Access to NHS Dentistry

Siobhan Baillie Excerpts

Thursday 10th February 2022 Westminster Hall

[Siobhan Baillie (Stroud) (Con)]

I congratulate my hon. Friend the Member for Waveney (Peter Aldous) on securing the debate. I enjoyed the spirited contribution by the hon. Member for Bootle (Peter Dowd)—particularly the characteristic political attacks. That highlights part of the problem that we are dealing with here. If we are unable to recognise the failures by a number of different Governments across a number of decades, we will never get solutions. Equally, if we continue constantly treating the NHS or anything about it as a political football, we will paralyse this country and things will not get done.

I know that the Labour party likes to blame everything on the Government, but today’s debate has been really useful for hearing all the different elements of what is going wrong for NHS dentistry, including the part that the NHS itself can play in handling HR, looking after staff and retention. I think that is important.

This is a critical, crucial health issue for my constituents in Stroud, as it is for other Members’ constituents. We have a number of different points of casework related to this issue, and we get emails about it all the time. Anybody who has had toothache knows that it is debilitating: we cannot get on with our day, we start off grumpy, and we end up not speaking—my husband likes that bit. Anybody who has seen a child with decaying teeth starts to worry about what is going on at home, and about the health and future of that child. They are right to do so, because once those teeth are decaying, it is very difficult to repair them.

I thank all of Stroud’s dentists: like other Members, I had so many dentists contact me during covid to offer help. They were some of the first people to be frustrated by the restrictions placed on them, but also the first to offer help. In Gloucestershire, the CCG has seen a drop of 17 NHS dentists between 2019-20 and 2020-21. That is a drop of 5% in one year, so it is a very worrying development, as colleagues have said. We believe that it is also likely to under-represent the real fall in capacity, because most dentists tend to reduce their NHS contracts before leaving the service, and only 33% of adults in Gloucestershire saw an NHS dentist in the two years to June 2021.

To provide some colour and some real-life experience, one of my constituents moved to Stroud in January 2020. She fell pregnant and was entitled to free dental care, but by the time she had obtained her MAT B1 certificate, she was unable to find a dentist. She could not find a dentist throughout her pregnancy, when she would have had that free dental care, and still has not found one. She spoke to 15 dentists in the local area—Stroud, Wotton, Stonehouse and Gloucester—all of whom told her that they were not accepting new NHS patients. One interesting and worrying point that she raised with me is that all of the dentists’ surgeries she spoke to that were accepting children as NHS patients—her little one is about one year old now—were doing so only if their parents joined them on a private basis. She and her husband have found themselves having to join on a private basis and pay the fees to make sure that her little one has NHS cover. So many parents would not have that option, but I do not think it should be my constituent’s only option for getting support for her child.

There are three key areas I would like the Minister to cover, and I have no doubt that she will do so. Norfolk desperately wants a training centre, just in case she has not got that point. First, what is the explanation for the delays in creating the improved new contracts for NHS dentists? We are spending £3 billion: why are we still in a situation where the actual terms of the contract—the piece of paper—are preventing people from getting into this worthy, skilled and amazing profession?

Secondly, what is the plan to address the recruitment issues? We have heard that almost 1,000 dentists quit the NHS last year; we have heard about the people going back to European countries; and we have heard that people are not coming from further afield abroad. Can existing resources be used to improve recruitment and retention? The Minister has responded to me very clearly: we have similar problems with midwifery services. We have lots of recruitment and retention issues in the NHS, so there are similarities; what can we do?

Thirdly, how are the Government using the post-pandemic period to reimagine NHS dentistry in both areas, the preventive action and the responsive package? With preventive action, we are hoping to bring in family hubs around the country that children can access from birth. Can those hubs be used to improve children’s and families’ awareness of healthcare and dental health? Also, turning to the responsive package, the points about data collection really worry me. As we have heard from a number of colleagues, we are never going to improve services if our CCGs around the country do not have the information they need.

Finally, I want everybody to think about the pain of toothache. It is absolutely awful to go through, and our constituents are really worried about this. I think we can make changes: I do not think that this is just a money issue, and given that there is so much cross-party support to make a change, I hope that we can do so.

Down Syndrome Bill

Siobhan Baillie Excerpts

3rd reading
Friday 4th February 2022 Commons Chamber

[Siobhan Baillie (Stroud) (Con)]

It is a pleasure to speak in this debate. I congratulate my right hon. Friend the Member for North Somerset (Dr Fox) on all of the work that he has done. I see that team Freddie and a number of friends are in the Public Gallery providing their support.

This Bill means a lot to thousands and thousands of campaigners. There are 47,000 people with Down syndrome and their families around the country. I give particular credit to the families from Stroud and Gloucestershire who have reached out to me to express their delight that this Bill has been introduced and also to explain their experiences and why it is so important. This is actually a spectacular use of a private Member’s Bill. I am also thrilled that the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), is at the Dispatch Box. We have discussed Down syndrome for many, many years, because we are both blessed with nephews with Down syndrome. Those boys give us great joy, particularly as a distraction from this mad job.

The Bill proposes, for the first time, a duty on the Secretary of State to give guidance on housing, education, youth offending and national health authorities. It also imposes a similar duty on the relevant authorities, which is very important. The guidance will set out the steps required to meet the needs of people with Down syndrome, and I sincerely believe that it will be the start—and it is the start—of many other areas of policy and work to undo some of the problems that people with Down syndrome face in their daily lives.

My nephew, Rhys, is now 19 years old. He is the light of every room he enters. He works for the Thames Valley Cleaning company at the Select Car Leasing Stadium for the Reading Royals. He is right royally unimpressed with me—I am not cool, particularly when I am in a suit on the telly, so I hope he is not watching now. Let me relate part of Rhys’s story—[Interruption.] I am sorry if I get upset. It is not just because I am pregnant; I once tried to talk about Rhys in Camden Council many years ago and cried then as well—

[Mr Mohindra]

Let me give my colleague a brief respite. I know that she is a massive fan of the Bill of my right hon. Friend the Member for North Somerset (Dr Fox) and I look to hearing further words from her.

