Baby Loss Awareness Week

Antoinette Sandbach Excerpts

Tuesday 8th October 2019 Commons Chamber

[Antoinette Sandbach (Eddisbury) (Ind)]

It is always a pleasure to follow the hon. Member for North Ayrshire and Arran (Patricia Gibson), who has been a real support on the all-party parliamentary group on baby loss and who always speaks incredibly powerfully not only about her own experiences but about what needs to change. I am grateful, too, to the Leader of the House, who provided time for this debate, and to the hon. Member for Banbury (Victoria Prentis), who helped with a pincer movement to encourage him to table the debate.

I thank the hon. Member for Colchester (Will Quince), who used to co-chair the APPG with me, and I give thanks particularly to the right hon. Member for South West Surrey (Mr Hunt), whose support for this issue when he was Health Secretary provided the political will to drive through the change that we have seen in the past few years, which has been incredibly important. It is an important testament and legacy that he has left, particularly given the reduction in numbers. There is a need for cultural change, and there is a need, too, for cultural change around mental health support, as seeking such support often had a stigma attached to it.

The right hon. Member for Runnymede and Weybridge (Mr Hammond), the former Chancellor, allocated £1.4 million of LIBOR funding to Alder Hey Children’s Hospital so that it could build a brand-new bereavement counselling centre. I recently went to see that centre, and it will be an exceptional resource in the north-west. Any parent who has lost a child, no matter how long ago, can go to Alder Hey and receive free support and counselling. I would like to make sure that people are aware of that. Alder Hey also operates a hotline that can signpost parents towards help. The Government can be really proud of the steps that they have taken to tackle some of the deep-rooted issues in maternity provision, stillbirth rates and neonatal deaths.

Progress achieved on the national bereavement care pathway should be celebrated. An alliance between the third sector and the national health service has achieved real change. Evaluation of the pathway showed that 92% of parents who had been on the pathway felt that they had been treated with respect; 89% felt that they had been communicated with sensitively; and 87% were offered access to ongoing emotional support after they left hospital. Trusts that have taken up the pathway have seen a real improvement in the care that has been offered to parents.

Further to the point made by the right hon. Member for South West Surrey, clinicians using the national bereavement care pathway felt that they were better prepared to communicate with bereaved parents, and the proportion had increased to 92%. The proportion of professionals who felt capable of discussing bad news with bereaved parents increased from 66% to 72%. There are other excellent results from the evaluation, but I will not go into them here.

[Sarah Champion]

Does the hon. Lady share my concern that that is not the case across all health trusts and that we need to make statutory provision?

[Antoinette Sandbach]

I absolutely do, and I shall come on to that. Having been through the system in Wales, where absolutely no bereavement care at all was offered to me—a charity set up by a former Member of Parliament paid for me to have counselling from Alder Hey—I am as aware as anyone of the issues around access to support. Some 130 NHS trusts have expressed an interest in using the bereavement care pathway, and they should be encouraged to take up best practice.

It is not all good news, however. The reality is that while many hospital trusts are now putting that support in place, the gap in provision comes when parents go back into the community. It is there that the issues need to be tackled. The information gathered by the Baby Loss Awareness Alliance showed that there was a clear need for specialist psychological support for parents. A freedom of information request sent out by Sands in July 2019 painted a picture of very patchy support, with commissioners in over 86% of areas across the UK telling us that they do not commission specialist therapies to support bereaved parents. That is quite scandalous when we look at the good progress that has been made in the acute sector. That is where the gap is present.

Less than 40% of commissioners said that that support was available for both parents, so when it was available, it was only available for one parent. That is completely wrong, for all the reasons my hon. Friend the Member for Colchester has outlined. It should not matter whether someone is a mum or dad; they should be able to access specialist psychological support if it is needed. Why is that important? Some 60% of bereaved parents said that, in the end, they did feel that they needed psychological support. Certainly, I did not want to talk to a load of volunteers; I wanted to talk to a professional who could give me the tools and the understanding to cope with the loss of my daughter and to be able to go back to work and start functioning in a normal way.

It is right to acknowledge that women who experience stillbirth, miscarriage or ectopic pregnancy are at high risk of post-traumatic stress disorder, anxiety and depression. I remember giving a speech to a City law firm, where I was told that it was extremely common that mothers never went back to work having lost a child, because of the impact of that loss on them. By investing in that support, we encourage the family to stay together and to get to a place where it is possible to live with loss and still contribute to society.

