Covid-19: Government Handling and Preparedness

Cherilyn Mackrory Excerpts

Thursday 27th May 2021 Commons Chamber

[Matt Hancock]

I have been working on the pandemic since January of last year—before the disease was even evident in this country. That is when we kicked off work on the vaccine, and I was told at first that it would typically take five years to develop a vaccine. I insisted that we drove at that as fast as we possibly could, and I am delighted at the progress that we have been able to make.

Of course it is right that we learn from everything that we understand and everything that we see and all the scientific advances. We should do that all the way through. This idea that we should wait for an inquiry in order to learn is wrong, but it is right that we go through all that happened at the appropriate time in order to ensure that we are best prepared for the inevitable pandemics of the future.

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

I thank my right hon. Friend for his visit to the Royal Cornwall hospital in Truro earlier this week. We met staff, toured the site of the new oncology wing and looked at the start-of-the-art plans for the new women and children’s hospital—part of our manifesto promise for 40 new hospitals.

Given the gravity of the situation that the Government faced at the beginning of the pandemic, and considering we now know that Dominic Cummings was a hugely disruptive force, I congratulate Ministers, not least my right hon. Friend, on staying focused on the evidence presented by the experts at the time as events changed quickly. Will my right hon. Friend assure me that he will ignore unsubstantiated Westminster gossip and stay focused on delivering the vaccine roll-out and our manifesto promises?

[Matt Hancock]

I think that is what the public expect us to do. I had a brilliant visit to Cornwall on Monday. It was a pleasure to go to Treliske to see my hon. Friend there and to talk about the new women and children’s hospital that we are building as part of the biggest ever investment in healthcare in Cornwall. Delivering on these priorities on which we were elected, and of course dealing with this pandemic and keeping people safe, is what the public want to see. That is what the expectations of the public are and it is my total focus.

Maternal Mental Health

Cherilyn Mackrory Excerpts

Wednesday 10th March 2021 Westminster Hall

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

I thank the hon. Member for Richmond Park (Sarah Olney) for securing this important debate.

We have heard some of the shocking figures on maternal mental health and we have heard about the evidence that new mothers have experienced poor maternal mental health as a result of the pandemic. “Maternal mental health and coping during the COVID 19 lockdown in the UK” from the covid-19 new mum study found that more than half of new mothers reported feeling down, lonely or irritable, and that 71% reported feeling worried since the beginning of the first lockdown.

Mental health service guidance from the Royal College of Psychiatrists sets out that perinatal mental health care continues to be essential during covid-19, and that face-to-face contact will be necessary in some circumstances. The Government and the NHS have said that mental health services, including the specialist perinatal services, remain very much open for business during the pandemic, and that providers have looked to how they can maximise the use of digital and virtual channels. I agree that that is not ideal, but I acknowledge that hospital trusts in difficult circumstances have worked extremely hard to reach out to mums.

In Cornwall, the Royal Cornwall Hospitals NHS Trust looks after 4,000 babies and mums every single year. I thank the midwifery team at the RCHT for looking after me and both my babies, one surviving and thriving and one whom, unfortunately, we lost. The trust has been reviewing visiting continually throughout the pandemic, and the latest arrangement of their services is that birthing partners are now available, that both parents may be in neonatal units at any time, and that partners may now attend the 12-week and 20-week scans. If other scans are required, they may also arrange that. That has come on from where we were during the first lockdown, so things are improving.

International data, from high, middle and low-income countries, suggests that perinatal illness is more prevalent among rural women. That is the second dimension that I would like to add to today’s debate, if I may. Cornwall is predominately rural, and the pandemic has absolutely exacerbated an already hidden issue, bringing it into the limelight.

For a new mum who lives rurally, it is very difficult to access baby groups and other new mums, to share stories and get peer support, mostly because of transportation issues. I agree that all new mums are suffering those difficulties in lockdown, but it is particularly an issue for rural new mums. Often, socioeconomically, rural new mums are on a lower income, so they cannot afford to get anywhere. It is also difficult for health visitors to get out and visit them.

