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.

Oral Answers to Questions

Antoinette Sandbach Excerpts

Tuesday 7th May 2019 Commons Chamber

[Matt Hancock]

The hon. Lady is absolutely right. I am glad that this discussion of improving quality across the NHS and social care has united the House in its enthusiasm to see best practice and ensure that people learn from it. We have seen an awful lot of learning in social care, as most social care is delivered by private sector providers, but there is more to do and there are different levers that we can pull. When social care providers lose their good or outstanding status, they also often lose their contracts, so there is an awful lot of pressure on them to learn from best practice around the country, and I would only emulate that.

[Antoinette Sandbach (Eddisbury) (Con)]

18. What steps he is taking to promote stem cell donation.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

Since 2011, the Department has provided more than £26 million to NHS Blood and Transplant and to Anthony Nolan, to improve stem cell donation, and is now establishing a unified UK stem cell registry. I would also highlight the inspirational work of Team Margot, who are working to increase the number of people on that stem cell register by enrolling themselves in the transatlantic rowing race. I urge all hon. Members to support that campaign.

[Antoinette Sandbach]

I hope the Minister will join me in praising my constituent Peter, who has myeloma and set up the “10,000 donors” register. There are now 22,000 donors registered, but Peter has a rare ethnic mix of English, Irish, Chinese and Portuguese. What more can be done to encourage donors from minority communities?

[Jackie Doyle-Price]

My hon. Friend is absolutely right. We have spent a lot of time encouraging donors from minority communities, but the real issue with regard to stem cell donation is that it is about genetic composition. We live in a wonderful society where we all have heritage going back in various, very complex ways, but that makes finding a suitable donor for stem cell donation extremely difficult. It is therefore important that we encourage people to take the test to establish their genetic heritage so that we can have more and more diverse people on the register.

Children with Life-limiting Conditions

Antoinette Sandbach Excerpts

Tuesday 29th January 2019 Westminster Hall

[Antoinette Sandbach (Eddisbury) (Con)]

It is a pleasure to serve under your chairmanship, Ms Dorries. I am grateful to the hon. Member for Strangford (Jim Shannon) for securing the debate and for his continuing interest in the matter.

It is exceptionally difficult to care for a child with a life-limiting condition. The Government have made progress on making things slightly easier in areas such as bereavement care, but I recognise that more needs to be done to support families who are going through the process, especially in terms of palliative care. The issue affects not just the 49,000 children in the UK who live with life-limiting or life-threatening health conditions, but their families and those who care for them. Those who are suffering from such conditions need the best medical care possible, but the families require care too, whether that is in the form of respite breaks or financial support for adjusting their homes and lives.

I sympathise somewhat with the Minister: she has to respond on behalf of her Department, but it is not just her Department that acts in this space. Local authorities, the voluntary sector and other Departments all have a role to play, and it will be possible to tackle the challenges faced by families only by taking an integrated approach that encompasses all of those groups.

[John Howell (Henley) (Con)]

My hon. Friend mentions the adjustments that need to be made in people’s homes. To what extent does she think local councils are living up to expectations in that respect?

[Antoinette Sandbach]

I will come on to that point, but I know that in my area the situation is certainly not as good as it might be.

I hope that the Minister will commit to ensuring that children have a right to an integrated assessment, a plan and a personal budget to address their individual needs. Likewise, I hope that she will agree to review health and social care law, not only to strengthen the rights and entitlements for disabled children and their families, but to clarify them. That clarification would be hugely welcome, because uncertainty leads to some local authorities failing to meet their obligations. For instance, Together for Short Lives reports that 21% of local authorities are failing to meet their legal duty to commission short breaks for disabled children. That postcode lottery is deeply unsatisfactory and requires the Minister’s attention.

I was concerned to discover from December 2017 data that only one of the four Cheshire clinical commissioning groups was developing a strategy or care pathway for children with life-limiting conditions. The same data shows that although some of my area’s CCGs offer out-of-hours paediatric palliative care consultants, community children’s nurses and psychological support, others do not. Given that families have 24/7 responsibility, should not the NHS? My area is lucky to have specialist paediatric care close at hand, thanks to Alder Hey Children’s Hospital, but it is clear that even in Cheshire more must be done, which probably means that more funding must be put in place.

The all-party parliamentary group on baby loss wrote to the Chancellor at the end of last year to ask for a guarantee of the future of the NHS England children’s hospice grant beyond March 2019; for an increase in its value to £25 million per year; for parity of funding between children’s and adult hospice and palliative care charities in England; and for a funded, cross-departmental children’s palliative strategy for England. I was pleased to see that the issue received attention in the NHS long-term plan, but I am concerned by the mismatch between NHS England’s 27 December announcement about children’s hospice funding under the plan, and what was published in the plan itself on 7 January: the announcement said that the money was for hospice funding, but the plan said that it would be for palliative services, including hospices. Will the Minister clarify whether that £25 million will be for children’s hospices only, or for a wider group of children’s palliative care services?

Likewise, will the Minister guarantee that the £11 million children’s hospice grant will be protected and increased as a result of the long-term plan? It is vital that we resolve that, because in 2006-07 the children’s hospice grant contributed 14% towards the cost of providing clinical care in children’s hospices across England, but by 2015-16, when the grant had risen to £11 million, it contributed an average of just 8%.