[Siobhan Baillie]

I am blessed by having great colleagues in this Chamber.

Alice fell pregnant aged 15. As she was so young—we had no Down syndrome in our family and there is a common belief that only older, geriatric mothers as they are often referred to in maternity terms have Down syndrome children—Alice was not offered any advice. She did not have any discussions about Down syndrome. She was 15 and scared. Her family was not around her, we did not know about the pregnancy in the early stages, and I doubt that she asked any questions. It was 20 years ago, too, so there were few smartphones and limited ability to google.

When Rhys was born, Alice was immediately in love with her baby son, but a few days later, my nurse mum spotted signs of Down syndrome. Notwithstanding the absolute love that she felt for her child, it is fair to say that my sister was pretty shocked by what was happening. Remembering that she was still a child herself and all the hopes and dreams that go into a pregnancy, I have since spoken to other parents of Down syndrome children and parents of other children with disabilities—

[Mr Mohindra]

On that point, does my hon. Friend agree that we need a real focus not just on the person with Down syndrome but on the bubble around them—carers, friends and family—because they are involved in the potential ups and downs of the journey as much as the person with Down syndrome themselves?

[Siobhan Baillie]

I completely agree. I have spoken to other parents who have discovered upon their child’s birth that they have a child with a disability about their fear, and about the loss of their hopes and dreams; their belief that they would take the child to university, or to get married, is dashed. With Down syndrome in particular, people believed that the child would die aged about 30. There is such a lack of education. That was particularly the case when Rhys was born, but I think it is still true now. Thinking about the bubble—the whole family—is incredibly important, and that is hopefully what the Bill will do. So much of what we think we know when it comes to disabilities is often not true.

[Ruth Edwards]

My hon. Friend is giving an incredibly powerful account of her personal experience. I know that she works with many parents and people with Down syndrome. Does she think that support for new parents to come to terms with and understand the condition of their child has improved at all since her sister gave birth, or does she believe that we are still quite far off the mark?

[Siobhan Baillie]

That is a really important question. I think there have been improvements—my right hon. Friend the Member for North Somerset will attest to that—but there is still a lack of understanding and education. We have a real issue with people feeling that they need to have a termination when they are told about Down syndrome. There is a big campaign on not screening out children with Down syndrome, because they live very fulfilled lives and bring great joy to so many people. Education for all is really important.

[Jonathan Gullis (Stoke-on-Trent North) (Con)]

Let me quickly add my support for the Bill introduced by my right hon. Friend the Member for North Somerset (Dr Fox). On the point that my hon. Friend the Member for Stroud (Siobhan Baillie) made about education, we need education not just for expectant parents or young people but for employers too. One of the things that shocks me most is that there are plenty of people who have Down syndrome who could, if they wanted, be in our workforce playing a fulfilling role. We know that the benefits of work include increased life expectancy, as well as better physical and mental health. Warwickshire County Council had a great scheme supporting employers to understand how to support not just people with Down syndrome but those with other learning disabilities, and how to make them an important part of their workforce. That encouraged a lot more people to enter the world of work. Does my hon. Friend agree that those are the sorts of things that we need to see happening, so that employers understand the full potential of everyone across our United Kingdom?

[Siobhan Baillie]

I completely agree. Rhys earns £9 an hour—he is far richer than me, because he has no outgoings—but he enjoys his job and he feels fulfilled by it. Schools such as The Shrubberies in my patch do an awful lot of work to make sure that people go on to be work-ready, as do our colleges, such as SGS Stroud. Again, that is why the focus that the Bill will bring for the Government, local authorities, schools—everybody—is so important. We are thinking slightly differently, and I really welcome that.

I should be honest and say that I did not handle my sister’s being pregnant very well. I was still a teenager myself. I genuinely thought that, as a teenage mum, her life was completely over and she would not get to enjoy a lot of the things that I had enjoyed, but I could not have been more wrong. She definitely had a very different life from me in many respects, but I deeply regret my lack of understanding and some of the anger I felt on her behalf. It was unjustified and it was wrong, because Rhys was the best thing that happened to all of us in our family for so many reasons. But, boy, our learning curve has been so steep. I have seen my little sister battle for the understanding of people with Down syndrome.

[Mr Mohindra]

One thing I wanted to mention was to ensure that we realise that this affected all communities up and down the country. It is not specific to a particular geographical area or heritage. Does my hon. Friend agree that the Bill will be beneficial to all communities?

[Siobhan Baillie]

Absolutely. That is so important. When I reel off this list, if I can get through it, Members will understand why it is so important.

I have seen my little sister battle for understanding about Down syndrome. I have seen her battle for the right to medical care for operations in a timely fashion. She has battled for education. She has battled for housing. She has battled to get landlords to take people with benefits. She has battled during the transition from Rhys being a child to an adult, and she is still doing that. She has battled to get the council to complete the required assessment. She has battled with the welfare system and disability living allowance appeals. She has battled with endless application forms and then had to re-do them because they have been lost by various authorities and had to start all over again. She has battled during covid. I know that a lot of families battled really fearing for their loved ones with Down syndrome, who are vulnerable, often with respiratory issues. Covid was thrown at all of us, but we found that parents were being ignored, or certainly felt they were being ignored, and not prioritised for vaccinations. The whole family was not being prioritised for vaccinations to protect the people with Down syndrome in their homes.

[Edward Timpson]

I think all of us are very moved by what my hon. Friend has had to say. Does she agree that her point about the battles she described demonstrates how important it is that, as the Government develop the guidance—I know my hon. Friend the Minister will very much have regard to this point—they involve the experiences, views, opinions and, I suspect, recommendations of those who have Down syndrome, or their parents, carers and supporters, so that they form the best possible guidance to deliver the right type of support at the right time and in the right way? That might then mean that those battles are much reduced and hopefully eradicated in future?

