I am delighted to move regulations under the Neonatal Care (Leave and Pay) Act 2023, which originated as a private Member’s Bill in the previous Parliament. I therefore pay tribute to Stuart McDonald, the former Member for Cumbernauld, Kilsyth and Kirkintilloch East, and Baroness Wyld for successfully steering the legislation through both Houses, so that it could secure Royal Assent in 2023.
The Act established new statutory entitlements to neonatal care leave and neonatal care pay for employed parents if their child starts to receive neonatal care within 28 days of birth and goes on to spend seven or more continuous days in care. These regulations are another step towards implementing neonatal care leave and pay in April 2025, and they are the first to be brought before the House under the Act.
There is currently no statutory entitlement to such rights for parents of children who require neonatal care. Parents in this difficult situation have had to rely on existing rights, such as maternity leave or annual leave, to be there to care for their baby and to support their partner. This approach has understandably caused additional stress for parents. Some mothers report that they had to leave work because they were not ready to return at the end of their maternity leave. As paternity leave is limited to two weeks, some fathers and partners have had to rely on statutory unpaid parental leave or the compassion of their employers to take time off work.
Around 40,000 babies a year spend more than a week in neonatal care. Once provisions on neonatal care leave and pay come into force in April, we estimate that around 60,000 parents will be eligible, and that around 34,000 parents will take up paid leave each year. Neonatal care leave will enable eligible parents to take a minimum of one week’s leave and a maximum of 12 weeks’ leave, depending on how long their baby receives neonatal care, on top of their other parental leave entitlements. It will be a day one right for employees.
Statutory neonatal care pay, like other family-related pay rights, will be available to employees who also meet continuity of service and minimum earnings tests. Eligible employees must have worked for their employer for at least 26 weeks, ending with the relevant week, and earn on average at least £125 a week before tax. If eligible, a parent will be able to claim a flat rate of £187.18 a week in 2025-26, or 90% of their average earnings, whichever amount is lower.
Does the Minister agree that these changes will not only support parents who are going through a really difficult time but will also be good for employers? By showing that they are supporting their employees to return to work with these additional rights, this will be good for employers in the long term, too.
My hon. Friend is right. The impact assessment refers to evidence showing that family-friendly policies are good for employers as well as for individuals. That is certainly the Government’s approach towards employment rights.
We have extensively consulted stakeholders, including charities and business representative organisations, to ensure that these regulations balance the needs of parents and businesses. These groups agree that the proposed reforms will provide substantial benefits to businesses, including the retention of their employees’ skills and knowledge, as my hon. Friend has just said. I will explain in detail a few points in the regulations, which have been developed through consultation with relevant Departments, including the Department of Health and Social Care.
We have a definition of neonatal care that encapsulates the different ways in which babies receive it, including beyond the walls of a hospital and through outreach care. This could include care that takes place in the family home, provided it meets the relevant criteria. We have included outreach care in the eligibility criteria to capture the many ways in which babies receive care, and to prevent a postcode lottery in which parents of children who receive the same clinical treatment may qualify in one area because they receive their treatment in hospital, but not in another area because they receive their treatment at home through an outreach care programme.
To ensure that as many parents as possible are eligible, the definition of “parent” in the regulations encompasses adoptive parents, foster-to-adopt parents and intended parents in surrogacy arrangements. Those who meet this definition will also be required to have caring responsibility for the child.
Having a baby in neonatal care is a difficult experience for any parent, whether the baby is admitted for one day or for many months. However, this entitlement will focus on parents of babies who experience prolonged stays in neonatal care as they will be in most need of additional support. A qualifying period of neonatal care will therefore be a minimum of seven continuous days, beginning on the day after the one on which the care starts. Starting the clock at one minute past midnight of the day after the child is admitted creates a consistent approach that does not vary from baby to baby.
