Oral Answers to Questions

Tim Loughton Excerpts

Tuesday 6th February 2018 Commons Chamber

[Jackie Doyle-Price]

We are becoming increasingly conscious of drinks with additional unnatural stimulants and their impact on people’s health generally, but obviously that becomes more acute with children’s health, so we will look more closely at it. I am glad that the hon. Gentleman has highlighted the initiatives that have been taken by individual retailers, because it is up to them to implement good practice.

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

Does my hon. Friend agree that the best way to achieve strong health and good mental health for children is at the very earliest stages and through forming a strong attachment between that child and their parent in the first 1,001 days from conception? If so, why is there not more in the mental health Green Paper about perinatal mental health?

[Jackie Doyle-Price]

The Green Paper very much focuses on what we are doing in schools, but my hon. Friend is absolutely right. He highlights the earliest of early intervention, and one reason why we are investing so much more in perinatal mental health is to ensure that the bonds between mother and baby are as strong as they can possibly be.

--- Later in debate ---

[Mr Speaker]

I will call the hon. Member for East Worthing and Shoreham (Tim Loughton) if his question is shorter than his tie.

[Tim Loughton]

Lipoedema affects 10% of women in this country, many without a diagnosis, so why are an increasing number of my constituents saying they cannot get any therapeutic interventions funded by the CCG? Will the Minister meet a delegation of those people and other hon. Members similarly affected?

[Steve Brine]

Yes, of course I will meet my short-tied hon. Friend with the delegation he requests.

Social Care

Tim Loughton Excerpts

Thursday 7th December 2017 Commons Chamber

[Jackie Doyle-Price]

The whole purpose of a Green Paper is to allow us properly to debate and challenge all options available. I am interested in what has happened in Scotland. The hon. Gentleman says that personal care is met by the Government there, but the lion’s share of costs for the elderly is of course the residential component, which is not met by the Scottish Government. We need to make sure that we are learning from the experience of everybody not only in these four nations, but across the world.

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

I appreciate the importance the Government attach to adult social care, but the title of this statement is “Social Care” and, as the Minister knows, I have a strong interest in children’s social care. At a time when the number of children coming into care continues to rise, the thresholds for intervention are rising and preventive work is I fear going south. As the number of adoptions has also diminished, will she and the Government reassure me that they attach the same importance to dealing with the challenges faced by children’s social care services up and down the country at the current time?

[Jackie Doyle-Price]

I absolutely give my hon. Friend that assurance. If I may, I will suggest to my hon. Friends in the Department for Education that they respond to him on those points.

Maternity Safety Strategy

Tim Loughton Excerpts

Tuesday 28th November 2017 Commons Chamber

[Mr Hunt]

I am happy to recommit to that. I apologise to the hon. Lady and her constituents for the delay. I will look into what happened right away.

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

The hon. Member for Nottingham South (Lilian Greenwood) pre-empted my question about my Bill and coroners. I make the offer to sit down with the Secretary of State and his draftsman to decide on the wording of my private Member’s Bill, which will be debated on 2 February, as the fastest way to achieve his goals and get the solution that all Members of the House want.

[Mr Hunt]

I am happy to do that and am most grateful for that very generous offer.

Oral Answers to Questions

Tim Loughton Excerpts

Tuesday 14th November 2017 Commons Chamber

[Mr Hunt]

That is absolutely our intention. We have signalled to the EU and to European countries that we want the closest possible relationship post-Brexit. We have made that big and generous offer, and we hope that they accept it.

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

T3. Thank you, Mr Officer Dibble Speaker. In my constituency we have the outstanding-rated Worthing Hospital and some outstanding GP practices, but we also have the Sussex and East Surrey sustainability and transformation plan, which has been rated in category 4 —“needs most improvement”. Part of the problem is that it is too big and does not follow a natural footprint. Will the Minister support local calls for it to be withdrawn, and help to make it fit for purpose and sustainable?

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

Sustainability and transformation plan footprints were determined as a result of discussions between local areas, NHS England and NHS Improvement. They reflect a number of factors including patient flow, the location of different organisations in the local health economy and natural geographies. We stated in the next steps of the “Five Year Forward View” that adjusting STP boundaries is open to discussions between us and NHS England when that is collectively requested by local organisations, and we mean that.

Baby Loss Awareness Week

Tim Loughton Excerpts

Tuesday 10th October 2017 Commons Chamber

[Victoria Prentis (Banbury) (Con)]

Thank you for calling me, Mr Deputy Speaker, although I have to say it is not a pleasure to speak in today’s debate. It is absolute torture for many of the speakers who have chosen to share their experiences with the House. It is, however, a pleasure to follow the extremely knowledgeable speech, as ever, of the hon. Member for Central Ayrshire (Dr Whitford). It is so good to hear the good news from Scotland about the real developments that have come from investigation into what happens when things go wrong.

I am most grateful to business managers—even if I am quite close to some of them—for allocating time during Baby Loss Awareness Week, and to all those who organised the extension of today’s sitting. It is a testament to the way the House has changed. I am grateful that you, Mr Deputy Speaker, have chosen to be in the Chair after your traumatic experiences last year listening to us. We are most grateful to all those who have enabled this debate.

It is fair to say that maternal safety keeps me awake at night. Issues with the maternity unit at Horton General Hospital in my constituency sadly continue. It is good to see my hon. Friend the Member for Witney (Robert Courts) in his place. I do not know what keeps him awake at night. Indeed, I do not know whether he is kept awake at night. If he is, I suspect his young son probably has something to do with it, but I also know that he worries as much as I do about the future of the unit. The uncertainty goes on. My hon. Friend, other campaigners and I are not giving in. I remain convinced that the current situation is unsafe. Significant numbers of transfers are taking place during labour. Babies have been born at the side of the road and in ambulances. Mothers and their babies are not getting the sort of care that is safe, kind and close to home, which is what everybody in the Chamber wills them to get.

Out of this morass sadly comes some dreadful casework. I have noticed that when something goes wrong, the shutters come down in the health service. Hospitals are on the defensive from the beginning and legal teams are called in. In one of the saddest cases I have had to deal with over the past year, Oxford University Hospitals NHS Foundation Trust responded by saying that it would not meet me or the family in question without legal representation. My attempts to ensure that there was a full and external review of the case by MBRRACE-UK, for example, were stalled for months. This is simply not acceptable. Families, along with most of us, are motivated by a burning desire to ensure that what happened to us will not happen again. They are not interested in compensation except where that is necessary for looking after a desperately sick child. They are motivated by change in practice.

