Children’s Mental Health Week 2024

Tim Loughton Excerpts

Tuesday 30th January 2024 Westminster Hall

[Dr Allin-Khan]

I thank my hon. Friend for his intervention, and he is absolutely right. This is about understanding. As I alluded to earlier, adverse childhood experiences are the single biggest driver of poor mental health in children and then later on in adults. Of course, there are other causes—most definitely—but adverse childhood experiences are huge. That is why, as my hon. Friend articulated so well, it is important to understand that, yes, there has to be money going directly into the mental health pot, but there must also be a wider ambition for our children. There must be an understanding of how we tackle these root drivers that are causing so many children to have poor mental health.

Inequality and poverty drive mental illness. We know that children from the very poorest households are four times more likely to develop a mental illness. Some 43% of children who are receiving mental health support from Place2Be, a fantastic organisation, are on free school meals. Addressing the mental health crisis in children must go hand in hand with addressing the cost of living crisis and child poverty. Yet, as many families continue to struggle to afford food and bills, the Government have offered little to tackle childhood poverty.

It will come as no surprise to Members here that I believe we need a set of policies that bring essential change to young people’s mental health. That means having specialists in schools; fixing the chronic staffing shortages and recruiting more staff; ensuring that patients are getting timely access to treatment and not languishing on long waiting lists, desperately waiting for that letter to come through the door telling them that they have an appointment; and enabling young people to access support in the community. As a country, we have a duty to be bold in our offer and uncompromising in our aims, with mental health interwoven into every decision the Government take.

[Tim Loughton (East Worthing and Shoreham) (Con)]

The hon. Lady is being very generous with allowing interventions. I agree with much of what she has said, particularly in regard to early intervention. I was the Children’s Minister when we set up the early intervention fund, which recognised that having money invested early and attention on children as young as possible would bear dividends later on. The hon. Lady has made a number of criticisms of the Government, saying that they have done nothing, but she has not mentioned the Best Start for Life project set up by the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), which is all about that early intervention, from conception to age two. Does she acknowledge the good that that is beginning to do, because in addition to adverse childhood experiences, the other biggest impact on a child’s mental health is the lack of attachment, or attachment dysfunction? There is a 99% correlation between a mother suffering from depression or low-level mental illness during pregnancy and the likelihood of her children going through similar mental health and depression episodes as teenagers. Therefore, working with parents, and particularly the mother, before conception is absolutely where we can have the biggest impact in making sure that children are well-balanced, ready to join society, join school and join nursery, and able to avoid many of the problems that happen later on.

[Dr Allin-Khan]

I thank the hon. Member for his intervention and for highlighting something that we so often forget. When we talk about mental illness and children’s mental health, we often do not talk about the early years—the early attachment-forming part of life that is so important for positive mental health. He is right that healthy mental health in a mother is essential for positive mental health in a child. I would pick him up slightly on some of his points, because if we look at health inequalities, the groups that I have been talking about, who are most adversely affected with their mental health, are the ones who struggle to access any of the support available. The numbers speak for themselves.

Of course, all projects, interventions and ambitions for our children and their parents are important, but right now we have a children’s mental health epidemic. That is why it is important that we talk about these things during Children’s Mental Health Week next week, and beforehand in this debate. As a country, we have to be bold in our offer and have mental health interwoven in every decision the Government make. That goes to the point made by the hon. Member for East Worthing and Shoreham (Tim Loughton), having been early years Minister, about the importance of having mental health not in a health silo but across Departments, from local planning applications to Bills taken through this House. However, our children are being failed by a lack of prevention and early intervention, by long waiting lists, by a lack of funding, by an overstretched system and by a Government who are simply not concerned with children’s mental wellbeing.

We simply cannot allow our children’s future to continue to be squandered as a result of more inaction. The Minister may challenge me on this point, but the proof of the pudding is in the eating. It is no longer time for warm words; they have to be backed up with resources and ambition for our children. I hope we will hear something new from the Minister today, and I thank everybody for attending the debate.

--- Later in debate ---

[Tim Loughton (East Worthing and Shoreham) (Con)]

I had not intended to speak, but there appears to be an opportunity to do so, and I am not one to pass it up, so I will make just a few comments. I declare my interests as per the Register of Members’ Financial Interests. Until recently, I was also for six years the chair of the trustees of the Parent-Infant Foundation, which did and continues to do very important work on infant mental health awareness, attachment and the provision of services.

I again congratulate the hon. Member for Tooting (Dr Allin-Khan) on securing this debate. It is a subject about which she knows much, and her passion shows through. I disagree with little of what she said, although her speech became a little partisan at some stages. This issue has besieged Governments over many years, but if one looks at the figures, most alarmingly, the incidence of mental illness among children has got particularly bad since the beginning of covid, and there are reasons for that that we should continue to be worried about. This is not a gradual progression; there has been a very serious downturn in recent years, which I will come back to.

I agree with all the comments that have been made about the disproportionate impact on children in the care system, children from black and minority ethnic backgrounds and those in poverty. However, as my hon. Friend the Member for Mid Norfolk (George Freeman) said, the issue is not exclusive to people from deprived backgrounds. In some projects run by the Parent-Infant Foundation around the country, we see parents from well-to-do city backgrounds who have serious attachment problems with their children. At times, we forget that mental illness spreads across the whole of society in different ways, and we need to be open to all of them.

[Wera Hobhouse]

Does the hon. Member not recognise that those from a less deprived background have better access to help than those from a poorer background?

[Tim Loughton]

There is something in that, and people from better-off backgrounds may have recourse to the private sector as well, but the point is that the illness impacts on everybody, although I certainly agree that the capacity to get early help for that illness is differentiated across families.

