 The next item of business today is consideration of business motion 4157 in the name of Joe Fitzpatrick on behalf of the Parliamentary Bureau, setting out a revised business programme for today. I would ask any member who wishes to speak against the motion to press their request to speak button now. I call on Joe Fitzpatrick to move motion 4157. Formally moved. Thank you. No member has asked to speak against the motion. I will put the question to the chamber. The question is that motion number 4157 in the name of Joe Fitzpatrick be agreed. Are we all agreed? Yes. The next item of business is a statement by Aileen Campbell on the national review of maternity and neonatal services. The minister will take questions at the end of her statement, therefore there should be no interruptions. I would call on any member who wishes to ask a question to press their request to speak buttons now. I call on the minister to move the motion. Thank you, Presiding Officer. I am pleased to update Parliament on our response to the publication of our review of maternity and neonatal services and set out our response to that report. Every day, our maternity services deliver an excellent service to families across Scotland. In our maternity care experience survey, women reported over 90 per cent satisfaction with the care that they received. We also continue to reduce rates of maternal mortality, stillbirth and neonatal mortality in Scotland to record low levels. The number of neonatal deaths has reduced by 40 per cent in Scotland since 2007. That means that in 2015, 76 more babies live where lives were saved due to the high-quality care provided by staff in neonatal units across Scotland. That also means that 76 fewer bereaved families. That improvement is a testament to the hard work of staff who look after sick babies in Scotland. We have a maternity system in Scotland that has high satisfaction ratings from women and continues to improve care and outcomes for the sickest babies. We are in a position of strength, but we are not complacent and know that there is much that we can do to make further improvements. That desire to improve and transform in part inspired the review. The report is a landmark publication that will represent a major opportunity to improve services even further. Its recommendations will transform service delivery in Scotland. For example, in our current system, there are women who currently experience no continuity of maternity care and can see numerous different midwives and obstetricians throughout their care journey. This is not what women want or what staff want, and evidence tells us that it is not good for care. To give women and staff what they tell us they want, which the report describes as family-centred care, will require a radical shift in the way that we deliver care. There is no doubt that such change will be challenging to deliver, and for many of our midwives and obstetricians it will represent a significant change in ways of working, but it will give better care. The importance of this review and its far-reaching and considered recommendations are down to the leadership of the chair, Jane Grant, and the members of the review group. I put on record my thanks to them for carrying out that commission. Their hard work and commitment has produced a report that is based on evidence and grounded in the views of families who use those services and the staff that deliver them. The breadth of engagement undertaken by the review team supported by the Scottish Health Council is impressive, and I welcome a report that is so strongly anchored in the views of hundreds of service users and staff across Scotland who contributed. I want to outline the next steps on implementation and highlight some of the key principles and recommendations in the port. First, it is my pleasure to announce that Jane Grant has agreed to chair the implementation of the review recommendations. It was Jane's drive, commitment and inclusive approach that produced such a well-researched and thorough report. As an experienced NHS chief executive, she is the right person to chair the major programme of implementation that we will now embark upon. Over the coming weeks, Jane will appoint the implementation group to drive forward delivery of the recommendations. Chared by Jane, this group will be tasked with progressing quickly the priority recommendations in providing a detailed plan and timetable for implementation over the five-year delivery period envisaged. I will ask this group to get under way quickly and to report back to me at regular intervals on progress. All of the 76 recommendations will take time to implement but are important, but there are a few that I will want to highlight. First, continuity of care. The report at length highlights the importance women and families attach to forming a relationship with professionals caring for them and having continuity. This recommendation, as the report acknowledges, challenges traditional NHS approaches. The report recommends identifying a number of early adopter boards to lead the change in practice, supported by proper training and development for staff who will require it. I am also pleased that a number of boards have already volunteered to do so. We will announce shortly which boards will lead the first phase of implementation and will work carefully with boards to scope out the scale of task and ensure that the early adopter boards can properly chest the challenges of implementation. Secondly, I want to move quickly with the proposals to implement the range of recommendations on pens, persons-centred maternity and neonatal care that are aimed at keeping families together. Those include recommendations to keep mother and baby together, to involve parents more in the delivery of care and to provide accommodation and a national approach to expenses for families with babies in neonatal care. I want to underline how important it is that families stay together. No mother wants to be separated from her new baby, even for a very short time. We should never underestimate the importance of the early days of life for family bonding, for breastfeeding and for attachment. I want that to