Down’s Syndrome Regression Disorder

Jess Brown-Fuller Excerpts

Tuesday 8th July 2025 Westminster Hall

[Jess Brown-Fuller (Chichester) (LD)]

I thank the hon. Member for Thurrock (Jen Craft) for securing this important debate, and for her ongoing advocacy on behalf of people with Down’s syndrome and those with special educational needs. The hon. Lady was in the Chamber yesterday when the Secretary of State made her statement about Best Start centres, and her contribution was really valued across the House. Her commitment to raising these issues, both in Westminster Hall and in the main Chamber, does not go unnoticed, and the voices of the individuals and families she raises, who are too often overlooked, are heard loud and clear.

I am grateful to Members from across the House for their contributions to this debate, and for shining a light on the often overlooked but deeply distressing reality of Down’s syndrome regression disorder, which is a little known but profoundly distressing condition that affects individuals when they are at a vulnerable point in their life, often during adolescence or early adulthood. As the hon. Member for Portsmouth North (Amanda Martin) said, it can be sudden and life altering for those with Down’s syndrome and for those who love them. This is not a rare curiosity that can be quietly ignored. It is a heartbreaking and complex condition that strips people of skills, independence and identity, often rapidly and with devastating consequences—and right now, families are being left to navigate it alone.

Regression in this context is the sudden and unexplained loss of previously acquired developmental abilities, including speech, motor skills, self-care and social interaction. It is not autism or dementia—it is entirely different—and it is something that we must understand far better than we currently do. There is currently no single known cause for the regression, which can be triggered by significant life stresses, mental health deterioration, underlying medical issues, infections, nutritional deficiencies, exposure to toxins or, as the hon. Member for Thurrock spoke about, extreme moments of stress. She shared a heartbreaking story about the young person who had a heartbreaking moment in school and did not really recover from it.

Despite its impact, frontline care staff have often never heard of the condition, and when symptoms emerge, diagnosis is often delayed or missed entirely. We need urgent investment in research to better understand the condition and develop evidence-based responses. It is a crisis of unmet need, because 80% of young people can make huge progress if it is caught and supported early enough. Families describe watching their loved ones retreat into silence, lose mobility or withdraw emotionally, often over just weeks or months.

I do not have a child with Down’s syndrome, but I think it is the same for every parent—watching their child change in a way that is indescribable, losing all the things that make them who they are, must be the most distressing thing that they can go through. The impact must be devastating. These families need answers; they need access to specialist assessments, co-ordinated care and, above all, hope that with the right support, their loved one might regain some of what has been lost. Right now, there is no clinical consensus on treatment, no national guidance and very little research funding.

In Chichester, my constituents are very lucky to have an incredible charity, the Chichester and Arun Down Syndrome Support Group, which works tirelessly to fill the gaps left by failings in public service provision. Ahead of this debate, the charity highlighted to me many of the challenges that their young people with Down’s syndrome face, particularly in accessing the support that they need throughout their education. Families have told me that, in hospital, when their Down’s syndrome child was born, they were presented with information from the Down’s syndrome group in Portsmouth, but were unable to access that service because they do not live there. Nationally, there needs to be support for every single child who is born.

The Liberal Democrats are calling for three clear things. First, we would like regression disorder to be embedded in professional training for care workers, supported by new national standards set by a national care agency and a professional framework overseen by a royal college of care workers. The frontline workforce needs to be equipped to recognise and respond to the condition early and effectively. Secondly, we need the Down Syndrome Act to be properly resourced. That means far more than just warm words: it means access to speech and language therapy, occupational therapy, mental health support, physiotherapy and primary care. It means making good on the promise of joined-up, lifelong support, not just at school age but well into adulthood. Thirdly, we need real action on social care. We need bold, cross-party agreement on a long-term settlement now—not in a decade—and we must give unpaid family carers the deal that they deserve, with paid leave, guaranteed respite and long overdue recognition.

Healthcare provision is also lagging. The NHS rightly recommends access to a wide range of specialists for people with Down’s syndrome, from physiotherapists and occupational therapists to speech and language support and mental healthcare, but too often families report waiting lists, postcode lotteries and providers that are simply not equipped to deal with complex needs such as regression. People with Down’s syndrome are often more likely to become seriously unwell from common infections such as flu and pneumonia, yet we are still not doing enough to ensure vaccine uptake. That is why we are calling for everyone with a disability or chronic health condition to have access to a named GP, to ensure early intervention, better diagnosis and ongoing support.

Too many people with Down’s syndrome are being let down by the education system, the care system and the NHS. The regression that some experience in young adulthood is not inevitable; in many cases, it can be managed or even reversed with the right support, but that support needs to be in place for every young person. In my constituency I have seen the strength of local charities such as the Chichester and Arun Down Syndrome Support Group, and organisations such as Together Our Community, but we cannot continue to rely on charitable good will to cover the cracks left by a failing system.

When a young person with Down’s syndrome starts to withdraw, lose speech or motor function or disconnect from their surroundings, their family do not need to be told to wait in a queue. They need a co-ordinated, knowledgeable and compassionate response, and they need it fast, so the question we must answer in this House today is simple: are we content to let families carry the burden alone, or are the Government ready to put in place the policies, funding and professional care that people with Down’s syndrome deserve? What steps will the Government take to drive forward research into Down’s syndrome regression disorder, get stronger training into the hands of those who need it, and guarantee that the joined-up care that people with Down’s syndrome so desperately deserve is finally delivered?

Infant Feeding

Jess Brown-Fuller Excerpts

Tuesday 1st July 2025 Commons Chamber

[Jess Brown-Fuller (Chichester) (LD)]

It is a pleasure to bring this Adjournment debate to the Chamber on a topic close to my heart. I refer hon. Members to my entry in the Register of Members’ Financial Interests as the Chair of the all-party parliamentary group for infant feeding. I am pleased as always to see the Minister in her place. I look forward to her response on behalf of the Government just days before the long awaited 10-year plan for the NHS.

When the Secretary of State for Health promised to create the “healthiest generation ever”, it was a bold and admirable ambition, and certainly one that I share with him. Every child deserves the opportunity to thrive regardless of their wealth or their postcode. When the Government talk of building a better future for children, their policies and schemes often start with school—with free school meals and breakfast clubs—or providing Government support for nurseries and early years settings, but there is little substance in the critical years from birth to three, and even less when it comes to policy around infant feeding, whether that is breastfeeding, formula feeding or a combination of the two.

I had my son nearly 11 years ago, and I remember with fondness the lactation consultant coming on to the ward in the maternity unit and showing me how best to hold my son to feed him and what to expect in the first few weeks after taking him home. I did not have an easy journey with breastfeeding: I suffered with pain when he latched, I had multiple bouts of mastitis and swelling—the list went on. My husband and I ran our own restaurant at the time, so he took approximately three hours of paternity leave before returning to work.

[Maya Ellis (Ribble Valley) (Lab)]

I am grateful to the hon. Member for the work we are doing together on the all-party parliamentary group for infant feeding and for her passion in this space. Breastfeeding is a full-time job. Only last week, Carrie Johnson, the wife of one of our former Prime Ministers, highlighted how easy it is to neglect your own needs as a mother while breastfeeding. Does the hon. Member agree that it is essential that the Government establish six weeks of paid paternity leave, so that breastfeeding mothers can focus on feeding their baby and partners can focus on looking after mum?

