The Minister for Health (Stephen Barclay)
May I join colleagues across the House in paying tribute to my hon. Friend the Member for Eddisbury (Antoinette Sandbach) for securing this debate on Baby Loss Awareness Week? It is particularly appropriate, as today marks the start of the 2018 campaign. How we reduce the numbers of baby losses is an issue that unites the House, as has been very much reflected in the tenor of this evening’s debate. May I also say to my hon. Friend the Member for Colchester (Will Quince) that I am sure that all in the Chamber will be thinking of Robert and him on Friday, as he marks that particularly poignant fourth anniversary?
My hon. Friend the Member for Eddisbury raised a number of important points in her speech, including about the national bereavement care pathway and the ongoing investigations at the three hospitals in England and Wales. I will address those shortly. She is right to recognise the higher profile that this issue has received in recent years, this being the third such debate in the last three years. That is very much testament to the work of the all-party group on baby loss and in particular my hon. Friends the Members for Eddisbury, for Colchester and for Banbury (Victoria Prentis), who is not in her place, the hon. Member for Washington and Sunderland West (Mrs Hodgson), to whom my opposite number correctly paid tribute and who very much moved the House in a previous debate, and the hon. Member for North Ayrshire and Arran (Patricia Gibson), who quite rightly spoke of Kenneth, who is very much in her thoughts and reflects much of the work that she has done in this place. The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) also made the point very well that this issue affects the family as a whole, including grandparents.
Martin Docherty-Hughes (West Dunbartonshire) (SNP)
I join the Minister in congratulating all the Members who have brought this issue to the Floor of the House today and especially the hon. Member for Eddisbury (Antoinette Sandbach) on securing the debate. The Minister has talked about the family, and we have heard much about the emotional journey for mothers and fathers who experience loss. We are living now in a more equal society, in which more lesbian women are becoming mothers, and they, too, experience loss through the death of a baby or young child. Will he ensure that that is reflected in the opportunities to learn about the lived experience of mothers, to which my hon. and good Friend the Member for North Ayrshire and Arran (Patricia Gibson) referred, whether they have a husband or a wife?
Stephen Barclay
The hon. Gentleman makes a valid point. He will have noticed that my colleague the Minister for Women and Equalities was in the Chamber for part of the debate, and I am sure that those sentiments are very much reflected in the work that she is doing. I am very happy to work with him to ensure that the Government’s approach takes those points on board.
Before coming to the wider areas of progress and considering what still needs to be done to deliver the improvements that we all want to see, I will address some of the specific comments made by Members across the House. My hon. Friend the Member for Colchester rightly mentioned the inconsistency between trusts. I understand that Sands is asking for the national bereavement care pathway to be included in the CQC’s inspection framework for maternity. I am happy to write to the CQC to request that this becomes part of the inspection regime. I think that can build on the point my hon. Friend the Member for Eddisbury made about recent progress in Medway.
My hon. Friend the Member for Colchester also suggested a training module for midwives on bereavement. Again, I am happy to write to Professor Ian Cummings, the chief executive of Health Education England, on that point and to share the correspondence with the all-party parliamentary group. One of the objectives of the pregnancy loss review is to recommend options to improve maternity care practice for parents who experience baby loss, so that is part of that work.
My hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who so often brings her clinical expertise to debates, raised the issue of travel costs. The Patient Advice and Liaison Service can advise on eligibility for schemes, as this tends to be specific to individual trusts, but it can apply in certain instances, particularly when linked to benefit entitlement.
My hon. Friend the Member for Gloucester (Richard Graham), who is no longer in his place, mentioned the important work of the hospital chaplaincy, and I think that Members on both sides of the House recognise the support that chaplains can offer following baby loss. Indeed, the bereavement care pathway guidance recommends offering parents contact with the chaplaincy team, so the role of the chaplaincy will be given greater visibility as the pathway is rolled out across more trusts.
The hon. Member for Ellesmere Port and Neston (Justin Madders) rightly mentioned midwife numbers. We recognise that the workforce do face pressure, as is reflected in the 25% increase in the number of midwifery training places that the Government are committed to. Indeed, numbers have increased in each of the last four years. But he makes a valid point and we are focused on dealing with the workforce pressures.
As a number of Members have recognised, the Government have a clear ambition to halve the rates of stillbirths, neonatal and maternal deaths and brain injuries that occur during or soon after birth by 2025, and to achieve at least a 20% reduction in these rates by 2020. Since the launch of the national maternity ambition in 2015, the Government have introduced a range of evidence-based interventions to support maternity and neonatal services, under the leadership of the maternity safety champions, who are responsible for promoting safety in their organisations.