be a core feature of our services in the future and I will ask the implementation group to prioritise those recommendations. Thirdly, on redesign of maternity services with a focus on local care and multidisciplinary community hubs, we all know that women want care to be delivered as close to home as possible. Again, I want boards to move quickly with the assessment of potential for hubs within their local areas to allow local delivery of the majority of maternity care as soon as possible. Finally, on the model of neonatal care, the model described in the report aims to reduce the number of babies who needed to spend time in neonatal units by keeping mothers and babies together in postnatal wards with in-reach support from neonatal staff and by putting in place wraparound community support to allow babies to be cared for at home by their parents sooner than they can be currently. All 15 neonatal units will remain and continue to care for babies in their area. The clinical evidence shows that the outcomes for the very smallest and the very sickest babies will be better if they are cared for in up to five enhanced neonatal units, delivering highly specialist care and moving to three such units in the longer term, if possible, based on experience of operating in up to five. This new model is based on evidence and emerging good practice from Scotland and the rest of the world. I want the implementation group to outline clear plans to allow the neonatal community to progress quickly with implementation of those recommendations. Again, that will be a priority for the implementation group. I have already outlined the strength of the engagement with women, families and staff in NHS boards that underpins the report. I want this partnership and co-production for delivery to be a core feature of implementation. I am sure that we all agree that solutions developed in partnership will have a far more chance of success and sustainability, but will also require time and space to ensure that the beginnings of this transformational shift are right. That is why I will continue to keep Parliament and spokespeople informed of progress, particularly on neonatal units and pathfinders. Proceeding on the basis of partnership and co-production will take care and time, and while the report has been warmly received across Scotland and discussions are already underway with the NHS community about the recommendations, implementation will be challenging and complex. I will request the chair of the implementation group to build partnership into delivery from its start, and I am prepared to give the implementation group the time to do that properly. Similarly, I am keen to work in partnership across the parliamentary chamber on that. Although much of what is in the report is about redeployment of existing resource, it is also clear that some of the recommendations will need investment to deliver. All boards are at different starting points in terms of delivery, and we will work closely with them learning lessons from early adopters and existing good practice to quantify what additional resource will be required. In many cases, it is hoped that this investment will realise savings over time, though improved outcomes for women and babies is ultimately the real prize. Finally, I will ask the implementation group to instigate a detailed piece of work on staffing. The review has firmly grounded in the views of staff, and the review report describes some of the challenges that they face. Those have also been reflected in recent reports by Bliss and the RCM, and I will ask the implementation group to undertake some early modelling work with NHS boards so that we can get a better understanding of the workforce changes that are required to take forward the package of recommendations, and that will align with the workforce strategy. The shift in care that the report describes sits within the overarching strategic context of our reform agenda for health and care services, as outlined in the national clinical strategy, the chief medical officer's annual report of realistic medicine and tackling inequalities. The Royal College of Midwives described the report as having the potential to revolutionise maternity care and to deliver safer and better services for women, babies and their families. Bliss Scotland described it as an ambitious and progressive vision for family centre care and good news for the future of Scottish neonatal services. This report makes a clear case for change in our maternity and neonatal services, and its recommendations and aims are supported by professionals, practitioners and importantly parents. Our aim is to make Scotland the best place to grow up, and that journey starts with excellent maternity care and giving all babies the very best start in life. Our job now is to implement those recommendations strategically and to take the time needed to ensure this unique opportunity to transform the way services are delivered makes good on our ambitions and visions. I welcome, Presiding Officer, questions to the statement. Thank you very much. I urge those who have not done so to press their request to speak buttons if they wish to ask a question. I thank the minister for early sight of her statement. We on these benches welcome this report and the general principles and recommendations contained within it, as well as the consensual approach that is professed by the minister today. We agree that, where possible, mothers having a normal delivery should have appropriate access to local or community-based maternity services. However, it is clear that there are still issues that the statement has not addressed. Let me name two. Firstly, we are concerned at the reduction in intensive care units, with the current eight units being reduced to between three and five, and ultimately to three by the end of this Parliament. Secondly, there are still major issues over staffing that the minister has brushed over in her statement. The Royal College of Midwives commented after publication of the report and outlined their concerns about retirement, saying that heads of midwifery get nearly double the amount of retirement that they used to get. They