts in this respect—to research, so that we can find out the causes of as many conditions as possible. It surely is not something we can be happy about, or be content to tolerate, that the rate of stillbirth in this country is higher than in so many European countries, including Germany, Sweden, Poland and Estonia.
It is a sad fact that in so many cases, the causes of death are potentially avoidable. Many who have spoken today have far greater experience and knowledge than I have, and I do not pretend to tell the House about those points, but it seems to me that the Government should consider mounting an education campaign so that mothers can, where possible, avoid any risks—the risks, for example, of smoking in pregnancy are well known, and they need to be made clear to everybody—and recognise the signs of an impending problem.
The MAMA Academy creates some fantastic wallets. I suggest that my hon. Friend writes to his local hospital trust and urges them to provide those wallets to their mothers-to-be. I know that the Countess of Chester is doing that for mums served by that trust. Each wallet has a lot of information on the front, which helps parents know when they should start worrying, because it alerts them to the signs that mean they should go to hospital and get scanned.
I am very grateful for that helpful intervention. I will almost certainly do that. [Interruption.] No doubt my hon. Friend the Member for Banbury will assist. That will be most welcome to mothers—and indeed fathers, who of course worry equally about such risk factors. That will be a great deal of help.
I wonder whether the Government would also consider the subject of scans. I am conscious that in this country we do not scan past 20 weeks, and that in Finland, which has one of the lowest rates of stillbirth in the world, there are much more frequent scans, continuing into the third trimester. Indeed, in that country, they also have regular checks on very young children. I appreciate that there are many important claims on resources, but ask the Government to continue to look at that because the causal link between Finland’s success and regular checks should be considered.
The theme of Baby Loss Awareness Week is support for bereaved parents and today, of all days, is World Mental Health Day. When tragic circumstances occur, all possible support must be available to parents. Nothing will ever make amends for the loss of a child and nothing will ever take them back to the day before that loss occurred. As anyone who has lost someone will realise, however, while the situation is never “better”, the realisation that you are not alone can and does help. We ought to bring that support to as many people as possible. I welcome the Government’s bereavement care pathway and the assistance provided for it by the all-party group.
My hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake), who is in his place, is introducing a private Member’s Bill. One would like to think that employers would be sympathetic in such circumstances: that is a basic, human and natural reaction. I am very grateful to my hon. Friend the Member for East Renfrewshire (Paul Masterton), who gave us a very clear example of when that is not always the case. If ever there were a clear example of why the Bill is necessary, we have heard it today—and of course I support it. Compassion, as well as the time and support to grieve, is vital for parents in such tragic circumstances.
I would like to end my brief comments on a local note. I am very grateful to my hon. Friend the Member for Banbury for mentioning Horton General hospital, and I support and echo everything she says. Her passion is clear to all. Like her, I remain of the view that downgrading Horton’s maternity services is unsafe. I remain of the view that asking mothers in the late stages of labour to travel on the very congested roads between Banbury and Oxford, or from the north of west Oxfordshire in my constituency to Oxford, is unsafe. I fear for the consequences if that situation is sustained. I deplore the way the consultation was handled: looking at maternity services at the hospital in phase one of a sustainability and transformation partnership, when the issue of maternity services across the whole of Oxfordshire, and particularly west Oxfordshire and my constituency, must be considered. It is not helpful to look at such services in isolation.
The people of Chipping Norton have equally valid concerns over the future of their midwifery-led unit. It is clearly critical in such an isolated rural area, where the weather has an effect on traffic on our congested roads, for expectant mothers and families to have access to full, high-quality midwifery and obstetrics care throughout the whole of Banbury and the north of west Oxfordshire. I will continue to work with my hon. Friend the Member for Banbury and others to ensure access throughout west Oxfordshire to the very highest quality maternity services.
This has been a compelling debate, which has once again shown the House at its best. I welcome the fact that we are discussing these issues again in the Chamber as part of Baby Loss Awareness Week. I hope that these extremely valuable debates will become an annual fixture, because they provide us with a very valuable opportunity to raise awareness of the work of the 40 baby loss charities who work together as the Baby Loss Awareness Week Alliance. They also give us the opportunity to assess what progress has been made in meeting our shared ambitions to improve prevention, treatment and bereavement care.
I recognise the work of the all-party group on baby loss. It is true to say, as a number of Members have today, that it has played a key role in ensuring that this issue is kept at the top of the Government’s agenda, and that some of the taboos that have so often surrounded this subject are broken down. There have been a number of excellent contributions from Members on all sides and I am grateful for the opportunity to be able to draw attention to some of them.
The hon. Member for North Ayrshire and Arran (Patricia Gibson) mentioned coroners’ inquests and fatal accident inquiries for stillbirths—an issue she has raised on a number of occasions. I pay tribute to her for her persistence in that campaign. She certainly made a compelling case that such inquiries would inform good practice and, more importantly, bereaved parents may get answers that they have not previously had.