I hope that the Minister will offer the reassurance that so many families deserve, not just about the finances but about integration and ending the postcode lottery. I am sure all hon. Members agree that these families need support, but now we must build on that agreement and implement a sustainable, compassionate plan to support them.

Baby Loss Awareness Week

Antoinette Sandbach Excerpts

Tuesday 9th October 2018 Commons Chamber

[Antoinette Sandbach (Eddisbury) (Con)]

I beg to move,

That this House has considered baby loss awareness week 2018.

I rise to open today’s debate on Baby Loss Awareness Week, and if you, Madam Deputy Speaker, or others wish to read the account of Fiona Crack and her husband about their daughter Willow that is on the BBC site today, you will understand why this debate has continuing endurance and relevance. I am also extremely grateful to my colleagues and the charities that have worked with us on the all-party parliamentary group on baby loss. I want to use my time to highlight some of the successes, to describe how we can ensure that we build on them and to mention a couple of areas where we must focus our efforts more closely as they have become areas of concern.

Looking back over the past year, I am proud of the higher profile of parental bereavement issues. Whereas before many people felt that they did not know how to approach the subject or what to say, we are increasingly seeing people coming forward and offering words of sympathy, kindness and condolence, and the 60 charities working in this field have produced an excellent video, which is available on YouTube under the title “Baby Loss Awareness Week”. Members of the public and anybody watching this debate can watch and see how to approach and discuss the subject.

This change has come about because of a slow and steady change in how we in this country treat those who have lost a child. All of those involved in Baby Loss Awareness Week can be proud of this change, from those of us in this place today to the fantastic charities and voluntary groups, such as Sands, the Lullaby Trust and the 60 other charities that have been involved in the initiative. In addition, doctors, nurses and midwives on the frontline have been changing attitudes during the past few years.

It is not just attitudes that have changed in the past year, but policy. I am delighted that the past year has seen two major policy shifts: the implementation of a pilot of the national bereavement care pathway; and the passage of the Parental Bereavement Act 2018 into law. I am sure that my hon. Friend the Member for Colchester (Will Quince) will want to discuss that Act in more detail, and I pay tribute to my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) for his able stewardship in taking the Bill through Parliament. This is a significant step in ensuring that those who lose a child can mourn their loss while knowing that they have a period of paid parental leave from their employment. It marks the introduction of a new benefit such as has not been seen in this country for many decades, and I welcome the progress that the Government have made on that.

I want to spend a little longer concentrating on the national bereavement care pathway. Good care cannot remove parents’ pain and grief, but it can help them through this devastating time. In contrast, poor care can significantly add to their distress. The national bereavement care pathway sets out to deliver that good quality care and it was designed to address the previous postcode lottery in quality of care. The first wave of pilots was launched this time last year, during Baby Loss Awareness Week 2017. Eleven trusts were joined by 21 more when the second wave started in April of this year. This week, we take another step forward, as all the documents, tools and resources are being made publicly available for the first time. The national bereavement care pathway is paving the way for excellent care after pregnancy and baby loss. It aims to improve the quality of bereavement care experienced by parents and families at all stages. That includes miscarriage, stillbirth, neonatal death, molar and ectopic pregnancy, termination of pregnancy due to foetal abnormality, and sudden and unexpected death in infants of up to 12 months. This bereavement care pathway provides healthcare professionals with detailed guidance, training programmes, staff resources and simplified paperwork so that they can provide high-quality bereavement care when families need it most.

We are lucky because an evaluation of the first wave of pilots has taken place, and the results have been really positive. Parents have responded overwhelmingly positively, considering what they went through at the time. Some 95% of parents surveyed agreed that the hospital was a caring and supportive environment; 98% of parents agreed that they were treated with respect; 90% felt that they were provided with information that was easy to understand; 92% felt that the decisions they made in hospital were the right ones at the time; and 96% felt that they were communicated with sensitively. That is so important, because that shows that there has been a huge change in advice and support. I think my hon. Friend the Member for Banbury (Victoria Prentis) will be talking about the less encouraging statistics for areas that have not been able to roll out the pathway.

It is not only parents but medical professionals who feel the difference. At the beginning of the pilot, medical professionals were interviewed and asked what was preventing the delivery of the best possible quality bereavement care. One said that

“people were in their own little bubbles. There wasn’t much sharing, nothing was passed around as a standard.”

Medical staff also identified a lack of staff training, poor bereavement suite facilities, complex paperwork, long delays in getting post-mortem results back, staff not knowing how to communicate with parents about their loss, and different levels of awareness or knowledge between departments at the same hospital. The evaluation shows that significant progress is being made on a number of those concerns. Some 77% of the professionals who are aware of the pathway agree that, overall, bereavement care has improved in their NHS trust during the period of the pilot. That is something that our national health service can be really proud of, because it represents a significant change. Two thirds of professionals who are aware of the pathway agree that it has helped to raise the profile of effective bereavement care in their trust. The proportion of health professionals who feel prepared to communicate with bereaved parents, able to discuss bad news with parents and supported to deliver good-quality bereavement care has increased. If this were an exam, the student would have passed with flying colours.

