Baby Loss Awareness Week Debate
Full Debate: Read Full DebateJeremy Hunt
Main Page: Jeremy Hunt (Conservative - Godalming and Ash)Department Debates - View all Jeremy Hunt's debates with the Department of Health and Social Care
(5 days, 22 hours ago)
Commons ChamberI thank the hon. Member for Rossendale and Darwen (Andy MacNae) for that excellent opening speech. I also thank him and the hon. Member for Sherwood Forest (Michelle Welsh) for co-sponsoring the debate with me.
Most of all, however, I thank the parents who have lost children, and who took me on a journey on this issue when I was Health Secretary. I am thinking of James Titcombe, who lost his son Joshua at Morecambe Bay; of Carl Hendrickson, who lost his wife Nittaya and his son Chester at Morecambe Bay; of Richard Stanton and Rhiannon Davies, who lost their daughter Kate at Shrewsbury and Telford; of Derek Richford, who lost his grandson Harry at East Kent. They, and many others, are watching this debate and can see that the Health Secretary is here. I thank her for being here for this Backbench Business debate; it means an awful lot, and I know that she cares about the issue.
I start by recognising that some progress has been made. Since I first stood at the Dispatch Box in 2014 with the Morecambe Bay inquiry, which was the first of many maternity safety inquiries, the neonatal deathrate has fallen by 21%—about 700 fewer deaths a year—but that is not good enough. The fall in death rates plateaued in 2020 and has not got much better, and since then we have had a worrying rise in maternal deaths. The 2025 target to halve neonatal deaths that I set in 2017 was missed.
There are three problems behind our lack of progress. First—and this is something for which I am partially responsible—there are too many recommendations. Earlier this year, Baroness Amos counted 748 maternity safety recommendations, mainly since 2015. The NHS is a world champion at doing reports into maternity safety, but sadly not a world champion at implementing the recommendations made.
It is encouraging that the Health Secretary says that there will be a recommendations hub, but could she give it real teeth, so that there is a timescale within which the NHS will decide if it is going to adopt a recommendation and, if it is going to, a person responsible for implementing it within the vast labyrinth that is the NHS? Could she give a timescale so that we and our constituents all know that something really is going to happen?
I know the right hon. Gentleman will be aware of the research that suggests that giving women access to specialised care after their first miscarriage can help prevent baby loss. Currently, specialist care is only offered after three miscarriages. It is estimated that supporting early intervention could prevent around 10,000 baby losses a year—that is one thing that could be done right now.
I absolutely agree with the hon. Gentleman, and his point closely links to the second of my three reasons, which is that we have still not, after all this time, implemented proper continuity of care. That should mean that every mother, from the moment she is told that she is pregnant, is assigned one team of doctors and midwives to be with her throughout pregnancy, birth and even after the birth. Clinical teams that know their patients are much more likely to identify risk when it happens and to avoid tragedies. That lack of continuity of care sits behind the feeling that we heard about in the speech by the hon. Member for Rossendale and Darwen: parents saying time after time that they feel forgotten in the system.
We hear quite often when women have high-risk pregnancies, “Don’t worry, contingency care is there.” I had placenta accreta last year, which is one of the few pregnancy conditions that still kill women in birth. I remember turning up for scans, having been told there was an 11% chance that I might die on the day I gave birth, and the high-risk team saying, “So it’s just a normal pregnancy, right? Everything’s going really great. We will get this done really quickly, find out how things are.” That is the lack of care taken with women who are carrying everything that matters at that time. Many people say, “Don’t worry, high-risk is fine. It is dealt with really well; it is only standard pregnancies” but I want to stress the point that there is still a comprehensive issue.
I thank my hon. Friend for that very powerful personal experience. I am concerned about this idea of women being moved from having no team to a high-risk team, because it cannot always be known in advance if someone is high risk. It is knowing every woman’s situation continuously that enables a team to understand whether she is deteriorating and whether, therefore, she is in need of specialist help.
