Oral Answers to Questions

Olivia Blake Excerpts

Tuesday 5th March 2024 Commons Chamber

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

13. When she plans to respond to the Joint Committee on the Draft Mental Health Bill’s report entitled “Draft Mental Health Bill 2022”, published on 19 January 2023.

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

I put on record my thanks to the members of the pre-legislative scrutiny Committee, which scrutinised our draft Mental Health Bill. We are looking at the recommendations and will respond to the Committee’s report shortly.

[Olivia Blake]

It is now over a year since the Joint Committee report on the draft Mental Health Bill was published. Despite repeated promises of reform, the Government have failed to act. More than 50,000 people are held under the Mental Health Act 1983. It is an outrage to them and to campaigners that reform has been de-prioritised. Will the Minister confirm when the Government plan to bring a formal Bill to Parliament and what conversations they have had with the Chancellor in the run-up to the Budget to ensure the reforms are properly resourced?

[Maria Caulfield]

As I have said, we have published our draft Bill, it has undergone pre-legislative scrutiny and I shall respond to the Committee’s recommendations shortly, but this is not just about legislative reform. As a result of the £143 million that we have invested in crisis support, we have already seen less use of the Mental Health Act 1983 because people are being seen earlier: our crisis cafés and crisis telephone services, for example, have led to a 15% reduction in the use of the Act.

Eating Disorders Awareness Week

Olivia Blake Excerpts

Thursday 29th February 2024 Westminster Hall

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

I thank hon. Members across the House for their support in this debate, and I thank the hon. Member for Bath (Wera Hobhouse) for securing it. All the work that the APPG on eating disorders does is very much appreciated, and it rightly puts this issue back in front of us to discuss during each and every Eating Disorders Awareness Week. I also thank the Backbench Business Committee for granting us time to debate this issue.

Like many serious mental illnesses, eating disorders are often endured in silence. That means symptoms can go unnoticed, resulting in devastating consequences. Without diagnosis and treatment, eating disorders can be deadly. They have the biggest mortality rate of any mental health condition.

Around 1.25 million people in the UK live with disordered eating—a number that has inevitably been made worse by the pandemic. Although younger women are especially at risk of suffering from eating disorders, it is vital to remember that eating disorders can and do affect all people regardless of age, gender, ethnicity or background. So the general topic of today’s debate—Eating Disorders Awareness Week—is an important one, and it is especially important to one of my constituents.

I want to talk about someone I have been supporting for the past two years, who has shared her deeply distressing experience as an in-patient on a mental health ward. She spoke about the way in which she was

“reduced to numbers before receiving help.”

Despite not being able to eat, drink or take medication for five full days on the ward, and after asking for medical help, she was told she would only be referred once she had reached a specific blood pressure and blood sugar reading.

During my constituent’s ordeal, she was not provided with any support at mealtimes and, eventually, staff stopped asking if she wanted any food or drink. That resulted in her being transferred to another hospital in a critical condition and requiring emergency medical treatment in the ambulance on the way. As my constituent rightly told me,

“no one should ever be left to the point of medical emergency before needing help.”

It is right that we acknowledge the hard work of eating disorder specialist NHS workers and campaigners in my constituency and across the country, such as Hope Virgo, whom we have heard about, and many others. Specialist frontline workers continue to provide vital life-saving care in increasingly difficult circumstances and with increasingly scarce resources. We also need much more training in eating disorders for all frontline staff so that they understand how to treat patients in their care.

We know that eating disorder services are at breaking point. Demand is going up, cases are becoming more critical, training and resources are scarce, and the availability of support is a postcode lottery. This means that unacceptable cases such as this are inevitably becoming more and more common. The current system is failing. As I said last year, we face a crisis with terrible human consequences.

The specific theme of this year’s Eating Disorders Awareness Week is avoidant/restrictive food intake disorder. Anyone can have ARFID; it can affect children, teenagers and adults. Although it is a little known and often misunderstood condition, it can have serious consequences for health if left untreated. Too often, misconceptions about picky or fussy eating trivialise this serious condition. The stigma and fear of judgment means that those with ARFID and their carers often suffer in silence. The charity, Beat, has reported an increase in calls to its helpline from people affected by ARFID. In 2018, it received 295 inquiries about the disorder. By 2023, that had ballooned to 2,054 calls.

