Sudden Unexpected Death in Childhood Debate
Full Debate: Read Full DebateCarla Lockhart
Main Page: Carla Lockhart (Democratic Unionist Party - Upper Bann)Department Debates - View all Carla Lockhart's debates with the Department of Health and Social Care
(1 day, 8 hours ago)
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Andy MacNae
I thank my hon. Friend for that intervention, which again focuses on the need for co-ordination in the effort to meet the scale of this challenge.
One of the most compelling issues requiring investigation is the association between SUDC and febrile seizures. National and international data show that 30% of SUDC cases involve a history of febrile seizures—10 times higher than in the general population. Frankie Grogan had 12 seizures before he died, but he was never reviewed by a specialist. At this point, it is really important to stress that febrile seizures are very common and SUDC is rare, but the persistence of this correlation—known before the last debate—demands investigation. A national plan must accelerate understanding of the link and determine whether children who have repeated febrile seizures, or a particular subset of affected children, need different pathways of care.
We must also improve public information. Information for families is inconsistent and, at times, invisible. Leaflets on febrile seizures vary significantly across NHS trusts; some fail to mention that seizures can occur during sleep or that monitoring options exist. SUDC itself—including the 60% of cases with no seizure history—is missing from the NHS website. After the 2023 debate, a token reference was added to the SIDS page, but then removed. Imagine a family receiving a post-mortem conclusion of SUDC but finding nothing when they search the NHS website. That is clearly unacceptable, but something that the Government can easily fix.
There has been welcome progress in other areas. The national child mortality database is a world-leading resource. Since the previous debate, the NCMD has created SUDC-specific forms and launched pathways for genomics and cardiac screening. SUDC UK, a charity founded only in 2017, has helped to ensure that families have access to whole genome sequencing through the R441 pathway. That advocacy was born out of what Nikki Speed, chief executive of SUDC UK, describes as the “paralysing fear” that she and many families carry every day. She explained to me that for years after her loss, she got little sleep, because she was constantly having to have a hand on her surviving children to be sure they were alive and well.
That fear leads families to delay trying for another child, even though a new life could be a source of hope and healing amid loss. It is completely rational for a parent to fear, if one of their seemingly healthy children has died without explanation, that their other seemingly healthy children could also be at risk. That is why genomic and cardiac screening is so important: it not only informs research but protects surviving siblings. For some families, genetic analysis has revealed risks requiring vital preventive treatment, yet those crucial tests are currently available only after the post-mortem process concludes, which brings me to the next point.
Paediatric pathology is in crisis, as summarised in a recent report by the Royal College of Pathologists. Families experiencing SUDC routinely wait nine to 12 months, or sometimes longer, for a post-mortem conclusion. During that time, they live in fear—fear for their surviving children, fear of future pregnancies, fear of the unknown. Their grief is suspended and their lives are on hold. Only after that traumatic wait can they finally access genomic testing or cardiac screening to safeguard their children.
After speaking with Brian and with Nikki, I would like to outline the typical timeline for a family affected by SUDC. Your child is fine. Then they die, leaving you traumatised and in shock. The child is taken away from you, and you have no control over what is happening. The ensuing process is statutory, but the response is based on evidence from infant death and so is suboptimal. After scary interactions with the police and in deep shock, you return home to deafening silence or to the child’s siblings, to whom you must tell the very worst news. Then you wait. You do not wait one week or two. You do not wait a month or even six. You most likely wait nine to 12 months. If the pathology is complex, you wait even longer. Throughout the whole wait, you are scared for your other children and scared to get pregnant again. You put your life and your grief on hold. Only then, often about a year later, do you receive the post-mortem report. You have been desperately waiting for this moment, but now it is here it brings back all the trauma of losing your child, and only now are you eligible to see whether anything hereditary is putting other family members at risk.
This is inhumane. When we lost our daughter, we had the answers right away, yet the trauma is still with us. I cannot fathom what it would be like to sit in deafening silence for months, and the long-term damage that that could do. This must change. A national plan should establish faster pathways for cases in which timely information directly affects vulnerable bereaved families and child safety.
The hon. Member is certainly making a very powerful speech on this issue. On 7 January 2024, Teddy Jason Williamson, aged just seven weeks and from my constituency, died of sudden infant death syndrome. Does the hon. Member agree that more practical support is required? Yes, we need research, but we also need there to be practical support: bereavement nurses, dedicated suites in hospitals, and counselling support post the death of the child.
Andy MacNae
Yes. I will touch on that in a moment. It is part of a wider picture of bereavement support and bereavement pathways nationally. From baby or infant loss to unexplained death in childhood, bereavement services are patchy and in many cases far below the standards that we need to see. We need to make that service universal.
Let us move on to another cause of trauma: child death investigations. This issue is wider than SUDC but has profound impacts. Current national guidelines—the statutory guidance and joint agency guidelines—are built on historical evidence from infant deaths and have not been updated since the new pathways for genetics and cardiology were launched. That is important as it may affect inequity of care and access to these important tests. Guidelines should be updated to reflect new evidence and current pathology timeframes, and any consultation on those updates should include charities such as SUDC UK, which supports families of children up to 18 years old.
