Pharmacy First

Cherilyn Mackrory Excerpts

Wednesday 31st January 2024 Commons Chamber

[Dame Andrea Leadsom]

The hon. Lady will be aware that, although a few are owned by GP practices, community pharmacies are usually private businesses. We are training the registered community pharmacists that we need. Obviously, it would be for that local area to put in place its own recruitment policies, but I would be happy to meet her to discuss that further.

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

I warmly welcome my right hon. Friend’s statement, and I put on the record my thanks to all the pharmacists who work in my constituency. The geography of my constituency can often mean that someone’s nearest pharmacy is about a mile and a half away across the water, so they end up driving 11 miles around to get to it. I believe that the mapping needs to change. Will she meet me to discuss it?

[Dame Andrea Leadsom]

I am always happy to meet my hon. Friend. Just to let her know, 100 pharmacies in Cornwall are signed up to Pharmacy First.

Rural Healthcare

Cherilyn Mackrory Excerpts

Wednesday 12th October 2022 Westminster Hall

[Anne Marie Morris]

More than that, we need to look at the different pathways in rural communities for heart, cancer and stroke treatment. I agree with the hon. Gentleman, but there is a lot more than just cancer, and the rural pathway to care has to be reviewed to see what is realistic in a rural area.

All of this has been made worse by a funding formula that is not fit for purpose. Although there is provision to uplift for rurality, it is not enough and it has been done without any real understanding of some of the challenges.

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

Cornwall has more visitors outside of London than anywhere else in the country, so we have our winter pressures and then there is no respite in the summer months for our staff. We have issues with housing so we cannot recruit staff. Does my hon. Friend agree that there is a case to be made for extra funding for places such as Cornwall, and perhaps the wider south-west, to ensure that we have enough funding to treat all our visitors as well as our residents?

[Anne Marie Morris]

That is an exceptionally fine point. I have no issue with it because we have a similar problem in Devon. The solution is not just about more recruitment and doing things in the same way, because the people to be recruited do not exist. We need to look at doing things differently, by creating new career paths with shorter training periods and trying to train, so we can then recruit, locally. Generally, people will follow a career where they are trained. We need more rural training for doctors and nurses, and that training needs to be not in the local city, but in the rural areas. For example, in Plymouth we have a fine medical school— Peninsula Medical School—but the challenge is that the experience that the individual trainee doctors and nurses gain is not rural, and it needs to be.

--- Later in debate ---

[Anne Marie Morris]

A point very well made, which I support.

Care, as we all know, is one of the biggest challenges. If we fix care, we will fix the backlog, so we also need to look at how we train and professionalise not care on its own, but care with health. We need to give care professionals the same respect as we give others—and, frankly, for the same sort of skill, we need to pay the same salary. That is crucial if we are ever to get this to work.

D for doctors is the last letter in the Government’s alphabet. The Government are looking for the GP appointments system to improve, so that anyone who needs to see a GP can do so within two weeks. They want to provide data so that individuals may choose which doctor they go to see, and they want to increase the use of pharmacies.

Now, all that is very worthy, but unfortunately, when it hits reality, it becomes the problem. In rural areas, there are too few doctors. If we had data, choice would be great, but there is no choice, because there is not another GP practice. The problem in rural areas is not the level of data, and it is not choice—there is none. It is recruiting the doctors we need. Recruitment in rural areas is in crisis. Yes, we should make more use of pharmacists—that would be fabulous—but in many rural areas pharmacies are closing because they cannot get enough pharmacists. We have a real conundrum, and that is crucial.

If we are to address the issue, we need proper rural medical schools, shorter career courses, and proper training for new routes into medicine and care. Physician associates are a great start, but the reality is that that is only one route, and it is still quite a long training period. More broadly, primary care is mission critical; we know that training in generalist skills across the doctoring profession, if I can put it like that, is done very early but not continued. We need those skills so that we have a much broader range of doctors who, when we have something like the pandemic, are able to cope with the issue. We also need more geriatricians.

D also stands for dentists. The new contract is welcome, but it has been discussed for eight years, I think. It needs to get done. Doctors and dentists need a fair return for the work done and they need to be incentivised to provide the best treatment for the patient. As I understand it, under the existing contract, dentists are in effect encouraged to sub-optimise. They are only paid a relatively small amount, so they will do the minimum rather than what is in the patient’s best interest. We need fairness for the dentist and for the individual patient to be at the forefront of the contract.

We need to step up recruitment, we need to create rural emergency hubs, and I think we need to appoint school dentists. In the same way that a GP is in charge of a particular care home, I see no reason why we should not have a dentist who is responsible for a particular school. I am not suggesting that they should go in and do fillings, but they would at least go in and do regular checks.

[Cherilyn Mackrory]

My hon. Friend is being very generous with her time, and I appreciate that. I remember—she may too—that, as schoolchildren, we had somebody come into school to check over our teeth, just to see if there was anything going on. It is my understanding that someone does not have to be a dentist to be able to tell whether something is going wrong; dental technicians, hygienists and others can do this work. Does she agree that it would be worth doing pilots around the country, particularly in rural areas, to see whether that could cut down some serious dental issues with our children?

[Anne Marie Morris]

That is an excellent suggestion. There is quite a lot for the Minister to take away and think about.

Having gone through the alphabet, I think there are a number of things that we need the Minister and his team to do, including recognising that rural really is different and that the way we look at it now simply does not work. We need to properly understand and investigate the need in different rural communities, and then we need proper funding. We need to look at how we train locally, which will improve recruitment and retention. We need to create new, shorter courses and new professions—and we need to do that now; otherwise, we are never going to get on top of the backlog. Waiting for degree-qualified nurses and doctors will simply take too long.

We need to equalise the professionalism and pay across health and care, and we need to integrate emergency response across all resources—police, fire, ambulance and first responders. I am happy to volunteer the south-west, which I think would be up for it, as a pilot area. I hope that the Minister will go away and think about that, and that he may be willing to meet those who have raised issues today to see if we cannot find some solutions and to discuss the other issues in my rural report.

Oral Answers to Questions

Cherilyn Mackrory Excerpts

Tuesday 19th July 2022 Commons Chamber

[Maggie Throup]

I have heard the hon. Gentleman speak passionately about the impact alcohol has had on his family, and I commend him for his continued campaigning on the matter. It is not just about plans; it is about action. Through the drugs strategy, we are making the largest ever single increase in drug treatment and recovery funding, with £532 million being invested to rebuild local authority-commissioned treatment services. That will benefit people seeking support for alcohol addiction, as alcohol and drugs services are often commissioned together. In addition, £27 million has been invested in an ambitious programme to establish alcohol care teams in the 25% of hospitals that are most affected by alcohol dependency.

