World Menopause Day

Andrea Leadsom Excerpts

Thursday 27th October 2022 Westminster Hall

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

It is a pleasure to serve under your chairmanship today, Mr Hollobone.

I pay particular tribute to the hon. Member for Swansea East (Carolyn Harris). Not only did she share some purple hair dye with my daughter, who at the time was 17, but she persuaded my daughter, who is now 18, to ask me about the menopause, so in my household anyway, the hon. Member is quite a famous person.

I also pay tribute to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes). I always get confused by that constituency name, because I represent South Northamptonshire, so it is somehow a real tongue-twister; I am sure she understands.

I also pay tribute to everyone here today who is now openly talking about the menopause. For me, all the way through until I started menopause—quite late, as it happened—I did not know the foggiest thing about it, literally. What is it? Nobody ever talked about the menopause, and that is extraordinary. We all chat about Viagra, and that serves a very different purpose; but the menopause, which affects 100% of women at some point in their lives, is somehow a taboo subject, particularly the consequences for women—feeling terrible, not being able to sleep and all the things that hon. Members have been talked about today.

Yet 41% of medical schools do not teach menopause as a mandatory subject. How utterly bizarre is that? It is completely strange. A study by Newson Health highlighted that 79% of women surveyed had visited their GP regarding clearly menopausal symptoms, yet only 37% were given hormone replacement therapy, and 23% were given antidepressants. In addition, women often face a wait of more than a year to get help. It is utterly ridiculous.

As Liz Earle, who is famous for her face products but is a real campaigner for helping women through the menopause, has said:

“It’s all about how to have a better second half of life, and I do believe the second half can be even better than the first.”

Hear, hear to that. Actually, in the second half of life, once the kids have grown up and you have got your life back and you are now an MP and want to get on, you actually want your hormone replacement therapy to be available on tap—don’t you, Mr Hollobone? “Yes”, I hear you say—shout, even.

I know that the Minister of State will be very sympathetic, because he really is a good listener, and while the menopause may not be his normal dinner-time conversation either, he will appreciate how important it is to all women of a certain age.

I will finish with the words of a lovely constituent who came to see me at my surgery:

“My GP encouraged me not to give up and 6 months later, after taking HRT, I’m now a new woman.”

So let us hear it for new women.

Infant Mental Health Awareness Week

Andrea Leadsom Excerpts

Thursday 16th June 2022 Westminster Hall

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

I beg to move,

That this House has considered Infant Mental Health Week 2022.

It is a great pleasure to serve under your chairmanship, Mrs Murray—I think for the first time. I am delighted to have secured this debate.

Infant Mental Health Week is an annual opportunity to highlight that human beings are the most underdeveloped creatures on earth at birth. Our brains, and therefore our responses, our reactions and our knowledge, are completely undeveloped. In fact, many people would say that we are born about two years premature. What other animal cannot do anything for itself until it is at least a year old? That is the plight of human beings.

Infant mental health is therefore, without any shadow of a doubt, more important than mental health throughout the rest of a person’s life. It is in that critical period when a person is so small and does not know what’s what or where’s where that their ability to have secure lifelong mental health is laid down.

From conception to the age of two, a secure and loving relationship between a baby and his or her carer literally shapes the way the baby’s brain develops. That is when the building blocks for lifelong physical and emotional health are laid down. Like a sponge, the baby’s developing brain will soak up the atmosphere around them and the environment that he or she is born into. In the womb, a baby whose mum is terrified of childbirth or is being treated with violence by her partner, or who is misusing alcohol or drugs, will be profoundly physically and mentally impacted by that experience.

Infant mental health, or, more specifically, early intervention in the first 1,001 critical days of life, from conception to the age of two, has been a passion of mine for more than 25 years. I chaired the Oxford Parent-Infant Project in 1999 and set up NorPIP, the Northamptonshire Parent Infant Partnership, providing parent-infant psychotherapy to families who are struggling to form a secure bond with their babies. I established national charity PIPUK—the Parent Infant Partnership—which went on to establish and support a number of other parent-infant teams right around the country. I also wrote the 1,001 critical days manifesto, which went on to become the First 1001 Days Movement. Infant mental health is a subject incredibly dear to my heart.

Science tells us that a secure and loving relationship with the key carer will shape the way in which the baby’s brain develops, with long-term and positive consequences for that baby’s mental health. Fundamentally, it is about self-regulation. A baby who is secure in his or her earliest relationships will later on be able to experience anger, fear, jealousy and disappointment, and will be able to regulate their own responses appropriately. It is the earliest relationship between parents and their babies that constructs that ability to self-regulate and hence delivers that pathway to good lifelong mental health.

Research released today by the Royal Foundation shows that 91% of parents and carers agree that early years are important in shaping an adult’s life, but only 17% recognise how uniquely important the period from birth to five is. As the Duchess of Cambridge has said,

“Our experiences in early childhood fundamentally impact our whole life and set the foundation for how we go on to thrive as individuals, with one another, as a community and as a society.”

In 2015, the National Childbirth Trust found that one in three first-time dads were worried about their mental health following their baby’s birth, and according to the Maternal Mental Health Alliance, up to one in five mums, sadly, suffer due to the lack of focus on support for mental health in the perinatal period. Unfortunately, we do not really have the granular information on perinatal depression among parents and carers that we would need to properly impact-assess the mental health effect on babies, but the mental health of the parent clearly impacts on their baby’s development. A good example is that a pregnant mum who, for whatever reason, suffers from stress will produce more cortisol—the stress hormone—in her bloodstream, which will pass through the placenta into the unborn child. The more stressed the mother, the more frequently the foetus is exposed to higher levels of cortisol, and we know that exposure to high levels of cortisol in the womb can lead to modifications in gene expressions before the baby is even born, so even in the womb, the potential for lifelong emotional and physical health is already being determined.

Once out of the womb, being left to cry unattended for continuous, lengthy periods of time, or being terrified by witnessing violence and anger within the family or loud and aggressive behaviour in their environment, will have the same impact on the baby: raising their levels of cortisol. Over lengthy periods, there is evidence that this damages the baby’s immune system and will give him or her a lifelong predisposition towards higher risk-taking behaviour. When a baby is born, they have no cognition at all: they can only cry, sleep or look around. They do not know if they are cold, hungry, bored or in pain. They only know that something is wrong, so a baby cries to attract the attention of a loving adult carer. When that carer turns up and takes the time to soothe, change, feed or sing to the baby, the impact of that tender and loving response brings the baby back to a state of calm and reduces their level of stress. This continues until the baby is old enough to understand how to regulate his or her own feelings.

