Child Death Review Process

– in the Scottish Parliament on 26th February 2019.

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Photo of Kenneth Gibson Kenneth Gibson Scottish National Party

1. To ask the Scottish Government, in light of recent Office for National Statistics figures showing that 218 avoidable child deaths occurred in Scotland in 2017, what progress has been made in implementing a child death review process, and when it will report. (S5T-01516)

Photo of Jeane Freeman Jeane Freeman Scottish National Party

We are establishing a national hub for the prevention of child deaths, which will launch in March this year. Its focus will be to oversee the child death review process to drive a reduction in child deaths, and it will start in full in early 2020. We are currently piloting that process in three health board areas, with a further two pilots commencing later this year. We will be investing £1 million from April in that important work.

Photo of Kenneth Gibson Kenneth Gibson Scottish National Party

As the cabinet secretary will be aware, the number of avoidable deaths among infants and children is proportionately higher in Scotland than elsewhere in the United Kingdom. The 2017 figures include victims of violence and accidents, and birth defects, sometimes linked to smoking and alcohol. Does she agree that, for the parents and those closest to the children who have died, it can be particularly traumatic to consider a death to have been avoidable, and therefore that minimising such fatalities must be an absolute priority?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

Mr Gibson is right that the number of avoidable deaths among infants and children is proportionately higher in Scotland than elsewhere in the UK. However, it is important to note that, since 2008, there has been a 32 per cent reduction in the number of child deaths under the age of 18 in Scotland.

I agree that minimising avoidable child deaths should be a priority for the Government, and it is. We are committed to driving down the rate of child deaths in Scotland by learning from the child death review process and working with the Royal College of Paediatrics and Child Health to ensure that we get the process right and, most important, that we apply the learning across the whole of our health service.

Photo of Kenneth Gibson Kenneth Gibson Scottish National Party

Professor Russell Viner, the president of the

Royal College of Paediatrics and Child Health, said that the Scottish Government is

“certainly moving in the right direction” by

“tackling child poverty and obesity. However, despite recommending a Scotland-wide child death review process to be implemented over four years ago, this is yet to ... be established.”

I welcome the 32 per cent reduction in deaths that the cabinet secretary has just mentioned and the new hub. Does she agree that the delay over the past four years implies that avoidable child deaths are not getting the priority that they deserve? How will she convince parents and others that the Scottish Government is urgently addressing this matter?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

I am grateful to Mr Gibson for that important supplementary question, and I understand why people are frustrated at what they feel has been too long a time before the process is fully in place. It is a priority for me and for the Government. We will launch in full in a month’s time. We will continue to update the Parliament on that process. It really does matter.

Over the past 10 years, we have seen a 32 per cent reduction in the number of child deaths under 18, a 28 per cent reduction in neonatal mortality and a 25 per cent reduction in the number of stillbirths.

Nonetheless, there is more that we need to do. We are working to establish the hub and to run the pilot processes in a staged way so that learning can be replicated across our boards. We will keep a close eye on the process and, as we make progress in the course of this calendar year, we will update the Parliament in order to reassure people that it really is a priority for the Government.

Photo of Miles Briggs Miles Briggs Conservative

It should concern every member of the Scottish Parliament that avoidable deaths among children, babies and teenagers are higher in Scotland than anywhere else in the UK.

Figures that were released in November 2018 showed that 600 babies have been born addicted to drugs in Scotland since 2015. What is the Scottish Government doing to take forward the pre-birth approach, as recommended by Sir Harry Burns?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

Much of the work in the best start programme, which I know Mr Briggs will be familiar with, as well as an innovative and improved approach to maternity care and the work that has been undertaken by Mr FitzPatrick on the healthy weight and diet programme, looking at preparation for pregnancy, all feeds into working with mums and those who are about to be mums on what they need to do to be as healthy as they can be so that their child can be as healthy as it can be when it is born.

That work is also picked up by our community-based midwives and our increased number of health visitors. It all comes together to begin to tackle issues such as smoking in pregnancy. We know that women want to address those issues, but sometimes they can feel that it is all too much and they are not quite sure where to start.

Using those healthcare supports through the midwife and the health visitor, who can develop important relationships with pregnant women and new mothers, is important in helping people—in a non-judgmental way—to make some of the changes that are critical for the healthiest possible birth of their new babies.

Photo of Mary Fee Mary Fee Labour

There remains a significant link between material deprivation and life expectancy. Figures that were released in December 2018 revealed that a boy who is born in one of the most affluent areas of the country can expect to live more than 10 years longer than one who is born in one of the poorest. What specific steps will the cabinet secretary and the Government take to end the scandal of health inequalities that persists in Scotland?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

A number of areas of work to tackle health inequalities are under way. As I am sure Mary Fee appreciates, not all of those sit in the health portfolio, and we need to tackle such inequalities much more widely. Work is being done on measures, such as the baby box and the new best start grant that is being administered by our new social security agency, that attempt to get practical support into the hands of mums, babies and small children. With our deep-end practices, community-based healthcare workers, community mental health workers, link workers and others, we are also looking at how we can reach all the people we need to reach on the preventative and improved lifestyle approaches that we need them to take.

However, we need to do that in a way that reflects where people are, rather than appearing to be judgmental and lecturing or being open to the accusation that it is easy for someone like me to say how they should stop smoking, eat more healthily or exercise more. When people are struggling to make ends meet and have families to bring up, such advice can seem too much and too impractical. By using connections with trusted healthcare workers and others to help people to identify practical ways within their means to make changes and improvements to their lifestyles, we will begin to tackle health inequalities. Such work can be done not only in this portfolio but more widely across the Government; work that is going on in education and elsewhere also plays a part.

It would be beneficial if, at some point—perhaps Mary Fee and I could co-operate on this—the Parliament could have a wider debate about how we might tackle health inequalities in the round, across our portfolios in the Government. I would be very happy to meet her to see whether we could make progress on that.