The hon. Member for Colchester (Will Quince) spoke with great passion and personal experience, and in his capacity as the co-chair of the APPG. He touched on a range of issues and highlighted the importance of mental health. I was rather troubled by what the hon. Member for Banbury (Victoria Prentis) said. I certainly recognise her description of a culture of defensiveness in certain trusts. She was absolutely right that most parents want answers, not compensation. We need to do more about the way in which the NHS handles these issues.
My hon. Friend the Member for Nottingham South (Lilian Greenwood) told us about her constituents, Jack and Sarah, who have recently spoken publicly about the tragic circumstances of the death of their daughter, Harriet. They felt that what they were told was not correct and want coroners’ inquests to be available for stillborn children. As my hon. Friend said, there seems to be growing cross-party support for such a move. I assure her that the Opposition Front Bench will do what we can to assist in making that campaign a reality.
The hon. Member for Eddisbury (Antoinette Sandbach), who also co-chairs the APPG, was right to pay tribute to the NHS staff who have really taken up the challenge laid down by the APPG of improving the experience for parents. She rightly drew attention to the wider public health factors that we need an awful lot more work on, and raised an important point about the need for CCGs to commission bereavement counselling consistently across the board. It is often a concern that CCGs do not commission services consistently across the country, so more examination and accountability is required.
My hon. Friend the Member for Kingston upon Hull North (Diana Johnson) spoke about her constituent’s son, William, whose ashes were scattered without his family’s knowledge. She spoke about this in the debate last year, so I am sorry to hear that there are still many unanswered questions. I hope that she does not have to come back to this debate next year to raise the same issues.
My hon. Friend the Member for Slough (Mr Dhesi) spoke about the terrible circumstances affecting one of his constituents and the need to improve awareness of group B strep. In last year’s debate, the right hon. Member for Mid Sussex (Sir Nicholas Soames) advised the House that one baby a day develops group B strep. We should be able to do a lot more about that, given that it is a largely preventable infection.
The hon. Member for Thirsk and Malton (Kevin Hollinrake) highlighted well the gaps in the law on bereavement leave. I wish him success with his private Member’s Bill. He made the valid point that we are also employers, so it is probably worth us examining the Independent Parliamentary Standards Authority terms and conditions following the debate to see whether there is anything more we can do to ensure that we are an exemplar.
We were privileged to hear from the hon. Member for Sleaford and North Hykeham (Dr Johnson), given her professional experience. She conveyed well how difficult it is for staff in some of these situations. Her reflections on her last 16 years in practice were informative and positive, and she made some excellent points about areas in which we can do better. I hope the Minister will take those points on board.
As we have heard from many hon. Members’ contributions today and in previous debates, the efforts of people here and among the public have gone a long way towards breaking down taboos. I pay tribute to those who have done so and the efforts of others in the public eye to raise awareness. For example, “Coronation Street” had a storyline involving a stillbirth earlier this year. I am sure that such television programmes have an even greater reach than Parliament TV. What made that storyline so poignant was that Kim Marsh, whose character portrayed the stillbirth onscreen, herself suffered a bereavement eight years before. She said of the broadcast that
“sharing is absolutely imperative to being able to put the pieces of your jigsaw back together”.
That is incredibly sound advice.
Many parents have spoken of the isolation they can feel, and we have heard from hon. Members today about how that has been a taboo subject for a very long time and about the difficulty people can have in discussing the loss of their child for what seems like many years. A constituent of mine, Nicole Bowles, is in that situation. She has set up a campaign, called Our Missing Piece, to make it easier for parents to let other people know that their family is missing a loved one. She has designed a badge for bereaved parents to wear as a way of telling the world that they are dealing with child loss. Her ambition is very simple but could have a very positive impact. She says:
“I hope that by creating this badge it helps to show that: It’s OK to talk to us; It’s okay to ask if we’re alright; It’s okay to say their name.”
I commend her campaign and I hope that this debate has gone some way to conveying the sentiments she expresses about the need to talk about these issues and break down the barriers that have been there for too long.
We know from the recent review of stillbirths and neonatal deaths in the UK that of the 782,720 births in 2015, 3,032 were stillbirths and 1,360 were neonatal deaths. This amounts to about 12 stillbirths or neonatal deaths every day. That is a huge number of families each and every week experiencing one of the biggest, if not the biggest, tragedy of their lives. It is a difficult figure to process, particularly because, as the hon. Member for Witney (Robert Courts) said, sometimes these deaths could have been avoided.
It is of course positive that perinatal mortality has decreased in this country, but the level of progress has not been good enough. According to The Lancet, the annual rate of stillbirth reduction in the UK has been slower than that in the vast majority of high-income countries. One of the key reasons for that is the high level of variability in the services offered. This country offers some of the best neonatal care in the world, along with some exemplary psychological and bereavement support, but unfortunately that is not available equally to everyone. Last year, NHS England reported a 25% variation in stillbirth rates across England. That is a startling figure, but it demonstrates that we have the capability to meet and exceed the Government’s target to reduce the number of stillbirths by 20% before 2021 if we ensure that everyone has access to the very best care and treatment. I welcome the progress the Minister referred to earlier towards meeting that target, and I hope that he will be able to update us annually on progress. I also invite him to consider whether it would be appropriate to expand the scope of the Government’s ambitions to focus also on reducing the number of premature births, given that prematurity contributes to a significant number of stillbirths and neonatal deaths each year.
