Baby Loss Awareness Week

Antoinette Sandbach Excerpts

Tuesday 10th October 2017 Commons Chamber

[Antoinette Sandbach (Eddisbury) (Con)]

It a pleasure to follow the hon. Member for Nottingham South (Lilian Greenwood). I know exactly how Jack and Sarah feel, because it was the burning desire to see change that motivated me and many others in the all-party parliamentary group on baby loss to work not only to reduce the number of neonatal deaths and stillbirths, but to consider how we can improve things for parents.

When we set up the APPG, saying that we wanted to achieve huge cuts in the number of families affected by all these issues and to put in place a bereavement care pathway seemed to be setting rather a large challenge. I pay enormous tribute not only to Members of this House—it has been a cross-party effort—but to parents and health professionals, who have risen to the challenge set by the APPG and the Department of Health. In a way, I can provide some comfort to a number of Members who have spoken today about miscarriage, for example, because the national bereavement care pathway, which was launched yesterday, in effect addresses loss from conception to up to one year post-birth. That is quite groundbreaking in a number of ways. Pilot schemes in 11 hospital trusts are developing specific pathways to address early miscarriage, late miscarriage and stillbirth, and for those in the very unfortunate situation of having to terminate because of foetal abnormality. I have been encouraged by the willingness of parents to come forward and talk about their experiences as part of the development of these pathways and to share their loss with medical professionals, including the Royal College of Obstetricians and Gynaecologists, and the Royal College of Midwives. There has absolutely been cross-working and buy-in for this change.

I am encouraged that the change is being supported by the Department of Health. Pilots are taking place so that lessons can be learned, with the outcome of those lessons applied before things are rolled out more widely and nationally. As somebody who sat in a room with white walls and a sofa that was not anything like a bereavement suite, I know at first hand, as do so many parents who have not been in such facilities, that when one visits a hospital such as Medway Maritime Hospital, which has the most extraordinary facilities, one can see that change is coming. The improvement and change in the past year has, to my mind, been something that I and many professionals did not imagine would happen as quickly as it has and in the way that it has.

I would absolutely support the hon. Member for Nottingham South if she proposed a ten-minute rule Bill to try to effect the change in coronial law that she spoke about. I myself will introduce a ten-minute rule Bill tomorrow on the regulation of foetal dopplers. I will expand on that point tomorrow, but the false reassurance they provide to parents can increase the risk of stillbirth. I know that my hon. Friend the Member for Colchester (Will Quince) put forward a Bill in the last Parliament that has now been taken up by my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake), and it is due to have its Second Reading on 20 October. There are therefore methods to effect change in this Parliament, and I know that the hon. Member for Nottingham South would find great support in the House for her constituents if she tried to effect the change that they propose. I know that I will be trying to get the Minister’s support tomorrow on the subject of foetal dopplers.

This is Parliament at its best. We are listening to constituents. We understand where there has been a failure in the system, and there is no doubt that the statistics show we need to make changes in this area. I am delighted that the Government have accepted that quickly and have therefore set ambitious targets. The chief executive of my local hospital, the Leighton Hospital, which has an award-winning maternity unit, was able to say to me that they had had 14 fewer deaths this year. That means 14 fewer families in my local areas going through the loss that so many in this House and outside it have seen. At the same time, I should say that the Countess of Chester Hospital is under investigation in relation to 15 baby deaths. There are concerns about care in relation to eight of them. So the perinatal mortality tool is crucial, as is the investigation of these incidents, in order that those lessons are learned, that good practice is shared and that professionals are honest with parents where something has gone wrong; they need to admit that and learn from it so that it does not affect other families. Let us get that open culture; the Health Secretary has talked openly about the need for no-fault investigation, and the need to learn from that culture is incredibly important. The hon. Member for Ellesmere Port and Neston (Justin Madders), who speaks for the Opposition on this matter, will know of the particular importance of that, because the Countess of Chester serves his area too and this directly affects all our constituents.

I say to the Minister that the huge progress that has been made is encouraging. The charities and colleges yesterday spoke about the great enthusiasm and drive that has come from working collaboratively together. If we can take that and use it, the progress we are starting to make can carry on. We can roll it out into the difficult areas. We know that they exist, so let me mention just two. First, we know that there are big issues in respect of minority ethnic groups that go beyond the hospital setting, often relating to factors in the environment. Those issues fall outside the Department of Health’s remit, but wider working will need to be done to examine how those factors can be addressed and whether or not public health issues arise in their regard.

The second area involves general practitioners. I sent out a freedom of information request to every clinical commissioning group in England, and less than 50% of them provide any form of bereavement counselling, whatever the death. So even not in relation to child loss, a lot of CCGs simply are not commissioning support in the community. Those CCGs have relied on provision from the acute sector, and the next piece of work from the all-party group will need to be on how we take the lessons learned from the acute sector into the primary care sector, because that will end up benefiting not just those who have lost a child, but those who have suffered a loss.

[Victoria Prentis]

The other sector that provides so much of the bereavement care, such as the service I helped open yesterday, is of course the charitable sector. Would my hon. Friend like to comment on whether CCGs should be encouraged to join that sector in funding bereavement counselling, such as that provided by Petals, in the future?

[Antoinette Sandbach]

My hon. Friend makes a good point, and she can probably guess that the reason for my freedom of information request was to put pressure on not only my local services, but services more widely. There is expertise out there that we can build on, but bereavement touches everybody and this Government’s focus on mental health gives us a real opportunity to approach death in a way that minimises its mental health impacts, which can be severe. We can roll out elsewhere the way in which the Department of Health is leading on baby loss and working together with the third sector. This year’s Baby Loss Awareness Week therefore perhaps has a message of hope that has not been present in the past two such debates we have had.