also spoke of general recruitment issues in the Highlands and in Grampian in particular. The report states that all women should have an appropriate level of choice in relation to place of birth. There are a number of choices that should be available to all women in Scotland, including birth at home, birth in an alongside or freestanding midwifery unit and hospital birth. To that end, what action will the minister take to ensure that all women in Scotland have that choice? Will the Government support the provision of such services in rural and remote areas of Scotland? I thank Donald Cameron for his series of questions. He said that he is eager and keen to work on a basis of consensus in delivering the recommendations of the report. In terms of the neonatal provision that he raised and his concerns about what he described as a reduction, there will always continue to be 15 neonatal units across the country. What we are talking about here in the report is about making sure that we have that clinically specialised care that will allow us to deliver better outcomes for the very, very sickest of babies, and that is where the careful planning will be required with that progression and enhancing that care for those sickest of babies. We are talking about a small proportion of babies across Scotland, but that is why it is important that we deliver that specialist care. We will also take care to do that, working with the clinicians, working with parents and with professionals to ensure that that role-production and that collaboration allow us to proceed on the basis of consensus. Again, as I said in my statement, I will continue to make sure that as that develops, we will continue to keep the Parliament informed of any moves. In terms of workforce, there is no doubt that that represents a fundamental shift in the way in which people will be required to work, but it is also important to recognise that the engagement that happened with professionals was a key message about what they wanted. It is why they wanted to deliver maternity services to women across the country, but it is important that we recognise that we have in place in Scotland a workforce strategy, that we have good numbers of women, and that we have midwives in our NHS, and that we will continue to work with professionals to ensure that we can improve on the situation that we have already in Scotland, which is based on a position of strength and work with staff as best as we can in terms of delivering on those recommendations. In terms of making sure that we deliver for women in rural areas, which I think was the last point that the member raised, of course we want to make sure that women have choice, appropriate choice, and that is again part and parcel of the recommendations based within this report. It is about making sure that we can remodel existing care structures to deliver for women and give them appropriate choice, but also recognising that for some specialisms that will require a bit more specialism and that it will require a bit more, in terms of working out where those specialisms will be delivered. That is the basis in which the neonatal recommendations are being taken forward. Again, much of the work will be delivered by the implementation group and done at a pace in which we can deliver good outcomes for women and also for babies. Anas Sarwar, I thank the minister for prior sight of the statement. I think that it is important to look at this report alongside the Bliss Scotland baby report, because it is clear that this Government's failure to workforce plan has left our maternity and neonatal units understaffed and existing staff overworked. Their report found that three quarters of units do not have enough nurses and two thirds of units do not have enough medical staff to meet minimum standards of care, and more than half of units do not have enough overnight accommodation for parents of critically ill babies. Can the minister therefore tell us when the Government will publish a detailed workforce plan, how many additional staff will be delivered and by when, and when all the units will meet national standards for high-quality care? The report recommends removing intensive care cuts from 10 units over the next five years, which 10 units will lose their intensive care cuts? What impact will that have on travel times and on keeping families together? The report also makes clear the desire to keep mothers and babies together. What additional capacity will therefore be created for free accommodation for parents of critically ill babies? Finally, the report says that all women should have the appropriate level of choice on where to deliver. Therefore, will the minister recognise that the proposals to close the maternity units at the Vale of Leven hospital and at the Inverclyde royal hospital are ill-thought through that she will call them in and reject them? I think that what he fails to recognise is that we have a good record in Scotland in terms of delivering maternity services. While there are challenges, as outlined in the report, we have some things that we should be proud of. We have an innovative midwifery workload and workforce planning tools. A UK first has helped to ensure that NHS Scotland continues to meet the RCM-recommended midwife-to-birth ratio, unlike in other parts of the UK, where RCM is clear that there is currently a shortage of midwives. Again, in Scotland, we are taking a leading way forward in delivering for women across the country. In terms of keeping babies and parents together, of course, that is why we want to transform the way in which maternity services are delivered in Scotland, making sure that we keep women alongside their babies, because we know how important that is for bonding, for attachment, for breastfeeding and a whole host of other positive outcomes for some of our most sick babies. Again, the neonatal recommendations for specialising neonatal care to from five to three services across the country are based on clinical evidence about what works for a very small proportion of babies across the country and making sure that we have good outcomes for those sick babies and making sure that we can do all we