I welcome the opportunity to contribute on behalf of His Majesty’s loyal Opposition, and I welcome the introduction of these two statutory instruments, which have been a long time coming. In 2019, the Conservatives made a manifesto commitment to introduce neonatal care leave. It was a shame that in that election, and in the most recent, no such commitment was made by the Labour party, now in government. That is no surprise, however; just like with all their good ideas, it usually turns out that they were ours.
Our commitment to introducing neonatal care leave led to our support of the Neonatal Care (Leave and Pay) Act 2023, which was stewarded by the former Member for Cumbernauld, Kilsyth and Kirkintilloch East, Stuart C McDonald and Baroness Wyld. That Act is the reason why the Government are introducing these statutory instruments today.
I am pleased that, with reservations, we will support the measures, so that we can continue to build on the sensible improvements to workers’ rights that we, as Conservatives, introduced in government. We introduced shared parental leave, giving more choice and flexibility to families, and carers leave, giving employees more time off to give or arrange care for their families. We supported flexible working, giving employers and employees more flexibility over working practices, and we achieved all that while increasing employment and wages, a thing that the Government are now realising is no easy feat.
The result of our reforms to workers’ rights is that Britain has some of the most generous maternity and paternity leave globally, meaning families are able to spend more time with their newborns. Those achievements were reached by working with businesses and employees. We worked with businesses not just out of courtesy, but because we know that without consulting businesses and taking on board their concerns, no progress will be made, no matter how good the intention. That is not something this Government have done, which is why their Employment Rights Bill is driving up unemployment before it has even been passed.
The shadow Minister talks about targets, but was it not his own Government that got rid of the targets for A&E waiting times, and then failed to meet their lowered targets?
It is a brave Labour politician who talks about health targets when, for so long, the NHS in Wales was performing, and continues to perform, worse than in England when it was run by the Conservatives.
To conclude, we will support these statutory instruments because they will support the 40,000 families who faced the incredibly difficult and worrisome experience of having a child in neonatal care. The instruments will build on our achievements that made the UK one of the best places in the world to be the parents of a newborn, and I hope the Government can continue to make progress.
I end by again thanking the former Member for Cumbernauld, Kilsyth and Kirkintilloch East and Baroness Wyld. I also thank Bliss and the Smallest Things for their consistent work that has kept neonatal care pay and leave at the top of all of our agendas.
I commend the Minister for bringing the statutory instruments before the House. They introduce much-needed and long-overdue support for new families, which I am sure will be welcomed by Members across the House.
As every parent will know, the time after childbirth is a time like no other. It is both incredibly special and incomparably difficult, with lasting effects on the wellbeing of parents, carers and their babies. I pay tribute to my constituent Ashley Wiseman. In 2018, she gave birth prematurely to twins at 24 weeks. Her first child Esme was sadly born sleeping. Her second child Isla was born 50 minutes later. Isla was admitted to neonatal care at Basildon hospital before being transferred to the Royal London hospital.
Ashley met me and told me about the fear and uncertainty that she felt at that time, the impossible choice that her family faced between returning to work or being beside their sick child, and the financial burden of travelling to visit Isla once she moved to the Royal London hospital. Ashley described what we would all find impossible to imagine: long stays on the ward, some of her darkest days, and Isla being given just a 2% chance of survival. After seven months in a neonatal intensive care unit, Isla was discharged, and last month she celebrated her seventh birthday.
Out of such a traumatic and stressful time, Ashley created Isla’s Journey, a charity offering support to families of babies in neonatal wards. The charity provides care packs for new parents at over 80 NICU wards across the UK. That simple support makes a huge difference to families by allowing parents to spend as much time as possible beside their baby, and the changes brought forward today will achieve the same thing. By providing a statutory right to paid leave for working families with babies in neonatal care, the regulations will remove the unimaginable and impossible choice for new parents of either returning to work to pay their bills or staying beside their desperately ill child.
It is difficult enough to have a child in the neonatal intensive care unit. Parents being with their new baby in the early days is vital for their mental and emotional wellbeing, as well as for the early life chances of the baby. The benefits of things like skin-to-skin contact and those early bonding experiences cannot be overstated, and that sometimes feels like an impossible task for parents whose baby is in the NICU. This legislative change removes one of those barriers to these early experiences being a joyful time for parents whose babies have an extra way to go when they are first born.