[Wera Hobhouse]

Does the hon. Member agree that this is also about the carers, care givers and the parents who need to know about the condition? They are often worried to death when they see a child or a young adolescent in such a condition and they do not know what to do.

[Olivia Blake]

I absolutely agree. I have had carers contacting me to ask where they can find guidance because of the limits locally, which I will go on to in a bit. That is probably why we have seen the increase in calls for support for carers.

Carers are hearing time and again that people are struggling to get the help that they desperately need. That is partly due to limited awareness, limited research on the condition and a lack of standardised treatment pathways. Today’s debate plays an important role in tackling the misconceptions in the system and raises awareness of a serious condition that can have fatal consequences if left untreated, due to malnutrition and other issues.

Another part of the problem is under-resourcing in the system. Since 2011, hospital admissions for eating disorders have nearly doubled in England, going from 2,287 to 4,462 last year, after peaking at 5,559 cases in the year 2021-22. Currently, 12.5% of 17 to 19-year-olds are estimated to suffer from disordered eating. Shockingly, an NHS England survey found that 59.4% of 17 to 19-year-olds exhibited behaviours that suggested it was possible that they had an eating disorder. Among girls, the figure rises to just over three quarters, at 77%.

While Ministers promised more funding, the scale of response simply is not matching the alarming level of demand. The waiting time targets for specialist eating disorder services for children and young people are consistently not met, even though they have only recently been put in place, while the lists have simply been growing longer and longer. As a bare minimum, there should be an action plan to address the backlog, and a similar target must be put in place for adults seeking help. That was part of a previous plan, but it has clearly been dropped in the major conditions strategy, which the hon. Member for Bath mentioned. Without a clear plan in place to meet those targets, it is really important that we make sure that care is available to people. All children and adults with an eating disorder should be able to get access to the care that they need.

It is not good enough to address the in-patient figures alone. We know that early intervention is the right treatment. The devastating consequences of eating disorders can be prevented, yet the Government have done very little to move us in the right direction towards preventive care.

Due to the delays in identification, referral and waiting times, those able to access treatment are waiting on average three and a half years between onset and start of treatment. That is far too long, when we know that the earlier we get to people, the better their chances. The delay is potentially fatal to many, with recovery being far more likely for patients who receive medical intervention early, when behaviour can be adapted before it becomes too ingrained. For ARFID, we need an NHS-commissioned treatment pathway and trained NHS staff so that people do not go undiagnosed or untreated, or sit in treatment pathways that are not suitable for their needs.

It is seven years since the Parliamentary and Health Service Ombudsman report, which has been mentioned. That report was damning. It concluded that patients had been failed by NHS eating disorder services. It is shameful that we cannot point to more progress in this area and that, since then, the ombudsman has felt the need to reiterate the findings of that report to try to get more action.

This crisis should be an opportunity to rethink our approach to how we support and treat people in the UK who suffer from an eating disorder. I urge the Minister to look at the transformative work that groups such as South Yorkshire Eating Disorder Association are doing to help build an alternative framework for care nationally. It is time that we acknowledged the crisis and committed the training and resources necessary to fix it.

Mental Health Treatment and Support

Olivia Blake Excerpts

Wednesday 7th June 2023 Commons Chamber

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

As an officer of the all-party parliamentary group on eating disorders—an issue that I will raise in my speech—I thank the right hon. Member for Chelmsford (Vicky Ford) for her bravery in sharing her experience.

The statistics on the crisis in the NHS, as raised by my hon. Friend the Member for Tooting (Dr Allin-Khan) and others, speak for themselves. The 5.4 million hours that people with mental health problems are waiting in A&E is a scandal. We know that the longer patients wait for treatment, the worse and more dangerous their conditions can become. While I would love to make this speech about the importance of prevention, unfortunately we see a crisis in the NHS, so I will focus on the issues of acuity mentioned by the hon. Member for St Albans (Daisy Cooper). Many of those who cannot access the mental health care that they need are children. A quarter of 17 to 19-year-olds have a probable mental illness. Nearly one in 10 seven to 16-year-olds and a third of 17 to 24-year-olds have tried to self-harm. My own NHS South Yorkshire integrated care board has a waiting list of 10,015 children.

