World Prematurity Day

Will Quince Excerpts

Tuesday 24th November 2015 Westminster Hall

[Will Quince (Colchester) (Con)]

I congratulate my hon. Friend the Member for Daventry (Chris Heaton-Harris) on securing this incredibly important debate. I will start by picking up on some of the points made by the hon. Member for Strangford (Jim Shannon) that focused on mortality, because our prematurity rates are a national scandal. He is absolutely right when he says that they have stagnated for about a decade. We have one of the worst records in the western world; I believe we are positioned 33 out of 35 countries. That is totally unacceptable considering we have one of the best health services in the world. It is a scandal.

When we talk about statistics and about being 33rd out of 35, we forget that we are actually talking about babies—more than 5,000 babies a year. More than 5,000 families go through the absolute tragedy of stillbirth or neonatal death. I very much welcome the fact that the Government now have a focus on the matter. Statistically, the third biggest cause of stillbirth and neonatal death is prematurity, and that is poignant to this debate.

The Government have recently made an announcement on stillbirth and neonatal death, as the hon. Member for Strangford rightly pointed out, with an ambition to reduce rates by 20% by the end of this Parliament and by half by 2030. That is a huge number—more than 2,000 babies who will be saved and 2,000 families who will not have to go through this most traumatic and awful experience. My wife and I have been through a full-term stillbirth, and it is a traumatic experience. As a Government, we should do anything we can to avoid those tragedies. I am glad that there is that renewed focus. That is key— it is the driver to ensure that we have the training and the best possible equipment.

Looking at the whole NHS, some of our hospitals have the best maternity units and are doing the best work anywhere in the world—second to none. Sadly, that is not consistent across the country. The situation is patchy. That is something that I very much hope the Minister will address as part of this programme. We must ensure that we have the later-pregnancy monitoring equipment that can save lives and, more importantly, the training so that midwives know what to spot and have the confidence to stand by what they believe in terms of diagnoses.

There is also the question of what we do when things do not go well; of course, as my hon. Friend the Member for Daventry suggested, we cannot avoid stillbirths or neonatal deaths. We can reduce the numbers, and the Government have measures in place to do so, but, sadly and tragically, there will always be stillbirths and neonatal deaths. I secured an Adjournment debate a few weeks ago in which I said that we must have the right procedures, processes and facilities to ensure that those who go through a stillbirth or neonatal death, particularly the parents, have a support network.

My hon. Friend the Member for Banbury (Victoria Prentis) talked about gynaecology counsellors and bereavement-trained midwives, and it is important that we have such facilities providing support in every maternity unit in the country. She rightly said that a huge number of marriages fail because of a stillbirth or neonatal death—I think the figure is a staggering 90%, which is enormous; I know the huge pressure that it put on my family and my relationship with my wife. I can entirely see how relationships can be broken up by that hugely traumatic experience. When I talk about the NHS, I know that we have the best facilities in the world, but we have to ensure that those facilities are available across the country. I am talking about specialist suites, bereavement-trained midwives, specialist nurses and psychological support, which is also important.

I am conscious of the time, but I will pick up on two other points. My hon. Friend the Member for Solihull (Julian Knight) mentioned hospital car parking, which was almost flippantly talked about, but it is hugely important. We forget that not everyone can afford to pay the £20 or £30 a week that some hospitals are charging. My hospital in Colchester has a reduced rate of £10 a week, I believe, but for some people even £10 a week is a huge amount of money. It is not only the parents but the families, the grandparents and the carers who are paying, so it is important that hospitals follow the guidance to ensure that hospital parking is affordable—or, even better, free so that families who are going through the most traumatic experience of their lives are not worrying about money. That is really important.

The hon. Member for Croydon North (Mr Reed) touched on an interesting point about the pressure on parents from prematurity and from having to go to the hospital. The mother is likely to be in hospital on an ongoing basis, but we forget about the importance of the father’s role. A father gets only two weeks’ paternity leave, after which he will be going back to work and either thinking all day about his premature child and then racing up to the hospital to try to squeeze in time with the baby in the morning and evening, or putting his job at risk by taking that time off, regardless of the consequences. Government guidance on the importance of employers understanding and recognising the pressures of prematurity on families is important.