The testimony of one parent who was involved in the pilot says it all:

“There was a doctor who was really, really helpful with me. It was such a shock and took such a long time for me to process why and how this happened; I must have gone in about five times, where she had to sit me down and tell me the same thing again and again. It was never too much trouble for her, and I needed that. Having patience with someone is really, really important—because you might have said it five or six times but I need you to say it again. She’s a doctor, she’s a very busy woman but she always made time to speak to me.”

This kind of care, and this kindness in care, is so important for parents in that position. They are going through the worst experience of their lives, and they are not always thinking straight. They are guaranteed to be sleep deprived and distraught. The kindness of a doctor or the concern of a midwife can be the first small building block on the road to recovery.

However, despite these successes and others, which I am sure colleagues from across the House will mention, we must continue with our work. In the most recent year for which figures are available, 5,500 babies were stillborn or died within 28 days of birth in the UK. Some of our European neighbours have managed to cut perinatal mortality rates by up to half, which shows there is still more to do. I welcome the Government’s target of halving perinatal mortality rates in the UK by 2025.

One thing I am becoming increasingly concerned about is the rising number of child death cases in hospitals. Although I am pleased that the light of transparency is being shone into these hospitals, I cannot help being concerned by the number of such cases in the last year. Shrewsbury and Telford Hospital NHS Trust has been the subject of horrific news, with the investigation into maternity care expanding to more than 100 cases. Likewise, in my own area, the Countess of Chester Hospital is the subject of a criminal investigation amid allegations that a member of medical staff was involved in 17 deaths and 15 non-fatal collapses. More broadly, a recent study found that the baby death rate was 10% higher than expected for a maternity unit.

Just last week, we saw the news from Wales that Cwm Taf University Health Board may have failed to properly investigate historical cases of stillbirth and neonatal deaths in its maternity units. I know that that case—the most recent—is devolved, and there will be things that the Minister cannot say while investigations are ongoing, but I would be grateful if he reassured the House about the steps that are being taken to address these specific issues, and what plans he has to ensure that when such issues arise in the future, there is a plan in place to support affected parents and ensure that the investigation is as quick and thorough as possible.

[Lilian Greenwood (Nottingham South) (Lab)]

The hon. Lady is speaking with great authority on this issue, as she always does. Does she agree that one thing the Government could do in this area, particularly when it comes to stillbirth, is to extend the power of coroners to investigate stillbirths of full-term babies? We have discussed that previously, and it is the subject of a private Member’s Bill. Does she think that that would help in the investigation, and therefore the prevention, of unnecessary deaths?

[Antoinette Sandbach]

I know that across the House there is a great interest in the need for coroners’ investigations, and I believe that the hon. Member for East Worthing and Shoreham (Tim Loughton) will be introducing a private Member’s Bill. I think that the idea has support from the Government. It is incredibly important for parents to give consent to post-mortems—that can be a very sensitive area, particularly for parents from ethnic minority backgrounds—because very often, medical findings assist with the research to discover the causes of stillbirth and neonatal death. The hon. Lady makes a very good point.

In closing, I hope that colleagues will recognise that this year has been one of significant policy wins.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

I echo the point that my hon. Friend the Member for Nottingham South (Lilian Greenwood) made by commending the hon. Member for Eddisbury (Antoinette Sandbach) on her joint leadership of the all-party group on baby loss and her support for the charities that have come together once again to initiate Baby Loss Awareness Week. Will she praise the intervention of a councillor in my constituency, Sarah Butterworth, and her husband Jon, whose baby, Tiger Lily, was stillborn in June 2005? They have joined in the support for Baby Loss Awareness Week to encourage more debate about this sensitive issue.

[Antoinette Sandbach]

I certainly join the hon. Gentleman in praising his constituents’ work in memory of Tiger Lily. Let me also refer to the story of Fiona Crack and her daughter Willow. Fiona went to speak to the hon. Gentleman’s constituents, and there is a detailed account on the BBC’s website, highlighting the way in which they have turned a negative into a positive in commemorating the memory of Tiger Lily and the steps that they are taking to help other parents in their grief. I believe that they help with the memory boxes; I have a memory box at home, and I know how valuable that is.

I think that there has been a real uptick and a real positive story to tell this year, given the policy wins that have come from the Government. We know that we must address these challenges, but we have come a huge way in the last three years, and we have won important changes in policy.

Members may be wondering what they can do to drive the changes that we need. First and foremost, they can join me in encouraging the Minister to fully fund the national bereavement care pathway into 2019-20, so that it is embedded and becomes the national standard for best practice. I hope that the Minister will have something to say about that when he winds up the debate. Secondly, Members on both sides of the House can engage with their local charities who help those who have lost a child, as, indeed, many of their constituents have. I know that many Members are present because of the work that their constituents have done, or because of their own experiences.

Members can also help to promote the national bereavement care pathway in their constituencies. We have seen from the pilot that it works, but political support and public awareness are crucial to ensuring that it is embedded throughout the UK. If Members leave this debate with one thing in their minds, let it be the testimony of a grieving parent who experienced the pathway:

“I was shocked at the level of care. I thought ‘this is the NHS, why are they making such an effort for me?’ I didn’t know care like this existed and I was blown away by it—my expectations were exceeded in every way”.