Even more important is the fact that at birth, a baby’s brain is only partially formed. It is understood that a baby’s brain puts on up to a billion neural connections every minute during the first year of life. Those neural connections are stimulated by the quality of attention of the principal loving carer and the baby’s experiences of the world around them, which is why parental attunement and loving attention are fundamental for the healthy brain development of a baby. Simply put, what we do with a baby from conception until the age of two is about building the human and emotional capacity of that infant; what we do after the age of two is almost all about trying to reverse damage that is already done. A wealth of evidence demonstrates that poor mental health, substance dependency and domestic abuse among parents lead to significantly poorer outcomes for babies and young children. Research from the Maternal Mental Health Alliance highlights that the locations with some of the greatest levels of socioeconomic deprivation are also those where poor maternal mental health is at its highest. When they start school, children from such disadvantaged backgrounds are on average four months behind their peers, and it gets worse from there.

The quality of attachment that a baby has to their principal adult caregiver therefore has a profound impact on their lifelong mental health, and our society’s ambition should be for every baby to achieve a secure attachment to that caregiver, be it mum, dad, kinship carer or adoptive parent. Secure attachment is the foundation for good lifelong mental health, its possible effects having an impact on parenting from one generation to the next: if a person was well parented, there is a high likelihood that they will become a good enough parent, and their baby will form a secure attachment to them. Examples of insecure attachment are therefore found where care giving is inconsistent.

Babies who suffer from insecure attachment are not given the consistent, loving care that they need in order to feel that the world is a good place and that people are generally kind. Neglect of a baby has a very damaging impact. The baby with insecure attachment will of course have other chances in life; we never write anyone off. Babies who are insecurely attached in the very early stages will have lots of other opportunities to make good friends and to have other key adults in their lives who might help to turn things around and help them build their own emotional capability, but there is no doubt that insecurely attached infants will always struggle a bit more in later life to deal with life’s ups and downs. It will be those babies who might struggle to keep friends and relationships and also to cope without help with parenting when their time comes. This is sometimes known as the cycle of deprivation, where a general lack of good mental health is passed down from one generation to the next.

The most challenging early mental health impact is reserved for babies who develop a disorganised attachment with their principal caregiver. That is where the person they rely on to look after them, soothe them and keep them alive is also the most dangerous person in their life. The person they turn to for comfort might one moment hurt them and the next moment hug them. Such babies often find that making sense of the world becomes very difficult, and many of the most damaging outcomes in society—criminality, suicide, self-harm, sociopathic behaviour—are enacted by those who suffer disorganised attachment as a baby. It should be blindingly obvious to all that whatever we do to invest in giving every baby the best start in life will pay us back a million times over—a billion times over—in terms of general wellbeing, healthy communities and a stronger society.

We had a long way to go before the covid lockdown, but there is no doubt that Infant Mental Health Awareness Week is vital because it shines a spotlight on the huge damage done by two years of pandemic lockdowns: dads and co-partners not permitted to be with mum and the new baby; face-to-face health visits and other support such as family hubs moving to virtual only; wider family and friends unable to meet the new arrival and provide support; babies not able to meet other babies; and an exacerbation of existing problems such as addiction, domestic violence and poor mental health.

Above all else, there was the devastating isolation at a time when we all know that new parents are desperate to get out of the house to go and chat to another parent about the sleep that they did not get last night, what size nappies the baby should have, what they are doing about weaning, and whether the baby has had its first tooth yet. All the chats, empathy and consolation that new parents give each other were missing during the covid lockdown. A report carried out by the Parent-Infant Foundation, Best Beginnings and Home Start, titled “Babies in lockdown”, revealed that six in 10 parents were concerned about parental mental health in lockdown, and two thirds said that covid had affected their ability to cope with caring for their baby.

We know that health visitors provide a vital support service to families who are struggling. Every family in England should be offered five mandated reviews from a health visitor between pregnancy and age two and a half as a minimum. Local authorities, many of which are still using phone and virtual appointments to count as reviews, have reported in their latest quarterly data, from May, that 18.6% of babies missed out on their nine to 12-month review and more than a quarter of toddlers missed out on their two to two-and-a-half-year review. That includes all those who got the telephone-only service. There were still many who did not get anything at all.

Data, again published in May, shows that only 85% of children in England were at or above their expected level in communication skills, compared with 89% before the pandemic, and 79% were at or above the expected level in five key development assessments at the review stage, compared with 83% pre pandemic.

A report by Ofsted in April 2022 found:

“The pandemic has continued to affect young children’s communication and language development, with many providers noticing delays in speech and language…The negative impact on children’s personal, social and emotional development has also continued, with many lacking confidence in group activities”

and

“social and friendship-building skills have been affected.”

There continues to be an impact on children’s physical development, including delays in babies learning to crawl and to walk. Lockdown has caused many challenges and exacerbated many existing ones.

The early years healthy development review, which I chair, could not have come at a more important time. Since the summer of 2020, the review has focused on ensuring that every baby gets the best start in life. Its vision sets out six key action areas, which were made Government policy in March 2021. The action areas will deliver, first, a joined-up set of Start for Life services for every family in England; secondly, the roll-out of family hubs as a welcoming place, providing physical, virtual and outreach services for every family in England; thirdly, trusted digital, virtual and telephone support designed to meet the needs of the baby and their carers, as well as the development of the digital red book, which will allow much greater continuity of care for every baby; and fourthly, a modern, mixed-skills workforce that will provide much greater continuity of care and that works, with the baby at the centre of everything we do, to deliver wraparound, empathetic support.

Fifthly, we need much more understanding of the impact and potential of early intervention, so we will improve data collection and evaluation, and outcomes for the mental health and wellbeing of babies and their families, and we will develop proportionate inspection of services. Sixthly, these action areas will require real leadership locally and nationally. Fundamentally, we need to ensure that the Treasury will continue to fund the “Best Start for Life” vision in the long run.

I am delighted that the vision is shared cross-party, and I have no doubt that the spokespeople here today on both sides of the Chamber will want to support giving every baby the best start for life. It is a fantastically cross-party issue, and I pay tribute to the many colleagues here today, as well as to those who could not be here, who have lent their support to this agenda over so many years.

The views and lived experiences of babies and their carers have been at the heart of the early years review. From Blackpool to Stoke-on-Trent, from Worthing to Bexleyheath, from Camden to Cornwall, parents have shared with us the good and the bad. My “1,001 Critical Days” podcast has highlighted the mental health journeys of parents and their babies, and an LBC phone-in made clear the challenges faced by so many dads and co-parents, and the particular support they need, which is currently lacking, in their amazing journey to parenting.

Time and again we have heard that every parent wants to know how to be a good a parent, where they can access early years support, what is on offer for them and why they might need that support. They want companionship and not to be isolated, and they want to be able to share their stories with parents in a similar situation.

We heard from parents of babies with disabilities that they do not want to be left out, stigmatised and treated as different. We heard from many parents from different ethnic backgrounds, as well as LGBT parents, single parents and foster parents, that they do not want to be treated any differently from other parents either. All parents, of every type, asked for a seamless, joined-up approach to accessing the support they need. Face-to-face support is a priority, but in this 21st century, parents and carers also want access to services virtually when things are urgent, they are pressed for time or they just have a quick question.