Where there has been a sudden or unexpected death, 39% of women three months after suffering an early pregnancy loss met the criteria for probable to moderate post-traumatic stress disorder. Some 68% of mothers and 44% of partners reported four or more negative psychological symptoms at 10 days. The important Bill brought forward by my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake), which allowed some paid bereavement leave for parents, allows some time for parents to come to terms with the issues they face and, very importantly, to find the services that will help them to deal with the loss they have suffered.

I encourage Ministers to read the “Life after Loss” report, which was published last week by the Centre for Mental Health. I support the Minister in the ambition to roll out national centres that will permit parents to access support locally, working with commissioners and the third sector, which can very often have expertise in this area. Support can be commissioned locally without the need for infrastructure, because there is already a third sector organisation. I am thinking of the Petals Charity, for example, which provides counselling. However, its services are not provided all over the UK.

There is another really good example in Wales: 2 Wish Upon A Star. This charity is proactive and not reactive in its approach. It contacts parents within hours of them leaving hospital to discuss their loss and to see what support they need. It can then put a counsellor in a car and on the way to the bereaved parents within hours, rather than them having to wait weeks or months for a referral. If we could roll out that kind of service, delivered by the third sector but supported by the national health service, in areas where there are gaps in provision, that would make a huge difference to parents’ lives.

As chair of the all-party group on baby loss, I said that I would not only celebrate success but hold feet to the fire, so I ask the Government to undertake a review of the current provision, including the evaluation of the models of best practice involving parents and professionals, and to develop quality standards and national guidance to support those planning, funding and delivering specialist psychological support—that must be delivered at CCG level. Acute hospitals are really beginning to deal with this, but the provision at a local level needs to be addressed. I also ask the Government to provide guidance to support local services to effectively assess the psychological support needs of bereaved parents and develop pathways to meet those needs.

It is a real pleasure that we can speak in this debate—an advantage of not proroguing—at the beginning of Baby Loss Awareness Week. It shows the valuable work that is done in this House and that is achieved through cross-party working with a Government who have been really committed to pushing forward this agenda. However, there is more work to do, and with the previous commitment to try to put mental health services on a par with physical health services, this is an area that needs addressing so that that support is put in place.

--- Later in debate ---

[Ms Dorries]

I thank the hon. Gentleman for his contribution, but I only have a few minutes left, so I have to move on.

My hon. Friend the Member for Eddisbury asked what we are doing to eliminate the stigma around mental health. As the Minister for Mental Health, I can say that we are doing a huge amount. I do not know whether anybody in the Chamber has managed to see it yet, but a campaign video was released this week called “Every Mind Matters”, which the royals kindly voiced over. It was written by Richard Curtis and features many celebrities, including Davina McCall. It is all about people who everybody knows and recognises talking about their own mental health issues, to break down the stigma. That is just one of the many campaigns that are taking place.

As I said in the debate on women’s mental health last week, when somebody breaks their leg, we put a plaster cast on the leg, and that is fine. When someone has a mental health issue, they do not want to talk about it. I hope that the stigma is reducing and that there is parity and equality between mental health and physical health. Campaigns like “Every Mind Matters” are getting us there.

[Antoinette Sandbach]

I am grateful to the Minister for giving way. The really good evidence that was disclosed in the debate about the way in which maternal loss of babies can cause PTSD shows that there needs to be concrete mental health support for parents who have gone through this experience.

[Ms Dorries]

What I will say to my hon. Friend in response is that, in the long-term plan, the NHS commits to

“improve access to and the quality of perinatal mental health care for mothers, their partners and children”.

We have committed in the long-term plan that an additional 24,000 women will have access to specialist perinatal mental health support, including more support for fathers and partners. That is part of the £2.3 billion investment in mental health that this Government recently announced. I will say it again: £2.3 billion. That is over half the annual prisons budget. Of course, some of that money has to be directed towards mothers in this situation.

My hon. Friend the Member for Banbury (Victoria Prentis) made an important point about infant mortality in other countries around the world. The Secretary of State for International Development announced a £600 million reproductive health supplies programme to help end preventable deaths of mothers, newborn babies and children in the developing world by 2030. It will give 20 million women and girls access to family planning, prevent 5 million unintended pregnancies each year up to 2025 and focus on the most vulnerable women, including FGM survivors. We are committed to working with Gavi, the Vaccines Alliance, to vaccinate a further 300 million children in the world’s poorest countries by 2025.