If those figures were not horrific enough, I want to talk about one further horrifying effect: that of people with eating disorders—often children or young people—having to wait to be given a tier 4 bed in a specialist ward owing to the acuity of their condition and because of the lack of preventive care available. Last year, a parent wrote to tell me that they were struggling to secure a mental health bed for their child, who had been diagnosed with anorexia. They would have gone anywhere in the country to get their child seen given the care they received while they were waiting. They needed urgent in-patient mental healthcare, but no tier 4 beds were available, so they had to be admitted to a general ward instead.

When the parents first contacted me, their child was being restrained most days to be fed. They were worried that, without specialist support, repetitive restraint was only making things worse. I have since spoken to numerous eating disorder specialists, researchers and medical staff who have all told me about the rising number of children with eating disorders being restrained—often unnecessarily —by staff in general medical wards without training, recording or following guidance. I have heard more first-hand stories. I warn hon. Members that these are not nice experiences to relay, but they should be shouted from the rooftops because they are the human consequences of a system that is understaffed, under-resourced and under strain.

One person told me that, as a 17-year-old, they were restrained for feeding via a nasogastric tube three or four times a day by five people; that went on for about 10 months. Another person told me that they were restrained for daily NG feeds by five to six staff at a time for six months. Sometimes, they were held for an hour after the feed and would come out with bruises, despite their screams during the restraint. I have heard stories of 15-year-olds being restrained at 11 o’clock at night for NG feeding. To be clear, it is not just the people I have described who are suffering because they must wait for access to the care they need; it is also causing tension between psychiatric staff and medical staff on wards because these people are getting inappropriate care.

It is shameful that in such settings the use of restraint does not need to be recorded. Its use is heavily regulated in mental health settings for a reason. The use of restraint and restrictive practice is really consequential to the conditions that people go on to develop and their ability to recover. I am disappointed that in a letter and in response to me following a debate, the Minister refused to act and close the loophole. I ask her to think again about closing that loophole so that, no matter where a person is in the system, they have the same rights around restraint and that it gets recorded.

Baby Loss and Safe Staffing in Maternity Care

Olivia Blake Excerpts

Tuesday 25th October 2022 Westminster Hall

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

It is a pleasure to serve under your chairship today, Mr Davies. I thank the hon. Member for Hartlepool (Jill Mortimer) for securing today’s important debate and speaking with such bravery. I also thank colleagues from the APPG for producing such an illuminating report, which looks beyond the stats and figures, and shines a much-needed light on the impact of staffing shortages in maternity settings.

Earlier this year, I met midwives in my own constituency, and what they had to say was deeply upsetting. They told me that they were in crisis, could not cope with the conditions, and felt burnt out, underpaid, undervalued and ignored. However, at the top of their list of concerns were the repercussions that that environment had on their ability to do their job. They described the constant stress of feeling unable to provide the quality of care they wanted to and that patients deserve, and spoke about the pressure they felt to take on extra shifts, knowing that if they did not, they would be leaving colleagues to suffer or, in the worst cases, patients in crisis.

[Margaret Greenwood (Wirral West) (Lab)]

My hon. Friend is making an important point, which is reflected in some of the conversations that I have had with people working in maternity services. I am sure she will be aware that we have lost 500 midwives from the NHS in England over the last year. Does she agree that it is important that the Government come forward, as a matter of urgency, with a plan to address this staffing shortage crisis?

[Olivia Blake]

I completely agree. The picture is the same up and down the country. Last year, the Royal College of Midwives warned of an “exodus”, as more than half of midwives surveyed said they would consider quitting their jobs. The result is that two thirds of midwives are unsatisfied with the quality of care that they are able to deliver. That is a bleak picture.