I am conscious of the time, so I will conclude by saying that we have one chance to get this right. I welcome the steps that the Government are taking. When they announced their ambition to reduce by half the number of stillbirths and neonatal deaths the week before last, it was my proudest moment in the six months since I was elected to this place. I welcome those steps, but we need to go further and ensure that people have the facilities, the processes and the places to go to as they go through this incredibly traumatic experience. We must also make sure that stillbirths and neonatal deaths are as rare as possible. I welcome this debate, and I congratulate my hon. Friend the Member for Daventry on securing it. This is an incredibly important issue that we can all get behind and support.

[Mr Philip Hollobone (in the Chair)]

If the Front Benchers can keep their speeches to 10 minutes, and if the Minister can conclude his remarks just after 10.55 am, Mr Heaton-Harris will have three minutes in which to offer us a pithy summary of the debate and I will have 30 seconds to put the motion to the House. We will then have achieved everything we set out to achieve today.

Maternity Units: Bereavement Care

Will Quince Excerpts

Monday 2nd November 2015 Commons Chamber

[Will Quince (Colchester) (Con)]

I am delighted to have secured this debate on bereavement care in maternity units, which stems from my own experience and from further research. I should stress that I am no expert in maternity or bereavement, but I speak from personal experience. In May 2014, my wife had her 20-week pregnancy scan, at which point an abnormality was identified. Further tests led to a diagnosis of Edwards syndrome. I do not want to go into the detail of my son’s condition, but Edwards syndrome is described as being “not compatible with life”, so we were well aware of the likely outcome. However, our son was clearly a fighter and he survived full term, to 41 weeks, but sadly, in October last year, he was stillborn.

As hard as it is to tell my story, it sets the scene for this debate and will, I hope, give the House a small insight into the experience of the parents of the 5,000 babies who are either stillborn or die within seven days of birth every year in England. It is difficult at the best of times to talk about death, particularly the death of children or babies. We all hope it will never happen to us. But there must be provision, facilities and trained staff ready, willing and able to assist families who find themselves in this awful position.

[Jim Shannon (Strangford) (DUP)]

I am pleased to be here to support the hon. Gentleman this evening. I realise that he is telling us a very personal story. The figures indicate that 11 babies are stillborn in the UK every day, which makes stillbirth 15 times more common than cot death. Does he agree that we need not only bereavement centres in hospitals but also the presence of someone from the Church to give spiritual, emotional and physical help at that time?

[Will Quince]

The hon. Gentleman makes a good point, and I thank him for his intervention. The chaplain at the hospital certainly gave us a huge amount of solace. They provide a really important service.

For my wife and I, our care was absolutely fantastic. I cannot praise highly enough the staff at Colchester general hospital who cared for us when we needed it most. The very positive experience that my wife and I had at Colchester represents the model I would like to see rolled out across the country. As the chance of our son being born alive was poor, we were booked into the Rosemary suite, a specialist bereavement suite at the hospital. Crucially, it was far enough away from the hustle and bustle of the maternity unit, with a room that the dad can also stay in and a lounge and kitchenette. It is as near as you can get to a home from home.

The suite gave me and my wife the chance mentally to prepare for what was to come. Importantly, it was away from the noise of crying babies and happy parents and families. It was a place to prepare but also a place to grieve in private, and somewhere that we could be with our son. Importantly, the Rosemary suite also had a cool cot, which is a piece of medical equipment that acts like a refrigerated cradle, so that babies who have died do not need to be taken straight to the mortuary. That means that parents and family members can spend as much time as they want with their baby. Sister Liz Barnes, the gynaecology nurse counsellor, gave us a huge amount of emotional support, both before and after the event. I cannot tell you what a comfort it was to have Liz with us, speaking to us and guiding us through the next steps and, of course, the funeral arrangements.

Having gone through that experience, I had assumed that every maternity unit in this country had a bereavement suite, but sadly that is far from the truth. I have heard shocking stories of a lack of compassion and care shown to parents of stillborn babies in maternity units. An article published in BMJ Open in 2013 on bereaved parents’ experience of stillbirth highlighted some of the problems in care for parents in some of our hospitals. The report carried interviews with bereaved parents and contained some very distressing responses. One mother said:

“They only left him with me for about an hour. Then they just took him away. I was begging them not to take my baby”.

Others talked of a poor experience with hospital staff. One said:

“I thought these people”—

midwives and doctors—

“knew what they were doing. I wish I hadn’t thought that now.”

Another claimed:

“The delivery was just awful from start to finish. They almost treated me like ‘the woman with the dead baby’. There was no sympathy. When I asked to see a doctor, this particular doctor came in and said, ‘We’re very busy.’ And his exact words, I’ll never forget them, “Well, with all due respect, your baby’s dead already’. Which was just the most awful thing you could say.”