[Siobhan Baillie]

I thank my hon. Friend for his contribution not just in that intervention, but in his speech. I loved the Shakin’ Stevens stories. I defer to his expertise as a former children’s Minister. That is why the Bill will do so much good. Even the fact that we are having this long debate today with so many colleagues is incredibly moving. I am pleased to see that the Minister is as equally moved as me and that it is not just me with the tissues on these Benches.

These problems have existed under multiple Governments, so parties of all political colours should hang our heads but also want to see improvements. We all know, from our surgeries and inboxes, that parents of disabled children who have to come to see their MP are often completely exhausted. They are exhausted by the fights to get things for their children that they know they should already have or have seen other children have. They also know that they have no choice but to continue fighting. I know that MPs of all political colours try to help, but we have to get better at getting the legislation and the policy right so they do not get to that stage.

The Government are trying really hard to make improvements to legislation and to the system and the practicalities for people with disabilities. The Minister with responsibility for disability, the Minister of State, Department for Work and Pensions, my hon. Friend the Member for Norwich North (Chloe Smith), is absolutely excellent and I have real confidence in her ability and commitment to secure change.

As part of my small role in trying to push through those changes, I sit on the Work and Pensions Committee, and we have been doing an inquiry into things such as personal independence payments. During the inquiry, we heard from an excellent representative from the Down’s Syndrome Association. She gave a few examples of things we can change that directly impact people with Down syndrome. She explained that it is usually the parents making welfare and disability applications.

We have heard today from a number of hon. Members that, thankfully, those with Down syndrome are living much longer. Their life expectancy is no longer 30 years, but 60 years. That means that their parents are also significantly older, and we must bear that in mind. The constant drive for digital-only application is welcome in many respects and will mean there is a record, so hopefully we will not have the constant losing of paperwork that many families have to deal with. However, there are many elderly families and elderly parents who cannot cope with that, and we must build that into our systems.

Separately, there is a new in-person assessment approach to PIP, which can throw up some interesting results—unintended, in some cases. Where previously a family could sit down and do a written submission about what they needed and what they wanted changed in their PIP, doing an in-person assessment is very reliant on the person with Down syndrome.

My nephew Rhys’s favourite word is yes, because he gets a positive response to it. If someone says to him, “Do you play for Reading Royals?”, he will say yes. “Do you run for a bus?” He will say yes. One thing that my sister said made her nearly jump up and down was something like, “Do you have your own life partner or girlfriend?” He was saying, “Oh yes, oh yes.” She said, “No, no, no! He absolutely doesn’t.” We must bear that in mind when we create those policies and programmes, because it will not always work for everybody.

I welcome all the focus on and learning about people with Down syndrome today. I am still learning—I think we all still need to learn from people with Down syndrome and listen to them.

[Ruth Edwards]

I hope Madam Deputy Speaker will forgive me, given the circumstances, but I have just been interrupted by a text message from my constituent Matt Barney, a hardworking councillor in Leake and Ruddington. He tells me that his cousin, Heidi Carter, is with us today in the Public Gallery. She has Down syndrome and campaigns to reduce the age limit at which abortion of babies with Down syndrome is permitted. I wanted to take this opportunity to thank her for all her work and to welcome her here.

[Siobhan Baillie]

I am grateful for that intervention. I am thrilled—I have seen you listening intently, and it is wonderful to have you here today, Heidi.

I will draw to a close, but I believe we must all learn from people with Down syndrome. We will genuinely be a better society for having done so. I commend my right hon. Friend the Member for North Somerset and I thank charities such as the Down’s Syndrome Association—there are many charities that I should have had a big list of, and I apologise that I do not. I also love the Down Syndrome Swimming GB Twitter and Instagram accounts, and enjoy following them.

I thank the Government for listening and taking action. I look forward to seeing this Bill progress to Royal Assent.

Midwives in the NHS

Siobhan Baillie Excerpts

Monday 17th January 2022 Commons Chamber

[Siobhan Baillie (Stroud) (Con)]

In late November, midwives, doulas, families and healthcare professionals across the country marched in their thousands. They powerfully set out their concerns about the issues they face, and 100,000 people signed a petition to ensure their voices are heard. It is both a privilege and a daunting prospect to be standing here to try to represent their views.

Before I continue, I declare an interest. I am pregnant and, although I was hoping people would think I had eaten too much Christmas trifle, I realise I am now struggling to hide the bump. God willing, there will be a summer bundle of joy to give me additional sleepless nights over and above the ones that are normal for an MP. This makes me a current case study for maternity services, with literal skin, blood and placenta in the game.

So far, I am one of the lucky ones. The service I received from the Stroud and Gloucestershire midwifery teams during my first pregnancy was world class. It is testament to Gloucestershire’s commitment to local expectant mothers that I not only received consistent care during my first pregnancy but I have the same midwife again. I thank them all, and Jan Partridge in particular. Her name should be enshrined in Hansard, as she is a legend not only in my household but in many others around my community. I know parents across the country feel the same about their own midwifery teams for their help during one of the most frightening, painful but special moments of life.

I stood on a manifesto promising to make the UK the best place in the world to give birth, with personal, high-quality support. I sincerely hope that we can make that a reality. The March with Midwives manifesto sets out demands, which include: listen—they seek an urgent consultation to understand the steps required to address the immediate crisis; fund—an immediate appropriate restorative pay rise for midwives and financial support for student midwives; enable—to make it possible for self-employed midwives to work, thus putting 250 experienced midwives immediately back into the workforce and providing flexibility; and reduce—provide a £5 million crisis fund to charitable organisations for the provision of breastfeeding support and antenatal education, to reduce the pressure on midwifery staff.

The manifesto is wide-ranging, but it does highlight a number of important concerns. All the briefings that I have been sent and everything I have read indicate that many things lead back to staffing levels.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing this debate; the number of MPs here is an indication of its importance.