Parents also want to avoid telling their story over and over again to different early years professionals, and there is huge support for a digital version of the red book, where parents can keep a permanent record of their baby’s birth experience, first tooth and first photo with Granny, along with all the other lovely records that parents want to have, as well as communicate with the professionals who are supporting them.

The positive to take away from today’s debate is that if we provide support and reach out to make sure that every family knows where to go to get help, and we educate families as to what good looks like, we can transform our society for the better. To end, in this platinum jubilee year, I would like to use the words of the Queen, who said:

“in the birth of a child, there is a new dawn with endless potential”.

[Mrs Sheryll Murray (in the Chair)]

I intend to call the Front-Bench spokespeople at a few minutes before 4 pm. I hope Members will bear that in mind. I call Munira Wilson.

--- Later in debate ---

[Dame Andrea Leadsom]

What a fantastic debate. We need to keep doing this—it is wonderful. Every time we get together, we have the most positive and constructive discussion about what is, in my view, the most significant contribution we can make to building a happier, healthier and more successful society.

I pay tribute to the hon. Member for Richmond Park (Sarah Olney), who recently held a Home-Start celebration. I remind her that one of the people there trying to get money from all of us told a wonderful story about how, sadly, he had lost his mum when he was quite young. His mum was on her death bed, and he was thanking her for being such a wonderful mother, and she said to him, “I’m not a wonderful mother; I was just well parented and I passed it on.” I thought that summed it up. That is what we need to do—we need to make sure that every family gets well parented so that they can parent well.

As a postscript, I will admit to something weird. I chair the review, so all the stuff that the Minister is talking about is well known to me. However, it is so lovely to hear her saying it. It feels like it is actually happening—it is not just a figment of my imagination. I thank colleagues for a wonderful debate.

Question put and agreed to.

Resolved,

That this House has considered Infant Mental Health Week 2022.

Midwives in the NHS

Andrea Leadsom Excerpts

Monday 17th January 2022 Commons Chamber

[Siobhan Baillie]

I think what we will hear from the Government is that there is a plan for recruitment, but we need more details. The Royal College of Midwives is certainly asking questions. My right hon. Friend the Member for South West Surrey (Jeremy Hunt) knows from the work of the Health and Social Care Committee that when the current Culture Secretary was maternity services Minister last year, she was incredibly passionate about this issue. She accepted that the NHS was short of the equivalent of 1,932 full-time midwives—but since then, sadly, the number has fallen by a further 222, leaving the shortage at over 2,000. Since records began in 2009, the number of NHS midwives has fallen in England year on year. We are in a really difficult situation at the moment.

To put this into perspective, there were more than 613,000 births in England and Wales in 2020. At the last count of midwives in 2021, there were 26,901 in England, but that drops to 22,301 if we look at part-time figures. By looking at the birth rate and the number of midwives, we can see just how stretched midwives are.

The Association for Improvements in Maternity Services says that

“urgent action is certainly needed to shore up what seems to be a maternity service that is losing staff at a catastrophic rate.”

Over half of midwives surveyed by the Royal College of Midwives say they are considering leaving their job. I know personally a wonderful midwife, Stevie, who has chosen to retire this year, and I wonder how many midwives are making the same choice. My mother, who is a nurse, not a midwife, is choosing to retire as well. They have had a pretty tough two years in the NHS, as we know, but the most worrying feature of the RCM survey, which the hon. Member for Strangford (Jim Shannon) mentioned, is that the highest levels of dissatisfaction are among newer midwives—those who have spent five years or less working in the NHS. So we have a pipeline problem, a new intake problem and a problem with retention of experienced staff.

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

I congratulate my hon. Friend on getting this important debate, and on the part she has played in looking at the best start in life for every baby, which we worked on together over many months. Does she agree that the problems not only for midwives but for the whole early years workforce have been exacerbated by the covid lockdown, with far too many families unable to see their health workers face to face and partners often excluded from important events such as scans and the birth itself?

[Siobhan Baillie]

I could not agree more, and I thank my right hon. Friend for everything she has done for early years provision. When we think about the early years and the importance of giving children the best start in life, we remember that midwives have children in their hands at year zero; it could not be any earlier than that. I will give more details of the reality of the pandemic world and what midwives and NHS staff have faced, but the effect on the beginning of the relationships and the fear when you do not have your partner with you in the ward has been absolutely awful. I appeal to all Ministers to think extremely carefully about further covid restrictions, if they ever again become necessary.

We know that the staffing shortage does not affect only midwives and hospital staff, but it has a real impact on families trying to bring new life into the world. As the hon. Member for Strangford alluded to, 87% of RCM members say that they delay using the toilet due to lack of time, more than 75% skip meals, and over half say they feel dehydrated most or all of the time at work—no doubt telling women to hydrate while unable to do so themselves. These professionals have the lives of our most precious loved ones in their hands. I ask the House: are those really the conditions we want them to be experiencing?

I have had messages from midwives all over the country. Last year, I received a letter from a former midwife saying that she was

“extremely concerned about the deepening crisis within maternity care.”

She handed in her notice. That is a loss of more than 10 years’ experience in clinical midwifery—experience that we cannot magic up overnight to replace her. She felt that she could not always provide the good, kind midwifery care that she was trained to give. She cited increasing paperwork, long hours and the inability to work hours that fitted around her family as key concerns.  She had begun dreading each shift. Being required to work faster and do more than was humanly possible meant fearing making a mistake that could lead to a tragic outcome.

Another midwife wrote a blog entitled, “How do we keep going when there is nothing left to give?” in which she talks about midwifery being a celebration of new life and how midwives get to share the joy of families starting out, but also how they are struggling in a system that does not allow them to do what they dreamed of, trained for and worked so hard for. With no staff available or even in the pipeline, the midwife describes having to close facilities, reduce antenatal education, and minimise post-natal visits. Another midwife talks about trusts having to introduce incentive payments, selling back annual leave and employing agency staff, but even then staff are declining the extra work because they are so cream-crackered and feel constantly stressed that the money just does not get them over the line.

Maternity staff are all incredibly caring human beings and they want to do a good job. They tell me they can recover from the physical strain of their job each day, but the mental anguish is weighing heavier and heavier. That mental strain is very real, as problems and errors in maternity services can have devastating consequences.

Although outcomes for mothers and babies have improved in so many areas in the last 10 years, any loss is too great. Understandably, the families affected cannot rest until they have knowledge of what happened and believe that it will not happen again. My heart breaks for them and, if I am honest, I will struggle to tell their stories without crying.

Birthrights is a UK charity that provides advice and information on legal rights, and trains doctors and midwives. The Ockenden review, which looked at maternity services, took serious evidence following the devastating loss at the Shrewsbury and Telford Hospital, and I know that the Health and Social Care Committee has also investigated maternity. Approximately 59%—about £4.2 billion—of the value of new clinical negligence claims is attributable to poor maternity care. In 2021, maternal mortality rates were found to be more than four times higher for black women, two times higher for mixed-ethnicity women and almost twice as high for Asian women. There is clearly so much more that we need to learn and change.