The solutions are quite simple: a proper workforce plan, pay that midwives can live off, conditions that do not drive them to burn out, and increased training opportunities for both new midwives and nurses wanting to convert to midwifery. Midwives across the country are calling for change, so I look forward to hearing the Minister’s response to the report. For the sake of midwives in my constituency and patients across the country, I hope she will commit to taking on board the recommendations.

Two years ago, during a Westminster Hall debate on baby loss, I was inspired by the brave Members around me to speak publicly for the first time about my own experience of miscarriage. I am glad to see the progress that has been made since then, and I put on record my huge appreciation to the campaigners and individuals who have worked tirelessly to achieve that, from Tommy’s and Sands to the campaigner Myleene Klass, who I have been working with. However, for the one in five women who will experience a miscarriage, not enough has changed. The support they receive is still not consistent nationally. Women must still experience three miscarriages in a row before they can access support and tests to find out what is causing the loss, and national miscarriage figures are still not recorded.

Just last week, I spoke to a constituent who has experienced three miscarriages. The experience has had huge repercussions on her mental health, but she has not been able to access NHS mental health support. Now that she has had three miscarriages, she can finally have the simple tests carried out, but she should not have had to wait.

Last year, the then Minister responsible for women’s health, the right hon. Member for Mid Bedfordshire (Ms Dorries), committed to addressing the issue. During an Adjournment debate on 17 June, she stated that the Department would include two of the three Tommy’s recommendations from The Lancet series, “Miscarriage matters”, in the women’s health strategy: to

“ensure that designated miscarriage services are available 24/7 to all”

and

“take steps to record every miscarriage in England.”

The Minister said that the implementation of the last recommendation—to end the three-miscarriage rule and bring in a graded model of care—was not in the remit of the strategy and would instead be left up to the Royal College of Obstetricians and Gynaecologists. I am pleased that the college has consulted on a graded model and adopted it into its guidance, although leadership is still missing from Government to ensure the resources to properly end the three-miscarriage rule. These are welcome steps, but unfortunately the other two were missing from the women’s health strategy.

I received more promises from the previous Minister, the hon. Member for Lewes (Maria Caulfield), that the recommendations would be included in the upcoming pregnancy review, but that review has not been published for years, as we have heard from other hon. Members. With the new Minister in charge, we are yet to receive any confirmation of when the review will be published and our calls will be met. In the light of that, will the Minister commit to including all three Lancet recommendations in the pregnancy loss review and to meeting with myself and campaigners at the earliest convenience to discuss that review? This cannot be something we speak about once a year and then dump in the “too hard to deal with” pile. These are vital and simple steps that we must take to improve miscarriage care for every woman who has or will experience a miscarriage. We cannot wait any longer; we need a new model of care for miscarriage.

Women’s Health Strategy for England

Olivia Blake Excerpts

Wednesday 20th July 2022 Commons Chamber

[Steve Barclay]

I am grateful to my right hon. Friend, who I know has campaigned for many years on this; mesh is a particular issue that he and I have spoken about in the past. On the quality of data I am very happy to work with him on any specific examples, and indeed with colleagues across the House, because I know there are others who have worked closely on the mesh campaign, to see how we get the right consistency and the right analysis of data, because that is a shared interest of all of us in the House today.

In terms of the Department for Education, I am very happy to take the matter forward with my right hon. Friend the Education Secretary to look at what schools can do to raise awareness. That ties in with the wider point about ensuring that patients have the right information and that, where issues and concerns arise, they are not fobbed off but taken seriously.

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

There have certainly been times, including now, when it has been very difficult for me to talk about my experience of miscarriage—an experience that is shared by one in five women and that happens in one in four pregnancies.

Last year, I held a debate and got the Government to agree to support some of the measures in the review on miscarriage in The Lancet, named “Miscarriage Matters”. The Royal College of Obstetricians and Gynaecologists now supports abandoning the three miscarriage rule in favour of a stepped response and graded model of care.

However, I want to know whether the other things promised at the end of that debate are included in this strategy. The first was access for everyone to 24/7 care. The second was data and recording of miscarriage on medical records; when I was called for my flu jab and asked why I had been called, the nurse said, “Because you’re pregnant,” then looked down and said, “Oh, well, you’re not, are you?” The third was stopping the need for unnecessary miscarriages by making the care better; we can prevent miscarriage in some cases even when it is beginning, and stop people having multiple miscarriages and having to live with this pain, increasing their risk of suicide.