Order. Before I call the Liberal Democrat spokesman, I remind the House that it is courteous for Members who wish to speak to be present for all the opening speeches.
Please accept my sincere apologies for being late, Madam Deputy Speaker. Things moved on at pace this afternoon. I will take what you said seriously into account.
The Liberal Democrats had such proposals in our manifesto, so we welcome the regulations. Some 34,000 people—equivalent to the population of Yate—are set to benefit from the regulations in the first year after they come into force. I note that the shadow Minister, the hon. Member for Mid Buckinghamshire (Greg Smith), said that the Conservatives promised to deliver such proposals, but—a bit like their hospitals programme—they failed to do so. One needs to bear that in mind.
I pay tribute to Stuart McDonald, a former MP whose private Member’s Bill—the Neonatal Care (Leave and Pay) Bill—addressed this issue. I also pay tribute to my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron), for sponsoring that Bill, which gave these proposals legs in the Chamber. I am delighted that they are coming to fruition today.
In my Torbay constituency, developing an attachment between parents and children is often a challenge, particularly for those who face serious difficulties in their lives. Many prematurely born youngsters are from more deprived backgrounds—there is twice the chance of that. We Liberal Democrats truly welcome the proposals, because they will drive strong attachment between parents and their babies, and that can only bear fruit for communities across the United Kingdom.
I pay tribute to all parents who have campaigned for change, and I commend the Smallest Things charity for its work on this issue. Co-founders Catriona and Sarah have put their heart and soul into the campaign, laying bare their own experiences to shine a light on the realities of neonatal intensive care and trauma faced by families.
These statutory instruments are a welcome and necessary step in ensuring that parents who find themselves in one of the most distressing and uncertain experiences of their lives have the right to neonatal leave and pay. Under the current system, parents have been left to rely on maternity, paternity or shared parental leave to care for their child in hospital. Neonatal care can often bring additional, unforeseen expenses, including travel costs. For many parents, statutory maternity or paternity pay simply does not stretch far enough.
Although the legislation is a step forward, we must recognise that more can be done. There is a wider picture of maternity and neonatal services that are under growing strain. The NHS workforce is overstretched, and maternity services have been repeatedly flagged as needing urgent attention. We need more midwives, more neonatal nurses and more support for families experiencing traumatic births and baby loss. Will the Minister outline what discussions he has had with colleagues to ensure that maternity and neonatal care services are properly resourced and funded?
Additionally, we must recognise that support for parents should not cease once they leave hospital. The impact of neonatal care does not go away when a baby is discharged, as many children and parents will have long-term health complications. According to Smallest Things, the incidence of mental health difficulties such as post-traumatic stress disorder are thought to be as high as 70%. We should have expanded access to NHS mental health support for all parents who experience a neonatal stay, rather than requiring them to wait until they are at breaking point.
The Government must do much more, alongside the welcome introduction of paid neonatal leave, to tackle and end the unacceptable maternal and neonatal health disparities. This legislation is long overdue, but there is still lots more to do to support families after neonatal care. The Liberal Democrats committed to the introduction of paid neonatal leave in our manifesto. I hope that the Government will continue down that route and consider what more they can do to improve maternity services, including with a national maternity safety ambition beyond 2025, with clear baselines to measure progress. We need real investment in the NHS workforce to ensure that every baby and every parent gets the care they deserve.
I thank all Members for participating in today’s debate—there have been some very thoughtful and moving contributions. I will start with my hon. Friend the Member for Thurrock (Jen Craft), who spoke movingly about Isla and her experiences in neonatal care. It was truly wonderful to hear that, having been given a 2% chance of survival, she recently celebrated her seventh birthday. That is a testament to the great work that many neonatal units do up and down the country, nurturing that very precious life and allowing it to flourish and grow. Of course, I would be happy to meet those from Isla’s Journey, but I will talk to my colleagues in the Department of Health and Social Care first about whether it might be more appropriate for them to conduct that meeting.