The impact of covid should not be underestimated. During covid, we saw the impact on new parents, particularly new single parents. One of the biggest impacts was the absence of health visitors able to go across the threshold of new parents’ homes, particularly on single parents having a child for the first time. There were the other horrors of covid going on, and people were detached from the normal family networks they might have, such as grandparents coming along to share their experience and give support. On top of that, they did not have a health visitor coming to visit them physically, because about three quarters of health visitors were diverted to the frontline of dealing with covid. It was only in the most deprived cases, where there were concerns, that health visitors physically got to go and visit.

On top of that, we had a decline in the numbers of health visitors, which reversed the position that the coalition Government produced, where we had an additional 4,200; quite rightly, that was a pledge by the Government, and it was actually delivered in the lifetime of one Government. Since then, numbers have declined again. I think there is absolutely a false economy.

[Dr Poulter]

I agree entirely with what my hon. Friend said about health visitors. I think I was actually the Minister who oversaw that increase in the number of health visitors. The change to commissioning by local authorities has been a very big mistake in the provision of health visitor services. I wonder more generally—after reflecting on the link between poverty and poor mental health—whether he would also reflect on family nurses, who provide significant support to deprived families and families with challenges. That workforce also struggled to do its good work during the pandemic, which has had a consequential effect on those families and indeed the mental health of young people.

[Tim Loughton]

My hon. Friend is absolutely right. Family nurse partnerships were another great success story, for which he can take part of the credit. There are various ways of providing that support, in particular to new families, but a lot of it was not available during covid.

I have a real concern about babies born during covid. We are only starting to see the consequences. I remember well one of our own colleagues in a debate in this Chamber during covid saying that she gave birth during that time and it was five months before her own baby got to meet another baby, and the baby did not react well—“What on earth is this? Another baby?” There were no mum and toddler classes available then, and there were no support networks of grandparents and others coming in. If there were no health visitors or other professionals there as well, it was difficult to spot signs of attachment disorder or safeguarding issues within a household—and we are only starting to see the consequences now. It has compounded the issues for these children. Now at last, they are at least being diagnosed with a mental illness, but it might have been prevented earlier if all that support was there. That really needs to be on the radar of the Department of Health and Social Care and the Department for Education.

Then there is the impact of school lockdowns, which should also not be underestimated. There is a strong correlation when it comes to children, particularly younger children, not being able to go to school and socialise with their friends, or go through all the normal disciplines of what school brings. There are also safeguarding concerns that teachers and early warning exercises can pick up. We are seeing the impact of children being cooped up at home and not able to get on with the ordinary day-to-day business of growing up and being a child, and there were many safeguarding problems as a result of the schools lockdowns.

I will not apportion blame here, but it was a big mistake that the schools were closed down, and the unions forced those closures in the early days. We are seeing the consequences now. I agree with many of the solutions. Of course we need more investment. The Government have been investing, but they need to invest more, and we need more professionals to come into the system, because they do not grow on trees. It is absolutely right that awareness is needed of mental health first aiders and the mental health support available in schools—and we need more of that.

The trouble is that when somebody’s mental health problem is spotted in school, the thresholds for getting the treatment, therapy or whatever they require are so high that it takes too long, and in too many cases the condition worsens over that time. It really is a false economy. We need far quicker referrals, and without having to go through so many hoops. As the hon. Member for Tooting said, parents are waiting weeks or months on end to get a referral—in many cases, just to get the diagnosis before they can actually get the appropriate treatment.

I also have big concerns about eating disorders. The Government have put a lot of investment into increasing eating disorder specialist placements, but they are full up. I had a particularly tragic case in my constituency. The father rang every hospital in the country, including all the private hospitals because he could afford to fund treatment for his daughter, but everywhere was full. Eventually he secured a bed on, I think, Christmas eve. This was a teenage girl who was suicidal and had been through various episodes before. Eventually she got good treatment in hospital.

But there is a problem when people come out of hospital; often it is a case of falling off a precipice because the support services are no longer there. We need a much better system where people who need residential intensive support can be supported when they come out of that residential environment, which is a particularly tricky time because too often they end up having to go back into that intensive residential environment.

[Dr Poulter]

rose—

[Tim Loughton]

I will give way one more time. I have one more point to make and then I will finish.

[Dr Poulter]

I thank my hon. Friend for giving way. He is making an excellent contribution to this debate. His points about eating disorders are absolutely right. On the arrangements that are in place for discharge from in-patient units and also on preventive care such as community services for eating disorders, does he agree with me that one of the challenges is that there has been a failure to develop the workforce in that area? There are many unfilled posts in community eating disorder services. Unless we get that right, we will not address the challenges of eating disorders that he has outlined.

[Tim Loughton]

Again, my hon. Friend reinforces my point. I think we have done better on the provision of beds for that intensive care, although there are still not enough of them, but we have not done nearly enough on picking up afterwards and on preventing people from getting to that stage in the first place. The issue disproportionately affects young girls, who have all the pressures of social media. The Media Bill is being discussed in the main Chamber at the moment, and we are clamping down on sites that pretend to be there to offer support but that actually encourage vulnerable teenagers into obscene eating disorders as though they are a badge of honour. So much more needs to be done. It is so expensive—financially, as well as socially—when we do not act at the appropriate time.

