Maternal Mental Health

Anna Sabine Excerpts

Wednesday 5th February 2025 Westminster Hall

[Laura Kyrke-Smith]

I agree; we need to shed more light on this, precisely for that and other reasons.

I will touch briefly on my first recommendation, which is to ensure that specialist perinatal mental health services are protected. In the last 10 years, there have been significant steps forward. Mother and baby units in particular can be an important part of someone’s treatment and recovery, as well as having significant benefits for the parent-infant relationship.

Tragically, there are still too many stories of women not being able to access those units. They are perhaps too far away from where a woman lives, or there is not a bed available, or the need for a mother to get that care has not been identified properly. We are still seeing mothers with newborns being put into adult psychiatric units and separated from their babies, despite the national guidance saying that mother and baby units are best practice. Continued support for these services is crucial, both in mother and baby units and in the community, and that must include research to develop the best interventions and robust evaluations of the care provided.

The Mental Health Bill is a sorely needed piece of legislation, and I really welcome it, but I wonder whether it might include a provision to ensure that all women who have given birth within the 12 months prior to admission to a psychiatric unit are given the option of being admitted to a ward where they can remain with their baby. That could help to prevent women from falling through the cracks in the system, as they do currently.

Secondly, I turn to routine maternity care, which is where the mental health support for the vast majority of women can and should sit. Again, we have seen progress, with some vital new services in place, including care for women experiencing baby loss, severe fear of childbirth, birth trauma and loss of custody at birth.

[Anna Sabine (Frome and East Somerset) (LD)]

I thank the hon. Member for calling this debate, which is clearly so important to her. In my constituency there is an excellent charity called HeartTalks that works with mothers who have experienced baby loss. Would she agree that post-partum check-ups are really important for all women, but particularly those who have suffered baby loss, regardless of the trimester it occurred in?

[Laura Kyrke-Smith]

I absolutely agree. A recent report from the Maternal Mental Health Alliance highlighted huge variation in the support services available locally, with confusing referral pathways, inequitable referral criteria and long waiting lists—some women have to wait six months for an assessment and up to a year for treatment. Too often, as I have noted, women are cared for unequally. Those who have existing disadvantages experience stubbornly poorer outcomes.

We need better integration of mental health into all routine contacts during pregnancy and after birth for all women who need it. During that period, women have an average of at least 16 routine contacts with health professionals, including GPs, midwives and others, and they are an ideal opportunity to ensure that women are routinely and compassionately asked about their mental health. I wonder if any healthcare professionals asked Sophie not just how the baby was but how she was. I wonder if the discussions about her baby’s feeding were had in a way that sought to reduce her anxiety. I wonder if she was given less attention because this was her third child, and her earlier experiences had been smoother—but I will never know.

In the same way that many physical health complications are dealt with by multidisciplinary maternity services, the same should be true for mental health care. That means midwives, health visitors and others being trained to ask the right questions and assess the risks, and then psychological therapists, equivalent to those employed in talking therapies, integrated into maternity teams to support women’s care where necessary. They would understand the specific needs and risks of the perinatal period, and be able to intervene quickly where that is needed.

Thirdly, I want to acknowledge the importance of community support for pregnant and new mums, as we have heard from other Members, and I recommend its expansion. There are fantastic voluntary groups providing some support, and in some places family support hubs are up and running, but often the postcode lottery kicks in again. We are a long way from the broader and more reliable provision that was established under the last Labour Government—notably the Sure Start model, which all the long-term evidence shows was so effective. As part of our national health mission to shift care from hospital to the community, we need to rebuild those community services, including for pregnant and new mums. We need them to be across the country and widely accessible, with clear maternal mental health guidance embedded in them.

Finally, it is incumbent on all of us to keep building a society where everyone understands the mental health challenges in the perinatal period, including the suicide risk in the most serious cases. Crucially, we all need to learn to be good allies to people who are struggling. I think about that a lot in relation to Sophie. When Sophie sent me messages saying, “Feeling desperate today”, and,

“I’m just not sure I have it in me to keep going”,

did I do enough? Did I worry about her anxiety? Yes. Did I worry about her being depressed? Yes. Did I worry about suicidal thoughts? Honestly, yes. But did I think she might take her own life? No. I have struggled with the guilt that I did not somehow do something to stop it, but I also recognise how ignorant I was and how hard this is.

I have had good conversations with Sophie’s dad about what needs to change. He is part of a group called Facing the Future—a support group for people who have lost family to suicide. One of his group members said:

“I think what I’d like to see is a more proactive and visible campaign to target those who are at risk. Not just for those at risk, but for their families/friends/carers/loved-ones. Let people know that it’s okay not to be okay...Give people the knowledge and confidence to ask someone they are concerned about how they are feeling, to know what to look for and ask, and to know where to go for help.”

That is absolutely right. There are some fantastic charities and campaigns out there. I know the Government are listening; I am particularly pleased that not just mental health, but suicide prevention are woven into our health mission, where moving from treatment to prevention is such an important focus more broadly. But there is more to do.

I conclude by saying that I do not want Sophie’s life to be defined by her death. I want it to be defined by her first-class Cambridge degree, her talents as a writer and actress, her Foreign Office career, her friendships, her playful sense of humour, and the beautiful family that she began to raise. I talk about her death because I hope her experience can be a catalyst for change.

While her story—every story like hers—and the wider statistics can seem bleak, the real story here is one of hope and potential. With the right support in place at this crucial and pressured time in women’s lives, they do surmount great mental health challenges and recover, often quickly and well—and their babies get off to a good start in life. The Government have embarked on transformative work to improve the country’s health, and better maternal mental health outcomes must be one test of our success.