[Jess Brown-Fuller]

I thank the hon. Member for her intervention. I was so pleased to hear the statement in the House earlier today. I know that she has been a tireless advocate for making sure that parental leave for all parents is improved dramatically. I thank her for her advocacy in that area.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady; I spoke to her before the debate. In the last Parliament, one of the Scots Nats MPs was chair of the APPG. I was supportive of that as a man, as I thought that was important. My wife was an example of where breastfeeding is so important. Is the hon. Lady aware that Northern Ireland had the top score—69.5 out of 100—among UK nations? That may be because Northern Ireland has already put policies in place and is the only nation to have completed updated resources on infant feeding and HIV. Will she join me in urging the Northern Ireland health trust to share best practice with the other devolved nations and with the Minister to help encourage breastfeeding among those mothers who are able to do so?

[Jess Brown-Fuller]

I thank the hon. Member for his intervention. He is right that Northern Ireland scored the highest in the report card format on the World Breastfeeding Trends Initiative, which I will come to. In comparison, England scored a paltry less than 50, which was very much due to scoring zero on infant feeding and HIV.

[Mr Connor Rand (Altrincham and Sale West) (Lab)]

I thank the hon. Member for securing this Adjournment debate on such an important topic. She spoke of some of the difficulties she had at the start of her breastfeeding journey, which my partner Catherine also experienced. When my partner had those difficulties, she accessed a breastfeeding support clinic in my constituency at Meadway health centre, which was a huge source of support and benefit to her. Does the hon. Member agree that it is important to protect and support access to such services, ensuring they are there for every woman who wishes to breastfeed?

[Jess Brown-Fuller]

It is as if the hon. Member has lifted my words directly off the page in a timely manner. The reason I managed to carry on was that I attended a peer support group in my local church hall every Monday morning, aptly called Milk. It was not about the professional support that I had while I was there—although that was great, and I give a shout-out to the wonderful Julie who supported all the mums—it was meeting the other mums who were going through the same things and the ability to ask each other questions and offer advice, as well as the amazing trained peer supporters, who were volunteers. I give a quick shout-out to Holly, who showed us that we could and would survive those difficult first few months and come out the other side, just like she had.

[Samantha Niblett (South Derbyshire) (Lab)]

I thank the hon. Member for securing this important Adjournment debate this evening. In South Derbyshire, I hear stories of services to support breastfeeding women being cut. I speak as a mum who breastfed to eight months, although I had that moment where I almost did not, and it was my community midwife who saved the day for me. Does the hon. Member agree that as well as having services to support breastfeeding women, whether they are successful in doing so, they decide not to or they cannot, we should create safe spaces for them? I have done exactly that in my constituency surgery, but I would like to see it in other venues.

[Jess Brown-Fuller]

I thank the hon. Member for sharing her personal story and for advocating for other breastfeeding and formula-feeding parents in her constituency. She highlights that there is a postcode lottery when it comes to that support. We need to see safe spaces across the board for all parents who are feeding.

In the group I attended, there were not just breastfeeding mums, but mums who were combination feeding, in the process of introducing solids or planning their feeding journey as they navigated returning to work. Some of those women became my closest friends and I still have them in my life all these years later.

--- Later in debate ---

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Before the hon. Member gets to her feet, I am just reminded of the midwifery-led Crowborough birthing unit, which helps the lovely mums in my constituency.

[Jess Brown-Fuller]

The hon. Gentleman highlights how important it is to have that community-based support in an area. Unfortunately, not every mother across the UK can say the same. There are areas where they have to travel up to an hour by car to attend that sort of group, and I will come on to that point.

When I had my daughter, five years after my son, the support that I had relied on had all but vanished. The Milk group was now being run out of, in effect, a broom cupboard at my local leisure centre, with no opportunity to socialise with other mums. Only six months later, the pandemic hit and my daughter’s health visitor reviews were done via Zoom, often without my daughter even on the screen. The local children and family centre in my constituency never reopened in the same way after the pandemic.

I was one of the lucky ones because I had already built my village around me five years earlier and I had a network of friends and family that I could call on. However, for those who have become new mothers in the last decade, that support has been all but vaporised, with community support groups patchy and often delivered by volunteers or those wonderful midwives in their time off.

It is essential to acknowledge and support those parents who cannot or choose not to breastfeed, to ensure that they feel empowered and confident in the decisions they make for their children’s nutrition and wellbeing. I am a proud advocate of every parent having choice, but that choice should be an informed one. Currently, it is not a level playing field, with formula companies preying on the vulnerability of parents.

The Competition and Markets Authority launched a market study into the formula industry in February 2024 and published its results earlier this year. The study provided a comprehensive, in-depth and up-to-date exploration of the infant formula market in the UK through a consultative process that has offered unique insights into the industry. A short extract from the CMA’s overview of its findings states:

“parents are often in vulnerable circumstances when they first make choices about whether and which infant formula to use, their brand choice is often based on incomplete or unclear information, and they are typically then reluctant to switch brands. Against this backdrop, manufacturers place significant emphasis on building their brands—including through their willingness to supply the NHS below cost—and differentiating their products to attract parents, rather than competing strongly on price. And price competition between retailers has typically been weak…Our analysis indicates that these features, in combination, are leading to poor outcomes for parents in terms of the choices they make and prices they pay for infant formula.”

In short, a vulnerable, extremely tired new parent is making choices on which formula to buy, but the claims on boxes of commercial infant formula are often unfounded. Parents have to choose between a £7 tin of formula and a £14 tin of formula, even though they are nutritionally equivalent. At a recent event, we heard the testimony of parents who had purchased the more expensive brand with the bold claims on its packaging, believing that they were doing the best for their child, only to then use fewer scoops when making a bottle to make the tin last longer. We have only to look at our supermarket shelves and see the formula milk locked in glass cabinets to understand that we have a crisis in families being able to feed their babies.

The cost of living challenges have spiralled into a food insecurity crisis, yet formula manufacturers increased prices by 24% in one year in 2023 and prices continue to rise well beyond inflation. Research shows that parents rarely switch brands once they have introduced a formula milk. This gives formula companies a clear incentive to offer their products to maternity wards at reduced prices, knowing that parents are likely to continue using the same brand when they go home. To address this, the CMA recommends standardised infant formula labelling in healthcare settings, which would eliminate this form of exploitative marketing.

Formula companies are also restricted from advertising newborn formula, but they get round this by advertising their follow-on, or stage 2, milk and making the packaging look exactly the same. The CMA recommendations ask for the Government to assess whether infant formula and follow-on milks are “clearly distinct”, then communicate that assessment to the manufacturers and enforcers. A Mintel report from 2016 reported that in 2015, for every baby born in the UK, companies spent a staggering £21 just on marketing follow-on formula. The CMA has made 11 recommendations to the Government, all of which aim to improve outcomes for parents. I am calling on the Government today to implement all 11 recommendations and finally to level the playing field for those parents who rely on formula to feed their babies.