My final point comes back to early intervention and prevention. The Best Start for Life project, pioneered by my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), really is a game changer. It has had the buy-in of all the political parties. I was a part of the various advisory research groups that we had in this place working with Members across the Floor, and we now have the roll-out of family hubs. This is all about supporting families, particularly mums, but not exclusively mums because fathers have a role; too often they are neglected and yet they are a part of the support mechanism. There are mental illness problems affecting new fathers, which are quite severe, as well as the perinatal mental illness around women. We need to do much more to make sure we have happy mothers and that we attack domestic violence problems, a third of which happen during pregnancy. If we have a happy mum, we have a happy baby, who is likely to grow up well attached, happier, well balanced, and more resilient against all the pressures and problems of mental illness in society that are manifested in schools and beyond.

It is not true to say that the Government have done nothing and have not invested in this issue. We need them to do more and invest more. The Best Start for Life project is one of the most exciting and fundamentally important projects for attacking a problem right at the beginning, before it becomes a much bigger problem for children, families and society as a whole.

[Several hon. Members rose—]

--- Later in debate ---

[Amy Callaghan (East Dunbartonshire) (SNP)]

I congratulate the hon. Member for Tooting (Dr Allin-Khan) on securing this debate and the passion and professional experience she brought to her contribution.

The contributions we have heard so far highlight how important it is to take action to improve children’s mental health and address the root causes and aggravating factors leading to poor mental health in children. As the MP for East Dunbartonshire and the SNP health spokesperson, I am fully committed to tackling the underlying causes of mental health issues. The key themes I want to reiterate are improving support for children who are struggling with their mental health, and poverty as a key driver of poor mental health. Addressing that is key, to ensure children are not taking on the burden of this Tory Government’s financial mismanagement.

I will start with support. The theme of this year’s children’s mental health week is “My Voice Matters”. It is important that we acknowledge in this place that we are here to represent our constituents and give a voice to those not feeling heard. It is our responsibility to advocate for those families and ensure that, when children are struggling with their mental health, they are met with support and a listening ear.

It is also important to note that LGBT young people are more likely to struggle with their mental health. It is no wonder, really, when the rhetoric in this place and from the Government constantly undermines and questions young people who may already be struggling with their identity. Instead of questioning and doubting these young people, we all have a duty to understand and support our young LGBT constituents. That is why the Scottish Government recently announced additional funding for a new project to support LGBT children and young people’s mental health. LGBT Youth Scotland will receive £50,000 to establish a new mental health LGBT youth commission. The commission will explore barriers and the challenges young LGBT people face when accessing mental health support and services. That will involve listening to young people and their lived experience to help inform future work, designing targeted and tangible solutions formulated by the LGBT Youth Scotland mental health ambassadors.

The SNP believes that supporting children’s wellbeing should be rights-based, strength-based, holistic and adaptable. That is why, in 2021, the Scottish Government published the whole school approach framework to assist schools in supporting children and young people’s mental health. The Scottish Government’s mental health transition and recovery plan also emphasises a health-promoting and preventative approach to mental health and wellbeing. The preventative approach is something we have heard about from across the Chamber today, so I am delighted to represent the SNP in that regard.

Education and the time children spend in schools have a large part to play in that approach, through raising awareness and understanding, and supporting the positive mental health of children and young people. Included in the framework are considerations for local authorities and guidance for schools to develop and embed policy in practice within schools and the wider community, and to support them in evaluating their mental health practices and identify areas for improvement. It is essential that schools, where children spend so much of their time, are equipped with the proper tools and knowledge to support children and ensure their mental health is prioritised and understood. That is why the Scottish Government also continue to support local authority partners with £60 million of funding to ensure that every secondary school has access to counselling services. The Scottish Government have also published a mental health and wellbeing strategy built around the three pillars of promote, prevent, provide: promoting positive mental health and wellbeing; preventing mental health issues occurring or escalating, while tackling underlying causes; and, of course, providing mental health and wellbeing support and care.

That leads me to the other major theme I want to highlight, which is tackling the underlying and aggravating causes of poor mental health, the most prominent being financial pressures and the impact of the Tory Government’s cost of living crisis. Childhood should be a time of happiness and freedom. Children should not need to worry about their family’s finances or whether they will be warm and well fed, a point explored by the hon. Member for East Worthing and Shoreham (Tim Loughton), who is no longer in his place.

[Tim Loughton]

Yes, I am!

[Amy Callaghan]

Oh, sorry, you’ve just moved.

Low-income families with children continue to be disproportionately hit during the crisis. It is no surprise that that has had an horrendous impact on mental health. When families are in fuel and food poverty, struggling to keep warm and fed, the stress is certainly not limited to parents, as mentioned by the hon. Member for Tooting. It can aggravate specific mental health conditions, including, but not limited to, eating disorders.

The cost of living payments from the British Government have been one-off flat-rate payments. That means that a single person receives the same as a family of five. Research has shown that single-person households saw their income rise by 6% thanks to those payments, which is of course welcome, whereas for families with two or three children, the increase was only 3.3%. The Work and Pensions Committee’s cost of living payment report states that the failure to provide extra support for families is notable and should be examined further by the UK Government. Unfortunately, the response from the British Government rejects the idea that cost of living support payments should take account of family size, despite that being a common sense recommendation based on data and fairness.

We in the SNP are deeply concerned about the UK Government’s welfare policies. Instead of heaping additional pressure on low-income families, the British Government need urgently to address the fundamental issues with universal credit. One particular example is ending the two-child limit and the rape clause, a policy that I am afraid would be kept by any future Labour Government. The End Child Poverty Coalition analysis estimates that almost 90,000 children in Scotland are impacted by the two-child limit, and ending it could lift 250,000 children—15,000 of whom are in Scotland—out of poverty. This British Government’s political choice to keep and force kids into poverty is simply to the detriment of children’s mental health across these isles.