When I was a brand-new mum, I did not get a midwife follow-up appointment; I had a phone call. My notes, I think, stated that I was well supported and absolutely fine, and yet eight months later I was diagnosed with postnatal depression. I did not know that I had postnatal depression; I thought I was tired, that I was not doing it properly and that I was not living up to being a real mum, and I did not know who to talk to. Even though I had close family support, I felt that I was not doing it right, until I broke one day. I saw my GP, and at that point I was diagnosed with postnatal depression. Luckily for me, not being in lockdown, I was able to go to group peer support and to meet other mums who were feeling exactly the same way, so I realised that I was perfectly normal and that it was something I would work through.

It is important that we recognise that that will be a growing problem because of covid. For a new mum, it is all about talking—we want to speak to other new mums, and when we cannot do that, we can get lost in our own head and everything feels a bit worse.

I have been working cross-party, and with my right hon. Friend the Member for South Northamptonshire (Andrea Leadsom) and my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) on the early years review, which I am privileged to be a part of at this late stage. It started its life, as we know, as the review into the first 1001 days. I will not repeat the words of my hon. Friend, who articulated this work wonderfully, but I look forward to the review coming, hopefully later this month.

My right hon. Friend the Member for South Northamptonshire was quoted as saying that the fact that babies have had little social contact during the first lockdown is clearly a bad thing, and that the repercussions are not yet known. Tackling some of the awful experiences of babies during lockdown and looking at how families can benefit from some of the positive experiences will be at the heart of the review. I look forward to its findings and hope that we can improve conditions for new parents and new babies because of it.

It is my sincere hope that when the new review’s findings come forward and policies are formulated, all parties will take a long-term view of all the important issues that we are discussing today, and that will come out as part of the review. I want to ensure that policy makers cease to use something as vital as the best start in life for babies and the mental health of mothers as a political football. Hopefully we can formulate something wonderful, so that when we look back at it in 20 years’ time we can all see how successful it has been and be very proud of it.

Healthcare Support Services: Conception to Age Two

Cherilyn Mackrory Excerpts

Tuesday 15th December 2020 Westminster Hall

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

I thank my right hon. Friend the Member for South Northamptonshire (Andrea Leadsom) for securing this debate. I pay tribute to the work that she has done over the past 20 years and that of other right hon. and hon. Members. I am only just starting my journey in this House, and it is a pleasure to work with such experienced colleagues, but hopefully I can bring some real-life experience to the table, having only recently finished being at what my sister would call “the cliff face” of having a baby or a small child in the house.

I had two pregnancies. One ended with the joy of my eldest daughter, and one ended in tragedy with a loss. I am now the co-chair of the all-party parliamentary group on baby loss with my right hon. Friend the Member for South West Surrey (Jeremy Hunt). He is doing an inquiry with the Health Committee on maternity services. We have been able to listen and drill down on some of the risks to babies’ lives and some of the solutions. If we can improve the outcomes for stillbirth and neonatal death, we will automatically improve outcomes for at-risk children who survive. In theory, all families should benefit.

Many tools will need to be deployed in conjunction with how we reimagine supporting the first 1,001 days, and I look forward to reading the recommendations when they come forward. Today, I want to focus on just one tool: continuity of carer. As we have heard, nurturing relationships begin before birth. The foetal brain develops rapidly during pregnancy and is influenced by the physical environment of the mother’s womb and the environment beyond it. Babies can experience adversity in the womb. For example, where domestic abuse occurs, research shows that babies’ stress regulation systems adapt accordingly, leaving them more responsive to threat, and consequently more irritable and difficult to settle once they are born.

