Children’s Palliative Care

Tim Loughton Excerpts

Monday 1st July 2019 Commons Chamber

[Dr Johnson]

I thank the hon. Gentleman for his intervention. I do indeed share his concern and will come to some of those figures in a moment.

To return to the care that is provided during the palliative care process, finally, the care will indeed be about end of life care and bereavement counselling. Children’s hospices throughout the United Kingdom provide some of this fantastic care. They have specialist medical, nursing and other professional staff and volunteers, and I pay tribute to them, as I know other Members do, for their dedication and the fantastic work they do.

[Tim Loughton (East Worthing and Shoreham) (Con)]

My hon. Friend is a great ambassador on this very important subject. I pay tribute to the Chestnut Tree House hospice, which does such a fantastic job in West Sussex. Does she acknowledge that, because of medical technological advances, many of these children will live for much longer than was anticipated many years ago, and for many of them this is about not care in a hospice but outreach care outside the hospice? It is therefore important that we have good support packages for the parents, including respite and care over a longer term, and that we are more imaginative in the way we build houses, so that children with life-limiting conditions can live in houses—perhaps new social house build—that reflect the increasing physical demands that they will have, so they can stay in their homes to be cared for appropriately?

[Dr Johnson]

I thank my hon. Friend for his intervention. He is indeed right. The demand for children’s hospice care is rising because there has been an increase in the number of children with life-limiting conditions and because those children are living longer and therefore require care for a longer period. The cost of providing that care is also increasing at a rate faster than inflation and faster than the money that the sector receives, which means that in some areas the money received has fallen in real terms.

Social Media and Health

Tim Loughton Excerpts

Tuesday 30th April 2019 Commons Chamber

[Matt Hancock]

The regulation of online harms will indeed be statutory. As I said, we are in the middle of a consultation on how, rather than whether, to put that in place. I am sure the hon. Lady will want to feed back, although I know her SNP colleagues in the Scottish Government in Edinburgh have been kept abreast of developments.

The hon. Lady raises complacency and financial resources. I will address both points. She is absolutely right that part of the problem is a complacency about some killer diseases, partly because we have hardly known them in this country for generations. As I said in my statement, measles is a horrible disease and a killer; it is deeply unpleasant. So, too, is rubella. Rubella might be hardly noticed by a pregnant woman. There might be a rash for three or four days which comes and goes, but the impact on the baby is permanent and very, very serious. On measles, rubella and other diseases, we have to be absolutely clear with the public about the consequences not only for their children but, even worse, for vulnerable children and adults who, maybe because they are immunosuppressed or very young, cannot have the vaccination. Their lives are directly threatened by a parent who chooses not to vaccinate. We need to be very clear and stark about that.

The hon. Lady mentions that the social media companies have contributed to Samaritans. That was Samaritans’ ask for this stage of putting together the organisation and experts it needs to provide clarity on the boundary of what is and is not acceptable in this space. I would, of course, be perfectly prepared to go and ask for more if more is needed. What is more, we are bringing forward a digital services tax. Historically, the global tax system has not worked well in taxing such companies fairly, because of the nature of how they make their money. We have worked for years to try to get a global consensus on how to tax them. We are now clear that we will bring forward the tax next year in the UK, regardless of whether we can get global consensus.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I applaud the Secretary of State for taking this initiative, and I certainly endorse the comments about the good of vaccination. However, I hope that the warm words of the social media companies that he recounted are matched by actions, because I am afraid that that is not the experience of the Home Affairs Committee, which again saw a woeful performance from the Facebook, Twitter and YouTube representatives who appeared before us last week.

Is the Secretary of State aware that it is not only a question of taking down or not allowing content on which those companies are not doing their job properly, but of the algorithms that they use actively promoting more extreme versions of what people may be searching for, whether that is material on the extreme right wing, terrorism, radicalisation or self-harm? Is he convinced that those companies will actually put their considerable money where he thinks their mouths are and make sure that serious interventions are made to stop this stuff being promoted to some of our most vulnerable citizens?

[Matt Hancock]

My hon. Friend is a man after my own heart on this. Am I convinced? I am convinced that social media companies have committed to it, and it is our job to keep them to those commitments. That is why I have pushed for a long time for a statutory regulator in this space, and I am delighted that the Government are bringing one forward.

For years, we in the House asked social media companies to do something, and there was an argument that, because they are global, we cannot really impact how their algorithms work. That is just rubbish. We are the legislator for this country—we set the rules, and we have a big role in setting the norms and expectations of what happens here. Just because a platform is global does not mean that it can be outside the rule of law of this country, so we will legislate in this space, and there will be a regulator that will be able precisely to keep track of those commitments and make sure that they are followed up. Having said that, the last two meetings have been positive, and we have seen changes as a result. What we have not yet seen is all this content being removed, so there is clearly a long way to go.