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

Last week, I chaired a joint meeting of the all-party parliamentary groups on maternity and on baby loss, where we heard from bereaved parents, maternity staff, and the fabulous and dedicated Donna Ockenden. Given that the women’s health strategy is about to be published, can the Minister or the Secretary of State reassure everybody in the sector that it will address maternity safety and the maternity staff numbers we so badly need?

[The Minister of State, Department for Health and Social Care (Maria Caulfield)]

I thank my hon. Friend for all her hard work campaigning on pregnancy and baby loss. We will publish the women’s health strategy shortly. Baby loss featured heavily in the call for evidence, and we committed to provide more than £200 million of funding to improve maternity staffing after the Ockenden review.

Ambulance Waiting Times: Royal Cornwall Hospital

Cherilyn Mackrory Excerpts

Wednesday 29th June 2022 Commons Chamber

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

This issue of ambulance waiting times at the Royal Cornwall Hospital is vital to my constituents and the whole of Cornwall. I want to start by thanking all health and social care colleagues for their hard work. They work with such professionalism, dedication and selflessness, despite being short-staffed and under immense pressure. It is telling that the constituents who write to me on these issues include praise for the staff who have helped them with such compassion and care in their time of need. Over the past 12 months, I, alongside my five Cornish MP colleagues, have had many meetings with NHS leaders and other Cornish healthcare stakeholders to discuss these challenges. We have also written to Ministers to highlight individual cases and the wider situation on numerous occasions, and I appreciate this opportunity to again highlight the situation in Cornwall to Ministers.

Ambulance waiting times at the Royal Cornwall Hospital are an increasing concern, with the hospital recently recording the worst ambulance wait times in the country, topping the list for the proportion of arrivals that were delayed by more than an hour, at 41%; this represents 10% of the wait times in the whole of England. There is widespread consensus that ambulance response times are slow in Cornwall due to handover delays. The Royal Cornwall Hospital has the highest percentage of handovers over 60 minutes, at 25%. That is particularly concerning, given that the NHS standard contract states that all handovers of patients between ambulances and accident and emergency should take place within 15 minutes, with none taking more than 30 minutes. These handover delays of over 15 minutes have contributed to an average of 255 ambulance hours lost every day in May. I receive several emails each week from constituents who have experienced these delays first hand. One such constituent wrote recently that they were transferred by ambulance to the RCH in the early afternoon. On arrival, there were 15 other ambulances already waiting for their patients to be admitted. During the afternoon, evening and night, they were transferred to five other ambulances and crews. The various categories of ambulances offered stretcher beds of varying levels of discomfort, and there was a shortage of blankets, no access to food and no toilet facilities. They were eventually admitted to the emergency department at around 5 the following morning.

Delayed handovers result in poorer ambulance response times, as ambulances queue outside A&E unable to attend patients waiting in the community. That leaves patients at increased risk of delays in diagnosis and treatment, and compromises the ability to respond to serious incidents. These delays also increase pressure on clinical staff and on ambulance service call handlers, who look after distressed patients and their families, who call again and again, desperate to hear their wait time. That can lead to thousands of additional calls, placing even more pressure on the service. Constituents have told me that they have waited 13 hours for an ambulance and that they have called many times in the interim to chase an update on the expected arrival time.

Let me be clear: these delays are not to do with ambulance service call handlers; they are a whole-system issue and are impacted by acute challenges elsewhere in the system, particularly with hospital capacity and patient flow. The issues include delayed discharges to social care and other services, as well as bed occupancy. As such, a whole-system approach is needed to tackle this issue.

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

This issue is important not only in Cornwall but in Plymouth, because Derriford Hospital serves part of Cornwall, providing some of the ambulances she mentioned. She is right that this is not the fault of the people who drive the ambulances or who dispatch them, but does she agree that it is utterly unsustainable that many ambulance crews may get only one shout per shift, because they spend the remainder of the shift queuing outside an emergency department in Cornwall or Plymouth waiting to hand over their patient? That is simply unsustainable if we are to have the NHS recovery we need in the south-west.

[Cherilyn Mackrory]

I thank the hon. Gentleman for his intervention, and he is absolutely right. He will know that, purely because of their geography, hospitals in Cornwall and Devon rely on each other, and the ambulance crews go between the two. He is also right that this is a multifaceted issue. Hopefully I will cover most of it in my speech and the Minister will respond knowing that there are many things we need to do to try to tackle it.

In Cornwall the capacity challenges stem partly from the hangover from the covid-19 restrictions. Predominantly, however, they are about staffing, which hinders our social care system’s ability to safely assess and care for patients at the rate necessary to clear the beds in the hospitals. On a single day last month, 190 beds in Cornwall were occupied by patients awaiting discharge into social care. Those patients had no medical need to be in those beds. Thankfully the number has now fallen below 130, but the issue remains that too many people are staying in hospital beds because of discharge challenges.

In March the Care Quality Commission inspected the whole of the Cornwall and the Isles of Scilly urgent and emergency care system. The report states:

“Delays in ambulance response times in Cornwall are extremely concerning and pose a high level of risk to patient safety. Ambulance handover delays at hospitals in the region were some of the highest recorded in England. This resulted in people being treated in the ambulances outside of the hospital, it also meant a significant reduction in the number of ambulances available to respond to 999 calls. These delays impacted on the safe care and treatment people received and posed a high risk to people awaiting a 999 response…Delays in discharge from acute medical care impacted on patient flow across urgent and emergency care pathways. This also resulted in delays in handovers from ambulance crews, prolonged waits and overcrowding in the Emergency Department due to the lack of bed capacity.”

The report goes on to state:

“Without significant improvement in patient flow and better collaborative working between health and social care, it is unlikely that patient safety and performance across urgent and emergency care will improve.”

That is key. Although we have seen some pilots and seen community services adapt to meet changes in demand, additional focus on health promotion and preventive healthcare is needed to support people to manage their own health needs.

The report also identified that adult social care in Cornwall has had one of the highest short staff shortage rates in the entire country. That directly affects the ability to discharge patients into the social care sector, as well as A&E and ambulance response times.

[Richard Foord (Tiverton and Honiton) (LD)]

During the by-election campaign in Tiverton and Honiton, almost everybody I spoke to on the doorstep had their own personal story about having to wait for an ambulance. This is not the fault of ambulance crews, but it is absolutely the system-wide issue that the hon. Member describes. Does she agree that what we really need is a community ambulance fund to alleviate some of the pressures we are experiencing in the south-west, given that we have the longest ambulance waiting times in the country?