This debate is timely, as last week I was delighted to host the World Breastfeeding Trends Initiative’s launch of its 2024 report here in Parliament. I would be delighted to give the Minister a copy if she does not already have one. The key takeaway from the report is that the UK has one of the lowest breastfeeding rates in the world. The report not only highlights the gaps in policy but creates a report card system for each of the four nations. I want to highlight a few things that were mentioned in the report.

Importantly, data—though its collection is uneven across the four nations—shows that the majority of mothers do set out to breastfeed. Despite this, by six to eight weeks, around 70% of babies in the UK receive some formula, and by six months only 1% of babies are exclusively breastfed.

[David Chadwick (Brecon, Radnor and Cwm Tawe) (LD)]

I commend my hon. Friend for the great work she is doing to improve the relationship between a mother and her infant—the most important relationship in the world. Will she join me in paying tribute to the midwives of Powys teaching health board, who have the largest county in Wales to cover? Will she also join me in paying tribute to Susan Grounds, who, after being a midwife for over 20 years, retired in March and was elected as a Lib Dem councillor in April?

[Jess Brown-Fuller]

My hon. Friend is absolutely right to say that these women have often been embedded in their communities for many years, helping women to raise their babies, and that they go on to do marvellous things in the community.

The majority of those who stop breastfeeding early wanted to breastfeed for longer, but did not receive the help they needed to resolve problems, all of which could be addressed with support from trained health workers, skilled peer supporters or specialist help in hospital, at home or in the community. The World Breastfeeding Trends Initiative report highlights the absence of national policy and governance in England. The devolved nations have pulled ahead on this front, with Scotland publishing a strategic framework, Wales having had an action plan since 2019 and Northern Ireland currently finalising its strategy. Support needs to be baked into policy and legislation because communities cannot do this alone. It being so early in this Parliament, the Government have all the opportunities to act. I was delighted to see today’s announcement of a review of the parental leave and pay system, and I hope that infant feeding will play into the considerations of better support for parents on maternity and paternity leave.

Health visitor teams have also dwindled over recent years, and an estimated 54,000 GP appointments could be saved every year if a professional feeding service was available in every community. Any strategy must be properly funded and integrated with current programmes across communities and healthcare settings, such as family hubs and Start for Life, which should themselves be expanded, particularly Start for Life, which is funded only in half of England’s local authorities. Some councils are choosing to make this an area to improve on, and I am pleased to see my local authority—West Sussex county council—include the early years as part of its health strategy for the next five years, even without the Start for Life funding, which it does not receive.

I would like to use an example of a mother who got in touch just last week to share her story. She had a traumatic birth with unexpected interventions. Her baby was quickly fed formula by hospital staff. The pump kit did not work in the hospital, and no meaningful help was available. She wants to feed her baby herself. She looked online when she got home to find help nearby, but there was nothing less than an hour away by car. She is struggling with which formula to use and does not understand the differences between them. She does not know other women with babies. She is feeling lost and isolated. Social media is full of conflicting advice, so she has gone out of the area for paid support, which she cannot afford on maternity pay, to help her try to regain a sense of reality. I am sure this lady’s story is the same for parents across the country.

If the reasons I have highlighted are not compelling enough, maybe the economic impact is. UK research back in 2012 on the costs of four diseases showed that even reaching moderate breastfeeding levels could save the NHS millions, and that the implementation of proven breastfeeding support systems would pay for itself within a year. For babies, breastfeeding strengthens the immune system and significantly reduces the risk of infections, obesity, asthma and long-term conditions, such as type 2 diabetes. For the mother, breastfeeding lowers the risk of breast and ovarian cancers and cardiovascular disease, and supports post-natal mental health.

I could say much more, but instead I will move to my asks of this Government. When will the Government make their decision on whether they will accept the 11 recommendations from the Competition and Markets Authority? Will the Minister consider following the devolved nations and introduce a comprehensive national infant feeding strategy to end the postcode lottery and provide support to all parents in their feeding journeys? Can we expect to see something about infant feeding in the upcoming NHS 10-year plan? Finally, there is little about breastfeeding in most health professionals training, but primary care has successfully integrated assisted roles into services such as pharmacists and social prescribers. Could the same model be extended to lactation consultants?

I would like to finish by thanking all those tireless activists and campaigners who have been fighting for all women to have support, guidance and trusted information when they begin motherhood. I will not risk trying to name them all as I will no doubt miss some, but a special thank you goes to the World Breastfeeding Trends Initiative steering group, First Steps Nutrition Trust and the former hon. Member for Glasgow Central who chaired the APPG before the general election.

--- Later in debate ---

[Ashley Dalton]

I agree. The hon. Member will see in the 10-year plan and some of the investments we are making—for instance, to reduce the number of women smoking in pregnancy—that the Government recognise that.

We recognise that infant feeding is critical to a baby’s healthy growth and development, and we recognise the significant benefits of breastfeeding for both mothers and babies. We are fully committed to supporting families to breastfeed should they choose to do so. We know that most mothers want to breastfeed, but many stop before they would ideally like to. While it has been positive to see many more mothers continuing to breastfeed in recent years, we know that they can face complex barriers to achieving their infant feeding goals.

I recognise the concerns raised through the World Breastfeeding Trends Initiative report on the UK infant feeding policy landscape. Health is devolved, and I would like to commend Northern Ireland for its performance in this area, which was raised by the hon. Member for Strangford. However, we know through the report that England scores poorly, and we want to change that.

Families need quality services, trustworthy information, affordable options and systems that support them, not hinder them. Midwives and maternity services play a crucial role through the perinatal period in preparing and supporting families around infant feeding. We have committed to training thousands more midwives to better support women throughout their pregnancy and beyond, and there has been an increase of over 1,300 full-time equivalent midwives in the workforce since April 2024. We will publish a refreshed workforce plan to deliver the transformed health service that we will build over the next decade.

To drive forward improvement in maternity and neonatal services, we announced the launch of a national independent investigation into maternity and neonatal care. The investigation will recommend one set of national actions by December. A national maternity and neonatal taskforce, chaired by the Secretary of State, will then bring together independent experts to co-produce a national plan to drive improvement.

As families transition from maternity services to the community, it is important that they continue to receive the support they need, and health visitors are key to this. However, we know that health visitor numbers have decreased and there is variation in the level of services across the country, but it remains a universal service, and we are committed to that. In the plan for change, we committed to strengthening health visiting services so that all families can access their support.

We are investing in family hubs and the Start for Life programme, with £18.5 million this year to improve infant feeding support across 75 local authorities in England. Start for Life services are helping parents to access support where they need it and in a location that suits them, whether that is their home, their family hub, a hospital setting or through the many voluntary sector organisations that have been referred to today. Local authorities are working with partners to embed local infant feeding strategies, joining up services for seamless support and tailoring them to their community, with both universal and targeted support. They are building up the workforce, investing in infant feeding specialists, delivering high-quality training and expanding networks of peer supporters. Funding is also helping to train staff to identify complex needs early such as tongue-tie, and to offer timely support.

