Covid-19

Kirsten Oswald Excerpts

Tuesday 12th May 2020 Commons Chamber

[Kirsten Oswald (East Renfrewshire) (SNP) [V]]

I start by sharing my huge gratitude to all the key workers in East Renfrewshire, who are doing such important work, and to the brilliant volunteers supporting our local community at this difficult time. I also pass on my condolences to those in East Renfrewshire who have lost loved ones.

For the UK Government to be described as “reckless” by the British Safety Council in the midst of a pandemic should make even this Prime Minister pause. It was a disappointment that he did not share his planning or consult—not just with the devolved Administrations, but with local authorities, trade unions, employer representatives, and even, reportedly, his own Cabinet. Having set his announcement for Sunday to allow people to get going with the measures on Monday, it emerged that no preparation had been done with regard to transport, childcare and many other issues. Confusion reigned, even among the Ministers set out to do the morning media rounds. Most announcements applied only to England—although you would struggle to tell—but many in the Prime Minister’s party are demanding that all four nations march towards the cliff edge in lockstep. The response from Scotland is firm: no chance.

Is it really time to stop protecting the NHS? If not, why is that disappearing from the heart of the campaign in England? And why was the “Stay Alert” slogan launched with green imagery? It is not difficult to see the signal that that is designed to send. As the Prime Minister prevaricates and blusters, it is clear that he is trying to nudge the population into an ill-considered move. Telling people to deal with the pandemic by staying alert is an abrogation of responsibility. A crisis of this magnitude demands leadership; thank goodness for Nicola Sturgeon and her fellow First Ministers.

But there is no going back to the same old, same old—even if we wanted to. The Prime Minister’s enthusiastic but vague encouragement for people in England to hop in their cars and get back to work is neither sensible nor realistic. It displays a lack of connection to the reality of people’s lives, never mind their working lives. The Prime Minister needs to remedy that as a matter of urgency if he has any interest in workers’ safety and wellbeing.

I applaud the UK Government for bringing in the furlough scheme but, as ever, the devil is in the less publicised detail. There will be disquiet at the impact on jobs of the employer contribution that the Chancellor announced today that he is looking for. I and other colleagues have been calling for flexibility in furloughing, and the Chancellor said today that there can be flexibility from August; we need to see partial furloughing before that. The Scottish Chamber of Commerce asks that flexibility takes account of a company’s ability to contribute, which will differ depending on location and sector. I hope that the Chancellor will take that on board.

Despite the recognition of the vulnerability of pregnant women at the start of this crisis, it took until yesterday for half a sentence of guidance to be produced. Women have had to take sick leave or annual leave because the UK Government failed to listen when the issue was highlighted to them. If we are to achieve an orderly end to lockdown when the time is right, listening will be vital, and fair, safe, flexible work will be key. The Government should focus on not only sustaining jobs but enhancing fairness and employment rights as we look ahead. They must properly examine how a universal basic income could underpin a sustainable and fair recovery, which will be so important in the months and years ahead.

Covid-19 Update

Kirsten Oswald Excerpts

Tuesday 5th May 2020 Commons Chamber

[Matt Hancock]

My right hon. Friend and I have been in discussions about this important issue. We have strengthened the rules on discharges to ensure that anybody being discharged from hospital into a care home gets tested and is then isolated ahead of the result of that test. If the test is negative, they can of course go into the home in the normal way; if the test is positive, that isolation must continue until they are through the virus and safe to go into the care home without taking coronavirus into the care home. I am glad to see in the latest numbers that the number of those who are dying from coronavirus in care homes is just starting to fall, but there is an awful lot more that we still need to do.

[Kirsten Oswald (East Renfrewshire) (SNP) [V]]

The Secretary of State said earlier that the tracing app would have privacy by design. It will be critical that there is a high degree of public confidence in the app if it is to work as he intends as part of efforts to trace the virus. What data protection will be put into place to ensure that the public are confident that this tool will be secure and that data cannot be misused?

[Matt Hancock]

The public can have confidence, not least because the data will be held on people’s own phone until they need to contact the NHS when, naturally, they will of course need to tell the NHS their identity in order to be tested. In that sense, privacy is there by design.

The wider point is that the app and the test, track and trace system will help to keep people safe. As I said yesterday when I launched the pilot in the Isle of Wight, people should download the app to protect the NHS and save lives. It is the civic duty of people on the Isle of Wight to do so, and it will be the civic duty of people throughout the country to do so. It has been designed with privacy at its heart. We are putting the source code on the internet so that people can see exactly what the app does. That reassurance, along with the motivation that they are helping to protect themselves and their community, will, I hope, lead to an awful lot of people downloading the app. I certainly will.

