Children’s Cancer Care: South-East

Jonathan Lord Excerpts

Wednesday 13th March 2024 Westminster Hall

[Dame Andrea Leadsom]

I will also take the intervention from my hon. Friend the Member for Woking (Mr Lord).

[Mr Jonathan Lord (Woking) (Con)]

Like several colleagues, I thank the existing hospitals for the amazing care that they have given over the years, but I agree with my hon. Friend the Member for Mole Valley: I do not think this decision is necessarily a no-brainer. We need to look at the final decision and report, and weigh up what is good and what is bad. Who knows what the final decision and its reasoning will be? I agree with the Minister that it has been a proper process. We should allow it to come to its conclusion very shortly, look at the evidence, and look at the decision in that light and with an open mind.

[Dame Andrea Leadsom]

I absolutely agree with my hon. Friends that the consultation is critical, that it has been an open consultation and that all views are being taken into account. I am grateful to them for supporting the process. As Members of Parliament and constituency representatives, we all want the best for our constituents, but in the case of clinical care, it is vital that those with specialist knowledge and understanding should be able to make such important decisions that will affect life and death outcomes for children.

The new centre will be a family-friendly centre forusb children and young people at the forefront of groundbreaking research, continuing a close relationship with the Institute of Cancer Research. The centre will lead joined-up working between different children’s cancer services so that children get proper access to care, wherever they live. Importantly, it will have many more services on site, reducing the need for some families to travel, which will be particularly helpful for children with complex needs and families that struggle to speak English.

I assure colleagues, and anyone who might be watching at home, that once the decision has been taken, there will be no sudden changes to how patients receive care. Of course, some families will naturally be worried about what the change might mean for their children. That is entirely normal, and NHS England will carefully involve every clinical team currently providing care, keeping parents and families closely updated at every stage. NHS England will encourage experienced staff to move to the future centre so that they can continue to provide a friendly and familiar face to the children they serve. No one from among the clinical staff will be made redundant in any future changes resulting directly from this decision. NHS England has met staff to listen to their views, and they assure me that that will continue.

The consultation heard from children, their carers, and families who have received the worst news. They have talked about their own experiences selflessly to try to help others. The consultation closed in December last year, and an independent research organisation published its findings in January. NHS England has taken into account every word of feedback and every inch of evidence to inform the decision-making process. NHS England leaders are meeting tomorrow to decide the future location of the centre. The meeting will be livestreamed so that everyone who is interested can hear the discussion and the decision.

In conclusion, wherever the future centre is placed, I am confident that tomorrow’s decision will offer the right outcome for our children and take all views into account.

LGBT+ People and Spouses: Social Care

Jonathan Lord Excerpts

Tuesday 12th September 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

It is a pleasure to serve under your chairmanship, Sir Robert. I apologise if this important debate is interrupted by a vote. I also apologise for the fact that my colleague the Minister for Social Care, my hon. Friend the Member for Faversham and Mid Kent (Helen Whately), has been in a car accident and cannot be here today.

I pay tribute to the hon. Member for Dulwich and West Norwood (Helen Hayes) for securing this debate on a hugely important issue, which is only likely to grow in importance over time. I express my sympathy to Ted for the appalling, abhorrent experience that he and Noel suffered. I am glad that compensation has been paid, although it is not enough, and I am happy to continue to discuss that case with the hon. Lady and her constituent after this debate.

People have a right to live in safety, free from abuse and neglect, and they should expect high-quality care and tailored support to meet their personal care needs. Nobody should be disadvantaged due to their background, sexual orientation, gender identity, culture or community.

The hon. Member for Denton and Reddish (Andrew Gwynne) has mentioned some of the guidance and the clear recent legislation we have passed to ensure that is the case. Care workers, social workers and everyone working in social care need to be sensitive to people’s individual needs and circumstances, including their sexual orientation and gender identity. It is vital they have the confidence to discuss individuals’ differences to find out how they can best provide care and meet individuals’ needs.

I want to thank our amazing social care workforce, who work tirelessly to deliver high-quality care to individuals. It is important to recognise the hard and brilliant work of the social care workforce, even though today we are talking about some horrendous failures in social care, where things have not gone right, as highlighted in a report by Compassion In Care that has been mentioned several times and which is called “Stripped of all Pride”. I read the report and found it absolutely harrowing. Some of the cases discussed are almost unbelievable. The report shines a spotlight on how LGBT people are subject to prejudices and biases, potentially from the workforce and, if they are in the workforce, from people receiving care. I want to pay tribute to the whistleblowers who spoke to that people working on that report for speaking out against the abuse and vulnerability they face, not just in the case of Ted and Noel but across the country. It is vital that LGBT people are free to live and work in care homes where the culture is inclusive and respectful.

Many people who require care and support may not have children; not just LGBT people but, as the hon. Member for York Central (Rachael Maskell) pointed out, other people too. It is essential that we have strong systems to protect them and we do not just rely on other friends and family members to pick up discrimination or abuse.

Care providers have a key role in safeguarding, and all the relevant care professions are subject to employer checks and controls. Guidance from the National Institute for Health and Care Excellence is clear that care homes must have a safeguarding lead and that they should make sure everyone knows who that is. As part of its inspection regime, the Care Quality Commission checks that care providers have effective systems to keep adults safe from abuse and neglect. I will set out some of those robust processes.

Local authorities have a duty to investigate safeguarding concerns under the Care Act 2014. Anyone who is concerned that an adult with care or support needs is at risk of or experiencing abuse or neglect should contact the provider and the adult safeguarding team in the relevant local authority. If someone is in immediate danger or it is believed that a crime, including hate crimes, has been committed people should contact the police too. Any form of abuse or neglect is unacceptable, and we need a focused and effective safeguarding system.

All social care providers already have a duty to be respectful of an individual’s protected characteristics, including their sexual orientation, and make sure that their staff have the appropriate training to cater for the individuals in their care. In its role, the CQC takes a preventive approach to people experiencing prejudice or abuse, and looking at the quality of care for LGBT people in adult social care has been one of its equality objectives over a number of years. It is important that those who may be more likely to experience discrimination are listened to and have their needs understood by the local authority. That is why, from now on, the CQC will assess equity in outcomes and consider how local authorities ensure that people with protected characteristics under the Equality Act 2010 are understood. The new duty we have created for the CQC to assess local authorities’ delivery of their Care Act duties went live in April 2023, and that will make a big difference in ensuring that those at the authority level are thinking actively and working on this vital issue.

CQC assessment of local authorities will increase transparency so that those who might be more likely to experience discrimination, such as LGBT people, are able to hold their local authority to account. It is not just about raising and enforcing standards; it is about having the resource to provide a good service. That is why I am making the record increase in social care funding that we have set out, with an extra £7.5 billion overall, including nearly £600 million for the workforce development plan, so that we have a high-quality social care workforce as well as strong rules.