[Cherilyn Mackrory]

I thank the hon. Gentleman for his intervention, and welcome him to the House for his first contribution. He will be aware that the CCG is responsible for distributing and commissioning services within his area. Therefore, this is not something that Ministers should have to implement. He should lobby his own CCG if he thinks that that is a beneficial service for his area.

The report also identified that adult social care in Cornwall has one of the highest rates of staff shortages in the entire country. It is right that the hospital has a comprehensive handover delay improvement plan that aims to maintain patient safety, to ensure the health and safety of trust staff and to promote effective joint working. These will cover key areas including: incidents management; reporting and external reviews; internal and external communication; data quality; and joint handover escalation plans.

The CCG is also taking positive action, working with the Conservative Cornwall Council, to use commission spend to try to bring more reablement workers online with more flexible care across Cornwall. In addition, it is plugging gaps in domiciliary care in central and mid-Cornwall, and in district nursing teams. Seventy five reablement workers will come online from November, and they are working with Health Education England to transfer their apprenticeship levy so that it is possible to employ even more people across Cornwall.

The CCG is also identifying young people who might want to stay in Cornwall. It has been learning from the work on recruitment fairs of the University Hospitals Plymouth NHS Trust, which is in the constituency of the hon. Member for Plymouth, Sutton and Devonport (Luke Pollard), and which has successfully attracted young people in Plymouth wishing to remain in the area.

In addition, the CCG is ensuring that joined-up, accessible care in local communities is treated as a priority, responding to local needs with the inclusion of NHS services, organisations and charities. The new integrated care board, which meets for the first time on Friday, will utilise existing assets in the community to improve the availability of care services.

It is also right that the providers of the Integrated Urgent Care Service have been commissioned for a six-month pilot to test new methods for handling incoming calls. This involves ensuring that low priority calls are being assessed by a clinician, such as a GP, and in turn being directed to the most appropriate setting for treatment and care. The initial phases of the pilot have provided a clear demonstration of positive outcomes for patients, showing a 71% reduction in the need for ambulances, so it is right that it is upscaling this approach to continue to reduce demand on the ambulance service.

Another trial aims to remove ambulance need for non-injury falls, by ensuring that calls are pulled from the call stack and passed to the IUCS call centre in Truro, where a dispatcher can dispatch a resource from the independent ambulance service. This means that where someone has fallen but is not at risk from an injury that might mean they should not be moved, they are attended and settled into a more comfortable place within their own home. They then have a follow-up referral with a community team, which aims to identify why they fell, allowing it to put in place safeguards to prevent reoccurrence. Early data has shown that, in positive cases, where paramedics have responded and assessed, the person is placed back in bed in their own home within an hour.

I am also pleased that the CCG is working on the vital development of facilities at Bodmin Hospital, including the development of the urgent treatment centre, the community assessment and treatment unit and the diagnostic hub, which will all contribute to reducing the care pressures that Cornwall faces and the pressure on the RCHT.

The next few weeks see the standing down of the CCG and the standing up of the integrated care system, which will provide a much more collaborative approach to the healthcare system. As a new MP, I will be grateful for that, because, learning on the job means that we have to learn what board does what, and now there will be just one board that is accountable. I am also grateful to the Government for already taking a range of actions to tackle this issue. In 2020, I was delighted that the hospital had £42.5million-worth of debt written off as part of the Government’s announcement to reset NHS finances. After NHS England announced its goal for a seven-minute average for ambulance response time, the Government stepped in with a £55 million investment in the NHS, helping to provide 700 additional staff in control rooms and on the frontline to improve response times.

That is alongside £4.4 million to keep an additional 154 ambulances on the road over the winter. In addition, NHS 111 is recruiting an extra 1,100 staff. Moreover a £250 million winter GP capacity fund will help to avoid unnecessary ambulance calls and visits to A&E. The Government are also right to have taken the difficult decision, which was unpopular in some corners, to implement the 1.25% health and social care levy, raising £12 billion a year on average over the next three years to fix the social care crisis.

Despite that progress, we still have an alarming situation, which is why the Government must look at all options to tackle the problem. They must look urgently at tackling the staffing shortages preventing us from moving patients out of hospital beds and into domiciliary care. Constituents who are already being cared for at home are seeing a reduction in care packages due to staff shortages, which will clearly have a cumulative effect on trying to discharge hospital patients.

Cornwall has recently been found to have the country’s most understaffed social care system, with ongoing challenges around recruitment and retention. Employers in the space compete for staff with the hospitality and retail sectors, with cost of living increases and housing affordability and availability problems adding to the weight of issues. I should add that that was the case before the pandemic, but it has been compounded by the effect of covid and we see it acutely now.

We must advertise care as a profession and a career path, not just a job. We should look at creative new measures to make the profession more attractive, improve the workplace culture, tackle burnout and offer higher salaries. We must also ensure staff can afford to rent or buy affordably in the area by tackling the housing crisis and promoting key worker housing. The Government must also recognise the challenges of rurality, an ageing population, higher demand for services and the hangover from covid, which have all contributed to this issue. I believe we should also increase the number of first responders in rural areas and look at the model of the parish nurse; both are vital to the local village I live in.

Reducing ambulance waiting times at the Royal Cornwall Hospital is an urgent issue for the people of Cornwall. I look forward to working with the Government on a range of solutions available to improve the situation, and of course the Minister is always welcome to come and visit.

Children’s Mental Health

Cherilyn Mackrory Excerpts

Tuesday 8th February 2022 Commons Chamber

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

I thank the Opposition for securing this debate. It is important that we shine a light on the issue. I have always said that it takes a village to raise a child, but it actually takes an awful lot more people than that. I thank everyone in Truro and Falmouth who helps children in their lives, such as council officers, health and care professionals, teachers, early year educators, child minders, charities, volunteers and, of course, parents and families.

I will highlight a few of the challenges that we are facing in Cornwall. The end of the national lottery HeadStart grant in July is a key issue for us. It has funded trauma-informed training in schools to support professionals to work directly with children. At the moment, it is not set to be replaced.

Cornwall gets money from the Department of Health and Social Care for health provision and from the Department for Education for schools, but nothing directly to the local authority. It uses its core budget to support emotional health and wellbeing. It invests in clinical psychologists to help the most vulnerable children and school nurses to help with emotional health and wellbeing in order to prevent the escalation of need. However, I am told that there is no defined budget.

Schools in Cornwall are training and becoming trauma-informed schools, which supports children and their parents in their journey around mental health and is good for their health and wellbeing. That is being supported by Cornwall Council wellbeing for education, which is led by educational psychologists to enable staff to promote and support pupils’ wellbeing. Cornwall has successfully set up the Bloom, which offers to support all professionals in advising children and young people around the county.