Surrogacy: Government Policy

Kirsten Oswald Excerpts

Tuesday 21st January 2020 Westminster Hall

[Andrew Percy]

I thank my hon. Friend for that intervention, and will come on to the issue of surrogacy arrangements in the United States. Nobody would question that surrogacy arrangements in that country operate in the best interest of the child, but they operate on a wholly different basis to surrogacy arrangements in the UK: they operate on a commercial basis, which many of us would not want to see here. It is fair to say that in this country, surrogacy arrangements work. There is no doubt that the welfare of the child is at the heart of surrogacy arrangements, and at the heart of the courts in this country. However, as the debate progresses, we can of course take examples of best practice from other jurisdictions, whether through legally enforceable surrogacy arrangements or whatever else.

[Kirsten Oswald (East Renfrewshire) (SNP)]

Does the hon. Gentleman share my view that it is important to focus on the altruistic nature of surrogacy as we go forward in this debate, and make sure that the welfare of the children concerned is not adversely impacted by an overly commercial focus?

[Andrew Percy]

I entirely agree. I will say more later, but there is a debate in the surrogacy community about the nature of payments and whether its basis should be altruistic or commercial. Throughout the process, the view of the all-party parliamentary group on surrogacy, which I formed with other hon. Members, has been that we must maintain the altruistic basis of surrogacy in the UK. There are others in the community who take a different view; I will say more about that in a moment.

The all-party parliamentary group undertook a number of hearings in response to the Law Commissions’ proposals. The principal purpose of the debate is to explain where we agree with them and where we do not, and I thank the Law Commissions for the way they have engaged with us. They have been proactive and positive in coming to APPG meetings and some of the hearings, and they have been open throughout the process. That view is shared by everybody across the surrogacy community.

We took evidence from a number of interested parties. We heard from surrogates, intended parents, parents who have created their families through surrogacy, and the legal community. We even took evidence from Tom Daley who, with his partner, chose to undertake their surrogacy arrangement in the UK, not in the United States, precisely because there are some big reasons why the US is not as attractive a jurisdiction—although it is perfectly safe—for such arrangements. Those sessions were really interesting and valuable. In response to the Law Commissions’ initial consultation, we have some clear views on what we would like to see.

[Andrew Percy]

It is absolutely the case that we need updated legislation. We welcome the arrangement of Tom Daley and his partner, Dustin Lance Black—I have just remembered his name; I am not very good at remembering actors’ names—because they are two loving parents who have created a loving family. They are a good example, because they demonstrate better than anyone, or as well as anyone, how loving families can be created in a range of ways—through surrogacy, IVF, adoption or marriage—in the UK in 2020.

Dustin Lance Black also undertook an interesting set of radio programmes, one of which, following surrogacy arrangements in the US, explained why they chose the UK and felt that the system here was better. The hon. Member for Strangford (Jim Shannon) is spot on, however, that we need a well-regulated and updated framework for surrogacy in the United Kingdom.

We as an all-party parliamentary group are positive and pleased by the Law Commissions’ proposals. We recognise how progressive many of them are, and that they balance most of the concerns about safeguards, ethical surrogacy and the welfare of children—of course—that were raised by stakeholders throughout the process. We also welcome the fact that, unlike in previous reports, the lived experience is front and centre of all the proposals. We believe that the commissions have engaged positively with the whole surrogacy community and interested parties.

Where do we agree? As I said, we are happy that a full root and branch review is taking place. We are also pleased that there is no move towards allowing the commercial surrogacy that we see in the United States, because it would then become the preserve of the wealthy. That is not the case with the altruistic nature of the current system, although it is not without expense or challenge. We have a situation in the United States where some families are now going out of the United States to undertake surrogacy because they cannot afford it there.

[Kirsten Oswald]

Everything that the hon. Gentleman has said builds up to the suggestion that it would be important to have clear guidance on what is meant by things such as “reasonable expenses”, and to balance that by ensuring that the regulation put in place is effective, efficient and fit for the intended purpose.

[Andrew Percy]

Absolutely; I could not agree more. That is exactly what we are calling for in the draft legislation, on which we hope we will receive support from both Front-Bench spokespeople. Although we want to avoid the commercial arrangements that exist elsewhere, we want a consultative focus on what payments should be considered legitimate in that surrogacy arrangement. In fairness, the Law Commissions’ consultation puts some of those things into broad categories of what may or may not be considered appropriate.

We also welcome the potential relaxation around advertising for or as a surrogate, and the proposal to divorce the issue of payments and costs from that of legal parenthood, so they are not tied together in the court system. When it comes to legal parenthood, the court system should be dealing only with what is in the best interests of the child.