Some highlighted a distressing rush to decision making. One mother said:

“I wish someone had said to me in those first few hours, ‘Even if you don’t want to see her now, you can see her in an hour or two. Or in a day or so’. I was left to believe that because I wasn’t ready to see her, that was final.”

Some of these examples are really hard to listen to, but there are also some very encouraging stories within the report. Some mothers spoke of the “very, very caring staff”. Another very movingly said:

“Even though she wasn’t breathing and she didn’t open her eyes, she”—

the midwife—

“still said you’ve got a beautiful baby girl. It just meant the world.”

I will remember until the day I die the midwife who helped me dress our son after he had sadly passed away, and she said, “You have a beautiful baby”. I will never forget that.

The report concludes that in these tragic situations, clinicians and hospital staff

“only have one chance to get it right”.

It also stated that the experience of stillbirth can be influenced as much by staff attitude and caring behaviours as by high-quality clinical procedures. Last month, a study said that the UK provides the best end-of life care in the world, but if we want to maintain this level, we should not forget end-of-life care for stillborn babies and those with very short lives. The impact of stillbirth and post-natal death on parents should not be understated.

As it stands, maternity bereavement care in English hospitals is patchy. A major survey by the bereavement charity, Sands, from 2010 highlighted that nearly half of the maternity units in England did not have a dedicated room on the labour ward for mothers whose baby has died. That is important because these rooms are where they cannot hear other babies, jubilant parents and visiting families. It is absolutely vital that more hospitals recognise the importance of bereavement suites and their role in easing the pain and loss of bereaved families. These bereavement suites should be separate from the main maternity unit.

Even though I was absolutely aware of the likely outcome when I entered the Rosemary suite in October last year, nothing can prepare you for the shock and the numbness that comes from seeing your wife give birth to a lifeless baby. The precious hours we spent in what I can describe only as beautiful silence afterwards helped me and my wife come to terms with what had just happened. No parent should have to face being taken to a room in a maternity ward of crying babies when you have just gone through a stillbirth.

Many charities, such as Sands, Cruse and The Compassionate Friends do a fantastic job in raising awareness of the support that should be provided to bereaved parents. Many of the bereavement suites in hospitals are actually partially funded and provided by the fantastic work of these charities. I know many bereaved parents, us included, raise money after their loss, knowing how valuable these suites are. I know there has been some progress made in this area. In 2013-14, the Government invested £35 million in new maternity equipment and facilities. That helped to fund nearly 20 new bereavement suites and areas to support bereaved families. There is also a growing recognition of the role of bereavement-trained midwives, and that is really important in helping bereaved families after stillbirth or infant death. In February 2014, the NHS published a report on the support available for loss in early and late pregnancy, which stated:

“There needs to be better recognition of the bereavement midwife role. Generally, these roles are not part of the original establishment. Trusts are beginning to recognise the value in having these specialised posts and they are becoming more commonplace.”

It is great to see trusts increasingly recognise the fantastic work that these specialist bereavement suites and the staff can play in these tragic circumstances. I know that my family were very grateful for the fantastic support that we received.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I thank my hon. Friend for making a very important and powerful speech, drawing on his own tragic experiences. I have seen such experiences in my own clinical work far too often. Does he agree that whereas we normally leave commissioning to the discretion of local commissioners, we should be pushing in the next mandate to NHS England for there to be standard commissioning for all clinical commissioning groups to ensure that all birthing units have appropriate bereavement space and facilities to look after women who have had a miscarriage or had a stillbirth?

[Will Quince]

I thank my hon. Friend for that. I could not have put it better myself. I recognise the work that he did when he was a Minister in this area, and the huge part that he played in that £35 million investment.



I wish to see the Department of Health do three things to improve maternity bereavement care in England: first, to carry out a full assessment of the state of maternity bereavement provision in England, including on the number of maternity bereavement suites in each of our maternity units; secondly, to work with NHS England and local clinical commissioning groups to raise awareness of maternity bereavement care; and, thirdly, to consider introducing guidelines that each maternity unit should have a specific maternity bereavement suite for families.

I hope that I have been able to do this matter justice in such a short period of time. Great quality maternity bereavement care had such a positive effect on my family and me. I want the great care that we received to be extended to many other bereaved families across our country. Ernest Hemingway is attributed with saying:

“For sale: baby shoes never worn”

Those words encapsulate in a brutally concise way the sadness of losing a child.