Access to Medical Cannabis

Tim Loughton Excerpts

Monday 8th April 2019 Commons Chamber

[Matt Hancock]

I entirely understand the hon. Gentleman’s point, and I feel the same way as he does about the urgency of these cases. The need to get a second opinion can be actioned immediately, and it will be, because the crucial point is that unlicensed medicines cannot be prescribed without a clinician. There are just over 95,000 clinicians on the specialist register, and any of those who have expertise in this area can, if their clinical judgment allows, make these prescriptions. That can happen right now.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I was very supportive of the case of Alfie Dingley and the change in the law. The Secretary of State is absolutely right that this must be based on clinical decisions. However, given that there are several hundred children suffering from severe intractable epilepsy, is not the problem that the guidance from NHS medical bodies is just too stringent? Is it true that only two NHS prescriptions have actually been issued to date? Given that Teagan Appleby has had at least a dozen prescribed drugs—I will not list them, to avoid stressing Hansard—as well as a nerve stimulator, what would be the downside of allowing her access to medical cannabis now?

[Matt Hancock]

My hon. Friend makes a good point. More than 80 prescriptions have been made, but that is for both THC and CBD. Of course, THC brings risks—the active elements within cannabis do bring risks. There are also benefits, as I have seen very clearly. It must be for a clinician to decide the balance of those risks. I have enormous sympathy for the families, having heard their personal testimony about the massive benefits for their children, who sometimes, as my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) said, have 300 seizures a day. Having seen that and looked them in the eye, I understand the benefits. However, it has to be a clinician who makes that judgment. I am not medically qualified and cannot overrule a clinician, but there are clinicians available who can provide a second opinion, and that is what I can ensure.

--- Later in debate ---

[Matt Hancock]

Yes, we are looking carefully at how we can use that legislation as effectively as possible. Understanding the medical consequences of any use of a drug is incredibly helpful evidence for where it should be prescribed further, and that is the thrust of the 2016 Act.

[Tim Loughton]

My hon. Friend the Member for Daventry (Chris Heaton-Harris) was a good Minister, too.

[Mr Speaker]

Another ex-Minister to compliment. I am bit surprised by the Secretary of State. He is slipping from his usual standard. I thought that he would be busily cultivating his hon. Friend. [Laughter.]

Health and Social Care Committee

Tim Loughton Excerpts

Thursday 28th February 2019 Westminster Hall

[Dr Williams]

I thank the hon. Lady for those questions. One of the Committee’s early reports of this session was about childhood obesity. We made specific recommendations in that report that we have not necessarily repeated in this one.

We saw many wonderful things in Blackpool. We did not learn about the specific service to which the hon. Lady refers, but we did learn that many services have come under a lot of financial pressure. Even though there was some Big Lottery investment for transformation, services still needed to be cut, which sounds counterintuitive.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I declare an interest as the chair of the all-party parliamentary group for conception to age two—first 1,001 days, which is slightly more long-term than the first 1,000 days of life, but not nearly as ambitious as the first 1,000 years of life, to which the right hon. Member for Exeter (Mr Bradshaw) erroneously referred. I am also the chairman of the charity Parent Infant Partnership UK. I am grateful to the hon. Member for Stockton South (Dr Williams) for referring to Sally Hogg, one of our staff members, and Beckie Lang, our chief executive, who gave evidence.

I welcome the report, and particularly the ambitious way that the hon. Gentleman has described it as the “second revolution” in early years services. He is absolutely dedicated to the whole subject, which is so important, and which many of us have been banging on about for some time. I have two questions. First, a slight disappointment is the shortage of space given to the case for investment. The hon. Gentleman knows as well as I do that, as we said in our all-party group report, “Building Great Britons”, the cost of child neglect is £15 billion a year, and the cost of maternal perinatal mental illness is £8.1 billion; that is £23 billion each year that we are spending on getting it wrong. Does he agree that we need to make the case that investment in this area will save substantial amounts financially and, more importantly, socially? The Treasury needs to understand that it is a serious investment case for the future.

Secondly, I approve of what the report says about locally delivered and joined-up services—a point that we put forward in our report, too. Does the hon. Gentleman agree that there is also a case, which we have made in the past, that that should be time-dated? Certainly, it should not take more than five years for every local area to have a united, joined-up, coherent and co-ordinated strategy for delivering this. It also needs to be measured, just as adoption scorecards were used at the Department for Education to measure the quality of the service delivery, so that it is not just a tick-box exercise. If we can get those two things right, the quality of the delivery will be much greater.