Sir Charles Pollard, the former chief constable of Thames Valley police, has been working tirelessly on producing restorative solutions in the justice sector—that is my background—and increasingly in the health sector, where the needs of all parties, including families, doctors and staff, are crucial. Constructive conversations can be had in carefully controlled environments. I think, particularly after having a lengthy conversation with my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), that it is important to find a new language. We do not want to apportion blame to anyone in any way, unlike in the justice sector. Finding a new language would be good for families and for staff, who are often traumatised by a loss on their watch.

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

There have been some exceptional speeches on this sensitive issue. I am not sure whether my hon. Friend is aware that my private Member’s Bill—the Civil Partnerships, Marriages and Deaths (Registration Etc.) Bill—includes a clause to give coroners the power to investigate late-term stillbirths. Extraordinarily, that is currently not available to them. Many parents who have gone through difficult stillbirths where the circumstances are unclear would like an independent assessment of what went wrong so that everybody can learn from the situation. I am sure my hon. Friend will support that.

[Victoria Prentis]

I will most certainly support that.

The hon. Member for North Ayrshire and Arran (Patricia Gibson) made an excellent speech in which she mentioned inquests and fatal accident inquiries. I do not know why so many of us involved in this debate are lawyers; it is very strange. These are, of course, very sensitive legal issues. We are talking about when a person becomes a person—things that we have not spoken about in places such as Parliament or the courts, and perhaps should have done, over the years. We have allowed a body of law to grow up that does not fit current requirements. Even though restorative solutions are great, inquests may also be appropriate and may also act restoratively. They do not have to be legalistic. They can be inquisitive, which is why inquests came into being. Inquests and, in Scotland, fatal accidents inquiries, have an important part to play in preventing stillbirths and neonatal deaths.

Today is World Mental Health Day, so it is particularly appropriate that we are talking about the bereavement care pathway in Baby Loss Awareness Week. As we have heard from other hon. Members, the pathway is very good in places but variable in others. We are making progress but we need to do more to ensure consistency, and I know the Minister is on top of this. The Care Quality Commission does not currently ask sufficiently in-depth questions about the quality of bereavement care on offer, but I am encouraged by the constructive conversations I have had with it on behalf of the all-party parliamentary group on baby loss recently and am hopeful that we will have real progress to report this time next year.

I would like to end on a high. Petals opened its new bereavement counselling service in Banbury yesterday, in the Horton General Hospital, and I was very pleased to be there. It offers bereaved families six sessions per couple. That might not be enough, and it certainly might not be appropriate for mothers and fathers to be seen together, but the evidence shows that what it does is of very real value and that its outcomes are valuable and beneficial to the couples who use its service. Lots of charities do similar work, as is clear from our well-attended APPG meetings.

We might not enjoy these debates, but they have begun to change both perceptions and the law, and I am grateful to the Minister and the previous Member for Ipswich for all their work. I would like to finish by congratulating us all.

Adult Social Care Funding

Tim Loughton Excerpts

Thursday 6th July 2017 Commons Chamber

[Steve Brine]

They have not all been sensible, but yours was marginally more sensible.

As I said earlier, this is a rapidly growing sector and it is imperative that we get the right people into the right jobs. That is why it is so important to work with organisations such as Skills for Care to improve the level of skills, and people in this sector are expected to benefit from the national living wage.

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

Worthing has the highest proportion of over 85-year-olds in the country. They tend to be not particularly well off, and their major asset is their property; so can the Minister ensure that, in welcoming the fact that we will have a grown-up debate at last, any sustainable solution recognises that people who have worked hard, paid their dues, looked after their family and done the right thing should be appreciated, not penalised, for having done so?

[Steve Brine]

I have said that we will consult on detailed proposals later this year, which will include a capital floor and an absolute limit on the amount that people can be asked to pay. Those two critical pillars must go together.

Baby Loss (Public Health Guidelines)

Tim Loughton Excerpts

Tuesday 21st March 2017 Commons Chamber

[Will Quince (Colchester) (Con)]

As my wife will testify, I am rarely early for things, so to be more than three hours early for something is a rare treat indeed. I know that both you, Mr Deputy Speaker, and the Minister will be pleased to know that I intend to take only about two and a half hours of the just over three hours available to me.

As the House knows, I am a passionate campaigner in the area of baby loss. Having unfortunately experienced it myself, I have always been clear that I want to use my position in the House to bring about change so that as few people as possible have to go through this absolute personal tragedy. In the latest year for which figures are available, there were 3,254 stillbirths in England and Wales, with a further 1,762 neonatal deaths shortly after birth. Every single one of those is a personal tragedy, yet perhaps the most galling aspect is that so many of these deaths—reportedly about half—are actually preventable.

I strongly welcome the Government’s plans to cut the stillbirth and neonatal death rate by 20% by 2020 and, furthermore, to reduce it by 50% over the next 15 years, but those are just numbers unless we put in the resources necessary to deliver on this. Trusts have received £4 million to buy better equipment and boost training to cut stillbirth and neonatal death. More than £1 million is also being provided to help develop training packages so that more maternity unit staff have the confidence to deliver safe care. It is hugely positive that the Department of Health has recognised the scale of the challenge and set aside this funding, but we need to focus as much on reducing the risks of stillbirth.

One significant risk factor remains one of the toughest to eliminate and, as a result, carries the greatest reward if we can address it: smoking in pregnancy. Let me be clear that this debate is absolutely not about criticising or demonising women and their partners who smoke during pregnancy. We all know that tobacco is highly addictive and it can be difficult to stop smoking. However, smoking while pregnant is the No. 1 modifiable risk factor for stillbirth. If I may, I will run through a few statistics: one in five stillbirths is associated with smoking; women who smoke are 27% more likely to have a miscarriage; their risk of having a stillbirth is a third higher than that of non-smokers; and mothers who smoke are more likely to have pre-term births and babies are who are small for their gestational age.

Maternal exposure to second-hand smoke during pregnancy is an independent risk factor for premature birth and low birth weight, yet only one man in four makes any change to his smoking habits when his partner is expecting a baby. If, tomorrow, every pregnancy was smoke-free, we would see 5,000 fewer miscarriages, 300 fewer perinatal deaths, and 2,200 fewer premature births every year. Were children not exposed to second-hand smoke, the number of sudden infant deaths could be reduced by 30%.