We have all benefited from amazing care from our NHS, but sometimes it does not have all the tools that it needs. The national bereavement care pathway gives it the tools that it needs to deal with this very difficult issue, and we must work to ensure that it is put in place throughout the country.

--- Later in debate ---

[Will Quince]

I thank the hon. Lady for her intervention. I will absolutely thank and pay tribute to that charity. In so many cases, bereaved parents want to do something to make a difference and to provide a legacy for or mark the life of their child, however short, and raising money to support our NHS or to provide support for bereaved parents is hugely worth while. If I heard the hon. Lady right, an incredible £300,000 was raised: I pay tribute to the work that parents across the country do to raise such sums, which support the NHS in providing world-class facilities. I will discuss this further in a bit, but although we do have world-class facilities and bereavement suites some of our hospitals do not have them, which is an issue in and of itself.

I have thanked charities, but it is also important to thank the clinicians and support staff within the NHS who work so hard in this area. They really are heroes, and their work is incredible. Midwives do an incredible job, because although they are so often there at the best time in someone’s life—when a child is born—they are sometimes sadly also there at the very worst time in someone’s life. Their ability to, in effect, wear both hats and provide that caring, compassionate, empathetic support is a credit to them. We really do have world-class staff in our NHS.

I also thank all the clinicians who are working so hard on the national bereavement care pathway. Numerous colleagues have mentioned it already, and it is important to reference the progress made so far. I do not want this to be a back-patting debate, because I will move on to some areas where the Government could do more, but we have achieved quite a lot in just over three years. The first, and probably most significant, achievement was the Government’s commitment to reduce stillbirth and neonatal death by 20% by 2020 and by half by 2025. I note that that target has been moved forward—I think the target three years ago was 2030—thanks to the work of the Secretary of State for Health and Social Care, Health Ministers and clinicians. Having spoken to the Department and to clinicians up and down the country, I understand that those targets are realistic and achievable and that we are on track to achieve them, which is quite incredible.

However, it is important to note that even if we achieve the target of reducing stillbirth and neonatal death by 50%, that still means that around 2,000 or 2,500 babies are dying in the UK every single year and that a similar number of families will be going through a horrific personal tragedy, so we must ensure that we have world-class support. That is why the national care bereavement pathway, which I think it is fair to say was a concept initially drawn up based on the APPG’s work with charities, is game changing. The pathway is game changing, because what we had and continue to have across our NHS is world-class bereavement care, but it can be found only in pockets. It is not consistent across the NHS.

A particular hospital trust may have one or perhaps even two specialist bereavement suites and one, two or maybe more specialist bereavement-trained midwives or gynaecological counsellors, and all sorts of charities may be supporting bereaved parents within that hospital trust. In other hospitals, however, there may be no bereavement suite and perhaps just one or even no specialist bereavement-trained midwives or gynaecological counsellors. That is an issue, so a national bereavement care pathway that provides consistent, compassionate, empathetic care and support across our NHS, whichever hospital one visits, is so important.

[Antoinette Sandbach]

I congratulate my hon. Friend on that point. However, even where world-class care is not available, that can change, and the Medway NHS Foundation Trust is a great example of that. It received a negative inspection report, but it completely turned the situation around and now has absolutely first-class facilities. World-class care is achievable when hospital managers and NHS trusts are absolutely committed to delivering it.

[Will Quince]

My hon. Friend is absolutely right. The core purpose of the national bereavement care pathway is to show what good care looks like so that it can be rolled out across our NHS. My hon. Friend is right that we can do that by having bereavement suites and trained gynaecological counsellors and midwives, and we are seeing it. The pathway has now been launched in 32 sites, and I must again praise the Government for their initial funding, which supported the establishment of the principle and the pilots, and then the further funding for the roll-out into more sites.

I echo the comments made by my hon. Friends the Members for Eddisbury and for Banbury (Victoria Prentis) about further funding to roll out the pathway to ensure that it reaches the entire NHS nationwide, but 77% of professionals at the pilot sites who were aware of the pathway agree that bereavement care improved in the trust during the trial, and some 95% of parents interviewed agreed that the hospital was a caring and supportive environment. We therefore know that the pathway is making a difference and will work, which is why the Government have been so supportive. We just want to ensure that it is rolled out. The roll-out has deliberately happened in stages because ensuring that it is effective and embedded is just as important as the initial implementation.

Others have mentioned the Parental Bereavement (Leave and Pay) Act 2018, which is an incredible and ground-breaking piece of legislation. It is the first time that workers have had such a right, and it is one of the best rights in this area in the world. I pay tribute to my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) for so ably and passionately steering the legislation through the House of Commons and then ensuring its passage through the House of Lords and beyond. It is game changing, because it means that, from 2020, parents who lose a child up to the age of 18 will be entitled to two weeks’ paid leave. That is particularly important in relation to this baby loss debate, because it means that parents who lose a child to stillbirth will also be entitled to those two weeks.

For a mother, those extra two weeks may not be a huge change because mothers are entitled to their full maternity leave, but for a father it is game changing. Instead of two weeks’ paternity leave, he will get four weeks, because he will get the additional two weeks of paid leave. The Act will make a huge difference to fathers up and down the country who go through the awful experience of a stillbirth.

