The Secretary of State for Health and Social Care (Yvette Cooper)
May I say a huge thank you to everybody who has spoken in the debate this evening for the personal stories they have told, the tributes they have given to their constituents and the personal stories of constituents that they have told? This is a moment for the whole House to come together and reflect on the babies lost and on our responsibility to do everything we can to support families who go through the unimaginable and lose a baby or child, and to do everything we possibly can to prevent it happening to more families in the future.
I thank the Members who secured the debate today. I thank my hon. Friend the Member for Rossendale and Darwen (Andy MacNae) for the work that I know he has done on the APPG and for his courage in talking about his own experiences and his determined focus on the action that is needed. I also thank the right hon. Member for Godalming and Ash (Sir Jeremy Hunt), one of my predecessors, who I know championed patient safety and maternity safety in particular. It is hugely welcome that he is still speaking out so strongly and has sat here throughout the entire debate this evening.
I particularly thank my hon. Friend the Member for Sherwood Forest (Michelle Welsh), who is doing such an incredible and invaluable job as our national maternity and neonatal adviser. I thank her for her work and the incredible job she is doing in ensuring that parents’ voices are heard, that babies are remembered and that change is driven forward for families in the future. Her work has been hugely powerful. I have seen the work that she has been doing with parents across the country and with the maternity taskforce.
I thank everyone, because no one should underestimate the courage that it takes to talk about some of the most devastating personal experiences in such a public forum and in a way that is all about helping and giving comfort to others. They have brought an empathy and humanity that, if we are honest, we do not always show in this place, but we have come together to show them this evening.
In particular, let me say that this debate is about Mallorie, Jasper, Jesse, Joshua, Nittaya, Chester, Kate, Harry, Alya, Aleah, Theo, Ida, Bran, Wynter, Harriet, Sebastian, Koupar, Teddy, Quinn, Aubrey, Grace, Poppy, Dexter, Luna, Theo, Siena, Rita, baby Ladybird and baby Collinge. We remember them all.
As my hon. Friend the Member for York Outer (Mr Charters) said, on this Thursday evening at 7 pm, hundreds of parents in every one of our constituencies will light candles at home to remember babies who they have lost. It is something that spreads across the world, from one time zone to the next, as a global wave of light to unite parents from every continent in an act of collective grief. We will go on social media and see the pictures of burning candles posted by mums and dads. For those families, the sense of loss does not go away and it does not grow lighter or less painful, but on that day of 15 October, there is at least the knowledge that it is shared and that together, we hold a candle up to an issue that for too long has been hidden, ignored or dismissed. We are saying to every family who have faced the pain of losing a baby, “You are not alone, and you deserve support.”
The hon. Member for Rutland and Stamford (Alicia Kearns) and the hon. Member for Lagan Valley (Sorcha Eastwood) raised an issue that I want to refer to. Earlier this evening, I had a conversation with Gina Jacobs, who lost her stillborn son Robert 57 years ago. At the hospital, he was taken away, and she never saw his face. Only years later did she discover that he had been buried in a mass grave without her knowledge. Just imagine the heartbreak of losing a child, followed by the pain of realising that something so important and personal had been kept from her. Across the decades, many bereaved parents have lost babies in NHS hospitals and been denied any say in, or any information about, what would happen to their remains. On behalf of the Government, I issue a profound apology to those parents—I have issued that apology to Gina today, but I issue it to so many more like Gina who have sought answers over many years. I am sorry for the unthinkable pain caused by those historic practices, because what happened to those parents should never have happened, and we need to ensure it can never happen again.
While I have the time to do so, I want to also recognise the parents of baby Dexter from my constituency, because Dexter’s mum Sophie is in the Gallery this evening. I spoke to Sophie and Dale some months ago, before I became Health Secretary. Their story and Dexter’s story had a profound impact on me, and it is one of the reasons I am so determined to make maternity and neonatal care a priority for the NHS and for the Government. Dexter died in 2018, less than 24 hours after his birth, following hospital failures that were admitted years later. I have listened to Sophie talk about the concerns they had not being listened to and about failures in diagnosis, early intervention and treatment. They went through the unimaginable and were then unable to get answers, and eight years later, they are still navigating NHS complaints, regulators, legal processes, the coronial system and the parliamentary ombudsman, trying to get answers and accountability. I want to acknowledge Sophie’s determination and the courage it takes to be here today, and the commitment of so many parents who have been through the unimaginable and through that trauma, but who keep campaigning for others.