The previous tobacco control plan set targets for reducing rates of smoking in pregnancy. In 2015-16, the number of women smoking at the time of delivery had fallen to 10.6%—below the Government’s target of 11%—yet the fact that the Government’s target has been met nationally masks geographical variations. Yes, we are seeing rates of 2% in Richmond, 2.2% in Wokingham and 2.4 % in Hammersmith and Fulham, but rates of smoking in pregnancy are 26.6% in Blackpool, 24.4% in South Tyneside and 24.1% in North East Lincolnshire.

Of the 209 clinical commissioning groups, 108 met the national ambition of 11% or less, but that means that 101 did not. It is even more worrying if we look for improvements in the rates of smoking in pregnancy in CCG areas. Yes, 14 CCGs have improved significantly over the past year, but 182 have rates that are about the same and, even more worryingly, 13 have significantly worse maternal smoking rates.

The Government have committed to renewing targets to reduce smoking in pregnancy. Reducing regional variation in smoking during pregnancy and among other population groups is a high priority for the Minister, and I know the Government are focusing on it as they finalise the tobacco control plan. I was pleased to see the recent news that NHS England granted £75,000 of funding to the 26 CCGs that are most challenged on maternal smoking.

How do we achieve the Government ambition for a 50% reduction in stillbirth and neonatal deaths by 2030? First, we need to publish a new tobacco control plan. The previous tobacco control plan for England expired at the end of 2015. The Government have promised that a new one will be published shortly. The publication of the strategy is now a matter of urgency, so will the Minister kindly advise on how shortly “shortly” is?

The strategy needs to include ambitious targets for reducing smoking in pregnancy. The Smoking in Pregnancy Challenge Group—a partnership of charities, royal colleges and academics—has called for a new national ambition to reduce the rate of smoking in pregnancy to less than 6% by 2020. I know the Department of Health is sympathetic to that aim and hope it will be included in the new tobacco control plan.

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

I congratulate my hon. Friend on securing a three hour and 53 minute debate on this important subject and thank him for all the work he does on baby loss. He may well address this issue later in his speech, but does he agree that the alarming figures for regional differentials also apply to stillbirth rates more generally? Another issue is cultural differences between different sections of our populations with very different outcomes. That, too, must be a priority for the Government, because wherever in the country someone is, surely they are entitled to the same level of support and the same health outcomes.

[Will Quince]

I thank my hon. Friend for that intervention. He, too, has done a huge amount of work in this area and is hugely supportive of the work of the all-party group on baby loss. He is quite right to highlight the regional variation that exists, and to which the Department is very much alive. I had not intended to focus on the specific demographics, in terms of race, but the figures do show that certain demographics have a higher propensity towards stillbirth. The honest answer is that we do not really know why, so there is a huge need for research in this area. I am not going to discuss that issue, but only because I want to focus specifically on smoking.

My hon. Friend is quite right about that particular demographic, and the reasons behind higher stillbirth and neonatal death rates may well be a public health issue. I hope that the Minister and the Department will look into that independently of this debate.

Secondly, communication to pregnant women must be sensitive and non-judgmental. Qualitative findings from the babyClear programme found that pregnant smokers found the interventions unsettling, but they were receptive to the messages if they were delivered sympathetically. To do that, healthcare professionals must feel able to have conversations about harm and have clear evidence-based resources and support for pregnant women.

Thirdly, the Government should ensure the implementation of guidance from the National Institute for Health and Care Excellence. NICE guidelines recommend that referral for help to stop smoking should be opt-out rather than opt-in. Research published by Nottingham University in April 2016 on opt-out and opt-in referral systems found that adding CO monitoring with opt-out referrals doubled the number of pregnant smokers setting quit dates and reporting smoking cessation.

Further, a recent evaluation of the babyClear programme in the north-east of England found that it delivered impressive results. BabyClear is an intervention to support implementing NICE guidance on reducing smoking in pregnancy. Let me give some background. BabyClear began in late 2012. Since then, smoking at the time of delivery has fallen by 4.0% in the north-east compared with 2.5% nationally. That equates to about 1,500 fewer women smoking during pregnancy in the north-east than in 2012. The cost of implementing the core babyClear package over five years is estimated at £30 per delivery.

Fourthly, we should embed smoking cessation across the maternity transformation plan. There are nine workstreams altogether and smoking cessation is central to achieving success in most of those. As an example, the workstream, “training the workforce”, should include training midwives on CO monitoring and referral, but there is a risk that smoking cessation is siloed into the workstream focused on improving prevention. It is vital that that does not happen.

Finally, the Nursing and Midwifery Council is updating its standards in relation to nurses and midwives. This training must be mandated and have smoking in pregnancy as a key part. These are all steps that can and should be taken by the Department of Health to help maintain the momentum on reducing smoking during pregnancy rates. However, there is one other suggestion that I would like the Minister to take away and discuss with his colleagues in other Departments. All alcohol bought in the UK carries a warning sign making it clear that pregnant women should not consume this product, yet only one packet of cigarettes in six carries a warning about the danger of smoking while pregnant. It is not unreasonable or unrealistic for all tobacco products to carry a similar warning to that seen on alcohol. I would be grateful to the Minister if he looked into the feasibility of introducing such a scheme. I understand that it falls under European law and European regulation, but that may, in the very near future, not be a problem.

This debate is absolutely not about criticising or demonising women and their partners who smoke during pregnancy. I fully appreciate that tobacco is highly addictive and that it is difficult to stop smoking. We also know that all parents want to give their baby the best possible start in life. We want a message to go out loudly and clearly that no matter what stage a woman is in her pregnancy, it is never too late to stop smoking. Yes, that can be difficult, but smoking is much more harmful to a baby than any stress that quitting may bring. Most importantly, we and the Department of Health will give parents all the support and tools to help them to quit.

--- Later in debate ---

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

I had not intended to speak in this debate—I just wanted to be part of it and perhaps to question the Minister—but you have tempted me, Mr Deputy Speaker, to add my three penn’orth. I, too, will not take up the remainder of the three hours and 50 minutes in making a few comments. I again congratulate my hon. Friend the Member for Colchester (Will Quince) on securing the debate.