--- Later in debate ---

[Robert Courts (Witney) (Con)]

May I say how honoured and humbled I am to follow so many hon. Members on both sides of the House who have made moving speeches about their own experiences, and those with very deep professional knowledge, chief among whom are the hon. Member for North Ayrshire and Arran (Patricia Gibson) and my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson)? May I also thank all the members of the all-party group—we have heard from my hon. Friends the Members for Colchester (Will Quince), for Banbury (Victoria Prentis) and for Eddisbury (Antoinette Sandbach)—whose passion for and commitment to this most important of all causes really shines through, as I am sure everybody on both sides of the House agrees? I thank all those who have spoken today through their own pain, as well as all those constituents who have written to all of us to enable us to raise in the Chamber a cause that matters so much to them. If they did not write and share those very difficult stories, we would not be able to do half as much to help.

In my brief comments today, I shall give voice to concerns that my constituents have raised, and I want to support all my colleagues, on both sides of the House, who are working so hard to make change, reducing the number of deaths in these most tragic circumstances and providing help to parents when, regrettably, deaths do occur. I am very grateful to my hon. Friend the Member for Banbury for mentioning my little boy Henry. I am experiencing the joy of being a new father. I can only imagine the trauma that any parent would feel, having lost someone in those circumstances. There is no doubt that a greater trauma for a parent could not be imagined.

I shall take a brief look at the statistics. As has been said, this is a very human subject—not one for pie charts or statistics—but I think we ought to look at them, if only to consider how far we have to go, and how much more space we need to cover to get close to a situation where stillbirths, and births in labour and shortly afterwards, are reduced to the lowest possible level. One in four pregnancies will end in miscarriage; 200,000 mothers and their families are affected every year; 3,245 stillbirths were recorded in 2014 by MBRRACE-UK. In 46% of stillbirths, the causes are unknown. That is a horrifyingly high statistic, and it is vital that we continue—I am grateful for the Government’s efforts in this respect—to research, so that we can find out the causes of as many conditions as possible. It surely is not something we can be happy about, or be content to tolerate, that the rate of stillbirth in this country is higher than in so many European countries, including Germany, Sweden, Poland and Estonia.

It is a sad fact that in so many cases, the causes of death are potentially avoidable. Many who have spoken today have far greater experience and knowledge than I have, and I do not pretend to tell the House about those points, but it seems to me that the Government should consider mounting an education campaign so that mothers can, where possible, avoid any risks—the risks, for example, of smoking in pregnancy are well known, and they need to be made clear to everybody—and recognise the signs of an impending problem.

[Antoinette Sandbach]

The MAMA Academy creates some fantastic wallets. I suggest that my hon. Friend writes to his local hospital trust and urges them to provide those wallets to their mothers-to-be. I know that the Countess of Chester is doing that for mums served by that trust. Each wallet has a lot of information on the front, which helps parents know when they should start worrying, because it alerts them to the signs that mean they should go to hospital and get scanned.

[Robert Courts]

I am very grateful for that helpful intervention. I will almost certainly do that. [Interruption.] No doubt my hon. Friend the Member for Banbury will assist. That will be most welcome to mothers—and indeed fathers, who of course worry equally about such risk factors. That will be a great deal of help.

I wonder whether the Government would also consider the subject of scans. I am conscious that in this country we do not scan past 20 weeks, and that in Finland, which has one of the lowest rates of stillbirth in the world, there are much more frequent scans, continuing into the third trimester. Indeed, in that country, they also have regular checks on very young children. I appreciate that there are many important claims on resources, but ask the Government to continue to look at that because the causal link between Finland’s success and regular checks should be considered.

The theme of Baby Loss Awareness Week is support for bereaved parents and today, of all days, is World Mental Health Day. When tragic circumstances occur, all possible support must be available to parents. Nothing will ever make amends for the loss of a child and nothing will ever take them back to the day before that loss occurred. As anyone who has lost someone will realise, however, while the situation is never “better”, the realisation that you are not alone can and does help. We ought to bring that support to as many people as possible. I welcome the Government’s bereavement care pathway and the assistance provided for it by the all-party group.

My hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake), who is in his place, is introducing a private Member’s Bill. One would like to think that employers would be sympathetic in such circumstances: that is a basic, human and natural reaction. I am very grateful to my hon. Friend the Member for East Renfrewshire (Paul Masterton), who gave us a very clear example of when that is not always the case. If ever there were a clear example of why the Bill is necessary, we have heard it today—and of course I support it. Compassion, as well as the time and support to grieve, is vital for parents in such tragic circumstances.

I would like to end my brief comments on a local note. I am very grateful to my hon. Friend the Member for Banbury for mentioning Horton General hospital, and I support and echo everything she says. Her passion is clear to all. Like her, I remain of the view that downgrading Horton’s maternity services is unsafe. I remain of the view that asking mothers in the late stages of labour to travel on the very congested roads between Banbury and Oxford, or from the north of west Oxfordshire in my constituency to Oxford, is unsafe. I fear for the consequences if that situation is sustained. I deplore the way the consultation was handled: looking at maternity services at the hospital in phase one of a sustainability and transformation partnership, when the issue of maternity services across the whole of Oxfordshire, and particularly west Oxfordshire and my constituency, must be considered. It is not helpful to look at such services in isolation.

The people of Chipping Norton have equally valid concerns over the future of their midwifery-led unit. It is clearly critical in such an isolated rural area, where the weather has an effect on traffic on our congested roads, for expectant mothers and families to have access to full, high-quality midwifery and obstetrics care throughout the whole of Banbury and the north of west Oxfordshire. I will continue to work with my hon. Friend the Member for Banbury and others to ensure access throughout west Oxfordshire to the very highest quality maternity services.