Leadership is key to developing an inclusive culture. The funded delivery partner of the Department of Health and Social Care, Skills for Care, has produced resources for care providers to help to develop a stronger awareness of the importance of equality and diversity standards. That helps social care leaders and their teams develop an inclusive and confident approach to diversity. I am aware that there are some providers that cater specifically to the LGBT community, which I think is great, and I want to recognise their important work. The hon. Member for Dulwich and West Norwood mentioned Tonic and I pay tribute to it and others across the country for their work. However, it is not just about them; it is about making sure that social care settings are suitable for everyone, whatever the setting.

I thank the hon. Members who have taken part in this important debate today and for shining a light on this important issue.

[Mr Jonathan Lord (Woking) (Con)]

I congratulate the hon. Member for Dulwich and West Norwood (Helen Hayes) on securing this debate, and on her moving and thoughtful speech. A lot has been said about driving such behaviour out of social care settings, but I wonder whether the Minister might say a little bit about the role that the police might have. We all want a fantastic ethos from social care settings, from local government and from national Government, but even with reasonable recruitment policies and so on, if there are bad apples in the sector, the damage they can do to vulnerable people over years or decades can be quite devastating. We need to make sure that those people are driven out if they get a police record, and are never able to enter that sector again.

[Neil O’Brien]

Absolutely. The police take this issue more and more seriously, which is vital. Some of the things that we have been talking about today, including in the “Stripped of all Pride” report, are clearly criminal offences, and it is important that we bring to justice all the people who do them. There is always much more to do, but the Government take this matter deadly seriously; it is horrific and appalling to hear about some of the treatment that people have experienced, and we are determined to stop that, using every single tool we have.

Oral Answers to Questions

Jonathan Lord Excerpts

Tuesday 11th July 2023 Commons Chamber

[Neil O’Brien]

Of course we are taking action to improve public health, and that includes children’s nutrition. That is why we are spending £150 million on healthy food schemes, such as the school fruit and vegetable scheme, the nursery milk scheme and Healthy Start. It is also why we are investing £330 million a year in school sport and the PE premium and a further £300 million through the youth investment fund. We will continue to take action on this key issue.

[Mr Jonathan Lord (Woking) (Con)]

I am delighted that a new diagnostic centre is shortly to be built at our terrific Woking Community Hospital, very close to Woking town centre. Does the Minister agree that providing state-of-the-art diagnostic care right in the heart of the community can cut NHS waiting lists, reduce carbon emissions and, most importantly, help to optimise health outcomes for patients?

Obesity Strategy 2020

Jonathan Lord Excerpts

Thursday 27th May 2021 Commons Chamber

[Mr Jonathan Lord (Woking) (Con) [V]]

While I welcome many aspects of the Government’s obesity strategy, today I want to argue against the Government’s outlined proposals to restrict TV and online advertising for high- fat, high-sugar and high-salt foods.

These proposals are blunt tools that will have little or no impact on obesity. The Government assess that both the TV watershed ban and the full online ban will lead to just a 4.5 daily calorie reduction among overweight children. That is completely inconsequential compared with initiatives such as The Daily Mile or Couch to 5K, which have the potential to increase calorific expenditure by about 100 calories a day, or targeted, community-based approaches, such as the Health, Exercise, Nutrition for the Really Young—HENRY—programme in Leeds or the Three Area Project in Wakefield. Those two programmes are based on a holistic approach. They address education, activity levels and food inequality, and have had measurable success.

Commentators might argue that the proposed bans do not matter, but they have large adverse impacts on broadcasters, online news media, advertising and production companies, food and drink companies, retailers and the hospitality sector. Advertisers have made it clear that this ad spend and investment will not be rerouted back through other channels but could leave the UK market altogether. The bans will reduce the advertising revenue that media reinvest in programming and content. They will prevent food and retail companies and the hospitality trade from communicating with their customers. They will impact jobs and remove most incentives food manufacturers have to invest in healthier alternatives in this market, because the alternatives themselves may still fall within scope.

The Quebec ban on advertising to children, introduced as long ago as 1980—incidentally, for reasons other than to tackle obesity—had no effect on childhood obesity rates in that province, compared with other provinces. Indeed, the prevalence of being overweight or obese among children in Quebec grew by 140% during the first 15 full years of the advertising ban—a faster increase than elsewhere in Canada, where those restrictions did not exist.

The UK’s advertising restrictions, currently in place across broadcast and non-broadcast advertising, including online advertising, are already among the strictest in the world. They restrict the exposure of HFSS advertising to children under 16. Although TV restrictions have been in place since 2008 and have reduced child exposure to HFSS on TV by around 70%, this has made no measurable impact on obesity rates. These current plans are disproportionate and not evidence-based; they are not targeted at the problem that the Government say needs to be addressed, which is to protect children. Indeed, they are sweeping and comprehensive, requiring new laws and a new regulatory structure.

I urge the Government to liaise much better with industry. The Committee on Advertising Practice, the advertising code body, has put to Ministers an alternative proposal to this online ad ban, which is targeted, workable, effective and enforceable. So, let us do that. Let us engage rather than have these damaging and over-the-top regulatory proposals.

Health Visitors (England)

Jonathan Lord Excerpts

Wednesday 23rd October 2019 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Mr Bone. I congratulate my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) on securing this important debate.

I also congratulate Members on the degree of consensus that there has been about how important health visitors are to each and every family they touch. I may not be able to answer Members’ contributions directly, but I will ensure that if there are further points to make after this debate, I will write to Members in due course. I pay tribute to my hon. Friend’s leadership and support on the issue of children and young people, and particularly his efforts to focus on those first 1,001 days, which can impact on social, economic and physical outcomes throughout life. I strongly agree about the importance of early years intervention, and that strengthening support at the very start can stop problems escalating and help the broader family. As both my hon. Friend and the hon. Member for Liverpool, Wavertree (Luciana Berger) pointed out, we can stop these problems before they start, or we can certainly intervene.

My hon. Friend made strong arguments for the value of health visitors and their ability to cross every threshold, which cannot be overestimated. Good health is one of our country’s greatest assets, and we cannot take it for granted; just as we save for retirement, we should be investing in our health throughout life, from the cradle to the grave. Starting in childhood—actually, even before a child is born—we can help to ensure that our children enter the world, and that they are raised, healthy and happy.

Most babies get a fantastic start in life, benefiting from the support of loving parents and dedicated health professionals. However, we know that some lives can be easier than others, often because of circumstances over which those babies have no control and the conditions in which they are brought up. Children who live in more deprived areas are more likely to be exposed to avoidable risks and have poorer outcomes by the time they start school. As the hon. Member for Liverpool, Wavertree pointed out, some of those things have impacts further down the line: at the weekend, a teacher said to me that if a child has poor linguistic skills, that will affect their ability to learn to read because of phonics and so on. It is right, therefore, for support to have a clear focus on reducing inequalities and targeting investment to meet higher needs.