I know that this is issue is close to the hearts of many across this House. Between them, the Prime Minister and the Leader of the House boast a lot of experience of births, and the Minister is an excellent person to be responding given her own professional experience. The Government have made two important commitments: the first is to train 3,650 student midwives over four years, starting in 2019-20, and the second is to employ an additional 1,200 midwives. Obviously, that is hugely welcome, but given the seriousness of the situation and the fact that midwives are taking to the streets, I ask the Minister to update us on any progress and explain the recent decline in the number of midwives.

Public Health

Andrea Leadsom Excerpts

Tuesday 14th December 2021 Commons Chamber

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

Our covid measures have, and continue to, hurt our citizens—from a man with late-stage dementia who is terrified of face masks to an 80-year-old constituent who got stuck in South Africa, not because of omicron, but because flights were suspended; and now, the news that non-urgent primary care will be diverted once again, with the huge risk of harm to babies and young children if face-to-face support is unavailable for long periods of time once again. And the creeping regulation is so hard to keep up with, resulting in teachers cancelling school plays, businesses stopping events and families staying away from happy occasions for fear of breaking a rule they did not know about. Surely the campaign against covid should now focus on two key fronts—more boosters and more education.

The action by Government on boosters is fantastic, but instead of criminalising people, why do we not start a hard-hitting public health campaign—“If you’re going out this Christmas, don’t forget to take a test” or, “If you’re seeing your granny, make sure you get a jab”? Let us persuade people, rather than criminalise them. And let us go much further to reassure those who have a fear of vaccines, whether because of a needle phobia, because of cultural sensitivities, or just because of fake news.

My specific concern about testing requirements for big events is the sheer challenge of enforceability in a commercial setting. It would be far better, in my view, to use the approach of a daily test or a vaccine exemption for NHS staff and carers instead. That would be a practical and fair solution for both carers and the cared-for, and it would be enforceable. It would also avoid the risk of losing NHS and care workers who were unwilling to accept compulsory vaccinations.

I have supported the Government throughout the pandemic when I could see the present danger that we faced, but this time around the measures proposed are precautionary—just in case—and I cannot see where this will end. Covid will be with us for many years to come and it is unthinkable that, every autumn from now on, we will be limiting the quality of life for all citizens, just to be on the safe side; and justifying our new illiberal rules on the basis that “They are less authoritarian than those of other countries” is truly appalling. That is not our culture; that is not our history.

This is a slippery slope, down which I do not want to slip, so I am afraid I will not be supporting these measures.

Covid-19 Update

Andrea Leadsom Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

The hon. Gentleman is right to point to the lag between the point of infection and hospitalisation. That emphasises the need to act early and strongly. That is why the booster programme and that response is so important in Scotland, in England and throughout the UK, and it is good that all four nations are working closely together on it.

On lateral flow tests as an alternative to self-isolation, I think they are the right approach. They can be taken daily, so the individual is tested each day for seven days, whereas a PCR would be a single test at a single moment. This is much more flexible and it is based on advice Ministers have received. On the hon. Gentleman’s questions on economic support, that is something we keep under review.

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

I congratulate the Government on the roll-out of the vaccination programme—it is impressive—but what does my right hon. Friend say to my constituent who says she is now less afraid of covid than she is of intrusive and incoherent Government regulations?

[Sajid Javid]

I would say to my right hon. Friend that I hope her constituent would appreciate that the Government have to act on the information they see before them on the rate of spread of this new variant and what we now know about its degree of vaccine escape—not just to protect my right hon. Friend’s constituent, but to protect that constituent’s loved ones and her community.

Covid-19 Update

Andrea Leadsom Excerpts

Monday 29th November 2021 Commons Chamber

[Sajid Javid]

Surely the hon. Gentleman is not suggesting that if we had had different rules on masks over the summer, this variant would not have emerged.

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

I am sure that my right hon. Friend will want to pay tribute to the South African Government for raising the existence of the omicron variant, which resulted in their having a travel ban imposed. I have constituents—and, in fact, a family member—stuck in South Africa. For how long does he expect cancellations and suspensions of flights to occur? It is a worrying time for anyone stuck overseas.

[Sajid Javid]

First, I join my right hon. Friend in again expressing thanks to the South African Government for how they have handled this difficult situation. I understand her point about her constituents. Many of us will have constituents in a similar position. It is hard to say when direct flights might start. We have started our hotel booking programme, which is one part of trying to get our citizens back, but we will do everything we can to support them in that way.

Health and Care Bill

Andrea Leadsom Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

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

This Bill can really help support giving every baby the best start for life.

First, new clause 55, in the name of my hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds), would require the Secretary of State to publish guidance on how integrated care systems should meet the needs specifically of babies. “The Best Start for Life” report, published in March, calls for every local area to publish a seamless start for life offer for every new family. That must include midwifery, health visiting, mental health support and targeted services such as couple counselling, debt advice and smoking cessation. Each of these services is currently provided from silos within the public, private and civic sectors, so properly integrating them is no small task. I urge my hon. Friend the Minister to ensure there is very clear guidance to every local area on how it should co-ordinate its support for babies.

I also want to support amendments 91 and 92, in the name of my hon. Friend the Member for Broxbourne (Sir Charles Walker), which call for parity of esteem between mental and physical health. Mental health support for families who are struggling in that critical early period is vital. The London School of Economics has assessed that perinatal depression, anxiety and psychosis carry a total long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK. Prevention is not only kinder but so much cheaper than cure.

Finally, I would like to support amendment 102, from my right hon. Friend the Member for Basingstoke (Mrs Miller), which calls for integrated care boards to provide clarity about their plans to tackle domestic violence. I am delighted that the Minister has already agreed to accept it. Analysis by the WAVE Trust indicates that up to 30% of domestic violence begins during pregnancy. The WAVE Trust highlights the crucial nature of experiences in the period of conception to the age of three in the formation of seriously violent personalities, largely because of the sensitive nature of the infant brain in those formative years. Domestic violence within a family is incredibly damaging to the emotional development of a baby, and I encourage my hon. Friend the Minister to ensure that plans for tackling domestic violence cover not just relations between partners, but reducing the impact on babies.

Madam Deputy Speaker, you may have heard me speak in this place before about giving every baby the best start for life, and I keep doing so because I am convinced that, if we invest in the 1,001 critical days, we really will transform our society for the better. It is in the period from conception to the age of two that the building blocks for lifelong physical and emotional health are laid down.

[Jess Phillips (Birmingham, Yardley) (Lab)]

I was not expecting to be called, Madam Deputy Speaker, but here we are. I want to tell a little story about my dad. My dad often rings me and tells me the things I should say in Parliament—I am not entirely sure any of you are quite ready for it, but I want to tell a story about my dad. He was born in the war, and they were given a council house by the Attlee Government—my dad could lecture us on it for weeks! He was given a council house, which his very Conservative parents bought in the 1980s. My granny, unbelievably—a lovely, generous woman—was a massive Thatcherite. She bought her council house in the 1980s, and that council house stands in my constituency. It is worth around £120,000.