Although long-term evaluation is needed to understand the full impact of the programme, some promising findings are emerging. For example, ambitious multi-layered integrated infant feeding plans have led to increased breastfeeding rates in Coventry, and local health visitor data shows an increase in breastfeeding at six to eight weeks from 51% to 57% in just 18 months. We are also helping families across the UK to access breastfeeding support 24 hours a day through the National Breastfeeding Helpline.

[Jess Brown-Fuller]

The Minister highlights some brilliant examples that are a gold standard in care, but does she recognise that the process the Government are currently undertaking, with only half of local authorities being funded, means that we still end up with a patchwork level of support for new mothers? They do not know where they are meant to go, because it is different when they cross a county border.

[Ashley Dalton]

This is very much targeted through the family hub service and support for Start for Life, and through the universal health visiting offer and the National Breastfeeding Helpline we aim to offer all women who are breastfeeding the support that they need to do so. Parental leave has been touched on, and we know that supporting parents goes beyond services. Returning to work can influence how families choose to feed their babies, and in the plan to make work pay we have committed to a review of the parental leave system. As the hon. Member said, that review was launched by the Department for Business and Trade in the Chamber earlier today, and we are delighted to see that come forward.

I have spoken a lot about breastfeeding, but we absolutely recognise that when families cannot or choose not to breastfeed, it is vital that they get formula that is safe, nutritionally complete and affordable. Infant formula regulations and Competition and Markets Authority recommendations are important, but we know that many families are struggling to afford infant formula. We welcome the report from the CMA into the UK infant and follow-on formula market. It highlighted some of the issues that the hon. Member raised, in particular by noting that families rely on brand reputation and price as a proxy for quality, often choosing more expensive products. However, specific regulations require all infant formula to comply with robust nutritional and compositional standards, so that all infant formula sold on the UK market meets the nutritional needs of babies, regardless of the price or brand.

The CMA has made 11 recommendations to the Government, with four aims: to eliminate brand influence in healthcare settings; to provide better information for parents in retail settings; to strengthen labelling and advertising rules; and to ensure effective enforcement of regulations. The Government are supportive of what the CMA is trying to achieve. We want parents to be confident enough to choose lower-priced products, and for manufacturers and retailers to compete more on price. The CMA recommendations are UK wide. We are considering them alongside colleagues in the devolved Governments, and aim to have a UK-wide response available as soon as possible.

In conclusion, I thank the hon. Member for raising this important matter. The Government are committed to giving children the best start in life, and we do not underestimate the challenge of getting this right for families. We will continue to strengthen key services, build on good practice, and identify where we can have the greatest impact for families. Tomorrow I will meet the all-party group on babies, and I look forward to discussing these issues further with them.

Question put and agreed to.

IVF Egg Donation: Young Women

Jess Brown-Fuller Excerpts

Thursday 26th June 2025 Westminster Hall

[Jess Brown-Fuller (Chichester) (LD)]

It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this important debate on an issue that affects so many. Although his focus was on egg retrieval, he also identified the value of IVF to families across the UK. Like other Members present, I have family and friends who have struggled with fertility. The pain it causes, and the emotional toll it can take on families, is immense and harrowing to watch. Modern medicine has eased those struggles through IVF, which is remarkable and a credit to the many scientists and medical professionals who have worked tirelessly to develop it. If you do not mind, Mr Efford, I will selfishly mention my best friend Lottie and her husband Marvin. They were both IVF babies nearly 40 years ago, and two years ago they managed to have their little baby boy Luca without any fertility struggles. What a gift he is.

Sadly, there is currently a postcode lottery for IVF and fertility services, which undermines the generosity of those who donate eggs and shatters the hopes and family lives of many couples. In much of the country, couples are entitled to just one round of IVF on the NHS, while in other areas, people can receive up to three rounds. It is crucial that people can expect high-quality treatment wherever they live, rather than being priced out of having children simply because of their postcode. Can the Minister therefore set out what steps the Government are taking to reduce that inequality of access to these life-changing reproductive health services?

A specific inequality still exists for the LGBTQ+ community. In England, NHS-funded access to IVF is available only to women who have not conceived after two years of regular unprotected intercourse or 12 cycles of artificial insemination. In practice, that requires all lesbian couples to pay for artificial insemination cycles before becoming eligible for NHS-funded IVF. That is an insurmountable financial barrier for many of those couples, given that cycles can cost thousands of pounds. Although the Government’s 2022 women’s health strategy pledged to remove that requirement for lesbian couples, the roll-out of that new policy has been painfully slow. As of April 2024, only four of the 42 integrated care boards in England have implemented it. The Liberal Democrats are pushing for all integrated care boards to make that change a priority to ensure equitable access to IVF for all lesbian couples who are looking to start a family. What work is the Department undertaking to ensure that the requirement is removed across all ICBs?

It is important to recognise the immense contribution that egg donors make to the IVF process. The lives of couples and families across the country have been transformed by the generosity and support of those who donate eggs or sperm to help them have children. Becoming an egg donor is a complex decision, and as highlighted by hon. Members’ contributions, it can have lifelong implications, especially considering that donors can consent to have their eggs stored for up to 55 years, and children who were born through a donation and who have turned 18 may contact the donor. Added to that, donors must undergo rigorous medical screening. They are brave, selfless individuals who perform acts of love for family members, friends and strangers alike. It is absolutely right that eggs are donated rather than bought or sold, and that there are rigorous protections in place to ensure that.

[Jonathan Hinder (Pendle and Clitheroe) (Lab)]

Does the hon. Lady not think that the fact that payments are given, whether they are badged as compensation or fees, means that we cannot actually say at the moment that donations are being given for purely altruistic reasons?

[Jess Brown-Fuller]

That is exactly why the hon. Member for Strangford brought forward this debate, and we share his concerns that any attempt to create a market for egg donation could lead to perverse outcomes. Advertising for egg donors to come forward should reflect that, stressing the benefits to others rather than attempting to frame compensation as a primary motivation to donate. We must ensure that women donating eggs do so willingly, not out of financial necessity, and are provided with appropriate support throughout the process.

It is right that the donors clinic is required by law to offer counselling, but the Government should investigate whether additional steps are needed to ensure proper medical regulation of that counselling, beyond what is already provided by the Professional Standards Authority. Is the Minister satisfied that the Advertising Standards Authority and the Competition and Markets Authority are adequately resourced and have sufficient capacity to uphold essential regulations in this area?

I will briefly touch on an equally complex and emotionally charged topic: surrogacy and legal parenthood from the point of birth. For the sake of the child, the surrogate and the legal parents, the matter needs to be handled with great sensitivity. The Liberal Democrats believe that all potential cases regarding legal parenthood of a new baby must ensure that the wellbeing of all involved is balanced and respected. There are, understandably, concerns about financial incentives for surrogates. For example, the Law Commission found that there is a lack of clarity about what payments can be made by the intended parents to the surrogate, which makes the law difficult to apply in practice. We believe that any proposed legislation should be published and subject to scrutiny before any changes to current practice are made.

So many lives around the world have been transformed by the miracle that is IVF, but there remains much work to be done to address the inequalities in NHS provision, end the postcode lottery, and ensure that lesbian couples have access to IVF fairly. We must also ensure that donors are not unduly influenced by exploitative marketing, and we hope the Government will take action following the debate to investigate that.