The Government have made good progress on the smoking front, and that needs to be recognised, but 10.6% of people still smoke through pregnancy. That figure needs to be brought well down into single figures. My hon. Friend made a good point about the use of advertising messages with regard to alcohol. Of course, unlike alcohol, this issue affects only half the population. The graphic images on cigarette packets of diseased lungs, and those grisly television adverts with pus coming out of lungs and so on, really send home the message about the harm that any smoking can do. Making that clear to women who still take the risk of smoking during pregnancy would help to get the figure down further.

We still have a major problem in this country with high levels of baby loss through stillbirth as well as through the rather less quantifiable form of miscarriage, the true extent of which we do not really know. As I said earlier, it must be a priority for Government to work out why we have regional and cultural differences, and to extend and learn from best practice rather better than we do at the moment. Some of the pilots and experiments that have happened in Scotland are something for the rest of the country to look at and learn from.

Given the title of this debate, we could, strictly speaking, extend it well beyond just smoking, and I am going to take advantage of that. On drinking, there has been a very confused message for some time. I am an officer of the all-party foetal alcohol syndrome group. We produced a report that urged complete abstinence as the only safe way, and that must be the default position. For women who do choose to continue to drink in some form during pregnancy, there need to be very clear health messages, and perhaps lower-alcohol alternatives. If someone has to drink, there are ways of potentially doing less damage to their baby. The Government can be part of that through the differential pricing tax mechanism. We are rather bad at that in this area.

I remember going to Denmark some years ago and visiting a children’s home just outside Copenhagen that specialised in treating children who were the victims of foetal alcohol syndrome—particularly children of mothers from Greenland, where there is a particular problem with heavy drinking. Those children were born with all sorts of disabilities, some of which manifested themselves as the symptoms that we know of in ongoing conditions such as autism.

There may be an understating of the effects of foetal alcohol syndrome because it can appear somewhere on the autistic spectrum as well. We need to do more research into that. There is no more stark example than we see in Denmark of a direct correlation between excessive drinking and giving birth to a child who will bear the effects of that for his or her whole life, with the learning disabilities and other things that go with it. We have lessons to learn from that. We still need stronger messages to go out to women during pregnancy about the potential, and potentially lifelong, harm that can be done by inappropriate drinking.

[Gavin Robinson (Belfast East) (DUP)]

Although a strong message is important, the delivery of that message is crucial. There is a good argument for saying that the shock-and-awe messaging used in advertisements about driver safety or alcohol, and on cigarette packets, does not have the impact that we believe it should. Many mothers might take cavalier decisions about themselves, as many of us do. I certainly do when it comes to food and its health benefits; I do not follow the guidance. Does the hon. Gentleman agree, however, that a mother would never want to damage the future prospects of her child? The sensitivity of the message, however strong it is, is the most important element.

[Tim Loughton]

The hon. Gentleman makes a fair point. We, as grown-ups, can make a conscious decision to be gluttonous or to over-imbibe. That does damage to our bodies and our bodies alone, although there may be a cost to the taxpayer through the national health service. If anyone should be more sensitive and sensible about the damage that could be done to another individual, it is a pregnant woman. A pregnant woman, or a woman considering pregnancy, should be more amenable to good health messages.

It is a question of horses for courses, and I take the point that the hon. Gentleman makes about shock-and-awe tactics. The AIDS adverts in the ’80s could be described as shock and awe, and they were exceedingly effective at the time. We still remember those tombstones. One can go too far, however; members of the public are smart, and they recognise over-emphasis for effect. It hits them in the face, and they say, “I do not need to take any notice of that.” We need smart messaging, which is credible and honed appropriately for its target audience.

That is why when we in the all-party group on foetal alcohol syndrome produced our report, we had a big debate about whether we should recommend complete abstinence or whether that was just not realistic for some people, who were still going to drink. I take the view that the default position must be that drinking harms a woman’s baby, but if someone absolutely has to drink, for whatever reason, there are less harmful—but always harmful—ways of doing so. We need to nuance that message appropriately for different audiences. Of course, different cultures have different attitudes to drinking, foods and so on.

I move on to a subject that is completely different, but still within the scope of this Adjournment debate: perinatal mental health. I declare an interest as the chair of the all-party group for the 1,001 critical days, and as the chairman of Parent Infant Partnership UK, a charity that is all about promoting good attachment among parents and their children in the period between conception and age two. One of the biggest, most powerful and most effective public health messages that we can give is that effecting a strong attachment with one’s child, right from the earliest days, will have lifelong benefits for that child. That includes the time that the child is in the womb. A mother who is happy, settled and in a good place is much more likely to pass on those positive messages to a child than a mother who is stressed and suffering from perinatal mental illness or various other pressures.

At least one in six women in this country will suffer some form of perinatal illness. We know from the science, which is producing considerable data, that a child who is not securely attached—preferably to both parents but certainly to the mother, to start with—is much less likely to thrive at school and to be settled and sociable, and more likely to fall into drink and drug problems and to have difficulties with housing and employment. The first 1,001 days are absolutely critical, and we should be doing more. It is a false economy not to do so, and not to invest money early on.

The Government have quite rightly flagged up the importance of mental health. The Prime Minister absolutely gets the importance of mental health, and particularly of perinatal mental health. The additional money allocated is good, but it is still not enough. The problem, as we all know, is that that money is not making it through to the sharp end, so opportunities are still being missed to identify women who have some form of mental health problem—typically depression around the time of pregnancy—signpost them to the appropriate services and deliver quality and appropriate services in a timely fashion. That is why the charity I chair, PIP UK, has seven PIPs around the country, operating out of children’s centres, to which women can be referred, often with their partners, to get the support and confidence they need to effect the strong bond and attachment with their child.

The Maternal Mental Health Alliance has costed the problem of not forming such bonds at £8.1 billion each and every year. I repeat that, each year, the cost of getting it wrong is over £8 billion. The cost of getting it right is substantially less, yet too many clinical commissioning groups around the country still do not even have a plan for delivering perinatal mental health for women where and when they actually need it. On top of that, in our report “Building Great Britons”, the all-party group calculated that the cost of child neglect is over £15 billion a year in this country. By not getting it right for really young children and for babies, we are therefore wasting £23 billion financially, but far more importantly we are not giving those children the very best start in life socially, which we could do with a bit more, smarter and better targeted up-front investment.