In the Royal College of Midwives annual survey, over half the midwives surveyed said they were considering leaving their jobs. Fifty per cent. said they would leave the NHS next year. Of those who were leaving, eight out of 10 said that they were concerned about staffing levels—the very thing that the hon. Lady has referred to—and that they were not satisfied with the quality of care that they were delivering.

Does the hon. Lady agree that urgent action must be taken today to support those midwives considering leaving the NHS, so that they feel able to do their jobs to the best of their ability?

[Siobhan Baillie]

I thank the hon. Gentleman for his intervention. Staffing issues are absolutely crucial and I want to pose a number of questions about them.

[Jeremy Hunt (South West Surrey) (Con)]

I congratulate my hon. Friend on securing this debate and on the forthcoming addition to her family.

On the point made by the hon. Member for Strangford (Jim Shannon) about staffing levels, does she agree that one of the most important reasons why we need to fill the staffing shortfalls—the 2,000 extra midwives needed immediately—is that we need to be better at identifying higher-risk pregnancies? Continuity of care, so that people are looked after by the same midwife throughout the pre-natal, birthing and post-natal periods, is an incredibly effective way to do that.

[Siobhan Baillie]

I could not agree more with both interventions. I think we are going to hear more from other Members about continuity of care, which is the way to manage pregnancy and how most midwives want to work. But that can be achieved in many hospitals and many midwife teams only if we have the staffing. Given the numbers at the moment, this is a key issue.

[Rachael Maskell (York Central) (Lab/Co-op)]

I am grateful to the hon. Member for securing today’s debate and also wish her well with her pregnancy.

I have spoken to midwives in York and visited maternity services. Many women find that they are diverted from York to other maternity services at the time of delivery—clearly, very stressful for them—because we just do not have adequate staffing. Does the hon. Member not agree that we need a proper workforce plan to ensure that women have the safety that they require through their pregnancy and particularly at the time of birth?

[Siobhan Baillie]

I think what we will hear from the Government is that there is a plan for recruitment, but we need more details. The Royal College of Midwives is certainly asking questions. My right hon. Friend the Member for South West Surrey (Jeremy Hunt) knows from the work of the Health and Social Care Committee that when the current Culture Secretary was maternity services Minister last year, she was incredibly passionate about this issue. She accepted that the NHS was short of the equivalent of 1,932 full-time midwives—but since then, sadly, the number has fallen by a further 222, leaving the shortage at over 2,000. Since records began in 2009, the number of NHS midwives has fallen in England year on year. We are in a really difficult situation at the moment.

To put this into perspective, there were more than 613,000 births in England and Wales in 2020. At the last count of midwives in 2021, there were 26,901 in England, but that drops to 22,301 if we look at part-time figures. By looking at the birth rate and the number of midwives, we can see just how stretched midwives are.

The Association for Improvements in Maternity Services says that

“urgent action is certainly needed to shore up what seems to be a maternity service that is losing staff at a catastrophic rate.”

Over half of midwives surveyed by the Royal College of Midwives say they are considering leaving their job. I know personally a wonderful midwife, Stevie, who has chosen to retire this year, and I wonder how many midwives are making the same choice. My mother, who is a nurse, not a midwife, is choosing to retire as well. They have had a pretty tough two years in the NHS, as we know, but the most worrying feature of the RCM survey, which the hon. Member for Strangford (Jim Shannon) mentioned, is that the highest levels of dissatisfaction are among newer midwives—those who have spent five years or less working in the NHS. So we have a pipeline problem, a new intake problem and a problem with retention of experienced staff.

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

I congratulate my hon. Friend on getting this important debate, and on the part she has played in looking at the best start in life for every baby, which we worked on together over many months. Does she agree that the problems not only for midwives but for the whole early years workforce have been exacerbated by the covid lockdown, with far too many families unable to see their health workers face to face and partners often excluded from important events such as scans and the birth itself?

[Siobhan Baillie]

I could not agree more, and I thank my right hon. Friend for everything she has done for early years provision. When we think about the early years and the importance of giving children the best start in life, we remember that midwives have children in their hands at year zero; it could not be any earlier than that. I will give more details of the reality of the pandemic world and what midwives and NHS staff have faced, but the effect on the beginning of the relationships and the fear when you do not have your partner with you in the ward has been absolutely awful. I appeal to all Ministers to think extremely carefully about further covid restrictions, if they ever again become necessary.

We know that the staffing shortage does not affect only midwives and hospital staff, but it has a real impact on families trying to bring new life into the world. As the hon. Member for Strangford alluded to, 87% of RCM members say that they delay using the toilet due to lack of time, more than 75% skip meals, and over half say they feel dehydrated most or all of the time at work—no doubt telling women to hydrate while unable to do so themselves. These professionals have the lives of our most precious loved ones in their hands. I ask the House: are those really the conditions we want them to be experiencing?

I have had messages from midwives all over the country. Last year, I received a letter from a former midwife saying that she was

“extremely concerned about the deepening crisis within maternity care.”

She handed in her notice. That is a loss of more than 10 years’ experience in clinical midwifery—experience that we cannot magic up overnight to replace her. She felt that she could not always provide the good, kind midwifery care that she was trained to give. She cited increasing paperwork, long hours and the inability to work hours that fitted around her family as key concerns.  She had begun dreading each shift. Being required to work faster and do more than was humanly possible meant fearing making a mistake that could lead to a tragic outcome.

Another midwife wrote a blog entitled, “How do we keep going when there is nothing left to give?” in which she talks about midwifery being a celebration of new life and how midwives get to share the joy of families starting out, but also how they are struggling in a system that does not allow them to do what they dreamed of, trained for and worked so hard for. With no staff available or even in the pipeline, the midwife describes having to close facilities, reduce antenatal education, and minimise post-natal visits. Another midwife talks about trusts having to introduce incentive payments, selling back annual leave and employing agency staff, but even then staff are declining the extra work because they are so cream-crackered and feel constantly stressed that the money just does not get them over the line.