Meanwhile, the Scottish Government have lifted 90,000 children out of poverty with ground-breaking, game-changing policies such as the Scottish child payment. We in the SNP are not the only ones who are concerned and calling on the British Government to end the two-child limit. The chief executive of the UK Committee for UNICEF, Jon Sparkes, said:

“We urge the UK government to take steps to protect all children from poverty, starting by making child poverty reduction a government priority, scrapping the two-child limit policy and benefits cap, and improving services and support, especially for the youngest children”.

I ask the Minister this: why is reducing child poverty not an ambition of this Government? We in the SNP call on the British Government to scrap the benefit cap and to introduce an essentials guarantee to ensure that universal credit is set at a level that allows households to cover essential costs such as food and utilities. As much as the Scottish Government progressively mitigates the policies of this place, 85% of welfare expenditure and income replacement benefits remain reserved to Westminster. That is why social security policy should be fully devolved to the Scottish Parliament.

Adverse childhood experiences are of course a significant factor in a child experiencing poor mental health, as outlined by the hon. Member for Bath (Wera Hobhouse), who chairs the childhood trauma all-party parliamentary group. ACEs and the trauma associated with them are, by and large, linked to poverty. I sat on and chaired children’s panels in the central belt of Scotland before being elected to this place. I saw at first hand the trauma that ACEs and poverty can cause to children and families. The SNP Scottish Government’s strategy of investing in people, investing in children, would work much more significantly if our hands were not tied by this place.

It is clear that the Scottish Government have the willingness and the ideas to help children’s mental health. We just need the powers. It is abundantly clear that, no matter which party forms a British Government after the next election, ending child poverty will not be a priority. Only with the full powers of independence will we be able to tackle the root causes of child poverty and improve the mental health of children in Scotland, continuing the Scottish Government’s current ambitions as an independent nation.

Horizon: Compensation and Convictions

Tim Loughton Excerpts

Monday 8th January 2024 Commons Chamber

[Kevin Hollinrake]

I thank the right hon. Member; he has contributed to every debate on this issue that I have been involved in as a Back Bencher and as a Minister, and he has paid close attention to this all the way through and demanded justice. As I said, the approach of the Post Office was brutal, gratuitous and shocking. Should people be held to account? Absolutely. I do not think we can start to dissuade people from taking these wrongful, disgraceful actions without a deterrent. Certainly, holding people to account by whatever means possible, including potentially prosecutions, would be a significant deterrent for people thinking of doing this kind of stuff in the future.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I very much welcome the Minister’s approach, but I also pay tribute to the work that he did to raise the profile of this issue before he took on that role. This is a scandal of historic proportions and heads must roll, with or without gongs attached to them. I am aware of only one sub-postmaster in my constituency who was pursued by the Post Office and not convicted, but it struck me that that is because I have very few sub-post offices left. Are there grounds for investigating whether the Post Office used this dodgy accounting to mismanage the profitability of individual branches to accelerate the closure programme of many of those branches, which left us, in many cases, with very few post office branches left for our constituents to use?

[Kevin Hollinrake]

I thank my hon. Friend for his question and for his work. He raises a very important point. The motivation behind the actions of the Post Office and executives and managers in the Post Office is something that Sir Wyn Williams is looking at as part of his inquiry, and I am very interested to see the results of that. There is no sense that I am aware of that this was just another method of trying to contribute towards the closure of a post office. Despite the closures that my right hon. Friend has experienced, that is principally about the general nature of the impact on high streets of changing shopping habits, which is causing difficulties for some of the network. We are determined to try to ensure that the post office network is more viable and more sustainable, including for individual businesses. A more generous deal on the banking framework between banks and post offices, in terms of the remuneration that they get to manage access to cash, for example, is one of the ways that we can make post offices more sustainable. We are fully committed to maintaining a significant network across the country, and it is currently set at 11,500 branches.

Baby Loss Awareness Week

Tim Loughton Excerpts

Thursday 19th October 2023 Commons Chamber

[Tim Loughton (East Worthing and Shoreham) (Con)]

It is a pleasure to speak on this important subject. I pay tribute to the hon. Members for Sheffield, Hallam (Olivia Blake) and for North Shropshire (Helen Morgan), and the others who have secured the debate. It has become something of a tradition that we mark Baby Loss Awareness Week, although we were not able to do so last week because of the recess.

This has also become one of the more emotional and harrowing debates—I have sat through many debates over many years—which is a great tribute to how this place has progressed. When I first came to this House all those years ago, as you did, Madam Deputy Speaker, baby loss was a subject that was not discussed. Certainly, the personal experiences of Members, particularly female Members, going through the trauma we heard about in the earlier debate and through baby loss generally, let alone the experience of partners, did not come out into the open. The stigma surrounding mental health meant that no Member of Parliament would dare to raise in public the fact that they might have some mental illness problems. Why would they not? A lot of the population have such problems, and we are just humans like the rest of the population, doing a particularly stressful job.

The progress that we have made over the 26 and a half years that we have been in Parliament, Madam Deputy Speaker, is a real tribute to this place, and to the bravery and openness of hon. Members who have come forward with their personal experiences. Those experiences enrich the way in which we scrutinise Government Departments, rules, regulations and legislation that needs to be brought in to deal with related problems. I pay tribute to all those who have shared their experiences. I was listening to the previous debate in my room, in between meetings, and I particularly pay tribute to my hon. Friend the Member for Stafford (Theo Clarke), as she said it was the first time that the specific issue of birth trauma had been mentioned here. She opened up incredibly emotionally about her own experiences.