All of us in this Chamber have a responsibility to Dexter’s family and to every family represented in this debate—a responsibility to listen, to learn and to act. As Sophie said to me earlier, trust begins with truth, and if you cannot get answers about what has happened, that compounds the anguish and the distress. That is why I have made maternity and neonatal care a priority; it is also why I want to recognise the wonderful care that so many midwives, consultants, support staff and health visitors in our NHS provide when families need it most, right across the country. However, we also know the devastating stories where things have gone wrong, where families did not get answers, and where so much more needs to be done. As part of our new maternity and neonatal taskforce, we need to ensure that we have a new national action plan drawn up, but also that work is done to establish a new modern services framework of proper standards across maternity and neonatal care. That is crucial because 25 years ago, when I was a junior Health Minister, I had responsibility for maternity services. That was a full quarter of a century ago. I was pregnant at the time, so Members can imagine that I had a particular interest in maternity services.
One of the things that I announced at that time was that there should be a new set of standards, with a national services framework for maternity and child health. When I arrived in the Department as Secretary of State, I said, “What do we need to do to address the Amos report, the Ockenden reviews, the Kirkup review of Morecambe Bay and the many different reviews that we have had?” One of the responses I got was, “We need a modern services framework.” I asked how different that would be from the old framework, given that we would need to modernise the standards from the existing one. They said that the existing one does not exist, because it had just been allowed to lapse. We therefore did not have a set of national standards in place. We have to put that right, and I think there is collective determination on that. The hon. Member for Meriden and Solihull East (Saqib Bhatti) referred to the importance of national standards, and that is one of the things that needs to be done as part of the work of the taskforce, alongside the action plan.
Right at the heart of this has to be listening to parents and in particular to mothers. The hon. Member for Rutland and Stamford (Alicia Kearns) spoke powerfully about her personal experience of feeling that she was left having to make choices or that she had to fight to be listened to. Nobody—no parent, no mother—should be in that situation. One reason that it is so important that we legislate for and appoint a new independent maternity and neonatal commissioner is that this issue cannot simply be something where a spotlight is shone when we have a debate in this House, when a new review comes out or when particular Health Secretaries say, “This is a priority.” It has to always be a priority for our health service, because it is about the very start of a family’s life. It is about some of the most important things that our national health service does.
Many Members have talked about miscarriage, and I pay tribute to my hon. Friends, including my hon. Friends the Members for Aylesbury (Laura Kyrke-Smith) and for Morecambe and Lunesdale (Lizzi Collinge), who have talked about the importance of miscarriage care. We are working with Tommy’s to assess its findings in its miscarriage study, which is hugely important. It is important that miscarriage care is included as part of the modern services framework that we are drawing up. My hon. Friend the Member for Cannock Chase (Josh Newbury) importantly talked about the impact that miscarriage care had on his constituent. That needs to be a central part of those standards and how we provide support for families in those circumstances. We should never underestimate the impact that miscarriage can have at different stages in a pregnancy, and the deep distress that can come from miscarriage through to stillbirth through to loss in neonatal care. At every stage, we must be aware of the long-lasting impact that loss can have on the family and the trauma that can be caused, too.
Many Members referred to the importance of bereavement care and services. We are already putting additional investment of £9 million into bereavement suites. Seven-day-a-week bereavement services need to be the standard across maternity and neonatal settings. All trusts are reporting compliance with that, but we need to ensure that it is happening in practice. They have also been funded to provide specialist bereavement midwives. Those services are crucial, because every family needs time to grieve after losing a baby, and needs immediate support and care.
My hon. Friend the Member for Cumbernauld and Kirkintilloch (Katrina Murray) spoke of the importance of the employment law reforms, and the fact that bereavement leave is now allowed for pregnancy loss before 24 weeks. We know of the impact that such losses can have on families, and the importance of being able to provide support at that time. We are currently drawing up a new mental health strategy, and that needs to include not just post-natal depression but bereavement, and the distress and trauma that can be experienced as part of maternity.
My hon. Friend the Member for Ealing Southall (Deirdre Costigan) spoke about inequality issues, such as the fact that black women have an increased risk of miscarriage, stillbirth and maternal mortality. It is shocking and deeply distressing that in the 2020s we are seeing inequalities of that kind, as well as seeing periods during which maternal mortality among some groups and in some areas has increased. That must be central to the work done by the maternity and neonatal taskforce. We will be setting out the targets and the progress that are needed and the action that we must take to address such inequalities, particularly those relating to ethnicity—we need to challenge racism—but also those involving deprivation.
