I am humbled once again to respond to such an important debate on behalf of the Opposition. I would like to begin by congratulating Antoinette Sandbach on securing today’s debate and on her continuing work in drawing from her personal experience to campaign on behalf of thousands of others who have been affected by this important subject. I also pay tribute to my hon. Friend Mrs Hodgson, who could not be with us tonight. As we have heard, her contribution to the all-party parliamentary group is greatly valued, as is the work of all the members of that group who have spoken tonight. There are something in the order of 630 registered APPGs, but few if any can claim to have so much success in bringing attention to this vital subject and securing a tangible change in policy.
As several Members have said, today’s debate has once again shown Parliament at its best, and I would like to reflect on some of the contributions that we have heard. The hon. Member for Eddisbury spoke in positive terms about the success of the national pathway and gave interesting statistics on parents’ feedback. Some 98% felt that they had been treated with respect, which is really important and, critically, 90% felt that they had been provided with information that was easy to understand. She gave the example of a parent who had to go and speak to the doctor on about five occasions to get an explanation that they were comfortable with, which brought home how important it is in this difficult area for parents to be empowered to ask questions and understand what has happened. It was also interesting to hear that medical professionals gave positive feedback as well.
The hon. Member for Eddisbury expressed concern about ongoing investigations in the Shrewsbury area at the Countess of Chester Hospital, and I am sure that when they conclude we will both have questions to ask. It is worth saying that one of the things of which I have been aware, particularly in relation to the Countess of Chester issue, is the impact on the local community. Many parents, whether they are directly affected or not, have children who were born at the hospital, and were understandably concerned when the news came out. We need to take that on board for future learning.
We heard from Ben Lake, who gave specific examples of how we should improve outcomes, and raised the importance of training and awareness of foetal movements, and improvements in ultrasound scanning. Victoria Prentis gave a wide-ranging speech. She always speaks with great personal knowledge and authority on this matter. She said that media coverage of this issue was pretty impressive and very sensitive, and that there was much more of it. She spoke positively, as did every Member who contributed, about the impact of the pathway. However, she pointed out that only 46% of maternity units provide mandatory bereavement training, some of which lasts only an hour or less. She was right to talk about the impact on staff of some of the issues with which they have to deal. She was right to highlight the fact that of course we need more midwives and that the focus should not just be on recruitment but on retention, and the serious challenges not just in midwifery but across the NHS workforce.
My hon. Friend Hugh Gaffney spoke from personal experience, and I thank him for doing so. He again raised access to mental health support and the lack of bereavement facilities in all units. He discussed the Bumblebee charity in his constituency, which was another example of how individuals turned their own experiences into a force for good. He ended with a tribute to his mother, who had to deal with stillborn babies in, presumably, the early years of the NHS, when things were treated very differently. We ought to pay credit to the service that she gave to the health service in a very different era for dealing with these issues.
It was a pleasure, as always, to hear from Will Quince, who gave a wide-ranging and compelling speech. He spoke about why it was important that we talk about these issues. No matter how short someone’s life, it is incredibly important to the parents. He will know of my own constituent, Nicole Bowles—the badge that I am wearing gives a signal that someone has suffered child bereavement and it is all right to talk about it. That is a really important message that we cannot repeat enough: it is okay to talk about these things, because it helps to raise awareness and discuss matters.
The hon. Gentleman was crystal clear that we need bereavement suites in every unit up and down the country, and he was right about having more midwifery training. He made a very fair point, which I presume comes from his own personal experience, about continuing support for parents when they are dealing with subsequent pregnancies. One can only imagine the anxiety that they face throughout the whole pregnancy in that situation, and I am sure the Minister will reflect on that. The hon. Gentleman also made one of the strongest arguments I have heard in support of international aid and what a difference it can make to tackling baby loss around the world.
Jamie Stone eloquently reminded us that this issue affects grandparents and the wider family, as well as the parents. Dr Johnson spoke from her professional background and experience when she said that the first question the parents always ask is, “Why?” and the second question is, “What can be done to prevent this happening again?” We have heard countless stories of parents taking that second question and using it as a force for good. She raised, as she did in the last debate, the impact on families of having to go to specialist units a long way from their homes, and I hope the Minister will reflect on that. She was also right to highlight the recent increase in sudden infant death syndrome, which is of great concern and is certainly perplexing.