The Government remain absolutely committed to working with partners to identify how to support growth in the community workforce, including through district nurses, general practice nursing, GPs, health visitors and school nursing—the team that my hon. Friend the Member for East Worthing and Shoreham described so well. We are taking significant actions to boost the workforce, including training more nurses, offering new routes into the professions, enhancing reward and pay packages to make nursing more attractive and improve retention, and encouraging those who have left nursing to return. I know that there is still post-qualification, but I do not pretend that there are no challenges; many Members have articulated the challenges that exist, particularly issues such as CPD, which we are aware of and are working on.

We know that the electronic staff records show a reduction in the number of health visitors employed by NHS organisations. However, we also know that this is not a complete picture of the health visitor workforce, who may be employed in social enterprises, private sector organisations or local government. I want to work with partners such as the Local Government Association and the Institute of Health Visiting to establish a much clearer picture, which is what the IHV asked for in its “Health Visiting in England: A Vision for the Future” report—I think it was recommendations 12 and 13. That will help to move the debate forward.

I am pleased that Health Education England is also leading on the development of a specialist community public health nursing standard. That standard will cover several roles, including those of health visitor, school nurse, occupational health nurse and family health nurse, and I am keen for that development to progress swiftly. Currently, as my hon. Friend mentioned, a specialist level 7 community and public health nurse apprenticeship is in development. That apprenticeship will offer an alternative route directly into the health visiting profession, on top of existing pathways that enable people to qualify as health visitors. We must make the best use of these highly skilled and valued members of the profession and of the broader healthcare family, and we must ensure that they can optimise the good they can do when they intervene in children’s lives.

Local authorities remain well placed to commission health visiting and early years support, but they should do so in partnership with all those around them.

[Mr Jonathan Lord (Woking) (Con)]

Like many other Members, I have been contacted by some terrific health visitors, in my case from Woking. They do a wonderful job, but against a very difficult financial backdrop. As the Minister looks to resource this area in the future, can we make sure that there is fair funding across the country, including to our counties?

[Jo Churchill]

I thank my hon. Friend for his intervention, which links to the fact that fragmentation also remains a challenge throughout the system, running counter to the aim of whole family support that my hon. Friend the Member for East Worthing and Shoreham mentioned. I believe strongly that there is scope to improve collaboration between councils and NHS bodies in order to improve delivery, particularly on important issues such as breastfeeding, immunisation and the like. The digital child health programme is one area in which we are helping to overcome barriers, securing national backing so that information is shared properly between key professionals. That is particularly important for strengthening the links between primary care and health visitors. However, there are further areas in which we can work together better to support those with higher needs, and I intend to reflect on the points made during this afternoon’s debate and work further on the recommendations of the “Vision for the Future” report.

The commitment to grow the public health grant as part of the local government settlement underlines the Government’s commitment to protecting and improving the health of the population. Local leaders remain well placed to make decisions for their communities; there is a disparity across the piece, and we need to better understand the data. Local decisions should be based on robust assessments of local needs, supported by workforce plans.

Research also suggests that there are short and long-term educational and socio-emotional benefits from early childhood education and care. That is why we have prioritised investment in early education; the 15 hours of free early education for disadvantaged two-year-olds is welcome. However, those benefits start earlier—with a person’s interaction with their health visitor when they are 28 weeks pregnant, or even before that, in personal, social and health education lessons in schools. In those lessons, we talk about healthy relationships and equip our young people with advice on issues such as substance abuse and parenting.

In the prevention Green Paper, we announced our commitment to modernise the Healthy Child Programme to reflect the latest evidence about how health visitors are part of a wider integrated workforce, providing support. Doing so provides an important opportunity to work with partners, and I will take my hon. Friend the Member for East Worthing and Shoreham up on his offer, made in his recent letter, to bring with him academics and other interested parties—I note that there are interested parties across this Chamber—to talk about how we can best move this forward. I want to ensure that support is both universal in reach and capable of a personalised response, focusing support where the additional needs suggest we should put it.

I understand the continued focus on five mandated contacts, which provide a vital opportunity for contact with families, and national data shows that coverage has improved. However, I take on board the points that have been made; I do not want to reduce contact to those five moments, and there have been some interesting conversations about other points of contact. I have heard some within the health visiting profession say that they are being pushed to tick the box but miss the point, and I have spoken to my local health visitor lead about that issue. Health visitors are highly qualified professionals who have an important leadership role, and I wish to reinvigorate that role. Through working closely with commissioners and other professionals, particularly midwives, health visitors are critical to a child’s journey.

If we are serious about supporting early intervention, that means starting with relationships. Becoming a parent is an important time in anyone’s life, but it does not come with a manual; we all need help, and professionals have an opportunity to give evidence-based advice and support. Our vision for prevention encompasses the whole of life. We are now reviewing the prevention Green Paper, including the response to it by my hon. Friend the Member for East Worthing and Shoreham. We will ask ourselves what more can be done, and we will work with local authorities and NHS bodies to address that question.

To give every child the best possible start in life and the opportunity to fulfil their potential, we need to fundamentally change the way we operate. I want to ensure that systems are in place to help infants as they develop, move to school and grow into adulthood; to overcome fragmented service provision; and to make the best of what exists, while using the evidence to maintain a resolute focus on additional needs. I look forward to working with my hon. Friend, and I am optimistic that we can make the change.

Department of Health and Social Care: Treasury Funding

Jonathan Lord Excerpts

Wednesday 4th September 2019 Commons Chamber

[Robert Halfon]

I thank my hon. Friend. He has attended every debate I have secured on the Princess Alexandra Hospital in Harlow. That shows that there is not just support across Essex and Hertfordshire, but from as far afield as his constituency of Strangford and across Northern Ireland. His question, in essence, is about important funding for devolution and fair funding across the board. I completely agree with him and I thank him again for coming, on this fifth occasion, to support my campaign for a new hospital in Harlow.

We need a new hospital for four substantive reasons. First, and there are no two ways about it, the hospital estate is falling down. It is crumbling around staff, patients and visitors, so much so that it is inhibiting the work of our hardworking NHS staff who brought the hospital out of special measures in 2018. The Health Secretary himself, having visited the hospital at the start of this year, stated in this Chamber that:

“the basement of Harlow hospital is in a worse state of disrepair than the basement of this building.”—[Official Report, 1 July 2019; Vol. 662, c. 941.]

That is saying something, Madam Deputy Speaker.

