PE1839, which was lodged by Maria Aitken on behalf of Caithness Health Action Team, 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.
Since the committee’s last consideration of the petition in December 2020, the committee wrote to the Scottish Government to ask when discussions about changes in rural service provision and arrangements for obstetric transfers across Scotland and the development of an in utero transfer risk assessment tool would be concluded.
In its response, the Scottish Government explains that the current priority for health boards is delivery of essential maternity services and managing the impact of Covid-19. Although the development of the in utero transfer risk assessment tool has continued, work on the underpinning protocol has not been able to progress. The Scottish Government is therefore unable to commit to firm timescales for that work, although it is still expected to be a deliverable of its best start programme approach.
The submission also notes the maternity transport group, which has been set up to develop the tools and protocols that are required to ensure that rural and remote staff are supported in their decision to transport pregnant women and that the correct medical expertise is involved.
A late submission has been received from Edward Mountain MSP, in which he suggests that the Scottish Government response would be “cold comfort” to pregnant women who have to be “blue-lighted” to centralised hospitals due to lack of local facilities. He acknowledges that, with the parliamentary session coming to an end, there may be little more that the committee can do with the petition, but he stresses that the problem has not gone away.
Rhoda Grant, who was hoping to attend but is now unable to join us owing to other commitments, has provided the following statement:
“A total of 90 per cent of Caithness women currently give birth in Raigmore hospital, over 100 miles away in Inverness and really that needs to be addressed. There has never been a risk assessment on emergency transfers or indeed on the journeys south that pregnant women face, sometimes in appalling weather conditions.
A focus group feedback on maternity services in November 2019 found the issue of road and possible ambulance transfer was a huge concern that ‘could not be overemphasised’.
There was an overriding opinion that many women were requesting an induction or an elective section in order that they could plan their journey and not have the stress and anxiety of undertaking the journey in an unplanned way while in labour. Transferring women in labour by air to Raigmore and also transferring medical experts into Caithness by air also have their problems, which seem insurmountable at the moment.
The CHAT health campaigners in Caithness, after many years of raising the concerns of parents and their families, are now asking that obstetrics support the community midwife unit based at Caithness general hospital to provide a 21st century experience for maternity services in the far north. This would need to have the equivalent paediatric support, something that appears never to have been considered.
I ask that the committee examine whether obstetric and paediatric support could be put in place at Caithness general hospital and, at the very least, that a risk assessment of emergency transfers takes place.”
This is obviously important and a very serious issue. It is probably quite difficult for somebody who lives in a city to understand or recognise the challenge of healthcare in more remote and rural areas. We have arguments about a hospital being moved a couple of miles in one direction or another, which can cause huge concern, but the scale is much greater in rural and remote areas.
I guess that the challenge always is the gap between providing a local service and ensuring that the staff who are there are sufficiently skilled and experienced to be able to deal with emergencies. That is a balance that the health service has to strike every day. I am interested in how other members feel the petition might be taken forward. There is a case for closing the petition, given what has already been said, but we may want to recognise that these are long-standing issues.
