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Neonatal Leave and Pay

Volume 708: debated on Wednesday 9 February 2022

Motion made, and Question proposed, That this House do now adjourn.—(Steve Double.)

Every year in the UK, tens of thousands of babies receive neonatal care. For the families of these children, the experience can be life changing. Neonatal care is the type of care that a baby receives in hospital if they are born premature, full-term but with a condition or illness that needs medical attention, or with a low birth weight. Rather than families bringing their child home shortly after birth, the child is admitted to a specialist neonatal care unit to receive the support that ensures they receive the best possible chances of survival and quality of life.

A wealth of evidence already exists that shows that, for children in neonatal care to have the best possible outcomes, they need their parents to be as involved in their care as much as possible and as early as possible. The Government already agree with this, and that the current leave and pay entitlements do not adequately support parents when their child is born sick or premature and requires neonatal care.

Many parents and campaigners have welcomed the proposals wholeheartedly to deliver neonatal leave and pay that will allow parents to take additional time off work when their child is in neonatal care, ensuring that they are no longer in the impossible position of having to choose between keeping their job and spending time with their baby. I am grateful to have secured this Adjournment debate to highlight the importance of delivering the Government’s commitment to delivering neonatal leave and pay by a set target date of 2023, and to make the case for how those in all parts of the House can work together to overcome the challenges and provide this vital support for families at the earliest possible opportunity.

First, I commend the hon. Gentleman for securing this Adjournment debate. I welcome this discussion as an essential part of employment reform, and I support him fully in his wish to expedite legislation so that both parents can take this leave together as a shared benefit. For that reason, I understand he will have lots of support right across the Chamber to achieve his goal.

I thank the hon. Gentleman for his support because for me, like for so many parents, this is personal.

In my own family’s case, my wife was admitted to hospital 22 weeks into her pregnancy following a number of complications, and we were completely unprepared to be told at that point—22 weeks in—that she could give birth at any time and that she would have to stay in hospital for the duration of the pregnancy, as well as that if she did go into labour, our baby might not survive long after childbirth, and if they did, the overwhelming likelihood was that they would live with significant disabilities or challenges.

Even with the incredible and compassionate support that you receive from neonatal intensive care unit consultants, taking you through every step and answering every question, there really is nothing that can prepare you for that type of conversation or for the choices that you are asked to make. I know that all parents deal with that in their own different way, but for me it left a mark that I know will never really leave me.

In our case, like so many others, this meant staying in hospital and praying every single day that the pregnancy lasted as long as possible. Every day feels like a month, but also like an incredible accomplishment, and I was in complete awe of my wife and so many other women who handled everything so magnificently. Six weeks later, our son, William, was born on 6 January last year, weighing just 2.4 lbs.

We did not know that our son was not breathing when he was born—we found that out a lot later; I cannot remember exactly when—but I do remember being told that he was going to be okay, and my wife was able to hold him for a few moments before he was taken to neonatal intensive care, where he stayed for 72 very long days before coming home. I would like to take this opportunity to thank the incredible team at Southmead Hospital and our midwife, Bev Alden, who was genuinely superb in going above and beyond the call of duty to support us.

The reason why I have highlighted this point about the journey before birth to the Minister at the start of this debate is to make the serious point that, for so many people, having a premature child is a very long journey. It does not start the day the child is born; it can start weeks or months beforehand. Delivering neonatal leave and pay supports families in one part of that journey, but not for the whole journey. There is more that Government, businesses, organisations and individuals can do to support them, but neonatal leave and pay is one thing the Government can do quickly.

Currently, the parents of a child in neonatal care rely on their existing statutory leave entitlements so they can be off work while their child is in hospital. That means that parents spend a proportion of their maternity or paternity leave with the baby in hospital. Babies who have spent a long time in hospital after birth are usually at an earlier stage in their development when their mother or parents go back to work, in comparison with their peers. That can be particularly challenging for mothers, many of whom would have liked to have additional time with their child but cannot afford to take any more time off. That leads only in one direction—less parental involvement in care, causing immense stress and leaving parents unsupported. It reduces the opportunity for bonding time with their child.

The current system is also a massive barrier for fathers and non-childbearing parents in particular. Earlier this week, 75% of parents who responded to a survey from Bliss, the incredible charity, said that they or their partner went back to work before their baby was home from hospital. Some of those children will still have been on ventilation and receiving critical care. Previous research suggests that the most common reason for that is they simply cannot afford to take more time off work. That is happening every single day, right around the country, to families of premature and sick children.