In the survey undertaken by the Surrogacy UK working group on legal reform, 82.3% of surrogates surveyed thought that legal parenthood should be determined at or before birth. People who go through surrogacy want to create families for other people; they do not want to be the legal parent at birth. They are not doing it to become a parent, but to help others to become parents. Surrogates clearly want the issue of legal parenthood to be dealt with before birth.

We also agree with the Law Commissions’ proposal for a new pathway to enable that, so that by going through the new pathway, intended parents would achieve legal parenthood at or before birth after going through a number of stages. One of those proposed stages is seeking legal advice, about which there are mixed views, because putting lawyers into the middle of something can be very expensive, but we certainly agree that having implications counselling before undertaking surrogacy is important.

We agree that the new pathway should include the surrogacy arrangements, which are legally unenforceable at the moment, and that it should promote CRB and health checks for intended parents and surrogates. They seem like sensible ways to do things, as does ensuring that individuals and teams can work with non-profit organisations for support on the pathway.

Under those proposals, the old pathway—the current pathway—would continue. We accept that that would be the case, but we would want it to change to ensure that if a relationship breaks down, no surrogate could continue to deny legal parenthood to the parents of the child. That is blatantly unfair and not in the child’s interest. That needs to be corrected, as in the case of twins A and B, who have gone through that process.

We agree that double donation should be permitted in domestic surrogacy, which is not currently allowed. We allow people to create a family through double donation via IVF, but under the current legislation, we are effectively punishing a couple for infertility by denying them the right to create a family through double donation via surrogacy. We welcome the fact that that would be rectified by the proposed changes.

On overseas surrogacy, we also agree that there should be a quick route to legal parenthood in UK law for those who have felt the need to engage in surrogacy overseas, but only in the case of jurisdictions where we are absolutely clear that the welfare of the child and of the surrogate have been maintained. Canada and the United States would be obvious examples of where that would be the case, but there may be other jurisdictions overseas where surrogacy is taking place where that might not be the case.

We also have some views on the regulation of non-profit surrogacy organisations. As long as it is not overly burdensome, bearing in mind that these are non-profit volunteer organisations, we have no problem with that regulation. Where we would like to see things to go a little bit further is on the issue of the underlying principle of altruism. Although this is not a view entirely consistent across everybody involved in the surrogacy community, we want to maintain that altruistic basis for the reasons I have said about the costs involved in more commercial systems. The issue of payments, as the hon. Member for East Renfrewshire (Kirsten Oswald) referenced, is open to debate in the consultation. The APPG took hearings on that issue, and we would like to see them more clearly defined. There are payments for loss of earnings and even to cover a small holiday for people after the arrangement, which most people would consider to be part of the altruistic nature of an agreement, but we do not want to see those arrangements massively expanded to the point where there is basically a commercial arrangement by the back door.

When surveyed for the Surrogacy UK law reform group work, 71% of surrogates agreed or strongly agreed that a surrogate should be able only to claim expenses and not to profit—if that is the correct word—from the arrangements. We recommend that intended parents should reimburse all actual costs incurred by surrogate, who should make neither a loss nor profit from the arrangement, and that there should be a better definition, as I have said, about what constitutes reasonable expenses. All parties, of course, have to be accountable for their compliance with these rules.

As I said, we welcome the new proposals, but there is a problem with the new pathway. If the surrogate raises an objection during the new pathway to legal parenthood before or at birth, we effectively find ourselves back in the current situation, where it ends up before the courts and legal parenthood would be automatically stripped from the intended parents—we end up back in the current, unacceptable situation. We would like to see some more work from the Law Commissions on that scenario, to ensure that it is resolved in a different way through other arrangements.

Our proposal would be that intended parents should retain legal parenthood unless or until a court ruling is made—that is effectively the reverse of where we are at the moment. In the current rules, the surrogate retains legal parenthood. Our view would be that if we are going through the new pathway and the surrogate raises concerns, legal parenthood should remain with the intended parents unless a court determines otherwise. Of course, the courts are always going to place the child, whatever the position on legal parenthood, with whoever is in the best interests of the child. That will never change. That is what the courts do presently; it is always about the welfare of the child.

We are broadly supportive of the changes. I know that in response the shadow Minister and the Minister cannot say a great deal, given the issue is being considered by the Law Commissions. What do we want from the Front-Bench spokespeople today? We would like a repetition of the really positive statement that my hon. Friend the Member for Thurrock made previously about how surrogacy is a progressive way of creating loving families in the UK, and is one that enjoys the support of the Government.