Maternity staff are all incredibly caring human beings and they want to do a good job. They tell me they can recover from the physical strain of their job each day, but the mental anguish is weighing heavier and heavier. That mental strain is very real, as problems and errors in maternity services can have devastating consequences.

Although outcomes for mothers and babies have improved in so many areas in the last 10 years, any loss is too great. Understandably, the families affected cannot rest until they have knowledge of what happened and believe that it will not happen again. My heart breaks for them and, if I am honest, I will struggle to tell their stories without crying.

Birthrights is a UK charity that provides advice and information on legal rights, and trains doctors and midwives. The Ockenden review, which looked at maternity services, took serious evidence following the devastating loss at the Shrewsbury and Telford Hospital, and I know that the Health and Social Care Committee has also investigated maternity. Approximately 59%—about £4.2 billion—of the value of new clinical negligence claims is attributable to poor maternity care. In 2021, maternal mortality rates were found to be more than four times higher for black women, two times higher for mixed-ethnicity women and almost twice as high for Asian women. There is clearly so much more that we need to learn and change.

I know that this is issue is close to the hearts of many across this House. Between them, the Prime Minister and the Leader of the House boast a lot of experience of births, and the Minister is an excellent person to be responding given her own professional experience. The Government have made two important commitments: the first is to train 3,650 student midwives over four years, starting in 2019-20, and the second is to employ an additional 1,200 midwives. Obviously, that is hugely welcome, but given the seriousness of the situation and the fact that midwives are taking to the streets, I ask the Minister to update us on any progress and explain the recent decline in the number of midwives.

[Peter Gibson (Darlington) (Con)]

I congratulate my hon. Friend not only on her pregnancy, but on securing the debate. As the son of a community midwife, I know how hard our midwives work. The issues that she is outlining are not just about recruitment, but about retention. Does she have any ideas on how we can tackle that retention issue, too?

[Siobhan Baillie]

It would be interesting to hear from the Minister on that. Midwives and some of the marchers have suggested talking about financial payments, but there also needs to be a culture shift. If we are asking midwives to do things that they desperately want to do, such as the continuity of care, but they do not have the staff teams to do them, they will feel as though they are failing. No money in the world will make that any better. Working together constantly and joined-up thinking are important to help that retention. I pay tribute to my hon. Friend’s mother.

I have some questions for the Minister. How many midwives are currently in training and recruitment? Why are babies not counted in the patient headcount to determine staff ratios? What measures, such as flexible working, are being considered to make the profession more attractive to those who have caring responsibilities or who are choosing a second career? Are we looking at salaries and financial support for students?

The issues that midwives face are incredibly complex, and as my hon. Friend the Member for Darlington (Peter Gibson) said, it is not just about staff. Midwives tell me that, without proper administrative support to reduce their huge non-clinical workload, they feel they are drowning in their jobs. The Association for Improvements in Maternity Services says that midwifery is a service that seems unable to support its own staff, including precious newly qualified members, with frequent reports of bullying. That is incredibly worrying. In England, that cultural problem was a key focus of the “Better Births” report in 2016, and it is an issue that the ongoing maternity transformation programme has been working to address.

The pandemic restrictions, which my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) mentioned, caused huge problems for mothers and partners. Mothers are now so scared that the restrictions will come back.

[Shaun Bailey (West Bromwich West) (Con)]

Further to the intervention from our right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), I am sure my hon. Friend will be aware that, contrary to NHS guidance, my own NHS trust, Sandwell and West Birmingham, stopped allowing birthing partners to be with expectant mothers. We managed to get that decision overturned, but just to re-emphasise the point, does my hon. Friend agree that birthing partners form an important partnership with midwives in ensuring that the safety of expectant mothers is paramount in the delivery process? I am sure she will expand on that later in her speech.

[Siobhan Baillie]

I thank my hon. Friend for all the campaigning that he has done—as has my hon. Friend the Member for Rutland and Melton (Alicia Kearns), who is not in the Chamber this evening—and he is absolutely right. Birthing partners not only provide that immediate bond and that precious time with the baby; they provide support for the mother and support for the team, and have the important ability to spot what is going on. A mother who is taking quite a lot of gas and air might need someone else to have a couple of conversations when she cannot do so herself.

We are making changes in schools so that we do not see restrictions and closures again, and I think that if we are ever faced with the need to introduce further covid restrictions, we cannot do that in maternity services. The restrictions have had a knock-on impact on midwives as well: seven out of 10 RCM members have experienced abuse about visiting restrictions. That abuse may well have come from very worried and well-meaning people, but there is no doubt that it has contributed to their wish to leave their jobs.

The campaign group Pregnant Then Screwed did a great deal of work on this, and 98% of respondents to its survey said that the possibility of further covid restrictions on maternity services was causing them anxiety. There is enough for pregnant women to be worried about without their having to worry about that. Mothers reported rushing their hospital care during the pandemic, and seeking early discharge so that they could get home to be with their partners. As was mentioned earlier by my right hon. Friend the Member for South West Surrey, women-centred care is the ethos of midwifery. and continuity of carer is the national recommendation. It is the right approach, but at no stage have the current staffing levels and the impact of covid been taken into account to assess the viability of a new system. The vaccine mandate continues to cause concern, and the potential loss of more staff is adding to the pressure-cooker effect.

We in Stroud are hugely proud of the facilities that we have. In the past, Stroud constituents have come together and fought to save the maternity unit, and that fight was so strong that I do not think anyone would dare to try to close it down again. We have also recently instigated an important campaign to deal with mental health and birth trauma. Between 25% and 40% of women view their experience of giving birth as traumatic—I am probably in there somewhere—and one in four have experienced sexual abuse. Such issues often have a huge impact on fears for pregnancies and future births. The campaign and the dedicated mental health team that Gloucestershire is setting up will change perceptions and conversations surrounding birth from the off. Our minor injuries unit across the road from the maternity unit has received a welcome £2 million for refurbishment purposes. I was at the hospital recently for my scan, and it is really buzzing. Although I have raised some serious matters, I do not want expectant mums to be worried about the care that they will receive at Stroud or anywhere else, as professional maternity teams will look after all of them.