Research from NHS England shows that one in five mums and one in 10 dads experience mental health problems during pregnancy and after birth. As we have already heard, pregnancy can often be a trigger for domestic abuse, and between 15% and 30% of domestic violence cases start during that time. The impact of those adversities can have a profound effect on an infant, whose healthy social and emotional development depends on loving and consistent care.

Professor Jacqueline Dunkley-Bent, the chief midwifery officer for England, spoke to our APPG earlier this year, and I was struck by the work that midwives are already doing in this area and the results they are getting. Continuity of carer is relationship-based care that saves babies’ lives. Baby loss is reduced by 16%, and women are 19% less likely to lose their baby before 24 weeks. It also reduces pre-term birth. We are asking for women to have the same midwife or a small team of midwives. In March 2019, 10,500 women were on the continuity of carer pathway—17% of all women booked in. That will hopefully rise to 35% by March 2021, and black and Asian women, and those living in deprived neighbourhoods, are currently being targeted. I would like to see that rolled out.

I would like continuity of carer to be promoted to all families and replicated in the health visitor sector, because it is so important. Parents’ responses shape their experiences; if they have a trusted carer they can go to if they are in crisis or struggling, whether it is with domestic violence or coercion in a relationship—or post-natal depression, which many of us have felt—an awful lot of that stress will be expelled. They might even go to the trusted carer for things such as reduced movement. Yes, it is okay to go and talk to a healthcare professional, but many women think that they are bothering a midwife, especially if they do not know them. If they have continuity of carer, all those problems can potentially be solved by a quick phone call, because they will trust somebody at the end of the phone.

I conclude by saying that I look forward to the recommendations coming forward. It is my hope that this issue will be cross-party and long term and that we will have enough funding to put real change in place for all families to come.

Baby Loss: Covid-19

Cherilyn Mackrory Excerpts

Thursday 5th November 2020 Westminster Hall

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

I beg to move,

That this House has considered the effect of the covid-19 outbreak on people experiencing baby loss.

It is a pleasure to serve under your chairmanship. Before I start, how should I address you—Chair?

[Siobhain McDonagh (in the Chair)]

However you like—it will not be the worst thing I have ever been called.

[Cherilyn Mackrory]

This is now the fifth year the House has marked Baby Loss Awareness Week—as with many things, covid-19 caused some delay, as Baby Loss Awareness Week took place a month ago—and I am pleased and grateful that we are here today. It is extremely encouraging and moving that right hon. and hon. Members have ensured that this important issue has been debated often in recent years, helping to deliver an unmistakable message outside this place about its importance in Parliament, the Department of Health and Social Care and the national health service. Most importantly, that sends a message to bereaved families, letting them know that there are people in this place who truly understand how it feels.

Please forgive me for telling my story today, in as much detail as I dare. It is important to me that my baby’s short story helps to shine a light on what is a really dark situation for many people. “I can see straightaway that something isn’t right”—those are the words that broke my heart and changed my life forever. It was 3 January 2019, and my husband and I were at the routine 20-week scan for our second baby. My first pregnancy had been healthy and straightforward and resulted in our fabulous daughter. At age 42, I had been slightly anxious about my 12-week scan, but happily all tests had come back clear. My midwife encouraged me to birth again at our midwife-led centre, and I was keen to stay healthy in order to do just that.

We had celebrated a low-key but cosy Christmas and new year with family and friends. I felt content and reassured by my kicking baby and wondered what the following year would bring. Three days later, we went for our 20-week scan and would receive the terrible news from the sonographer that our baby had an extremely severe form of spina bifida. I lay on the couch and grabbed my husband’s hand tightly. Tears stung my eyes—not unlike now. When I glanced at him, his eyes were watering, too. We did not dare believe what had just happened.

Just over an hour later, we were sitting in the office at our main hospital, the Royal Cornwall Hospital in Truro, with a wonderful consultant and an incredibly kind bereavement midwife. We were met at reception and taken to a small room and brought some tea. I just knew this was not going to end well, but I did not know what to expect. I was checked again, and any hope we had was extinguished by a slow and silent shake of the head. But my baby was still kicking. So started the most traumatic weekend of my life to date.