I know that the Minister will fully appreciate that we would like her to follow up on the guidance issued by my hon. Friend the Member for Thurrock, and to ensure that it is being shared appropriately across maternity units, with healthcare workers and with trusts across the country. It was fantastic guidance, which really does help take away some of the nervousness that some people perhaps have when they see a surrogacy arrangement. Will she commit to checking and pursuing that with the various trusts, maternity units and elsewhere?

It would also be great if the Minister could spend some time at the APPG—the shadow Minister is also welcome—and meet with surrogates and parents who have gone through or intended parents who hope to go through the process. There is a legacy from the debate from the eighties. I remember as a kid that sometimes it did not feel quite right, because we were seeing arrangements with lots of money changing hands in the United States and in other jurisdictions, and I think some people still have a misconception around surrogacy. Sitting down with surrogates and intended parents is a good way to hear about how this is a really normal thing; it is just another way that families are created. People go through IVF or adoption, and surrogacy is just another way of creating a family. There are plenty of kids in this country who are brought up in loving families, but I think it is fair to say that those who are brought into the world through surrogacy have a particular advantage in that that family is even more loving. If the Minister were to sit down with surrogates and intended parents, I am sure she will feel that too.

I would also welcome any assurance she could give that she will continue to find the money to pay for this process, started by the brilliant work of my hon. Friend the Member for Thurrock. We are halfway through the process, so one would assume that that would be the case. We would also appreciate if she could spend some time, if she has not already, with the Law Commissions, after she has met the APPG, to get a sense on where they are heading.

Although I know the Minister cannot commit to this, because managing business is always a challenge, I hope that when the draft Bill is put forward, parliamentary time will be set aside. Regardless of anyone’s views on the general election, one good thing is that now there is at least certainty. That will perhaps allow time—we will not be crowded out quite as much as we have been in the last two years by other issues—so that we can get the legislation right. The legislation from the ’80s was fine for a period, but it was a rapid response to an issue that was perhaps not fully understood or appreciated, and things have moved on. The country has moved on. The legislation needs to move on and that is why it is so good that we are at this point.

I will say no more in the hope that there is time for other people to speak. I thank everybody in the surrogacy community for the work they have done in pushing this issue and we look forward to the next stage.

--- Later in debate ---

[Kirsten Oswald (East Renfrewshire) (SNP)]

It is a pleasure to serve under your chairmanship, Sir David. We have heard a great deal of useful information in the two speeches that have been made. There can be no doubt in the mind of anyone who has watched the debate that change is needed. I thank the hon. Member for Brigg and Goole (Andrew Percy) for securing the debate. It is a really important topic and, as he suggested, the laws around surrogacy are simply outdated. They need to be improved as a matter of priority, so that children, surrogates and intended parents can be far better supported.

We hear a great deal in this place about the importance of family. If that is sincerely meant, we need to understand that not all families are the same and that families coming together via surrogacy require particular support by making the law work for everyone involved. When I started to look into this issue, I realised that the laws on surrogacy had not changed since they were introduced in the 1980s—which were not yesterday—and that they do not reflect the huge changes in society that have taken place in the intervening decades. It is no wonder that the laws of 40 years ago do not meet the needs of families and people who wish to become families today. That is expressed very well by Brilliant Beginnings and NGA Law, which said:

“The law cannot comfortably deal with the modern realities of diverse surrogacy experience, and as a result the courts have stretched the rules to make orders crucial to safeguard children’s welfare…There are limits to how far the courts can evolve the law and some children (particularly those born to single parents) have been left without resolved parentage. Judges of the High Court Family Division have repeatedly and consistently expressed concern about UK surrogacy law.”

That is, of course, completely unacceptable. In any case, surely intended parents should not have to go through a cumbersome and lengthy court process in order to become their child’s legal parents. That is a welfare issue, and it significantly affects the intended parents’ ability to make important decisions about the child in their care.

I am glad to hear the enthusiasm for a new legal framework for surrogacy, and for the importance of having the interests of the child, surrogates and intended parents at the centre. It was interesting that Lady Paton, who is the chair of the Scottish Law Commission, said:

“Surrogacy has become a significant issue in today’s society. The interests of all the parties involved must be properly regulated and protected. That is the focus of our proposals.”

That interest and focus is very welcome. The Scottish Government will consider the report and its recommendations once they are finalised, and I look forward to that. In the meantime, I would reflect on the views of my constituents, Stuart and Gordon, who are on their surrogacy journey and have expressed their situation—they are dealing with it better than I ever could. They told me:

“We got married in 2018 and have been together for four years. We have always wanted to have a family but as a male couple, the challenges of creating our own family are much harder.”