Children need routine. They also need stability, stimulation and ambition. Most Members in this Chamber will be shocked to hear that there are children in Cornwall who have never seen the sea. Cornwall is an important place where we can exploit our blue and green environment, with surfing, fishing, swimming and forest schools. Where these schemes are set up, they are life-changing for children with mental health issues and difficult home lives. They not only teach children practical life skills, but build confidence and resilience. For me, that is the opposite of being sat at a screen, continuously exposed to social media and the media-driven anxious society in which we find ourselves today. As a society we must do better. For example, rather than yelling at each other from one side of the Chamber to the other, we should work together to do better for our children. We must set an example and do much better in this Chamber.

I would like to see anyone and everyone who comes into contact with a child to inspire them; to let them know that they can achieve. If we do that from the start, from the very early years, I think we will do better in the future.

Dentist Industry and NHS Backlogs

Cherilyn Mackrory Excerpts

Monday 7th February 2022 Commons Chamber

[Andy Carter]

My hon. Friend is absolutely right: many of the dentists I have spoken to say that working with these activity targets is like being on a treadmill. It wrongly puts the focus on meeting targets, rather than delivering the sort of patient care we need to be delivered in our dentists’ surgeries.

On the back of receiving news from constituents who contacted me that a surgery in Appleton was to close, I went to see Dr Mansour Mirza, who runs Appleton Park dental surgery. He talked me through his decision to give notice to the NHS. He was handing back a contract worth hundreds of thousands of pounds which his practice had had for many years. I want to thank Dr Mirza for being so open and so frank with me about the decision that he had to take earlier this year. Providing the treatment that he is required to deliver under the contract just does not add up. It costs him more to provide the services than he is paid. No one can survive over the long term if that is the case, so it is hardly surprising that his contract, like many others around the United Kingdom, is being handed back to the NHS.

I am also grateful to David Flattery, a dentist who lives in Lymm and owns and manages a practice in Altrincham, for his insights. He says that the incentives to take on new NHS patients at his practice are slim to none, owing to the workload and the quotas that he has to meet under the “units of dental activity” system. When he explained how the system works, with units attributed to particular types of treatment, I came away scratching my head. Dentists are effectively paid the same for delivering a check-up as they are for root canal work, although one of those procedures involves a tremendous amount more work than the other. That makes little sense.

The Minister will know that UDAs simply do not work, and it is time to replace the contract with a more modern system which reflects dentistry in the 21st century. Dr Miraz told me that his private work had been subsidising the NHS contract for many years, and that despite wanting to continue, he simply could not afford to provide the NHS services that he had signed up to. Shockingly, the regional NHS team did not seem to want to find a solution: they have simply left people without access to any NHS dentist.

There is a real fear that NHS dentistry will disappear in the months and years to come. Dentists want to do the job of dentistry. It seems from what I have heard about the experience of dentists working through the pandemic that the likelihood of having payment clawed back by the NHS has grown. In the current quarter, dentists need to deliver 80% of their contracted UDAs, at a time when the prevalence of covid and the omicron variant is at its highest point in the entire pandemic, but the targets that have been set for dentists have risen during that period. If patients cancel or staff are sick and dentists cannot deliver that 80% of UDAs, the dentists lose funding, which means that they cannot pay the salaries of their staff, meet the rent, or provide future services for children or those with the lowest earnings. I believe that dentists are conscientious and caring healthcare professionals. They want to treat their patients, but they also want to be treated fairly by the NHS. Mr Flattery told me:

“If we really want to incentivise prevention, we need to see change urgently. ‘Incentives’ to just drill and fill is what the industry has been arguing against for many years.”

The latest NHS dental statistics show that in NHS Warrington clinical commissioning group, only 33.6% of child patients were seen by a dentist in the 12 months to June 2021, a fall from 54% patients the year before.

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

My hon. Friend is advancing a compelling argument, and much of what he is saying rings true in Cornwall as well. One of my passions relates to childhood dentistry, or the lack of it. When we question the authorities in Cornwall, we often find that they are not entirely aware of the scale of the problem that they have. Many Cornish Members are currently conducting their own online dentistry survey.

When I was a child—I do not know whether other Members had the same experience—we used to have dental checks at school, and our parents were told if there was a problem. When I investigated, I was told that it was not necessary for a dentist to carry out the checks; a dental professional could do them, and a letter would then go home to the child’s parents. Would my hon. Friend support piloting such schemes again, particularly in deprived areas, along with preventive medicine to stop children needing to go to the dentist with serious problems in the first place?

[Andy Carter]

My hon. Friend raises an interesting point. I spent Friday afternoon with a GP practice in Warrington South and heard from the doctor there about the work that is now undertaken by nurse practitioners in the surgery and in the community. It seems sensible to me to upskill dental nurses to become dental nurse practitioners who can work in the community, and in schools in particular, to try to give guidance to parents to support families and to ensure that children’s dental health is a priority.

My hon. Friend identifies issues in child oral health. If we are not careful, we will store up an incredible problem for the future. We need to see it as a priority. The notion of having a six-month check-up has gone, for many good reasons, but many children are not seeing a dentist over a 12 month or even two-year period. We need to think carefully about that, so I absolutely support her point.

According to the NHS workforce study, 147 fewer dentists are working in the NHS in the north-west than in the previous year. In Warrington, there are 64 dentists per 100,000 of the population and we are seeing considerable falls on previous years.

In the long term, root and branch reforms need to be instigated in the dentistry sector. I hope that the Minister can explain what steps the Government are taking to increase training places in the north of England. I ask her to instigate a national recruitment drive to increase the number of people going to university to study dentistry and to introduce incentives for dentists to relocate to areas such as Warrington and to work in smaller practices where they provide an incredible service to local communities.

I ask the Minister about the new dental contract too. As I mentioned, I think most of the underlying problems in NHS dentistry spring from the fact that the current contract, which dates back to 2006, is not fit for purpose. It is inadequate and does not reflect the needs of dentists and their patients today. I hope that she can explain what steps she will take to bring forward a new contract and how she can work with dentists, patient groups and other interested parties around the country to ensure that the contract reflects what dentists and their patients need for the next decade. Does the Minister agree that we must break the idea of units of dental activity and ensure that NHS dentistry is available to all those who need it, as well as prioritising preventive care?

Finally, what can she say to my constituents, such as Paul and Paula Green, who have paid their national insurance contributions and paid their taxes but who, because of where they live in Warrington, can no longer get access to NHS treatment because nobody wants to provide a service through an NHS contract? I thank the Minister and look forward to hearing her reply.