can. That is why we are taking forward those recommendations at a pace and a scale that is comfortable to ensure that we can transform the way in which care is given and we can improve outcomes for babies. That is something that we need to unite behind. That is going to have to be based on clinical evidence, but what tells us is the best for the babies across our country. As I said in my statement, we will be looking at things around accommodation and transport to make sure that those people who live in rural areas across the country are able to access those specialist care in a way that is comfortable for them and do not have unnecessary stress and strains that we know has happened in the past. We want to eliminate to ensure that every mother gets the very best care and that every child gets the best start in life. Fulton MacGregor I take this opportunity to remind the chamber that I am the parliamentary liaison officer to the health secretary. Can the minister outline what the expected patient care benefits are from the recommendation that every woman using maternity services has a primary midwife? The recommendations are to make sure that there is a continuity of care for women across their maternity journey. That is because people want to develop relationships, they want to have familiarity and they want to make sure that they are informed. This whole process has been developed with deep engagement with mothers and with mothers to be with professionals. There is a meeting of minds on that. That is the way in which people who deliver maternity services want to create the service as well. They want to make sure that they have a relationship that is built up with the mother who is in their care. The potential to transform the way in which maternity services are delivered in the country is great. We have a unique opportunity to now build on the recommendations in the report, transform the way in which maternity services are delivered in Scotland and really make sure that we embed co-production, partnership and empowering of women across the country to deliver what they want to happen across our country. I welcome the fact that the review calls on all NHS boards to review their current access to perinatal mental health services to ensure early and equitable access is available to high-quality services with a clear referral pathway. However, given NHS boards' difficulties in recruiting trained psychological staff, what more can be done by the Scottish Government to ensure that perinatal mental health services are appropriately staffed so that mothers who need those services and who would benefit from early intervention are not kept waiting for months for that support? I thank Miles Briggs for his question. I recognise the real and long-lasting interests that he has had on the issue and more generally on mental health. I know that he hosted a conference yesterday as well. I would be absolutely pleased to get some of the outcomes from that if he wishes to share those. Maureen Watt, the Minister for Mental Health, announced a managed clinical network around perinatal mental health. Of course, we are taking forward the mental health strategy, which will also dovetail into the work around improvements for maternity and neonatal services in the country. We have a whole host of other ways in which we provide support for those who are more vulnerable, including things like the family nurse partnership, which engages deeply with women who are potentially vulnerable, young, first-time mothers, teenage mothers, and we are rolling that out across the country. There are a range of services at present, but, of course, we recognise the challenges that exist. That is why the minister announced the MCN, and that is why we are taking forward a mental health strategy. Together we will make improvements for women's and mothers' mental health issues because of the real recognition in the report that we have to make vast improvements on that area. Clare Haughey I would like to refer members to my register of interests. I am a registered mental health nurse, currently registered with the NMC. I think that it is important to start off by thanking all those who work in our NHS. They do a fantastic job and provide an excellent maternal and neonatal service, and I welcome the update from the minister. I wonder if she could expand further on any development and training opportunities as a result of this review and confirm that she will be working with NHS boards to examine staffing implications. Absolutely. Again, this reflects that this will require a shift in the traditional norms of delivering maternity services across the country. However, however has been done with engagement with NHS staff in response to what they have told those who are involved with the review. There will be implications for workforce that will require remodelling, and that will also require training to ensure that we have the correct and appropriate services in place to deliver for mothers who are about to use maternity services across the country. Clare Haughey is absolutely also correct to recognise the hard work and endeavour of staff across our country. We are in a position of strength in how we deliver maternity services in Scotland, but we want to build on that and improve it further. Jackie Baillie Time last year, before the Scottish Parliament elections, the SNP accused me of scaremongering when I spoke about the closure of the Vale of Leven maternity unit. Immediately after the election, the proposals that were denied were published. I very much welcome the minister's commitment to delivering maternity services closer to whom. Is she aware that NHS Greater Glasgow and Clyde have kicked the formal consultation into the long grass and surprise surprise will not be considered by the health board until after the election? I am sure that the minister will view that as a deeply cynical move, so will she today put an end to this nonsense and commit to the continuation of the full maternity unit at the Vale for the remainder of this Parliament? The member mentions the Vale of Leven. As yet, there are no firm proposals from NHS Greater Glasgow and Clyde on the future