They talked about their wish to start a family as being really important to them and, of course, to so many other people. It is something that we take for granted, but for Stuart and Gordon, as for other couples on a surrogacy journey, that is not the case. They simply want to be able to move forward with the certainty that the law is keeping pace with society, and that the frameworks that should be in place take proper account of the need to be efficient and effective, with a focus on the people involved at the heart of it.

As things stand, the system is needlessly and illogically stressful. It is confusing and assuredly not in the interests of the welfare of the child concerned. I hope that we can find constructive ways forward, and I look forward to hearing from the Minister. I hope the law can catch up with the reality of our communities, so that my constituents and others in similar positions are able to have their families that they wish for.

Breast Cancer Drugs

Kirsten Oswald Excerpts

Thursday 26th January 2017 Commons Chamber

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to take part in today’s important debate and I thank the hon. Member for Mitcham and Morden (Siobhain McDonagh) for securing it. I am grateful to her for her contribution and the cases that she used to illustrate it. She eloquently put a human face to the problem.

The debate about access to Kadcyla and other breast cancer drugs is of immense interest to the public on both sides of the border. Breast cancer is the most common cancer, which was shown by the many individual constituency cases cited by hon. Members of all parties today.

As has been said, Kadcyla is an effective life-extending treatment, which gives some women with incurable secondary breast cancer up to nine months longer than the alternatives, and has fewer side effects and a cost of around £90,000 per patient. In Scotland, Kadcyla has never been available on the NHS.

The Scottish Medicines Consortium, which makes its decisions independently of Ministers and Parliament, decided in October 2014 not to approve Kadcyla for routine use in Scotland. After considering all the available evidence, it felt that the health benefits were not sufficient in relation to the treatment’s cost. Patients have, therefore, been able to access the drug only in exceptional circumstances through individual patient treatment requests—IPTRs. It is estimated that more than 100 women in Scotland could benefit from Kadcyla annually.

A Kadcyla discount has been offered by the pharmaceutical company Roche and it recently wrote to Scottish Government officials about a patient access scheme. Roche has now resubmitted its application to the SMC, so that it can be considered for routine use in the NHS across Scotland. That is currently being assessed—

[Kirsten Oswald (East Renfrewshire) (SNP)]

Will my hon. Friend join me in hoping for a positive outcome in relation to Kadcyla for our constituents who are affected by secondary breast cancer, to whom this debate means so much?

[Martyn Day]

I thank my hon. Friend for that point and I join her in hoping for a positive outcome. We expect a decision to be made in March with an announcement on 10 April.

The SNP Scottish Government have substantially increased access to new medicines, particularly for cancer, with plenty of reforms and investment in recent years. The Scottish Government will build on recent reforms and make further improvements, in collaboration with patients and NHS staff, by accepting the recommendations of Dr Brian Montgomery’s review. Shona Robison, Cabinet Secretary for Health, Wellbeing and Sport, has announced that the Scottish Government will take forward all 28 of the review’s recommendations. Dr Montgomery was tasked to examine how changes made to the Scottish Medicines Consortium process in 2014 affected access to medicines for rare and end-of-life conditions. His recommendations set out how the process for appraising medicines could be made more open, transparent and robust.

Among the Montgomery recommendations—the House need not worry; I will not list all 28 of them—is to give the SMC an additional decision option of an interim recommendation for use subject to ongoing evaluation, which will allow collection of more data on a medicine’s real-world effectiveness. Another is the introduction of managed access agreements, under which medicine would be provided at a discounted price for a period of time, again to collect real-world data on its effectiveness. Another recommendation is to make greater use of national procurement in NHS National Services Scotland— NSS—to lead negotiations on cost with the pharma industry to get the fairest price possible. Better capturing of patient outcome data in the real world is vital to enable us to determine whether medicines are bringing the expected level of benefits to patients.

Beyond the recommendations of the review, Ms Robison has also announced improvements to the processes for non-routine access to medicines on an individual case-by-case basis. The peer approved clinical system or PACS, piloted in Glasgow in 2015 to handle applications for ultra-orphan medicines, has been successfully rolled out across Scotland. A second tier of PACS will now be introduced to replace and build upon the existing individual patient treatment request system. A new national appeals process will be introduced through the new tier of PACS, and that will include consideration of equity of access with other parts of the UK as a material part of its decision-making process.

In November Gregor McNie, Cancer Research UK’s senior public affairs manager in Scotland, said:

“SMC does a difficult but necessary job to assess whether new cancer drugs should be made available on the NHS. Following the SMC reforms, we’ve been pleased to see a significant increase in the availability of cancer drugs in Scotland and we support the review’s recommendations to make further progress.”

