Preterm Birth Committee Report

Baroness Wyld Excerpts

Friday 6th June 2025 Lords Chamber

[Baroness Wyld (Con)]

My Lords, I add my thanks to the noble Lord, Lord Patel. The committee could not have wished for anybody better qualified to be our chair. He did it with his unique blend of professional brilliance and deep compassion, and we were very lucky to have him. I thank my noble friend Lady Bertin, who proposed the committee. As we have heard, she challenged your Lordships’ House to show ambition in its approach to this issue, and I know she made me even more determined to fight for better outcomes for women, their babies and families. She kept telling me to remember who we were doing this for.

On that note, it has been an absolute privilege for me to get to know some of the parents who gave evidence to us. I want to take a moment to acknowledge the strength it took for those parents to come and tell their stories to a public hearing of a Select Committee and to allow us to question them in order that we could find recommendations that would, we hope, improve the experience for others.

I have three general observations. First, given that, as we have heard, we still do not know enough about preterm labour, we owe it to women to do better research, as the noble Lord, Lord Winston, said. Secondly, where we do know a fair bit about ensuring the best possible quality care, women still cannot trust that this will be delivered consistently. Thirdly, as our recommendations show, it should be possible to reduce risk and improve outcomes.

It seems to me that there is a disappointing lack of pace and grip from the Government, despite very warm words in their response to our report. I emphasise that I am very grateful to the Minister for the time that she has given me to discuss these issues. I have said in the national media that I was convinced that the will is there to tackle this issue, and I am very happy to put that on the record here. I accept that the Government are making progress on preventive health care. I was very grateful for the smooth way in which they delivered the regulations to implement the Neonatal Care (Leave and Pay) Bill, which I took through this House in 2023. It is in that spirit that I come to this debate. I will never play politics on this, and I will be delighted if the Minister is able to contradict me in her summing up, because I will now be more critical on the response to our recommendations.

Our committee acknowledged the complexity of preterm birth. Witnesses expressed different views about the usefulness of just one overarching target of a reduction to 6% by 2025, which the Minister has acknowledged will be missed. None of this means that, from a policy perspective, preterm births should be put in the “too difficult” category. The Government have rightly accepted the principle that we need to address focus on tackling the stark and unacceptable inequalities, including the rate of preterm births, that exist for black and Asian women and babies, and women and babies from the most deprived backgrounds. The Government therefore need to set out how they intend to get there. Given that it is almost seven months since publication of the report, I would be surprised if the Minister was unable to say where the Government have landed on targets or whether they have come to a view.

I want to focus in the main on several recommendations from chapters 4 and 5 of the report, in which we examined how to improve the outcomes for preterm babies and the experiences of their families. As we have heard, many babies who are born early flourish, but during our committee sessions we heard from witnesses for whom that has not always been the case, including Francesca and Nadia, both mothers of preterm twins. I cannot do justice to that session in the time available today, but their campaigning call for all parents to be properly supported in the care of their babies born in hospital and on their return home must be acted on by the Government.

It seems to me astonishing that so many of us will stand up today in Parliament in 2025 and have to argue the case that all parents must be able to stay overnight with their tiny and unwell babies in neonatal units, including neonatal intensive care. They should be involved in their baby’s care as much as possible and should be able to hold them. They must be listened to when their instinct tells them that something is wrong. The charity Bliss outlined evidence showing that family integrated care leads to a range of benefits, including increased weight gain, improved breastfeeding, and reduced rates of mortality and morbidity.

If the Government and the NHS agree with this, why have they not yet published the review of the NHS maternity and neonatal estate survey, as requested by the committee and promised “early in 2025”? In answer to a Written Question I tabled in April, the DHSC said that NHS England would do this “shortly”, and we are now in June. Is the Minister able to give a definitive date for this to be published? Given that we await the NHS 10-year plan, can she say what consideration has been given to the need to extend and improve accommodation in neonatal units?

As we have heard, we made it clear that the impact of preterm birth does not end once families go home. Despite the fact that up to 40% of mothers experience symptoms of post-traumatic stress disorder six months after a preterm birth, witnesses told us that counselling after a preterm birth is either “not in place” or “not offered as standard.”

I raised the wider issue of perinatal mental health in the House last month. Can the Minister expand on the answers she gave then to address the committee’s recommendation that the Government and NHS England should detail the steps they are taking to ensure equitable access to neonatal outreach and perinatal mental health services for all families who experience preterm birth?

This ties closely to recommendation 8 on the need to develop specialist knowledge of the needs of preterm babies and their families into health visitor training and continuous professional development, with protected training time. As my noble friend Lady Bertin mentioned, it is people and relationships that can help others turn corners.

Finally, I turn to one of the most disappointing findings of the report, which is that the follow-up assessments for children born pre term that are recommended by NICE

“are not being consistently delivered, in particular at age four”,

as was outlined by the noble Lord, Lord Patel. I think I speak for the whole committee in saying that we were highly dismayed that neither NHS England nor the DHSC could explain why this was the case or who was going to grip it. I know that the Government are in the process of an NHS restructure; I am certainly looking not to open up that debate today but, rather, to emphasise the committee’s desire to see swift resolution here. I would be most grateful for a precise answer from the Minister.

To sum up, although there was a huge amount of specialist knowledge and experience in this report, at its core, it is very simple: we can and must do better for babies, mothers and families. The most powerful evidence comes from those parents who have campaigned with a quiet dignity to spare others the pain that they have experienced. I feel a huge responsibility to keep up the momentum to deliver change for them; I reiterate to the Minister my commitment that I will work cross-party to try to do just that.