Paid leave for parents of babies in neonatal care already exists in different countries around the world. In Ireland, paid maternity leave is extended by the amount of time between birth and the original expected birth date, and there is a similar system in Germany. In Sweden, maternity leave begins at the point the baby is discharged from hospital, rather than the birth date. Here in the UK, the Government and we, generally, have a record of supporting parents to be proud of. We have a generous and flexible system for many parents. The Government and the Minister are committed to making the UK the best place possible to live and work, and that includes the ability to grow and raise a family. That is why so many people were delighted by the Government’s commitment to finally deliver on neonatal leave and pay and to put it in the last manifesto.

I want to make the point of the significant mental and emotional toll on parents in the situation of having a child in neonatal intensive care. Research by Bliss back in 2018 shows that 80% of parents who have a child admitted to neonatal intensive care felt that their mental health suffered, and a huge 35% of parents report that their mental health was significantly worse after time on the neonatal unit. Regardless of the circumstances, parents want to be with their children. That is obvious; all parents will say that. But when your child is so small and vulnerable, it is painfully difficult to be apart from them. You just want to be there.

Even when they are in the best possible hands, a NICU can be a really worrying and scary place to be. They take some getting used to, because you are with lots of new people, there are children in very difficult circumstances and just because of the noise—the constant beeping from equipment around the unit takes getting used to. The mental pressure on parents is huge. I would say to anyone trying to understand the experience, imagine having to sit with your child in an incubator or having to learn how to feed your child through a tube, while worrying whether you can afford to pay your bus fare home. For too many people, that is the case.

Imagine going through this journey while feeling guilty about not spending time with the children you have at home, because you are in the NICU every spare minute of the day. You feel guilty, because you are unsure how to hold and support your child. When you do have time at home, I promise every spare minute is spent in a permanent state of worry about receiving unscheduled telephone calls from the hospital bearing bad news, which, for too many, do come. You worry about the pressures that it puts on you as a family, and about how you would cope as a family unit if the worst were to happen. I distinctly remember our darkest day when we were told that our son was going downhill quickly and he was going to be treated for necrotising enterocolitis, and that one potential outcome for which we would have to be prepared was for him to be transferred to a hospice.

Let me make this point to the Minister: we cannot expect parents to be worrying about whether they will have a job to go back to while dealing with these situations. The Government agree with this—there is no disagreement—so it is time for us to work together to deliver it. The Government want to do it, and I know that the Minister does as well. He has been hugely supportive to me and to colleagues on both sides of the House who have talked to him about this issue on a number of occasions. I thank him for his help, and I also thank the Government for the work that they have done on the issue since the general election.

In the March 2020 Budget, the Chancellor reaffirmed the Government’s ambition to deliver this important reform, and earmarked the necessary funding to deliver the policy in 2023-24. In the same month, the response to the consultation was published. It confirmed a number of further details about the delivery of neonatal leave and pay, including the intention to legislate through the Employment Bill. I was pleased to hear the Prime Minister, during Prime Minister’s questions in November last year, repeat the commitment to deliver legislation “one way or another”.

So we all want to do this. The question is how are we going to do it, when, and through what vehicle in Parliament? Ministers have made clear that they want to do it through the Employment Bill. The argument I would advance to this Minister is that the Employment Bill is significant and substantial legislation that will take time to pass through Parliament. While neonatal leave and pay enjoys widespread cross-party support, many wider aspects of the proposed Bill are likely to face far greater opposition. Despite the uncontroversial nature of the proposal, tying its successful delivery to the more controversial Employment Bill is not the fastest way in which to secure its introduction.

Generally when we are introducing reforms of this type, they take effect from April, at the start of the financial year. In order to meet the 2023 target for which the Government have set aside funds and to which they have committed themselves, neonatal leave and pay legislation will need to have passed through Parliament before that date, in enough time to ensure that Her Majesty’s Revenue and Customs and employers are given sufficient notice. If we are to meet the commitment to deliver this on time, we need to start now.

I wrote to the Minister about the issue in October, and he kindly wrote back to me, informing me of the progress that his Department was making. He also made it clear that significant work was required for the policy to be delivered, including the extra work that would have to be done by HMRC to ensure that staff were ready to upgrade the necessary IT systems. The policy will take time to implement, and that is why I think there are legitimate questions to be asked about the delivery vehicle for this reform. I should be grateful if the Minister could confirm that the Government still intend to deliver it from April 2023.

