Neonatal Leave and Pay

Luke Hall Excerpts

Wednesday 9th February 2022 Commons Chamber

[Luke Hall (Thornbury and Yate) (Con)]

Every year in the UK, tens of thousands of babies receive neonatal care. For the families of these children, the experience can be life changing. Neonatal care is the type of care that a baby receives in hospital if they are born premature, full-term but with a condition or illness that needs medical attention, or with a low birth weight. Rather than families bringing their child home shortly after birth, the child is admitted to a specialist neonatal care unit to receive the support that ensures they receive the best possible chances of survival and quality of life.

A wealth of evidence already exists that shows that, for children in neonatal care to have the best possible outcomes, they need their parents to be as involved in their care as much as possible and as early as possible. The Government already agree with this, and that the current leave and pay entitlements do not adequately support parents when their child is born sick or premature and requires neonatal care.

Many parents and campaigners have welcomed the proposals wholeheartedly to deliver neonatal leave and pay that will allow parents to take additional time off work when their child is in neonatal care, ensuring that they are no longer in the impossible position of having to choose between keeping their job and spending time with their baby. I am grateful to have secured this Adjournment debate to highlight the importance of delivering the Government’s commitment to delivering neonatal leave and pay by a set target date of 2023, and to make the case for how those in all parts of the House can work together to overcome the challenges and provide this vital support for families at the earliest possible opportunity.

[Jim Shannon (Strangford) (DUP)]

First, I commend the hon. Gentleman for securing this Adjournment debate. I welcome this discussion as an essential part of employment reform, and I support him fully in his wish to expedite legislation so that both parents can take this leave together as a shared benefit. For that reason, I understand he will have lots of support right across the Chamber to achieve his goal.

[Luke Hall]

I thank the hon. Gentleman for his support because for me, like for so many parents, this is personal.

In my own family’s case, my wife was admitted to hospital 22 weeks into her pregnancy following a number of complications, and we were completely unprepared to be told at that point—22 weeks in—that she could give birth at any time and that she would have to stay in hospital for the duration of the pregnancy, as well as that if she did go into labour, our baby might not survive long after childbirth, and if they did, the overwhelming likelihood was that they would live with significant disabilities or challenges.

Even with the incredible and compassionate support that you receive from neonatal intensive care unit consultants, taking you through every step and answering every question, there really is nothing that can prepare you for that type of conversation or for the choices that you are asked to make. I know that all parents deal with that in their own different way, but for me it left a mark that I know will never really leave me.

In our case, like so many others, this meant staying in hospital and praying every single day that the pregnancy lasted as long as possible. Every day feels like a month, but also like an incredible accomplishment, and I was in complete awe of my wife and so many other women who handled everything so magnificently. Six weeks later, our son, William, was born on 6 January last year, weighing just 2.4 lbs.

We did not know that our son was not breathing when he was born—we found that out a lot later; I cannot remember exactly when—but I do remember being told that he was going to be okay, and my wife was able to hold him for a few moments before he was taken to neonatal intensive care, where he stayed for 72 very long days before coming home. I would like to take this opportunity to thank the incredible team at Southmead Hospital and our midwife, Bev Alden, who was genuinely superb in going above and beyond the call of duty to support us.

The reason why I have highlighted this point about the journey before birth to the Minister at the start of this debate is to make the serious point that, for so many people, having a premature child is a very long journey. It does not start the day the child is born; it can start weeks or months beforehand. Delivering neonatal leave and pay supports families in one part of that journey, but not for the whole journey. There is more that Government, businesses, organisations and individuals can do to support them, but neonatal leave and pay is one thing the Government can do quickly.

Currently, the parents of a child in neonatal care rely on their existing statutory leave entitlements so they can be off work while their child is in hospital. That means that parents spend a proportion of their maternity or paternity leave with the baby in hospital. Babies who have spent a long time in hospital after birth are usually at an earlier stage in their development when their mother or parents go back to work, in comparison with their peers. That can be particularly challenging for mothers, many of whom would have liked to have additional time with their child but cannot afford to take any more time off. That leads only in one direction—less parental involvement in care, causing immense stress and leaving parents unsupported. It reduces the opportunity for bonding time with their child.

The current system is also a massive barrier for fathers and non-childbearing parents in particular. Earlier this week, 75% of parents who responded to a survey from Bliss, the incredible charity, said that they or their partner went back to work before their baby was home from hospital. Some of those children will still have been on ventilation and receiving critical care. Previous research suggests that the most common reason for that is they simply cannot afford to take more time off work. That is happening every single day, right around the country, to families of premature and sick children.

Paid leave for parents of babies in neonatal care already exists in different countries around the world. In Ireland, paid maternity leave is extended by the amount of time between birth and the original expected birth date, and there is a similar system in Germany. In Sweden, maternity leave begins at the point the baby is discharged from hospital, rather than the birth date. Here in the UK, the Government and we, generally, have a record of supporting parents to be proud of. We have a generous and flexible system for many parents. The Government and the Minister are committed to making the UK the best place possible to live and work, and that includes the ability to grow and raise a family. That is why so many people were delighted by the Government’s commitment to finally deliver on neonatal leave and pay and to put it in the last manifesto.

