Parliament Workbench
Data: Official Report to 12 Nov 2026

Official Report · Committee

New Petitions

Maternity Models (Remote and Rural Areas) (PE1839)

Wednesday 16 December 2020 Public Petitions Committee About 12:30 Petitions 8 contributions · 6 speakers

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The record

8 contributions
Johann Lamont Lab The Convener · Glasgow
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The next new petition is PE1839, by Maria Aitken on behalf of Caithness Health Action Team, calling on the Scottish Government to review maternity models in remote and rural areas. The petition calls on the Scottish Government to ask all relevant health boards to review their maternity model to ensure that it meets the needs of remote and rural communities. In its submission, the Scottish Government explains that it is discussing changes in rural service provision and arrangements for obstetric transfers across Scotland. Furthermore, a maternity transport expert working group has been convened to develop a tool to assist clinicians in their decision-making process.

The Scottish Government highlights that NHS Highland is part of the best start north steering group, which was set up to review maternity and neonatal services across NHS Shetland, NHS Orkney, NHS Highland and NHS Grampian. Inclusive of that programme of work, NHS Highland is undertaking a review of its perinatal mental health service and, with Scottish Government investment, will be looking to expand its current perinatal mental health service provision. The petitioner believes that the centralisation of maternity services, when there is a distance of over 100 miles to the nearest service, has a significant negative effect on mothers’ perinatal mental health, their unborn babies, and children left separated from their main caregivers while mother and father are miles away. Rhoda Grant is here in support of the petition.

Rhoda Grant Lab Highlands and Islands
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Thank you, convener. I appreciate your calling me again. I think that this is the fourth petition that I am speaking to; I appreciate your forbearance. The petition is important and the petitioner has made her case well. I have been involved for a number of years with mothers’ concerns about the maternity services in Caithness. In February 2019, at First Minister’s question time, I asked about a case in which one twin was born in Golspie and the other in Inverness. That seems like a horrendous circumstance.

12:30

The staff available that night made sure that nothing went wrong and that the delivery was safe, but you can imagine the stress of travelling over 100 miles in a land ambulance, in labour, knowing that there are complications and that you need a hospital where there are obstetricians. I said when they changed Caithness from an obstetrics-led maternity unit to a midwife-led maternity unit that they should do a risk assessment of the transfer journeys to Raigmore that would be needed if there were complications in a woman’s labour. I have looked at the matter in some depth, especially after the case that I cited, and it appears that if a woman is in labour, helicopter transport is not an option, because a helicopter is an unsuitable environment in which to give birth, because of the movement and the lack of space and the like.

I have also pursued the Scottish specialist transport and retrieval service—ScotSTAR—which is run by the Scottish Ambulance Service and which flies specialists to the area of need. They can also provide retrieval teams to fly people back to the specialist units. I know that they deal with paediatrics, but I have been pursuing whether they could deal with obstetrics as well, and fly obstetricians out to places like Caithness General, rather than expecting the mum to travel 100 miles in the back of an ambulance with no safe delivery space between Caithness general hospital and Raigmore hospital in Inverness. The Scottish Government needs to look at that. I know that it is looking at best start, but the trouble is that the work has been stalled and no outcome has been forthcoming.

The difficulty is that this has gone on for a number of years. An added complication is that mums, knowing that there could be complications, or that there might be, are now opting for elective caesareans. A caesarean is a major operation, but that is the only way they can deal with family constraints, so that other children are looked after. They are booked in, which means that they have a time and a date when they will have to go to Inverness and they can make suitable arrangements. Having major surgery because you cannot access obstetric services on your doorstep is not safe, either.

I urge the committee to take the matter seriously, get in touch with the Government, put some speed around the best start review, and make sure that there are specialists available who can fly out to those mums, rather than having to put somebody in labour in the back of an ambulance without any realistic knowledge of whether they will give birth in the back of an ambulance on the road or reach their destination in time. There have also been stories of mums in labour reaching Raigmore in the back of an ambulance, being told that there is no room and having to go on further to Aberdeen, which is totally unacceptable. The petition is serious and it needs to be considered seriously.

Johann Lamont Lab The Convener · Glasgow
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Edward Mountain has asked that we record his support for the petition. He cannot attend the meeting, as he is convening a Rural Economy Committee meeting. Members can bear that in mind.

Tom Mason Con North East Scotland
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Treatment for newborns and mothers in rural areas is very important. Some serious thought is needed about what might go wrong to ensure that all eventualities are covered. There is a great amount of detail to be sorted through and planning to be done. If a review is taking place, we need a timescale on it. I remember, two years ago, asking the minister about best start; I did not get very satisfactory answers to some my questions. We should write to the Scottish Government again to ask what the timescale is for the review and make sure that all the bases are covered to the public’s satisfaction.

The anxiety that must be experienced by expectant mothers in rural areas must sometimes be quite terrifying. Fortunately, being a man, I do not have to go through that process, and I guess that I am lucky. I worry that there are problems in certain places that could be avoided. Natural births are always a risk, but I think that we can cover most of the risk much more satisfactorily than we do. We should keep the petition open, write to the Government to get a timescale on the review—and make sure that we get the right answers. We can take a view once we have answers from the Government.