Breast Cancer NOW has said that

“Scottish Government reforms give fresh hope for a medicines system that will put patients and their families first.”

It also said:

“Scotland’s approach to reform is a useful example to the rest of the UK about ways in which the system can be improved.”

[Kirsten Oswald]

I thank my hon. Friend for his words about the flexibility of approach and the need to continue to keep pushing forward to ensure that we allow access to as many of these drugs as possible for the people who are in such need. Will he join me in commending the Scottish Government and the SMC for that approach, and in hoping that it will continue and make a difference?

[Martyn Day]

I do indeed join my hon. Friend in those comments.

A new and ambitious Scottish cancer strategy, launched in 2016, aims to stop anyone dying from breast cancer by 2050, and breast cancer is of course a priority in the Scottish Government’s Detect Cancer Early initiative. We need to do many things to move forward in that direction.

No debate seems complete these days without reference to Brexit, and this issue is no exception. The Health Secretary has stated that the UK will not be in the European Medicines Agency. If so, there could be implications for the way in which medicines are regulated, and marketing authorisations will be required from the Medicines and Healthcare Products Regulatory Agency for the UK. I am in no doubt that the implications will be less efficiency and possibly longer processes for obtaining authorisations, resulting—I fear—in innovative drugs taking longer to reach patients. Some industry leaders predict delays in the region of 150 days, based on the examples of Switzerland and Canada.

According to a piece that appeared last year in the Financial Times, when Sir Michael Rawlins, chair of the MHRA, was asked whether it would be able to take on all the extra work registering new drugs and medical devices currently carried out by the EMA, he said, “Certainly not”. It seems that considerable investment and recruitment will be required to re-establish it as a stand-alone national regulator. I am keen to hear from the Minister how delayed drug access for UK patients will be avoided.

Stillbirth

Kirsten Oswald Excerpts

Thursday 9th June 2016 Westminster Hall

[Kirsten Oswald (East Renfrewshire) (SNP)]

It is a pleasure to serve under your chairship, Sir David. I commend my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) for securing this debate and for her heartfelt, considered and important contribution. It will have made a difference to many families, and I believe it will truly help to drive improvements.

We have heard about Sands. Sands awareness month should be a matter of concern to every Member of this House. Stillbirth can affect any family, and it is vital that we give it proper consideration and have ample time to discuss the varied and complex issues that surround it. I understand that stillbirth is a topic that is so hard to think of, let alone to debate here, but if we do not, we miss the opportunity to confront issues facing children and families who have been affected throughout Scotland and the UK. They deserve our attention and consideration.

I know that many people have their own personal experiences to draw on; I am very fortunate that this is not an experience I have had directly. I cannot say how thankful I am for that, and for the excellent care that I was fortunate to receive during my two pregnancies. But, like many here today, I know that not everyone has had experiences like mine. Far too many people watching today will have experienced the heartbreak of stillbirth. I will never forget a little girl who would have been the very same age as my eldest son, but who was stillborn. That is one of the memories that will stay with me forever. It is important that we remember all these children and acknowledge them.

We are fortunate to have access to excellent House of Commons Library briefings for debates. I was struck by the introduction to a briefing relating to this debate, which said:

“When a baby dies the impact on a family can be profound, with many parents reporting symptoms of anxiety and depression for years after their baby has died.”

I appreciate that that statement was included in that briefing because, although it seems obvious to all of us here today, it needed to be written down and put in black in white to be absolutely clear. There can be few things that anyone will ever have to deal with that are more difficult than the loss of their baby. It will have a terrible impact on family members, and for a long time. It is not something parents or families will ever forget about.

It is also vital that we continue to take steps to look at why stillbirth happens and what we can do to minimise the instances and increase awareness among medical professionals and parents of anything that might cause concern and be worth looking at.

[Joanna Cherry (Edinburgh South West) (SNP)]

I am grateful to my hon. Friend for giving way, and congratulate my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) on her very moving speech. Some Members may be aware that before I came to the House I specialised in medical negligence law, mainly acting for pursuers, or plaintiffs as they are known south of the border. Drawing on what our hon. Friend the Member for North Ayrshire and Arran said, does my hon. Friend agree that what is most important in cases where there has been medical mismanagement is a prompt investigation, a prompt apology and an undertaking to ensure that whatever lessons are required to be learned are learned?

[Kirsten Oswald]

I agree entirely with my hon. and learned Friend.