My dad went on to get an education—a free education—and he moved into an area of Birmingham that was not very trendy at the time. He stayed there, I was born there, and my brothers lived there. All through our lives we watched that area get a little bit trendier, and the price of my dad’s house, which he bought for £30,000, went up and up and up. He didn’t particularly do much work—he likes to woodwork in his garage, but he has not done much. His house is probably worth around £700,000 now, and it was £30,000 when he bought it.

If my dad were here today, what he would say to hon. Members, and what he will almost certainly say to me, because he watches it all, lurking on Twitter, is that he does not deserve to keep his wealth for his children at any greater rate than the people who live in the council house that his parents bought on Frodesley Road in Sheldon. Yet today, the people who live in my constituency and the council house that my granny bought, to try to get a better life, will subsidise the care of my father, who has a £700,000 house that I do not need to inherit. I’m all right. I’ve got quite a good job. It is totally unacceptable that that is the situation we are putting almost all my constituents in, compared with constituents in Chipping Norton, for example, or the constituents of other hon. Members who have stood up and spoken. My constituents will largely be left with nothing. They will not be grateful.

Giving Every Baby the Best Start in Life

Andrea Leadsom Excerpts

Tuesday 9th November 2021 Commons Chamber

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

It is a pleasure to follow the hon. Member for Richmond Park (Sarah Olney) in this important debate, and I congratulate her and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) as fellow co-sponsors and tireless fellow campaigners for giving every baby the best start in life.

Despite the rough and tumble of politics, there are times when colleagues from all parties in the House come together. Early years is one such cross-party issue. Over the past 11 years in Parliament, I have been proud to work with many colleagues on the early years. The hon. Members for Manchester Central (Lucy Powell) and for Washington and Sunderland West (Mrs Hodgson), my stalwart and long-standing hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), and my hon. Friends the Members for Eddisbury (Edward Timpson) and for Winchester (Steve Brine) have all been amazing campaigners for the earliest years, as has the hon. Member for Glasgow Central (Alison Thewliss). The former Member for Birkenhead, Lord Field, and the former Member for East Dunbartonshire, Jo Swinson, have been great allies, as have all those Members who supported the all-party group conception to age two: first 1,001 days, and Ministers on the inter-ministerial group on early years family support from 2018-19.

It is fantastic that since the 2019 general election, the early years agenda has received fresh support from new colleagues such as my hon. Friends the Members for Penistone and Stocksbridge (Miriam Cates), for Stroud (Siobhan Baillie), for Cities of London and Westminster (Nickie Aiken), for Truro and Falmouth (Cherilyn Mackrory), and for Ruislip, Northwood and Pinner (David Simmonds). I also pay tribute to the late Baroness Tessa Jowell. She and I worked together on the 1,001 critical days agenda, and she campaigned for it to be introduced as part of the sustainable development goals at the United Nations. I must also mention the superb work of the Royal Foundation and its Centre for Early Childhood. The commitment from Her Royal Highness the Duchess of Cambridge and her team has generated fresh attention for ensuring that every baby gets the best start in life.

This subject has been my personal passion for more than 20 years, from chairing the Oxford parent-infant project, to setting up the parent infant partnership UK, and the Northamptonshire parent infant partnership, establishing the 1,001 critical days manifesto and the all-party group conception to age two: first 1,001 days, and chairing the inter-ministerial group in the Government of my right hon. Friend the Member for Maidenhead (Mrs May). July 2020 marked a huge opportunity when the Prime Minister commissioned the early years healthy development review and invited me to chair it. Since then, we have been able to build on years of cross-party support, and a wealth of knowledge and expertise from the early years sector, to create a new vision for the 1,001 critical days initiative that was launched in March this year. The review has put the baby’s needs at the centre of all our work. Through meetings with parents and carers, virtual visits to local areas, and detailed discussions with parliamentarians, practitioners, academics and charities, we heard about the experience of early years services and support, and about what is going well and where change is needed.

First and foremost, we learnt from every parent and carer of their strong desire to be the best parent they can be, but we also learnt that new prospective parents often struggle to find the support they need. We heard from many parents who had deep concerns about their own or their partner’s mental health, and struggled to get timely support. We heard from many mums who desperately wanted to breastfeed but gave up because the support was not there. Parents told us how frustrating it was to keep telling their story over and over again to different people. Their cry was, “Why don’t you people ever speak to each other?” Equally, we heard from professionals and volunteers who said it would have been so helpful for them if they had known before meeting a new parent or carer about previous trauma or health challenges.

We heard from many dads about how excluded they felt from what they saw as “mum-centric” services. Some felt that they should not ask for any support for themselves, while others just felt sidelined and, in some cases, traumatised by what their partner had gone through in childbirth. We heard from foster carers of babies how little information came their way when caring for a vulnerable baby. More specifically, in 40 cases of babies who went into foster care, only two arrived with their red book. Those carers had no formal information about that baby’s early traumas that had caused them to be taken away from their birth family.

We heard from same-sex couples about unhelpful assumptions by early years professionals about their relationship and parenting roles. We heard from black mums about how particular cultural and health issues can be overlooked by busy staff. We heard from single mums and single dads about how they can feel isolated, and sometimes stigmatised, at such a life-changing time. We heard from many parents with particular challenges, such as not speaking English well, concerns about possible disabilities, experiencing violence in their lives, or other significant challenges. We heard that support is inconsistent and sometimes hard to access.

It comes as no surprise that the covid pandemic has been an extraordinarily difficult time for new families who, through no fault of their own, have not been able to access services or support in the normal way. The “Babies in Lockdown” report from the Parent-Infant Foundation, Best Beginnings and Home-Start reveals that nearly seven in 10 parents felt that changes brought about by covid were affecting their unborn baby, their baby, or their young child, and that 35% of parents would like help with their concerns about their relationship with their baby. The report also found that nine out of 10 parents and carers experienced higher levels of anxiety during lockdown.

Despite the many stories of difficulties, we also heard fantastic examples of good support for families. Many health visitors went the extra mile to keep in contact with families who were struggling, and many families found it incredibly reassuring to be able to text or Zoom their health visitor at short notice. Parenting programmes have been a huge support to many families, and we virtually visited Camden’s Bump to Baby programme, where classes continued online throughout the pandemic, and have proved incredibly popular with new parents and carers who are also helped to make friendships outside the programme. Dads gave us positive feedback on services that gave them space to share their experiences, without worrying about whether they were taking the focus away from the other partner’s health and wellbeing.

In lockdown, we also heard about excellent online and virtual services, and how they came into their own. One such service, Parent Talk, provided by Action for Children, reported a 430% increase in the number of parents seeking advice online during the pandemic. The Baby Buddy app, produced by Best Beginnings, has seen a huge take-up of its digital and virtual advice for everything from breastfeeding to nappy changing, and from sleep management to mental health concerns. Many local authorities are now determined to improve their joined-up offer to new parents and carers, so I certainly feel that we are pushing against an open door.