Gail Ross SNP Caithness, Sutherland and Ross
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I absolutely support the petition in the round. I agree that all health boards and organisations should consider what would be the best services for local need. Nobody wants to send pregnant women 100 miles to give birth and I would love to see something provided locally, if there is a different way to do it. I said right at the start that I supported the recommendations in the NHS Highland review. I am not a medical expert, but the model had to change. I will point out that the petition states:

“In NHS Highland, the decision was made in November 2016 that the obstetric maternity model was ‘unsafe’ and that the maternity service at Caithness General Hospital in Wick was to be downgraded to a Community Midwifery Unit service.”

When the petition says that the review deemed the current model “unsafe”, that model was obstetrics without paediatrics. It was an unsafe model because a baby died. The review also pointed out that, under that model, there could have been other babies who died and who might have been saved. Using the word “unsafe” in the petition does a great disservice to the families who suffered because of that model of service delivery and who welcomed the reconfiguration to Caithness maternity unit.

We must take it into account that we have moved on since the reconfiguration. The review was published in 2016, and there has been a lot of progress since, both in the community and in NHS Highland. The service is not perfect—nothing is—and nobody says that anything is risk free. As I said, I absolutely agree that services provided anywhere—in urban, rural or island communities—should be what is appropriate for that community. I am content to write to the Scottish Government to find out whether what Rhoda Grant suggests would be possible. I am open to bringing on anything from other countries to try to make this less risky, if you want to use that word. I am absolutely alive to all the issues that have come up, and probably will continue to come up. There is a lot of work.

Local councillors are working with the NHS. Rhoda Grant and Edward Mountain obviously have regular contact with NHS Highland, as do I and other elected members. I agree that we should write to the Scottish Government to ask for an update on the maternity transport working group and, as Tom Mason suggested, the best start review. Convener, you also said in your opening remarks that NHS Highland is undertaking a review of its perinatal mental health services, which is great. Work is on-going.

I think that there is a lot of feeling that, just because we are so far north, we have been left behind and services have all been centralised in Inverness. As opposed to the petition about HIAL that we discussed previously, where I did not agree with centralisation, the decision about CMU was not made just to send everybody to Inverness to give birth. The decision was made because of a massive safety issue. We need to keep that in mind, but of course be open to suggestions about how we make the service better.

Maurice Corry Con West Scotland
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I agree that we should write to the Scottish Government on the points that have already been raised by my colleagues. I support all that has been said. I also think that services must be appropriate to each community to minimise risk, but obviously safety is foremost and paramount to that. Yes, there is the question of centres of excellence. I know that that is the policy in Scotland and we also have that in the central belt, but nevertheless, the delivery of care in our communities is terribly important. We must not lose sight of that.

We must obviously deliver the very best care for our expectant mothers in every way or shape possible, and avoid having to travel 100-mile or more distances, or anything like that, to give birth. I support writing to the Scottish Government to confirm the timescales that will be implemented at the conclusion of the discussion and also the outcome of the work of the maternity transport expert working group. I support the petition remaining open until we can get clarification and feedback.

David Torrance SNP Kirkcaldy
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I am happy to go with my colleagues’ recommendations.

Johann Lamont Lab The Convener · Glasgow
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In the interests of time, since we are under a bit of pressure, I will not call Rhoda Grant again, because I think that people have responded to what she said about writing to the Scottish Government. The issues to highlight would be those that are reflected in what she and other committee members have said.

Gail Ross made a challenging point about when centralisation is centralisation for its own sake, and when it is necessary. We had this argument about acute services in Glasgow, where people felt that the hospital being on the other side of the city was too far away. The issue is greatly amplified in remote, rural and fragile communities.

For the benefit of Rhoda Grant and Edward Mountain, I will say that the committee notes those points and that we will write to the Scottish Government in the terms that have been described. I thank Rhoda Grant for her attendance. I am not sure whether she is engaged in any more meetings. I would not be surprised.

In this meeting

Everything on 16 Dec 2020 →
  1. 09:30 Decision on Taking Business in Private Procedure · 1
  2. 09:30 Continued Petitions Petitions · 54
  3. 10:15 Continued Petitions Petitions · 7
  4. 10:30 Continued Petitions Petitions · 10
  5. 10:30 Continued Petitions Petitions · 7
  6. 10:30 Continued Petitions Petitions · 10
  7. 10:45 Continued Petitions Petitions · 6
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  9. 10:45 Continued Petitions Petitions · 15
  10. 11:45 Continued Petitions Petitions · 7
  11. 11:45 Continued Petitions Petitions · 6
  12. 12:00 Continued Petitions Petitions · 6
  13. 12:00 New Petitions Petitions · 10
  14. 12:30 New Petitions Petitions · 8
  15. 12:30 New Petitions Petitions · 6
  16. 12:45 New Petitions Petitions · 8

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