[Dr Williams]

I thank the hon. Gentleman for his advice and input at the start of the inquiry, and for the work that he has done as the chair of the all-party group, which is about the first 1,001 days—what is a day between friends? The economic case is exceptionally strong, and I am sure that the Minister has heard him make it eloquently. We all need to work together to make sure that we put the case to the Treasury. Ultimately, those spending decisions will have to be made in the comprehensive spending review; that feels like an opportune time.

The hon. Gentleman suggested that we ensure that there is a timeframe, that the commitment is not open-ended, and that local authorities have plans within a short time. We learned in our inquiry that local authorities are often left to just get on with it. The Committee felt that there was a need for much more central control and measurement, and for more accountability by central Government.

Early Parenthood: Supporting Fathers

Tim Loughton Excerpts

Wednesday 30th January 2019 Westminster Hall

[Tracey Crouch]

I would love to come. Single parents play an incredibly important role, but for various reasons they are often maligned. Meeting single dads who are doing their very best, in whatever circumstances they find themselves bringing up their children, is an incredibly important part of that conversation. I would be delighted to come to the event on 20 March.

I want to address three points: perinatal support, loneliness in new dads, and shared parental leave. The first comes wholly under the Department of Health and Social Care; the second does partially; the third might not, but is important to the debate because it relates to the overall wellbeing of our children.

In December, the Centre for Social Justice published a really interesting report, “Testing Times: Supporting fathers during the perinatal period and early parenthood”. It looked in detail at written evidence submitted to the Select Committee on Health and Social Care inquiry into the first 1,000 days of life by the Fatherhood Institute, which described support for fathers as “toothless” and noted criticisms that within health services,

“well-meaning…father-inclusive policy-making…has been more ‘rhetoric than reality’”.

On the back of those comments, the CSJ did some additional polling. It found that seven in 10 new fathers

“were made to feel like a ‘spare part’”,

six in 10 said that they had

“had no conversations at all with a midwife about their role”,

and nearly half said that they had

“received little or no advice at all…on their role as a dad.”

However, it also found that

“more than 9 in 10 are present ‘at the scans and the birth’”

and that there is

“strong correlation between active father engagement and improved childhood outcomes.”

That is a recurring theme in a really interesting book on equal parenting co-authored by one of our own lobby journalists, James Millar. It includes several quotations from the 2015 UN-backed report, “State of the World’s Fathers”, about how engagement in the first year of a baby’s life is good for the dad as well as the baby. Substantial and high-quality father involvement can encourage a child’s positive social interaction and lead to higher cognitive development scores.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I congratulate my hon. Friend on securing a debate on this important issue. It is hardly surprising that so many dads feel left out when the NHS guidance refers to them not as fathers or dads but as “birthing partners”. Perinatal depression in mums is linked to depression in teenagers: there is a 99% likelihood that a 16-year-old suffering from depression had a mother with perinatal mental health problems, including depression. What is overlooked is that 20% of fathers also experience perinatal mental health problems, which has a big influence on their parenting skills and on their engagement with and attachment to their own children. We need to do more about that.

[Tracey Crouch]

I am grateful to my hon. Friend for raising that point. I saw those statistics while researching my speech; perhaps the Minister’s reply will describe her Department’s work on post-natal depression for mums and dads. I do not have time to cover everything, but I agree that language is incredibly important. I appreciate that the term “birthing partners” is used in order not to cause offence, because our society and how we bring up children are very different now, but it is important that we think about the language and make our communication with fathers as inclusive as possible.

--- Later in debate ---

[Tracey Crouch]

One reason why I wanted to hold this debate is that I feel it is hard for male colleagues to raise the subject. As a mother, I know that if my other half had come to me and said, “I am feeling a bit down,” I would have said, “But you didn’t give birth to the child!” For many years, we have forgotten that it is very much about a partnership. There are many issues that mothers still face—there are still huge issues around discrimination in maternity and everything else—but that must not mean that we forget the issues that fathers face, and that is why this is an important debate.

I completely understand why male colleagues might not have felt comfortable in raising this issue, because they may well feel that they would be accused of forgetting all the other issues around maternity discrimination. I feel very honoured to be raising it on behalf of all the dads out there. Perhaps I can talk about it with more ease.

The constituent of the hon. Member for Ogmore (Chris Elmore) is doing a brilliant job in raising the issue of men’s mental health, post-baby. It is important that we do that. If that equates to having more training, that is what must happen, although I am always loth to say that our hard-working health professionals need any more training than they already get. They have a very important job to do, and by and large they are all doing it brilliantly.

One aspect of parenthood that can impact on wellbeing is loneliness. When Jo Cox stood in the Chamber and spoke of her own challenges with loneliness, including the example of becoming a mother, she widened discussion on the subject. I, too, had my own brushes with maternity-leave loneliness. While the rest of the world here was discussing the referendum campaigns, I was on maternity leave. I dealt with that by going to the supermarket every day, just for a chat.