Oral Answers to Questions

Cherilyn Mackrory Excerpts

Tuesday 18th January 2022 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

From the start of the pandemic, the UK has worked to support equitable access to covid-19 vaccines. It helped to establish the international joint procurement initiative COVAX, which supports higher and lower-income countries in securing the vaccines they need. As my right hon. Friend the Secretary of State has indicated, we are committed to delivering 100 million doses by mid-June; we had delivered more than 30 million by the end of 2021. The UK leads the way on variants through the UK Health Security Agency, and we are willing to progress that technology throughout the world.

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

T8. Building the women’s and children’s hospital at the Royal Cornwall Hospital was a key promise of this Government, and the Secretary of State’s predecessor was very supportive of it. Will my hon. Friend reaffirm the Department’s commitment to the building and agree to meet me to ensure that everything is done to get this vital project delivered on time?

[Edward Argar]

We remain fully committed to the delivery of the important new women’s and children’s hospital in Truro for the Royal Cornwall Hospitals NHS Trust as part of our new hospital programme. My right hon. Friend the Secretary of State remains committed to it, and of course I would be delighted to meet my hon. Friend.

NHS England Funding: Announcement to Media

Cherilyn Mackrory Excerpts

Monday 25th October 2021 Commons Chamber

[Edward Argar]

The hon. Lady asks a very important question. Patient safety, including in midwifery and births, is central to what we are about in this Government and in NHS England. That is one reason why we have seen more than 9,000 more nurses, midwives and health visitors recruited, but we need to continue to do more, and we will continue to do so.

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

I am certain my constituents will warmly welcome this additional funding. There is currently unprecedented demand on health and care services in Cornwall, more now than at any point in the pandemic. The Royal Cornwall Hospital in Truro has escalated its operational level from operational pressures escalation level 4, or OPEL4, to “internal critical incident”. I welcome the meeting that the Cornish MPs had with the Minister last week. I have written to the Secretary of State to ask how we can get some additional support to help us to de-escalate this unprecedented situation.

[Edward Argar]

As my hon. Friend alludes to, I met her and other hon. Friends from Cornwall last week to discuss this matter. I appreciate the pressures facing the NHS in Cornwall, particularly after the pressures it faced over the summer, when other parts of the system may have experienced slightly less pressure, because of all the holidaymakers who rightly go to visit Cornwall. I look forward to working with her further on this and thank the staff of the trust for what they are doing. We recognise the challenges, which is why we are providing this extra capital funding, including capital funding from previous pots, to her trust. I am happy to have a further meeting with her and her chief exec, if she feels that would be helpful.

Baby Loss Awareness Week

Cherilyn Mackrory Excerpts

Thursday 23rd September 2021 Commons Chamber

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

I beg to move,

That this House has considered the matter of Baby Loss Awareness Week.

Ahead of Baby Loss Awareness Week 2021, which falls in recess this year, between 9 and 15 October, it was important to bring this debate to the House to highlight the fantastic strides that are being made in this area, to underline where more needs to be achieved, and for Members to reflect not only on their own personal experiences, but on those of our constituents.

Considering that one in 14 babies dies before, during or soon after birth, Baby Loss Awareness Week continues to be an essential focal point for bereaved families. I thank hon. and right hon. Members across the House—those who are here today and those who are unable to be here—for their solid and unwavering support for this most difficult of issues. I am grateful to those who have spared the time to speak and I pay particular thanks to the Backbench Business Committee for enabling this consideration to return to the Chamber, illustrating to bereaved families across the country how important their experiences are to representatives in this place.

On the run-up to this debate, I have been struck by the number of colleagues from all parts of the House who have spoken to me privately about their losses. Many are still simply unable to speak in public about their own experience, as it is still too difficult, even after many years.

As co-chair of the all-party group on baby loss, I have received wonderful support from: my co-chair, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who has utilised his knowledge and expertise to advance the cause; the many bereavement charities; and Ministers from the Department of Health and Social Care, particularly my right hon. Friend the Member for Mid Bedfordshire (Ms Dorries), who, as Minister, totally comprehended the issues and championed much progress in this area.

In that vein, I warmly welcome the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), to her place and look forward to continuing the excellent work already begun. In addition, I know that my hon. Friend the Member for Meriden (Saqib Bhatti) would have been here to speak had he not been promoted to the Health and Social Care Front-Bench team. He was marshalling the Balsall Common Fun Run and, on his behalf, I pay tribute to the Lily Mae Foundation for organising nearly 1,000 runners.

Last year was my first such experience in this role. I told the story of my loss—the diagnosis of severe spina bifida at the 20-week scan, and the choice, which is actually no choice at all, to terminate. I talked about the termination itself, the delivery, the cuddles and the kisses for my tiny daughter, Lily, and, finally, letting her go—you never really let them go, though, do you? I talked about how difficult it was to leave the hospital without my baby, about how it physically aches, and about how a part of my heart and soul had been left behind.

I wish to put on record my thanks again to the wonderful bereavement midwifery team at the Royal Cornwall Hospital in Truro. The kindness and compassion that they showed us in our darkest hours will never be forgotten. My work in this place, on this very subject, has given me a focus to channel my energy, but I will not lie that it is difficult at times. My grieving is now done quietly at home in stolen moments with her photograph—

[Nickie Aiken (Cities of London and Westminster) (Con)]

Does my hon. Friend agree that it is an amazing achievement for her to bring this debate today and that she will get cross-party support from all of us?

[Cherilyn Mackrory]

rose—

[Madam Deputy Speaker (Dame Rosie Winterton)]

If the hon. Lady wants to take a break, we can take another speaker and come back to her if that is what she would like.

[Cherilyn Mackrory]

Thank you, Madam Deputy Speaker, for your words and my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) for intervening.

Today, I wish to extend my sincere condolences to anyone who has experienced the loss of a baby. To anyone to whom this has happened, despite what they may see, I say that the sun will shine again. It does not feel like it now, but one day it just does. For me, the dark clouds of shock, anger, guilt and dreadful, dreadful sadness do eventually dissipate—

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

I pay huge tribute to my hon. Friend for her courage in coming to this place to share her views. I know that she is speaking for so many people who have such a tough time, whether through miscarriage or stillbirth. This was her terrible experience of a child who was not going to make it, but all of us here have her back. We all agree with her, and there are so many people here who would like nothing more than to see much more done in that critical period of maternity. All our thanks go to her for her bravery today.

[Cherilyn Mackrory]

I thank my right hon. Friend for her intervention and kind words.