Accessibility of Radiotherapy

Anna Sabine Excerpts

Tuesday 4th February 2025 Westminster Hall

[Tim Farron]

My hon. Friend is absolutely correct. Back at the time of the last Labour Government, the national radiotherapy advisory group recommended that it was bad practice for anybody to live beyond 45 minutes of a radiotherapy centre one-way, or a round trip of an hour and a half, yet so many people—7.5 million people—including his constituents and my constituents, live beyond that.

[Anna Sabine (Frome and East Somerset) (LD)]

On that specific point, I do not want to show off about who has the worst travel times for radiotherapy, but nobody in my constituency of Frome and East Somerset who does not own a car lives within that recommended 45-minute NHS travel time. Does my hon. Friend agree that reliable, quick and affordable public transport is key, and that the recent increase to the bus fare cap has not helped with the situation?

[Tim Farron]

Yes. By definition, almost all of the radiotherapy deserts—those places that are beyond sensible and safe travelling times—are rural communities. As a result, they have terrible public transport. It is not just about the cost. The increase in the bus fare cap is hugely damaging, but for many of our communities—my hon. Friend’s and mine alike—it almost does not matter what the bus cap is; if there is no bus to spend the fare on, people are stuffed, really. That has a huge impact on their cancer outcomes, which means whether they survive or not.

NHS Dentistry: South-west

Anna Sabine Excerpts

Tuesday 12th November 2024 Westminster Hall

[Anna Sabine (Frome and East Somerset) (LD)]

I thank my hon. Friend the Member for Honiton and Sidmouth (Richard Foord) for securing the debate. As the MP for a rural constituency in Somerset, I do not need to repeat the well-known fact that the south-west is one of the worst dental deserts in England.

As a mum, and as someone who received excellent dental care as a child because my grandad was a dentist, I particularly worry about the effects on children. With such a scarcity of NHS practices accepting new patients and with the rising cost of living, working families simply cannot afford to go private. More often than not, that means that parents have to unwillingly forfeit their children’s health.

This is a topic that people care about up and down the country. The regular emails I receive about it from my Frome and East Somerset constituents normally describe the same regrettable situation: they cannot get a space, there is no room anywhere in the vicinity and they are forced to go to hospital. However, one recent casework email was particularly stark: it was from a retired man and his wife who have recently become kinship carers for their two grandchildren following the sudden death of their daughter. Although one child had “luckily” already started orthodontic treatment prior to their mum’s death, the grandparents cannot find a single NHS practice that will onboard the other child. They receive the state pension and one child benefit. Luck should never be a factor in the question of children’s health, let alone set two siblings apart. NHS dentistry should be there to level the playing field and give access to all, regardless of background or family set-up.

I know from having met local dentists and national dentist groups that the growing consensus is that there are two reasons why there are so few spaces in NHS dental practice. One reason is budget; the other is the availability of NHS dentists, many of whom are leaving the NHS or leaving dentistry altogether because of low morale and stress. Recruitment is already difficult, but retainment is even more so. NHS dentistry has been chronically underfunded. The UK spends the smallest proportion of its health budget on dentistry of any European nation, and England spends almost half less per head than other parts of the UK.

Just as working families in the south-west are struggling with the rising cost of living, high inflation, energy costs and the cost of everyday household items, so are NHS dental practices. The chronic underfunding has coincided with rising overheads. Most notably, the rise in employer’s national insurance contributions announced in the Budget will have a severe impact on NHS dental practices, which are already on their knees. That tax rise will significantly affect health and care services for patients. The Liberal Democrats fear that it will only make the crisis in our NHS and social care sector even worse.

We have urged the Chancellor of the Exchequer to urgently rethink the rise in employer’s national insurance contributions, either by cancelling it for all employers or at the very least by exempting those employers that provide vital health and care services, including GP services, dentists, social care providers and pharmacies. Without that exemption, the health and care crisis will only worsen and regional disparity will widen. Children in the south-west region will depend on good fortune. Parents will feel helpless and will be forced to make sacrifices. It risks setting apart and setting back thousands of children.

Access to Primary Healthcare

Anna Sabine Excerpts

Wednesday 16th October 2024 Commons Chamber

[Anna Sabine (Frome and East Somerset) (LD)]

Before I make some brief comments about dentistry, I must say that some Government Members seemed genuinely confused about our claims that the Liberals had anything to do with the founding of the NHS. I urge them to google the Beveridge report.

My grandfather was a dentist, so as a child I was privileged enough to have access to dental care as and when I needed it, although when I was eight I did fall down the stairs at his surgery and break my arm while he was doing my dad’s fillings, so possibly his health and safety was not as good as his dentistry. Many children nowadays do not have the same access to dentistry as I did as a child. In the past year in Somerset, the percentage of children seen by a dentist was just 42%, when the English average is more than 55%. The percentage of adults seen in the past two years is still only 32%.

The Darzi review revealed that only about 30% to 40% of NHS dental practices are accepting new children and adult registrations. That is leaving many with no option but to go private. My constituency of Frome and East Somerset is also considered a dental desert. It is predominantly rural, which means that access to services is even more limited. The lack of public transport means that accessing dental services is difficult already, and with practices not taking on new patients, they are pushed even further afield. I had an email from two constituents from Frome earlier this month. They have been unable to see an NHS dentist for four years due to a lack of availability for new patients. They said in their email that

“it not only affects our oral health, but contributes to broader health issues that can arise from neglecting dental care”,

and they are anxious about potential long-term impacts.

Getting a dentist appointment should never be as hard as it is now, and I urge support for our motion to help reduce dental deserts and rescue NHS dentistry from disaster.