I welcome the support from the Liberal Democrat spokesperson, the hon. Member for Torbay (Steve Darling). He spoke about the importance of parental attachment, something that we are beginning to understand is vital to a child’s development—the more we can do in that area, the better. I also understand the point that the hon. Member for Eastleigh (Liz Jarvis) made, and I recently visited the Countess of Chester, which is building a new children and mother unit. That is absolutely fantastic to see, and clearly, we want to build on investment in this area over coming years.
I felt that the shadow Minister, the hon. Member for Mid Buckinghamshire (Greg Smith) was a little churlish in his support for these regulations. I do not understand the criticism on the basis that these measures were in the Conservatives’ 2019 manifesto, since they did not actually implement them. Given that their Government undertook a consultation six years ago, criticising us for bringing these regulations forward within six months seems a little rich.
Of course, the shadow Minister is already blaming the Employment Rights Bill before it is passed for any rise in unemployment. It is completely nonsensical to argue that legislation that is unlikely to be enacted until next year could be responsible for job losses now. It is the kind of talk that we heard when the minimum wage was introduced—it was wrong then, and it is wrong now. To address the shadow Minister’s point about why this day one right is not in line with pay, that is consistent with all other parental leave entitlements. Pay comes in after 26 weeks, because a baseline of information about a person’s pay is needed in order to implement such a right.
Employers will administer the statutory payments on behalf of the Government. Small employers will be able to recover 103% of the statutory payment from the Exchequer, while larger employers can recover 92% of payments and will therefore incur wage-like costs equivalent to 8% of the statutory payments they make. This is a similar arrangement to that in place for other parental payments.
Together, these regulations will provide protection and support for parents at an incredibly challenging time. These entitlements provide a floor, and employers can and should go further if they are able.
The total amount of statutory neonatal care leave and pay available to parents will be capped at a maximum of 12 weeks, which balances the needs of businesses with the needs of parents. It is also worth noting that the entitlement will be in addition to other entitlements to parental leave and pay that parents may also be eligible for.
The leave and pay can be taken in two tiers. Tier 1 leave can be taken when the baby is receiving neonatal care and for one week after they stop receiving care. That leave can be taken at short notice, allowing parents to act flexibly in an emergency. Tier 2 leave can be taken after the baby has left neonatal care and therefore requires more prescription to ensure the needs of employers are balanced against the needs of employees. That approach provides flexibility for parents and crucially allows them to work around existing leave entitlements, such as maternity or paternity leave.
Employees will need to give notice to take leave and pay, and provide their employer with the information set out in the regulations. The method depends on which tier of leave they take and, as Members will expect, the stipulations in tier 1 are less stringent than those in tier 2. When the employee wants to take leave in tier 1, they will need to notify their employer before they start work on the first day of absence or as soon as possible thereafter. For pay, notice must be given within 28 days, beginning with the first day of the week in which pay is being claimed. When the employee wants to take leave in tier 2, they will need to give notice 15 days in advance for one week of leave and 28 days in advance for two or more weeks of leave. That is because leave in tier 2 can be more easily planned. The same notice requirements will also apply for pay. Furthermore, parents are not required to provide proof of their child receiving neonatal care. To make a claim in respect of pay, the employee may need to provide a signed self-declaration.
Parents who are out of the workforce on family leave for extended periods may be at more risk from redundancy when they first return to work. We have therefore ensured that parents on neonatal care leave will be protected from redundancy, and those who have taken six continuous weeks of neonatal care leave will also be protected until their child turns 18 months.
We anticipate that there will be some impact on businesses regarding familiarisation with the policy and managing the impact of employee absences. Like other family-related pay entitlements, employers will be responsible for administering the statutory payment on behalf of the Government. Overall, we estimate that the net annual recurring cost to businesses will be around £22.5 million. We also anticipate there will be a one-off familiarisation cost to businesses, which we estimate to be £4.7 million.