We had no idea what would happen next. Our world had started to swim and spiral away, and neither of us knew what questions we should ask.

[Jim Shannon (Strangford) (DUP)]

I will try not to get emotional myself. I understand the hon. Lady’s grief—we all do. We understand how important it is for parents to come through this terrible time. We have had similar things in my own family, so I understand exactly how she feels. I was trying to give her a bit of time, and what do I do? I start to blubber as well. I apologise for that. I just want to say that I really feel her pain.

[Cherilyn Mackrory]

I am most grateful to the hon. Gentleman for his intervention, which has succeeded.

I must say that we were looked after with extreme kindness by everyone at the RCHT. Not a day goes by when I do not think of them and thank them silently. On that day, we were barely left alone. We were provided with lots of information and given lots of time to process. I want to emphasise that, because what comes next feels pretty brutal. However, the staff make it all as bearable as they can, but it is shocking when it happens, and I want to convey that.

We were talked through what I am going to call the process. Before we left that day, I had signed a form to consent to infanticide—the termination of our much-wanted baby’s life. This is a decision that the mother must make, as the baby still belongs to her body. I could have chosen not to do this, but at nearly 21 weeks gestation my baby had no rights of its own. To be born before dying, a midwife would stay with the baby until it passes away. I am told that this is much more traumatic for the baby.

The next day we returned and endured the procedure. I have never felt so helpless. I was voluntarily allowing somebody to inject a long needle through my skin, into my womb and into my baby’s heart, so that they could inject some potassium to end that little life. Our baby was very strong, and it took longer than it usually does. I hung on to my husband and let him be strong for me, not that he felt that he was. I felt my baby kicking until the very end.

Two days later we returned to the RCHT. It was a Sunday morning, and we had been told to go to the Daisy suite. That is where women birth if their baby is going to be stillborn. It means they do not have to interact with other pregnant women or newborns while labouring. However, when we got there, it was being used by another woman who was there with her dad. She had been brought in as an emergency the night before, and her baby had stopped moving at 38 weeks. I felt that she needed the space more than I did.

I was induced and endured an eight and a half hour labour, which was much longer and far more intense than with my first baby. Finally, I delivered. I had not planned to look at my baby. To be honest, I was scared of what I might see. The midwife said to me, “You have the most beautiful baby girl.” And there she was, a perfect, beautiful, sleeping girl. She was tiny. She looked just like her big sister. I held her, I kissed her and I told her how much she was loved, and then I let her go. We named her Lily Wren Mackrory—Lily for peace, Wren because she is our smallest little girl, Mackrory.

Baby loss is far more widespread than I ever realised before it happened to my family. Many people are bearing this grief, often silently. Pregnancy and childbirth have always been perilous for women. Even now, in 2020, with all our medical advances, there are so many babies we simply cannot save. Miscarriage, stillbirth and the death of a newborn are all too common. Thousands of parents experience pregnancy or baby loss every year. It is estimated that one in four pregnancies ends in miscarriage, and 14 babies are stillborn or die shortly after birth every day in the UK.

I do not want to be completely self-indulgent during my speech today, but I do not know how else to relay how raw that feels for those parents and how important it is that we talk about it. I have one word to describe the grief I felt following the loss of Lily—primal. I just wanted to bring my baby home. I wanted her to be healthy. It dominated my entire being. I wanted to watch her kicking feet and to feel the grip of her tiny fingers on mine.

Weirdly, I gained an understanding about why some species, particularly penguins, steal each other’s babies when their own eggs do not make it. It is a physical ache down the arms and in the stomach. What had I got wrong? What had I eaten or not eaten that had made her so poorly? Was it because I was too old? Since I already had one healthy, amazing child, perhaps I had simply pushed my luck. Of course, none of that is true.