The NHS cannot take away the loss or the grief, but we can make sure that every parent has the time, space and environment in which to grieve in peace.

NHS (Contracts and Conditions)

Will Quince Excerpts

Monday 14th September 2015 Westminster Hall

[Will Quince (Colchester) (Con)]

Thank you, Ms Vaz; I missed the first few minutes of the debate owing to a delegated legislation Committee, so I appreciate your calling me to speak. I speak not as a healthcare professional, but as a husband, father and proud supporter of our NHS. I am passionate about our NHS, because it has always been there for me and my family when we needed it. My daughter was born in Colchester general hospital and my son sadly passed away there in October last year. I cannot fault the care and compassion that the NHS gave me and my family, and I will never forget that. Yet, I am bombarded with criticism that, as I am a Conservative, I must somehow care less about the NHS than the Labour party does. The scaremongering and empty rhetoric is patronising and insulting. It has to stop.

I spent several months, as we all did, speaking with constituents in the run-up to the general election. The message I received was loud and clear: they care deeply about our NHS and want us to work together to address the underlying causes and challenges facing it—challenges like an ageing population and the rise in long-term health conditions like diabetes and dementia. They do not want cheap party political point scoring.

I am fortunate to represent a constituency with a large general hospital. The pressures on my own hospital are well known, as it is currently in special measures. Last year, we saw a major incident declared in relation to accident and emergency. I desperately want Colchester hospital to come out of special measures as soon as possible. However, I want it to happen only when the healthcare regulators feel that it has improved significantly enough to warrant it. Although I and many others were saddened to see Colchester receive an inadequate rating from the CQC, that close scrutiny is absolutely necessary. High standards at the trust are needed to address some of the deep-rooted issues facing the hospital. That is why I welcome the steps taken by the Secretary of State to introduce such a rigorous inspection regime, which puts patient safety at its heart.

I do not recognise the assertions of the petition we are debating today. The changes to contracts and conditions for workers in the NHS are absolutely vital to help us deliver the seven-day NHS that we all need. Diseases and illnesses do not strike only in the working week. Patients should get the same high-quality, safe care on a Saturday and Sunday as they do on a weekday. To take the case of my grandmother, who also sadly passed away last year, why can someone diagnosed with cancer at the beginning of the week have radiotherapy within two to three days, but someone diagnosed at the end of the week have to wait until Monday? That is not acceptable, which is why we need better flexibility in NHS staff contracts, going hand in hand with recruiting more doctors, consultants and nurses to staff those enhanced services.

Colchester general hospital emergency department has undergone a major reform programme over the past six months, which has contributed significantly to a sustained improvement in performance. The trust invested in three rapid assessment and diagnostic units, which have increased the department’s ability to assess and treat patients rapidly, resulting in shorter stays. In addition, there is now an action plan in place to address low staffing levels, which have improved significantly on every shift. The trust is welcoming a cohort of new substantive nurses, who are joining following a successful recruitment campaign. I sat on the recruitment panel for the new chief executive of the trust, Frank Sims, and I am very confident that he will be able to help turn the trust around. He has a strong record on staff engagement and working with partner organisations—two areas in which our trust desperately needs to improve.

I want to put on record the help and support that the Secretary of State has given Colchester general hospital. He has visited twice during the past year and has taken a genuine interest in our local healthcare. I also very much welcome the recent announcement about the success regime, which shows the determination of the Secretary of State to address the underlying issues facing the NHS in Essex and tackle them head on. Identifying problems, bringing in better leadership and helping our health and care systems to work better together is, in my view, the right approach.

NHS professionals tell us what is needed to address the underlying issues in the system: better self and family care; early diagnosis of illness and response; more focus on preventive healthcare; faster access to medication; community-based care where appropriate; and quicker discharge into community services. We can argue and debate about the process and the different ways of implementing the change our NHS needs. We can debate the funding. We could and should debate the future challenges. Make no mistake, our NHS will need to adapt over the next five years to keep pace with our changing demography and society, but let us make it a grown-up debate based on evidence and professional opinion, not conjecture and scaremongering.

NHS Success Regime

Will Quince Excerpts

Thursday 4th June 2015 Commons Chamber

[Ben Gummer]

I welcome the hon. Lady to her place. She will not know that there was an Adjournment debate at the end of the last Parliament on precisely this issue. I invite her to seek such a debate if she wishes to discuss local issues with me or other Ministers. The success regime has been devised by Simon Stevens and NHS England. It will be clinically led, fulfilling our desire to see the NHS led by doctors, not Whitehall bureaucrats.