I am glad that in my hon. Friend’s winding-up speech she mentioned how the issue affects dads as well. It is not a female-only issue; it is a parents issue. Where there are two parents involved in a child’s life, the impact of baby loss can be incredible on the male parent, and we should never forget that. Too often, health officials speak over the heads of fathers to the mothers, but fathers have an equally vested interest in what happens, not only to their partner but to their new-born baby as well.

[Cherilyn Mackrory]

Does my hon. Friend agree that the fact that aftercare for fathers is often lacking places a huge burden on relationships? Sadly, the statistics show that 50% of relationships can break down after the loss of a baby. Does he agree that we need to do much more to support fathers, as well as mothers, after the loss of a baby?

[Tim Loughton]

My hon. Friend, who again has great experience and has been exceedingly forward with her own experiences, is absolutely right. There have been many studies on maternal perinatal mental health problems. The latest estimate is that that costs this country over £8 billion, and there has been an increase in perinatal mental health problems among women, exacerbated by the lockdown.

As happened to our own colleagues, for many months babies born during lockdown did not come into contact with another baby, or with extended family members such as grandparents, who would usually be at the hospital bedside to welcome a new baby, but were not allowed to be there. Speaking as the chairman of the all-party parliamentary group for conception to age two: first 1001 days, we are only starting to see the considerable impact of that on babies. We will only start to see that as those babies grow up and go to school.

However, there have not been as many studies about the impact on the mental health of fathers. There is good evidence to suggest that fathers can suffer considerably, yet the support networks, which are still not good enough for mums, are not nearly good enough for fathers. It is a false economy not to support that.

In a minute, I want to have another rant about my Act, the Civil Partnerships, Marriages and Deaths (Registration etc) Act 2019—that is the real reason for my coming to this debate, although I always try to take part, because the Act deals with stillbirth, in particular—but first I will make some general comments.

It is good that we are discussing this issue and that the profile is so much higher than it has been in previous years, but there is a lot of work still to do. The stillbirth rates have come down and there has been progress. Back in 1993, there were 5.7 stillbirths per 1,000 births. There were 2,866 stillbirths in 2021, so the figure is now about 3.8 or 3.9 stillbirths per 1,000 births. There has been progress, but in order to get to the target under the national maternity safety ambitions, which was launched in 2015, we need to get that figure down to about 2.6 by 2025, so there is a lot of work still to do on stillbirths.

Compared with other European countries, our record on stillbirth remains poor. We rate sixth worst out the 28 European Union countries plus the UK. The countries below us are Bulgaria, Malta, Croatia, Slovakia and Romania, which have perhaps traditionally not had as advanced and sophisticated health services as we have in this country. There is no real excuse why we have not made more progress.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

The hon. Gentleman is correct in what he is saying. Does he agree that one of the problems across the UK is that, on the whole, most of the stillbirths we have are preventable? When mistakes occur, as they inevitably will at times, there is a culture of cover-up and secrecy, so the lessons that need to be learned are not being learned, because NHS trusts and health boards are too busy trying to cover their backs rather than finding out what went wrong.

[Tim Loughton]

The hon. Lady gallops way ahead of me; I will come on to speak about that. That is what my private Member’s Bill, now an Act, seeks to address, so I will come back to those comments.

Stillbirths are not the only issue. Progress has been poor on neonatal death rates, which have plateaued for some years and are even further away from coming down to those 2025 targets. There were 1,719 neonatal deaths last year—that is deaths within 28 days of being born. There is also the whole subject of miscarriage. I will not go into great detail on that, but we know that at least one in five pregnancies end in miscarriage, and there are probably more that we do not know about. The Government have done a lot of good work on this. I pay tribute to the former Health and Social Care Secretary, now Chancellor of the Exchequer, for his emphasis on safety in hospitals, particularly safety around maternity, and for the launch of the Safer Care Maternity action plan back in 2016, which were all about improvements in maternity safety training. The Our Chance campaign was targeted at pregnant women and their families to raise awareness of symptoms that can lead to stillbirth.

The inauguration of bereavement suites in hospitals was another important development—I have seen my own in Worthing. It was wholly unsatisfactory that a woman, following a stillbirth, would be placed in a bed next to a mother who had fortunately had a healthy, screaming baby. The impact on the mother and the father of having a stillbirth and then seeing the reverse was traumatic and had to be dealt with. The bereavement suites provided a more discreet, private area, away from those mums lucky enough to have healthy babies.

[Douglas Ross]

I am grateful to my hon. Friend for giving way. It allows me the opportunity to welcome the fact that, last week, NHS Grampian announced the upgrading of the bereavement suite at Dr Gray’s Hospital. Marsha Dean from Elgin, one of two bereavement specialist midwives in the NHS Grampian area, welcomed that. Tina Megevand from Moray Sands said, “It’s so very important that anyone affected by pregnancy loss or death of a baby gets the best possible bereavement care and is offered a safe, protected space to spend time and make memories with their baby.” What my hon. Friend has just said is crucial and I just wanted to put on record our appreciation in Moray for having such a facility.

[Tim Loughton]

I am grateful to my hon. Friend for putting on record what his local hospital is doing, and I hope that that is happening around the country. Certainly, my own hospital takes great pride in its bereavement suites and they have made a big difference to the impact on parents in its maternity wing.

We have had the Ockenden report as well as the Cumberlege review, so there has been a lot of activity from the Department of Health and Social Care, but we need to go so much further. Although I will not go into detail here, I wish to reference the high incidence of stillbirths and baby loss among the black, Asian and minority ethnic community, who are something like five times less likely to receive maternal aftercare.

