The Official Report is a written record of public meetings of the Parliament and committees.
All Official Reports of meetings in the Debating Chamber of the Scottish Parliament.
All Official Reports of public meetings of committees.
Displaying 798 contributions
Meeting of the Parliament [Draft]
Meeting date: 6 February 2025
Jenni Minto
I recognise the very important work that Monica Lennon has done in women’s health and for her constituents. I cannot give a timeframe just now, but my team of officials is working closely with NHS boards to ensure that those separate spaces are created as soon as possible. In some cases, it might be down to the financing of the building of the hospital, or there might be issues with trying to find a specific space. There are a number of reasons, but we are working closely with health boards.
In developing the framework, an expert miscarriage group and a writing group were established, and I am deeply grateful to everyone who has been involved. The expert group was co-chaired by Colin Duncan, a professor of reproductive medicine and science at the University of Edinburgh, and Professor Justine Craig, Scotland’s chief midwifery officer, and it had wide representation from across the NHS, the royal colleges and third sector organisations.
The expert group has set out timescales for delivery of the framework and its 34 deliverables and actions. I acknowledge that this is a difficult time for boards and that there will be some challenges to implementation, which is why I am pleased to announce £1.5 million of funding for boards in the next financial year to support that very important work.
Kath Abrahams, the chief executive officer of Tommy’s national centre for miscarriage research, has today described the framework as
“a real milestone on the path to excellent care for women and families in Scotland”.
As well as Tommy’s, the organisations Held In Our Hearts, the Stillbirth and Neonatal Death Charity and the Miscarriage Association have been at the heart of the work, and I thank them for their crucial input.
Thankfully, for most women, a first miscarriage is also their last, but that does not mean that it is not a devastating experience that is full of questions that often just cannot be answered, such as “Why did it happen to me?”, “Did I do something wrong?” and “Can I help to prevent it from happening again?”
Although there are often no answers, we can provide women with as much information as possible. I am aware that the documents that have been published today are dense and are aimed specifically at senior management and health professionals involved in miscarriage care. However, I know from speaking to women and partners who have experienced miscarriage that there is a real need to provide more clear and accessible information to those who are going through the experience.
Meeting of the Parliament [Draft]
Meeting date: 6 February 2025
Jenni Minto
During my time as the Minister for Public Health and Women’s Health—and, indeed, during my life—I have heard many devastating stories from people who have been affected by miscarriage and baby loss. The charity Tommy’s has said that one in two adults have experienced or know someone who has experienced miscarriage or baby loss, so I know that many people in the chamber and those who are watching us today will have been affected by such issues. I extend my heartfelt condolences to all those who have experienced miscarriage or baby loss. I know that the pain does not go away. However, I hope that, by speaking out about miscarriage and stillbirth, we can help to break the associated stigma and ensure that women and families feel empowered to find their voice and access the right care and support for them.
I am pleased to bring forward a debate on this very important topic. I hope that it serves as an opportunity to reflect on progress that has been made and to discuss the next steps for improving miscarriage care in Scotland.
Today, we became the first country in the United Kingdom to publish a Government delivery framework for miscarriage care, alongside a new progesterone pathway, since the publication of The Lancet report, which was a pivotal moment in the campaign for better miscarriage care. Those documents will make a real difference in ensuring that those who experience miscarriage receive a good standard of care and support wherever they live in Scotland.
Key to that is ensuring that women do not have to wait until they have had a third miscarriage before receiving tailored support, that they can access care in dedicated early pregnancy units or services and that separate spaces are provided in hospitals for those who experience pregnancy or baby loss, whether a miscarriage or a stillbirth. We also remain resolute in our commitment to expand access to progesterone for women who need it.
We have made progress on all those commitments, but we believe that the delivery framework will be key to driving progress and to focusing on areas in which improvement is still required.
Meeting of the Parliament [Draft]
Meeting date: 6 February 2025
Jenni Minto
The debate this afternoon has again highlighted how vital it is to prioritise the healthcare needs of women. I thank every member who has shared their personal miscarriage or stillbirth story this afternoon and those who have shared their constituents’ journeys. I have spoken to Monica Lennon about this previously. It is an absolute privilege to listen to her constituents and to understand how she can make a difference.
Speaking personally, one of my constituents came to me and described the situation that she ended up in, having to travel to a hospital where she was in the same space as women who were about to give birth, and the impact that that had on her and her partner. That has stuck with me and has been my leading light, as Louise Caldwell has been for Monica Lennon and Beatrice Wishart.
It is a privilege to hear such stories and to know that we can try to make a difference. I hope and believe that the work that we have been doing to improve miscarriage support in Scotland will move in that direction. I therefore thank everyone in the chamber for the tone of the debate and for raising their points.
Brian Whittle and others raised mental health. I touched on the meetings that I have had with Held in Our Hearts and the help at home that it provides here in Lothian and in NHS Highland. That organisation recognises and understands that women and families need support at the appropriate time. The women whom I met who had received that support were clear that the personal phone call that they got from Held in Our Hearts staff or volunteers had helped their mental health and wellbeing and—if “coming to terms” is not quite the right phrase to use—their ability to find a path through their baby loss. That is why I was pleased to be able to agree funding for Held in Our Hearts in the current financial year and in the following year.
