Support for Infants and Parents etc (Information) Bill [HL]

Baroness Uddin Excerpts

2nd reading
Friday 6th September 2024 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, it is a privilege to follow the noble Baroness, Lady Finlay, and all the other powerful contributions to this debate. I welcome the Bill and I thank the noble Lord, Lord Farmer, for introducing it and for so eloquently describing the complex nature of services required to support parents. I take this opportunity to commend Dame Andrea Leadsom for her continuous commitment to women’s services.

Parents and mothers require a wide range of care and support during pregnancy. I should know: I gave birth to five children. I love the idea of the noble Lord, Lord Hannan, coming along as a fathers’ champion and bringing Cate Blanchett; I think she might still attract many fathers from different quarters. Ideally, there should be a seamless structural system of care in place as the child navigates their new world. The discourse surrounding parental support and infant care may have gained some momentum, not least from these debates; however, a holistic framework tailored to the needs of parents and children remains inconsistent and erratic, and absent in some communities. Parents’ and families’ voices need to be heard and reflected in the diversity of our communities. We do not need to reinvent services or programmes; there are countless pockets of best practice for us to reference and to inform national standards of care.

I want to highlight the work of one such organisation, which has lasted for 40 years. In the early 1980s, a group of women of Bangladeshi, Somali and Vietnamese heritage set up an advocacy scheme as a response to a lack of adequate prenatal and postnatal maternity care. At the time, urgent attention was required to prevent postnatal deaths and trauma. Research was conducted by Jean Taylor, a Tower Hamlets midwife who highlighted the immense deficit in maternity care for a significant group of black and Asian women, which led to establishing the first women-led advocacy scheme in the country. It was enthusiastically supported by visionary leaders in the NHS and local government, with funds, who recognised that structural discrimination was a harmful factor that significantly impacted the physical and mental well-being and health outcomes for the mother, the family and the child.

Through the advocacy service, at the point of entry, each woman would receive a comprehensive and detailed plan for the family for the duration of their pregnancy and up to the age of two years, with a holistic plan for postnatal support taking on board the physical and mental health needs of mothers. Each woman received a detailed package of information on how to access health visitors, postnatal check-ups, mental health screening, support for breastfeeding, such as breastfeeding buddies, and infant care.

The evidence demonstrated that early intervention was conclusive with regards to empowering parents. This was possible due to the statutory role of health visitors and the associated community health services in place at the time. In addition, there was a broad range of NGOs that provided a wraparound system of support for families, including advice on housing, finances, social care, training, language and leisure facilities. All of these, incidentally, address the first 1,001 days of children’s lives, providing a vital foundation for both the emotional and physical well-being of mother and child and for the early indication of any vulnerabilities and complex needs of mother and child in their family setting.

Overall, there was regular co-operation and co-ordination with statutory and voluntary organisations, with an agreed referral system to flag up any concerns, as well as successes, which evidently resulted in confidence and trust among parents and professionals alike. There were no smartphones or emails for communication, and I can still remember the many handwritten posters and leaflets, in many languages. We were all willing to do it, whether as volunteers or paid workers.

We have to accept that many such organisations that took decades to develop have suffered from neglect and deep cuts; this, along with essential community centres shutting down, has had huge long-term negative consequences on parents’ and children’s welfare and health. It must be said that most women of affluent backgrounds or from affluent areas may not experience similar challenges, unless, of course, they have a black or Asian heritage, when their education or social economic advantage may still be overshadowed by discrimination in the services. Even now, many women I have spoken to are not sufficiently aware of the information they are entitled to and, more so, are not given it with consistency. Many women are simply instructed to find information on Google or on a website, when advice and guidance from properly trained and skilled staff who are present for the duration of new parents’ and children’s lives is more impactful.

In addressing support for all parents and children, it is imperative to consider the detrimental effect of continuous and persistent inequalities and discrimination experienced by a substantial number of women in the maternity care services. It is nothing short of a crisis. The facts have been well-recorded, again and again, in countless research, that black and Asian women in our statutory system are four times more likely to die during childbirth than their counterparts. The status quo continues unabated. As the mother of a son who suffered injury during birth 46 years ago, I am shocked at how many parents still say that they did not have sufficient support or information about birth trauma and its prolonged consequences.

Incidentally, I spoke to the mother of Tafida Raqeeb, who is currently residing in Italy; she is waiting for her daughter to return to the UK to be supported in our system. She referred to other parents who feel unsupported by hospital administration and staff during critical care crises. Many women are grief-stricken, in their own words, due to systemic racism and failures which profoundly impacted their maternity care and mental well-being.

We seem to be living in the dark ages when it comes to the treatment of certain groups of women, who feel dismissed by healthcare professionals, their concerns ignored and their pain undertreated. We know that the result is often delayed diagnoses and treatment, resulting in complications that could easily have been avoided. It is a tragic outcome that should be unthinkable in a modern healthcare system. If we are speaking here about proper information, there has to be clear messaging about a safe route for parents to raise their concerns in confidence and safety. I did not see that in the Bill.

The transition into parenthood can be emotionally and physically overwhelming. Postnatal care remains woefully inadequate in the UK, particularly for women of my colour and faith. Women’s voices and participation in shaping services is fundamental to best practice. It is about their right to dignity in care. Also fundamental is investment in the workforce for midwives, health visitors and advocacy staff, without which we will not tackle persistent social determinants of poor health as it disproportionately affects women and their families. All parents are entitled to the highest quality of services and information. That is the mark of a just and civilised society. Given the pressures on the NHS and all other public services, does the Minister agree that holistic statutory provision will safeguard parents and their children’s well-being and be cost-effective in the long term?

Black, Asian and Minority-Ethnic Women: Maternal Mortality Rates

Baroness Uddin Excerpts

Monday 29th July 2024 Lords Chamber

[Baroness Merron (Lab)]

I certainly agree with the noble Baroness that the maternity landscape is extremely crowded; there have been a number of reports and inquiries, along with investigations. I shall look very closely with officials at the recommendations from those reports as well as those that are forthcoming. With regard to an independent commissioner, I feel that there is general agreement about what the issues are, and the most important priority is to take action. Of course, in reviewing what is going on, as I am now in this post, I will consider all suggestions, and that includes the one from the noble Baroness.

[Baroness Uddin (Non-Afl)]

My Lords, I also thank my noble friend Lady Gohir for her continuous campaign. I declare an interest having been involved in these matters in Tower Hamlets for some 40 years. I congratulate the Minister on her ministerial role. When she seeks to consolidate these matters and take the best course of action, will she ensure that she looks at the reports that have been on the shelves at the Royal London Hospital trust for the best part of 40 years?

[Baroness Merron (Lab)]

I thank the noble Baroness for her kind remarks and good wishes. Certainly, all reports will be considered because we will look for what works.