Hansard

First, I thank all the members who have supported my motion and those who will speak in the debate. I also thank Jane Plumb of the Group B Strep Support charity for her briefing.

The campaign to introduce group B Streptococcus, or GBS, testing was first brought to my attention in 2013 through Jackie Watt, from Kilwinning, the grandmother of baby Lola, who tragically died after contracting Strep B shortly after her birth at Crosshouse hospital. I am delighted to say that Lola’s parents, Tracey and Stephen, now have two beautiful daughters, Brooke and Ellie, who are both thriving.

I congratulate Jackie Watt on her stoic campaign to raise awareness of GBS and to have testing offered in Scotland. Jackie’s petition, on awareness of Strep B in pregnancy and infants, is being considered by the Public Petitions Committee.

GBS is the most common cause of life-threatening infection in newborn babies. It usually lives, without causing symptoms, in human intestines and genital tracts. However, it can be passed from mother to baby at the delivery stage of labour and, unsurprisingly, it is the single biggest risk factor for a newborn baby. Given that, we would expect public awareness to be high. However, that is not the case, as my motion states, and there is a

“lack of public awareness regarding group B streptococcus (GBS) and the effects that it can have on newborn babies”.

In the United Kingdom, it has been estimated that Strep B infects more than 500 babies a year. Sadly, 50 babies die as result of contracting Strep B and around 30 suffer lifelong physical and mental disabilities.

Group B Strep Support has found that incidents of early-onset GBS are higher in Scotland than in the rest of the UK, and that the Scottish rate has increased from 12 in 2000 to 25 in 2014. That may seem like a small number, but in my view even one incident is too many when Strep B is preventable and can be identified through a relatively simple and inexpensive test, which costs around £15 in the private sector.

Indeed, 22 developed countries, including the USA, Canada, Germany and Spain, offer routine testing for GBS at 35 to 37 weeks of pregnancy. Recently, I discovered that, in the UK, around 60 per cent of obstetric units offer testing to some or all pregnant women and 76 per cent carry out tests at the mother’s request. Despite that fact, the Royal College of Obstetricians and Gynaecologists does not recommend routine testing, but the Scottish Government is not bound by that approach and it is free to issue whatever guidance it wishes to issue.

Routine screening for GBS has proven to be effective. For example, in the US, where screening was introduced in 1996, the rate fell from one to 0.24 per 1,000 live births in 2013. The University of Birmingham carried out studies into the cost effectiveness of introducing routine screening for GBS and found that £427,000 would be saved for every baby death that was avoided and £32,000 would be saved per infection that was avoided. Those figures are, of course, estimates and the figures will vary, but other cost benefit analyses have found that screening is more cost effective than risk-based approaches. Given the current financial pressures on the national health service, will the minister say in her summing up whether the Scottish Government will consider carrying out its own cost benefit analysis to see how much could be saved by adopting routine testing?

I understand that there are some concerns around testing, such as concerns about the safety of using antibiotics during pregnancy, the willingness of patients to accept testing and the enriched culture medium or ECM test not being reliable. However, the recommended antibiotic to use is penicillin, which is narrow spectrum, safe and effective against GBS. Most people know whether they have a penicillin allergy, and they can be offered an alternative.

On the criticism of the ECM test not being reliable, it is correct to state that it is not 100 per cent accurate and, indeed, it will not identify which babies will develop early-onset GBS infection. However, it is much better than relying on risk factors alone, which is the current guidance, and it is highly predictive of GBS carriage status when it is done properly, within five weeks of delivery. Essentially, we must remember that the ECM test is a test to identify risk, not to diagnose a condition.

Guernsey and trusts such as the London North West Healthcare NHS Trust offer universal screening, which has been welcomed by patients and health professionals alike. Previous screening surveys have found that health professionals want to be able to offer antenatal testing for group B Strep using ECM tests, women would like it to be offered, and infection rates have notably fallen where universal screening has been introduced.

I hope that I have laid out a firm argument as to why routine GBS testing should be offered by the NHS in Scotland. As studies have shown, it is cost effective, and on every piece of data, universal testing has been proven to dramatically reduce incidences, whereas risk-based testing seems to mean an increase in incidences.

The guidance from the Royal College of Obstetricians and Gynaecologists has been overtaken by events, with more maternity units offering testing regardless of the guidelines or, indeed, as I said earlier, introducing universal screening. Given that the Scottish Government is not bound by that guidance, I urge it to introduce updated guidelines so that there is consistency and standardised care across all hospitals and expectant mothers can be confident that they are receiving accurate information about GBS and whether they can be offered routine testing, or are given information on how testing can be accessed privately. I ask the Scottish Government whether it will consider carrying out a cost benefit analysis to find out what the benefits of that would be, so that no other family will have to suffer the trauma that the parents of baby Lola have experienced.