As hon. Members have mentioned, there are also real challenges and big vacancies in the midwifery workforce. As has been said, 38% of maternity services have been rated as requiring improvements in safety, so there is still a long way to go. One thing that has particularly alarmed me—I am sure other hon. Members will have had the briefing from that excellent charity, Sands—is the state of perinatal pathology. I think my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) may be talking further on that. Currently, there is a significant proportion of parents who have to wait more than three to six months for their babies’ post mortem to be undertaken and for the results to be communicated to them. Those waiting times are then further exacerbated by poor communications about what is happening. Having gone through the trauma of losing a newborn baby, parents then have to wait a long time to find out what happened, which causes them additional trauma.

As I mentioned earlier, there is the whole issue of mental illness and, in particular, the impact of mental illness and depression and the prevalence among teenage mothers. It is important that we deal with that early and that the support is there because we know—the Minister mentioned this in the previous debate—about the high incidence of suicide linked to the perinatal period.

Therefore, this is an important subject. Good work has been done. The Government have good plans, but there is still a lot of work to do before we can genuinely say that this is a very safe country in which to give birth and we rank with the top countries across the rest of Europe.

I wish to talk about my excellent private Member’s Act, which passed through Parliament some time ago. Madam Deputy Speaker, you will not be surprised to hear me mention it again because I have raised it on the Floor of the House many times. I have harangued the Minister about it many times and will continue to do so.

My Civil Partnerships, Marriages and Deaths (Registration etc.) Act 2019 passed through its final stages in this House on 15 March 2019. It received Royal Assent on 26 March 2019; that is 1,303 days ago. It did four things. First, it enabled opposite sex couples to have a civil partnership. That became law on new year’s eve 2019. On that day, 167 couples availed themselves of that opportunity and many thousands have since, so we can tick that box. A second part of the Act enabled for the first time the names of mothers to be included on marriage certificates. Up until then, they did not exist, which particularly added insult to injury if it was the mother who brought up the child who was getting married and the father, whose name does appear, had never been on the scene at all. That at last was reversed with my Act—another tick.

Another part of the Act mandated the Secretary of State for Health and Social Care to produce a pregnancy loss review. A committee was set up—I sat on that committee —and in July this year the independent pregnancy loss review, which contained many recommendations—there were some good things in it, even though it had not met since 2018—was at last published, so another tick.

The fourth part of my Act was on coroners’ investigations into stillbirths. What was agreed by this House unanimously, with Government support, following much scrutiny in the other place as well, was that the Secretary of State must

“make arrangements for the preparation of a report on whether, and if so how, the law ought to be changed to enable or require coroners to investigate still-births”,

and that, after the report had been published, the Lord Chancellor may, by regulations, amend part 1 of the Coroners and Justice Act 2009. It was a very simple amendment to ensure that, in future, coroners had the power to investigate stillbirths. It did not require any more primary legislation. It required a one-line amendment to the Coroners and Justice Act.

When I made my speech for my private Member’s Bill on 15 March 2019, I could not have been more wrong. I said then that I knew that we were pushing at an open door with my last measure, as the Health Secretary had signalled his support for it at the Dispatch Box during a statement on stillbirths in November. I then set out the anomaly in the law where coroners in England have the power to investigate any unexplained death of any humans unless they are stillbirths. That is because a baby who dies during delivery is not legally considered to have lived. If the baby has not lived, it has not died and coroners can investigate deaths only where there is a body of a deceased person.

Most people agreed—certainly the coroners themselves, who strongly supported this—that that is an anomaly in the law. Given some of the scandals that I will come to in a minute, it has given rise to a suspicion—this is the point that the hon. Member for North Ayrshire and Arran (Patricia Gibson) raised—that some stillbirths that went unexplained might have been avoidable, and were mistakenly registered as stillbirths because that effectively excluded the coroner from launching a further investigation. My Bill was therefore simple in its aim.

A consultation was launched, actually before my Bill became an Act, because the Secretary of State was so supportive of it and saw it as a formality. The consultation on the changes closed on 18 June 2019—over four years ago—and has still not been published. In order for new regulations to come in, the consultation and subsequent proposals have to be published, but we still have not got over the first bar of publishing the consultation. I have frequently queried when the Government will publish the consultation, and have frequently received a barrage of excuses. Of course, covid was the first excuse for why the consultation results—not even the proposals—could not be published.

The matter was chased up by the Justice Committee, which produced its own report on coroners and reinforced the need to get on with the measures in my Act. That message was reinforced by the Health and Social Care Committee, which also produced a report to say that the Government needed to get on with the measures. Today’s Minister, for whom I have a lot of time, as my near neighbour in Lewes, has written to me several times. One of the excuses was that we needed to wait for the Health and Care Act 2022 to go through in the last Session because of various considerations that could have an impact. That Act passed last year, so is not a consideration anymore.

We then had to get the pregnancy loss review published, for which we had waited since 2019. That has now been published, as I have said. We then had the further excuse that the Ministry of Justice was dragging its feet. The problem is that it is a Department of Health and a Ministry of Justice issue. I have tackled the Minister for Justice on several occasions. I asked for a joint meeting with the Minister for Health and the Minister for Justice. That meeting was cancelled six times, until it eventually happened on 21 March this year, when I was told that everything was in hand and being sorted out. I raised the matter again in Justice questions on 12 September. I was told:

“Both the Health Minister and I are pushing this as fast as we possibly can.”—[Official Report, 12 September 2023; Vol. 737, c. 766.]