For new fathers, it can be harder. When my other half took his three months shared parenting leave, he felt isolated from baby groups, as many were either branded “mother and baby” or were predominantly made up of mums, making him feel less inclined to go in. There are excellent apps connecting mums, such as Mush, which we profiled in the loneliness strategy, as did the CSJ in its report, but there are hardly any dad apps set up to connect full-time fathers. The Secretary of State for Health and Social Care, with his digital background, may be interested in upscaling that from a health perspective.

The loneliness strategy, which I was privileged to publish on behalf of the Government in October 2018, specifically, on my request, used an infographic of a dad pushing a baby to highlight becoming a parent as a trigger for loneliness while at the same time reflecting that it is not a gender issue. The more we all acknowledge loneliness as an issue, the quicker we will reduce the stigma and instead create connections that help to combat it. I was pleased that the Department of Health and Social Care was a core partner in the delivery of the strategy.

The CSJ noted that children's centres are a key part of delivering opportunities for dads to connect, and that many were not doing so, despite its being a legal requirement. I know that children’s centres are a politically contentious issue because of funding and I would hate the debate to be bogged down by that, but the centres in my constituency, some of which have restructured, could play an enormously important role in creating support networks for dads. It is a shame that because of funding pressures, gaps in services are occurring.

[Tim Loughton]

My hon. Friend makes a very important point. The problem with the children’s centres—a fantastic asset—at the moment is that they are closed most of the time when dads can access them, particularly at weekends. Some of the best children’s centres are those that open at weekends, have football teams that dads and their children can come along to, and have computer-reading facilities latched on to that. It is a way of getting dads into the children’s centres. The centres need to be used much more at weekends and outside of working times when many fathers cannot access them.

[Tracey Crouch]

I agree with my hon. Friend, but it is very important that we do not fall into the trap of talking about dads as weekend parents. The point of the debate is to discuss how society has evolved; there is a lot more equal parenting. I completely understand his point. I shall come on to talk about shared parenting. The take-up of shared parenting is so low that many fathers can play that meaningful role in parenting only at weekends, so we would want those services to be open. Children’s centres have an incredibly important role, which is not just about creating a connection, but also about, for example, trying to break the cycle in domestic abuse. They play a fundamental role. I know that the Stefanou Foundation is doing some excellent work in supporting such initiatives.

I accept that my own experience is based on good fortune, and that it could easily be criticised as coming from a comfortably-off middle-class professional, but we need to do so much more on shared parenting than we do at the moment. We lag very far behind other countries on shared parenting, particularly Scandinavian countries.

What I see from my other half taking shared parenting is a very special bond between him and our son. Sadly, there are still a significant number of men who are ineligible for parental leave, and for those that are eligible there is a financial disincentive to take it. The Fawcett Society found that nearly seven in 10 people believed that men who took time off work to look after a baby should be entitled to the same pay and amount of leave as women. In Germany, fathers on leave are paid two thirds of their salary and in Sweden it is 80% of their income. Here it is £145 per week. We managed because I am paid well, but an average or low-income family would inevitably struggle, so while many might want to, it is unsurprising that take-up of parental leave is so low.

I know that much work is being undertaken to improve the situation. I thought the speeches in our debate on proxy voting on Monday evening encouraging male colleagues to take shared parenting leave were really helpful, and we could set an example in this place. I commented earlier on the wider societal and health benefits of a father’s meaningful engagement in the upbringing of a child. To me, doing more to improve our shared parenting policies is a no-brainer.

There is so much more I could have spoken about this morning, including the emerging organisations that help support fathers, such as workingdads.co.uk, which seeks employment with flexible, child-friendly hours, and the really funny social media accounts, such as Man vs. Baby, which might make light of some of the challenges that fathers face but also highlights that they exist in the first place. Ultimately, if we accept that meaningful fatherly engagement with their children is good for the health and wellbeing not just of the child but of the dad, making sure that we provide the infrastructure to support them, from neonatal to perinatal and beyond, is simply common sense, fair and equal—good economics but also really good politics.

--- Later in debate ---

[Fiona Bruce]

My hon. Friend makes an excellent point and I will indeed refer to it.

My hon. Friend the Member for Chatham and Aylesford (Tracey Crouch), who introduced the debate so well, referred to a CSJ report from this year. Another CSJ report, “Every Family Matters”, which was produced as long ago as July 2009, said very similar things, such as the importance of strengthening families and of having a good, strong input into a child’s life. Yet I have here an interesting statistic: 43% of unmarried parents split up before a child’s fifth birthday, but only 8% of married parents do. That is an interesting factor for us to consider: if we are looking at strengthening family life, we should not forget that supporting marriage is part of that.