One midwife told me that midwives do not speak out because they are always trying to put the women in their charge at ease, but unfortunately it has reached the point at which they feel that they must do so, which is why they have sent me here today. That said, although a Minister will respond tonight, the issues raised are clearly not just for the Government to address. NHS trusts, their human resources teams, managers, and all of us as patients in society need to think about how we behave, how we use the NHS, and how we can improve it. Making the NHS a political football, claiming that more and more money is the only way to fix issues, or putting the NHS on a pedestal so that there can be no criticism or open scrutiny, will not help a single midwife in this great country. I believe that the men and women of our maternity services deserve better. They literally hold new life in their hands, along with all the hopes, dreams and responsibilities that come with that job.

I leave the final words to a midwife who told me:

“I love my job. I love supporting women and the team. But I too feel that maybe this is as far as I can go. I have never suffered with mental health concerns prior to this last year. Anxiety has crept into my normally happy life due to work issues.”

I think that that is quite a stark way in which to end the debate, and I genuinely think that we can do better. I look forward to hearing from the Minister, who I know cares deeply about this issue, and I am grateful for the time that I have been allowed tonight.

[Mr Deputy Speaker (Mr Nigel Evans)]

The hon. Member for Stroud (Siobhan Baillie) and the Minister have agreed that Taiwo Owatemi may make a short contribution. I ask her please to allow the Minister some time to sum up.

Public Health

Siobhan Baillie Excerpts

Tuesday 14th December 2021 Commons Chamber

[Dr Fox]

I absolutely agree, and what we do not require is more advice from Ministers on this subject; we require decisions from Ministers on this subject.

I also want to raise the issue of masks. I receive letters, as I imagine all Members do, from people who say, “There is no point in wearing masks because they do not stop transmission.” I assume that those people would not like their surgeons to wear masks during a surgical procedure. This is nonsense: mask wearing is a common-sense thing for us to do if it reduces transmission to some degree. It is a minor inconvenience to the vast majority of people and it is a sensible measure for the Government to introduce, and I therefore support it.

I cannot say the same for the Government’s covid passport. I do not believe it passes the necessity test, and I think the good working of the insurance industry and the availability of civil remedy in the courts are enough to drive the behaviour of venues towards sensible public health policy. We, as a Government, should not be creating criminal offences unnecessarily. I worry about enforcement and penalties in a system that is already overloaded. There is no evidence from Scotland or elsewhere that covid passports actually work. France was mentioned earlier, and there are more than twice as many people in hospital with covid in France than in the United Kingdom.

[Siobhan Baillie (Stroud) (Con)]

Will my right hon. Friend give way?

[Dr Fox]

I have given way once. I am conscious that colleagues want to speak, so I will not give way again.

I assume the lateral flow tests will have to be externally validated, which will add a cost to anyone who wants to go to one of these venues. That will not be the help to the hospitality industry that has been suggested by the Secretary of State and the shadow Secretary of State.

When compulsory vaccination was introduced for care workers, many hon. Members took the view that it was the thin end of the wedge, but we were assured that it would be care workers and no one else. Now it is all NHS workers, with a few exemptions. The ground for compulsory vaccination is that these staff will be working with vulnerable members of the public. Well, so will the police and some retail and post office workers. Where does it stop?

The hon. Member for Blackley and Broughton (Graham Stringer) made the valid point that this is a retrospective change to the terms and conditions of people who already work in the NHS, and it is likely that we will lose staff as a consequence. This is completely unnecessary when more than 91% of NHS staff have already volunteered to be vaccinated. It is disproportionate and illogical, and I do not believe it will be effective. If the logic of the Government’s position on covid passports is that people must be given a choice between being vaccinated and getting a daily lateral flow test, why does that not operate in the health service, too? The lack of logic in many of these measures diminishes support for the Government’s case.

I end on a positive note. Many of these measures are relatively small beer compared with what we can achieve through the booster campaign, so it is essential that the one message we leave the House with tonight is that every one of us has a duty to say to every one of our constituents, “Go out, get immunised and get a booster. That is the best way you can help yourself, your family, your community and wider public health.” If there is to be unanimity in the House at this time of year, that is surely the message that must resonate.

Oral Answers to Questions

Siobhan Baillie Excerpts

Tuesday 19th October 2021 Commons Chamber

[Siobhan Baillie (Stroud) (Con)]

We all know that when the care sector is struggling, the NHS feels the pressure, and that is certainly the case in Gloucestershire at the moment. The demand for adult social care is increasing for us locally by 4% year on year, which is higher than the average, and the huge number of requests for new care packages means that there are now delays for domiciliary care, as the market cannot respond to demand. Will the Minister, who I welcome to her new post, tell the House and the Gloucestershire care sector that the Government are working to support us? Will she meet the six Gloucestershire MPs and the leader of the council to discuss this matter?

[Gillian Keegan]

This is absolutely vital. The recent announcement of £500 million over three years to fund social care professionalisation is very warmly welcomed by the sector. It is a sector that employs 1.54 million people. It is larger than the NHS, construction, transport or food and drink. I am of course happy to meet my hon. Friend and other Gloucestershire MPs. I know this issue is a challenge. We have some short-term actions, and it is a key pillar of our long-term reform.

Coronavirus

Siobhan Baillie Excerpts

Wednesday 16th June 2021 Commons Chamber

[Siobhan Baillie (Stroud) (Con)]

This great country is the cradle of freedom. For over eight centuries, at least since the time of Magna Carta, this mother of Parliaments has protected the rights and liberties of the British people. I, together with many others in this place, have been deeply troubled by the temporary restrictions that we have asked the British people to observe and the sacrifices we have asked them to make. I have supported every covid decision to date with a clear sight of the need to tackle the virus that was rampaging through Gloucestershire and the UK, when hospitalisations and covid deaths were a serious daily threat. My heart continues to go out to everybody who has lost loved ones.