I said earlier that this was not a back-patting debate. Far, far more needs to be done. Earlier we had reference to bereavement suites. It is essential that we have bereavement suites in every hospital up and down the country. It is not acceptable that any parent should have to suffer a stillbirth or neonatal death in a maternity unit where they can hear happy families, crying babies and people with balloons and teddies—all the joy of that. People who are going through this most traumatic of experiences need somewhere quiet for reflection, to grieve and to spend time with their baby in peace. We know that we can provide this because NHS trusts up and down the country are providing bereavement suites. In Colchester we were lucky to have use of the Rosemary suite, and I am not quite sure what we would have done without it.

So we have to ensure, Minister, that we have a bereavement suite in every hospital away from the main maternity unit. Ideally, I would like another room to be available, because you cannot book in. You do not know when exactly you are going to have a baby—these things do come on, as my wife and I found out with our second, who was born at home, unexpectedly. It was also a pretty traumatic experience, but it ended well. The point is that people do not know and they cannot book suites out. They can just turn up at hospital. If, sadly, the suite is already being used, another room should be available. It might not have the full facilities of a bereavement suite, but it is important to have that room.

As was mentioned earlier, cold cots are also important. Not all parents will want to spend time with their child, but those who want to should be able to spend as much as they need after the birth, and for that cold cots are important.

As I mentioned earlier, it is important that bereavement-trained midwives or gynaecological counsellors are available in every hospital—not part time but full time, and available for parents when they need them. Let us not forget that many stillbirths and neonatal deaths are sudden and unexpected. It is a hugely traumatic experience and people need support immediately. A trained individual is so important. However, there is merit in ensuring that bereavement training is a module in the midwifery course so that every midwife is trained to an extent, because sadly we know that they will come across stillbirth and neonatal death in their career.

The other thing is to ensure that there is learning from every miscarriage and stillbirth. We still do not really understand why 50% of stillbirths happen. I will come on to it, but research is so important. I have already mentioned embedding the national bereavement care pathway.

I want to touch on the new pregnancy loss review, because it has not been mentioned so far. One of its heads is Zoe Clark-Coates of the Mariposa Trust. We often talk about stillbirth and neonatal death, but we do not talk enough about miscarriage and we still do not really know the true numbers of miscarriages. Colleagues in the Chamber have spoken emotively in previous debates about their experience of losing a child at less than 24 weeks. They said that their loss was not recognised in any way because it was classed as a miscarriage, not a stillbirth, even though they gave birth. This is why the pregnancy loss review is so important.

I echo the comments made by my hon. Friend the Member for Banbury about post-mortems. Too often, people are scared to have the conversation about a post-mortem. It is a difficult subject; I would not want to approach parents who have just lost a child and ask if they would consider a post-mortem. But it is so important that that question is asked, because post-mortems will enable us to start to understand why stillbirths happen. So changing cultures within NHS trusts to ensure that that question is asked as a matter of course is important. The parents can say no, but if they are not offered the opportunity, they may look back and say, “My child’s life could have made a difference to future children.”

I would like to see the national bereavement care pathway and bereavement support more widely included as part of the matrix and assessment regime for the Care Quality Commission. We do not put enough emphasis on bereavement and the support that parents are given. I would also like to see support for subsequent pregnancies. There is pretty good support in many NHS trusts at the point at which someone suffers a loss, but what about subsequent pregnancies? Often the mother and the father will be thinking every single day up until the 12-week scan, every single day up until the 20-week scan, “Is this going to happen again?” But at that point often no support is available unless they reach out. The support network is patchy across the country.

My hon. Friend the Member for Gloucester (Richard Graham) spoke about fathers, and he was absolutely right to do so. As I said at the beginning of the debate, it is important that men take part in it. So often, men bottle things up. They think they have to be the tough guy and hold it all in to support the family. I did it, and I have spoken to other fathers, so I know that it is a common reaction. Men are often treated like the spare part. That is by accident, not design. The chaplain or midwife will often be talking to the mother—understandably—but the father has just witnessed the woman they love give birth to a child they love and have now lost. They have been through the experience too. They are often the ones who will have to go off and tell family members, register the death and make arrangements for the funeral. So it is important to ensure that fathers have all the necessary support available to them, and it is one area that the NHS needs to get much better at.

It is important that we have more research into baby loss. The taboo nature of this issue means that charities that specialise in it—even the bigger ones such as Sands, the Lullaby Trust, the Mariposa Trust and others—do not get the financial support that other charities do. I implore people up and down the country to support baby loss charities, because they can fund vital research, which will lead to fewer babies dying.

Lastly, I want to touch on another passion of mine. We talk about 15 babies dying every single day in the UK. Every single one is a tragedy. But 7,175 die every single day worldwide. Every day 830 mothers die from preventable causes related to pregnancy, and 99% of them are in developing countries. So let us be passionate about reducing stillbirth and neonatal death here in the UK, but let us be equally passionate about tackling this issue worldwide. I am a big champion of UK aid because I know that it makes a difference around the world. UK aid is not sold, especially by some of the right-wing media, but it is so important in tackling issues such as this. I do not think that there is one person in this country who would say that spending money on reducing the number of deaths of babies is not money well spent. If we were to get the newborn mortality rate of every country down to the average of high-income countries such as our own, or even better below it, that would save 16 million lives a year.