Sadly, the UK has one of the highest rates of family breakdown among the 30 OECD countries. Just two thirds of children aged nought to 14 live with both parents. In the OECD countries overall, 84% of children of those ages live with both parents. Very interesting work is being done on the link between those factors and British productivity, which is 18% below the OECD average.

[Tim Loughton]

I admire my hon. Friend’s determination to promote marriage, but I must give a plug for my private Member’s Bill on civil partnerships, which, if it passes through the Lords, will make civil partnerships available for opposite sex couples by the end of this year. They would be an additional incentive for those couples to stay together, as overseas statistics show, particularly for the good of the children.

[Fiona Bruce]

It is so important that we do what we can. In the very short time that I have left, I will touch on some of the practical policies in “A Manifesto to Strengthen Families”, which more than 60 Members of Parliament support, and express a degree of frustration that the Government have not taken them up more practically. I know that individual Cabinet Ministers are very interested, but in order to see some real progress we need a senior Cabinet-level Minister who is responsible for drawing together the manifesto’s several policies.

I will touch on some of the manifesto’s policies on fathers. Policies 8, 9 and 11 talk about promoting the importance of active fatherhood in a child’s life. Policy 8 says:

“Maternity services should maximise opportunities to draw fathers-to-be in early.”

Policy 9 proposes that, where appropriate,

“The Government should…require all fathers to be included on birth certificates.”

Policy 11 proposes that “high quality marriage preparation” should be available at a cost-effective rate for young people thinking of getting married.

Finally, one of our key policies is the promotion of family hubs. As we have heard, children’s centres are not always as effective as they need to be. Families need support bringing up children, not just aged nought to five, but nought to 19. In the teenage years particularly, the input by fathers into their sons’ lives is often critical. We believe that it would be really positive to have family hubs in each local community, to support families at every stage of a child’s development.

I am disappointed that the Government have not taken that up more strongly. We shall continue to persevere and to press them to do so. The good news is that many local authorities have taken up those ideas very strongly and family hubs are springing up across the country. I invite colleagues to a family hubs fair, which will take place on 14 February. It is convened by Westminster City Council, which is setting up its own family hubs. The fair will flagship best practice from local authorities across the country that have set up family hubs, specifically to show how we can best support families with children. I am sure that there will be many examples of how we can best support fathers to engage in their sons’ lives, which is such an important thing on which we need to focus.

Mental Health First Aid in the Workplace

Tim Loughton Excerpts

Thursday 17th January 2019 Commons Chamber

[Johnny Mercer]

The hon. Lady is right. There is no point in getting people to come forward and talk about mental health, which can be very difficult, if we do not have the services or access to them to help them, after they have made themselves vulnerable in that way. That is why I am so keen to keep our foot to the gas and ensure that we start delivering on this. We have made progress—that is undeniable—but clearly there is a long way to go, and I will come on to that.

I want to address the point about legislation. As someone who does a lot of work in the armed forces community and on the armed forces covenant, I know that people will say, “Why legislate?” I have learnt in this place that we can have a number of good ideas and initiatives that we can encourage people to do but, ultimately, this is too big a challenge to be left to personalities involved in companies at different times. Sometimes we have to legislate for it. This is not a problem for the companies that already do this, but sometimes the most vulnerable people in our communities deserve the Government legislating and letting them know that we are on side.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I am sorry that I was not here for the beginning of the speech by the hon. Member for Liverpool, Wavertree (Luciana Berger). I was having my own health and wellbeing check with our excellent service here. The practice nurse was particularly keen to know about my stress levels, given the experience we have all had in the last week, but I am good for another few years.

My hon. Friend may know that I am the co-chair of the all-party parliamentary group on mindfulness, which is a simple way of looking after employees’ mental health. Before Christmas, we held a seminar here involving military figures. He knows, from his experience, the high level of mental health issues among that group. I am glad to say that the Army is now seriously looking at how this measure can be introduced, and why wouldn’t it? This is a win-win situation: if an employer looks after its employees and its workforce, they tend to do a better job, and they look after the company or Army unit better as well.

[Johnny Mercer]

I thank my hon. Friend for his intervention. He is right; the military has come a long way. It gets a hard time, but the Army in particular has come a long way on the importance of mindfulness and how much easier it is to keep a healthy mind than get better from a mental illness. I thank him for all the work he does on that. We all come to this place for different reasons, but there is no doubt that the mental health challenge of a decade and a half of combat operations has ripped apart the circle of friends that I grew up with, so I have a real passion for getting this right.

As the hon. Member for Liverpool, Wavertree says, we need to look at this in a slightly different way in this country. We are very good in this place at talking from the Front Bench about what we are putting into services in terms of money and priority, and that is extremely important, but we need to turn the telescope around and ask what it actually feels like to be in the community waiting for access to child and adolescent mental health services or mental health treatment. That is the true metric of what we do in this place. I strongly encourage the Government to look at that approach.