However, we are in a very different situation now, and I cannot support a confused further delay of the road map in these circumstances. Now is the time to trust the British people, and we have heard that a lot tonight. We must trust them to continue acting with caution, and we must trust them to make choices to protect the health of their friends, family and loved ones.

I am proud of how the people and businesses of Stroud, the valleys and vale have supported their neighbours. They have volunteered in their thousands and put themselves forward for vaccinations, all to regain their historic freedoms, to stay well and to get back to some form of normal. In Stroud, we have 87% of people vaccinated for the first time and 55% fully vaccinated. Thankfully, only three people are in hospital in Gloucestershire with covid, and I pray for their swift recovery.

At a time when our hospitals are nowhere near overwhelmed by covid and we are told we need to learn to live with the virus, it is only right that we now look to protect the others from the impact of restrictions. To dismiss this delay as only being four weeks is disrespectful. These weeks are crucial for many, but not least for businesses that invested money and hope in being able to trade viably next week. For those in the hospitality, entertainment, weddings, exercise and travel sectors, these summer weeks follow a lost summer last year, and they cannot be made up over the autumn and winter months.

Being involved in the negotiations for the wedding industry has also led me to this position. Months of work, evidence gathering and sensible suggestions were swept aside by health officials at the last minute without explanation and against a backdrop of thousands of people hugging at the football and the cricket, which I loved by the way. Why reject testing, like we have in sporting events, and then make a father wear a mask walking his daughter down the aisle? He will eat a maskless dinner with her later that day. What have we come to when the Government are banning dance floors? I am equally confuzzled by banning singing in churches. Our predominantly double-jabbed congregations just want to sing to God—let them sing.

These are not easy decisions. The difficulties facing our Government are extraordinary, and I sincerely respect those on both sides of the House who have different views. I have the utmost respect for the Prime Minister and the Health Secretary, and I do not mind saying out loud that this was a difficult decision, but with the welfare of Stroud firmly in my mind, I praise the courage and sacrifice that the people of this great nation have shown, and I say that now is the time for us to trust the people and give them their freedom day.

Women’s Health Strategy

Siobhan Baillie Excerpts

Monday 8th March 2021 Commons Chamber

[Ms Dorries]

The Government are committed to developing a sexual and reproductive health strategy, which we plan to publish in 2021. Development of the sexual and reproductive health strategy will be separate from the women’s health strategy. However, officials are working closely together to ensure coherence between the sexual and reproductive health strategy and the women’s health strategy. We hope that they will not contradict each other; we want them to work closely together. The sexual and reproductive health strategy is an incredibly important piece of work in its own right.

Abortion is not a part of the women’s health strategy because, as everyone in the House knows, abortion is a free vote issue—it is a conscience issue; it is something that Members decide as individuals, not as parties—and therefore it is more appropriate that that goes into a strategy on sexual and reproductive health and contraception than the women’s health strategy. That does not mean that those subjects are off limits when women respond to the call for evidence on the women’s health strategy. Nothing is off limits; women can talk about anything. We have not yet decided what will go into the women’s health strategy, because we want to hear what women have to say and what issues we are contacted about that we can develop in terms of policy. We will be working closely, and officials will be working side by side.

The right hon. Lady also mentioned LARC. Access to SRH services is being maintained during covid-19, with a scaling up of online services. In response to covid, Public Health England launched a national framework for e-sexual and reproductive healthcare, which allows local authorities and service providers to purchase an expanded range of online services, including emergency contraception and the contraceptive pill. Those services have continued during the pandemic.

I congratulate the right hon. Lady on the work that she does in her APPG. I hope that she will inform its members and those she knows who have an interest in women’s health issues to click on the link and provide their evidence to us.

[Siobhan Baillie (Stroud) (Con)]

On International Women’s Day, I would like the House to think about women with complex and multiple needs—addiction, trauma, abuse and eating disorders. Some lives are just too complicated for one service, and some experiences are just too awful for many of us to contemplate. These women can, however, turn their lives around safely with the right support; I think of organisations in my constituency such as the Nelson Trust, which does so much brilliant work. Will my hon. Friend confirm that women with complex and multiple needs will not be forgotten in this strategy?

[Ms Dorries]

I would like to reassure my hon. Friend, and I hope that she will do her utmost to make sure that those women she is aware of are aware of the link and will provide us with their evidence. It is the evidence that we need to develop the women’s health strategy, so we need to hear from exactly the women she is talking about. Complex needs are just that: they are very complex. We need to know about these women’s experiences in the healthcare sector—what acts as a barrier to them, where they think they are not heard, where they think their voices are drowned out and where they feel they are not listened to and do not get the services they should get. I will use endometriosis as an example. It can take women seven to eight years to be diagnosed, all the time being told that they may have a mental health condition, that it is something they have to live with and that that level of pain is normal for a woman to experience, when none of those things is true. We want to hear from those women.

I thank my hon. Friend for her question, which is really important. She is right: many women suffer from a number of complex health issues and have difficult lives. That is why we have made responding so simple, via a link on a phone and taking a few minutes. I really hope that those women hear this call and will respond.

Oral Answers to Questions

Siobhan Baillie Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Edward Argar]

I am grateful to my hon. Friend for his question. May I join him in paying tribute to his local Hospital of St. Cross and the team who have done an amazing job in very challenging circumstances over the past year? I know that he is a strong champion of it and of his local NHS—I think I can recall him volunteering at the Locke House vaccine centre recently in support of his NHS. Of that critical infrastructure funding to which I referred, £2.2 million was allocated to his trust and local hospital. As I mentioned in my initial answer, we will be making further capital allocations shortly, which will benefit district hospitals, including his own.

[Siobhan Baillie (Stroud) (Con)]

What steps his Department is taking to support people suffering from long covid.