The right hon. Member for Godalming and Ash (Sir Jeremy Hunt) and my hon. Friend the Member for Morecambe and Lunesdale referred to the normal birth ideology. There is no place for any ideology in childbirth: childbirth has to be about the mums and the babies and safety, and about what is right for the family. As my hon. Friend said, it has to be about safety. It has to be about informed choice, and it has to be about compassion. No mother should ever feel the pressure to live up to a particular kind of ideal birth. As we know, we are all different, and services need to reflect and support that.
The hon. Member for North Devon (Ian Roome) spoke of the challenges that he has been facing, and the challenges that mothers and families have been facing, in his constituency. I know that later this week he will meet my hon. Friend the Member for Sherwood Forest, the national maternity and neonatal adviser. I have spoken several times to the NHS chief executive exactly about what is happening in North Devon. I know that, because this is a workforce challenge, the hospital is taking action to increase recruitment, and that is crucial. It is unfair for families to be worrying, at a time when they should be looking forward to the birth of a new baby, about having to travel for two hours because local services are not open. We are looking into ways of ensuring that there is appropriate support for getting those services open in North Devon, but we are also looking at the workforce issues in other rural areas where more remote services are crucial and need to be provided and sustained, and we will continue to consider maternity issues in that context.
The hon. Member for Mid Sussex (Alison Bennett) raised the important subject of Group B strep. We have a trial under way. There will be a report within the next 12 months, and the information and evidence will go to the UK National Screening Committee, which will examine the issue of testing. I thank the hon. Lady’s constituent, who I understand has been campaigning for a long time.
Let me also give a personal undertaking to my hon. Friend the Member for Lancaster and Wyre (Cat Smith) to follow up the issue of the baby loss certificates directly with the Scottish Government. It is unthinkable that she could be left in such a distressing situation, and that others will be in a similar distressing situation, because of a lack of co-ordination between Governments with which we should be able to deal.
I hope the House forgives me if I have not covered the other points that have been made. I am keen to follow up on the important points about CPR training, maternity triage, regulation and a series of other things, but I want to come back to a broader issue. It feels to me as though maternity services and neonatal services have not been taken seriously enough by the NHS and the Government for too long, and have too often been treated as a sidecar. Hospitals and acute trusts have a lot of things happening, but my sense is that the maternity unit has often been treated as a bit of a sidecar to the main hospital. Although there may be some brilliant work and support being done within a maternity unit, it is not always seen by the rest of the hospital and the rest of the trust, so when things go wrong, too often too little is done. When parents are not listened to and something goes awry with the support, care and compassion that are needed, often strong enough action is not taken to make sure that something is done.
In those cases, it has meant that we have had mothers and babies treated as second-class patients. Mothers and babies should never be treated as second-class patients, because one of the most important things that our NHS does is to be there at the very start of a new family’s life. If we get that right for a new family, it supports them for the rest of their lives. I recognise the remarkable and wonderful care provided in many places, but I still have a strong sense that, overall, our NHS has not been giving start of life, maternity and neonatal services the priority that they really need to be given.
Alicia Kearns
When the Secretary of State meets her officials and has this discussion, I urge her to cite what happened during the pandemic. Despite the fact that it was medically illogical, what did middle managers do in NHS hospitals? They said that women who were coming to give birth or to miscarry had to do so without their partners. People told me, “This is a nonsense, Alicia. Stop saying that women are being treated badly by the NHS. Women have given birth for thousands of years.” Women were mistreated during the pandemic and we were shown the maternity sidecar, exactly as the Secretary of State said. I say to anyone who stands in her way on this issue that she is absolutely right. We have the evidence of the last few years, and I urge her to use it.
Yvette Cooper
I take very seriously the points that the hon. Member makes, and I look forward to talking to her in more detail very soon.
The wider point that I want to make is that we are trying to implement many changes, and we are looking at different rules and different services. We are expanding Martha’s rule to all maternity and neonatal services so that there is a clear way—not just for women in labour and their families, but for staff in maternity services and neonatal services—to raise concerns, to ask for a second opinion and to make sure that we are building in the need to listen to families. However, all of this works only if it is part of a wider recognition that we have to give much greater priority to maternal and neonatal care.
The final thought that I will leave with people is that tonight’s debate has been about baby loss and the most distressing of circumstances, but we know that if support is really to be about giving every family and child the best start in life, it cannot just be about childbirth. It is about what happens throughout maternity and in those first few years as well. That is why I think one of the other most important things we are doing is restoring the Sure Start health services to family hubs right across the country and going back to co-ordinated support—every service coming together to support families and babies at the very start of their life. I again thank everyone who has spoken in this debate.