I entered Parliament and suddenly had the opportunity to speak with many people who had experienced the loss of a baby. Unlike me, many have no idea why their baby had died. As well as prevention of baby loss, which I will come to later, my focus in this place is on the care for bereaved families. The all-party group was instrumental in the creation of the Government-backed national bereavement care pathway, which seeks to improve the quality and consistency of bereavement care received by parents in NHS trusts in England after pregnancy or baby loss.

There are different experiences from place to place. While the Department of Health and Social Care strongly urges the trusts to take part in the pathway, mandating it and its nine standards would lead to greater time, funding and resources being made available to healthcare professionals to deliver this. Poor bereavement care, from the moment of diagnosis and the breaking of bad news, exacerbates the profound pain felt by parents. Although approaches to bereavement care in the UK have greatly improved in recent years, inconsistency still remains, often resulting in a postcode lottery for parents.

As of last month, all NHS trusts in England have either expressed interest in, or formally committed to, implementing the pathway within their hospitals and their services. Trusts require additional funding, however, to fully implement the standards, especially to ensure that every hospital has an appropriate bereavement suite, specialist staff and training.

As I mentioned earlier, the care that we received in Cornwall on the weekend that we lost Lily was second to none. However, while I was able to access bereavement counselling through my work, my husband has never been offered anything. It is my opinion that supporting partners and the wider family are not being looked after in the way that we would hope. Because the mother births the child, dads and supporting partners often feel the need to be “strong”—to be there for them. People often ask how mum is, but may not ask how dad is. That is not healthy. What about the wider family? Grandparents are grieving for their lost grandchild and wondering how best to support. Siblings are wondering what has happened.

My daughter was only four when we lost Lily. She knew I was pregnant and we tried to explain what had happened in an age-appropriate way. She seemed to accept this as children do and did not mention it again—until a couple of weeks ago. Completely out of the blue and without warning, she said, “Mummy, when I was four, you were going to have a baby but then didn’t.” Crikey! Wham! What do you do? On the hoof, I needed to explain calmly to my now almost seven-year-old what had happened. I do not know whether I explained it in the right way, but she knows now that, if there are questions, we are always here. I do not want it to be a spectre on her childhood to wonder what happened to her mystery sister. It reminded me that a child’s mind can often make up what they do not know, and we need to make sure that siblings and the wider bereaved family are cared for long after the event.

[Angela Crawley (Lanark and Hamilton East) (SNP)]

I commend the hon. Member for her bravery in speaking about such a personal and intimate matter. She speaks about partners and the wider family. There has never been a more important point about ensuring that both affected parents are able to take leave. Does she support my Miscarriage Leave Bill, which will ensure that both parents can take paid leave during this traumatic time?

[Cherilyn Mackrory]

The hon. Member and I have spoken about this issue. Since that conversation, I have taken her Bill to the Employment Minister, so I hope that we will hear more about it later in the year.

Despite our making good progress, more needs to be done if the Government’s ambition to halve baby deaths by 2025 is to be met. If the current trajectory of reducing stillbirths is maintained, England may be off meeting that 2025 ambition. The Health and Social Care Committee report noted:

“The improvements in rates of stillbirths and neonatal deaths are good but are not shared equally among all women and babies. Babies from minority ethnic or socioeconomically deprived backgrounds continue to be at significantly greater risk of perinatal death than their white or less deprived peers.”

Babies should not be at higher risk simply because of their parents’ postcode, ethnicity or income. I will let my APPG co-chair and Chair of the Select Committee speak to the findings of the report. However, it appears that health inequalities in maternity outcomes have been known about for more than 70 years, yet there are still no evidence-based interventions taking place to reduce the risks.

Continuity of carer could significantly improve outcomes for women from ethnic minorities and those living in deprived areas. Way back in 2010, the Marmot review proposed a strategy to address the social determinants of health through six policy objectives, with the highest priority objective being to give every child the best start in life. Marmot noted that in utero environments affect adult health. Maternal health—including stress, diet, drug and alcohol abuse, and tobacco use during pregnancy—has a significant influence on foetal and early brain development. Midwives have a key role in promoting public health. Individual needs and concerns can be better addressed when midwives know the woman and her family, and continuity of carer is a key enabler of that. This public health work is of most benefit to vulnerable and at-risk families, who may require more time and tailored resources. Additional work is required to address the needs of these groups, because they are simply more at risk.

As well as improving clinical outcomes for mothers and babies, continuity of carer models can also result in cost savings compared with traditional models of care, because there are fewer premature babies, so fewer neonatal cot days are required; the incremental cost per pre-term child surviving to 18 years compared with a term survivor is estimated at nearly £23,000, and most of the additional costs are likely to occur in the early years of a child’s life; there are fewer obstetric interventions, with women 10% less likely to have an instrumental birth; and there are fewer epidurals and so on.

[Olivia Blake (Sheffield, Hallam) (Lab)]

Does the hon. Member share a concern that has been raised with me by midwives—that the term “continuity of carer” has been misinterpreted by some trusts, with multiple midwives seeing people in their early appointments to increase the chance that that person will see the same midwife in hospital?

[Cherilyn Mackrory]

Although it would be fantastic to have just one midwife, continuity of carer is actually more likely to mean two midwives or a very small team of midwives. The idea is that the patient can trust that small team, open up to them more and work with them for their own health and the health of their baby.

A continuity of carer model can assist with outside issues affecting a pregnancy, including by picking up on signs of domestic abuse. Sands, the bereavement charity, is calling for an additional Government-funded confidential inquiry into tackling inequalities in this area. Confidential inquiries have been crucial in driving down maternal and perinatal death rates in some groups. These in-depth reviews of all case notes conclude within a finite period and with solid recommendations. Previous confidential inquiries—for example, into term stillbirths and deaths in labour—have transformed our understanding of the changes needed to make care safer, and have contributed significantly to reducing deaths in some groups.

The additional risks faced by women from black and minority ethnic groups have been exacerbated by covid, and this highlights the urgent need to improve equity in maternity. The UK Obstetric Surveillance System study found that more than half of pregnant women admitted to hospital during the pandemic with a covid infection in pregnancy were from an ethnic background.

In June 2020, the chief midwifery officer, Jacqueline Dunkley-Bent, wrote to all NHS midwifery services highlighting the impact of covid-19, and the additional risks faced by women and babies from ethnic minorities. The letter called on the services to take four specific actions to minimise this additional risk: increase support of at-risk pregnant women, including by ensuring that clinicians have a lower threshold to review, admit and consider women from ethnic backgrounds; reach out and reassure women from ethnic backgrounds, with tailored communications; ensure that hospitals discuss vitamin supplements and nutrition in pregnancy, particularly vitamin D; and ensure that all providers record on maternity information systems the ethnicity of every woman, as well as other risk factors, such as living in a deprived postcode area, co-morbidities and so on.