Stillbirth rates remained largely unchanged from the late 1990s to 2011. More recent figures have shown a decline, and the rate is now at its lowest level since 1992. Of course, that is positive, and there is undoubtedly a desire from both the UK and Scottish Governments to progress towards improving those figures further, but, as my hon. Friend the Member for North Ayrshire and Arran said, a desire is not enough: real action is needed. Maureen Watt, the then Scottish Public Health Minister, noted that

“The Scottish Government responded to a parliamentary petition in 2010…by forming a stillbirth working group and setting an aim in 2012 to reduce stillbirths by 15 per cent by 2015”.

She also noted a subsequent reduction of 18% in stillbirth rates, which

“shows that a combination of approaches”

can make an impact. Importantly, she stated that

“ministers were determined to reduce rates further.”

As my hon. Friend said at the beginning of her speech, this is not an issue of party politics, as I am confident that everyone present agrees; it is about finding ways to improve prospects for babies and preventing heartbreak and loss for families. We can all agree that this issue should have our support.

I am pleased that Scotland has made progress on reducing the stillbirth rate in recent years and similarly that the UK has made progress, but there is much work to be done and we must commit to focusing on that. It is also important that mothers who go through this traumatic and heartbreaking experience are offered the appropriate support and care, and have access, as my hon. Friends have said, to a complaints process that is open and transparent and offers opportunity for redress.

The comments made about the importance of investigation and the role of coroners are worth considering. It was interesting to see the Royal College of Midwives in The Lancet stating:

“Attention to preventing stillbirths in approach to term and 36 weeks plus must be improved”,

and that more must be done, just as we heard from my hon. Friend the Member for North Ayrshire and Arran. We need to focus our minds on the stark statistics that she has told us about. One third of stillbirths happen at term—37 weeks’ gestation or beyond—and in the vast majority of all stillbirths we never know what has befallen the baby. These areas need to be addressed with as much energy and urgency as we address important messages regarding maternal health and wellbeing.

Researchers for the Campaign for Safer Births have estimated that approximately 500 babies die every year because of avoidable factors during birth. Many are left permanently brain-damaged or disabled. They believe that all these tragic deaths and injuries could be avoided with better care. They aim to raise awareness of the issue, which my hon. Friend has surely helped to do by securing this debate today. They want to see safety improvements in maternity units and the provision of information to those who have experienced poor care or negligence.

I believe that a combination of approaches, such as those adopted by the Scottish Government, can make a material difference, but it is clear that we must be committed to driving change if we want to continue to reduce stillbirth rates. That will not happen without continued targeted action. The stillbirth group established by the Scottish Government has provided evidence that the stillbirth rate has fallen in Scotland since it commenced its work. There are 15 maternity units in Scotland taking part in a UK-wide study looking at foetal movements, which we have heard are a vital indicator, and, in particular, at how units respond to women who report decreased foetal movement. I am hopeful that there will be further progress in Scotland and the UK in this very important area.

In March 2015, the Scottish Government appointed Catherine Calderwood, an obstetrician and gynaecologist who was the national clinical director for maternity and women’s health for NHS England, as chief medical officer. That is important. Her work on reducing stillbirths and neonatal deaths in Scotland and avoidable harm in maternity services will be influential as we continue to push for vital further reductions in the number of stillborn babies. Those stillborn children are our children—they are our families’, our friends’ and our neighbours’ children—and we can best respect that by supporting continuing research, encouraging open conversations about stillbirth and helping to break down the taboos that are still all too prevalent. As politicians, we must push for new research and new ways of working, and encourage real dialogue among medical professionals about stillbirth, particularly where things have gone wrong with the care provided.

I express again my admiration for my hon. Friend the Member for North Ayrshire and Arran for securing this most important debate, and to the other speakers who have contributed.

Brain Tumours

Kirsten Oswald Excerpts

Monday 18th April 2016 Westminster Hall

[Ian Blackford]

I am most grateful for the hon. Gentleman’s intervention. He demonstrates, as does the hon. Member for Eastbourne (Caroline Ansell), that we are so lucky that people such as them have been able to come through this. It demonstrates why we need investment in diagnosis, research and support for those affected and their families—so much needs to be done, because there is so much that we are losing as a society. So many young people’s lives are being taken away. If we do the right thing by putting that investment in, we can deal with the issues and ensure that many of our people can survive this dreadful disease.

[Kirsten Oswald (East Renfrewshire) (SNP)]

Like many Members here, a number of my constituents have contacted me who are suffering from brain tumours or have family members suffering from brain tumours. My mother is suffering from a brain tumour. No matter what I hear from them about excellent treatment and fantastic charitable work, I agree that there is no substitute for investing in research so that in future other people do not have to suffer such experiences, as so many are.