As well as variability, another area where we need to make significant progress is ensuring safe staffing levels at all times on all neonatal units. The 2015 Bliss report “Hanging in the Balance” found that 64% of neonatal units did not have enough nurses to meet the national standards on safe staffing and that 70% of neonatal intensive care units regularly looked after more babies than was considered safe. As we know from exchanges this morning in departmental questions, there are huge challenges in the workforce at the moment, and the Government have set out their strategy to deal with them, so I hope that we will see progress. It is certainly something that we will be monitoring closely.
Finally, I turn to the key theme of this year’s Baby Loss Awareness Week, which the hon. Member for Colchester referred to: bereavement care. This is an area that stretches from the level of support available immediately following a neonatal death to the medium and long-term support available to families. I welcome yesterday’s announcement on the national bereavement care pathway, which will see 11 sites in England trial the use of new materials, guidelines and training for professionals. The trial, leading to a full roll-out in a year’s time, has the potential to tackle long-standing and unacceptable variances in bereavement care and ensure that all bereaved parents are offered equal, high-quality, individualised, safe and sensitive care, which is something everyone in the House wants to see.
I suspect that the challenge of a successful roll-out will be ensuring that sufficient time is set aside for the training that staff will need. I welcome the news from the Minister about the funds and support that will be available for the delivery of that training, but we must recognise that training is a continuing process, and we must keep an eye on progress in the years to come. As I said earlier, another big challenge is ensuring that the workforce are in a position to deliver the pathway. Last year, Sands found that 38% of maternity units did not have a specialist bereavement midwife based there, while Bliss has found that 30% of neonatal units do not have access to any psychological support.
There is also a need for capital investment. We have heard from a number of Members today about the importance of bereavement suites, and we know that one in three trusts and health boards does not have a dedicated bereavement room in each maternity unit. I am aware that the Government have ambitious plans to release significant parts of the NHS estate, and I should be grateful if the Minister could reassure us that there will be consideration of the shortfall in the number of bereavement suites before any disposals proceed.
There is much more to be done, but I think the hon. Member for Eddisbury (Antoinette Sandbach) summed up the position well when she said that, for the first time, there was some hope. Let us continue to move forward in that spirit.
I am grateful for the opportunity to respond to some of the points that have been raised during this excellent debate. It is important to recognise and welcome the cross-party support from Members, including the hon. Member for Ellesmere Port and Neston (Justin Madders). We heard 14 contributions from other Members, including five, by my count, who have personally suffered—or their families have suffered—the loss or miscarriage of a baby, as well as two from experienced doctors: my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) and the hon. Member for Central Ayrshire (Dr Whitford), who brought their particular expertise to the debate. I am grateful for the support from Members on both sides of the House for the Government’s action plan—for what we have done in the 12 months since our last debate on this subject, and for what we are planning to do.
A number of issues have been raised today. I will not go into detail about Members’ constituency concerns, although I will say to the hon. Member for Kingston upon Hull North (Diana Johnson) that when, as a Shropshire Member, I was dealing with one of my constituents who suffered an inability to find out what had happened to the ashes of the baby they had lost, which was similar to what occurred in Hull, my experience was of talking to the local authority and persuading it that this was the right thing to do. I should be happy to help the hon. Lady, if she needs help from the Department, to emphasise again to her local authority that it is indeed the right thing to do.
Members have challenged me on a couple of issues, particularly that of coroners’ reports. We are introducing a perinatal mortality review tool to allow investigations to be undertaken, with information collated in a manner that can then inform and be learned from. We will watch with interest what happens in Scotland, but at this point I think we need to get the tool working and see how it goes. In my opening speech, I mentioned the health service safety investigations branch on which we are consulting. We envisage it as having a role in looking at some of the more extreme cases, but only if it decides to do so.
A number of colleagues talked about the use of private Members’ Bills to try to drive this agenda forward. I can confirm to my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) that the Government will support his Bill on bereavement leave, which was also mentioned in the excellent speech of my hon. Friend the Member for East Renfrewshire (Paul Masterton). I cannot promise that we will support all the other measures that the all-party parliamentary group comes up with, but we will certainly look at them with interest.
Following last night’s launch of the national bereavement care pathway, I am particularly pleased, in Baby Loss Awareness Week, that that has received so much support from the APPG, the charities and the healthcare professionals who work in this field. Finally, let me say a big thank you to all the midwives, doctors and healthcare support workers who do such a fantastic job, delivering more than 700,000 babies successfully and also helping parents who, sadly, do not experience the happiness of a healthy baby.
Question put and agreed to.
That this House has considered Baby Loss Awareness week.