Why am I so interested in this? As everybody now knows, I have had OCD for a long time. Obviously, I like to pretend that it is some sort of distant memory, but my close friends and family know that it is not. It is much better, but there is no doubt that, if there had been mental health first aid when I was a boy, growing up and going into the military, my life would have been completely changed. We cannot underestimate how important it is to intervene early, when someone is so much more likely to get better. I will never forget the Saturday afternoon when I ended up in the Maudsley, thinking, “How did I end up here? How did this all start?” If policies like this had been talked about 20 years ago, millions of lives would have been very different.

I talk about this because it sends a powerful message: you can get better. People think that they are managing their mental health for the rest of their life, they reach their zenith and that is it. I cannot over-emphasise how wrong that is. Clearly managing a mental health challenge is a difficulty, but it can absolutely be done, and the chances of doing that are exponentially increased by early intervention. If we can get into workplaces and say to people, “We take mental health as seriously as physical health,” we will affect millions of lives, which is ultimately what we come to this place every week to do.

I pay tribute again to the hon. Member for Liverpool, Wavertree and the right hon. Member for North Norfolk, who have done a lot of the heavy lifting on this. There are not many people here today, but in some ways, that does not matter. There will be people following this intensely because they have a mental health challenge. They may be 15, 16 or 17-year-old young boys, like I was, who never talk about it and who learn about what is going on through their phone but do not even talk to their parents. When I spoke about my OCD in the Evening Standard, I had loads of phone calls the next day, but the best one was from a 16-year-old boy who said he had never spoken to his parents or anyone about it.

There will be a lot of people watching this debate who were devastated when it was cancelled before Christmas. They are the people we are here for, and that is why people like me speak out. It is not easy to speak about individual issues in this House, but I want to say to boys and girls who are watching this now and may be struggling: don’t think for a minute that because there are not lots of people here, and there is not the raucous shouting that we have seen in the last few days, this is in any way less important to many of us in this place. Just because we are quieter, it does not mean that we do not hear you.

There is a mental health revolution going on in this country—we have seen it start and people are talking about it. The Government have committed to parity of esteem. We are flicking over from meeting one in four mental health needs at the moment to one in three. Clearly there is a big unmet need and we have further to go, but it is an unstoppable direction of travel, and today is another point on that march.

I sincerely hope that the Government can take forward these recommendations. I slightly disagree with the hon. Member for Liverpool, Wavertree only on one point: parity of esteem does mean something. However, she is right: it does not if people in our communities do not feel it. It is not good enough here to say, “Parity of esteem is a wonderful thing. Haven’t we done well? We’ve put it into Government legislation.” It is meaningless unless the people who use the services actually feel like they are treated in the same way and have the same access to treatments as those with physical health problems. I commend the hon. Member for Liverpool, Wavertree and the right hon. Member for North Norfolk for the march we are taking on this, together with the stuff we have done on money and mental health. In this Parliament of immense turbulence, for those who are watching—the quieter ones, whom I have spoken about—this march will continue. They have some wonderful advocates in this place and we keep going.

Foetal Alcohol Spectrum Disorder

Tim Loughton Excerpts

Thursday 17th January 2019 Commons Chamber

[Bill Esterson]

I thank my hon. Friend for her intervention which prompts me to cite a recent study from the Washington State University. Its foetal alcohol syndrome diagnostic and prevention network has identified that foetuses can experience vastly different FASD outcomes despite being exposed to identical amounts of alcohol—which is what happens with twins. There is no way of predicting what will happen, and its conclusion, which I am glad to see the chief medical officer now accepts, is that the only safe amount to drink is “none at all”.

I am asking that the chief medical officer’s advice and guidance, which has now been accepted by the National Institute for Health and Care Excellence as well, be given much greater prominence and that we build awareness so that everyone understands it, especially, but not exclusively, health professionals. I am asking that we have a proper study of incidence so that we need not rely on the limited evidence of the Bristol University study. It was only able to make rough estimates, given the nature of its research, but if it is between 6% and 17%, it really does need that intervention and prevalence study.

We have to build greater understanding among health professionals and professionals right across the public sector. I have mentioned support as well. There needs to be greater support for those living with FASD—both those suffering from it and those caring for them— and those in education and elsewhere who are looking after them.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I commend the hon. Gentleman for all the work he has done raising the profile of this condition. He knows I support him through the all-party group, and he knows of the experiences I have had with children’s homes in Denmark, which very much pioneered the work here, because of the alcohol problems among residents of Greenland and others. He is absolutely right that many of our children in the care system are directly affected by this. Does he agree that we have to get much better at giving clear advice, as we now do on smoking and its impact on lungs? We need a similar campaign to make absolutely clear to women exactly what the risks are to their unborn children if they continue to drink, as many of them will do.