The national maternity review’s 2016 report “Better Births” highlighted the increased risk of twins and multiple births. Tamba—now known as the Twins Trust—and the National Childbirth Trust told the report that there needs to be greater recognition of high-risk groups, such as those who have multiple births. Some 10% to 15% of such babies have an unexpected admission to a neonatal unit. The Multiple Births Foundation has said that risks and complications associated with multiple births are still poorly understood by the public and are underestimated by professionals. Multiple births have gone up and the mortality rate is higher among people who have those pregnancies. Again, more research is needed to understand better the risks posed by multiple births. Owing to the increase in fertility treatment and the increased maternal age, twins and multiple births are on the increase, so we must do better to ensure better outcomes.

I again thank colleagues who are here today, and those who have worked so hard in this sector to ensure that babies and their families have the very best outcomes. There is a lot of work still to do. I look forward to my engagement with the new Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), who I know will share our passion and use her vast experience to advance these causes.

We approach this year’s Baby Loss Awareness Week with events being held around the country and reflection in our hearts. The annual wave of light gives those of us who have suffered a loss the opportunity to light a candle in memory of our babies at the same time. It is a powerful signal, with thousands of people sharing messages and photos of their candles, showing just how many families are suffering with their own grief. This issue matters to every single Member of Parliament; it affects us all.

Let us use this opportunity to speak openly about our children, and to ensure that fewer and fewer families have to suffer this experience in the future. I am proud to lead a debate in this place that shows Parliament and parliamentarians at their very best. This important issue rises above party divisions, and, as we have seen today, the compassion of Members towards one another shines through.

--- Later in debate ---

[Cherilyn Mackrory]

I thank all right hon. and hon. Members who have spoken today for the support that we have given to one other and for the timely interventions. I will not go through all the speeches because I have only a short time to sum up, but I would like to extend my gratitude to my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) and accept her invitation to meet the team at St Mary’s Hospital in Paddington. I give special thanks to my right hon. Friend the Member for South West Surrey (Jeremy Hunt) for his candid testimony, which is both personal and full of bags of experience. I could not be more grateful for being able to co-chair the all-party group with him. With our new Minister on the Front Bench, this all-party group can continue to do great things and I very much hope we will be able to do so.

I also pay tribute to the hon. Member for North Ayrshire and Arran (Patricia Gibson), who religiously attends the all-party group and carries baby Kenneth in her heart. She spoke powerfully about the isolation of grief, and I can completely relate to that. I hope that events such as today’s debate bust that stigma and that people start talking to each other. Year after year, this is the toughest debate in Parliament to participate in, but it is oh so very important.

Pregnancy and baby loss has often been seen as a women’s issue, and it is a very powerful women’s issue—we have heard about the mental health side of things and we need to not let women down on that. More than that, however, it is a family issue and a community issue. We need to be looking out for each other and to make sure that families are looking out for each other, and that we all talk about these things. You name the children, you talk about that baby; it is not something that should be shied away from because we do not know what to say. Anything we say will be the right thing to say simply because we are talking about it.

I conclude by thanking all colleagues once again for their powerful testimony, and I look forward to continuing the very important work of the all-party group.

Reducing Baby Loss

Cherilyn Mackrory Excerpts

Tuesday 20th July 2021 Westminster Hall

[James Gray (in the Chair)]

I start with a few parish notices, as it were. First, we do all continue to wear a mask, apart from when we are speaking. Secondly, I am told that we are now allowed to intervene, if we are physically in the room, on one another, although perhaps we want to keep such interventions to a relatively minimal number. Thirdly, let me remind those who are with us virtually—welcome to you all—that you have to remain in the room with your television camera on throughout. You cannot turn the TV camera off and go off for a cup of coffee; you have to be here in the debate throughout—from beginning to end.

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

I beg to move,

That this House has considered progress towards the national ambition to reduce baby loss.

Sir James, it is a pleasure—

[James Gray (in the Chair)]

Order. I regret to say I am not Sir James—perhaps one day. I am just Mr Gray.

[Cherilyn Mackrory]

Thank you, Mr Gray. I had just promoted you. It is a pleasure to serve under your chairmanship.

The ambition is to halve the rate of stillbirths and neonatal deaths by 2025 and to have achieved a 20% reduction in these rates by now. Every day in the UK, about 14 babies die before, during or soon after their birth. Baby deaths need to fall much faster if the Government’s national maternity safety ambition is to meet that important target. The ambition also includes halving maternal deaths and brain injuries in babies that occur during or soon after birth by 2025, and reducing the pre-term birth rate from 8% to 6% by 2025.

Earlier this month, the Health and Social Care Committee published its report about maternity safety. I co-chair the all-party parliamentary group on baby loss with the Chair of the Health and Social Care Committee, my right hon. Friend the Member for South West Surrey (Jeremy Hunt). The Select Committee report echoes much of what we have been hearing from hospital trusts, health professionals, bereavement charities, bereaved families and others throughout our work in the APPG. I pay tribute to everybody who speaks out on this most upsetting of topics. It is a crucial issue on which we must all work together to achieve success.

The Select Committee report notes that progress towards reducing the rate of stillbirths and neonatal deaths has been “impressive”, with its external expert panel rating it as good, although it notes that the baseline for the progress was low in comparison with other countries, such as Sweden, and that there is still a “worrying” level of variation in the quality of care. On stillbirth, the report from the expert panel notes:

“The Department has achieved the interim target of a 20% reduction earlier than the 2020 deadline. However, increased efforts are required to meet the final target”

of a halving in 2025. On neonatal deaths, the report states:

“Good progress has been made towards achieving a 50% reduction…by 2025. However, it has been difficult to determine the full extent of the Government’s progress due to a change in the measure of progress against the National Maternity Ambition on neonatal deaths, with concerns expressed about the validity and unintended consequences of this change. This change in measuring progress has potentially inflated the achievement in the data analysed and may inadvertently exclude extremely pre-term babies from the on-going national efforts to improve neonatal outcomes. We encourage the Department to continue to measure and drive progress towards reducing mortality in both the population of babies born before and after 24-weeks’ gestation.”

On maternal deaths, the report concludes:

“No discernible progress has been made towards reducing the 2010 rate of maternal deaths by 50% by 2025”,

which I find alarming. It continues:

“The factors contributing to maternal deaths are predominantly indirect, such as existing disease, and therefore complex to address. Tackling the causes of maternal death will require concerted efforts, with a focus on pre-conception interventions and improved post-natal support, particularly relating to mental health support…In addition, the worsening disparity in risk of maternal death for women from minority ethnic and socio-economically deprived backgrounds needs to be urgently addressed.”