Given that the Palace of Westminster has been promised a £3 billion restoration, I ask the Minister: when will the Treasury prioritise the crumbling basement of our NHS hospital in Harlow? Whenever I visit Princess Alexandra Hospital—as a patient, visitor, or in my capacity as an MP—I am genuinely astounded by the quality of care and exceptional service that is delivered, as was the Health Secretary on his visit. Following a comprehensive tour, he said:

“I’m incredibly impressed with how much the staff are managing to do in the current facilities.”

My inbox, however, is filled with the anxieties of constituents about the pressure on A&E and the condition of the estate. The doctors, nurses and specialists are working in extremely tight spaces, in an immensely pressurised environment. Staff simply cannot be expected to make service improvements, nor to meet NHS waiting time guidelines. I ask the Minister: how can we expect our NHS staff to deliver the high standards that we demand when they do not have the physical space, bed capacity or modern equipment to carry out their jobs?

In no other working environment would we expect as much in the 21st century. The remarkable hospital staff —everyone from the cleaners, porters, ancillary staff, nurses, doctors and consultants to the management team, led by a very special chief executive, Lance McCarthy —have progressed in leaps and bounds. I am particularly grateful to the chief executive for his decision to keep domestic services in-house, protecting the jobs and livelihoods of many Harlow residents.

In July, I was delighted to welcome Kathy Gibbs into Westminster for the NHS parliamentary awards. She was a finalist for the lifetime achievement award after dedicating her entire career to Princess Alexandra Hospital in Harlow. The neonatal unit has received a number of accolades for its dedicated care and has recently been shortlisted as a finalist to receive the Bliss neonatal excellence team award. Should the Minister wish to see at first hand the brilliant work that is done in the busy maternity ward, I encourage him to catch up with the latest series of W Channel’s documentary following TV personality Emma Willis as she joined our Harlow hospital team to train as a maternity care assistant.

All across the hospital, there is a collective effort to raise standards. The entire catering team at the hospital’s restaurant were celebrating recently, having again been awarded a five-star food hygiene rating from environmental health officers. Despite the challenges that they face, Princess Alexandra NHS staff are making progress beyond expectations. In the light of their hard work and proven capabilities, does the Minister agree that our NHS staff are some of the most deserving of a new hospital and place of work that is fit for purpose? They have shown us what they can do in an outdated, difficult working environment—just imagine what they could achieve if they were given the tools to succeed.

Our population is growing at an extraordinary rate, placing enormous strain on local healthcare resources. Our hospital, and town, was built in the 1950s to serve a population of approximately 90,000. Since then, Harlow has seen considerable change, going from strength to strength. We have a thriving enterprise hub—Kao Park—which is home to a state-of-the-art data centre and international businesses such as Pearson and Raytheon, offering unparalleled employment opportunities to thousands of residents. Thousands of new housing developments are under construction to accommodate our fast-growing population and help first-time buyers to get on the ladder of opportunity.

Yet, with this extraordinary population growth, there is unbearable pressure on staff at the Princess Alexandra. Our hospital is struggling to cope with healthcare demands from around 350,000 people, exacerbated by the closure of nearby A&E units at Chase Farm Hospital and the Queen Elizabeth II Hospital. We have one of the busiest A&E units in the country and this trajectory of growth is only set to continue. Soon, Harlow will become home to Public Health England, and we have the chance to become the public health science capital of the world, offering employment to hundreds of people and bringing in many new residents. The near completion of junction 7A on the M11 will improve accessibility to our town, encouraging investment and prospects for business expansion. Given this faster-than-average population growth, does my hon. Friend the Minister agree that we cannot expect our NHS staff to bear the brunt of such demand without giving them the proper resource—a new health campus—to do so?

It is not only about numbers. The third challenge that Harlow faces has been caused by out-of-area placements into large-scale, commercial-to-residential conversions. Permitted development rights legislation has been a disaster for our town. Many of the families placed in temporary accommodation in Harlow by London councils have additional healthcare needs and come to our hospital for medical support, yet neither our local council nor the Princess Alexandra Hospital are given any extra funding to provide this. We face unique pressures on our health and social care resources in Harlow. Does the Minister not agree that a healthcare campus would help to alleviate these pressures as well as offering space for further expansion?

Fourthly, as a champion of skills and the ladder of opportunity, which I know the Minister in his previous role cared deeply about, we need this health campus to create a hub for learning, skills, training, research and development in Essex. Already, the Princess Alexandra Hospital is winning awards for its high-quality training, mentoring and career progression. Fair Train, a national organisation championing work-based learning, awarded our Harlow hospital the gold rating—the top rating—for its workplace opportunities.

That said, the hospital faces immense challenges with recruiting and maintaining qualified professionals, in part due to the appeal of London hospitals and private practices just 40 minutes away. The new health campus would bring with it exciting opportunities for scientific research collaborations with Public Health England and local enterprises. Apprenticeships and unrivalled training courses with Harlow College would help to upskill our workforce and give Essex residents new opportunities to further their life chances.

The new healthcare campus in Harlow could lead the way in health science education and training. Does the Minister recognise the wider benefits that the new healthcare campus would have in upskilling people of all ages in Essex and Hertfordshire, creating employment and research opportunities and boosting our economic prospects? Will he help to make Harlow the health science capital of the world by granting the capital funding to make that a reality?

As the steady stream of investment into our Harlow hospital shows, the Government are aware of the unique pressures that the Princess Alexandra Hospital faces. At the start of this year, I was privileged to open the Charnley ward, a desperately needed £3.3 million development constructed in just four months. Last December, we received £9.5 million to provide additional bed capacity, and in the autumn there was a £2 million investment to make preparations for the busy winter period ahead. Does the Minister not agree, however, that it is the Conservative way to consider what is best value for money for the taxpayer and that, while short-term cash investment provides much-needed relief, it does not go to the heart of the problem?

[Mr Jonathan Lord (Woking) (Con)]

My right hon. Friend is making a brilliant case for a new health campus in Harlow. Will he allow the Minister in response to dilate a bit on the need for money to follow where population growth has taken place, as it has in Surrey and Woking? He makes a very good case for that in terms of his constituency, but of course there are wider effects as well, particularly in terms of capital investment, as he rightly says.

Drug Treatment Services

Jonathan Lord Excerpts

Tuesday 16th July 2019 Westminster Hall

[Jeff Smith]

I thank my right hon. Friend for making that important point. Durham constabulary’s Checkpoint scheme, through which low and medium-level offenders with drug dependency are diverted into treatment rather than the criminal justice system, has reduced arrests by 11% and convictions by 9.7%, and has made a positive contribution in relation to participants’ drug use, physical and mental health, finances, accommodation status and relationships. There are benefits right across society when we send people into help and treatment, rather than into custody.