[Bill Esterson]

The hon. Gentleman is absolutely right to draw the comparison with smoking. There is no way anybody does not understand that you do not smoke when you are pregnant. We need the same cultural understanding of the effect of alcohol.

I am very pleased that the chief medical officer listened to the all-party group’s advice in the inquiry that we held when we published our report at the end of 2015 and that the guidance is now right and advises women not to drink at all if they are pregnant or planning to conceive. NICE caught up last year, but many people, including some health professionals, still regard the previous guidance as relevant. There is a question mark for many. They think, “If the advice previously was one or two drinks, maybe it’s still okay”. It is not, and we need to make that clear.

The country has a history in this respect going back many years. A glass of Guinness used to be thought a good idea for pregnant women because of the iron.

Baby Loss Awareness Week

Tim Loughton Excerpts

Tuesday 9th October 2018 Commons Chamber

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I wish to join my colleagues in commending the Members who have so bravely recounted their own experiences of baby loss here tonight and at last year’s baby loss debate. As many have said, the loss of a baby is one that no parent should ever have to bear. I am fortunate not to have suffered such a loss, but as a children’s doctor I have, unfortunately, been the bearer of such bad news on too many occasions.

In my experience, the first reaction of a parent confronted with the tragic death of a baby is to ask, “Why? Why did this happen? Why my child? Why me?” In these agonising circumstances, answers as to why this situation has occurred can help to provide respite. The second reaction, one that is testament to the incredible empathy human beings have, even in the most difficult circumstances, is the desire to ensure that lessons are learned from their personal tragedy so that no one else has to endure that same heartbreak. I am in awe of colleagues, such as those here this evening, who have been through such a traumatic experience and found the strength not just to share that experience, but to use it to campaign successfully for improvements in care and to highlight areas to improve so that others do not experience such suffering in the future. I commend the work of the all-party group and my hon. Friends the Members for Colchester (Will Quince), for Eddisbury (Antoinette Sandbach) and for Banbury (Victoria Prentis) for their work to develop the bereavement care pathway. I have worked in hospitals where there has been excellent bereavement care, with the bereavement suite that has been described, and in others where the care has been less well developed, and I have seen the importance of the national bereavement care pathway. I congratulate them on it.

Although he is no longer in his seat, I also congratulate my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) on his private Member’s Bill, which has developed child bereavement leave. As my hon. Friend the Member for Colchester has said, it will enable mothers to have an extra two weeks of maternity leave and fathers to have a doubling of their leave—some extra time to reflect and be at home with their family.

One recent improvement that the Government have made is the introduction of independent investigations by the Healthcare Safety Investigation Branch, which will look at every case of stillbirth or life-changing injury. That will help to meet the needs of parents in respect of that first question—“Why did this happen?”—and to prevent it from happening again. When the lessons are disseminated throughout the health service, doctors and midwives will be able to learn from previous experience to ensure that problems do not occur in future. It will be important—I look to the Minister to respond on this—to ensure that health professionals can speak openly in investigations without fear of blame. A blame culture will deter people from speaking openly and prevent improvements to patient safety. I have spoken numerous times in the Chamber about patient safety, and I am hopeful that the national roll-out of investigations will help us to meet the NHS’s goal of becoming the safest healthcare system in the world in which to give birth.

One development in neonatal care that I have seen in my 17 years of practice is the increasing centralisation of neonatal care, with the smallest and sickest infants now transported to specialist centres. I have worked in these centres and, although they provide exceptional care, they are often many miles away from the hospital where the child was first admitted or where the family live. For example, if a baby’s family live in Sleaford and North Hykeham, their nearest tertiary centre is in Nottingham. If the centre in Nottingham is full, the family may be sent many hours away to Norwich, Sheffield or Leicester. For working families on low incomes, the need to visit their sick baby several hours away imposes significant travel costs. Some families go through intense financial difficulty to meet that need to travel, while others have the distress of being physically unable to travel to see their baby as often as they would wish because they do not have the money to get to the tertiary centres. I raised the very same issue in the debate last year and would be interested to hear an update from the Minister on any measures being taken to help struggling families, many of whom work, to meet the travel costs in such an extremely distressing situation.

[Tim Loughton (East Worthing and Shoreham) (Con)]

My hon. Friend makes a good point about safety. In respect of smaller hospitals retaining maternity services, some years ago there was an attempt to downgrade Worthing Hospital and St Richard’s Hospital, such that they would lose their maternity departments and the service would be centralised in Brighton or Portsmouth. Fortunately, we defeated those proposals, and Worthing maternity department is now rated outstanding. It is also rated as the safest maternity department in the country; indeed, many mums now come from Brighton to Worthing because of its success. There is clearly a case for larger specialised hospitals for particular ailments and problems that need specialist treatment, but in most cases we need a good-quality, safe and trusted maternity service closer to where the parents live.

