Preterm Birth Committee Report

Baroness Brinton Excerpts

Friday 6th June 2025 Lords Chamber

[Baroness Brinton (LD)]

My Lords, it is a pleasure to follow the noble Baroness, Lady Blackstone. I congratulate the noble Lord, Lord Patel, and his committee on this excellent report. It takes the recommendations of Lady Cumberlege’s 2016 report, Better Births, on to a new, more detailed, more expert level—including, very importantly, experts by experience—by assessing our hospitals preterm birth services in the light of the decade that has followed.

I talked to Lady Cumberlege late in 2016 about the Better Births report, because my first two identical granddaughters were born in May 2016 at 29 weeks, just like those of the noble Baroness, Lady Blackstone. They were at heightened risk because they had twin-to-twin transfusion across the placenta, which is dangerous to both twins, and the status of one of them was already serious prior even to that point. My son and my daughter-in-law lived the full experience of preterm birth and its after-effects full on for four years, so although I want to focus on the recommendations and the Government’s response, it is in the context of probably the most intense period of our family’s lives.

I need to say at the start that these two now nine year-old twins are healthy, active and intelligent, which is only possible because Kingston Hospital, the Evelina hospital and their local community services, as well as organisations such as the Twins and Multiple Births Association and Bliss, delivered everything that they needed to survive and grow. The noble Baroness, Lady Seccombe, talked about the importance of health visitors; they are as pressurised as our GPs and we need more of them.

The committee’s report is excellent, and the expertise of its members, especially its chair, the noble Lord, Lord Patel, is evident in the recommendations. But, as I have said, I want to look, from these Benches, at the Government’s responses to the report. It is good that they have in principle accepted the report’s recommendations, but it is their implementation that I want to ask about. I echo the question from the noble Baroness, Lady Bennett, about staffing levels and working practices for midwives, which other noble Lords have also spoken about.

The Government’s response begins by assessing the challenges ahead for maternity services, reporting frankly on the “broken NHS”, as well as the very specific problems in a number of maternity services. Only yesterday, the Health Service Journal said that an analysis of the extra money for the NHS this year showed that it is effectively all spent already. Can the Minister say whether there is sufficient resource this year and in future years to effect the changes that the Government aspire to, not just during this Parliament but immediately, this year and next year?

At the start, the Government’s response speaks about the excellence of the NHS’s Saving Babies’ Lives Care Bundle, but notes that its application is inconsistent. Is there specific funding to ensure that the bundle can be delivered consistently across the country by April 2026? The same is true of the key targets to reduce the rate of preterm births, given that the previous target of reducing the rate to 6% by this year will not be met, as others have said. The Government’s response is silent on new targets to replace this, citing only the challenges. Can the Minister tell us when new targets will be announced?

The Government cite the £50 million NIHR challenge fund, created a year ago by the previous Government to provide researchers and policymakers with resources to assess new ways to tackle maternity disparities and poor pregnancy outcomes. I agree that this is vital, but when will the reports be concluded and published? The noble Lord, Lord Winston, spoke of the importance of more research on miscarriage. He is right. That should be considered too.

The noble Baroness, Lady Goudie, set out how important early advice and guidance is to help to reduce rates of preterm birth, and recommendation 2 sets out the advice and access to information that future parents need long before the pregnancy. I welcome the Government’s endorsement of this, but much of it is funded through the public health budget, which is notoriously under pressure. The noble Baroness, Lady Bennett, highlighted this, and the noble Baroness, Lady Sugg, and the noble Lord, Lord Weir, also talked about the real problems of financial inequalities.

There is also a reference to the GP postnatal check-up six to eight weeks after birth being carried out in full. The proposals are excellent, but do our currently hard-pressed GPs have the capacity to deliver this vital check-up in the detail that is actually needed?

Recommendation 3 focuses on clinical guidance for preterm birth care. My daughter-in-law’s experience of a complex pregnancy, with twin-to-twin transfusion and not just one but both girls’ lives at risk, was absolutely textbook. The delicacy with which the risks were explained to her and my son and the care before, during and after the operation in utero at 16 weeks on her girls, were breathtaking. Things seemed to happen so fast, but all the staff we encountered as a family were caring and careful. When the girls arrived at 29 weeks we were all ready, but a couple of days beforehand we were warned that there might not be two NICU incubators at Kingston, and one of them might have to go to Southampton, the nearest NICU with a space—yes, Southampton. Can you imagine two new parents, one of whom has had a caesarean, trying to manage two babies in NICUs 60 miles apart? The noble Baroness, Lady Penn, was right to raise this issue. Luckily, on the day, they had two incubators at Kingston; I suspect that another family was sent to Southampton. Will there be a review of the number of NICU incubators to prevent this happening?

We were warned that one of the twins might have severe problems or not survive. She did—all 700 grams of her. The noble Baroness, Lady Bertin, spoke about the tiny size of these babies. My son could hold baby A—her whole body—in the palm of his hand. The care for both in those first few days in NICU was outstanding and supportive. The other baby—all of 1.5 kilograms—came home, but A’s issues, which were not unusual for a baby of her size and problems, continued. After a few weeks, she moved to the Evelina hospital and remained there until she was 10 months old. NICU, PICU, and then the long-term Snow Leopard ward were all extraordinary. Yet we watched our children manage one twin at home in Barnes and the other in hospital in Waterloo, as well as my son holding down his job and the stress that it put on the pair of them.

I thank the noble Baroness, Lady Wyld, for her Neonatal Care (Leave and Pay) Act, which will undoubtedly help families. The noble Baroness, Lady Penn, said that we need better parental leave, and she is right. The legislation that Jo Swinson led in coalition was a start, but we all knew that it was just a first step.

Recommendations 5 and 6 on parental accommodation for neonatal support are just the tip of the iceberg. We—the grandparents, aunts, uncles and friends—all had the privilege of supporting our children. In my case, I was able to be at the Evelina most mornings, but this was a first for us, too. As the noble Baroness, Lady Bertin, pointed out, the start of the report quotes a parent saying:

“The impact of prematurity does not end upon discharge from a neonatal unit”—


so true. A had a ventilator, and a nasal and then gastric tube, until she was nearly four. We were trained by the Evelina Hospital to manage these so that we could babysit both girls and stay overnight to give their parents a break. Without it, they could have had no respite. Care was not available from the local community.

Recommendation 9 suggests that NHS England should take action to deal with follow-up assessments, especially the one at the age of four. Our family had the benefit of an effective series of follow-up assessments, even though by that stage, A had a clear dislike of people in white coats—and who can blame her? At her final assessment she walked firmly and bravely through the door. We were thrilled that she did not have to return again. By then, the speech and language therapists had supported her into excellent speaking. Her hole in the heart had healed, and she no longer needed that damn ventilator, although she still finds running difficult, unlike her twin.

The baby who used to wave over the river at granny’s office, also known as the House of Lords, every night from her ward, Snow Leopard Ward, now has a passion for wild cats and sponsors snow leopards at Marwell Zoo. She has no memory of what happened, but she would not be with us without every single one of the professionals who were there for her, her twin and their parents from the moment of that first scan at Kingston Hospital. My hope is that the report by the noble Lord, Lord Patel, and government action will ensure that this is the case for all families facing this extraordinary time in their lives, because a consistently delivered service will not just save the lives of preterm babies, but improve the quality of their lives.