A number of stakeholders have identified that the lack of resources not only puts a strain on current treatments and activities, but stifles innovation in new ideas and treatments. That leads me to another key point, which is on our wider approach to drug treatment and policy. There are measures that we can take to reduce deaths and that would lead to less demand on drug treatment services, but the Government are either not encouraging or not permitting them. The most obvious is what many call drug consumption rooms, although I prefer the term overdose prevention centres, which are aimed at those with severe addictions. People will take their drugs—they have them in their possession, so they will inject them, and there is no way that we can stop them doing that—but rather than being left to inject their drugs in a bedsit or back alley, alone with an increased risk of overdose, they can go to one of the centres, where a nurse is on hand; they can use in a sterile clinical space with medical supervision, and naloxone on hand to reverse any overdose.

There are two great benefits to the centres. First, they save lives: no one dies of an overdose in such facilities. Secondly, they also have services for addicts to engage with. It might be the first time that addicts have come into contact with services, so they could be encouraged into other treatment options. At least 100 drug consumption rooms operate in at least 66 cities around the world, in 10 countries. In a number of European countries, such as in Spain, Germany and the Netherlands, supervised drug consumption has become an integrated part of services offered within drug treatment systems.

Police and crime commissioners and health professionals have been assessing the value of piloting such facilities in various areas, but the Government position is to block the pilots. Furthermore, the Government are unwilling to revisit the legislative framework, and so are insistent that we cannot make provision for the centres. However, according to the European Monitoring Centre for Drugs and Drug Addiction last year:

“There is no evidence to suggest that the availability of safer injecting facilities increases drug use or frequency of injecting”.

Equally:

“These services facilitate rather than delay treatment entry and do not result in higher rates of local drug-related crime.”

Drug consumption rooms, overdose prevention centres or whatever we want to call them simply make sense, and it is very regrettable that the Government will not allow them to become part of our treatment landscape.

On the subject of innovative models of service delivery, I mention the Checkpoint scheme in Durham.

[Mr Jonathan Lord (Woking) (Con)]

The hon. Gentleman is making some excellent points. Does not the thrust of his argument lead to the conclusion that, if one were to regulate and control but decriminalise more broadly, many of the social ills and medical problems might be reduced? Is it not time for a royal commission to look more broadly at the troubling social disease of drugs?

[Jeff Smith]

The hon. Gentleman makes an excellent point. I absolutely agree that we need regulation and control. Personally, I am not sure about royal commissions, because they tend to kick things into the long grass a bit, but perhaps a parliamentary commission or some other way of looking at the problem, trying to come to a consensus and taking the politics out of it—stop people weaponising drugs as a political issue—is the way forward. We need to look at that, because our system is not working. This is not a debate about wider drug policy but, clearly, that policy is not working, and it is resulting in the kind of problems that we face—addicts need the kind of drug treatment services that this debate is about.

I will try to be quick, because other people want to contribute to this short debate. On innovative models of service delivery, naloxone is a life-saving medication that can be used to reverse opioid overdose. However, coverage across England remains poor and the guidance is confusing. If we cannot convince the Government to increase funding for naloxone treatment by implementing a national naloxone programme, they should at least offer national support and guidance for local authorities and prisons. Finally, on drug safety testing, the Home Office refuses explicitly to sanction drug safety testing, which is a simple measure that could save lives and result in fewer people needing treated for drug harms.

We therefore need a refocus of our spending priorities. Funding constraints are curbing the effectiveness of proven treatment and harm reduction measures at the same time as we spend fortunes on drug law enforcement. In 2014-15, for example, an estimated £1.6 billion was spent on drug law enforcement, compared with only £541 million on drug treatment and harm reduction services over the same period. However, while we know that treatment services are cost-effective and save money, the Home Office’s own evaluation of its last drug strategy could not demonstrate value for money in drug law enforcement or enforcement-related activities.

The Government, unfortunately, are preoccupied with trying to stop people from taking drugs—something no one has managed to do in centuries of human behaviour—instead of focusing on harm reduction and treatment. Problematic drug users are stigmatised by our policies and treated as criminals, leaving them less likely to access the life-saving drug treatment services that they need, for fear of arrest. Meanwhile, the services that are available—as we heard earlier—have had their funding slashed and continue to be squeezed.

I need to conclude with some proposals. First, the one consistent message from all stakeholders who have been in touch and care about the issue is that we need to reverse the cuts to our struggling drug and alcohol treatment system. We need to reinvest in those services. The Camurus report released today states:

“The evidence shows that we are fast approaching a point at which we risk doing irreparable damage to our hard-won recovery system, leaving services unable to meet the scale of need that exists.”

The Government must therefore use the upcoming spending review to increase spending on drug treatment services. They need to provide local authorities with additional funding towards those services, without which the ability of services to meet demand will continue to decline.

Among other proposals I suggest the Government should consider guaranteeing the delivery of substance misuse services by making them a statutory, mandated service to end the ambiguity about their delivery and to underline importance of protecting budgets. The Government should also look at the commissioning regime—the consensus among many stakeholders is that it is not working and is too variable—to see whether it is fit for purpose. A 2017 report by the Advisory Council on the Misuse of Drugs asked whether the constant re-procurement of addiction services creates unnecessary instability in the system, resulting in poorer recovery outcomes, which is something I have seen on a small scale in the area of south Manchester I represent. Finally, we need to remove barriers to overdose prevention centres and drug safety testing to encourage faster use of heroin-assisted treatment. Such proposals can stop deaths and reduce the numbers going into treatment. We are looking at a public health emergency, and we need to act.

The shadow Health Secretary, my hon. Friend the Member for Leicester South (Jonathan Ashworth), has talked movingly about his experience of alcoholism in his family. He has promised that a future Labour Government will reverse the decline in the drug and alcohol treatment sector. I fully support him in that endeavour, but we cannot wait. We need the Government to act to safeguard our drug treatment services and, most importantly, to safeguard those who use them.

HPV Vaccinations for MSM

Jonathan Lord Excerpts

Tuesday 7th June 2016 Westminster Hall

[Jane Ellison]

They do exist in other nations. I am making a statement of fact of how the system operates and how people access sexual health clinics. I will come to the devolved Administrations.

We have decided that the best way to resolve these and other issues is to pilot the programme. My hon. Friend the Member for Finchley and Golders Green asked who the vaccine will be available to under the pilot. The JCVI recommended a targeted programme aimed at MSM already attending GUM and HIV clinics, so under the pilot, MSM will be offered the vaccine during their existing appointment if they are at a participating clinic. Public Health England is running the pilot, which should confirm whether such a programme can be delivered at a cost-effective price.