I am pleased to report that we remain on course to achieve our 2020 ambition. The stillbirth rate in England fell from 5.1 to 4.1 per 1,000 births between 2010 and 2017, representing a decrease of almost 20%, which equates to 827 fewer stillbirths. We currently have the lowest stillbirth rate on record. The neonatal mortality rate also fell from 2.9 to 2.8 per 1,000 live births between 2010 and 2016. Many Members will be aware that multiple pregnancies are at greater risk of perinatal death, so I welcome the findings in a recent MBRRACE-UK report showing that the stillbirth rate for UK twins almost halved between 2014 and 2016, with a fall of 44%. In addition, neonatal deaths among UK twins has dropped by 30%.
There are areas of progress, but as my hon. Friend the Member for Colchester rightly said, part of the focus of today’s debate is on the areas where we need to improve, not just on the areas where there has been progress. One key area relates to ethnic minority groups, where we know stillbirth and neonatal mortality rates are increasing rather than decreasing. The Government continue to work with others to develop and implement policies to tackle such inequalities. This is an area on which we would be very happy to work with the APPG. It is an issue of concern to Members on all sides of the House.
A number of Members raised the role of the Healthcare Safety Investigation Branch and the importance of identifying where there are lessons to be learned. My hon. Friend the Member for Sleaford and North Hykeham is right that clinicians must be free to speak up where mistakes have been made. Indeed, the former Secretary of State championed that in his work on patient safety. It is also why we are improving investigations into term stillbirths. There is a role for the Royal College of Obstetricians and Gynaecologists in terms of the Each Baby Counts programme. Considerable work is under way, part of which, as my hon. Friend the Member for Eddisbury recognised, is on ensuring that in respect of the investigations at the specific hospitals she mentioned the appropriate lessons are learned. She will appreciate that, as they are live investigations, I cannot comment on them in detail.
Evidence demonstrates that women who have a midwife-led continuity model of care are less likely to suffer baby loss. In March, the Secretary of State pledged that most women will receive such care throughout pregnancy, labour and birth by 2021, with 20%, or about 130,000 women, benefiting by 2019. This will help to bolster maternity safety and further improve care standards.
It is positive to see the impact that many initiatives can have on reducing baby loss, but the Government recognise the need to improve the care bereaved families experience. That is why the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), the Minister with responsibility for maternity care, recently announced full funding of £106,000 to the charity Sands to continue the roll-out of the national bereavement care pathway. I hope that reassures my hon. Friend the Member for Eddisbury that the value of the care pathway is very much recognised within Government. As my hon. Friend mentioned, this initiative has seen a positive response from parents and medical professionals, with 77% of professionals saying bereavement care has improved.
On pregnancy loss and the pregnancy loss review, which my Department commissioned earlier this year, the review has been considering the question of whether legislation should provide new rights to bereaved parents to register pre-24-week pregnancy loss, as well as investigating the impact of such losses on families and how care can be improved for parents who experience it. That review is currently scheduled to be completed in the new year. A number of very important points on that pre-24-week period were raised.
The Department of Health and Social Care and the Ministry of Justice have been consulting with coroners, patients’ groups and charities to consider the role of the coroner in relation to stillbirths. This is about ensuring that bereaved parents are given a full account of the events leading up to the loss of their baby and that important lessons are learned. The hon. Member for Nottingham South (Lilian Greenwood) in particular made a point on the role of coroners in an intervention. This work will continue over the coming months.
In conclusion, progress is being made. I think that was recognised in a number of the speeches this evening, particularly in respect of: the commitment to fund in full the national roll-out of the bereavement care pathway in 2018-19, for which guidance and resources have been released today; the ongoing pregnancy loss review, which is due to report in early 2019; the work being done by the Department of Health and Social Care and the Ministry of Justice regarding the role of the coroner in investigating stillbirths; the progression of the private Member’s Bill, which will have its Third Reading on 26 October, promoted by my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) on those last two issues; and the recent passage of the Parental Bereavement (Leave and Pay) Act 2018, mentioned by a number of Members, through the work of my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake).
I would like to close by making it clear that the Government are actively listening to concerns on this issue. This issue unites the House. On behalf of the Government, I very much look forward to working with the APPG, and Members across the House, to ensure that the progress we have seen in recent years continues, so that we can all tackle the most appalling loss that the families we represent can face.