On pre-term births, the report acknowledges that

“this target was only added to the National Ambition in 2017. Therefore, the window for newly introduced measures to impact on the data is very narrow…While the initiatives currently being implemented by the Department are welcomed, we anticipate that increased efforts will be required to counteract the setbacks to reducing pre-term”

deaths arising from the COVID-19 pandemic.

Great strides have been made in this vitally important space, and it is important to acknowledge that, but there is still more to do. Last week, I had the pleasure of speaking to some members of our excellent midwifery team at the Royal Cornwall Hospital in Treliske, in Truro. Because of continuing covid restrictions, that was conducted remotely, and it was a bittersweet meeting for me, not least because the tech let me down after about 20 minutes. I had a conversation with the fabulous consultant obstetrician, Karen Watkins, who was able to tell me how things were going at Treliske and what further things the team felt needed to be done to accelerate the national ambition.

It was Karen who had delivered the shattering news to my husband and me that our baby could not be saved, that she would have no chance of life. It was Karen who performed the procedure to humanely end Lily’s life—the most frightening point of mine. Last week, I had the privilege of thanking her, as face to face as we could get online, for her kindness, compassion and professionalism in such devastating circumstances. Not everybody gets the chance to do that. The entire bereavement midwifery team at Treliske are outstanding, and I continue to be in awe of our local team, of how they do such a difficult job, are able to support families at their lowest ebb, and continue to take special care of our babies after they have died.

The impact of covid on those issues seems to be a mixed bag, which is against the expectation. There was a peak in stillbirth and neonatal death in March 2020 and another in January 2021. Our team in Cornwall points to a slow and steady decline in the numbers since 2010. This year, there have been two stillbirths so far. In a so-called usual year, there would have been between eight and 12 by now. It is difficult to commend this figure, however, as the team do not yet really know what to attribute it to, apart from natural peaks and troughs. It could be a temporary irregularity; more research will need to be done to see whether we can find a pattern. This is no comfort at all to the two Cornish families who have suffered that unbearable loss.

The APPG has heard evidence from the sector about how covid has exacerbated existing inequalities. Inequality is the biggest issue that needs to be tackled to reduce the number of babies dying and to improve maternity safety. The Health and Social Care Committee report highlights the need to tackle “unacceptable inequalities in outcomes”. The report by the health and social care expert panel report notes that

“improvements in rates of stillbirths and neonatal deaths are good but are not shared equally among all women and babies. Babies from minority ethnic or socioeconomically deprived backgrounds continue to be at significantly greater risk of perinatal death than their white or less deprived peers.”

It is fair to say that mums and babies should not be at an unfair risk just because of their background.

The Select Committee’s recommendation that the Government introduce a target to end the disparity in maternal and neonatal outcomes, with a clear timeline for achieving that target, is exactly right. Work must be done urgently to identify a suitable target and ways to evidence the gap closing nationally, supported by the evidence of progress locally. The target must aim to achieve equity among all groups and ensure that those who currently have the least good outcomes have the best outcomes.

What needs to be done? I have taken it down to five or six points. First, on staffing, action is needed to address staffing shortfalls in maternity services. At a minimum, we need nearly 500 more obstetricians and nearly 2,000 more midwives. I welcome the recent increase in funding for the maternity workforce, but there will need to be further funding commitments to deliver the safe staffing levels that expectant mothers should receive. In Cornwall, when Karen Watkins started 14 years ago, there were eight consultant obstetricians. Today, there are still eight. None of them are dedicated bereavement obstetricians, and staff need to take on this role as part of their existing duties.

Secondly, on training, the 2016 maternity safety training fund has delivered positive outcomes. More funding is required to embed ongoing and sustainable access to training for all maternity staff, given changes in the practice, developments on how to deliver safely and aspects related to covid-19. Funding for backfill cover when training takes place is also desirable.

Thirdly, on parent involvement, after a patient safety incident, too often families are not provided with the appropriate, timely and compassionate support that they deserve. Involving families in a compassionate manner is a crucial part of the investigation process. The Healthcare Safety Investigation Branch has taken considerable steps to improve family engagement but must continue to pursue improvements in that area.

Fourthly, on clinician confidence, this is related to the earlier point about training, but is also about giving clinicians the confidence to report issues without worry. I welcome the Government’s proposal to review clinical negligence in the NHS more broadly. Elements of the rapid resolution and redress scheme have been implemented, but the scheme has not yet been implemented in full. Until it is, there is a high risk that the fundamental changes needed to improve the safety of maternity services may fail to be achieved.

Fifthly, carer continuity is close to my heart. I am a huge advocate for this, and it has been shown to improve the outcomes of those who currently have the worst outcomes. I would like to ensure that those involved in delivering carer continuity have received the appropriate training, and that all professionals are competent and trained in all the work they are able to do, particularly in relation to black mothers, where the disparities are the greatest. Carer continuity helps to point out other issues that might not be specifically or medically looked for such as domestic violence.

Sixthly, we need more research. If a baby dies at term, the parents ask why, and often there is no answer. I would like to see more money put into research and development so that we can understand more about this horrific phenomenon. There is more to say, and I am sure colleagues will add to the discussion today. I thank the Minister for her continued support in this area, and I know she is listening.

Group B strep is the most common cause of life-threatening infection in newborn babies, causing a range of serious infections including pneumonia, meningitis and sepsis.

Screening could save 50 babies a year, and protect a further 70 from life-changing issues. Our Minister has been a force in trying to ensure that all women can ask for the group B strep screening and that all hospital trusts can offer it.

We have just passed the halfway point in this important journey to 2025, and I would like to thank all the healthcare professionals who have contributed to the successes so far. I call on the Government to work with them to achieve the rest and save as many lives as possible in the future.

--- Later in debate ---

[Cherilyn Mackrory]

In the short time left, I thank all Members for their kindness. I have been catapulted into this position quite recently and it was not something that I was expecting to have to advocate on, but I am pleased that I am. I am pleased that I can stand up for parents and families who have had to go through a similar thing. We have had a robust and interesting discussion.

I make a plea for two things. First, our all-party parliamentary group on baby loss is meeting the Minister this afternoon at 3 o’clock, so anybody watching who would like to come along is very welcome. Secondly, I will be applying for another debate from the Backbench Business Committee for Baby Loss Awareness Week this autumn, in October, and if the Committee is listening, please, please, may we have it in the main Chamber? It is important, and that would show the utmost respect to parents who have been through this.

Question put and agreed to.

Resolved,

That this House has considered progress towards the national ambition to reduce baby loss.