In terms of evaluation, which my hon. Friend also referred to, data collected by clinics will be used to monitor coverage of the HPV vaccine and the proportion of MSM completing the course of vaccine. The impact of the vaccine on HPV-related cancers will obviously take many years to emerge, but the impact on the diagnosis of genital warts will be a useful proxy for that and will be seen much sooner. I expect to be updated regularly on the pilot’s progress. My hon. Friend knows that I have taken a strong personal interest in this programme, and I will of course consider how best to share the information.

I understand that some stakeholders are disappointed that we are not rolling out the programme nationally immediately and some hon. Members here today have noted that Scotland and Wales have committed to implementing the JCVI’s advice in full. However, they have yet to confirm how or when they will start. Scotland has not started yet, and we are happy to share lessons from the pilot as it is no doubt considering how to move forward. Officials from the Department, Public Health England and the devolved Administrations meet regularly on this issue and will continue to do so to share experience and learning. Health is a devolved matter.

I confirm that Northern Ireland officials are on our project board, but they do not yet have a ministerial decision on how they will respond to the JCVI advice on MSM. Obviously there are issues to be raised with that devolved Administration.

The key thing to stress is that this is a large-scale pilot and I was somewhat disappointed by some of the stakeholders’ comments, particularly talk of stalling or of small pilots. This is a large-scale pilot that should eventually reach up to 40,000 MSM— more than 35% of those who attend GUM and HIV clinics annually. It will have a good geographical spread, including areas with the highest MSM populations, as well as rural areas with smaller MSM populations. That is relevant because, although there has been some piloting of vaccination in some clinics, it has been in a very limited geographical area and would not tell us enough about how this would work in practice in a national roll-out. The pilots will have a much broader spread. I can also confirm that the pilot will use the vaccine Gardasil-4 which was successful in the recent HPV procurement exercise.

I am pleased to announce that the pilot in England has already started. Two clinics went live in the pilot yesterday and others will come on board as soon as they are ready, hopefully over the next few months. There has been a positive and enthusiastic response from clinics invited to participate, and I am grateful to all those working on the ground to make this happen.

My hon. Friend asked how long the pilot will run. It will run during 2016-17 and decisions on next steps will be dependent on the progress and outcome of the pilot.

[Jonathan Lord (Woking) (Con)]

Like other Members, I pay tribute to the leadership on this issue of my hon. Friend the Member for Finchley and Golders Green (Mike Freer) whose work is appreciated across the House.

I have been following the debate very carefully, but it is not clear in my mind how a pilot of MSM will act as some sort of proxy or in any way affect the decision on immunising schoolboys. I do not see how one will inform the other.

[Jane Ellison]

I have not claimed that one is dependent on the other. They are two separate recommendations from the JCVI, and I will explain what is happening with boys. There are many questions about extending the HPV vaccine to boys and I understand the wish for it to be available to all adolescents regardless of gender. The JCVI is reconsidering its initial advice on this and modelling is under way to inform its consideration. Public Health England expects to complete the modelling by early 2017 and the JCVI’s advice is expected to follow soon after that, after which we can respond. We will look at that as a priority when we get it.

We have discussed in this Chamber whether we can speed that up. I recognise the frustration that people have expressed and I have talked personally to Public Health England officials who are involved in the modelling work. It would be a huge programme to roll out to adolescent boys and JCVI needs to base its advice on very robust analysis of cost-effectiveness. To do that, a complex model is being built. I have been assured that this is not about additional resource. I have asked whether it is a case of needing additional resource to speed the work up, but I am assured that it is not. It is because of the complexity of the model development and the fact that some of the models are time-consuming to run. Essentially, they are modelling behaviour over time, and to do that, one needs time in order to be able to understand how different aspects of the model interact with one another. I have been told—I have no reason to doubt this, because I have asked experts involved in it—that shortcuts could undermine the validity of the results and could not be supported by the JCVI. The model is building on the cervical screening model to create an integrated model of both HPV screening and vaccination, so that we get an understanding of what the interplay is between vaccination and screening programmes in the prevention, diagnosis and treatment of HPV.

I am happy to write with more detail to hon. Members, but I hope that I have given them a sense of the fact that this is complex work: it is under way and we will look to respond to it as soon as we can. However, these are important decisions that the JCVI will take and, because the Government have always acted on its recommendations, it is important that it gets them right and they are based on the right data. This is a significant programme, but the work is well under way and I will look to report back to the House at every opportunity I can.

The HPV vaccination programme for girls is going very well, and there is now scope for an additional programme to make a difference to the lives of MSM, which this will. The pilot will provide answers to the questions that we still have and the answers that we need for a programme of this nature—I have hinted at some of the delivery complexities. We expect to see benefits from the pilot emerge relatively soon through the reduction in genital warts cases and through treatment in MSM, particularly by targeting higher risk MSM.

I hope that that updates the House as fully as possible at this stage. As I said, I will be happy to update it in the future on how the pilots are going. I want to end by again congratulating my hon. Friend the Member for Finchley and Golders Green on initiating the debate and on his persistent campaigning, and to reassure and commit to the House my determination to improve the health and wellbeing of MSM and to see this pilot as a significant step forward in that task.

Oral Answers to Questions

Jonathan Lord Excerpts

Tuesday 26th November 2013 Commons Chamber

[Mr Hunt]

As the hon. Gentleman will know, we are constantly reviewing all policies that could reduce tobacco use among young people. Smoking is the No. 1 killer, so dealing with it would be the best way of reducing this country’s premature mortality rates, which are far too high.

[Jonathan Lord (Woking) (Con)]

23. Does the Secretary of State agree that transparency is critical in improving hospital standards and that, following the Government’s latest measures in response to the Francis report, the health cover-ups by the previous Government will never be allowed to happen again?

[Mr Hunt]

The Labour party does not like to hear this, but the reality is that micro-managing the NHS through top-down targets failed to deal with the problems of compassionate care. My hon. Friend is absolutely right that the best way to deal with this is through total transparency, so that when we are sure there is a problem, the public find out about it quickly and it is dealt with quickly.

Stillbirth Certification

Jonathan Lord Excerpts

Wednesday 31st October 2012 Westminster Hall

[Chris Heaton-Harris]

That is my intention in raising this debate today. However, this is about not just the certification element, which I hope the Minister will answer, but the need for more awareness of all the issues around stillbirth and neo-natal care.

Having the flexibility for parents to be able to choose to have a birth and death certificate for babies born after 24 completed weeks of pregnancy but showing no signs of life, would massively help a large number of parents in their grief and show that the state recognises that they had a wonderful child. As some parents would be distressed at the possibility of having to go down that route, I wonder whether we could have a more flexible system whereby parents have the choice of a formal birth certificate, a stillbirth certificate issued by the hospital or—if they so choose—nothing. In modern society, we have the ability and sensibility to deal with the matter of certification, which is important to most of the parents to whom I have spoken because it is a simple process of formally naming their deceased baby.