I reiterate to the Minister and his colleague, the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon (Nicola Blackwood)—she very kindly saw a delegation from the all-party group on the 1,001 critical days recently, and I know she takes this subject very seriously and has convened a roundtable—that we absolutely must come up with such public health messages and talk in this place about the importance of getting it right early on, but what matters at the end of the day is actually delivering the service to those women where it is needed, at the appropriate time and place.

Finally, may I take the liberty of mentioning to the Minister, as I think I did in a previous Adjournment debate, the question of the registration of stillbirths? It is a subject on which I have campaigned for some years in this place, and on which I have had a private Member’s Bill. This falls within the remit of baby loss, which is in the title of this Adjournment debate; I know you are scrupulous, Mr Speaker, about our not straying beyond the remit of a debate.

Following some very helpful responses from predecessor Ministers and officials at the Department of Health and having convened various roundtables—with the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists and other key players, as well as various stillborn charities—I thought we had got to a place where the law could be changed to emulate what has been done in New South Wales in Australia. However, we still have a iniquitous and highly distressing situation: somebody who has gone through the trauma of carrying a child as far as 23 weeks and six days will find, if the child is, tragically, born prematurely and stillborn, that the child is not recognised in the eyes of the state, although a child born just after the 24-week threshold will be recognised as a stillborn child. I have previously raised the example of a woman who had twins either side of that threshold: sadly, they both died, but one was never recognised, while the other was recognised as a stillborn child, with a certificate being issued by the hospital.

For a woman who has given birth to a stillborn child, such a situation is one of the most sensitive and vulnerable of times. My hon. Friend the Member for Colchester knows this so well, and other hon. Members have given their own very emotional accounts of going through such traumas. The fact is that the state has still, so far, failed to take the straightforward and fairly cost-free step of coming up with a simple registration scheme for those for whom such a scheme would help to provide some form of closure.

For a stillborn child born at under 24 weeks—what I am talking about is different from miscarriage, although I am in no way trying to underplay the trauma caused by having a miscarriage—to be recognised as a human being, rather than as a child who, sadly, was born before an artificial threshold, seems to me to be a sensible but humane thing to do to help the too many women who still give birth to stillborn babies. We need to bring that figure down, and we are doing so. In the meantime, we can at least give some succour and comfort to parents who have to go through this situation by saying that we appreciate and recognise what has happened, and sympathise and empathise with what they have gone through.

May I ask the Minister again whether there is any way that we can get this campaign going again? The issue has featured in one of our national soaps: an actress who went through it in real life re-enacted it in “Coronation Street”. There has also been a lot about it in the press. I ask the Minister to ask his Department to look at this issue again to see whether something can be done, because I think there could be a solution.

Mr Speaker, I have more than abused my privilege in this three hour and 50 minute debate, but these are issues on which there is a good deal of sympathy and empathy in the House. Yet again, we are greatly indebted to my hon. Friend the Member for Colchester for bringing them back to the House, where we have the power to make a difference to our future constituents’ lives.

[The Minister of State, Department of Health (Mr Philip Dunne)]

I congratulate my hon. Friend the Member for Colchester (Will Quince) on securing this debate on public health guidance and baby loss. I also congratulate you, Mr Speaker, on scheduling it on a day when the other business, inexplicably, was so curtailed, thereby enabling some very distinguished Members on both sides of the House who chair directly relevant all- party groups to make unusually—I would not say unprecedentedly, Mr Speaker, because you would be better placed than I to say whether it was unprecedented—long contributions in an Adjournment debate, and very welcome they were too.

We know from families who have experienced baby loss that the silence that often surrounds the loss can make the experience much harder. For that reason, I join the tributes from the right hon. Member for Rother Valley (Sir Kevin Barron) and my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) to my hon. Friend the Member for Colchester for the work that he does in leading the all-party parliamentary group on baby loss and for bringing the experiences that he has suffered to bear on this issue a number of times.

Before I address the specific points made by my hon. Friend the Member for Colchester—I counted six challenges that he laid down in his speech, and I will try to address each of them—as I have the luxury of a little time, I will set the scene on the work the Government are undertaking to reduce adverse outcomes during pregnancy and the neonatal period.

My hon. Friend referred to the maternity transformation programme in England, which began a year ago. It provides an opportunity to shape services for the future. Improving women’s health requires a collaborative approach across the entire health system, including commissioners, primary care, maternity services, public health and local authorities, to meet the needs of women and their partners. The result of all that work is that England is a very safe country in which to have a baby. Sadly, a small number of babies are stillborn or die soon after birth but, according to the latest figures, stillbirths and neonatal deaths occur in 0.5% and 0.3% of births respectively.

We are absolutely committed to improving maternity care and recognise that every loss is a personal tragedy for the family concerned. As a result, it is our national ambition to halve the rate of stillbirths, neonatal deaths, maternal deaths and brain injuries that occur during or soon after birth by 50% by 2030. We are making considerable progress. The other day, I had the privilege of attending the Royal College of Midwives awards ceremony—one of the more enjoyable parts of my role in the Department of Health—where I was able to confirm that since 2010, the proportion of stillbirths is down by 10%, the proportion of neonatal deaths by 14% and the proportion of maternal deaths by 20%. Our plan is having some effect, which is very pleasing, but there is always more that we can do.

To support the NHS in achieving this ambition, we have a national package of measures with funding attached, including: an £8 million maternity safety training fund to support maternity services in developing and maintaining high standards of leadership, teamwork, communication, clinical skills and a culture of safety; a media campaign, “Our Chance”, comprising 25 animations and videos targeted towards pregnant women and their families to raise awareness of the symptoms that can lead to stillbirth; and a £250,000 maternity safety innovation fund to support local maternity services to create and pilot new ideas.

The fund was allocated in the past couple of weeks. One project that secured funding will develop a one-stop multidisciplinary care clinic for women with diabetes, hypertension, morbid obesity and epilepsy. Another project aims to develop a pathway whereby all women with high carbon monoxide breath test results—this was referred to by my hon. Friend—are referred for serial ultrasound measurements to provide them with more information about the potential impact of smoking on the child they are carrying. We are also investing £500,000 to develop a new tool to enable maternity and neonatal services to systematically review and learn from every stillbirth and neonatal death in a standardised way.