[Ian Blackford]

I hope that we have crossed that Rubicon today and that the Government will recognise the responsibility that they have. This is the last big cancer where we have not had the appropriate funding into research. Let us ensure that we take our responsibilities seriously, not only for all those here today, but for all those we can protect from this dreadful disease in years to come.

Katy’s words, which I read out earlier, are a call for action. We cannot and must not let down her or the many others who have asked us as parliamentarians to address this terrible killer. The case for increased funding is irrefutable. We know that brain tumours kill more children and adults under 40 than any other cancer. Like most cancers, the incidence of brain cancer is rising. Fewer than 20% of those diagnosed with brain cancer survive beyond five years, but despite those shocking statistics brain tumour research accounted for just 1.5% of the £498 million spent on cancer research in 2014. Less than £8 million is spent on brain tumour research.

As Maria Lester has said:

“History has shown that where funding leads, breakthroughs follow. Just look at the improved survival rates for breast cancer and leukaemia since the 1970s. I would like to add here that I do not wish to see money redirected from other cancers but overall investment increased so that brain cancer achieves parity of funding.”

Brain Tumour Research has echoed that by calling for funding to increase to between £30 million and £35 million. It has also quantified that there is an average of 6.9 deaths of men and women under 45 for every £1 million in research spending on all cancers. For brain cancer there is an average of 82.5 deaths of men and women under 45 for every £1 million spent on research. Those statistics should shock and shame us and all, and they demonstrate why we must take action.

In conclusion, it is important that the Government respond positively to the petitioners, the Petitions Committee report and those asking legitimate questions this afternoon. I hope the Minister does that. I ask him to not let us down. Most importantly, will he give some hope to those who will suffer from this cancer by showing that we are determined to improve the survival rate by taking action and making it a priority?

Oral Answers to Questions

Kirsten Oswald Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Jane Ellison]

Absolutely. The consideration of all aspects of how we eliminate hepatitis C over time is important, but we should not underestimate what a difficult job that is, largely because an awful lot of people are not aware that they have it—they are asymptomatic and therefore much of the burden of the disease is not visible to us. However, there is always more we can do, and we continue to make this issue a priority.

[Kirsten Oswald (East Renfrewshire) (SNP)]

4. Whether the terms and conditions of the junior doctors contract were finalised before he took the decision to introduce that contract.

[The Secretary of State for Health (Mr Jeremy Hunt)]

May I start by echoing the thoughts of my the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), for the people of Brussels, with whom we stand shoulder to shoulder?

In my statement to the House on 11 February, I gave a broad outline of the new terms for doctors and dentists in training, which were recommended as fair and reasonable by Sir David Dalton. I am still reviewing the exact terms, alongside the equality impact assessment, and finalised terms will be published shortly.

[Kirsten Oswald]

When the Secretary of State declared that he was imposing the contract on junior doctors last month, he claimed the support of senior NHS leaders, many of whom subsequently denied supporting his position. Given that foundation trusts are free to offer their own terms, how does he envisage enforcing that contract?

[Mr Hunt]

We consulted widely with NHS leaders about the terms of the new contract, and they confirmed that it was fair and reasonable. Any decision to proceed with a new contract when it is not possible to have a negotiated settlement is inevitably controversial, but we wanted to ensure that independent people thought that the terms of the contract were fair. I think we have done that, and when junior doctors see their new contracts—as they will do shortly—they will realise that we were right to say that.

Mental Health (Armed Forces Veterans)

Kirsten Oswald Excerpts

Wednesday 14th October 2015 Commons Chamber

[Dr Cameron]

I thank the hon. Gentleman. I should be pleased if the Minister would comment on those matters, which are very specific to Northern Ireland.

Problems arising in the current system appear to relate to a number of issues, including help-seeking, referral, assessment, and access to appropriate treatments. One study reported that only a quarter of those with diagnosed mental health problems had accessed medical help. It has also been reported that stigma and lack of trust or confidence in providers of mental health services represent some of the main barriers preventing service personnel and veterans from seeking help. Stigma concerning mental health problems is particularly problematic for military forces who are required to be physically and psychologically resilient. It has been emphasised to me that the attitudes of the Ministry of Defence are also important in that regard, and that there is a need to be upfront in acknowledging the mental health issues that can arise from military service, as well as the physical risks, in order to prevent such barriers.

[Kirsten Oswald (East Renfrewshire) (SNP)]

I wonder whether my hon. Friend is aware of reports of drone pilots experiencing higher levels of post-traumatic stress disorder than those flying conventional aircraft. Issues of stress are causing some concern, and questions relating to recruitment and retention are beginning to emerge. Will my hon. Friend join me in urging the Minister to commit himself to more research and support for service personnel and veterans in that context?