Preventable Baby Loss

Karin Smyth Excerpts

Wednesday 4th September 2024 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mr Dowd, and to speak for the Government in this important and moving debate. I am grateful to the hon. Member for Ashfield (Lee Anderson) for raising this important issue. As my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) said, it is the last taboo, and the hon. Member for Clacton (Nigel Farage) articulated well the difficulties that many people have in knowing what to say.

The debate gives me the opportunity to put on the record my deepest sympathies to the bereaved families: thank you for making the decision to come here today. Others might be listening in on the Parliament channel. The decision to attend is brave, and I commend the hon. Member for Ashfield for giving voice to the moving and harrowing stories of Emma and Rob, Bianca Chapman, Amelia Bradley and Hayley Moore, about their babies, Olivia, Imiza and Theo.

We know that preventable baby loss remains a serious issue every time such debates come before the House. Today, we have heard how many people have taken part in previous debates; I have listened in before. What little consolation they must be for parents and wider families who have lost a loved one, but I am always inspired. I hope that the families present today recognise that every Member of Parliament is also a human being, with their own experience and that of their families. The issue touches every family; as the hon. Member for Strangford (Jim Shannon) said, it stays with families for decades. Sharing such experiences is brave of hon. Members, but they have given voice to how important the issue is.

Every baby’s death is tragic, but all the more devastating when parents are told that it could have been prevented. As we have heard, report after report has told us that this remains a serious issue in our health service, and that is backed up by the data. Two years ago, the Office for National Statistics found that almost 2,300 stillbirths were recorded in England and almost 1,700 neonatal deaths, a rate of 2.9 per 1,000 live births.

In 2022, I welcomed the Ockenden review, as many did, but it made for harrowing reading. The Government’s position is that any preventable death is unacceptable. We are committed to ensuring that all baby deaths that can be prevented will be prevented. Donna Ockenden’s review shone a light on maternity staff too exhausted to do their jobs. It showed patterns of poor care, a lack of adequate training for staff, and failure in governance and leadership that led to widespread avoidable harm and death, and to shocking inequalities in maternity provision. Dr Bill Kirkup’s review of East Kent identified similar themes, but also showed that leadership and culture changes were needed. That is why this Government stood on a manifesto commitment to train thousands more midwives and to set an explicit target to close the black and Asian maternal mortality gap.

There are a number of initiatives, some of which we have heard about today, and I will run through some of them. If I do not address some concerns expressed by hon. Members in my update, we will get be in touch with people, including the official Opposition—I commend the hon. Member for Sleaford and North Hykeham (Dr Johnson) on her experience in this area as a clinician as well as a spokesperson.

The NHS put in place a three-year plan to deliver the reviews’ recommendations to make maternity and neonatal care safer, more tailored to every new mother’s needs, and more equitable. That includes the Saving Babies Lives care bundle, which is being rolled out to every trust. That provides maternity units with guidance and interventions to reduce stillbirths, neonatal brain injury, neonatal death and pre-term birth. That will need to be updated regularly, but I will confirm the details to the hon. Lady.

The plan also includes initiatives to reduce inequalities. As we have heard, a serious cause for concern is the higher rate of stillbirths, neonatal deaths and pre-term births among babies from the black and Asian ethnic groups. Babies of black ethnicity are about twice as likely to be stillborn as babies of white ethnicity. That is unacceptable in modern Britain. We will not rest until outcomes are equally good for everyone in this country.

We also know that women living in deprived areas, not least my own constituency, are more likely to suffer adverse outcomes. In 2022, the stillbirth rate per 1,000 births in the 10% most deprived areas in England was 5.0, or 389; in the 10% least deprived areas in England, the stillbirth rate was 3.7 or 155. All local maternity and neonatal systems have equity and equality action plans in place to tackle such inequalities. NHS England is investing £10 million every year to target the 10 most deprived areas of England.

Wider work is also important. NHS Resolution’s maternity incentive scheme is improving maternity safety by rewarding NHS trusts that demonstrate that they are taking concrete steps to improve the quality of care for women, families and newborns. The National Institute for Health and Care Research has commissioned studies into how we can prevent pre-term births and improve care for mothers and babies. This year it launched a £50 million funding call, challenging researchers and policymakers to come up with new ways of tackling maternity inequalities and poor pregnancy outcomes.

There are ongoing initiatives to ensure that lessons are learned from every individual tragic event and to prevent similar events from happening in the future. All hospitals already carry out internal perinatal mortality reviews, which create reports that aim to provide answers for bereaved parents about why their baby died. They also help hospitals to improve care and ensure they try to learn something from every tragedy, wherever it happens.

The maternity and newborn safety investigations programme conducts independent investigations of early neonatal deaths, intrapartum stillbirths and severe brain injury in babies following labour. All trusts are required to tell the programme about these incidents. It will then carry out an independent investigation and make safety recommendations to improve maternity services. Coroners are also required to investigate deaths that are violent, unnatural or of unknown cause, although their remit excludes stillbirths; but that should leave no stone unturned when it comes to uncovering the cause of death, including an inquest where appropriate. Additionally, as of June 2024, I am assured that all NHS trusts have signed up to the national bereavement care pathway, which many hon. Members have raised today.

The existing measures, taken together, are helping to achieve improvements; we have already heard about some of the positives. Since 2010, the neonatal mortality rate has decreased by 25% for babies with at least 24 weeks’ completed gestation, the stillbirth rate in England has decreased by 23%, and the overall rate of brain injuries occurring during or soon after birth fell by 2%. But we know, and have heard so movingly today, that more must be done.

People rightly expect assurances that lessons will be learned and that things that went wrong are not repeated. As hon. Members have pointed out, the sad truth is that we are likely to be debating these issues in the future, when the CQC releases its next report on maternity inspections and when Donna Ockenden completes her investigation into Nottingham. I expect to be speaking with hon. Members again about this issue, and my noble Friend Baroness Merron, Minister for Patient Safety, Women’s Health and Mental Health, will be following that very closely.

Many of the issues identified locally are being repeated across the country, so I am clear that national leadership is needed. The Government will be honest about the challenges facing the health service and are serious about tackling them. I will listen to women and their families and do everything I can as a Minister to help deliver safer and fairer maternity and neonatal services for women and their babies. I really commend hon. Members who have shared their experiences today— particularly new Members; I do not think I would have been able to do that as a new Member of Parliament. My hon. Friend the Member for Washington and Gateshead South spoke very honestly about how long it took for her to do that. That was valuable.

It may not be for me to say as Government Minister, but I commend the work that my hon. Friend the Member for Washington and Gateshead South and other colleagues across parties have done in the APPG on baby loss. They have raised these issues and worked with Government Ministers, which is really important as parliamentarians. I hope that is reassuring to families here today. That work will hopefully be continued by parliamentarians across the House. Perhaps that will be an outcome of the issue being raised today, so early in this Parliament.

We need to listen to these women and their babies. We need to make sure that we have the midwives and other staff necessary to keep women and their babies safe. Before I finish, I should say that if I have missed anything, hon. Members should please get in touch. I say to my hon. Friend the Member for Sheffield Hallam (Olivia Blake) that we welcome the Tommy’s miscarriage pilot, and my ministerial colleague will be looking closely at those recommendations.

As a new Government, we want to end sticking-plaster politics; that means real and lasting change in the health service. That will take time, but we will build a better future for women in this country. That includes by making sure that all baby deaths that can be prevented will be prevented.