My hon. Friend also talked about making maternal mortality a never event. I am not sure that that will be an achievable objective, but NHS England is supporting the establishment of maternal medicine networks, which ensure that women with acute and chronic medical problems have timely access to special advice and care at all stages of their pregnancy.

The hon. Member for Ellesmere Port and Neston (Justin Madders) spoke about grief. Grief, for me, is the last taboo; it is the one thing that people still do not talk about. People still do not talk about how grief affects them, and I hope that some of the investment we are putting into mental health services and community services will help people to address grief.

My hon. Friend the Member for Brigg and Goole (Andrew Percy) spoke about somebody who works in his office who has raised funds for the Cherished suite, and the right hon. Member for Broxtowe (Anna Soubry) spoke about the serenity suite. Over 50% of hospitals now have such suites, which are so important. I do not want to reiterate what anybody has said, but the fact that babies are born in a part of a hospital that is traditionally filled with joy is incredibly difficult. My hon. Friend the Member for Colchester has told me that it makes such a difference if people have somewhere to go and even to stay overnight with their baby, and where the family can go. Over 50% of hospitals in the UK have these suites, and I am going to ask that these suites are made available in the maternity areas at all the 40 new hospitals that are being built. [Hon. Members: “Hear, hear.”] I will ask; I will certainly push.

I want to continue with the points raised, and please pull me up if I miss anybody out. The hon. Member for Strangford (Jim Shannon) spoke so passionately—thank you. I know he has spoken in every baby loss debate we have had, and he has also spoken in the past about the important role that chaplains play in such situations. I would like to thank him for his incredible contribution. He asked about the pregnancy loss review. It is currently working with key partners to make recommendations to the Government about improving the care and support that women and families receive when experiencing a pre-24 week gestation baby loss. We are hoping the report will be published in due course and not too long from now.

I would like to speak about an area that I have particularly focused on, which is group B strep support. I have spoken about this many times, and I had my own Adjournment debate on it before I was a Minister. When I arrived in the Department, I set five key priorities, and this is No. 1 in the key priority areas because this in itself will prevent infant mortality. Group B strep is a leading cause of bacterial infection in newborn babies—just to put that on the record. I fully support the review that is taking place, and I hope that it has some further information so that we can make progress on this in, I hope, the not-too-distant future.

The hon. Member for Rotherham (Sarah Champion) spoke about hospices. I have Keech Hospice in my own constituency. I think hospices and their role is slightly outside the debate, bearing in mind the level of investment that we are putting into mental health services and counselling services. Somebody mentioned improving access to psychological therapies and the importance of talking therapies. I hope that any mother or family who needs mental health counselling as a result of baby loss will in future be able to access those services. I will write to her about the role of hospices in this particular area.

I appreciate the support from Members on both sides of the House in relation to the maternity safety ambition. I echo your words, Madam Deputy Speaker, about the tone of this House in such important debates. One of the most important things to come out of the debate today is the importance of learning for improvement and what we are beginning to learn through the perinatal mortality review tool and the Healthcare Safety Investigation Branch, which I have mentioned, that was introduced by the former Secretary of State.

I would like to remind Members that the NHS is still—and the NHS in the UK is still—the safest place in the world to have a baby: 0.7% of all births result in a stillbirth or a neonatal death. Having said that, on a day like today, 12 babies in England and 15 across the UK will be stillborn or die soon after birth, and many more families will lose a baby through miscarriage, ectopic pregnancy and other causes. We are, however, making progress: in 2015, the figure was 17 babies a day. Maternity and neonatal safety initiatives are beginning to improve outcomes, with most of the anticipated impacts still to be realised, as safety improvements are embedded in maternity and neonatal services and as we learn more from research and investigations about which babies die and why.

Finally, as we have discussed, the theme of Baby Loss Awareness Week 2019 is psychological support for those bereaved parents who need it. I understand that a working group is being convened to support the development of maternity outreach clinics that will integrate maternity reproductive health and psychological therapy for women experiencing mental health difficulties arising from and directly related to the maternity experience. I will undertake to ask this working group if it could consider extending the maternity experience to those who have lost a child in pregnancy, during labour and childbirth in the neonatal period.

I would like to finish by thanking all the midwives, doctors and healthcare support workers who do such a fantastic job in delivering more than 600,000 babies successfully every year and in helping the parents who, sadly, do not experience the happiness of a healthy baby.