Lilian Greenwood mentioned the issue of inquests into stillbirths. I have been leading on that area in the all-party group because of my previous legal background and the fact that I spent much of my legal life conducting inquests on behalf of the Government. There is a current private Member’s Bill on this issue. It is a very broad Bill; the Member in charge likes to refer to it as the hatched, matched and dispatched Bill, which gives some idea of its scope. This is an extremely difficult and sensitive area both legally and in terms of the messaging. Many interest groups are concerned that it touches on the law about abortions and the law about when babies become beings and part of society, but there is no need for much of that discussion in this debate; it does not in fact need to touch on those terribly difficult issues. We in the all-party group are working hard with the Department and the Ministry of Justice, which is also very involved in this, to push this issue forward and to try to ensure that that does not happen and that we are able to address any concerns in the very small number of cases where an inquest would be helpful and extra transparency is needed. I know from my own experience that inquests are very hard for families. The Scots are also working in this area, and, give us time, as next year we may have some announcements, I hope.
Returning to Sands, I want to mention the brilliant work of my constituent Karen. She is one of the 40 volunteers to be nominated as part of the charity’s anniversary celebrations, and I am looking forward to welcoming her to Westminster later this week at our parliamentary reception. I am also very much looking forward to the service we are having in St Mary Undercroft on Thursday and I encourage anybody who works in this House, whether as a Member or peer or any of our staff, to come to that service. It is extremely warm and friendly; everybody might weep throughout, but in a positive way.
I must also praise the BBC—wow, two Conservative MPs praising the BBC in successive speeches—for highlighting our awareness week. The slot on “The Chris Evans Breakfast Show” this morning meant I had to stop the car; it was about the amazing bereavement midwife Nicola Taylor and a couple she helped around the birth of their three babies, and it was incredibly powerful. Fiona Crack’s story is currently on the BBC website. If any Member’s concentration wavers in this debate, I ask them to look at it, or perhaps better to do so when they get home tonight. “Woman’s Hour” is also handling this issue extremely sensitively and well.
I want to touch on three points this evening. First, the bereavement care pathway is, as my hon. Friend the Member for Eddisbury said, a real success. I received some brilliant care but also some less good care when our baby died 18 years ago. Crucially, the national bereavement care pathway embeds the standards across trusts—across the nation—as a matter of course; that is very important. The situation at present is still patchy. According to Sands, only 46% of trusts with maternity units provide mandatory bereavement care training for maternity unit staff. Of those, 86% provide their staff with just one hour or less of training on bereavement care each year.
While it is of course right that we focus on families, we should also think a little about midwives and obstetricians, who are also very affected by the death of a baby in their care. They often build up an enduring relationship with families, and their future health and ability to function must be considered in thinking about what training they receive.
I want to focus on neonatal units, too. They are very stressful places. Anybody with a child on a neonatal unit is not a happy parent; it is not the place they want to be. Some 41% of neonatal unit patients have no access to a trained mental health worker, and many neonatal units still do not have dedicated bereavement facilities. The Government have funded better bereavement places in nearly 40 hospitals, but this is only the beginning. Prioritising the pathway within the new NHS long-term plan would make a real difference. Planning one year ahead is not good enough. We know that despite our best efforts to reduce neonatal death and stillbirth bereavements will continue to occur, and we need to plan for that. I hope the Minister will have some good news for us on this today. My hon. Friend described the Government as passing the exam with flying colours. I agree and am very grateful for what they have done, but I would say that if the Government want to be an A* pupil, further work is needed in this area so that this becomes the norm.
My second point is that better training is only possible if we have enough midwives. I hosted the launch of the Royal College of Midwives “State of Maternity Services” report recently, which found that finally more midwives are entering training. When I hosted it last year we were very concerned by the ageing of the profession. We are all getting older—we cannot help that—but I am pleased to say that we now have over 2,100 more full-time equivalent midwives in the NHS than we did in 2010, and the vast majority are in their 20s and 30s. It is also important that we focus on retaining these midwives and persuading former midwives back to work. This is progress in the right direction, but the situation remains critical. I really do wake up at night worrying about labouring mothers in my constituency in north Oxfordshire going to the Horton General Hospital to give birth only to be told that the unit has closed because the midwife who staffs it has been sent to cover gaps at the John Radcliffe. This been the case on at least three separate occasions in recent weeks. If anybody knows of anyone who is thinking of becoming a midwife, please encourage them to do so. It is a brilliant profession and it is important that the Department continues to encourage the training and retention of the midwives we need.
Finally, I want to touch on perinatal mental health. On the eve of world mental health day, it seems appropriate to focus on the mental health of mothers and fathers. Pregnancy presents the health service with a brilliant opportunity to engage with people who are becoming parents and to give them life lessons that will improve health choices for them and their children. Their mental health is as important as their physical health. We know that those who have had difficult pregnancies or have lost children will, understandably, struggle with subsequent births. We need to identify families at risk and pour resource in before it is needed. These families may not fit into the usual definitions of post-natal care.
The definition and structure of care in the six-week post-natal period has changed very little in the past 150 years, but during this time there have been dramatic changes in women’s health and our attitude to birth—and indeed in the outcomes of birth. It is critical that contraception is also discussed and is easily available during this time. Waiting months to have a long-acting contraceptive fitted is not helpful to new mothers. It might seem ridiculous to bring up the subject of contraception in a debate on baby loss, but it is important given the maternal mortality statistics. Some of the women who are dying while giving birth should not have been pregnant in the first place. It is critical that we deal with contraception early, where that is appropriate, and that we give people real choices so that they can get the contraception that works for them straight after they have given birth.
We in the all-party parliamentary group will continue to say the unsayable on issues such as baby ashes or the appropriateness or otherwise of inquests. These are dark areas for any society to deal with, but I believe that the APPG has been a force for good. I am really proud to play my part in breaking the silence.