Bob Doris and Fulton MacGregor both referred to Shona Robison’s debate in the Parliament a couple of years ago. When I read the Official Report of that debate, I was struck by the frequent use of the word “stigma”. I agree with Rachael Hamilton that the men in the chamber today have shown their compassion and understanding of the situation. The fact that they have been able to talk about the situations that they have personally experienced or that they recognise from their constituents is incredibly important. I thank them very much for doing so.
Douglas Ross gave us the quote:
“you’re the midwife no-one wants to meet but I’m really glad I did.”
I am fairly sure that I heard that story when I was at Dr Gray’s hospital. It shows the compassion that we need from all our healthcare staff. I hope that the framework that we have released today gives health boards the structure to ensure that there is support for their staff.
Meeting of the Parliament [Draft]
Meeting date: 6 February 2025
Jenni Minto
I would like to make some progress.
That is why we have been working with the charity Tommy’s and a group of professionals and third sector organisations to develop patient leaflets. There are three leaflets, which are entitled “I think I’m having a miscarriage”, “After a miscarriage” and “Miscarriage: dads and partners”. All three leaflets are available digitally from today and will link to the newly published, vastly expanded and improved NHS Inform miscarriage pages. We also have a leaflet on reducing the risk of stillbirth, a copy of which is given to every pregnant woman in Scotland.
Following the publication of the framework, we will work closely with Tommy’s and Held In Our Hearts to develop a patients charter that sets out clearly the care and support to which women are entitled and how they can access it. I will ensure that people with lived experience and health professionals are involved in the development of the charter.
To ensure that all women and their partners receive the support and care that they need, we must have a more accurate picture of the number of miscarriages in Scotland. We commissioned Public Health Scotland to collect that data, initially concentrating on establishing data collection for miscarriages in which women present to early pregnancy units and services. I am pleased to announce that a data set has been agreed and that Public Health Scotland is now testing it in boards.
We know that miscarriage can be devastating for partners, who often feel a great sense of helplessness. We also know that many dads and partners believe that they need to put their feelings to one side to support their partner. That is just one example of why tackling stigma is so important. We need to break the silence that too often goes alongside miscarriage and stillbirth to ensure that everyone who needs support receives it. I am pleased that we in the Parliament are playing our part in speaking out today.
One of my first engagements as a minister was to the Sands and Scottish Government national bereavement care pathway conference. The powerful speeches and atmosphere of that event will stay with me always. There was a real warmth in the room, which might seem to be a strange thing to say, but it was clear that everyone there, no matter their personal circumstances, wanted to support others and share experiences to improve things for others.
We continue to work closely with Sands. As well as funding and supporting the development of the national bereavement care pathway programme, we continue to fund Sands to support boards with implementation of all five pathways for pregnancy and baby loss. Last year, I attended a round-table meeting that was hosted by Held In Our Hearts and Bob Doris to hear about the innovative hospital-to-home project. I then had the privilege of visiting its premises to chat again with its chief executive, Nicola Welsh, staff members and bereaved parents, and I was pleased to confirm £60,000 of funding for the project for this year and the next. We have also launched a memorial book of pregnancy and baby loss prior to 24 weeks, because we know that, for many people, recognition of their loss provides some comfort and validation during an incredibly painful time.
I have said many times previously how immensely proud I am to hold the position of Minister for Public Health and Women’s Health. Today, as I open this important debate, is no exception. I hope that, in coming together today and speaking openly about miscarriage in our national Parliament, we can help to break down the stigma, send a message to people that they are not alone and, importantly, drive improvement for those who access miscarriage care.
I move,
That the Parliament recognises the devastating impact that miscarriage and stillbirth can have on women and their families, and extends its condolences to all those who have been affected; acknowledges the importance of good stillbirth care and that improvements continue to be made by NHS boards and through the stillbirth national bereavement care pathway; notes that, although miscarriage care in Scotland is generally considered to be of high quality, there is still more to do to standardise and end the variation in the care and support delivered across Scotland; welcomes efforts from NHS boards to further improve miscarriage care following recommendations in The Lancet series, Miscarriage Matters, and Royal College of Obstetricians and Gynaecologists and NICE guidelines around the use of progesterone; thanks hardworking NHS staff and all those who have contributed to the progress to date for their care and professionalism when caring for women experiencing miscarriage; welcomes the publication of the Delivery Framework for Miscarriage Care in Scotland and the Progesterone Pathway as key steps in implementing a graded model of care that will ensure that women receive tailored support from their first miscarriage; supports the provision of dedicated facilities for women experiencing unexpected pregnancy complications, miscarriage or still birth, and believes that it is vital that everyone in society, including employers, works together to break the stigma surrounding miscarriage and stillbirth to ensure that women and their families can access the information, care and support that is right for them.
