Baby Loss Awareness Week

Debate between Angela Crawley and Jeremy Hunt

Thursday 23rd September 2021 Commons Chamber

[Angela Crawley]

Does the right hon. Gentleman believe, as I do, that fathers, like mothers and like any parent, have the right to have a grieving process and should have the right to paid leave in order to do so?

[Jeremy Hunt]

I thank the hon. Lady for giving me a moment to recover. She makes a very powerful argument. Without committing to supporting her proposal, I would hope that all employers would listen to her speech and offer that leave voluntarily on compassionate grounds, because that is the responsible and kind thing to do.

I want, in my brief comments, to talk about another group of people less often talked about who also feel this grief—the doctors, nurses and midwives responsible for a child’s care. Some people have used the phrase “second victim” to describe the agonising sadness people feel when they are responsible for a child’s care and that child dies. When I was Health Secretary, many times I asked people working in hospitals what the biggest tragedy and professional shock they had ever had was, and they would often say that it related to the death of a child. Even more acute is when that death was caused by an error. Those doctors, nurses, midwives and frontline professionals, who go into their profession with the highest and noblest of motives, have to live with the fact that perhaps because of an ordinary human mistake—the kind of mistake that all of us can make—something really terrible happened.

We as politicians, and those in nearly every other profession, make mistakes the whole time—a media appearance goes wrong, a speech goes down badly, we lose an election, or whatever it is—but the consequence is not someone dying. Frontline health professionals have the courage to go into a profession where they are taking that risk every day. When those tragedies happen, those frontline professionals want nothing more than to be completely open, transparent and honest about what happened so that we can learn from the mistake and put in place processes and systems so that it never happens again. But, in truth, we make it practically impossible for them to do that. They are terrified about losing their job, about the Care Quality Commission, about being struck off the medical or nursing register, about the reputation of their unit, about the reputation of their hospital, and about lawyers, who get involved very quickly.

When I was Health Secretary—I do not think this has changed even now—every week I signed off a multimillion-pound payment to a family whose child was disabled for life because of medical error that the NHS accepted. Most weeks it happened twice. Overall, the cost of that compensation for medical error in the NHS is £2.4 billion a year. Just under half of that relates to maternity. We have got to the obscene situation where we pay more in compensation to families when something has gone wrong than on the entire cost of every doctor and every nurse working in maternity units up and down the country. Why is that? It is because of a simple problem that the Health and Social Care Committee—I am delighted to see members of the Committee in their places on both sides of the House—is urgently asking the Government to address.

If, because of a mistake, a child is born disabled, the parents quite understandably want financial support to deal with the unexpected costs that the family will face for the whole of that child’s life. However, under the law, the only way to get that compensation is if a court agrees that there was clinical negligence. Quite understandably, parents will fight to get that compensation and, also understandably, the doctors, nurses and midwives become defensive if they are accused of clinical negligence. It does not have to be that way. We need a system where people are entitled to compensation as soon as it is accepted that a mistake was made without the necessity to prove clinical negligence.

The country with the highest safety standards and the lowest number of baby deaths in Europe is Sweden, which has about half our level of baby deaths. In Sweden, compensation is given more quickly just on the basis of a mistake being made, with the result not that they pay more but that they pay massively less, because they have half the number of tragedies that we have. Surely those of us who are passionate about patient safety will support that, and those who are—as we all are—worried about baby deaths will support that. Even people in the Treasury should understand that the way to reduce the obscene compensation bill is to make it easier for families in those terrible situations to claim compensation. If we had the same maternity safety levels as Sweden, 1,000 more babies would survive every single year. Just think of the heartache and the transformation in the lives of families up and down the country were we to do that.

I turn briefly to the other recommendations in the Select Committee’s report, published in July. One of the most important recommendations relates to staffing. When it comes to medical error, if there are not enough staff on a ward, the likelihood of mistakes will self-evidently be higher. Eight out of 10 midwives say that there are not enough midwives on their shifts, and Health Education England—the Government’s own body—says that there is a shortage of just over 1,900 midwives across the system. NHS Providers thinks that there is a shortage of about 500 doctors in maternity units and the Royal College of Anaesthetists says that there is a shortage across the system of about 1,000 anaesthetists. The cost of putting that right is between £200 million and £350 million a year. That is a significant amount. The Government deserve credit for already agreeing to put in £95 million a year, but that additional cost is as nothing compared to the £2.4 billion that we are paying in compensation every year. I hope that the Government will agree to put right that staffing shortfall. They have said this week that they are considering that.

Training is another vital issue. It is so important for doctors, nurses and midwives to have the time to learn from things that go wrong and to improve systems, but they can do that only if there is protected time for training in their busy schedules. I commend Baby Lifeline for the fantastic, proven training that it does, which has saved many lives. It is led by the inspirational Judy Ledger, who was inspired to do what she does by her tragedies. The report also talks about more screening and health inequalities, both of which were mentioned by my hon. Friend the Member for Truro and Falmouth.

I finish with two brief points. First, it would be wrong to say that this is an NHS problem. It is a tragedy that happens in all countries all over the world, and this year the World Health Organisation has made maternal and newborn loss the theme of World Patient Safety Day. The WHO says that, every day across the world, 7,000 babies die and the majority of those deaths are preventable.

Finally, we should remember the tremendous progress that has been made. In the last decade, the number of neonatal deaths is down by 25% and the number of stillbirths is down 30%. I commend Jacqueline Dunkley-Bent and Matthew Jolly in NHS England, who are leading the maternity safety transformation programme, and the many doctors, nurses and midwives who are supporting them. I also commend charities such as Sands and the Lullaby Trust as well as many others. Most of all, I commend the families who have campaigned through thick and thin, including James Titcombe, remembering his son Joshua; Derek Richford, remembering his grandson Harry; Carl Hendrickson, remembering his son Chester and his wife Nittaya; and Richard Stanton and Rhiannon Davies, remembering their daughter Kate. There are many others. Five babies die every single day. This is our moment to put it right.