Having our then four-year-old meant that a daily routine had to continue, thank goodness. My husband and I were alarmed by the statistic we read that 50% of couples who experience baby loss end up splitting up. We were determined not to be one of them. We vowed to let each other grieve at our own individual pace and not to expect too much of each other. One would take the load when the other felt overwhelmed, angry or helpless. We allowed family and trusted friends to help us as a couple, as well as separately, but during the worst days I thought I would never recover. People do, of course, but they are changed. That was how 2019 began for me, and it ended with me coming into this place.

The experience I have just described is fairly shocking when it happens, but sadly it is not unusual. This year, Baby Loss Awareness Week focused on highlighting baby loss during the covid pandemic. From start to finish, I simply could not have got through that horrendous weekend without my husband at my side, yet we have been expecting women to do that since covid hit our shores earlier this year. As co-chair of the all-party parliamentary group on baby loss, I have had the privilege of listening to many experiences and testimonies and learning what baby loss charities and the APPG have achieved so far. Despite my position in this, I am still fairly new to the experience.

Last year, during Baby Loss Awareness Week, before I became a Member of Parliament, I attended a service in Truro with my husband as a member of the public and a bereaved parent. I looked at the book of remembrance, at Lily’s date, and there was her name in full. It was the first time I had seen it written anywhere, apart from in a small memorial that we had placed on my grandmother’s grave. There was another name there: a little boy named Isaac. I realised straightaway that he was the baby boy who had been born on the Daisy suite on the same day as Lily.

In August 2020, the APPG held a virtual meeting—my first as co-chair—focused on the impact of covid-19 on pregnancy and baby loss. We heard evidence from organisations that support women and partners who experience loss at any stage. The evidence was stark. Covid-19 has exacerbated existing challenges and has had a negative impact on the experience of women and their partners and families at the worst possible time of their lives. Hospital trusts that had traditionally been struggling in this area appear to be the most vulnerable.

I will summarise what the APPG found. Partners have been excluded from appointments and scans, and often have not even been able to join the consultation by video or speaker phone. That has led to women receiving bad news or making decisions alone. In a neonatal setting, mothers and partners had visiting rights severely restricted. Those factors all increased the sense of isolation experienced by bereaved women and their families. Thanks to a successful campaign led by my hon. Friend the Member for Rutland and Melton (Alicia Kearns), many trusts have reversed the decision to prevent partners from being present at scans and births. However, many still cannot or will not.

Women have reported restrictions on the way that they can access health services relating to their pregnancy. They often find that accident and emergency is the only route available. Scans have been cancelled, and mothers with concerns about their baby’s movement have reported being sent away from hospitals. Some key staff, such as health visitors, have been redeployed during the pandemic, which means that women cannot access the services they need. After receiving bad news, information on options and choices has not been forthcoming. For example, women report a lack of information about pain, bleeding and what to do with pregnancy remains after experiencing a miscarriage.

In maternity and neonatal settings, a lack of time and available space has impacted on whether staff can provide opportunities for memory-making after a stillbirth or a neonatal death. That is massively important for grief and recovery. In some cases, women chose not to access health services, taking the important “stay at home” message of the Government’s campaign to heart. In the early stages of the covid pandemic, in some hospital settings, personal protective equipment was a barrier to delivery of compassionate bereavement care, and staff struggled to communicate in the way they would prefer. Hospitals reported shortages of face-to-face interpreters to help communicate with women who do not speak English. After a stillbirth, neonatal death or sudden infant death, some families whose baby had a post-mortem had the results communicated by post or email, which is not appropriate.

Although some new ways of communicating began during lockdown, such as virtual antenatal appointments, they are not accessible to all and do not always provide the same reassurance as an in-person scan or consultation. I even heard the tragic story via one of our bereavement charities of a woman who had given birth to a stillborn baby, and because the mother had tested positive for covid, her baby was simply zipped in a body bag and taken away. I must add that that was at the height of the pandemic in April.