I want to make the point of the significant mental and emotional toll on parents in the situation of having a child in neonatal intensive care. Research by Bliss back in 2018 shows that 80% of parents who have a child admitted to neonatal intensive care felt that their mental health suffered, and a huge 35% of parents report that their mental health was significantly worse after time on the neonatal unit. Regardless of the circumstances, parents want to be with their children. That is obvious; all parents will say that. But when your child is so small and vulnerable, it is painfully difficult to be apart from them. You just want to be there.

Even when they are in the best possible hands, a NICU can be a really worrying and scary place to be. They take some getting used to, because you are with lots of new people, there are children in very difficult circumstances and just because of the noise—the constant beeping from equipment around the unit takes getting used to. The mental pressure on parents is huge. I would say to anyone trying to understand the experience, imagine having to sit with your child in an incubator or having to learn how to feed your child through a tube, while worrying whether you can afford to pay your bus fare home. For too many people, that is the case.

Imagine going through this journey while feeling guilty about not spending time with the children you have at home, because you are in the NICU every spare minute of the day. You feel guilty, because you are unsure how to hold and support your child. When you do have time at home, I promise every spare minute is spent in a permanent state of worry about receiving unscheduled telephone calls from the hospital bearing bad news, which, for too many, do come. You worry about the pressures that it puts on you as a family, and about how you would cope as a family unit if the worst were to happen. I distinctly remember our darkest day when we were told that our son was going downhill quickly and he was going to be treated for necrotising enterocolitis, and that one potential outcome for which we would have to be prepared was for him to be transferred to a hospice.

Let me make this point to the Minister: we cannot expect parents to be worrying about whether they will have a job to go back to while dealing with these situations. The Government agree with this—there is no disagreement—so it is time for us to work together to deliver it. The Government want to do it, and I know that the Minister does as well. He has been hugely supportive to me and to colleagues on both sides of the House who have talked to him about this issue on a number of occasions. I thank him for his help, and I also thank the Government for the work that they have done on the issue since the general election.

In the March 2020 Budget, the Chancellor reaffirmed the Government’s ambition to deliver this important reform, and earmarked the necessary funding to deliver the policy in 2023-24. In the same month, the response to the consultation was published. It confirmed a number of further details about the delivery of neonatal leave and pay, including the intention to legislate through the Employment Bill. I was pleased to hear the Prime Minister, during Prime Minister’s questions in November last year, repeat the commitment to deliver legislation “one way or another”.

So we all want to do this. The question is how are we going to do it, when, and through what vehicle in Parliament? Ministers have made clear that they want to do it through the Employment Bill. The argument I would advance to this Minister is that the Employment Bill is significant and substantial legislation that will take time to pass through Parliament. While neonatal leave and pay enjoys widespread cross-party support, many wider aspects of the proposed Bill are likely to face far greater opposition. Despite the uncontroversial nature of the proposal, tying its successful delivery to the more controversial Employment Bill is not the fastest way in which to secure its introduction.

Generally when we are introducing reforms of this type, they take effect from April, at the start of the financial year. In order to meet the 2023 target for which the Government have set aside funds and to which they have committed themselves, neonatal leave and pay legislation will need to have passed through Parliament before that date, in enough time to ensure that Her Majesty’s Revenue and Customs and employers are given sufficient notice. If we are to meet the commitment to deliver this on time, we need to start now.

I wrote to the Minister about the issue in October, and he kindly wrote back to me, informing me of the progress that his Department was making. He also made it clear that significant work was required for the policy to be delivered, including the extra work that would have to be done by HMRC to ensure that staff were ready to upgrade the necessary IT systems. The policy will take time to implement, and that is why I think there are legitimate questions to be asked about the delivery vehicle for this reform. I should be grateful if the Minister could confirm that the Government still intend to deliver it from April 2023.

I think that one clear way in which this can be delivered on time is through a stand-alone Bill. The policy development and the consultation have already taken place, and there is a precedent for passing reforms of this type through Parliament quickly. The Parental Bereavement (Leave and Pay) Act 2018 provides a clear model for us to pass this legislation. It is uncontroversial, and it has cross-party and cross-sector support. In the past, the Minister has made a point that I completely appreciate—that this will have to be delivered alongside other measures in the Employment Bill—but I should be grateful if he could explain exactly what those measures are, and also explain why they cannot be delivered as part of stand-alone legislation. I also ask him whether he will meet me, the new Leader of the House—assuming that my right hon. Friend is willing—and other Members to discuss how this can be delivered on time, which is what we all want to see.

I do not want to give too long a list, but I should be grateful if the Minister could update the House on the work that he and his Department have already done in anticipation of delivering this policy, to ensure that it will be ready on time and ready to go once we can find a legislative vehicle to deliver it. I should like to know whether, for example, the guidance is ready for the Department for Business, Energy and Industrial Strategy and HMRC, and how much work has been done. Finally, I should like to know whether the Department is starting to explore alternatives to deliver support for families if it proves difficult to legislate. I hope I have managed to convey at least a sense, on behalf of many families around the country, of how important this commitment is and how grateful we are to the Minister and the Government for making it. We all want to see it delivered and rolled out as quickly as possible. It is down to us to find the right vehicle for that, because delivering neonatal leave and pay will enable the thousands of babies born into neonatal care every year to benefit from their parents’ being where they should be, by their side, providing that vital care. It will also deliver support and reassurance to all those new mothers, fathers and carers who need it the most in the most vulnerable and stressful days of their lives. I say to the Minister, “The solution is clear, it commands widespread support and it is within our grasp—please help us to make it happen.”