Our report, “The Best Start for Life: A Vision for the 1,001 Critical Days”, was launched by the Prime Minister in March this year. It contains six action areas. The first is that every local area should publish its own joined-up set of start for life services so that every parent and carer knows where to go for help.

The second is a welcoming hub for every family, in the form of family hubs. Those will build on the excellent work done by the late Baroness Tessa Jowell and others on creating Sure Starts, but the benefit of family hubs is that they will be the place where every family goes for support and advice, including from midwives, health visitors, mental health support workers and breastfeeding advisers within their walls. Not only will those services be physically available but they will be virtually available through the family hub model.

The third action area is a digital version of the red book, which will provide parents and carers with a record of their baby’s earliest life, from lovely moments such as their first tooth and their first steps, all the way to records of immunisations and professional support interventions.

The fourth action area is about the workforce. We all know that health visitors provide critical support for new parents and carers, but we also know that their case load can be very heavy, and parents and carers have told us that they really want more continuity of care and more frequent contact in the earliest years. We are therefore working with health visitors and local areas to consider resourcing levels and training needs, and whether a mixed-skill workforce can provide that greater continuity of care.

The fifth action area is to continually improve the start for life offer. A key action will be to establish parent and carer panels in every local area to ensure that the voices of families are heard when services are designed and improved. We are looking at improving the collection of data, at the evaluation of different interventions and at the need for proportionate inspection of the start for life offer in each area. A final but critical action area is to ensure that there is sound leadership, both locally and nationally, to drive the ambition to give every baby the best start for life.

I want to say a huge thank you to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Erewash (Maggie Throup), and to all the review’s sponsoring Ministers, past and present, for their support for the review. I am sure that it was their commitment, combined with the support of the Prime Minister and the Chancellor, that ensured such a positive spending review settlement for the earliest years, with £82 million for family hubs, £50 million for parenting programmes, £10 million for the start for life offer, £50 million for breastfeeding support, £100 million for infant and perinatal mental health support, £10 million for new workforce pilots, and a £200 million uplift for the supporting families programme. I believe that £500 million is a transformational sum that will allow many more parents and carers access to the vital help they need to give their baby the best start for life.

Why does this matter so much to our society? Well, we know that it is in the period from conception to the age of two when the building blocks for physical and emotional health are laid down. Babies born into secure and supportive homes will usually go on to become happy children who do well at school and grow into adults who cope well with life’s ups and downs and are more likely to hold down a job, have better health outcomes and form healthy relationships themselves. On the other hand, we know that in families under pressure, particularly where there is partner conflict, substance misuse, poor mental health or deprivation, the consequences for a baby’s developing mind in that critical early period can be far-reaching and very harmful.

Prevention is not just kinder; it is also significantly cheaper than cure. For example, the NHS has estimated that for every one-year cohort of births in England, the long-term cost of lack of timely access to quality perinatal mental health care is £1.2 billion to the NHS and social services and more than £8 billion to society. That is for every year’s cohort. We also know that up to 30% of domestic violence begins during pregnancy, and that health issues such as tooth decay and childhood obesity cost hundreds of millions of pounds every year in health-related expenses. We believe that those things could be significantly reduced by better education and support for new families.

With these six action areas, I think we can transform our approach to early years support and services, improving the health outcomes and life chances of the youngest in our society. Just as we need to level up economic opportunity across the country, we must also focus on where it begins—that critical period of human life from conception to the age of two.

[Jonathan Edwards]

The right hon. Member is giving a very comprehensive speech. Does she also agree that the Government should look at the issue of shared parental leave? The stats seem to indicate that fewer than 4% of eligible fathers take up the Government’s current policy. The Government need to look at that, and the forthcoming employment Bill may be an opportunity to strengthen those provisions.

[Dame Andrea Leadsom]

I completely agree with the hon. Gentleman that it would be fantastic for families and babies if more dads took up shared parental leave. Of course, as he will know, that has been legislated for. Unfortunately, as he points out, far too few fathers have taken it up to date. I certainly wish that more would have the confidence to do so.

I believe that all colleagues across the House would agree that the world in which we all want to live is one where every baby is nurtured to fulfil their potential, where good lifelong emotional wellbeing is the norm, where our society is productive and co-operative, and where every one of our citizens has the chance to be the very best that they can be.

--- Later in debate ---

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I would like to start by thanking the hon. Member for Richmond Park (Sarah Olney), the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) and my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) for securing this debate at this incredibly important time. I also offer my thanks to the right hon. Member for South Northamptonshire for her tireless campaigning on this issue over many years, for her recent leadership of the early years review and for her success in securing funding for the sector in the recent Budget. All those are to be welcomed. It is not easy getting money out of a Chancellor, as we all know. She also knows my dismay at the short-sighted cuts that preceded this funding, making it all the more necessary. I know she agrees that we need to ensure that no Government cut valuable services such as Sure Start or family hubs ever again.

I stand here as a former shadow Minister for children and families, a role now most ably held by my hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq). It has been said that once anyone has been a children’s Minister, like the hon. Member for East Worthing and Shoreham (Tim Loughton), or a shadow, they can never quite leave the issue alone. It is sort of like an “Order of the Babies” maybe, or a ministerial Hotel California.

Covid-19 has had a profound impact on all of us, but the effects of the lockdown restrictions and social distancing measures were keenly felt in the early years sector. I welcome the “Babies in Lockdown” survey report published today by the Parent-Infant Foundation, Home-Start UK and Best Beginnings. The pandemic is, sadly, far from over, and the report offers signs that the early years sector has developed a form of long covid, if you like. The survey found that nearly a third of mothers questioned reported that health visitor drop-in clinics that existed before the pandemic were no longer operating. I urge colleagues to read the report.

But let me take Members back to 1970, well before Zoom and Teams. Back then, fewer than a quarter of mothers worked; society expected a full-time mother. Without a central focus on the early years, and no talk of the 1,001 critical days or adverse childhood experiences, the education of very young children was neglected. Baroness Blackstone, writing in 1974, highlighted the fact that only 10% of three and four-year-olds attended state nursery schools or classes in 1971, with some areas receiving no service at all.

To combat the lack of state nursery education, the mothers did it themselves. Belle Tutaev set up a playgroup with her neighbour which eventually bloomed into the Pre-School Playgroups Association. This has since become the Early Years Alliance. But the state should have taken up this mantle, rather than the already burdened mothers. Not everyone was convinced of that principle, however. In 1980, George Young, then the Conservative Secretary of State for Social Services, said that he did not

“accept that it is the state’s job to provide day care to enable the parents of young children to go out to work”.

Listening to the debate today, 40 years on, we can see how far we have come from that thinking.