UK aid is already making a huge difference to this issue. In 2015-16, something like £124 million was spent on maternal and neonatal health. That is equivalent to about 15% of aid spending. The Department for International Development is supporting programmes in about 16 countries, focusing on maternal and neonatal health. I recently made a visit with Unicef to Ethiopia, a country that has a high prevalence of baby loss. Although the number of deaths of children aged between one month and five years has dramatically fallen in recent decades, newborn death remains a massive issue. Think of the difference we can make worldwide if we can share some of the learnings from this country and others in the western world by using UK aid and support from clinicians in this country. Let me give an example of that.

One of the biggest causes of newborn death in Ethiopia is sepsis, which is relatively rare in the UK because we have high levels of hygiene and sanitation. UK aid water projects will make a huge difference on that, but we can do far more. At one neonatal unit there, the scrubs and clogs I was asked to put on were dirtier than the clothes I was wearing, which was a little worrying. There was a baby in there with sepsis, and I spoke to the doctor, who was a general practitioner, not a specialist in gynaecology or an obstetrician. There is a real need for some specialism and specialist training there. I asked, “Where is the hand wash? Where is your alcohol rub? This is commonplace. You can’t go about 10 feet along a hospital corridor in the UK without finding an alcohol rub dispenser.” He replied, “Ah, yes, I’ve got some of this” and he reached into a bottom drawer, underneath a load of stuff, and pulled it out. This is exactly the sort of intervention, on cleanliness, hygiene and sanitation, that we in the UK can share with countries around the world and that can make a difference. So I invite the Minister, and I will also be pushing the Secretary of State for International Development on this, to have a little more focus on tackling infant mortality, stillbirth and neonatal death on a global scale.

I have probably spoken for long enough, but I just want to say that this is a hugely important subject. We in the all-party group will continue our work, and I wish to thank all Members here from across the House, the Government and Members from all parties for their ongoing support.

--- Later in debate ---

[Antoinette Sandbach]

It is a pleasure to follow the Minister and the commitments he has made. As he said, this issue unites the House. The hon. Member for North Ayrshire and Arran (Patricia Gibson) spoke about her dread about today’s debate, as did my hon. Friend the Member for Banbury (Victoria Prentis), and I did not go to sleep last night because of the worry and the feelings that it brings back. But the hon. Member for North Ayrshire and Arran also spoke about the optimism for this year and what we have achieved in the past three years. As the Opposition spokesman said, personal tragedy moves people to go to enormous lengths, and we have heard from Members across the House about constituents who have gone to enormous lengths to try and build on their experiences, ensure that lessons have been learned and make sure that things are better for those who follow.

Three themes emerged from the debate. The first, which is where we started three years ago, is about breaking the silence. My hon. Friend the Member for Colchester (Will Quince), in the week in which Robert has his fourth birthday, spoke about taking on the taboo of speaking about childhood death. We have all taken on that taboo in this House. Each year, different aspects of it emerge. The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) spoke about his mother suffering in silence. So many people have suffered in silence; indeed, the hon. Member for Strangford (Jim Shannon) had his mother and sister share that experience. We are breaking that taboo, we are breaking that silence, working together with those 60 charities that cover all sorts of loss and that are embedded in our communities and supporting our constituents who have been through this.

There is some optimism and hope in Baby Loss Awareness Week, not least because on Saturday we have the wave of light, which travels across the world as parents light candles in memory of their children. The hon. Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney) also spoke about the role of his mother. At that point in time, with the newly emerging NHS, looking after what are commonly referred to as angel babies must have been very difficult, and I know that my own mother suffered in silence from her own experience, although she was not looking after stillborn babies. That work is important, as was the work of his constituent, Gordon, with Bumblebee Babies.

The second theme was pregnancy support. The hon. Member for Ceredigion (Ben Lake) spoke about this, and particularly about ultrasound scanning in the third trimester. I campaigned on that in Wales when I was an elected Member of the Welsh Assembly, and I urge him to work with his colleagues in the devolved Assembly to try to deliver it. Ultrasound scans in the third trimester have been proven in other jurisdictions to reduce stillbirth and neonatal death, and they can make an important contribution to the debate going forward. He also spoke about the work of Gareth and Clare in memory of Mari-Leisa.

My hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) was the only Member to mention Group B Strep Support, which forms an incredibly important part of this debate. A test for group B strep can be done for £11, and people can discover whether or not their baby might be vulnerable to it. That is an area that we can perhaps work on. I am grateful to her for raising the matter, in the light of her clinical experience, and I know that other Members of the House have campaigned on it.

The hon. Member for North Ayrshire and Arran said that prevention was the key. Pregnancy support—both around smoking and for BAME communities, who are, as the Minister mentioned, particularly vulnerable—is absolutely critical to that. The MAMA Academy wellbeing wallets have been used in the Countess of Chester Hospital trust, and they recently saved two lives. Because the women had on the front of their medical notes the areas of concern that they should look at, they went and sought help, and there are two babies alive today who might not otherwise have been. Prevention is key.

The third theme that came out of today’s debate was post-bereavement care and support. The Government have made huge strides, working together with the third sector. The best abilities of the third sector have been harnessed together with the drive and ambition of the Department of Health to deliver the national bereavement care pathway, and that is a really good example of co-operative working. I think it will lead to a huge change in the quality of care and help to end the postcode lottery that parents face.