The Government are seeking to put in place infrastructure to improve maternal health, but clearly young mothers, partners and families have a role to play too. The evidence shows that the national maternity ambition cannot be achieved through improvements to NHS maternity services alone and the public health contribution will be crucial. It is vital that women and their families are made aware of and understand the lifestyle risk factors that can impact on the outcomes for them and their babies, and the changes they can make to increase their likelihood of positive outcomes. Hon. Members referred to a number of them.

As soon as a lady knows she is pregnant, she should be encouraged to contact her maternity service for a full assessment of health, risk factors and choices, so that a personalised plan of care can be prepared. Women with complex social factors, in particular teenagers and those from disadvantaged groups, do not always access maternity services early or attend regularly for antenatal care, and poorer outcomes are reported for both mother and baby. Maternity services need to be proactive in engaging all women.

Early in pregnancy, a midwife will provide a woman with information to support a healthy pregnancy. This will include information about nutrition and diet, including supplements such as folic acid and vitamin D as well as lifestyle advice, central to which is smoking cessation—on which my hon. Friend focused his remarks—the risks of recreational drug misuse and alcohol consumption, which my hon. Friend the Member for East Worthing and Shoreham focused on in his remarks.

When starting pregnancy, not all women will have the same risk of something going wrong, and women’s health before and during pregnancy are some of the factors that most influence rates of stillbirth, neonatal death and maternal death. We know that a body mass index of over 40 doubles the risk of stillbirth. A quarter of stillbirths are associated with smoking, and alcohol consumption is associated with an estimated 40% increase to stillbirth risk. In addition, the MBRRACE-UK perinatal mortality surveillance report, published in June last year, showed that women living in poverty have a 57% higher risk of having a stillbirth. Women from black and minority ethnic groups have a 50% higher risk, and teenage mothers and mothers over 40 have a 39% higher risk of having a stillbirth.

Those striking facts are why the Department of Health will continue to work closely with Public Health England and voluntary organisations to help women to have a healthy pregnancy and families to have the best start in life. Last year, NHS England published new guidance that aims to reduce the number of stillbirths in England. Building on existing clinical guidance and best practice, the guidance was developed by NHS England working with organisations including the Royal College of Midwives, Royal College of Obstetricians and Gynaecologists, British Maternal and Fetal Medicine Society and Sands, the stillbirth and neonatal death charity. The Saving Babies’ Lives Care Bundle includes key elements intended to significantly impact on stillbirth rates through reducing smoking in pregnancy, detecting foetal growth restriction, raising awareness of reduced foetal movement and improving effective foetal monitoring during labour.

I now come specifically to the challenges posed by smoking in pregnancy. My hon. Friend the Member for Colchester stole most of my thunder by declaring many of the statistics on the impact of smoking, but I am particularly pleased that he focused on the fact that the plan, as set out in the tobacco control plan for England in 2011, which set a target to reduce the number of women smoking in pregnancy to 11% or fewer, has now been achieved at the national level, with a rate of 10.6% for England as a whole. As my hon. Friend also pointed out, this masks wide geographical variations across the country, ranging from 4.9% across London to 16.9% in Cumbria and the north-east. There was an even greater difference at the level of clinical commissioning groups, from which I believe my hon. Friend collected his statistics. These range from 1.5% at the low end to over 26% at the higher end, which is clearly a totally unacceptable variation.

Although we have made progress in recent years, about 70,000 babies continue to be born each year to mothers who smoke—and more if we include exposure to second-hand smoke. My hon. Friend made an interesting observation about the impact of partners continuing to smoke while their partners are pregnant. My hon. Friend mentioned the figure of 25%, so for one in four pregnant women their partners continue to smoke. That is an area on which we need to focus our attention and seek to raise the awareness of the impact of passive smoking. I am grateful to my hon. Friend for raising that issue.

Smoking during pregnancy is the main modifiable risk factor for a range of poor pregnancy outcomes. It is known to cause up to 2,200 premature births, as my hon. Friend said, 5,000 miscarriages and 300 perinatal deaths every year across the UK. It also increases the risk of developing a number of respiratory conditions, attention and hyperactivity difficulties, learning difficulties, problems with the ear, nose and throat, obesity and diabetes. Pregnant women under 20 are six times more likely to smoke than those aged 35 or over. Specialist stop smoking support, while available to pregnant women, clearly needs to be targeted on those higher-risk groups. That provides much of the challenge that my hon. Friend set for us in his remarks.

We are looking to take considerable action to advance the cause of reducing smoking. My hon. Friend asked in particular when we intend to publish the next iteration of the tobacco control plan. He asked me to define a well-used parliamentary term—“shortly”. I regret to say that it is way beyond my pay grade to provide closer definitions of that term. There are others, including someone who recently arrived in the Chamber, who might have some influence on the speed with which plans emerge from the Government. I very much hope that we will be able to progress with the next iteration of the tobacco control plan in the next few months.

My hon. Friend referred to the babyClear programme, which is about informing pregnant women about the risks they run from continuing to smoke. It is an important programme that has been evaluated by Newcastle University, which published some findings last month. We think that this is closely aligned with the NICE guidance, which is appropriate. It builds on the point made by my hon. Friend and by the hon. Member for Belfast East (Gavin Robinson) about the sensitivity involved in giving advice to pregnant women. My hon. Friend the Member for East Worthing and Shoreham referred to the mental health challenges that pregnancy can cause for some women. I think there is a sensitivity involved in the delivery of hard-hitting messages to women who find it impossible to shake their addiction to smoking. We must be aware, in conveying the message that persisting in smoking during pregnancy may lead to long-lasting damage to the baby, that there may be mental health implications to which we need to be alert.

My hon. Friend the Member for Colchester mentioned the possibility of introducing an opt-out, rather than an opt-in, for carbon monoxide testing of women who present as pregnant to their maternity services. That is an interesting idea, and I am certainly willing to discuss it with NHS England and the Department. If it is possible for such a test to identify pregnant women who are smoking, it would be foolish of us not to introduce it.

My hon. Friend referred to the maternity transformation plan. I will write to him giving a specific response to his ideas and explaining how they might be used to embed smoking cessation in the nine elements of that plan. I cannot give him a similar reassurance about the training programmes for midwives, because they are determined independently by the Nursing & Midwifery Council and it is not for me to prescribe what should be involved in such training, but the debate will doubtless be heard by the midwife trainers.