Jim Shannon spoke with great sincerity about his own family’s experiences. He drew a contrast between how his mother’s generation dealt with such issues and how we are beginning to talk about them much more openly today. He was right to say that we are all probably connected in some way to someone who has suffered such a loss.
As we have heard, today’s debate coincides with the 16th year of Baby Loss Awareness Week, which is an important opportunity for us all to unite with bereaved parents and their families and friends to commemorate the lives of babies who died during, before or shortly after birth. I echo the comments made in praise of the more than 60 charities that now collaborate on this week. When I first spoke on this subject two years ago, around 40 charities were involved. That increase in numbers shows what an impact this week has had on raising awareness and bringing people together, which is what we want to see. Each of those organisations should be extremely proud of what they do and of the way they work together to drive through change on a national basis. It seems to be a characteristic of this issue that personal tragedy moves people to go to huge lengths to help others in the same position. In doing so, they display extraordinary levels of courage and resilience, and I pay tribute to them all.
As well as using today’s debate to raise awareness, this is an opportunity to take stock of progress and once again highlight the fact that although excellent care is available in the country, it is not available to everyone everywhere. It has been said many times before and during the debate that one of the key challenges for the Government is to tackle regional disparities. In England alone, there is still a 25% variation in stillbirths. Although there has been a reduction in the stillbirth rate and the perinatal mortality rate, it is quite a slight one, and sadly the neonatal mortality rate in England and Wales has increased two years in a row.
While we can rightly say that we are beginning to improve the approach to those dealing with the consequences of baby loss, it seems that we still have a long way to go in understanding and really tackling the causes of it. The example we have heard a number of times today is that 15 babies every single day are stillborn or do not live past the first month, and it is believed from studies that up to 80% of those deaths could be avoided. As the hon. Member for Colchester said, too many deaths remain unexplained, and as many Members have said, we are still a long way behind where we should be in terms of prevention. According to The Lancet, the annual rate of stillbirth reduction in the UK has been slower than in the vast majority of comparable high-income countries.
One measure that may hopefully make inroads into improving outcomes is the maternity safety training fund, but as a one-off limited fund, it was by definition restricted. I raised the concern last year that time might not be found for the training to reach all those who would benefit from it, so it was disappointing to hear from Baby Lifeline that workforce pressures meant that many staff could not access the training available under the scheme. It gave clear examples of where the training given has improved outcomes, but this must not be the end of the story. The fund needs to be repeated on an annual basis and, crucially, staff need to be given the time and space to take advantage of what is on offer.
In many areas of the NHS, workforce challenges are the biggest barrier to improving outcomes. The “Bliss baby report 2015: hanging in the balance” stated that 64% of neonatal units did not have enough nurses to meet safe staffing levels and 70% of units looked after more babies than is considered safe. That was three years ago, and on many indicators, the staffing situation is more acute now than it was then. We know that we have a shortfall in nurses of more than 40,000. We have more nurses and midwives leaving the register than joining it, and registrations by people from the European economic area are dropping dramatically. We know that the demographics of the existing workforce are not in our favour, which is why the retention issues raised are so important. I would be grateful if the Minister updated us in his concluding comments on whether any progress has been made to improve the figures that Bliss set out in 2015.
It is also worth considering staffing challenges in the context of the worthy aim of introducing a continuity of carer model, when even the modest target of 20% of women being covered by March 2019 looks challenging. Can the Minister can say whether we are on track to meet that and when he anticipates there being full coverage? There is ample evidence to show that continuity of care can make a big difference to outcomes as well as the patient experience.
Finally, I want to say a few words about the national bereavement care pathway, as it has been rightly trumpeted this evening. It is clearly making a big difference on the ground, but it needs to be rolled out comprehensively as soon as possible. The Prime Minister indicated some time ago that it would be rolled out nationally by about this time. Again, I wonder whether the Minister can update us on that ambition.
In conclusion, the debates that we have had over the last few years, and again tonight, underline the importance of the work undertaken by hon. Members and the many charities in the sector. It means that the silence that we talk about is now beginning to end. It is not possible to overstate how courageous those who have spoken out about their personal experiences are or how influential those interventions have proven to be. Having now spoken out, we must continue to talk about what we need to do to improve outcomes. This year my council will be joining the wave of light, and I am hopeful that other public buildings in my constituency will join in—I am doing what I can to encourage them. Such symbolism can only increase public awareness of this subject, and if actions like that reach just one grieving parent who may have felt that they were alone, but who now feels that they have someone to turn to, then it will have been worth it.