GP Funding: South-west England

Jess Brown-Fuller Excerpts

Wednesday 25th June 2025 Westminster Hall

[Jess Brown-Fuller (Chichester) (LD)]

It is a pleasure to serve under your chairmanship, Dame Siobhain. I thank my hon. Friend the Member for Newton Abbot (Martin Wrigley) for securing today’s important and timely debate. He is a tireless advocate for his local community, and I commend him for shining a spotlight on GP funding and the broader state of healthcare in the south-west. He spoke about the funding model for GPs, which is complex, obscure and outdated, and does not account for rurality.

As the Liberal Democrat spokesperson for hospitals and primary care, I hear all too often from my constituents and from people across the country who are struggling to access the care they need. Our NHS is the pride of the nation, but years of underfunding and mismanagement under the last Conservative Government have left services in crisis.

Nowhere is that more apparent than in general practice, with patients facing increasingly long waits to see a GP, as highlighted by my hon. Friend’s statistics. In 2019, the average GP had 1,900 patients on their books; today, they have 2,400, and some people cannot get an appointment at all. People rightly tell me that they are not included in the Government’s waiting list statistics because they have not managed to get on a waiting list in the first place—or even speak to a doctor.

Those are not isolated complaints. I am sure many hon. Members will recognise those concerns from their own constituency surgeries, or from spending a morning with their local GP, as my hon. Friend the Member for Mid Dorset and North Poole (Vikki Slade) described. We also need to be honest about the scale of the problem. In 2024 alone, more than 2 million people in the south-west waited over 28 days for a GP appointment, and that pattern is repeated across the country. Chichester is not in the south-west, but nearly 30% of patients in my constituency had to wait more than two weeks, and around 8% waited more than a month. That is not acceptable.

The hon. Member for St Austell and Newquay (Noah Law) made an important point about tourism. The population of my coastal communities such as Selsey, Pagham and the Witterings doubles over the summer months with holidaymakers, which can put additional stress on primary care services.

My hon. Friend the Member for South Cotswolds (Dr Savage) made an important point about the role that planning and ICBs play. Too often, developers come forward with large site proposals that include a GP surgery on the site. However, unless they have buy-in from the ICB, so often those GP surgeries that have been specifically designed for that purpose sit empty without a GP practice to go into them.

My hon. Friend also spoke about her village of Sherston. It might not be the centre of my universe—that is my little rural village of Westbourne—but both Sherston and Westbourne face the exact same problems. My village of Westbourne is about to lose its rural surgery; we are waiting for the ICB’s final decision. Residents of Westbourne do not have a public transport link to the GP that they are being asked to go to, across the border in Emsworth.

The Liberal Democrats believe that everyone should have the ability to live a healthy and fulfilling life, which means they must have timely and local access to healthcare, whether that is from a GP, a dentist, a pharmacist or a mental health professional. We must invest in early access to community care, in order to relieve the burden on hospitals and fix the social care crisis that leaves too many people stuck in hospital beds waiting for help that never comes.

Research by the House of Commons Library that was commissioned by the Liberal Democrats found that funding for GP practices was cut by £350 million in real terms between 2019 and 2024. Those cuts have hit communities hard, and the impact is being felt not only by patients but by the hard-working professionals trying to keep the system going. GPs who I speak to are burnt out and overburdened, and GPs in general are leaving the profession in record numbers. The result is a vicious cycle, with fewer staff, longer waits and growing public frustration. I know some incredible GPs, and New Zealand is really lucky to have them, but I would rather they were here. Despite a 2019 Conservative pledge to hire 6,000 more GPs, by the general election last year there were 500 fewer GPs than when that pledge was made. In fact, the UK has 16% fewer qualified GPs per capita than comparable high-income countries.

It does not have to be that way. Healthcare is not a luxury. It is a fundamental right and not a privilege. Everyone should be able to see a GP when they need to, and that is why the Liberal Democrats are calling for a legal right to see a GP within seven days, or within 24 hours if the situation is urgent. To make this a reality, we are calling for the recruitment of 8,000 more GPs. We would achieve that by supporting junior doctors to specialise in general practice and by introducing new schemes to help experienced GPs to return to the workforce.

As my hon. Friend the Member for Yeovil (Adam Dance) said, we also believe that everyone over 70 and those with long-term conditions should have access to a named GP. Such continuity of care is not only vital for building trust and supporting staff morale; it also improves health outcomes and saves money in the long term. As my hon. Friend the Member for Oxford West and Abingdon (Layla Moran), who is the Chair of the Health and Social Care Committee, has said, continuity of care is key. Patients who have had the same GP for more than 15 years have a 25% lower chance of dying compared with patients who change GPs regularly. Continuity of care builds trust, improves outcomes and reduces hospital admissions. It is good for patients, good for staff and good for the system as a whole.

We must also address the broader picture. Community pharmacies are closing at an alarming rate when they should be playing a bigger role in delivering frontline care. Fairer and more sustainable funding is needed to keep these services open, to relieve pressure on GPs. I am a big fan of Pharmacy First and I know that the Minister is, too; I have heard him talk about his passion for it. But pharmacists in my constituency tell me that with the regular increase in targets, they are struggling to keep up.

[Adam Dance]

I spent an evening with one of my local pharmacists, and it was so shocking that people were coming 20 or 30 miles to his pharmacy, because it was the only one open near my village of South Petherton. He was struggling so much because he could not get the medication that people needed, despite the fact that they were travelling so far to try and get medication from him. Does my hon. Friend agree that that is just not good enough and that the Government need to support pharmacies a lot more?

[Jess Brown-Fuller]

I am sure the Minister will talk about the hub and spoke model that the Government are championing, but my hon. Friend is right about the difficulties in rural areas especially. Many constituents have talked to me about the distance they are having to travel to get basic medication that means they can function, go to work the next day or get their children to school.

This is why we have been calling for a fairer and more sustainable long-term funding model for community pharmacies. They play a vital role in relieving pressure on GPs, yet they are being squeezed out of existence. Since 2017, 1,200 pharmacies have shut their doors. Community Pharmacy England has warned of real-terms funding cuts of at least 25% since 2015, leaving the network on the brink of collapse.

This is not just a failing system; it is a broken one. This Labour Government have a responsibility to act. They were elected on a promise of change, but that change must begin with fixing our NHS. I am sure the Minister will celebrate the budget increase, but as my hon. Friend the Member for Melksham and Devizes (Brian Mathew) said, this has been swallowed by the increased costs and national insurance contributions. That is why the Liberal Democrats tabled an amendment to exempt healthcare services from the NICs rise, which the Government chose not to accept.

General practice is the front door to our health system. If we do not invest properly in GP services, everything else suffers. We must not let that door remain closed to so many. As my hon. Friend the Member for Newton Abbot rightly said, we do not have to accept broken systems—we can fix them, and now is the time to prove that we will. Will the Minister commit to the Liberal Democrat proposal of a legal right for patients to see a GP within seven days, or within 24 hours in urgent cases? Does he agree that everyone over 70 and those with long-term health conditions should have access to a named GP?