My hon. Friend’s final request was for a warning on cigarette packets that would specifically alert people to the risks of smoking during pregnancy. Again, I am afraid that that is not in my gift, but it is a very interesting idea. As was pointed out by the right hon. Member for Rother Valley, there are already some stark and shocking images on cigarette packaging. We have just engaged in a major consultation that has led to the introduction of plain packaging. I suggest that my hon. Friend send his proposals to those who are responsible for monitoring the impact of plain packaging across Government.

I hope that I have addressed my hon. Friend’s points. Let me now respond to the requests from the right hon. Member for Rother Valley, who is the vice-chair of the all-party parliamentary group on smoking and health, in relation to e-cigarettes. He suggested that, as a research priority, we should ask Public Health England to consider whether they are helpful or unhelpful in encouraging pregnant women to stop smoking, and also whether the nicotine contained in them could lead to foetal damage in the future. I think that that is potentially an interesting subject for research, and I should be happy to pose the question to Public Health England.

I am pleased that my hon. Friend the Member for East Worthing and Shoreham was able to contribute to the debate, because he is very knowledgeable about these issues. He welcomed the progress that is being made in reducing smoking, and I am glad he recognised that. However, he focused many of his remarks on another aspect of public health guidance, in his capacity as chair of the all-party parliamentary group for foetal alcohol spectrum disorder.

[Tim Loughton]

I am not the chair. I am an officer.

[Mr Dunne]

I stand corrected.

Significant health messages are being sent about the consequences of continuing to drink while pregnant, and, again, progress is being made. I do not have the figures in front of me relating to the level of alcohol that pregnant women continue to consume, but the Government share my hon. Friend’s ambition. We must continue to bear down on alcohol consumption, because it has the potential to cause lifelong harm to babies.

My hon. Friend finished with a request that we consider once more the registration date for stillbirths, and his example of the twins falling either side of the 24-week definition puts the points very concisely and starkly. Again, I am not in a position to give him comfort on that issue here and now, but I will write to him, having consulted colleagues in the Department of Health on where we stand on it.

On that basis, I am very grateful to my hon. Friend the Member for Colchester for securing this debate and giving us the opportunity to spend almost an hour, I think, discussing this subject, which is unusual and welcome.

Question put and agreed to.

Oral Answers to Questions

Tim Loughton Excerpts

Tuesday 21st March 2017 Commons Chamber

[Mr Dunne]

I recognise that when the proposal was put forward back in 2012, it led to a process that we felt was wrong, and we therefore stopped it. This process, we hope, is being conducted in a more rigorous and fairer way, and will lead to outcomes driven, as I say, by improving patient experience.

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

13. What the estimated cost of private finance initiative liabilities to the NHS is in (a) 2016-17 and (b) the subsequent three financial years.

[The Minister of State, Department of Health (Mr Philip Dunne)]

Labour’s legacy cost from the 103 hospital PFI schemes entered into between 1997 and 2010 was a public sector liability of £77 billion. The estimated total NHS PFI payments for the financial year ending at the end of this month is £1.97 billion, and the totals for the next three financial years are £2.04 billion, £2.11 billion and £2.16 billion.

[Tim Loughton]

Those are alarming figures, so what are the Government doing to support the trusts affected by those expensive and inflexible PFI and other deals reached under the previous Labour Government? What assessment has the Minister made of what the funds could be buying in the NHS now if it was not saddled by this Labour debt legacy?

[Mr Dunne]

My hon. Friend is right to point out that the Opposition constantly complain about the cost of the PFI programmes that they themselves initiated. The Government are making large efforts to support trusts in dealing with the PFI legacy. We are giving the seven trusts worst affected by PFI schemes access to a £1.5 billion support fund over a 25-year period. In 2014 alone, trusts negotiated savings worth over £250 million on their contracts.

Health and Social Care

Tim Loughton Excerpts

Monday 27th February 2017 Commons Chamber

[Anne Marie Morris]

My hon. Friend makes a fair point. I have one of those constituencies where communities are not very well off. Many of the facilities that are there to provide social care are failing because we do not have the more affluent individuals who can ensure that some of our care homes, particularly nursing care homes, are alive and well. I am now down to just three for a very large constituency, and that is completely inadequate.

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

My hon. Friend and I both have constituencies with a large proportion of elderly people. Indeed, Worthing has the highest proportion of over-85s in the whole country. This is a double whammy, because people who are over 85 tend to require a great deal more healthcare, stay in hospital for longer, and have multiple problems in hospital that cost more—we are looking after them well and need to look after them better—and the social care side when they do come out of hospital, too often delayed, is costly as well. Those are the growing pressures that the estimates appear not to take proper account of.

[Anne Marie Morris]

My hon. Friend makes an extremely good point. He is right that the cost of ageing is not adequately taken into account. The way the Government measure health outcomes is predicated on the number of births and looking at the lifespan of the population. Because people live longer in areas like my constituency in Devon, it is assumed that we therefore have better health outcomes, but that does not allow for the fact that we have a low number of live births. Many people move into our lovely area when they are much older, and so the level of improvement is small. There are some basic, fundamental flaws in the way the Government—not just this Government; it has gone on for years—estimate the need in an area. As my hon. Friend rightly says, one of the biggest challenges is age.

Integration is expected somehow to be the solution to all our problems, but there is no transition funding to allow for double running, and there are, as far as I am aware, not many pooled budgets. As we have heard, these plans make certain assumptions about the recruitment of individuals, but we cannot recruit at the level we need now, never mind what we will need for the future. There is also a lack of training in the specialisms that we are going to need. Specifically in some of our more rural areas—we have talked about the ageing population—we need more specialist generalists. That is agreed by most of the royal colleges, but it is not being put into practice. So many issues will impact on the effectiveness of integration that I doubt that it is really going to be a way forward in reducing costs. I am concerned that the integration model, while very welcome, has not been fully thought through. The barrier to its being successful is that there will be unbudgeted costs. There is no evidence for the assumption that demand will decrease, and so no evidence that integration will deliver savings. It therefore seems to me that these estimates cannot really be sound. Real cost estimates are needed.

We have failed to address the element of social care that is paid for privately. I refer here to the Dilnot report and the Care Act 2014. We are talking about how the Government’s money—the taxpayer’s money—is to be shared out between the two systems, but we should never forget that social care is means-tested as opposed to the NHS, which is free at the point of delivery. If we do not try to ensure that the necessary savings are made by individuals taking responsibility, with or without the Government stepping in, we will find that the demand on the NHS is simply too great for the system to succeed and for these estimates to be valid.