This is appalling. Madam Deputy Speaker, you and I have been in this House for an equally long time. I cannot remember a piece of legislation waiting to be enacted for as long as this, particularly when there appear to be no objections to it. It has been passed unanimously and is not contentious; the coroners want to do it. It is absolutely extraordinary. I will take this opportunity to put it out in the open yet again that the Government need to get on with this. The legislation is even more important now than when it was passed in 2019, and when I produced it as a private Member’s Bill in 2017.

Four things needed to be resolved about how coroners would look at these matters, and they have all been resolved. First, we all agreed that they should look only at full-term stillbirths. That is where a stillbirth is least likely to happen, and therefore more questions arise. I think that everybody agreed on that. Secondly, it should be at the discretion of the coroner. The coroner will certainly not want to look at every single stillbirth, but where questions are raised by the parent or others that something has gone a bit awry and we need more information, the coroner can decide at his or her discretion whether there is a case for further investigation. We are talking about dozens, or scores, of cases, not hundreds or thousands.

Thirdly, it will be up to the coroner to decide, even if the parents do not want a review. That was a difficult one, but there is evidence that some stillbirths can be brought on by domestic violence during pregnancy, and obviously there may be a cover-up because a mum is being coerced. It is right that there should not be a veto and it should be down to the coroner to decide. Fourthly, the coroners have decided that it is not a significant resource issue. We do not need to train up a fleet of specialist coroners; they always want more money, but they think that they can simply take on the responsibility. All those things have been resolved. There are no outstanding questions, but as I said the need for the legislation has grown since it went through.

I do not need to remind everybody about the various scandals that have happened. The Nottingham maternity review currently under way covers the latest of those revelations. It will be the UK’s largest maternity review, with 1,266 families having already contacted the review team with their concerns. The Shrewsbury and Telford Hospital NHS Trust review, which has already been mentioned, of the deaths of more than 200 babies and nine mothers between 2000 and 2019, found that 201 babies could or would have survived had the trust provided better care, and that families were wrongly blamed when their babies died, were locked out of inquiries into what happened, and were treated without compassion and kindness.

The Morecambe Bay review in 2015 found unnecessary deaths of 11 babies and one mother between 2004 and 2013 due to oxygen shortages, mismanaged labour, failure to recognise complications, and so on. When the East Kent review was published, the headline was that the East Kent Hospitals University NHS Foundation Trust was logging baby deaths as stillbirths when in fact they were not stillbirths. What would the reason for that be? Potentially a cover-up, so that a further investigation by a coroner could not take place.

The East Kent review into the ongoing problems with the trust was described as harrowing, with more than 80 concerns about midwives and nurses working at the trust investigated by the regulators since 2015, including cases involving the police. Eleven midwives and nurses from the trust have been struck off, suspended or placed under conditions in relation to such cases, and 64 doctors from the hospital have been subject to investigation by the General Medical Council over the last decade, with three struck off and three suspended. The report showed a failure to implement the recommendations of earlier reports, allowing failings to continue at East Kent, and at other hospitals elsewhere in the country.

It needs reinforcing that most nurses, midwives and doctors do a fantastic job in difficult circumstances. They most of all will want to ensure that incompetence by a few, and potential cover-up, do not effectively undermine the reputation of those working in maternity care across the whole country.

[Cherilyn Mackrory]

My hon. Friend is making brilliant points, which I am so grateful for. Does he agree that those healthcare professionals will probably welcome this because it will start to break down the blame culture that the hon. Member for North Ayrshire and Arran (Patricia Gibson) talked about?

[Tim Loughton]

My hon. Friend is absolutely right. We do not want a blame game. When I was the Minister for Children and we reviewed extraordinary and harrowing child deaths at the hands of various people, it was the blame game for social workers that so undermined the profession. It is not social workers who kill children; it is carers and others with evil intent. But where there has been incompetence, where the system has perhaps contributed to that incompetence or has effectively obstructed a professional from getting on with their job in the way that they would like to and can do, that is where we need the findings. In some cases, that may require a coronial investigation, which can look under every stone and really get down to the roots of the problems, rather than just point a finger of blame with which the whole profession gets tarred.

That is why—you will be relieved to hear, Madam Deputy Speaker, that I am about to end—my Bill, if I do say so myself, brought in some important and necessary changes in the law, most of which have happened, have been welcomed and have gone very well. This change was widely welcomed, but has not been enacted, and the need for it to be enacted has never been greater.

Back in 2019, ahead of the December election, I had promised couples that the regulations to allow civil partnerships would be brought in before the end of the year. On the last day before Parliament was dissolved, those regulations were brought to the Floor of the House, and I had to move them—that would normally be done in Committee—in order to get them through in time with the help of the Chief whip. I do not want to have to do the same at the very last breath just ahead of the 2024 election, because there is no excuse for this not having happened several years ago.

I plead with the Minister. She supports these changes. The Government support these changes. This Parliament—both Houses—supports these changes. Parents, professionals and coroners support these changes. Why is she not getting on with bringing them in? Please, please, please knock heads together across both Departments and get these regulations laid, get the consultation results published, and let us bring in an additional layer of safety for parents who go through the trauma of stillbirth and have unanswered questions when they leave hospital without the child that they had hoped they would leave with.

Legislative Definition of Sex

Tim Loughton Excerpts

Monday 12th June 2023 Westminster Hall

[Tim Loughton (East Worthing and Shoreham) (Con)]

I think many people find it extraordinary that we are having a debate on having to redefine sex in the Equality Act, but people will find it even more extraordinary that some speakers have warned us against having this debate in this place—supposedly, people are frightened about having this debate. There is a problem. That problem has been due to the conflation of sex and gender, and it is this place that rightfully needs to put it right. It is up to us as parliamentarians to speak out—as the opening speaker said, openly, fearlessly and respectfully, and, I hope, also without fear of being cancelled, of appearing in an Oxfam cartoon or of being described as weaponising this important subject.