We could do so much more. Miscarriages are taboo and too often they are put in the “too hard to deal with” box. A certificate would be lovely, yes, but that is not enough. We need adequate care that rapidly reduces the need for people to go through this trauma again and again.

Draft Mental Health Bill

Olivia Blake Excerpts

Monday 27th June 2022 Commons Chamber

[Sajid Javid]

This is a very important issue on which the Government have been working with people across the sector, including in the NHS. We will shortly publish information on how we will build in the right support in the community plan.

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

I am afraid we are overseeing a scandal brewing in compulsory treatment as a result of covid. Because of the lack of available tier 4 beds, children up and down the country are in medical wards, and we see unsettling reports of restraint being used to feed them even though, when they get to see a mental health professional, they should not be force fed. I am conscious that the Secretary of State has answered a question about this already, but will the Government commit to starting to record restraint for feeding, no matter where patients are in the system and including in medical wards?

Special Educational Needs and Children’s Mental Health Services

Olivia Blake Excerpts

Wednesday 9th February 2022 Westminster Hall

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

I thank the hon. Member for Newbury (Laura Farris) for securing this important debate. I was not expecting to be called quite so early.

I will focus my remarks on my own personal experience of having ADHD, dyslexia and dyspraxia, none of which were recognised during my schooling. I want to highlight this because it is a journey of things going wrong and children not being fully supported.

By the age of 12, the average child with ADHD has received 20,000 more negative comments about their behaviour than their peers. “Lazy,” “distracted,” “too chatty,” “fidgety,” “failing to meet potential,” “disorganised” and “in disarray”: those were all comments that were levelled at me as a child, and they stick in my brain to this day and make me consider all my actions daily. This has led to huge feelings of anxiety and depression—a feeling that I am always doing something wrong. My ADHD was diagnosed only last year, and I have only just started taking medication, which has been life-changing.

There are two sides to the coin on this issue. When children and young people are supported at home and in school with the love and understanding that they deserve and need, they can flourish, as I feel I have flourished. I thank my family for the support that they showed me throughout my education to enable me to get to where I am today.

However, I meet too many children whose stories are still the same: their needs are not recognised or are not severe enough to merit critical help, and they are stuck in the middle, reaching their potential in some subjects and failing in others. They also feel that they are not listened to, that they cannot access support and that there is something critically wrong with them. They internalise negative comments about themselves, which is really damaging in the long term.

There are also lots of huge positives to being neurodivergent. Neurodivergent people are more likely to be entrepreneurs, and to take the risk of setting up businesses. However, the dark side is that they are more likely to try illicit drugs and to get involved in crime. There really are bright and dark sides. To any young person who is struggling at school, I say: “Don’t worry. There is always something else for you to strive towards. You just need to find what you are good at, and you will relish that opportunity.” No one should be held back because they have a diagnosis of ADHD, autism, dyslexia or dyspraxia. All children should be supported to get the best out of themselves.

However, far too often our education system is one-size-fits-all. I am really proud to chair the all-party parliamentary group for special educational needs and disabilities. It is so important that we change the classroom and home environment for these children, so that their behaviours are understood, and they can fully experience school and get to where they need to be.

So many things have gone wrong during the pandemic. Some children with autism have flourished through online learning, but others have found themselves isolated from their friends, peers, teachers and support. Several organisations are yet to start providing the therapeutic interventions that they are meant to provide under children’s education, health and care plans, and this is causing huge disruption to the ability of those children to thrive. Three quarters of disabled children have seen progress in managing their conditions and overall development regress in the pandemic. This is urgent and critical. Those who receive a diagnosis of dyslexia should also be screened for ADHD or other neurodivergent conditions, because the crossover is huge. We are letting our young people down by not helping them to get the tools they need to understand themselves—first and foremost—and how they fit in with the world.