--- Later in debate ---

[Jess Brown-Fuller]

It is interesting that the Minister mentioned devolution, because the effect of the cuts to ICBs has meant that Sussex ICB is now having conversations with Surrey ICB about a merger. The cuts are therefore achieving the exact opposite of devolution, because such a merger would move power further away from communities. Does he have any thoughts on that?

[Stephen Kinnock]

Integrated care boards in the south-west have received almost £1.3 billion in their primary medical care allocation for ’25-26, which is an increase of nearly 13% compared with ’24-25, so I am not quite sure where the hon. Lady is getting her figures. For me, a 13% increase is not a cut.

That growth in local resources includes the south-west’s share of the additional £889 million agreed for the GP contract, as well as the transfer of some additional roles reimbursement scheme funding that had previously been held centrally by NHS England. Those funding allocations will be further uplifted to fund in full the pay recommendations of the DDRB and the NHS Pay Review Body.

Oral Answers to Questions

Jess Brown-Fuller Excerpts

Tuesday 17th June 2025 Commons Chamber

[Wes Streeting]

Probably because being that prescriptive about every housing development is not sensible, even if the thrust of what the hon. Member describes—that as new housing development is built, we need to ensure that local infrastructure goes alongside it—is the right approach. I take what he says about the number of GPs, and as I have said, we do not pretend to have fixed all the problems in 11 months, but with respect, those are three more GPs than were there before. I know there is more to do, but give me time, and we will rebuild general practice for his constituents and anyone else’s.

[Jess Brown-Fuller (Chichester) (LD)]

Access to GPs in my constituency of Chichester is being undermined by the closure of the Westbourne branch of Emsworth medical practice at the end of this month. Patients will now have to travel to Emsworth, but we are talking about a small rural village, and there is no public transport to get my elderly and vulnerable patients to that medical practice over the border. Will the Secretary of State please meet me to urgently discuss how we can protect this vital service in a rural village in Chichester?

[Wes Streeting]

I can well understand the hon. Member’s concern and her constituents’ concern. Practice closures are hard on communities wherever they are, but they disproportionately hit rural communities and those that suffer with poor transport connectivity. I would urge her in the first instance to raise the specific local issues with the ICB. However, I reassure her and other right hon. and hon. Members that the needs of rural, coastal and remote communities are very much in our mind—and, crucially, in the 10-year plan—and our thinking about how we build genuine neighbourhood health services in all types of neighbourhood.

Chronic Urinary Tract Infections

Jess Brown-Fuller Excerpts

Wednesday 21st May 2025 Westminster Hall

[Jess Brown-Fuller (Chichester) (LD)]

It is a pleasure to serve under your chairmanship, Sir Desmond. It is also a pleasure to see the Minister in her place. I thank my hon. Friend the Member for Sutton and Cheam (Luke Taylor) for securing today’s debate and for being a champion for both his constituents and the wider population suffering with UTIs. Although I will not mention all the contributions this morning, I must mention that of the hon. Member for Stoke-on-Trent South (Dr Gardner), whose speech was not only passionate, but well informed and very personal. It is the hardest thing to share a personal story, and I commend her for her bravery this morning.

Urinary tract infections are far more common than many realise and far more serious than many assume, and women are 30 times more likely to suffer from a UTI than men. They are agonising and can, in some cases, even be fatal. Between 2018 and 2023, 1.8 million hospital admissions in England involved UTIs, not to mention the no doubt countless GP appointments.

Chronic urinary tract infections, where symptoms do not go away, are a particularly distressing form of this condition. My hon. Friend the Member for Sutton and Cheam spoke about sufferers being in bedbound isolation and unbearable pain, preventing them from living their lives and often from attending important family events and moments that should be celebrated, because this condition can be so debilitating.

Short courses of antibiotics often fail, and urine tests can come back negative, even when the patient is in clear discomfort. That is because chronic UTIs can be caused by bacteria entering the lining of the bladder, which makes them much harder to detect and treat. The diagnostic tools available to us are simply not good enough. Midstream urine cultures are still considered the gold standard for diagnosing acute UTIs, but recent research shows that MSUs miss a wide range of bacteria, which leaves many sufferers undiagnosed, untreated and often feeling disbelieved.

Like most women, I am grateful that I do not suffer from regular UTIs, although I do remember the panic as a child when I was in absolute agony. I do not know whether this is oversharing, but I remember my mum running in with a milk bottle of cold water to pour on me while I went to the toilet, just to take an element of that pain away for me, as a young child experiencing something I did not understand.

I have seen how a UTI can be particularly debilitating for those living with dementia. I experienced that with my nana during her final years. She could not identify that she was experiencing pain, so it fell to us, as her family, to recognise the symptoms. Her carer would test her urine most days, as she became so prone to infections. Those can cause sudden and alarming changes in behaviour, known as delirium, which is often exhibited as confusion, agitation, hallucinations or sudden withdrawal.

My nana ended up being hospitalised for some severe UTIs in her final months. Her hallucinations were quite often enjoyed by the family, and I particularly remember one where she was very cross at me for coming to her hospital late at night with an entire choir, singing to her and waking up the whole ward. That obviously did not happen, but in her delirium she was absolutely convinced that I had not respected her sleep. Such symptoms are often mistaken for the progression of dementia, leading to the underlying UTI going uncured.

Social care has a key role to play in UTIs, but only 45% of care workers receive any sort of dementia-specific training. We were incredibly lucky that the carer we had for my nana was dementia-trained and recognised the signs of UTIs before they got too bad. Families are also vital in this process, especially when someone cannot advocate for themselves. As my hon. Friend the Member for Sutton and Cheam mentioned, when patients are so exhausted from having to fight a system that does not believe them, families often have to step in and be their advocates. People cannot do this alone.

Too often, UTIs are dismissed as short term or minor, but for many people, particularly those with underlying conditions, they are anything but. We welcome the NHS’s recognition of chronic UTIs as a legitimate condition since 2022, but too many people still suffer in silence or are dismissed, misdiagnosed and left without adequate support. That is why we urge the Government to explore ways to improve diagnosis, particularly for chronic UTIs. Further research is desperately needed.

The Liberal Democrats are calling for a significant expansion in the capacity of the Medicines and Healthcare products Regulatory Agency, and for a comprehensive agreement with the European Medicines Agency. We must ensure that new treatments can reach UK patients without delay, especially as we currently rely on three different strands of antibiotics to treat UTIs, as the hon. Member for Stoke-on-Trent South said. Those who suffer regularly are at risk of developing antimicrobial resistance, which then makes treatments less effective. If they are also allergic to certain strands, they are incredibly limited in the antibiotics they can receive. The hon. Member also mentioned that there is a UTI vaccine in other countries, which I am very interested in.

Continuity of care is equally important. Everyone with a long-term condition such as a chronic UTI should have access to a named GP. That would help to build understanding, avoid delays and improve outcomes, especially for those whose symptoms may be dismissed or misunderstood.