[Will Quince (Colchester) (Con)]

I welcome the announcement. Colchester general hospital is in special measures. One of the biggest issues facing our hospital is the recruitment of nursing staff. Will my hon. Friend give an assurance that county-wide recruitment will be included as part of the success regime?

[Ben Gummer]

Every single aspect that is troubling local health economies, including recruitment, I understand, will be within the scope of success regimes.

Health and Social Care

Will Quince Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Will Quince (Colchester) (Con)]

It is a great honour to represent Colchester in Parliament. Colchester is not only the most beautiful town in Britain, but the oldest recorded and the Roman capital of Britain long before they discovered Londinium. We are blessed with rich heritage, including Roman walls, the only Roman circus in the country, a castle that is the largest Norman keep in Europe, and the largest Victorian water tower in the United Kingdom.

Colchester is also famously connected to two significant women in British history: first, Queen Boudicca, who was arguably the original Essex girl and who sacked Roman Colchester in AD60; and, secondly, the late Baroness Thatcher, who worked as a chemist while living in Colchester. Colchester has been a garrison town since the Romans and is now the home to 16 Air Assault Brigade. We are incredibly proud of our armed forces, and the link between the garrison and the town is stronger than ever.

Colchester is the cultural capital of Essex, with our multimillion-pound arts centre, Firstsite, which, although it has been tough, we are growing to love. We also have fantastic venues, including the Mercury theatre, the arts centre and the Minories gallery. It is an admittedly little known fact that Colchester is arguably the home of the nursery rhyme, with “Twinkle, Twinkle, Little Star” and “Humpty Dumpty” both being written there.

The final Colchester institution that I cannot fail to mention is, of course, Sir Bob Russell. I would like to take this opportunity to pay tribute to my predecessor, who served in this House for 18 years and, before that, for more than 20 years on Colchester Borough Council, where he served both as council leader and as mayor. He was held in high regard and had a reputation for being a hard-working constituency Member of Parliament. Although he and I rarely agreed politically, I respect him for the decades of public service he has given to our town and this country. As a mark of the tradition started by Sir Bob, I am today wearing the Colchester crest on my lapel, but I make no apologies for drawing a line at yellow waistcoats. In seriousness, I would like to put on record my thanks to Sir Bob and wish him well for the future.

It was Richard Nixon who said,

“only if you’ve been in the deepest valley can you ever know how magnificent it is to be on the highest mountain.”

I know that all too well. My first election was in 2003, when I was at university in Aberystwyth in mid-Wales and stood for Ceredigion County Council. It was only when nominations closed that I found out that I was the only Conservative candidate in the entire county, the reason for which became clearer on polling day when I received 26 votes—it was especially pertinent that 10 of them had signed my nomination paper. In that context, I cannot put into words my gratitude to the people of Colchester for putting their faith in me and giving me the opportunity to serve both my town and my country.

I am pleased to be making my maiden speech following Her Majesty’s Gracious Speech, particularly as part of today’s health debate, as I am fortunate to represent a town with a large general hospital. Colchester general hospital is currently in special measures, and I very much thank my right hon. Friend the Secretary of State for Health for visiting the hospital twice this year and for delivering 35 extra doctors and 66 extra nurses since 2010. My constituents will welcome the increased investment in the NHS of £8 billion a year by 2020, as set out in the Gracious Speech. Rest assured that I will be fighting for a considerable sum of that investment to come to Colchester.

Although the trust has a plan to get our hospital out of special measures, the hospital has a significant threat on the horizon, with NHS England due to decide in the coming months whether we are to retain our urology cancer surgical unit. I fully back the campaign to save Colchester’s urology cancer surgery unit. Our local centre serves the whole of north Essex; it is unrealistic to ask elderly patients from Colchester, let alone from as far afield as Clapton or Harwich, to travel the 60-odd miles to Southend for treatment. We have a fantastic cancer centre at Colchester hospital; indeed, we have one of the most modern radiotherapy centres in Europe. We have leading experts providing care to patients. In fact, less than three months ago £250,000 was invested in a urology day unit at Colchester hospital. We should be building on that, not trying to take it away. I have written to my right hon. Friend the Secretary of State on this subject, and hope that he will meet me at his earliest convenience.

Colchester was the first capital of Roman Britain. I intend to be its champion and, where necessary, its gladiator here in Westminster.