From investigation to family support, NCMD data tells us that 30% of all child deaths are sudden and unexpected, and a fifth of families leave A&E with no understanding of why their child has died. While consistency has improved since the last debate, the quality of bereavement support remains deeply uneven, as the hon. Member for Upper Bann (Carla Lockhart) has raised. Families affected by SUDC often experience complicated grief with severe and long-lasting consequences for parents and siblings, and this requires specialist support. The NIHR-funded Quintet project and the wider strategic partnership for sudden child death will soon provide evidence-based recommendations for supporting those families. These should be incorporated into a national plan.
To conclude, what is lacking is not expertise nor compassion; rather, it is co-ordination and leadership. I am calling for a Government-led national plan for sudden unexplained death in childhood. That would turn the issues that I have raised into strategic objectives with clear timelines, milestones and measurable outcomes. It should be developed alongside families, clinicians and researchers, and report back to Parliament every two years. Such a plan would send a powerful message: these children matter, their deaths are not footnotes, and unexplained does not mean unimportant. My thanks to Brian Topping, Nikki Speed, the courageous families here today and all those who have worked tirelessly for progress and understanding. I hope that this debate can play a part in delivering that.
It is a pleasure to serve under your chairship, Sir John. I thank the hon. Member for Rossendale and Darwen (Andy MacNae) for raising this issue and pay tribute to him for his bravery in exposing his own devastating grief at the loss of his precious daughter to try to bring about the change in research and support that is so desperately needed.
This is an incredibly difficult subject; indeed, it is often whispered about, if it is spoken of at all. SUDC is a tragedy that strikes without warning, leaving families across our communities in a state of profound, unanswered grief. Over the years, I have met too many families whose joy has gone, and my heart aches for them as well.
In Northern Ireland, we pride ourselves on our close-knit communities, our resilience and our ability to respond to things in a family way. However, when a family faces SUDC, that resilience is tested by the unique pain caused by having no answers. Unlike sudden infant death syndrome, which affects babies under one year old, SUDC claims the lives of children aged from one to 18.
I will look at the reality at home and, as I always do, give a Northern Ireland perspective. According to recent data from the Lullaby Trust, although the number of children who die is small, the impact is immeasurable and is felt not only by the parents and siblings but by the extended family, in schools and churches, and throughout the community. When that stone hits the water, the ripples go far.
In 2023, 16 unexpected deaths of babies and young children were recorded in Northern Ireland. While thorough investigations may eventually find explanations for many of those, those that remain unexplained leave a permanent void. Northern Ireland has historically seen the highest infant mortality rate in the United Kingdom, and it is currently at 4.2 deaths per 1,000 live births. The trends are quite worrying. Although SUDC is distinct from infant mortality, those figures highlight the broader, urgent need to prioritise child health and research in Northern Ireland.
For children aged one to four, SUDC is one of the leading causes of death across the United Kingdom, often ranking higher than traffic accidents or fire, yet it remains one of the most under-recognised medical tragedies of our time. When we ask the Minister for help, that is what we are asking about.
Will my hon. Friend join me in commending Dr Julie Rankin, a consultant in emergency medicine, who has been instrumental in working with the Williamson family from my constituency to create a bereavement suite in Craigavon Area hospital in memory of those little children who have died suddenly in unexplained circumstances? As we speak today, they are actually at a research event at Queen’s University Belfast, which demonstrates that Northern Ireland is advancing these things for families who are impacted.
My hon. Friend is absolutely right. She and I, and probably everyone else in the Chamber, would recognise the importance of parents having someone there to comfort them when such an awful tragedy takes place, and it is vital that my hon. Friend underlined that. One of my three asks of the Minister—which I will come to shortly—will be for research, and Queen’s University is to the fore on that.
For a child aged one to four, SUDC is one of the leading causes of death across the United Kingdom, yet it remains one of the most under-recognised medical tragedies. That is really the point I want to make: this is a medical tragedy and we are not doing enough, so we need to do more, as I think everybody has said.
The unexplained nature of these deaths is perhaps the cruellest part. Families go to wake their child for school or for a day of play, only to find the unthinkable. The Northern Ireland Statistics and Research Agency continues to track these tragedies, noting that they can affect any family, regardless of background.
But we are not here today simply to acknowledge or indeed to remember; we are here to advocate for change. When he set the scene, the hon. Member for Rossendale and Darwen was very clear about what he wanted, which is probably what we all want. First, we need more research, and that is one of my three asks of the Minister. I am very pleased to see her in her place; it has been a pleasure to work alongside her on many subjects over the years we have been here, and I wish her well—I wished her well last time and I wish her well again—in the role she plays. We need more research in order to move beyond the unexplained and find the “why” of the problem. Secondly, we need better support for families navigating the complex joint agency response that follows a sudden death. Thirdly, we need something that today’s debate will help to raise: awareness.
Those are my three asks, so that no parent in Glasgow, Newtownards, Swansea or Somerset feels that they are the only one in the world that this has happened to. We owe it to the children we have lost and to the families they have left behind—[Interruption.]