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

The Government are working hard to set up patient-focused, evidence-based and effective support for people with long covid. In October, NHS England and NHS Improvement announced a five-part package of measures, including the establishment of 69 multi-disciplinary assessment services. Last week, almost £20 million of research funding was committed to helping identify the causes of long covid and the effective therapies to treat people who suffer from some of the chronic symptoms.

[Siobhan Baillie]

My constituent Emma Samms, the actress, has pulled together a reunion of the cast of “Dynasty” to add some glamour to fundraise for research into long covid. In Gloucestershire, we are also setting up a clinic. We clearly need to learn an awful lot more about the symptoms. Will my hon. Friend join me in praising those initiatives and continue to reassure us that we will provide full support to GPs, hospitals and patients for this awful disease?

[Jo Churchill]

I thank my hon. Friend for her question. I am delighted to join her in congratulating Emma, who I know is using her experience of having had covid to launch such an innovative fundraising idea. I already have a Dallas-style hairdo, because I have not been to the hairdressers for some months. I just need some shoulder pads. I thank her and all volunteers and fundraisers for their marvellous job in coming up with some really great ideas to support research.

Public Health

Siobhan Baillie Excerpts

Wednesday 6th January 2021 Commons Chamber

[Siobhan Baillie (Stroud) (Con)]

There are a hundred things about Stroud that I could rise to stand up for today, but given the shortness of time, I will focus on education, exercise and entrepreneurs. First, I want to say that I will be supporting the Government tonight. From speaking to the Gloucestershire NHS and health teams, I am clear that our hospitals and key workers are under extraordinary pressure. Life would not be normal, and local businesses would not flourish, if ambulances were queuing around the Gloucestershire Royal Hospital or if, worse still, images of body bags were filling the news, as we have seen in other countries. I accept that drastic action is needed right now, and it is for all of us to work together to get out of this lockdown with the can-do attitude and compassion shown by my hon. Friends on either side of me, the hon. Members for Gravesham (Adam Holloway) and for Broxbourne (Sir Charles Walker).

However, I thought that we had reached an under-standing that education needed to continue. In the first lockdown, 55% of teachers in the most deprived areas suggested that students were learning for less than one hour a day. Eating disorders are now on the rise, and mental health issues are rife. We have to be honest: there is simply no replacement for face-to-face teaching. No amount of money, whizzy technology or free devices will bridge the education gap that the covid pandemic has created. Children need time in school, and they need their families to not be fraught from juggling home working, home schooling and worse. Stroud teachers are also phenomenal, and have already jumped through extensive logistical hoops to get our schools covid safe. I ask that the Government help to reopen schools without delay, and do not let children get caught in political games.

On exercise, I want to see gyms, parkruns, fishing, and clubs such as golf, tennis, archery and swimming open as soon as possible. Living with excess weight puts people at greater risk of serious illness or death from covid-19. Government guidance says:

“Look after your physical wellbeing: Your physical health has a big impact on how you are feeling emotionally and mentally”,

so why cut off businesses that effectively help us fight covid and protect our mental health? Do not get me wrong: the rise of walking, running, cycling and online classes is positive. However, please do not underestimate the benefits of gyms and sports clubs. The professionals who work in these places know their health and mental health onions, and we need them to survive in order to produce the healthy society we know is necessary to cope with covid now and prosper in the future.

On entrepreneurs, please will the Government look urgently at the Campaign for Real Ale’s campaign regarding the sale of takeaway alcohol? As the Prince Albert pub in my patch brilliantly pointed out, it is not fair to stop this activity when supermarkets and off-licences can sell regardless. I have been relentless on the plight of the wedding and events industry, and we need a road map and pilot studies in Stroud. It was wrong to not give support to our fantastic limited companies that reside in Stroud when the virus was going to be gone in a few months, and it is wrong now.

Covid-19 Update

Siobhan Baillie Excerpts

Wednesday 30th December 2020 Commons Chamber

[Matt Hancock]

I have just announced the need to move a significant proportion of England into tier 4 restrictions, and I welcome the implicit support for that measure. Where it is possible to keep some of the freedoms that we all cherish, we should do so, and that is the basis for our tiered approach.

I of course welcome the hon. Lady’s support for the roll-out of the Oxford-AstraZeneca vaccine, which will happen right across the UK from Monday. It has been a pleasure working with Jeane Freeman, the SNP Government’s Cabinet Secretary for Health in Holyrood, to ensure that this vaccine, which has been bought, developed and supported effectively by UK science right across the country, can be deployed properly to everybody in the whole of the UK on a fair and equitable basis according to their clinical need. I look forward to working very hard to make sure that happens.

[Siobhan Baillie (Stroud) (Con) [V]]

Many businesses in Gloucestershire are gutted to be placed in tier 4. This makes the roll-out of the vaccine even more important. However, there is a worrying increase in anti-vax information in Stroud that is causing a lot of distress and upset for local people. It is appalling that our Gloucestershire Hospitals NHS Foundation Trust had to spend its precious time during this pandemic defending itself against films on social media that were wrongly claiming that the hospital is empty. Will the Secretary of State assist me to reassure Stroud about the vaccines and encourage people not to share covid information from unofficial sources to stop this dangerous, damaging and disrespectful behaviour?

[Matt Hancock]

Yes, I strongly agree with my hon. Friend, who speaks very powerfully about the need for proper, authorised information about these vaccines, which save lives. We have been very careful to ensure that the independent regulator makes the decision on how these vaccines should be deployed, and indeed whether they should be deployed, and it is confident in their safety and their efficacy. It is that information, and all the information that is set out by the NHS, that people should look to if they have questions—if they want to know how and why the vaccine works, and who it should be used for. I pay tribute to all those who work in the hospitals of Gloucestershire. It is hard work at the moment in the NHS. Rates of coronavirus in Gloucestershire have really shot up over just the past two or three weeks, and unfortunately that is why we have had to take the action that we have on restrictions. I want to thank all of the NHS for doing all the work that it has been doing over Christmas and will have to do over the weeks ahead.