It was the last Labour Government who finally addressed this problem. I have spoken before, as others have today, about the late Tessa Jowell’s Sure Start programme being a beacon of early years policy. Sure Start brought children’s services together under one roof, uniting healthcare with wellbeing, education with childcare, babies with other babies, and parents with other parents. There were 3,620 Sure Start centres in 2010 under Labour. That has fallen, as we heard from the hon. Member for Richmond Park, by more than 1,300 in the past decade or more of Conservative Governments. Those that remain have been effectively hollowed out, offering only skeleton services with minimal opening hours. While the Government’s pledge to fund 75 more family hubs is obviously welcome, it does little to make up for that loss. I know the hon. Member for East Worthing and Shoreham said it is not all about the buildings but, when we have lost 1,300 and replaced them with 75, it is trying to get a quart into a pint pot, as they used to say.

[Dame Andrea Leadsom]

It has been such a pleasure to work with the hon. Lady on this topic for so many years. I just want to put on the record that it is not 75 family hubs, but 75 upper-tier local authorities; it will be for them to decide, but it could be hundreds or thousands of family hubs. The hon. Member for Newcastle upon Tyne North (Catherine McKinnell) drew the same conclusion, so I really want to set the record straight on that point, if the hon. Lady will forgive me.

[Mrs Hodgson]

I am very grateful to the right hon. Lady. That is an important clarification, and we must ensure it is out there that maybe it will not just be 75, but that they can make it many more. Let us hope it is 1,300; I am sure she will agree with that. That said, I warmly welcome what I think is the Government’s tacit admission that they got it wrong when they defunded the Sure Start programme, even though, as we all remember, on the eve of the 2010 election, David Cameron promised it would be safe in his hands.

However, we are where we are. Earlier this year, I also co-chaired a cross-party early years commission alongside the hon. Member for Eddisbury (Edward Timpson), who, as a former children’s Minister, is also a member of the “Order of the Babies” and a resident of the ministerial Hotel California. The commission heard from a wide range of stakeholders, including educators, academics and policy professionals. I will take the House through some of the recommendations in the comprehensive report.

First, there should be integration of health and education support for children, ensuring that every child receives the health visitor appointments they are entitled to and a new health visit when the child is 18 months old. Secondly, because too few families have access to essential services, a locally relevant and dedicated parent support service is needed in every community in every area. Thirdly, we should upskill early education practitioners by investing in continuing professional development, so that the workforce stay fit to face the challenges of the future. Those proposals could easily be made reality. I sincerely hope that, as part of the £500 million brought forward in the Budget, the Government will deliver all of what we seek in this debate.

As we take part in this debate, we are mindful that the babies and children themselves will not be listening. They will not be tweeting their agreement or penning letters to our offices. I will spare a moment to mention how, beyond their value on their own terms, reforms to the early years offer can be instrumental in improving the lives of those without children, via the economy.

The Early Intervention Foundation found that the cost of late intervention in 2016-17 was £17 billion, owing to the need for services to help with mental health issues, youth crime and exclusion, including a £5.3 billion spend on looked-after children. Early intervention can offset that cost. The Carolina Approach to Responsive Education programme provided intensive, high-quality childcare for ages 0 to 5 in the United States of America and delivered a 13% return on investment per child each year. It netted IQ gains, higher wages, increased likelihood of home ownership and higher scores on achievement tests.

For the family unit, the economic returns are clear too. As the hon. Member for Richmond Park said, parents in areas with Sure Start local programmes moved into paid work more quickly than those without, reducing the benefits bill to the taxpayer and increasing tax receipts for the Treasury. But that is not the full picture: the economic benefits are often only modelled on specific, targeted interventions, whereas the benefits of intervention fan out across a range of factors, such as reducing the later burden on the public purse— the whole point of early intervention—and greater participation in the economy over many years. As such, it is practically very difficult to model the effects of a web of measures applied at once. So just imagine the results we could achieve if those interventions were provided simultaneously, with wholesale improved outcomes delivered via intensive early years support. Britain’s early years offer has the potential to be much greater than the sum of its parts.

To conclude, I would like to look to the world we are creating as legislators in this place. As we speak, delegates from around the world are discussing the means of preserving the planet and protecting the environment in Glasgow at COP26. It is incredibly important that we limit climate change to an increase of 1.5°. Missing, I believe, is leadership for those who will grow up into these environments. The pursuit of climate justice is in no small part to ensure that our children and their children’s children do not face an uninhabitable, hostile world. As those at COP26 work for the future of the planet, let us, here and now, seize this golden opportunity to help those who will inherit it.

Baby Loss Awareness Week

Andrea Leadsom Excerpts

Thursday 23rd September 2021 Commons Chamber

[Cherilyn Mackrory]

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

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

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

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

[Cherilyn Mackrory]

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

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

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

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

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

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

--- Later in debate ---

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

I thank all Members of the House who have taken part in the debate this afternoon. The shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), is right to say that this is an issue that unites us all and puts politics aside. The loss of a baby is never easy to discuss, whether it is the loss of your own baby or a baby known to you, or the experience of a constituent, it is a hugely emotional and sensitive area, and time is often not the great healer it is made out to be. This debate has raised some difficult but important issues.

I also thank the co-chairs of the all-party parliamentary group on baby loss: my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory), who spoke extremely bravely about her experience of losing baby Lily; and my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who also helped to secure this debate. The response and strength of feeling shows how many lives have been affected and touched by this issue. There have been so many moving contributions, and I cannot name them all, but they included those from the hon. Member for Pontypridd (Alex Davies-Jones), my hon. Friend the Member for Bracknell (James Sunderland) and the hon. Member for North Ayrshire and Arran (Patricia Gibson), who talked about baby Kenneth.

This is the sixth year that a debate has been held to mark Baby Loss Awareness Week, and I am honoured to take part as the new Minister for primary care and patient safety and to work with all hon. and right hon. Members across the House to make a difference in an area as vital and important as maternal and neonatal safety. It is perhaps fitting that the debate is happening so soon after I have taken on this role, as it has sharply focused my mind on the huge amount of work there is to do in improving the outcomes for families and babies.

The Government’s maternity ambition is to halve the 2010 rates of stillbirth, neonatal and maternal deaths and brain injuries in babies occurring during or soon after birth by 2025. The ambition also includes reducing the rate of pre-term births from 8% to 6%, and we are making progress on that. Since 2010, there has been a reduction of 25% in stillbirth rates and a 29% reduction in neonatal mortality rates for babies born after 24 weeks gestation. There is, however, progress to be made on reducing maternal mortality rates, brain injury rates and pre-term birth rates, because progress has been slower than any of us would have hoped. There are pilot schemes in place, however, including those introduced under the brain injury reduction programme, which saw £9.4 million-worth of investment during the spending review last year going towards reducing the incidence of birth-related brain injuries. The pilots will produce cutting-edge training and expert guidance, and I hope to report back to the House on their impact.

My hon. Friend the Member for Truro and Falmouth raised some incredibly important points, and I want to touch on a few of them. Financial investment can of course make a difference in improving maternity services. NHS England announced earlier this year an additional £95 million of recurrent funding for maternity services to support the recruitment of 1,200 midwives and 100 consultant obstetricians and the implementation of the actions arising from the Ockenden report. NHS England and NHS Improvement are also providing an additional £52 million to fast-track a long-term plan commitment for all women to be able to access their maternity notes and information via a smartphone or other device by 2024.