I think that one clear way in which this can be delivered on time is through a stand-alone Bill. The policy development and the consultation have already taken place, and there is a precedent for passing reforms of this type through Parliament quickly. The Parental Bereavement (Leave and Pay) Act 2018 provides a clear model for us to pass this legislation. It is uncontroversial, and it has cross-party and cross-sector support. In the past, the Minister has made a point that I completely appreciate—that this will have to be delivered alongside other measures in the Employment Bill—but I should be grateful if he could explain exactly what those measures are, and also explain why they cannot be delivered as part of stand-alone legislation. I also ask him whether he will meet me, the new Leader of the House—assuming that my right hon. Friend is willing—and other Members to discuss how this can be delivered on time, which is what we all want to see.

I do not want to give too long a list, but I should be grateful if the Minister could update the House on the work that he and his Department have already done in anticipation of delivering this policy, to ensure that it will be ready on time and ready to go once we can find a legislative vehicle to deliver it. I should like to know whether, for example, the guidance is ready for the Department for Business, Energy and Industrial Strategy and HMRC, and how much work has been done. Finally, I should like to know whether the Department is starting to explore alternatives to deliver support for families if it proves difficult to legislate. I hope I have managed to convey at least a sense, on behalf of many families around the country, of how important this commitment is and how grateful we are to the Minister and the Government for making it. We all want to see it delivered and rolled out as quickly as possible. It is down to us to find the right vehicle for that, because delivering neonatal leave and pay will enable the thousands of babies born into neonatal care every year to benefit from their parents’ being where they should be, by their side, providing that vital care. It will also deliver support and reassurance to all those new mothers, fathers and carers who need it the most in the most vulnerable and stressful days of their lives. I say to the Minister, “The solution is clear, it commands widespread support and it is within our grasp—please help us to make it happen.”

I congratulate my hon. Friend the Member for Thornbury and Yate (Luke Hall) wholeheartedly on securing today’s debate. This is an important issue, and I am very grateful to him for bringing it to the attention of Parliament in the way he did, baring his soul. I know Roisin will be proud of him today.

We have heard his personal account that the impact of having a young baby in neonatal care has on parents, and the additional pressure that having to balance employment with caring for their child places on them. My hon. Friend has spoken with such depth of personal experience and it brings home that what we do here, when we are looking to bring forward the Employment Bill, and all the work the officials do matters. This really matters on a human scale to people on a day-to-day basis, as we have just heard. I am grateful to him for his candour, and for raising awareness of this issue. It is a shame that the rhythm of this House means that that speech has not had the audience in the Chamber, but I know people will be watching it and reading the account in the Official Report. Bringing this matter to our attention is amazing.

In the UK, an estimated 100,000 babies are admitted to neonatal care every year following their birth. Many of those babies spend prolonged periods of time on a neonatal care unit in a hospital as a result of having been born prematurely, or for other health conditions. It is, as we have heard, an incredibly worrying and stressful time for parents. They will naturally want to be able to focus their attention on getting through that period, supporting each other and their baby. However, some may have concerns about their ability to do that and keep their jobs. I sympathise with anyone who has found themselves in that position.

Currently, parents in those circumstances tend to rely on their statutory leave entitlements, for example maternity or paternity leave. In practice, that means a considerable proportion of their leave may be used while the baby in still neonatal care or that they do not have sufficient leave to remain with their baby for the necessary period.

A survey conducted by the charity Bliss in 2019 found that 66% of fathers had to return to work while their baby was still receiving specialist neonatal care, and that 36% of fathers resorted to being signed off sick in order to spend time with their baby in a neonatal unit. That can, in some cases, have a negative impact on their employment record. Fathers and partners may also experience negative effects on their physical and mental health from trying to combine work with caring for the child and the mother. Other parents of babies in neonatal care have reported that they had to return to work earlier than they had planned due to suffering financial hardship from being away from work.

Considering those different scenarios, it is clear that the current leave and pay entitlements do not adequately support parents of babies in neonatal care. In March 2020, following a Government consultation on the issue, we committed to introducing the new entitlement to neonatal leave and pay, and I can assure my hon. Friend that we remain very much committed to that. Our planned neonatal leave and pay entitlement will allow parents to take additional time off work in circumstances where their child is admitted to neonatal care, ensuring that they are no longer in the incredibly difficult position of having to choose between risking their job and spending much-needed time with their baby.