Defibrillators in Public Areas

Tim Loughton Excerpts

Monday 16th January 2017 Commons Chamber

[Maria Eagle]

The hon. Gentleman has had a frightening experience in his family, and also learnt the incredible importance of not only having defibrillators available, but having people who know how to use them. I could hardly better his family’s example of how important that is.

A study by the British Heart Foundation found that for every single minute without defibrillation, chances of survival fall by between 7% and 10%. The Care Quality Commission sets a response target of eight minutes for emergency ambulance services, but we know that ambulances cannot possibly arrive within that time in every case. Even if they did, the chances of survival without immediate defibrillation and CPR will have already plummeted to 20% or lower. Access to a defibrillator can therefore make a huge difference. If cardiac arrest is recognised, basic first aid is given, 999 is called and CPR is applied, in combination with rapid and effective defibrillation, the chances of survival can exceed 50%. In fact, in some cases it can be as high as 80%. However, immediate action is vital. A defibrillator must be at hand for those survival rates to be realised.

Three people who know that better than most are my constituents Mark, Joanne and Ben King. In 2011, Mark and Joanne King lost their son Oliver, and Ben lost his brother. Oliver tragically died following a sudden cardiac arrest while racing in, and winning, a school swimming competition. He was just 12 years old. He had a hidden heart condition, and without access to a defibrillator at school his chances of survival on that day were dramatically reduced. Had he lived, this Saturday would have been his 18th birthday.

I never met Oliver, but I have been struck by talking to those who knew him well. He was clearly a very happy and popular boy, judging by the tributes that poured in from those who knew him following the shock of that terrible day. He was known as a big character at King David High School. His teachers recall his “uncompromising zest for life” and how he was loved and respected by boys and girls and teachers alike. His best friend David recalls Oliver’s charm and how it was deployed on more than one occasion to get them out of a tricky situation. This year is particularly difficult for David, as he will be celebrating the milestone of turning 18 without his best friend.

Everyone mentions Oliver’s love of football—he was a staunch Evertonian. His family and friends all recall his great talent and potential on the pitch. One of his teachers describes him as

“a sportsman at heart and a natural at whatever he turned his hand to”.

Above all, Oliver was caring, loving and incredibly close to his family:

“family was everything to Oliver.”

It goes without saying that Oliver’s death left many who knew and loved him with a great sense of loss. His family and friends are sadly not alone in going through this terrible ordeal. As well as the thousands of people who die every year following sudden cardiac arrest, there are thousands more who are now faced with the agonising reality of living without their loved one.

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

I pay tribute to the hon. Lady for bringing this important subject to the House and for her good fortune in having, potentially, three and a half hours in which to debate it. She has given an emotional case of somebody for whom, for the sake of a relatively simple and inexpensive bit of kit, the outcome might have been different. Does she agree that public buildings—certainly places such as schools—should automatically be fitted with a defibrillator?

Will the hon. Lady pay tribute to Sompting Big Local in my constituency, which has a lottery grant for the enhancement of the village? Its first priority was to install four defibrillators in every corner of the village, including one outside the local pharmacy, because it saw it as a worthwhile thing to do. Many other people have imaginatively used things such as redundant telephone boxes by replacing them with defibrillators as an obvious help point for local people. Should not we just be doing those things automatically?

[Maria Eagle]

I agree very much with the hon. Gentleman. He has set out an example from his constituency. Around the country, there are many ways in which communities are starting to ensure that they have access to defibrillators so that, if needed, they are there. I welcome that. We should try to ensure that defibrillators are available throughout our land—up and down, north and south, and east and west. What happened to Oliver is not as rare as we might hope. In the UK, some 270 young people tragically die every year of sudden cardiac arrest while at school. That furthers the hon. Gentleman’s point that having defibrillators routinely available in schools seems to be a no-brainer.

In 2012, Oliver’s parents, Mark and Joanne, set up the Oliver King Foundation in memory of their son. It aims to raise awareness of the conditions that lead to sudden cardiac arrest, which is vital as the family did not know that Oliver had any condition that might have led to what happened. If they had known, probably with the diagnosis of a simple electrocardiogram test, they may well have been able to take steps that could have avoided what happened. Other aims of the foundation are to purchase and place defibrillators in schools and sports centres, to train staff how to use them and to hold screening events to enable simple, painless ECG testing to help diagnose such conditions and ensure that what happened to Oliver does not happen to the children of other families.

Mark and Joanne have done an incredible job. Their aim is simple: to ensure that no more families have to go through what they did, knowing that the death of a son, daughter, mother, father or friend may have been prevented. They campaign tirelessly and effectively to ensure that every school in the country is equipped with an automated external defibrillator. They have the support of more than 200 hon. and right hon. Members of this House, across parties.

Automated external defibrillators are specifically designed for use by non-medically trained people. They are remarkable, life-saving machines that are not difficult to use. The machine will apply an electrical pulse only when it detects an irregular heart rate and it talks the user through the process, step by step. However, at about £1,200, AEDs are not cheap and, even if provided, some people are often afraid of using them. As a result, many schools and high-risk public areas in the UK are still not equipped with them. As a direct result of the work of the Oliver King Foundation, more than 800 schools and public places now have this life-saving kit and people who are confident to use it. In Liverpool, Oliver’s home city, not a single school is now without one thanks to the work of the foundation and Liverpool City Council.

The foundation has also managed to train 15,000 people around the country in how to use an AED, thus making sure that in sudden difficult circumstances the confidence is there to use this life-saving kit. As a direct result, 11 lives have been saved that would otherwise have been lost, including an elderly gentleman who suffered a heart attack at his local gym. Thanks to the staff’s quick thinking and use of the gym’s defibrillator, he was sat up and talking by the time the emergency services arrived. In Woolton in my constituency, where Oliver used to live, an AED provided by the foundation was deployed three times this December alone. If the defibrillator is available and training is provided, people will use one: it is as simple as that.

However, we cannot and should not be reliant on charities to do all the heavy lifting and work in this policy area. In November, the hon. Member for Lewes (Maria Caulfield) introduced the Defibrillators (Availability) Bill under the 10-minute rule procedure, with the purpose being to

“increase the rates of survival rates from non-hospital cardiac arrests across the UK”.

Its objective is basically to do for the nation what the OK Foundation has done for Liverpool and is continuing to do in its work in other places: providing defibrillators in public places and training people to use them.