of the units in the Vale, and I understand that boards are currently considering the recommendations in light of their review as published. However, the report suggests that it is important to maximise the potential of CMUs and that boards should undertake an assessment of their viability against the agreed national framework to ensure consistency involving local service users so that their needs can be balanced with the need to maximise the use of resources. We would expect boards to take cognisance of the report, but I will gently point out to Jackie Baillie that the Vale of Leven hospital is there because of the work of this Government to ensure its future. Jackie Baillie's uncomfortable truth for Jackie Baillie was that her administration was prepared to close the Vale of Leven. Jackie Baillie might see that that is abhorring, but her colleagues who are shouting 10 years at us would have been shut for 10 years if her party had been brought back to power. It was this Government that took decisive action and gave the Vale of Leven a future that is bright. Many of the aspirations in the report deserve support, especially the emphasis on local care. However, in terms of delivering local care, will the minister commit to supporting our more rural neonatal units in maternity services such as the excellent service at Dr Gray's and Elgin? Will she acknowledge that, to maintain those services, the current pressures have to be addressed by health boards in terms of workforce planning and resources, particularly given that, in more rural units, a vacancy for a consultant or a midwife can have a disproportionate impact? It is not always in the best interests of mums and babies to travel long distances in clinical practical resource reasons. Richard Lochhead is right to point out the importance of workforce planning, and that is why we will enshrine safe staffing and law by putting our workforce planning tools on a statutory footing. He is also correct to point out the importance of rural services, which is another key element of the report, where mothers and families have told us how important they feel it is to have services delivered as close to home as it possibly can be. Of course, that raises challenges where there is a requirement for specialist interventions. I reiterate that we do attach a great importance to rural services across our country, but that signifies a transformation in the way that services will be delivered and will continue to work with health boards, patients and mothers and maternity users across the country to ensure that that key principle of ensuring that maternity services can be delivered close to home is the way in which we proceed as we implement the recommendations. I thank the minister for advance sight of the statement. The statement says that babies will be better, the very sickest babies will be better if they are cared for in up to five enhanced neonatal units, delivering highly specialist care, moving to three such units in the longer term, if possible. Can the minister advise what would trigger such a move? If there are fewer units, that will necessitate more transport. To what extent has Scott Star been involved in the review process and what work is planned to ensure that we have sufficient capacity in our neonatal transport services? Scott Star will be absolutely involved in the process of recognising the requirements, the greater requirements that we have made of transportation as we work through the recommendations around neonatal units. Again, I said in my statement that I will keep the Parliament abreast of those as things progress around the neonatal recommendations. Because we have to do this in a managed way, that is recognised in the report. The first step is to make the move up to five units, and that will require careful planning and capacity building in some units. The move to three will be considered over a much longer timescale and will be informed by the experience of moving to those initial five units. That, of course, will also be influenced by the recommendations and the aspirations that are set out in our national clinical strategy. Alex Cole-Hamilton will be followed by Stuart McMillan. I thank the minister for advance sight of her statement. Given that one in five new mothers experienced mental health difficulties as a result of pregnancy and childbirth, I very much welcome the comments of the minister in response to Miles Briggs earlier. In Scotland today, only five health boards currently have specialist community perinatal mental health teams. Will the minister outline practical steps that her Government will take to expand provision across other health boards and to equip maternity ward staff and neonatal staff with the tools to identify early onset mental health issues when they first appear? Minister. Again, the importance of good maternal mental health is a big feature of the report as published. Again, that recognition was a motivator in the Minister for Mental Health, publishing an MCN and committing to rolling out best practice across the country. We recognise that there are challenges that still persist around mental health for mothers and mental health more generally, which is why the Minister for Mental Health will be publishing her strategy very soon. However, the point that Alex Cole-Hamilton makes is a good one. We will take a nice sense of his keen interest in ensuring that we can do better by mothers around their mental health as we implement the recommendations. We will ensure that the implementation group and gene grant that leads it will prioritise that work. Thank you very much. Minister, the RCM Scotland director Mary Ross Davies said earlier this month that, in terms of midwife numbers in Scotland, we are doing well. We have known for a long time in England that there is a really significant shortage of midwives. Can the minister outline if the RCM will be engaged in national and regional workforce planning to ensure that we have the right mix and numbers of staff in the future and also to avoid the shortages being experienced in England? Again, we have a commitment to make sure that we have the right complement of staff. We have