The third reason we still have this problem after all this time is the one I really want to focus on: the ideological obsession that still exists in some parts of the NHS with so-called natural or normal birth. That leads to the promotion of vaginal birth over and above C-sections in a way that, all too often, sees interventions and escalations happen too late, and mothers and babies die.
I do not ask the House to take my word for it, as some of the reports have commented on this issue. Bill Kirkup, who did the Morecambe Bay report, said that maternity services at Furness general hospital
“became strongly influenced by a small number of dominant individuals whose over-zealous pursuit of the natural childbirth approach led at times to inappropriate and unsafe care.”
Donna Ockenden told the Select Committee about Shrewsbury and Telford:
“We have spoken to hundreds of women who said to us that they felt pressured to have a normal birth. My clinical team said they have seen examples, even in situations where a normal birth in their own hospital would be contraindicated, of women being pressured”.
She said there was
“a multi-professional…focus on normal birth at pretty much any cost.”
Again, at the launch of the Nottingham inquiry, Donna Ockenden said there were hundreds of cases where
“the quest for normal birth continued. And avoidance of intervention persisted”.
Finally, in Leeds, Fiona Winser-Ramm told The Times she was convinced that “normal birth” ideology played a part in the death of her daughter, Aliona.
Dr Prinsley
I am very impressed to see both a former Health Secretary and the present Health Secretary here late in the evening for this debate, which is a sign of the subject’s importance.
Does the right hon. Gentleman feel that fundamental to the third problem he describes is the breakdown in relationships between the profession of midwifery and the profession of obstetrics, and that there is, in some instances, what appears to be a competition between these two crucial professions, and that one answer may be to find some way of getting the two professions closer together?
I defer to the hon. Gentleman’s clinical experience, but I absolutely agree with him. He has hit the nail on the head.
Before I come on to my solutions, I want to say why I think this is still a problem. Very senior voices are still promoting “normal birth” ideology, including a former president of the Royal College of Midwives who told LBC in June:
“Doctors have taken over maternity, and they’re not doing it very well.”
It really is time to stop denying the problem and start solving it. Never again should the promotion of an ideology about a so-called preferable type of birth lead to a mother or baby being put at risk.
I want to unite those points by drawing again on personal experience. My son reacted badly to being induced, and his heart rate stopped. We were rushed to the emergency room: “We have to get him out! We have to get him out!” Just before they cut, somebody screamed, “Stop! His heart rate has gone back to normal. He’s fine. You don’t need a C-section.”
Stood at the end of the bed were an obstetrician and a midwife, and the midwife said, “Great, you don’t need a C-section any more.” The surgeon said, “Yes, she does. She needs to have it now. She needs to have it.” They said to me, “You need to decide.” They refused to come to an agreement about what was safer for my baby, and they said that I had to make that decision.
That is exactly the problem, and my right hon. Friend is so brave to make the point, because he will come under criticism for saying that there is such a thing as an obsession with natural birth. A safe birth is the best birth, and I am thankful to him for his bravery in making that point tonight.
I thank my hon. Friend for her courage in talking about her personal experience, which says it better than I ever could.
That leads me to my conclusion and what I think are the solutions. First, bringing together the points made by my hon. Friend and the hon. Member for Bury St Edmunds and Stowmarket (Dr Prinsley), we need a total overhaul of midwifery education to make it clear that there has to be teamwork around every birth. It is not midwives versus doctors; it is midwives and doctors working together for the safe delivery of every single child.
Secondly, we need a shared agreement across both professions about what risk is, and about when escalation is required—total agreement about the moment for intervention—so that something such as my hon. Friend describes never happens again.
Finally, we need to rehumanise the whole process through which the NHS takes care of pregnant mothers and newly born babies so that from the moment of pregnancy, every mother is assigned one team of doctors and midwives who are responsible for that mother and child right the way through pregnancy and after birth. No one should ever be turned into a number or a type of care. Everyone is a human being and should always treated that way by the NHS.
This week we are here to remember the babies and mothers who should be here but are not. We recognise the progress that has been made in their name, but we also have a duty to the families to be humble about the failures as well.