Neonatal leave and pay will apply to parents of babies who are admitted into hospital up to the age of 28 days and who have a continuous stay in hospital of seven full days or more. Eligible parents will be able to take up to 12 weeks of paid leave on top of their other parental entitlements such as maternity and paid paternity leave. Neonatal leave will be a day-one right, meaning that it will be available to an employee from their first day in a new job. Statutory neonatal pay, like other family-related pay rights, will be available to those employees who meet continuity of service and minimum earnings tests.

While we understand that the introduction of neonatal leave and pay will create a small burden on businesses, we believe that the benefit to business will outweigh any costs. Policies such as neonatal leave and pay that enable parents to participate in the labour market and to succeed and progress in work not only benefit individual employees but give employers access to a bigger pool of talent. Such reforms will also help businesses, because employers who embrace family-friendly policies are so much more likely to see greater employee loyalty, commitment and motivation.

In addition to our plans to introduce neonatal leave and pay, the UK has a range of policies in place that support employees to balance work with family life and other personal commitments and responsibilities. They include: a right to request flexible working; generous family-related leave and pay entitlements; and protections from detriment for parents who take or seek to take family-related time off work. The UK’s maternity leave system is one of the most generous in the world. Pregnant women and new mothers are entitled to take up to 52 weeks of leave—that is a day-one right with no qualifying period of service—and up to 39 weeks of statutory maternity pay if they are eligible. Maternity leave can be started up to 11 weeks before the expected week of childbirth.

Fathers of premature babies have the flexibility to take their one or two weeks of paternity leave and pay within eight weeks of the expected date of birth rather than having to take the leave within eight weeks of the baby’s actual birth, if they wish. We also have a manifesto commitment to make paternity leave more flexible and will set out our response on that in due course.

The right to emergency leave—time off for dependants —allows all employees a reasonable amount of unpaid time off work to deal with an unexpected or sudden emergency involving a child or dependant and to put care arrangements in place. Additionally, all employed parents have a right to up to 18 weeks of unpaid parental leave for each child up to a child’s 18th birthday.

The Government are committed to introducing new employment measures as we seek to build a high-skilled, high-productivity, high-wage economy that delivers on our ambition to make the UK the best place in the world to work and grow a business. I reassure my hon. Friend that further detail on reforms to our employment framework will be published in due course. Naturally, covid-19 has affected our progress in introducing the new entitlement to Parliament, but we remain committed to doing so as soon as parliamentary time allows. In the meantime, we are moving forward with the work. That includes working with lawyers on our legislative approach, which is likely to include both primary and extensive secondary legislation, as well as considering how the entitlement will be implemented. It will also, in due course, require accessible and thorough guidance for both employers and employees.

As I mentioned, delivery of the new entitlement will need primary legislation as well as changes to the HMRC IT payment system to allow employers to administer statutory neonatal pay on behalf of the Government. Officials are in discussion with HMRC colleagues about the establishment of that IT system. It is a large-scale project, and we are ensuring that the relevant teams in HMRC are as prepared as possible, that they fully understand what is required and how much resource will be needed. We are doing the necessary groundwork so that we are in the best position to implement neonatal leave and pay once legislation is in place.

I recognise my hon. Friend’s points about whether the entitlement could be delivered through a stand-alone Bill or alternative measures. Due to pressures on parliamentary time, it might be challenging to introduce a stand-alone Bill, but we remain committed to introducing neonatal leave and pay and will do so as soon as parliamentary time allows. We understand and sympathise with the position of parents with children in neonatal care and remain fully committed to the introduction of neonatal leave and pay. In the meantime, we have other parental leave entitlements that are available to new parents and we encourage employers to continue to respond with flexibility and compassion to parents in that very difficult position. I have spoken to a number of businesses that have great schemes in place to deal with such life events, such as ASOS. I try to showcase that good work, because they do not need to wait for a legislative framework.

I close by thanking my hon. Friend for his incredible contributions to the debate and I thank everyone who has worked hard to raise awareness of the difficult situation of parents remaining in employment when their children are in neonatal care. As always, I would be delighted to meet my hon. Friend and other Members of the House to discuss the issues further as we move towards getting these provisions on the statute book.

Question put and agreed to.

House adjourned.