Lastly, I want to touch on the role of community pharmacies, which the hon. Member for Strangford (Jim Shannon) mentioned. The Pharmacy First scheme, which was introduced in England in January last year, has the potential to relieve pressure on GPs and to provide quicker treatment for uncomplicated UTIs, but many pharmacies are struggling to meet the consultation targets required to access funding. Ongoing financial and operational pressures are undermining the very service that we need to provide, and in the year to date we have lost the equivalent of four community pharmacies a week.

My questions to the Minister are as follows. What steps is her Department taking to support community pharmacies in delivering the Pharmacy First service, especially those struggling to meet the increase in consultation targets, and to ensure that patients with UTIs can access timely, local and effective care? Pharmacy First is currently available only for those with UTIs between the ages of 16 and 64. Is there a plan to widen that age range? Given the known limitations of current testing methods, will the Minister also outline what steps are being taken to ensure that better diagnostic tools are made available? Is there any plan to introduce a UTI vaccine? Finally, will chronic UTIs be included in the 10-year health plan, and is that still on track to be published in June?

World Asthma Day

Jess Brown-Fuller Excerpts

Thursday 15th May 2025 Westminster Hall

[Jess Brown-Fuller (Chichester) (LD)]

It is a pleasure to serve under your chairmanship, Dr Huq, and always a pleasure to see the Minister in her place. I thank the hon. Member for Strangford (Jim Shannon) for securing this important and timely debate to mark World Asthma Day, which took place last week. As the chair of the all-party parliamentary group for respiratory health, he is a tireless advocate for the millions of people across the UK living with lung conditions—and, indeed, multiple other conditions. As my party’s health spokesperson, I have been in this Chamber many times for debates that he has secured. He is certainly a credit to the less-spoken-about health conditions. His commitment to raising awareness and driving change in health is deeply appreciated, and I commend him for his leadership.

To mark World Asthma Day 2025, the Global Initiative for Asthma has chosen the theme “Make Inhaled Treatments Accessible for ALL”. It is pertinent that this debate follows one on international development and global health—a powerful reminder of the need to ensure people with asthma have access to the treatments they need, not just to manage their day-to-day symptoms, but to prevent life-threatening attacks.

Asthma remains one of the most common chronic health conditions worldwide, yet, as the hon. Gentleman clearly set out, progress over the past two decades have been slow. Lung conditions are now the third biggest killer in the UK. Hospitalisations due to respiratory illness have doubled in the past 20 years, and the UK has seen little improvement in outcomes over that time. Those are not just statistics—they are people, and they reflect a systematic failure to treat respiratory health with the seriousness it demands.

There are 7.2 million people living with diagnosed asthma in the UK today, including 2 million children—one in nine adults and one in eight children. The UK’s asthma death rate is higher than the OECD average, and the highest in Europe. Every day, four people in this country die from asthma attacks. Every 10 seconds, someone experiences an asthma attack that could be life-threatening. That should be a wake-up call.

In my constituency of Chichester, 7.5% of GP patients aged six and over have been prescribed some form of asthma-related medication in the past year. That statistic is higher than the national average, and it represents hundreds of families trying to manage a condition that, with the right support, should not prevent anyone from living a full and active life. Yet time and again those are the families let down in other areas, by poor housing, air pollution—as the hon. Member for Bournemouth West (Jessica Toale) mentioned—inconsistent care and a public health system that has been hollowed out over the past decade.

The UK should be a world leader in public health. We have a long history of innovation, grassroots sports, high-quality food production and leading medical research, but, thanks to the previous Government, we now lag behind our international peers. It is profoundly troubling that our children experience some of the worst asthma outcomes across Europe and other high-income countries. The Liberal Democrats are calling on the Government to take urgent action.

First and foremost, we must reverse the Conservative cuts to public health funding, but we must not stop there. We need a comprehensive approach that tackles the root causes of poor lung health, from poverty and cold, damp housing to polluted air and hazardous working environments. We want an increase to the public health grant delivered by local authorities, with part of that funding set out for communities facing the greatest health inequalities. Those communities must be supported by co-designed solutions, including better smoking cessation services, stronger action on air quality and improvements to housing and occupational health.

Prevention must be at the heart of our approach. That means investing in primary care, supporting individuals to improve their own health and giving local areas the tools they need to build healthier environments. It is one of the most effective ways that we can reduce pressure on NHS services and deliver better value for money to taxpayers.

The Liberal Democrats would also take decisive action on air pollution by passing a clean air Act based on World Health Organisation guidelines and establishing a new air quality agency to enforce those standards. We must do more to ensure access to consistent, high-quality care for those already living with long-term respiratory conditions such as asthma. That includes guaranteeing that people with severe asthma have access to a named GP so that they do not have to constantly retell their story to new clinicians, and increasing the capacity of the Medicines and Healthcare products Regulatory Agency so that new treatments can reach patients more quickly.

I was on a Delegated Legislation Committee earlier this week, with the Minister, where the funding for the MHRA was increased. However, it was not clear whether that would speed up the process of getting new medicines to patients. As the hon. Member for Strangford rightly pointed out, the scale of this issue demands urgency. Four asthma deaths every day and a life-threatening attack every 10 seconds are tragedies could be prevented, if only we prioritised respiratory health as we ought to.

Will the Minister, therefore, commit to setting aside part of the public health grant to support those communities facing the largest health inequalities? Will the Government propose a new clean air Act based on World Health Organisation guidelines, to ensure those with severe, long-term respiratory conditions are not breathing in harmful pollutants? Finally, when can we expect the publication of the 10-year health plan, and will respiratory health be included?

Asthma is not just a clinical issue; it is a question of justice and of whether we are willing to tackle the social and environmental factors that make people ill in the first place. I hope the Minister will reflect seriously on what has been said today.

Draft Medical Devices and Blood Safety and Quality (Fees Amendment) Regulations

Jess Brown-Fuller Excerpts

Monday 12th May 2025 General Committees

[Jess Brown-Fuller (Chichester) (LD)]

I thank the Minister for her speech. As she says, the Medicines and Healthcare products Regulatory Agency is a world-class regulator that should be innovative, transparent and truly independent, while maintaining high standards and always putting public health first. In recent years, however, confidence in MHRA standards has been undermined by the Primodos, vaginal mesh and infected blood scandals. It is crucial that we ensure that those mistakes are never repeated, and that the MHRA regains the public’s trust.

The MHRA has suffered from insufficient staffing levels and inflexibility around funding and resourcing, and patients are the ones paying the price. The Government should aim for nothing less than halving the time in which new treatments reach patients for life-threatening conditions such as cancer. The Liberal Democrats therefore support additional resource for the MHRA, but that must go hand in hand with greater capacity and a stronger service to address past failings. Can the Minister confirm that when the regulations are made, we will see an increase in the speed at which patients receive treatments? Can she tell us when that improvement will be delivered?

Concerns were expressed during the consultation that fee hikes, some of which exceed inflation, will stifle innovation and undermine important research. What assurances can the Minister provide that there will be no deterioration in the number or quality of new products? Is she confident that payment waivers and easement measures are sufficient to stop small and medium-sized enterprises significantly cutting back their activity?

