Baby Loss Awareness Week

Justin Madders Excerpts

Tuesday 10th October 2017 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

This has been a compelling debate, which has once again shown the House at its best. I welcome the fact that we are discussing these issues again in the Chamber as part of Baby Loss Awareness Week. I hope that these extremely valuable debates will become an annual fixture, because they provide us with a very valuable opportunity to raise awareness of the work of the 40 baby loss charities who work together as the Baby Loss Awareness Week Alliance. They also give us the opportunity to assess what progress has been made in meeting our shared ambitions to improve prevention, treatment and bereavement care.

I recognise the work of the all-party group on baby loss. It is true to say, as a number of Members have today, that it has played a key role in ensuring that this issue is kept at the top of the Government’s agenda, and that some of the taboos that have so often surrounded this subject are broken down. There have been a number of excellent contributions from Members on all sides and I am grateful for the opportunity to be able to draw attention to some of them.

The hon. Member for North Ayrshire and Arran (Patricia Gibson) mentioned coroners’ inquests and fatal accident inquiries for stillbirths—an issue she has raised on a number of occasions. I pay tribute to her for her persistence in that campaign. She certainly made a compelling case that such inquiries would inform good practice and, more importantly, bereaved parents may get answers that they have not previously had.

The hon. Member for Colchester (Will Quince) spoke with great passion and personal experience, and in his capacity as the co-chair of the APPG. He touched on a range of issues and highlighted the importance of mental health. I was rather troubled by what the hon. Member for Banbury (Victoria Prentis) said. I certainly recognise her description of a culture of defensiveness in certain trusts. She was absolutely right that most parents want answers, not compensation. We need to do more about the way in which the NHS handles these issues.

My hon. Friend the Member for Nottingham South (Lilian Greenwood) told us about her constituents, Jack and Sarah, who have recently spoken publicly about the tragic circumstances of the death of their daughter, Harriet. They felt that what they were told was not correct and want coroners’ inquests to be available for stillborn children. As my hon. Friend said, there seems to be growing cross-party support for such a move. I assure her that the Opposition Front Bench will do what we can to assist in making that campaign a reality.

The hon. Member for Eddisbury (Antoinette Sandbach), who also co-chairs the APPG, was right to pay tribute to the NHS staff who have really taken up the challenge laid down by the APPG of improving the experience for parents. She rightly drew attention to the wider public health factors that we need an awful lot more work on, and raised an important point about the need for CCGs to commission bereavement counselling consistently across the board. It is often a concern that CCGs do not commission services consistently across the country, so more examination and accountability is required.

My hon. Friend the Member for Kingston upon Hull North (Diana Johnson) spoke about her constituent’s son, William, whose ashes were scattered without his family’s knowledge. She spoke about this in the debate last year, so I am sorry to hear that there are still many unanswered questions. I hope that she does not have to come back to this debate next year to raise the same issues.

My hon. Friend the Member for Slough (Mr Dhesi) spoke about the terrible circumstances affecting one of his constituents and the need to improve awareness of group B strep. In last year’s debate, the right hon. Member for Mid Sussex (Sir Nicholas Soames) advised the House that one baby a day develops group B strep. We should be able to do a lot more about that, given that it is a largely preventable infection.

The hon. Member for Thirsk and Malton (Kevin Hollinrake) highlighted well the gaps in the law on bereavement leave. I wish him success with his private Member’s Bill. He made the valid point that we are also employers, so it is probably worth us examining the Independent Parliamentary Standards Authority terms and conditions following the debate to see whether there is anything more we can do to ensure that we are an exemplar.

We were privileged to hear from the hon. Member for Sleaford and North Hykeham (Dr Johnson), given her professional experience. She conveyed well how difficult it is for staff in some of these situations. Her reflections on her last 16 years in practice were informative and positive, and she made some excellent points about areas in which we can do better. I hope the Minister will take those points on board.

As we have heard from many hon. Members’ contributions today and in previous debates, the efforts of people here and among the public have gone a long way towards breaking down taboos. I pay tribute to those who have done so and the efforts of others in the public eye to raise awareness. For example, “Coronation Street” had a storyline involving a stillbirth earlier this year. I am sure that such television programmes have an even greater reach than Parliament TV. What made that storyline so poignant was that Kim Marsh, whose character portrayed the stillbirth onscreen, herself suffered a bereavement eight years before. She said of the broadcast that

“sharing is absolutely imperative to being able to put the pieces of your jigsaw back together”.