[Dr Johnson]

I congratulate the hospital in Worthing for its outstanding success. My hon. Friend is right that there is a balance to be struck between the centralisation of care for babies who require very low-volume but high-specialist care, and the need for care to be delivered as close as is reasonably practical to the individual family concerned. That is true of all medical specialties, really. In the case of neonates, we probably have the balance roughly right, but a trend may be starting whereby people ask for things to be centralised that in my perception do not really need to be centralised. As a professional, I often see babies who are not returned to the step-down care as quickly as they could be. Babies are sometimes kept in the tertiary centres for longer than is absolutely necessary. There are complex reasons for that, but I would be grateful if the Minister looked into the issue so that babies can be returned closer to home as soon as possible.

I welcome the Government’s ambitious aims to halve the rate of stillbirths and neonatal deaths by 2025. That will be possible only by reducing the number of pre-term deliveries, which are the leading cause of neonatal death in the UK. The Department of Health and Social Care’s goal of reducing pre-term birth from 8% to 6% will require a lot more research and intervention. We have a healthier population of women, but the number of pre-term babies continues to increase. More funding is needed for pregnancy research, and particularly for research into the causes of pre-eclampsia, cervical length and infections such as group B strep, as well as for the identification of small babies with early scanning. There must also be more work to discourage smoking, which we already know is an established risk factor for pre-term delivery. I welcome the previous Secretary of State’s saying in November 2017 that the Government will reduce smoking during pregnancy from 10.6% to 6% and raise awareness of foetal movement. All those things will contribute towards the reduction of the number of neonatal deaths and stillbirths. Through that work, the Government are best placed to meet their “halve it” aim, and in doing so save 4,000 lives.

Finally, I wish to discuss those babies who die in the post-neonatal period—that is, under the age of one but after 28 days of life. Currently, 1.1 in every 1,000 babies die in the post-neonatal period. The major reason is babies having congenital malformations, and the second most common reason is sudden infant death, the rate of which has recently increased, although the cause is not clear. What is the Minister doing to identify the reasons for the recent increase in sudden infant deaths? What is being done to prevent the number of sudden infant deaths from rising further and, indeed, to bring it down?

Oral Answers to Questions

Tim Loughton Excerpts

Tuesday 24th July 2018 Commons Chamber

[Matt Hancock]

Yes, the hon. Gentleman is absolutely right. We published information on this issue just last week. We absolutely will consult the Scottish Government and all interested stakeholders. It is a very important matter to get right.

[Tim Loughton (East Worthing and Shoreham) (Con)]

T5. Last year, 7.3 million people were prescribed antidepressants, including more than 70,000 children. That is an increase of more than 500% in the past 20 years. In welcoming the Secretary of State’s announcement on social prescribing, may I, as co-chair of the all-party group on mindfulness, ask him what part mindfulness and other evidence-based non-drug options will play in the strategy? Would he like to undertake a mindfulness course, and in doing so join the now more than 150 other MPs and Lords who have done so at Westminster?

[Matt Hancock]

I would be absolutely thrilled to. I have previously participated in mindfulness training. In fact, the former chairman of my local Conservative association became a mindfulness instructor, which shows how much we take it seriously locally. I pay tribute to my hon. Friend’s work on this issue. He will have seen that, even in my first two weeks in this role I have already spoken out in favour of moves towards social prescribing and the broader prescribing of less intervention and less medicinal methods, where possible, because medicines do of course have their place. The work that he has done on this issue over many years is to be applauded.

NHS Outsourcing and Privatisation

Tim Loughton Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Jonathan Ashworth]

The hon. Member for East Worthing and Shoreham (Tim Loughton) seems so desperately keen that I will take his intervention and then I will hear from Ashfield and make some progress.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I am really grateful to the shadow Minister. Under the last Labour Government, before Worthing became the outstanding hospital it is now, there was a long list of patients requiring hip and knee replacements. To speed up the list, the hospital contracted with a local private hospital. Those patients were treated much more speedily, at least to the same quality, and actually at a lower cost per patient than if it had been done in-house— and, of course, the patients did not have to pay a penny themselves. Is that the sort of privatisation the hon. Gentleman so opposes?

[Jonathan Ashworth]

I can reassure the hon. Gentleman that no, it is not. I agree with the Secretary of State that the

“use of the independent sector to bring waiting times down and raise standards is not privatisation.”

They were the words of the Secretary of State when he spoke at his own party conference the other year. The Labour Government did spot-purchase from the private sector to bring down the huge waiting lists that we inherited in 1997; but our concern is about contracts for delivery of healthcare services being handed out to private sector providers who not only provide poor quality to patients but give the taxpayer a poor deal. It is a different situation.