Over the course of my time in this place, I have raised the matter of stillbirth certification a number of times. However, on each occasion I have received a similar reply from the Department of Health. One reply said:

“The registration of stillbirths and live births serve different purposes.”

It helps Departments collect statistical data and

“enables us to monitor the causes of stillbirth.”

Another reply said:

“Different state benefits are available to parents depending on whether a child was live-born or stillborn, so it is important to be able to distinguish one certificate from another.”

I completely understand the need for the state and the Department to be able to collect these important data for use in research. In fact, I am keen to encourage the Department to do more. However, I simply cannot understand why in 2012, with all the modern technology that we have at our disposal, we cannot, in a sophisticated way, collect all the data that are required and issue birth and death certificates when they are requested by parents.

[Jonathan Lord (Woking) (Con)]

I am grateful to my hon. Friend for giving way and I commend him for pursuing this issue in Westminster Hall when I know that there is another debate very close to his heart going on in the main Chamber. Does he have any information that he could share with us about how other countries do things, which might help to nudge the Department of Health in the right direction on this matter?

[Chris Heaton-Harris]

There is actually quite a lot of information out there. There is a very good charity called Sands, which has brought me lots of examples of best practice from across Europe, and indeed from different states in the USA. I am not saying that those methods would all work if they were brought into the NHS. However, by looking at the research that has been going on in Denmark and in Australia, and at the best practice in France and in some states in the US, we might be able to form much better practice in the UK to spread throughout the NHS. There are examples of good practice out there, and although I cannot cite them “fact for fact” off the top of my head right now, the charity Sands has all that information on its website. Sands is a very good resource for information.

I want to go back to the issue of what the state can do when it comes to stillbirth certification. I am quite sure that a sensible and easy solution can be found that allows these certificates to be issued and at the same time enables the state to have all the right information that it might require about any situation around each stillbirth.

Knowing that this debate was coming up, I asked some parents to try to help me to express why this new flexibility—if we are able to have it—would help them. A mum in my local area called Michelle told me this:

“My son was 9 days past his due date when he died at the end of my labour in May 2011; he weighed 7 pounds and 7 ounces, had wavy fair hair and was perfect. I can still feel the weight of him in my arms and how soft his skin felt. To be told your child has died is the worst pain a parent can feel but to be told they will not be recognised as a person in their own right but a statistic is heart-breaking. My son looked like any other baby, I went through a labour like any other mother but I didn’t have the happy ending. Going to the registry office to register his death was made harder knowing that the parents waiting with us would be registering their baby’s birth yet we would only be allowed to register our son’s death, not given the dignity of having a birth certificate. I feel I am being punished for not having a child that was lucky enough to take a first breath or to hear his first cry. A birth certificate is incredibly important to me and unless you have lost a child who has had the misfortune of being labelled as stillborn it is difficult to understand the need for this recognition. I have been lucky enough to go on to have a daughter, I love both my son and daughter equally yet they are not treated equally in the eyes of the law.”

She went on to say:

“This cruel law needs to be changed, what sense does it make to only register the death when the baby has to be born first regardless if he will take a first breath.”

I know from previous conversations that I have had with the Minister that he completely understands all the issues that I have raised here today, and I very much look forward to hearing his comments. All I ask is that he returns to his Department, reflects on today’s debate and considers whether it is actually not too difficult to build into the system the flexibility that I and a large number of parents from across the country would like to see. It would mean a great deal to a lot of people, Michelle included.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

Thank you, Mr Owen, for calling me to speak. It is a great pleasure to serve under your chairmanship; like my hon. Friend the Member for Daventry (Chris Heaton-Harris), it is the first time that I have done so.

I pay particular tribute to my hon. Friend for raising this matter in Westminster Hall today. He and I have worked together in the past to raise awareness of the need to do more to support those families who have had the terrible experience of stillbirth. We have also worked together in the past to discuss the need for greater research in this area. He is absolutely right to highlight a number of the issues that he has raised today, and I will deal with the issues that he has raised in turn.

In my own medical career as a doctor, I have never seen anything more tragic than either a very badly injured or ill child, or a dead baby. The death of a baby is probably the worst situation that I came across, and losing a child is the worst experience for family and friends; it lives with people for ever. For some families, there is no coming to terms with the death of a child. It is a very difficult thing to live with and we must continue to do all we can to support those families, working with Sands and the other organisations that do a very good job in supporting those families; we must continue to do more.

My hon. Friend quite rightly highlighted the unacceptable regional variation in stillbirths. From the figures for 2011, we know that the strategic health authority for the north-east of England reported 5.8 stillbirths per 1,000 live births, whereas the SHAs for the east of England and the south-west of England reported 4.7 stillbirths per 1,000 live births. As I say, that is an unacceptable variation. There is an acknowledgment by the Royal College of Obstetricians and Gynaecologists, by the Royal College of Midwives and by Sands and many organisations that we need to do more to reduce the rate of stillbirths in this country. We must continue to do more to research the factors that cause stillbirth. As my hon. Friend said, in many cases the cause of a stillbirth is still unclear. We also need to continue to crack down on this unacceptable regional variation, and learn where there is good practice in combating and reducing stillbirth rates and where the NHS is doing things better, so that that good practice can be rolled out across the country.

As I said, the death of a baby, whether during pregnancy or following birth, is probably the worst tragedy that anybody can face, and that is true both from the point of view of a health care professional and from a family’s perspective. Stillbirth is not only the loss of a child, but the loss of all the hopes and dreams that the family would have had about what that baby would have become and what it would have meant to them in the years ahead. That is why it is particularly important that this is an area that we continue to focus on, to reduce stillbirth rates and so that both the Department of Health and medical professionals take this issue increasingly seriously. As my hon. Friend rightly highlighted, our stillbirth rates are 33rd out of 35 high-income nations and as a country we need to do better than that and improve on those rates.

[Jonathan Lord]

I am glad to hear my hon. Friend the Minister and my hon. Friend the Member for Daventry (Chris Heaton-Harris) talk about the work of Sands. I myself have had constituents come to me with the help of Sands, and my hon. Friend the Minister speaks very well about that organisation and about the real hurt of those families who have suffered a stillbirth.

However, could my hon. Friend the Minister just give us a little bit more information as to why he thinks the stillbirth rates in this country are higher than they should be, and why they are higher than the rates in many other western countries? What are the reasons behind that? That is the crucial thing—to stop this terrible tragedy happening to other families.

[Dr Poulter]

I thank my hon. Friend for that question, and he makes a very good point. As we have said today, we have high stillbirth rates in this country. One factor that the Royal College of Obstetricians and Gynaecologists has picked up on is the fact that there are sometimes variations in clinical practice, including in picking up on early warning signs that we know are associated with stillbirth, for example reduced foetal movements during pregnancy. That sort of thing always concerned me as a front-line professional and it concerns many midwives.