15:42Meeting of the Parliament [Draft]
Meeting date: 6 February 2025
Jenni Minto
I understand where Douglas Ross is coming from. What is important is that this is the start of a process. I will go on to talk more about the framework and its importance to Scotland. I am offering to have a meeting, at some point after the debate, with members who are interested in learning more about the issue. I thank him for his intervention, which allowed me to say that.
Although the framework focuses on miscarriage care in the first trimester, I want to take a moment to acknowledge the women and families who go through baby loss and stillbirth at later stages. It is vital that they receive excellent care and support at such an incredibly difficult time, and I know that improvements continue to be made by NHS boards and through the stillbirth national bereavement care pathway.
In developing the framework, we carried out a scoping exercise across all NHS boards into the availability of services for miscarriage and unexpected pregnancy complications. Although the “Miscarriage Care and Facilities in Scotland: Scoping Report National Overview” sets out that all NHS boards have
“dedicated facilities for women experiencing unexpected pregnancy complications”
and
“services available for women experiencing miscarriage”,
there is variation in how those services are delivered.
For example, 10 boards have a dedicated early pregnancy unit, with the rest delivering early pregnancy services through existing services. Eleven boards have a separate room, ward or area away from the labour ward for women experiencing miscarriage. Boards without a separate space are aware that that must be addressed as a priority and are working on providing that space.
Although elements of the graded approach to miscarriage, as recommended by The Lancet’s report, can be accessed in 13 out of 14 boards, none consistently deliver all elements, in particular after the first or second miscarriage.
Meeting of the Parliament [Draft]
Meeting date: 6 February 2025
Jenni Minto
I was about to move on to that. As I said earlier, I am delighted to announce that the Scottish Government has agreed £1.5 million of funding to support miscarriage care. I would like to go further than that—I am still arguing to go further—but I am so pleased that I have got that £1.5 million to allocate as appropriate.
We will ask NHS boards to assess what their services are delivering now and how we can progress that support. Very close work is happening between my officials and NHS boards on that. It is one of the conversations that we may have at a future meeting with officials and, I hope, with Professor Justine Craig, our chief midwifery officer.
Bob Doris raised a point about research. The Scottish Government works very closely with Tommy’s, which is a leader in miscarriage research. We meet regularly for discussions including on on-going research and clinical trials. The chief scientist in the Scottish Government also works to support and increase the level of high-quality research in Scotland. Those are other ways in which we are looking at improving knowledge across Scotland and, perhaps, finding some solutions.
Meeting of the Parliament [Draft]
Meeting date: 6 February 2025
Jenni Minto
That is quite a wide-ranging question. I recognise exactly the point that he makes about fertility and ectopic pregnancy. There is a pathway and a framework for that—I am very happy to get more information and come back to the member on that.
I am so pleased that Beatrice Wishart talked about the northern star ward at NHS Shetland’s Gilbert Bain hospital. It is a star. I hope that other health boards can see that, review it and work towards matching that standard.
I am grateful to everyone for their input to this important debate. I am also grateful for the hard work that the chairs of the working groups have undertaken, for their leadership and for the time that they have given to ensure that the framework for miscarriage care in Scotland and the progesterone pathway are as strong as they can be. They will make a difference to the lives of women who go through miscarriage or threatened miscarriage in future.
I am deeply grateful to the professionals who take care of women and their families every day in Scotland following a miscarriage. That includes the professionals who break bad news, the staff who take care of women following a confirmed miscarriage and the third sector organisations that look after women and their families. I also thank the people with lived experience who have fought so hard to bring about the change.
Finally, I thank everyone in the chamber for their speeches. I look forward to continuing the discussion.
Meeting of the Parliament [Draft]
Meeting date: 6 February 2025
Jenni Minto
I recognise the role that the Liberal Democrats played in ensuring that the hospices received additional funding. I agree that, in the light of the bill that Liam McArthur is taking through Parliament, it cannot be one or the other, which is why I am very pleased that we had our palliative care consultation, which closed in January. That is an important way of working to ensure that people in Scotland get the right options on end-of-life and palliative care.
Meeting of the Parliament [Draft]
Meeting date: 6 February 2025
Jenni Minto
The draft budget for 2025-26 now includes £5 million of investment to support independent hospices to provide pay parity with national health service agenda for change levels. The aim of that is to support hospices to retain staff who deliver essential end-of-life and palliative care services. My officials are already undertaking work to explore the mechanisms for providing that funding, while respecting the roles of integration joint boards and local commissioning arrangements.
Meeting of the Parliament [Draft]
Meeting date: 6 February 2025
Jenni Minto
Like Michelle Thomson, I have had the privilege of seeing the incredible work that independent hospices do—both personally and as a minister. I also recognise that Labour’s decision to increase employer national insurance has created huge pressure across the whole of the public and third sectors, including Scottish hospices. If that is not fully funded by the United Kingdom Government, it will pose risks to service delivery.
We remain committed to working with the hospice sector and IJBs to develop a new national funding framework that will support IJBs and independent hospices to agree sustainable funding, planning and commissioning arrangements to meet their local populations’ needs. We will be creating a partnership group to drive that work.