I hope that the Minister will think more about how we can intervene as early as possible to avoid young people becoming incredibly depressed and anxious about just who they are—because they are round pegs trying to fit into square holes. It is critical that we support young people to thrive and give back to our society and economy by being the great pioneers and entrepreneurs that we all want to see.

I also have the privilege of having someone with autism in my family—

[Yvonne Fovargue (in the Chair)]

Order. I call Aaron Bell.

Children’s Mental Health

Olivia Blake Excerpts

Tuesday 8th February 2022 Commons Chamber

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

I am glad we are talking about this issue today, because the figures quoted at the beginning of the debate are shocking. In my area of south Yorkshire and Bassetlaw, three quarters of children referred to mental health services are not seen within the four-week period. I find that beyond belief, but in other areas of the country that rises to nine in 10 children. That is a horrific indictment of the Government’s approach and just goes to show that setting a target is only half the job. The energy and resources need to be put into meeting it too.

Other Members have eloquently outlined the broader picture of the crisis in children’s mental health, and Labour’s plan to address it. I want to use the opportunity of this debate to highlight a particular mental health problem and the effect that the lack of specialist services is having on children. The pandemic has seen soaring numbers of children suffering eating disorders. Some statistics we have not heard yet today are that between April and October last year 4,238 children were admitted to hospital with an eating disorder. That is an increase of 41% on the figures in 2020 and an increase of 59% on 2019, when the figure was 2,508. That is a dramatic increase in eating disorder inpatients, which should be incredibly concerning to all of us.

Of all the mental health issues, eating disorders are the No. 1 killer. It is perhaps even more concerning that, when these children and young people are admitted, the shortage of tier 4 beds and mental health practitioners means that they are often put in the wrong place in the system and do not receive support from people trained in eating disorders. These children are suffering from acute mental health problems and, unfortunately, restraint is regularly used on health wards, not mental health wards. That is not a good intervention, and it is not an appropriate therapeutic pathway for such acutely ill children. They all deserve a tier 4 bed, given how ill they are. At the moment, they are treated only for the physical consequences of their eating disorder and do not receive any kind of mental health intervention. That ignores the whole cause of their eating disorder.

Members have highlighted that we are failing our young people and children on the four-week target. It is also vital that the care that is finally provided is provided by the right people, not by people who are unqualified to meet their needs, as is happening to thousands of children with eating disorders up and down the country. There is a real danger that the system is actively contributing to making their mental health problem worse and harder to treat.

Does the Minister have figures on the use of physical restraint against children with eating disorders in acute wards that are not mental health wards?

Covid-19 Update

Olivia Blake Excerpts

Thursday 21st October 2021 Commons Chamber

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

I declare that I have diabetes. One in three people who have died from covid had diabetes, yet it has been unclear to those with diabetes whether they are eligible for a third vaccine. Can the Minister clarify whether all groups, including group 6, will be offered a booster? Will that be urgently communicated to people suffering from diabetes?

[Maggie Throup]

The booster has been offered to all those in cohorts 1 to 9, so cohort 6 is included in that.

Baby Loss Awareness Week

Olivia Blake Excerpts

Thursday 23rd September 2021 Commons Chamber

[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.

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[Robert Largan (High Peak) (Con)]

It is a privilege to follow my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken). She spoke about her own personal experience and her rainbow baby. I do not think the term existed when I was born, but I am my mum’s rainbow baby, and it was lovely to hear my hon. Friend’s speech. I also congratulate my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) on her powerful and courageous speech, and on all the work she has been doing since she was elected.

Baby Loss Awareness Week gives us all an opportunity to think about families that have suffered that tragedy and what can be done to help. We have heard a number of very moving stories in this debate, and I cannot begin to imagine how painful that experience must be for bereaved parents. I appreciate how difficult it is for people to be open in public about the loss of a baby or a pregnancy. According to the Baby Loss Awareness Week alliance, one in four pregnancies ends in miscarriage, and 14 babies are stillborn or die shortly after birth every day. One of the most powerful things to help those who have experienced that loss is to do everything possible to stop the same thing from happening to other parents.