The APPG found that lockdown had exacerbated risk factors for some types of baby loss—particularly involving deprivation and domestic violence. After a loss, the isolation of lockdown contributed to negative impacts on women’s and partners’ mental health and their ability to access support from friends, family, psychological professionals and community outreach services.

In response, the APPG called on NHS England to initiate a minimum acceptable standard for involving partners when pregnancy or baby loss is anticipated or occurs, whether in relation to attendance at scans or appointments, or parental access to neonatal units. There is too much variation between hospitals at present, which must be addressed with national guidance. I know that that has already begun. I also ask for the swift reinstatement of the provision of choices for women facing pregnancy or baby loss in respect of the mental health impacts of covid-19 on those bereaved through pregnancy and baby loss, in order to plan services for that group in the future.

I thank the Department of Health and Social Care; health professionals; baby loss charities such as Sands, The Lullaby Trust, Aching Arms, and particularly Cradle in Cornwall and a lovely lady there named Emma Pearce—there are so many to mention; Members of this place, past and present; and, most of all, bereaved families for their co-operation on the work to date in this vitally important APPG. I hope that, while in post, my right hon. Friend the Member for South West Surrey (Jeremy Hunt) and I can continue their important work and bring solace to families in their darkest time, as well as trying to prevent more losses in the first place. I look forward to working with colleagues, including the Minister, to achieve that.

--- Later in debate ---

[Cherilyn Mackrory]

I will make it brief. I thank all right hon. and hon. Members for being here this afternoon and for the stories that they shared, and particularly the hon. Member for Sheffield, Hallam (Olivia Blake)—that was incredibly brave; it is so raw still. I also pay tribute to the hon. Member for Luton North (Sarah Owen), who has shown such kindness to me over the past few weeks and spoken to me privately—we have shared our stories. I think this is a tribute to how this Parliament can work, and I hope that we will be in the Chamber this time next year.

Question put and agreed to.

Resolved,

That this House has considered the effect of the covid-19 outbreak on people experiencing baby loss.

Oral Answers to Questions

Cherilyn Mackrory Excerpts

Tuesday 23rd June 2020 Commons Chamber

[Jo Churchill]

The hon. Gentleman will know which parts of that are still open for discussion between us, but we are of course driving hard to make sure that patients get their radiotherapy and treatment as quickly as they can. The NHS has a “Help Us Help You” campaign: it is open for business and people should make sure that they attend any appointment they are called to.

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

What steps his Department is taking to support the mental health of NHS workers during the covid-19 outbreak.

[Jane Stevenson (Wolverhampton North East) (Con)]

What steps his Department is taking to support the mental health of NHS workers during the covid-19 outbreak.

[The Minister for Care (Helen Whately)]

Our NHS workers—from the doctors, nurses and allied health professionals to the healthcare assistants, porters and all those who work behind the scenes—are truly heroes. I wish to say a special thank you to students: thank you to the medical students and nursing students who courageously stepped up to work at the frontline in a global pandemic. I am determined to do all that we can for our NHS workers. We have set up a round-the-clock mental health support line, which includes a freephone helpline run by the Samaritans and an out-of-hours text support service provided by Shout.

[Cherilyn Mackrory]

I thank the Minister for her answer and wish her a very happy birthday.

Due to physical challenges with geography in rural communities, such as much of my Truro and Falmouth constituency, there can be higher incidences of mental health issues, loneliness and isolation, and that has been intensified by the covid-19 pandemic. Will my hon. Friend provide an update on departmental plans for support for mental health issues in rural communities?

[Helen Whately]

My hon. Friend is absolutely right: we anticipate an increase in demand for mental health support, including in rural communities, as a result of the pandemic. We are working with the NHS and a wide range of stakeholders to understand the need for mental health support all over the country and to make sure that that support is in place.