Despite those costs, we anticipate that there will be further benefits to businesses, as there is evidence that shows, as has already been mentioned, that workplaces offering a range of extensive family-related policies are more likely to have above-average performance relative to workplaces without such practices. My officials are working with His Majesty’s Revenue and Customs to ensure there is clear guidance on gov.uk to support employers in implementing this policy, and with Bliss, to which I pay tribute for its work in this area, to ensure that parents can access the information they need to understand their entitlement as easily as possible.
I thank all those who have been involved in the development of neonatal care leave, including the premature and sick babies charities, for their tireless campaigns and support. I hope they are proud that we have got this on the statute book and that the regulation will be introduced today. It will make a real difference to hard-working families, who need the support at such a critical time. I commend the regulations to the House.
In the plan to make work pay, the Government committed to rights from an employee’s first day, but for neonatal care pay, that is not the case. Will the Minister confirm whether this is the first step in rolling back on day one rights? Under the Neonatal Care (Leave and Pay) Act 2023, the right to neonatal care leave and pay will come into force in less than two months. Why have the Government waited to introduce the instruments until now, leaving businesses less than eight weeks to prepare and plan? We have heard that the Prime Minister has requested a growth test on all policies. Has the Minister conducted a growth test on this policy? If not, why not?
More generally, this Government’s record on health, in particular women’s health, has been disappointing. At the end of last month, the Health Secretary dropped women’s health targets and those for women’s health hubs. That decision will impact 600,000 women on waiting lists, lead to preventable disease progression and lead to more women attending A&E, unable to work, care or live a fulfilled life. The Labour manifesto made a commitment to prioritise women’s health, but this Government are making a habit of taking with one hand to give with the other. Will the Minister confirm whether he raised his concerns over the cancellation of health targets, which have an impact on these measures, with the Secretary of State for Health and Social Care?
As Ashley and other parents can attest, there is still more to be done. For example, Isla’s Journey advocates for a travel support fund for parents, because when a child is admitted to a neonatal ward miles from home, parents have to make long and costly journeys to spend time with their baby. While the new regulations will take away the compounding financial burden of a loss of income, the travel still comes at a significant cost. Unless they are an in-patient, mothers and other parents are not provided with basic amenities, such as a meal, on the ward. When Isla was transferred to the Royal London hospital, Ashley said that it became near impossible to give her body the correct nutrition she needed to breastfeed. When her child’s life was so fragile, she often did not want to leave her side for a moment, even to find something to eat. Other parents have chosen not to eat to pay for their travel to the hospital.
While I welcome the measures the Government are taking in the statutory instruments to remove worries around leave and pay for parents at an unimaginably difficult time, I ask that the Minister takes away those suggestions for how the Government can go further and perhaps meet me and the team at Isla’s Journey to discuss measures that can make parents’ lives that little bit easier. Making those changes would improve the wellbeing of families with babies in the NICU and the life chances of those babies so that parents could focus on what truly matters most to them: the care of their child.
No parent should be sitting by their baby’s cot worrying about pay or work. It is the Government’s duty to provide families with the stability, care and support they need during such a critical and challenging time.
In conclusion, it is welcome to see support for these measures across the House. The first few weeks after a baby is born are precious, and for a child in neonatal care, that time is even more important. As we have heard, the lack of options for parents who find themselves in that truly challenging situation serves only to worsen what, for many parents, is the most traumatic period of their lives. We hope that giving parents the additional rights and flexibility they need through these regulations will provide some much-needed support, reassurance and stability. Parents dealing with a very ill newborn should not have to worry about whether they can get the time off work that they need, or indeed whether they will have a job to go back to at all. As a nation, we can all understand that, and of course the best employers do these things already. However, by legislating, we send a clear message that all parents in that situation—according to some estimates, there could be up to 60,000—will be able to put all their focus on their child, which is as it should be.
On that note, I commend these regulations to the House.