That is incredibly sound advice.

Many parents have spoken of the isolation they can feel, and we have heard from hon. Members today about how that has been a taboo subject for a very long time and about the difficulty people can have in discussing the loss of their child for what seems like many years. A constituent of mine, Nicole Bowles, is in that situation. She has set up a campaign, called Our Missing Piece, to make it easier for parents to let other people know that their family is missing a loved one. She has designed a badge for bereaved parents to wear as a way of telling the world that they are dealing with child loss. Her ambition is very simple but could have a very positive impact. She says:

“I hope that by creating this badge it helps to show that: It’s OK to talk to us; It’s okay to ask if we’re alright; It’s okay to say their name.”

I commend her campaign and I hope that this debate has gone some way to conveying the sentiments she expresses about the need to talk about these issues and break down the barriers that have been there for too long.

We know from the recent review of stillbirths and neonatal deaths in the UK that of the 782,720 births in 2015, 3,032 were stillbirths and 1,360 were neonatal deaths. This amounts to about 12 stillbirths or neonatal deaths every day. That is a huge number of families each and every week experiencing one of the biggest, if not the biggest, tragedy of their lives. It is a difficult figure to process, particularly because, as the hon. Member for Witney (Robert Courts) said, sometimes these deaths could have been avoided.

It is of course positive that perinatal mortality has decreased in this country, but the level of progress has not been good enough. According to The Lancet, the annual rate of stillbirth reduction in the UK has been slower than that in the vast majority of high-income countries. One of the key reasons for that is the high level of variability in the services offered. This country offers some of the best neonatal care in the world, along with some exemplary psychological and bereavement support, but unfortunately that is not available equally to everyone. Last year, NHS England reported a 25% variation in stillbirth rates across England. That is a startling figure, but it demonstrates that we have the capability to meet and exceed the Government’s target to reduce the number of stillbirths by 20% before 2021 if we ensure that everyone has access to the very best care and treatment. I welcome the progress the Minister referred to earlier towards meeting that target, and I hope that he will be able to update us annually on progress. I also invite him to consider whether it would be appropriate to expand the scope of the Government’s ambitions to focus also on reducing the number of premature births, given that prematurity contributes to a significant number of stillbirths and neonatal deaths each year.

As well as variability, another area where we need to make significant progress is ensuring safe staffing levels at all times on all neonatal units. The 2015 Bliss report “Hanging in the Balance” found that 64% of neonatal units did not have enough nurses to meet the national standards on safe staffing and that 70% of neonatal intensive care units regularly looked after more babies than was considered safe. As we know from exchanges this morning in departmental questions, there are huge challenges in the workforce at the moment, and the Government have set out their strategy to deal with them, so I hope that we will see progress. It is certainly something that we will be monitoring closely.

Finally, I turn to the key theme of this year’s Baby Loss Awareness Week, which the hon. Member for Colchester referred to: bereavement care. This is an area that stretches from the level of support available immediately following a neonatal death to the medium and long-term support available to families. I welcome yesterday’s announcement on the national bereavement care pathway, which will see 11 sites in England trial the use of new materials, guidelines and training for professionals. The trial, leading to a full roll-out in a year’s time, has the potential to tackle long-standing and unacceptable variances in bereavement care and ensure that all bereaved parents are offered equal, high-quality, individualised, safe and sensitive care, which is something everyone in the House wants to see.

I suspect that the challenge of a successful roll-out will be ensuring that sufficient time is set aside for the training that staff will need. I welcome the news from the Minister about the funds and support that will be available for the delivery of that training, but we must recognise that training is a continuing process, and we must keep an eye on progress in the years to come. As I said earlier, another big challenge is ensuring that the workforce are in a position to deliver the pathway. Last year, Sands found that 38% of maternity units did not have a specialist bereavement midwife based there, while Bliss has found that 30% of neonatal units do not have access to any psychological support.

There is also a need for capital investment. We have heard from a number of Members today about the importance of bereavement suites, and we know that one in three trusts and health boards does not have a dedicated bereavement room in each maternity unit. I am aware that the Government have ambitious plans to release significant parts of the NHS estate, and I should be grateful if the Minister could reassure us that there will be consideration of the shortfall in the number of bereavement suites before any disposals proceed.

There is much more to be done, but I think the hon. Member for Eddisbury (Antoinette Sandbach) summed up the position well when she said that, for the first time, there was some hope. Let us continue to move forward in that spirit.