My constituency of High Peak is home to some inspiring and hardworking maternity teams and bereavement organisations, and I wish in particular to talk about one organisation, and about my constituent, Ciara Curran, who asked me to share her story. Ciara lost her baby daughter Sinead 11 years ago in April 2010 due to pre-term pre-labour rupture of the membranes, also known as PPROM. That condition is when the waters break before 37 weeks of pregnancy, and it puts mother and baby at risk of infection. After such a devastating loss, Ciara went on to set up an organisation called Little Heartbeats to help women who have lost a baby to PPROM, and to ensure that pregnant mothers receive the best possible care if diagnosed with that condition.

Little Heartbeats has worked with the Royal College of Obstetricians and Gynaecologists to produce clinical guidelines and patient information leaflets to help prevent the loss of babies from PPROM. It has also launched studies into the impact of PPROM, as well as possible treatments such as stem cell patches. In recognition of the work done by Ciara and her team, Little Heartbeats received the Butterfly Award for best support organisation in 2017, and it was shortlisted for The Sun’s NHS Who Cares Wins health awards this year. It is amazing to see someone who has dealt with such loss respond with tremendous courage and compassion.

However, we still need greater awareness and a clearer understanding of PPROM, helping us to better identify and treat it. I sincerely hope that the Health and Social Care Committee will look into how the condition can be better managed, and learn from the stories of women such as Ciara who have lost babies to PPROM. I have written to the Chair of that Committee, who is in his place today, on that point. He gave a remarkably powerful speech, and I sincerely hope the Minister listened carefully to it.

We need to make improvements to antenatal and maternity care more widely. That is why I am campaigning for an improved maternity unit and antenatal clinic for Tameside General Hospital, which serves my constituents in places such as Glossop, Hadfield, Charlesworth, Gamesley and Tintwistle. The Charlesworth building at Tameside Hospital houses the current maternity unit and antenatal clinic. Originally built in 1971, it has poor insulation and problems with overheating that affect sensitive clinical equipment, including incubators for new-born babies, and impact on the wellbeing of patients and staff alike. Capital investment is badly needed to improve the comfort of patients and staff by improving insulation and providing new welfare stations and waiting areas. That will also deliver better care for mothers and babies by ensuring that clinical equipment is not overworked. I very much hope that Ministers will carefully consider Tameside Hospital’s bid for that crucial project as part of the health infrastructure plan, which alongside the planned new urgent care centre at Tameside, the proposed emergency care campus at Stepping Hill Hospital, and the long-planned new health centre for Buxton, would make a significant difference to healthcare provision locally.

I thank all the doctors, nurses, midwives, researchers, and organisers who do so much to address this challenge. Ultimately, the NHS cannot deliver world-class care without the dedication and perseverance of its amazing staff. They deserve our thanks, but they also need our support. The Royal College of Midwives has said that maternity services are experiencing a shortage of 2,000 midwives. In a 2020 survey, seven out of 10 midwives said that they were considering leaving the profession. The pandemic has put huge amounts of pressure on NHS staff, and it is vital that midwifery benefits from the Government’s £36 billion package of support for the health and social care system. It is also important that bereaved parents can get specific support and better access to counselling. The Baby Loss Awareness Week alliance carried out a 2019 survey, revealing that 60% of parents who have experienced baby loss said that they needed specialist psychological support but could not get it with the NHS. We need to improve access to counselling and invest more in prenatal nurses, giving them the right training to help parents who experience baby loss. If we are going to meet the Government’s national maternity safety ambition to see baby deaths fall by 50% by 2025, then action is clearly needed.

[Olivia Blake]

I thank the hon. Member for highlighting counselling, which is such an important issue. Does he accept that the quadrupled risk of suicide among people who experience miscarriage should be taken into consideration in suicide prevention work?

[Robert Largan]

I am grateful to my constituency neighbour for her intervention, and I absolutely take that point. That definitely needs to be taken fully into consideration.

The House has been grappling with lots of lots of big, difficult issues these past months. We often have heated debates, and I am sure that we will have many more, for the foreseeable future. But there are times, like this, when parliamentarians can come together to try to find solutions to our shared challenges. Let us work together to help those who are going through the darkest of times and give them hope that things will get better.