I know that the previous Secretary of State for Health was absolutely committed to the idea that health professionals should not close ranks to try to protect other health professionals when things go wrong. The idea is to promote transparency and openness. As my hon. Friend the Member for Sleaford and North Hykeham said, it is about the “why?”—the desire to find out why something happened and make sure that it does not happen to anyone else. I think we should take forward such positive learning experiences to help to reduce the number of neonatal deaths, stillbirths and perinatal losses. There is work to be done, but there is much to celebrate. Many other events are taking place during Baby Loss Awareness Week, and I urge Members to get involved in them.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Thank you. It has been an excellent, honest and constructive debate.

Question put and agreed to.

Resolved,

That this House has considered baby loss awareness week 2018.

Maternity Safety Strategy

Antoinette Sandbach Excerpts

Tuesday 28th November 2017 Commons Chamber

[Mr Hunt]

Let me simply say that there is an excellent Scottish patient safety programme. Given that one of the main objectives behind the statement is to share best practice, I would be very happy to talk to the chief medical officer in Scotland and to Jason Leitch about how we can exchange information and learn from each other’s systems.

[Antoinette Sandbach (Eddisbury) (Con)]

As every parent who has lost a child knows, what they want most is answers. I therefore congratulate the Secretary of State on bringing forward the healthcare safety investigation branch, because such independence will be crucial in gaining the buy-in of parents and in their knowing what has happened in their particular case. How will the learning from those investigations be shared?

[Mr Hunt]

I thank my hon. Friend for her extraordinary campaigning on this issue. Yes, we want parents to get the answer more quickly, but we also want to be able to answer the question that every parent asks: “Can you guarantee that this won’t happen again?” The investigators will have an explicit dual remit: to get to the bottom of what happened, but also to spread that message around the system so that the same mistake is not repeated. That is the objective of setting up a new team of people to do this.

Oral Answers to Questions

Antoinette Sandbach Excerpts

Tuesday 14th November 2017 Commons Chamber

[Mr Hunt]

No one should have to wait weeks for a GP appointment in Stroud or anywhere else. We have a lack of capacity in general practice, which is why we decided to embark on a plan to get 5,000 more doctors working in general practice. That is one of the biggest ever increases in the capacity of general practice. I am afraid that it will take time to feed its way through the system, but we are confident that we will deliver it.

[Antoinette Sandbach (Eddisbury) (Con)]

4. What steps he is taking to improve the safety of maternity services in NHS hospitals.

[The Secretary of State for Health (Mr Jeremy Hunt)]

It is me again, Mr Speaker. Every week, we have four claims against the NHS relating to brain-injured babies, and there is still far too much avoidable harm and avoidable death when it comes to our maternity services. That is why I launched an ambition in 2014 to halve the amount of neonatal death, neonatal injury, maternal death and stillbirths.

[Antoinette Sandbach]

The Secretary of State has rightly focused on the importance of reducing infant mortality. The police are investigating the unusually high number of baby deaths at the Countess of Chester Hospital. Will he update my constituents on the progress of that investigation and on the measures being taken to ensure safety at the Countess of Chester, which serves the northern part of my constituency?

[Mr Hunt]

First, I should like to thank my hon. Friend for her campaigning on maternity safety, which has engendered huge respect on both sides of the House. She will obviously understand that I cannot comment on that particular police investigation. None the less, immediately after the issues surfaced, safety measures were taken so that the hospital does not now provide care for babies born before 32 weeks, and it is implementing 24 recommendations from the Royal College of Paediatrics and Child Health.

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.

Contaminated Blood

Antoinette Sandbach Excerpts

Tuesday 11th July 2017 Commons Chamber

[Rebecca Pow (Taunton Deane) (Con)]

I welcome you, Madam Deputy Speaker, as this is the first time I have spoken with you in the Chair.

I am pleased to follow the hon. Member for Hammersmith (Andy Slaughter). The case he mentioned is almost unreal, and few of us could believe it to be true if we had not lived through this issue ourselves. I pay tribute to all the campaigners up and down the country who have worked so hard to get this issue on the agenda—in particular the hon. Member for Kingston upon Hull North (Diana Johnson), but also many Members from across the House. This shows us pulling together and how Parliament should work. It has taken a long time, but we can make a difference. I hope this really will make a difference to those victims who have suffered, and that today’s announcement will change people’s lives once the public inquiry gets going. I would very much like to thank the Prime Minister and the Government for listening and for responding over this tragic affair.

When I became MP for Taunton Deane, one of the first people who came to see me, who does not want to be named, visited my surgery to tell me the desperate story of how his whole life had been blighted by being treated—inadvertently—with infected blood, as in so many other examples that we have heard today. I was quite naive. I had never engaged with anybody in that situation before, and I was deeply shocked by his account of all that he had gone through for his whole life. Being given infected blood had plagued and blighted his life. He was ill, of course, but also his quality of life was affected. One of the effects that resonated most with me was that it affected his relationship with his son—he did not have the time to spend with him. We all take for granted that we can leave our children an inheritance, even if it is not very much—some money for a car or a share of a house. My constituent was distraught and felt he had not done justice to his son because his illness meant that he had a problem holding down jobs. Not only was he suffering from the blight of the illness, but he carried that guilt with him.