Money is not the only solution, however. One key way to improve outcomes is to look at what has gone wrong in the past, and the perinatal mortality review tool is important in that regard. The Health Departments in England, Wales and Scotland collectively fund the perinatal mortality review tool so that the deaths of all babies between 22 weeks gestation and four weeks old are reviewed to provide answers to bereaved parents about how their baby died and so that the NHS can learn lessons and improve care. All bereaved parents now have the option to be involved in a high-quality review of the death of their baby and, according to the last perinatal mortality review tool annual report last year, 84% of review cases in England, 86% of cases in Wales and 87% of cases in Scotland included parents in their final reports. It is by learning from parents and listening to their concerns that we will ultimately improve services for families and save lives.

The shadow Minister and my hon. Friend the Member for Truro and Falmouth raised the issue of tackling inequalities in perinatal outcomes for women from black, Asian and other minority ethnic groups. There are huge disparities in outcome across different communities. Earlier this month, NHS England and NHS Improvement published an equity and equality strategy, supported by a £6.8 million investment, to address the causes of inequalities in health outcomes, experience and access. It provides guidance for local maternity systems and focuses on black, Asian and minority ethnic groups, who currently experience poor maternal health outcomes. This is a priority area for me, and I take the point raised by my hon. Friend the Member for Truro and Falmouth about the importance of continuity of care.

In helping to support bereaved families following the tragic loss of a baby, I am delighted to hear that we have now reached the milestone of every NHS trust in England having expressed an interest with Sands in joining the national bereavement care pathway programme, and 65% of trusts are now members. We will continue to take a cross-Government approach to assessing what more needs to be done to support bereaved families.

I will discuss with my ministerial colleagues the point raised by the hon. Member for Lanark and Hamilton East (Angela Crawley), in particular, on leave for those who have experienced a miscarriage before 24 weeks.

Important points have been made about mandating a pathway and funding to ensure that every hospital has an appropriate bereavement suite and specialist staff and training. I will feed back to the House on our progress on that, as I recognise that we need to move swiftly.

My hon. Friend the Member for Truro and Falmouth, like many other hon. Members, commented on mental health support for bereaved fathers, parents, families and siblings. We heard from my right hon. Friend the Member for South West Surrey about the impact that the loss of baby Sarah had on his whole family. Losing a baby can have a massive impact on the whole family, and this Government are committed to expanding and transforming mental health services in England so that people, including those affected by the loss of a baby, get the help and support they need. My hon. Friend the Member for Guildford (Angela Richardson) could not have been more eloquent about the experience of not getting it right.

We have a long-term commitment that a further 24,000 women will be able to access specialist perinatal mental healthcare by 2023, building on the additional 30,000 women who can access such services this year.

[Dame Andrea Leadsom]

Does my hon. Friend agree that, along with all the things she is talking about, we need a joined-up set of start of life services, such as the Government are already working so hard to implement in their “Best start for life” work? If we could provide continuity of care and wraparound support for families, so many of the health disparities and terrible outcomes would be avoided.

Coronavirus

Andrea Leadsom Excerpts

Wednesday 16th June 2021 Commons Chamber

[Matt Hancock]

My right hon. Friend makes a really important point. The answer is that the majority are in the younger age group who have not yet had the chance to be vaccinated. Just under one fifth of those going into hospital in the last week have had both jabs, about a fifth have had one jab and the majority have not had any. The majority are under the age of 50 and have not yet had the opportunity to have both jabs. I think there is a material difference when it comes to the state’s responsibility to offer the vaccine to all adults. The duty that we have when somebody has not been offered the vaccine is greater than the duty we have when we have offered a vaccine but somebody has chosen not to take it up. There is a material difference between those two situations that I think my right hon. Friend was getting at.

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

May I just take what our right hon. Friend the Member for North Somerset (Dr Fox) said one step further? If I choose not to have, say, a yellow fever jab when I am going to a place that suffers yellow fever, the Government of the United Kingdom take no interest whatever in my illness status. When my right hon. Friend the Secretary of State says that he has less of a duty, surely what he means is that he has no duty at all. It is for people to take up the vaccine.

--- Later in debate ---

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

Thank you, Mr Deputy Speaker.

Is it not wonderful to see so many colleagues in the Chamber having a proper debate? It is really interesting to hear what colleagues have to say. I have to add my own deep concern about any restrictions on people’s liberty. Frankly, if we were not already in step 3 of lockdown, I cannot imagine that with the current data, anyone in this place would today vote for four weeks of restrictions on businesses, on weddings, on church congregations and, yes, on young people’s end of school year celebrations. Nevertheless, I am going to disappoint some colleagues in this place by saying that I will, with a very heavy heart, support the Government, trusting that the Government are determined—as we have been assured by my right hon. Friend the Secretary of State for Health—that, if possible, those restrictions will be lifted after two weeks and not four. I urge them to do that.

I want to use these short remarks to raise a few specific questions on behalf of my constituency and others. First, many businesses in the hospitality sector are open but unable to make a profit because of the social distancing rules. Can those rules be relaxed a bit in these last few weeks? Surely we can do that.

Secondly, many employers in hospitality and other sectors are now desperately trying to recruit staff through jobcentres, yet I am told by businesses in my patch that many people are not responding to offers of interviews. I do not know whether colleagues are also finding that, but businesses in my area are concerned that the long period of enforced lockdown and enforced inactivity is leading to an issue of motivation. Sometimes it is just easier to stay at home rather than getting back out there again. What are we going to do? Many colleagues have talked about the success of frightening people into staying home. Surely we are going to need something to help people feel motivated and want to get back out there to work, to get our economy going again and to help themselves to recover from this difficult period.

Thirdly, my constituency is home to Silverstone and the British grand prix, which is due to take place from 16 to 19 July. Can my hon. Friend the Minister assure me that this iconic, world-famous event—surely, one of the best of British—can go ahead with a capacity crowd, albeit subject to covid testing?

Fourthly, I am pleased that the Government have listened to wedding businesses and the many couples who are looking to tie the knot, and have agreed to let weddings of any size go ahead, subject to social distancing. As colleagues have said and as my hon. Friend the Minister will appreciate, for many couples, if they can hug but not dance, if they cannot have a band and they have to socially distance, that will not be the kind of big day they wanted for themselves and their families. Will he reconsider that?

Finally, my hon. Friend will realise that school and university students are now faced, for the second year in a row, with no end-of-year celebrations. No parents’ days, no prize-givings—in other words, none of the rites of passage that mean so much to so many people. Can we look at that again in these last few weeks? It has been such a long haul. As I have said, I will reluctantly support the Government, but I do urge the Front Benchers to show more flexibility during these final few weeks so that some of the joys of summer can light up people’s lives once again.