already mentioned that our innovative midwifery workload and workforce planning tools—a UK first—have helped to ensure that the NHS ratio in Scotland continue to meet the RCM recommendation of midwife-to-birth ratio, unlike in England, where the RCM is clear that there is currently a shortage of midwives. However, we are not complacent in Scotland. We will know that we will have to do more. That is also about redeployment of existing maternity staff and midwives to ensure that we can transform the way in which maternity services are delivered in Scotland, which challenges the existing norms of the way in which the NHS delivers maternity services and ensures that there is continuity of care on a person-centred approach. We will continue to engage with staff as we move forward with the implementation and the recommendation group will continue to engage with staff on that. Brian Whittle is followed by Neil Bibby. I declare an interest in that one of my daughters is a midwife. There are currently about 500 midwives in training spread over the next three years. The Royal College of Midwifery reports that 41 per cent of current midwives, around 1,200, are over the age of 50 and are therefore eligible to retire at the age of 55. NHS Greater Glasgow and Clyde reports that they are losing midwives at double the rate that they used to. With the inevitable chronic loss of experience that cannot be replaced by newly qualified staff, how does the Scottish Government propose to correct the lack of foresight by the then health secretary, Nicola Sturgeon, in which she cut maternity training places in 2011 and ensure that not only are staffing levels raised to an appropriate level but also that crucial levels of experience in maternity services are not lost to enable delivery of this strategy? In a number of responses that I have made to members who have asked questions about maternity and midwife numbers, I have mentioned that Scotland's ratio continues to be better than many other areas of the United Kingdom. I also want to give some clarity to Brian Whittle that we have increased the student-midwife intake for five years in a row, including another 4.9 per cent increase for 2017-18. That equates to 191 midwifery training places in 2017-18, which complies to 172 students in 2006-07. We also will have to cope and deal with the situation imposed by his party around Brexit, in which we rely on many EU nationals to deliver many services across our country. The reality is that those are things that we are having to deal with with our workforce planning. I hope that Brian Whittle has been so robust in his question with me, with his colleagues down south. I am ensuring that we can make sure that Scotland's position is protected. What is motivating me to move forward with the implementation of the recommendations is to transform the way in which maternity services are delivered in our country and to build on a position of strength that we currently have in Scotland, in which mothers report a high degree of satisfaction and improvements to outcomes for our babies. I will take two very brief questions if the minister is brief. Neil Bibby. Ministers have plans to reduce intensive care units at neonatal units across Scotland. Today, NHS Greater and Glasgow Clyde agreed to submit their plan to close the children's ward at the RAH. That comes after months of denials from the SNP that those proposals even existed. The final decision will rest with the SNP Government, and it must be rejected. Can the minister tell me whether the RAH is one of the neonatal units to be downgraded further with a removal of intensive care cuts too? Given that the review talks about the need for choice in local maternity provision, will the minister make sure that the Government keeps its promise to protect services in the Clyde and reject plans to close the Inverclyde birthing unit? We have within the recommendations that there is a move for five neonatal units that will specialise to provide care for the very sickest of babies. That is about providing a specialist service for our very sickest babies and to do so with the knowledge that that is driven by clinical evidence to deliver good outcomes for those sick babies. I said in my statement that I will keep Parliament informed of that progress and to make sure that, when we do so, it is at a pace and a scale of change that is comfortable to ensure that that can be as smooth as it possibly can be. The NHS Greater Glasgow and Clyde has continued to work through its proposals. I know that he has a real interest in the services that are delivered close to his home, but we will expect our NHS boards to take cognisance of the recommendations within our report and proceed on that basis. I welcome the statement and the minister's commitment to accept all 76 recommendations in the report. Working to continue to reduce stillbirths and neonatal deaths must be this Government's absolute priority. Nevertheless, for those families who have suffered such a tragedy, what steps will now be taken to ensure that they are then treated with empathy, dignity and respect by the NHS rather than confronted with inertia, suspicion and hostility when trying to find out how and why their baby died? I thank Kenny Gibson for raising the question. I cannot imagine the pain and suffering that any parent goes through when they have lost a child. He is right to make sure that we, when we improve the maternity services, parents are treated with respect, dignity and empathy after having to cope with such a dramatic loss. There are reasons to be hopeful about the improvements that we are seeing around maternity services because they are safer than they have ever been, but that does not take away from the pain of a family that is having to endure such a loss. We will continue to make sure that we support parents through bereavement and make sure that we have a better understanding of what that will require. bereavement is very much a part of the recommendations that are set out within the report and will take cognisance of members' own experience and personal suffering around any improvements that they think we should take forward in the review.