Reducing Baby Loss — [James Gray in the Chair]

Part of the debate – in Westminster Hall at 9:53 am on 20th July 2021.

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Photo of Fleur Anderson Fleur Anderson Shadow Minister (Cabinet Office) 9:53 am, 20th July 2021

It is a pleasure to serve under your chairship, Mr Gray, and to follow my hon. Friend Lilian Greenwood. I congratulate and thank Cherilyn Mackrory for securing this incredibly important debate. I am so sorry for her loss but I thank her for her bravery in sharing it and for her ongoing campaigning in this area.

I also thank campaigning organisations, including the Stillbirth and Neonatal Death Society, Tommy’s and the Lullaby Trust, and all the members of the Pregnancy and Baby Charities Network, as well as bereavement organisations such as the Good Grief Trust for all they do to support parents and families and for their continued campaigns for change.

I thank all my constituents who have recently written to me about this important debate, underlining the reason for having this debate now and why we need to look again at the plan for the national ambition to reduce baby loss and at progress towards that. I am certain that all Members present share my ambition that the UK should be the safest place in the world to have a baby. However, as broken-hearted mothers and fathers across the UK can testify, it is not, and that is the reason for the debate today.

There are stark inequalities: background makes a difference, as well as where mothers have their babies. That should not be case—the highest standards should be equally available across our country. Recent reports from the Health and Social Care Committee, the Ockenden review of maternity services at Shrewsbury and Telford Hospital NHS Trust, the ongoing investigation at East Kent Hospitals University NHS Foundation Trust, and the devastating revelations from Nottingham University Hospitals NHS Trust—which have been outlined by my hon. Friend the Member for Nottingham South—plainly demonstrate just how much more there is to do.

Although huge strides have been made over the past two decades, that progress has now plateaued and we need to know why and address this. In 2019, the neonatal mortality rate in England and Wales was 2.8 deaths per 1,000 live births, the same as it was in 2017—the third consecutive year of no change. The latest statistics for neonatal mortality published by the World Bank rate the UK as the 37th country globally, making us one of the worst-performing countries in the developed world in this area. As the hon. Member for Truro and Falmouth highlighted, the recent report into progress on maternal mortality said that

“No discernible progress has been made towards reducing the 2010 rate of maternal deaths by 50% by 2025.”

There are huge inequalities in the experience of maternal mortality and baby loss that have gone unaddressed for too long. Babies from minority ethnic and socioeconomically deprived backgrounds remain at an increased risk of death: if a woman is black or poor, it is more likely that she will die or that her baby will die, which is absolutely unacceptable. In 2017, babies born to black or black British parents had a 67% increased risk of neonatal death compared with babies of white ethnicity, and babies born to Asian parents had a 72% increased risk of neonatal death compared with babies of white ethnicity. The 2020 MBRRACE-UK “Saving Lives, Improving Mothers’ Care” report shows that the risk of maternal death in 2016 to 2018 continued to be four times higher among women from black ethnic minority backgrounds than among white women, and that that risk is twice as high for women from Asian backgrounds as it is for white women.

The Office for National Statistics’ latest “Births and infant mortality by ethnicity in England and Wales” report, published in May this year, highlighted substantial inequalities in infant mortality rates among black and other ethnic minority groups. Some of this variation may be explained by other areas of inequality, including deprivation, but the association between social deprivation and child mortality is clear, and there are modifiable factors that can make a difference. This can be addressed—it can be changed. I have raised this issue with NHS South West London Clinical Commissioning Group, and it must be addressed in partnership with those who have relevant lived experience and build on the knowledge of specialist agencies in each area.

Two further issues that need action have been raised with me by constituents. The first is miscarriage: a constituent has raised with me the issue of access to information and support following a miscarriage, and Tommy’s is campaigning on this issue as well. I met with a constituent yesterday who told me that women in the UK have to endure three consecutive miscarriages before they are referred for full investigation. She feels very angry about this situation and how it has affected her and women across the country. It is simply unacceptable for a couple to go through that much suffering and uncertainty and for it not to be addressed until there have been three miscarriages.

Another issue is that of culture. We are talking a lot today about funding: there is a need for increased funding, for staffing in particular, but there is also the issue of culture, which was raised by my hon. Friend the Member for Nottingham South. One constituent wrote to me to say that there had been a lack of investment over a long period of time and that that had played a big part in why the services are what they are today, but she also wanted to highlight behavioural issues within maternity—with bullying and hostile attitudes among members of staff. She said that trainees in obstetrics and gynaecology report a high rate of being undermined, higher than other medical specialities.

It is also well known that, in some services, hostility between midwives and obstetricians contributes to services being unsafe. These issues, not only about resources but about culture, need to be addressed and understood: there needs to be a cultural shift. Reporting should be welcomed within NHS trusts, and change should result from such reporting.

I have some requests for the Minister today. First, I underline the calls from Members earlier in the debate about the need for enhanced data collection and sharing. What gets counted counts, and the first thing anyone sitting down and looking at this area sees is that there are big gaps. Secondly, there should be a review of the impact of covid on our neonatal services.

Thirdly, there should be a plan to increase staffing levels; as has been outlined, we need to increase those. How much will they be increased by next year, the year after and the year after that, so we can achieve those 2025 levels? There needs to be action on ethnic disparity and much more focus within every clinical commissioning group on why those differences exist, learning from each other and from best practice and building on that, with a change in culture where needed.

What additional measures is the Minister taking to achieve the national ambition to halve stillbirths, neonatal deaths, maternal deaths and brain injuries by 2025? As we have seen in the debate and from the recent reports and statistics, business as usual is not going to achieve those aims at all. Will the Government commit to publishing specific national targets before the end of 2022—earlier, ideally—that reflect a bold commitment to action on inequalities due to ethnicity and deprivation, underpinned by specialist pathways and workstreams in every local maternity system?

I pay tribute to all the midwives working so hard across our country for all that they have had to change and go through in the last year, and to all the families affected by the issue. Ambition is all well and good, but it needs to be matched by action and boldness. A lack of both is currently letting down parents and babies across the country and it has to change, starting today.