Hansard

I am pleased to open the debate to mark world prematurity day, which fell on 17 November.

I vividly remember visiting my great-nephew just over a year ago in a special care baby unit. He was only a few days old and just out of an incubator. My niece told me that we could see him but we were not allowed to lift or cuddle him. When we were peering into his cot, a nurse told us that we could pick him up and hold him. That was a special moment. Needless to say, he is now doing well and getting up to mischief, and those days seem far away.

Other babies are not as lucky. In the United Kingdom, one in 300 babies dies within four weeks of birth. In Scotland, one in seven babies are admitted to neonatal care every year because of early birth, being small or being too sick. Therefore the quality framework for neonatal care is welcome, and I pay tribute to the work of the professionals and parents who have been involved in drawing it up, as well as to Bliss Scotland and Sands—the Stillbirth and Neonatal Death Society.

Bliss Scotland drew our attention to the problems that are faced in neonatal care in its “A chance for change Bliss Baby Report and Manifesto: Scotland 2011”. It tells us that there is a significant shortage of nurses for sick babies in at least three level 3 units, and four neonatal units reported having problems with recruiting doctors and consultants. There is a lack of counselling services for parents who need emotional support and a lack of accommodation for them when their babies are in facilities that are away from their homes.

The British Association of Perinatal Medicine has outlined staffing guidelines. There should be a nurse ratio of 1:1 for babies who need neonatal intensive care, and the nurse should have a post-registration certificate in neonatal intensive care. The BAPM also recommends a nurse ratio of 1:2 for babies who require high-dependency care and that the nurse should have had training in neonatal care, and that there should be a nurse ratio of 1:4 for babies who require special care.

Three out of the eight neonatal units that responded to Bliss Scotland gave information on nursing levels and occupancy rates that did not meet those standards, and units are not meeting the minimum standards for nurse training. The Royal College of Nursing standards say that 70 per cent of nurses who work in neonatal intensive care units should have a qualification in specialised neonatal care, but half of the level 3 units that responded to Bliss Scotland did not meet that standard. They reported that it is difficult to release nurses for training.

Neonatal units are also having problems with recruiting consultant-level doctors. One nurse said that posts cannot be filled because of a lack of applicants and funding. Because of that, neonatal units have to close their doors to babies who need that specialist care.

In June 2010, fewer than half of the units provided parents with access to counselling. Counselling is crucial because parents who have gone through the trauma of having a child in neonatal care are at higher risk of developing depression or anxiety. We can all imagine the stress that is caused by a seriously ill loved one, but the illness of a tiny baby causes untold stress, so counselling and support are crucial for those parents.

Bliss Scotland also found out that there is a need for 38 more overnight rooms to accommodate parents. Babies and families have to travel far from home to access care because there are only 16 neonatal care units in Scotland. That has emotional and financial implications for the families who need to be close to their child. Access to overnight rooms that allow parents to be close to the unit is crucial for them and their baby.

We also need to make sure that adequate specialist transport is available. My region covers the majority of Scottish islands, and listening to parents whose child has been airlifted to a neonatal care unit while they have been left behind on an island is heart-rending. It is difficult enough to be separated but somehow having sea between the parents and the baby makes it worse. Fathers also often have to face making an awful decision about where they should be if their baby’s mother is also seriously ill. Those parents need practical and emotional support. It is right that specialist staff who care for babies in transit are given priority on flights and in ambulances, but we need to find ways of allowing parents to travel if they are fit and able to do so.

We also need to make sure that there are sufficient allied health professionals to support families and children. Physiotherapy, nutritional support and indeed speech therapy might be needed to help young babies with swallowing, as that is often an issue for babies who need intensive care. We also need palliative care support for parents; that is one of the most difficult areas and it is essential that parents are supported through it.

The quality framework deals with many of those important issues, but it requires to be implemented quickly. World prematurity day takes place every November. It allows us to focus on issues, gives us the opportunity to gauge the improvements that have been made during the year, and allows us to renew our efforts to ensure that we offer a world-class service to premature babies and their families.

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