My constituent raised two practical concerns with me about the system. First, he felt that the level of financial support was not sufficient to enable him to feel secure and he was constantly struggling. Secondly, the scheme that administered his payment—the Macfarlane Trust, which other hon. Members have mentioned—did not work effectively and as a result did not adequately support those it was designed to help.

I have spoken on this issue several times in the Chamber and in Westminster Hall, as well as privately to the Department of Health. I was pleased to hear that the Government had listened to our voices and it is welcome that this autumn a new single scheme will be introduced, with additional funding of £125 million, to replace the complicated system of five different support schemes. The devil will be in the detail, but I know that the Government will take into consideration all the comments from the consultation. I hope that that will iron out some of the problems that so many people have struggled with and make life better for the victims.

I am also pleased with the moves that the Government have made on transparency—another issue that hon. Members have mentioned. I appreciate the serious concerns about how this has been handled in the past, but I know that Ministers are keen from now on to make all information readily available. That has been promised in the inquiry announced today.

[Antoinette Sandbach (Eddisbury) (Con)]

I am grateful to my hon. Friend for giving way because I, too, have a constituent who has been infected by contaminated blood since the 1960s. He will be delighted with the public inquiry, because he wants to know why it happened and how he can gain access to proper compensation. Transparency is vital in this case.

[Rebecca Pow]

I thank my hon. Friend for that intervention and I could not agree more. Transparency should be the nub of the inquiry, because it is important for my constituent and for all those who have had their lives changed forever through no fault of their own. We must remember that they have not brought it on themselves.

I thank the Government for listening and giving the issue the attention it deserves. I also thank them for more than doubling the Department’s annual spend in this area. Let us make sure that the funding gets to the people who really need it. I thank the Government for announcing the inquiry as I will be able to give my constituent a glimmer of hope both that the Prime Minister has understood the issues and called for the inquiry, and that we will get the inquiry right. Public inquiries are rare events and we need to make sure this one works. New evidence will emerge, and I urge that all relevant and commercially sensitive documents are made available. With the right framework, progress can be made and—I hope—the right thing done at last. I urge the Minister to ensure above all that the inquiry does not drag on too long. For those who have suffered for too long already, time is of the essence.

Oral Answers to Questions

Antoinette Sandbach Excerpts

Tuesday 21st March 2017 Commons Chamber

[Mr Hunt]

First, let me first reassure you, Mr Speaker, that I will be attending the Brexit committee when it is relevant to the NHS; in fact, I shall attend it this week, because issues relating to the NHS are coming up in it. What we are not going to do in that committee, however, is to take steps that would risk the welfare of British citizens living in countries such as Spain, Ireland and France. That is why, although it is a top priority for us to negotiate the rights of EU citizens living in Britain, including those working in the NHS, it has to be part of an agreement that protects the rights of British citizens abroad.

[Antoinette Sandbach (Eddisbury) (Con)]

T4. Last Friday, Laurel Bank surgery in my constituency attended a careers fair at Bishop Heber High School. Does the Secretary of State agree that that kind of outreach work by GPs among young people encourages them to study medicine and work in our great NHS?

[Mr Hunt]

I absolutely agree. What I think my hon. Friend should tell her constituents—I am sure she will—is that general practice is going to be the most exciting, fastest-growing part of the NHS, where care is going to be transformed, making this the right thing to do.

CQC: NHS Deaths Review

Antoinette Sandbach Excerpts

Tuesday 13th December 2016 Commons Chamber

[Mr Hunt]

First, I am sure the whole House will join me in offering my condolences to the hon. Gentleman for what happened to his father. The incredible grief that he and others feel when they lose a family member is compounded if it is subsequently discovered that the death was avoidable.

The hon. Gentleman raises a very important point. The CQC was not specifically looking at the issue of locums in this report, but in many other reports, on many occasions, it has talked about the dangers of locum and agency staff for precisely the reason he mentions. It is partly because people are not necessarily around at the time of an investigation, as they have moved on and work somewhere else, but it is also partly because, as I am sure we all believe, staff can give better care if they are in a team of people who know and trust each other. That is not possible if the majority of staff are employed on a temporary basis. He makes a very important point.

[Antoinette Sandbach (Eddisbury) (Con)]

It is clear that half of medical negligence claims are in the field of maternity. Does the Secretary of State agree that the fear of legal action often prevents people from speaking out? How will the safe space be created that does not allow lawyers to intervene—very often lawyers slow up the process? An early admission of fault and a willingness to express the fact that lessons have been learned would provide so much comfort for families.

[Mr Hunt]

My hon. Friend has spoken very eloquently about that issue many times in this House. If a baby is born with a serious brain injury there will typically be a court case that lasts 11 years, and a settlement of around £6 million. That family are having to cope with the shock of having a disabled child—some families say that that is a kind of mourning process because the baby is not the one they were expecting, although they then go on to give the most extraordinary love to that child—and we compound it by making them go through a legal process that lasts more than a decade. It is absolutely shocking and despicable if that happens. We need to find a way to get those families the financial support that they need earlier, and make sure that we learn the lessons more quickly. That is absolutely what this agenda is all about.