However, we need to have in place across the NHS better systems so that professionals can work with women to identify those early warning signs that something may be wrong in a pregnancy and to ensure that women come in quickly and seek help, or hopefully, rather than seeking help because something is going wrong, in many cases they can seek reassurance. However, where things are not right for a baby, we must ensure that the medical help is on hand to intervene quickly and to support the pregnant woman and hopefully mum-to-be.

There are parallels that can be drawn between where we are now with stillbirths and the situation with cot deaths a number of years ago. Back in the 1980s, the cot death rate was very high, peaking at 2.3 deaths per 1,000 live births in 1988. Following the launch of the “Back to Sleep” campaign in the early 1990s, the rate declined dramatically, falling to 0.6 deaths per 1,000 live births in 1995. This reduction has continued as awareness of the key messages on reducing the risk of cot death has increased. By 2010, the rate was 0.22 per 1,000 live births. To put that in real life rather than statistical terms, we are actually talking about a reduction from some 3,000 cot deaths a year to 300 or 400, which is not perfect, because we still have babies dying of cot death, but raising awareness and targeting cot death has proved to be an effective way of reducing rates. That is something we can learn from in the discussion we are having today about stillbirth.

The point that all hon. Members have made today is that the decline in stillbirths in the United Kingdom has not kept pace with that of comparable countries. According to The Lancet, we rank 33rd in the world for stillbirths. We need to ensure that we do better and take this issue seriously.

Both my hon. Friends have spoken about Sands. It is worth highlighting what that organisation has done. It provides tremendous support for families who find themselves in very difficult situations. It has highlighted the vital importance of the Government and the medical profession—midwives are taking this issue on board and are taking it more seriously—supporting families to make sure that in future pregnant women and families do not have to suffer the problems associated with stillbirth.

Sands has raised a number of issues, including research, which we have talked about and which I will come on to in a moment, and the fact that action is required to raise awareness, as we saw with cot death in the past, of the known risk factors for stillbirth so that prospective parents can make better choices and understand what could go wrong in pregnancy and what the warning signs may be—for example, reduced foetal movements. We need to ensure that parents are informed and that health care professionals know how to support parents and pregnant mums to help them to recognise the warning signs. They need to provide reassurance and care where appropriate and need to intervene when very serious concerns are raised.

We have said that it is not acceptable that the UK has one of the worst stillbirth rates in the developed world. We have developed a stillbirth prevention work programme, which my hon. Friend the Member for Daventry alluded to earlier. The Government are taking this piece of work very seriously, in conjunction with the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists, and the NHS to help to iron out the unacceptable variations in practice and the unacceptable regional variations that we have talked about.

The development of this work programme has been informed by a workshop jointly hosted by Sands and the Department of Health, which took place on 1 March this year. Discussions focused on key areas such as raising awareness and improving identification of babies at risk and improving perinatal reviews. We are continuing with this work to ensure that we can put that into practice throughout the NHS so that we provide pregnant mums with the support that they deserve.

My hon. Friend rightly raised the issue of research. It is important that we fully understand stillbirths. We do not always know what the cause of a stillbirth was. It is important that we do research and look into what the unknown causes and reasons might be. What are the factors that cause stillbirths? We know some of the causes; we do not know all of them. Continuing to research and focus on that is important.

The Government have funded a number of research programmes. Most recently, the Department has funded research through the National Institute for Health Research and the policy research programme. An estimated spend relating to maternal and foetal health has increased from £4.4 million in 2006-07 to £12.7 million in 2010-11. The issue of improving foetal health, babies’ health and maternal health is something that we take very seriously.

Working with Sands, the Department’s policy research programme has funded a policy research unit in maternal health and care at the national perinatal epidemiology unit at Oxford university. Research themes focus particularly on pregnancy loss, perinatal morbidity, maternal morbidity and maternal mortality.

The National Institute for Health Research in Cambridge has an ongoing programme of research on women’s health. A major focus of that research is understanding the determinants of stillbirth risk and using that understanding to improve clinical care of pregnant women. Indeed, last week I visited Manchester where there is a very high quality of care for pregnant women and for newborn babies. The university of Manchester’s maternal and foetal health research centre is currently leading projects in understanding the reasons for stillbirth. I know it will be looking to feed that in nationally so that we can continue to reduce stillbirth rates.

Research on its own is not enough. When we have the research, we have to ensure that we get it out there to the professionals, sharing it and the information from that with parents, to help them to make informed choices about their care and to be aware of the risks and the possible warning signs of stillbirth. Raising awareness is so important. It is an issue highlighted in particular by the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists. They have said that there is unacceptable variation, as we have accepted in this Chamber, in the rate of stillbirth and in how some health care professionals interact with families and pregnant women during pregnancy. Working up national guidelines that focus on professionals supporting families, as well as being aware of the other factors, is an important part of reducing stillbirth.

Another point made by my hon. Friend is that families who have suffered a stillbirth have not always received good bereavement support. We know that a lot of care and attention has been paid to ensure that more support and care is given to families—the royal colleges have taken that on board—and we are looking seriously at how we can provide more support. Many hospitals and trusts have invested in bereavement rooms and quiet areas for families when they have had early pregnancy loss or a stillbirth. That is right, because although maternity things generally go well and we have a good outcome, when things go badly we need to ensure that we are prepared and have a supportive environment to look after families in such circumstances.

Finally, it is important to focus on certification, an issue raised by my hon. Friend. I will look into the matter in more detail and get back to him in writing as well, rather than try to put together an answer in the two or three minutes available to me. He made the point that some mums who give birth have to go through the whole birthing process—they actually give birth to a dead baby—and that is an incredibly traumatic and difficult thing to do, because they know that their baby is not alive. Some mums, however, have to do that. In such situations, although the law, with such things as birth and death certificates, is there for good reason, the human reality is sometimes not recognised in the law as effectively as we might like. There will, though, sometimes be difficulties with law, however we have it. As best we can, we have tried to mitigate such situations by beginning to provide more supportive environments for parents after a stillbirth and by providing certificates recognising that there has been a stillbirth after 24 weeks. That goes some way towards recognising the difficult and tragic event—we recognise that a baby has been born, although the baby was not born alive. I will write to my hon. Friend in more detail in the next few weeks, because the issue deserves more than a few sentences at the end of the debate.

I thank my hon. Friend and pay tribute to his work on raising awareness of such an important issue. The Government are very much committed to taking forward our work with Sands and ensuring that we reduce stillbirth rates in this country, as well as providing more research to investigate the causes of stillbirth and better support for bereaved parents in what is perhaps the most difficult thing I have ever seen in my medical career.

Question put and agreed to.