Oral Answers to Questions

Jess Brown-Fuller Excerpts

Tuesday 6th May 2025 Commons Chamber

[Jess Brown-Fuller (Chichester) (LD)]

NHS Sussex ICB is one of only five in England not to commission a minor eye conditions service—known as MECS—in community optometry settings. That means that patients in Chichester with urgent or minor eye issues have to either join the 8 am queue for a GP appointment or go to their hospital rather than being seen quickly on the high street. Given that 99.9% of MECS patients elsewhere in England are seen within 24 hours, will the Minister set out what action he is taking to ensure that those services are commissioned consistently across all ICBs within the 10-year health plan?

[Stephen Kinnock]

ICBs are responsible for the commissioning of these services, which are clearly extremely important, and the early intervention side of eye care is particularly important. I would be more than happy to look into that issue with the hon. Lady’s ICB if she wrote to me and made further representations.

Black Maternal Health Awareness Week

Jess Brown-Fuller Excerpts

Tuesday 29th April 2025 Westminster Hall

[Jess Brown-Fuller (Chichester) (LD)]

I congratulate the hon. Member for Clapham and Brixton Hill (Bell Ribeiro-Addy) on securing today’s important and timely debate, following Black Maternal Health Awareness Week earlier this month. Her opening remarks were comprehensive and thoughtful. I am always pleased to hear from the hon. Member for Sherwood Forest (Michelle Welsh), who is a passionate advocate for improved maternity services in Nottingham and across the UK; I am pleased to serve on the APPG with her at the helm.

Women are at their most vulnerable during pregnancy, as they carry another human life, and they deserve the very best care. They have more touchpoints with the NHS than they will have for most of their lives. We engage with the NHS when we are born and when we need to access care at the end of our lives. When we are carrying a child, we have more moments in front of medical professionals than for the majority of our lives.

Following its inspection of 131 maternity units, the Care Quality Commission found that 65% were not safe for women to give birth, 47% required improvement on safety, and 18% were inadequate. The commission warned that it is concerned about the potential normalising of serious harm in maternity care. Those risks are particularly stark for women of colour in this country, for whom pregnancy continues to carry an unacceptable level of danger. As the Darzi report highlighted, black women are almost three times as likely as white women to die during childbirth, while neonatal mortality among the most deprived quintile is more than double that among the least deprived. That is nothing less than a national scandal.

Maternity care is an issue close to my heart, having had two very different experiences giving birth in my local hospital in Chichester. I tabled an early-day motion on maternity care and secured a Backbench Business debate in this Chamber on that subject just two months ago. Like the hon. Member for Sherwood Forest, I am in regular contact with Donna Ockenden, who produced the Ockenden report. Her findings, along with those of Dr Bill Kirkup, show that the problems identified at the Shrewsbury and Telford trust and the East Kent trust are not isolated incidents. The same issues are systemic and widespread across many NHS trusts up and down the country.

In preparation for the previous debate on maternity services as a whole, I spoke to families across the country who had experienced devastating failures in the system. They went into hospital expecting the joyful outcome of going home with a child, but instead they had to return without their baby, carrying the trauma of that experience for the rest of their lives.

As the hon. Member for Clapham and Brixton Hill mentioned, the MBRRACE-UK report for 2021 to 2023 confirms that inequalities in maternal mortality rates persist, with a nearly threefold difference among women from black ethnic backgrounds, and an almost twofold difference among women from Asian ethnic backgrounds, compared with white women. Women living in the most deprived areas continue to experience maternal mortality rates that are twice those in the least deprived areas. Care for black women who experience stillbirth or neonatal death is often inadequate.

Ethnicity is still not routinely recognised as a risk factor in, for example, the screening and prevention of conditions such as gestational diabetes. Births to black mothers are almost twice as likely to be investigated for NHS safety failings, and black mothers are twice as likely to suffer from perinatal mental illness compared with their white counterparts.

I pay tribute to my hon. Friend the Member for Twickenham (Munira Wilson), who has long talked about these disparities. She introduced the Miscarriage and Stillbirth (Black and Asian Women) Bill in 2022, which sought to require the Secretary of State to lay annual reports before Parliament on efforts to reduce miscarriage and stillbirth rates among black and Asian women, but unfortunately it was not carried over into the next Session.

When so many of our conversations in this House and in the other place are about the economic pressure we are under as a country, it is worth reflecting that, on top of the enormous human toll of this issue, failure also has a financial cost. Obstetric claims make up just 13% of clinical negligence cases handled by NHS Resolution, but they cost more than £1 billion a year, which is nearly 60% of the total cost.

Across the country, families face unbearable grief and trauma because of failures in maternity care, and that burden is falling disproportionately on black women and families. We Liberal Democrats are committed to transforming maternity services to make the UK the safest place in the world to have a baby, and we fully support the work of Black Maternal Health Awareness Week in drawing attention to these critical issues. Our general election manifesto pledged to revolutionise perinatal mental health support, not only for those currently pregnant and for new mothers but for those who have endured miscarriage or stillbirth.

We have been clear that the Government must, as a priority of the highest urgency, implement all the immediate and essential actions recommended by the Ockenden report. It is deeply concerning that, years after the tragedies at the Shrewsbury and Telford trust and the East Kent trust, failures are still widespread and efforts to address them appear piecemeal.

When my hon. Friend the Member for North Shropshire (Helen Morgan) recently questioned the Department on the implementation of the Ockenden recommendations, it was alarming that it could not confirm whether the actions had been implemented, nor did it appear to have a system for centrally monitoring the progress. The Minister pointed to the three-year delivery plan for maternity and neonatal services as the Department’s main response.

Deeper analysis shows serious shortcomings. Many measures in the plan have no meaningful numerical targets, which makes real accountability for the difference made by the plan very hard to track. Targets for expanding access to perinatal mental health support are being missed, even as some improvement is noted, and staff satisfaction indicators remain worryingly low, with some measures still recording fewer than half of staff expressing confidence in educational opportunities or in their management’s response to unsafe practices.

The target set in 2010 to halve maternal mortality looks increasingly out of reach. Maternal mortality rates did not fall for a decade, and they actually increased between 2021 and 2023. Worse still, no updated data has been published for the last two years on the rates of serious brain injury, stillbirth, neonatal mortality or preterm birth. Without transparency and accountability, women will continue to be failed, and black women, who already bear the brunt of the disparities, will continue to be disproportionately harmed. That is why I ask the Minister to commit to reviewing these issues urgently, to meet me and my colleagues from the Liberal Democrat health team to discuss a more effective plan to improve maternity safety, and to set out a clear path to address the deep disparities in black maternal health.

Alongside that, the Liberal Democrats are calling for a cross-Government strategy, led by the Department of Health and Social Care, with annual progress reports on reducing miscarriage and stillbirth rates among ethnic minorities. We also call for increased funding for public health initiatives, with a portion earmarked to allow communities facing the worst health inequalities to co-produce solutions tailored to their specific needs. We propose the establishment of a health creation unit in the Cabinet Office to lead work across Government to improve health and tackle inequalities.

Black women have waited too long for their concerns to be heard, for the system to change and for justice to be done. We owe it to them and to every woman, family and baby in this country to get maternity services right. No woman should fear for her life or her child’s life because of the colour of her skin or the postcode that she lives in. We have to do better.