There is currently confusion about how the Equality Act operates in relation to sex. That is jeopardising the provision of single-sex and separate-sex services allowed for by the Act, including in hospital wards, care provision, sports and schools, as we have heard. Amending the Act to ensure that references to “sex” mean biological sex would resolve that confusion for everyone concerned. It is about clarification, not change. It does not remove the rights of transgender people. They are protected from discrimination on the basis of gender reassignment, which comes under a protected characteristic in the same Act.

The clarification would make it simpler to provide single-sex services and accommodation. It would provide clarity for single-sex associations, including charities, women’s refuges and sports associations. It would also provide clarity to schools, which is increasingly becoming an issue. All of that can be done using section 23 of the GRA without the need for new primary legislation.

I support the first petition to make the Equality Act clearer for several reasons. I echo what other hon. Members have said, but I will talk about one particular application of the Act, which is to allow clear and fair women’s sport, and to ensure it gets the support that it needs. It is just over a decade since London hosted the world’s greatest sporting spectacle, the Olympics, when Team GB did us proud. Since then, one sport after another has allowed male-born athletes who later identify as women to compete as women. Around 60 governing bodies have opened up the female category to male athletes, who benefit from all the physical advantages of testosterone during puberty. Incredibly, that includes some combat sports such as wrestling and judo, which are very physical.

The entire purpose of competitive women’s sport is to allow girls and women to compete fairly, like against like, and to recognise and reward female excellence. That is why we have separate Paralympic games, and separate categories within them to reflect the abilities of certain people. We also do not hear much about transgender men competing in male sport. We know that males are bigger, stronger, faster. During puberty, testosterone broadens their shoulders, and makes their bones and muscles larger and far stronger. There is no way to undo those changes. They are so advantageous in sport that in every single track and field event, the women’s world record has been surpassed many times not just by elite male athletes but by teenage boys.

UK law allows women’s sport to be restricted to females. Even transgender males who have a gender recognition certificate stating that their sex is female can lawfully be excluded from women’s sport, as recently confirmed by the EHRC. However, sporting regulators have said they worry that even with the law behind them, they risk vexatious, costly legal actions and being dragged on social media for being transphobic and exclusionary. A legal opinion commissioned by UK Athletics alerted the body to those risks; it wants to exclude all males from female sports but worries that it will get sued. Sports organisations also worry that they might not be covered by the exclusion that relates to competition when it comes to other parts of sport: training, handing out funding, running recreational sports and providing facilities such as changing rooms.

Last year, the UK sports councils looked at the science, and concluded that it is categorically unfair to allow males into female sport. However, the campaign group Fair Play for Women still knows of men competing in women’s events. In English football, there are around 50 such males. A 30-something male was selected as goalkeeper for the British universities team. In individual sports such as cycling and running, women have lost medals and prizes to males identifying as female.

This is an issue not just for elite sports, but at the junior level. Parents worry that their daughters will get injured on the field playing with bigger, stronger, heavier boys who identify as girls. Faced with such unfairness and risk, women and girls vote with their feet. A measure that is described as “inclusive” actually means that girls and women are excluded from their own competition. This week we have heard about the English women’s angling team. In swimming, many women, including those who have had breast cancer and Muslim women, want female-only sessions, but now they can find a male “woman” in the changing room and in the pool with them. I pay tribute to Sharron Davies for all her work in this area.

It is not fair on women and girls who spend years training in their sport, only to have it snatched away by competing against somebody who is biologically different. We owe it to the amazing women of Team GB to sort out this issue, and we owe it to every girl who dreams of being on the podium one day, like the women who are their sporting heroes. I support the first petition.

Oral Answers to Questions

Tim Loughton Excerpts

Thursday 18th May 2023 Commons Chamber

[Ms Ghani]

The energy charter treaty, which is under review, falls under the responsibilities of the Department for Energy Security and Net Zero, which has been formed from half of my previous Department. In their negotiations to modernise the ECT, the former Departments for International Trade and for Business, Energy and Industrial Strategy worked in close collaboration and DIT led on the investment provisions, so there is no doubt that the hon. Lady’s question would be better focused at the other Department.

[Tim Loughton (East Worthing and Shoreham) (Con)]

11. Whether her Department has provided recent guidance to companies negotiating contracts with Chinese-owned businesses.

[The Minister of State, Department for Business and Trade (Nigel Huddleston)]

Our bilateral trade with China was worth £111 billion last year. The Department provides expert guidance to help UK companies succeed in China, ranging from specialised support through the export support service to practical assistance from our extensive overseas network. We will continue to support engagement, while ensuring our national security and values are protected.

[Tim Loughton]

This House has voted to recognise the genocide by China. This House has passed legislation to limit companies doing business in Xinjiang and to restrict Chinese companies getting involved in sensitive UK infrastructure projects, including Hikvision, which has over a million security cameras in this country and just reported an increase in sales in this country of more 50%. What message does it send when a UK trade Minister, from the Minister’s team, goes to Beijing, feting Chinese Ministers for Chinese investment in the UK, as if the golden age of UK-China relations was still a thing?

[Nigel Huddleston]

My hon. Friend raises many important points, but the key thing is that the relationship with China has been laid out recently in the integrated review, the integrated review refresh and in the Foreign Secretary’s speech, and we have made it very clear that we need to balance our trading interests with our national security interests, for the very reasons that my hon. Friend outlines.