Maternity Safety Strategy

John Bercow Excerpts

Tuesday 28th November 2017 Commons Chamber

[Several hon. Members rose—]

[Mr Speaker]

Order. This is an extremely important and sensitive matter, and we appreciate the statement on it. However, the business to follow—the final day of debate on the Budget—is also extremely important, and no fewer than 67 right hon. and hon. Members have indicated a wish to speak. Exceptionally, therefore, I may not feel able to call everybody on this statement. In any event, there is a premium on brevity from Back Benchers and Front Benchers alike.

[Dr Sarah Wollaston (Totnes) (Con)]

I warmly welcome the Secretary of State’s announcements today, including the move to allow coroners to investigate full-term stillbirths. Will he set out the current waiting time for post-mortems for infants because, as he will be aware, there is a shortage of the very highly specialised pathologists who carry out this vital work?

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

Last month’s debate on baby loss has been mentioned, and I too took part in it, although I have thankfully been spared the pain suffered by some Members of the House. Such a debate really helps to bring out for everyone on both sides of the House how important this issue is, and I do not think there will be anyone who does not welcome this statement and the ambition it shows.

In Scotland, we had a higher stillbirth, neonatal and perinatal death rate in 2012, but our new chief medical officer was actually an obstetrician, and that may have led to the change of focus in 2013, when she established the maternity and children quality improvement collaborative and the national stillbirth group—all as part of the Scottish patient safety initiative—as well as the neonatal managed clinical networks across Scotland. That has enabled us to drop our stillbirth rate by more than a quarter, and to drop our neonatal death rate by 50%.

This has been achieved despite the challenges we face of really difficult geography, including getting people off islands. It is easy to spot the woman who has a history of difficult births or to spot a woman with comorbidities, such as obesity or diabetes, but anyone who has been involved in birth knows that even the healthiest pregnancy can go wrong at the last minute. For us, as in rural parts of the north and west of England, there are transport issues in relation to how women with problems during labour are identified and transported if a higher specialism is required, and those issues must be looked at.

This is very much about the provision of neonatal services, including the movement of patients, and the availability of expertise and of neonatal intensive care units. However, as came out several times during the debate on baby loss, another issue is that of pre-term birth and stillbirth, so this is also about trying to change some of those things. After Scotland’s recent review in February, the focus will be on the consistent monitoring of growth, as a failure to thrive can identify a third of impending stillbirths; the continuity of care, which the Secretary of State has referenced; and especially smoking. Although the Secretary of State mentioned getting smoking rates down—and in Scotland, sadly, they are higher—the rate in the most deprived communities is more than four times that in the least deprived communities. That has an impact on every level of child loss.

Finally, on research, it is important that we learn, for example from the new information about women sleeping on their side in the last trimester. We need to fund the research to learn those things and then share the information—

[Mr Speaker]

Order. I have the highest regard for the hon. Lady, who is a considerable medical authority. I gave her a little leeway, but I say very gently that not only did she exceed her time by a minute, but she pursued her usual, rather discursive approach. In these situations, what is required is a question or a series of questions with a question mark or a series of question marks, rather than general analysis. We will leave it there for now. I say that in the most good-natured spirit to the hon. Lady.

I call Antoinette Sandbach.

[Mr Hunt]

rose—

[Mr Speaker]

I forgot that we had heard from the hon. Member for Central Ayrshire (Dr Whitford), but we had not yet heard from the Secretary of State. Apologies.

[Mr Hunt]

I actually agreed with everything the hon. Member for Central Ayrshire said. I will give a rather more brief response.

[Mr Speaker]

Order. As I have just been advised by the distinguished Clerk at the Table, who swivelled round so to advise me, there is really no need for a response, because there was no question. However, I will indulge the right hon. Gentleman to the point of a paragraph.

[Mr Hunt]

Let me simply say that there is an excellent Scottish patient safety programme. Given that one of the main objectives behind the statement is to share best practice, I would be very happy to talk to the chief medical officer in Scotland and to Jason Leitch about how we can exchange information and learn from each other’s systems.