Our next new petition is PE898, by Mrs Lynne Simpson, on the provision of maternity services in rural areas. It calls on the Scottish Parliament to urge the Scottish Executive to review the provision of maternity services in rural communities to ensure that the quality of services and local access to services are retained. The petitioner refers to a petition that has been signed by 15,300 people from Fraserburgh and the surrounding area to save the 24-hour Fraserburgh maternity unit, which is under threat of closure.We are joined by Stewart Stevenson, who has indicated an interest in the petition. Stewart, do you want to comment?
Official Report · Committee
New Petitions
Maternity Services (Rural Areas) (PE898)
Speakers
Choose an MSP to read only their contributions- Michael McMahon Lab 8
- Stewart Stevenson SNP 3
- Jackie Baillie Lab 3
- Sandra White SNP 3
- John Scott Con 2
The record
19 contributionsI am aware that the committee has dealt with a number of petitions in the past that relate to changes in or proposed closures of maternity units. I want to highlight why this petition is different and why it deserves consideration beyond the committee. First, this maternity unit is perhaps different from others that have been the subject of public agitation in that it is a midwife-led, community-based unit. There have been some developments since the other petitions came to Parliament, such as the proposals in the Kerr report, which seeks to devolve to the community as much activity as possible that can safely be done in the community. The proposals to close this and a number of other community maternity units in the Grampian NHS Board area deserve examination. We should consider whether it is appropriate for Parliament to seek to persuade the minister to intervene and give further direction to the health board on the implementation of the policies that are contained in the Kerr report.There are some special considerations in relation to Fraserburgh. The first and key one is that, despite the fact that it has a population of 15,000, Fraserburgh is relatively isolated from major centres of hospital support and national health service acute services provision. It is the only town with a population of more than 10,000 that is more than an hour's travel away from an acute services hospital. If services were transferred from the maternity unit in Fraserburgh to Aberdeen, where the director of nursing at NHS Grampian has already said there is no spare capacity, it would involve a round trip of more than four hours to go there by public transport. That illustrates why the Fraserburgh community feels particularly strongly about the matter. Fraserburgh is also isolated from good transport links in general. There are no railways in that part of Scotland at all. Indeed, once the Borders rail link is built, I will represent the only constituency in Scotland that has neither railway nor airport, which illustrates some of the local issues. In the public gallery today are the petitioner, Valerie Ritchie, and her friend and fellow campaigner, Rachel Allan. Wendy Bowie would have been here, but she gave birth in the unit in Fraserburgh on Monday. Like many of the inhabitants of Fraserburgh and the surrounding area in the past, she is committed to taking the opportunity to give birth close to home, friends and family when it is safe to do so. We hope that the committee will agree, in the light of the Kerr report, that the matter deserves further consideration by the Parliament and that the petition is distinctly different in its focus from previous petitions. We ask the committee to acknowledge that the midwife-led unit makes a particular contribution in an environment in which there is a shortage of obstetric consultants and that it would be quite perverse to allow Grampian NHS Board to proceed with a reduction in midwife units when there is a need to relieve the burden on consultants rather than increase it. I am happy to answer any questions that I think I can answer.
Thank you. I would like to say, for the record, that we have previously considered PE689, PE707 and PE718, which were all on maternity services. One of them, by Jamie Stone, was about consultant-led maternity services in the Highlands. The committee never examines the specifics of an individual decision; that is not what we are here to do. We consider the general issue that is raised by a given petition, so although I understand that the Fraserburgh situation is new to Fraserburgh, it is not new to the committee, because decisions have led to concerns before and we have addressed petitions that have been in a similar vein. I point that out so that members stay focused on what we need to look at. We will not sit in judgment on the decision re Fraserburgh, but we will look at how the decision-making process arrived at that decision. If members stick to that, we can consider the petition in that way.
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I would like to be helpful and to consider the matter in its general context. We have considered a number of petitions about maternity services in the round before. What interests me about PE898 is that it throws up the principle of what we are doing with midwife-led services. Those are being hailed as the answer in other parts of Scotland, so I am slightly curious as to the reasons given for the reduction in the midwife-led service and whether that has anything to tell us about wider policy. Will the minister have to sign off the proposals, or is the matter internal to NHS Grampian?
My understanding—and it is a qualified understanding—is that the minister will have to sign off the changes that the community health partnership, as part of NHS Grampian, is proposing. To ensure that I do not mislead the committee, I should say that the change is part of a series of changes that are being made, but it is fair to say that it is the one that is attracting the greatest focus. Mike Rumbles led a members' business debate on the situation in Aboyne, which is different, and I understand that there are threats to maternity units elsewhere in Scotland, although I cannot offer the committee much specific information. However, Jackie Baillie is certainly correct that the petition is distinctly different from previous petitions on the issue in that respect. It is worth saying that English health boards are talking directly to midwife-led units in Aberdeenshire to gain their advice and experience in establishing new units in rural England. That illustrates the regard in which the work that is done there is held.
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I want to press you on the reasons why you are—
I do not want us to get into a question-and-answer session with Stewart Stevenson, because we are trying to address the petition and Stewart is not here as the petitioner; he is here to comment on it because he has local knowledge or an interest in the issue. Our aim is not to have a dialogue with him but, if you need clarification on anything, I am more than happy for you to ask him for it. I am trying to get a discussion rather than a question-and-answer session.
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I want to establish whether the generic reasons for the reduction relate to a wider policy position, rather than simply to what is happening in that locale.
The relevant policy issue is the Kerr report, which focuses on ensuring that we deliver health services as close to the point of need as possible. That applies to a range of services, but especially to maternity services, which deal with people who are well, not ill, and which, of all services, most need to be delivered locally. There is an opportunity to deliver the services locally through midwife-led units, which are cost effective. That is a particularly important point that is in line with the Executive's policies as exemplified in the Kerr report, which has been produced since the committee considered the previous petitions on maternity services. The Parliament should be aware of whether the Executive's policy is being implemented appropriately on the ground—I bring an example that suggests that it is not.
We have received various petitions on the issue, most of which have concentrated on consultant-led services. The present one, which is on maternity services in rural areas, is slightly different, particularly given that we now have the Kerr report.I seek clarification on a couple of issues. Stewart Stevenson might be able to provide clarification, or we could write to the Executive or Grampian NHS Board. Was a consultation carried out throughout the Highlands and other rural areas on the closure of midwife-led maternity units? Was the Royal College of Midwives approached regarding the closure of the units? Perhaps there are not enough midwives, or there may be another simple reason, but many questions need to be answered. Obviously, the issue is not just about Fraserburgh; it is about the Highlands and all other rural areas. Was a consultation carried out similar to the one that was done in Glasgow? In Glasgow, we felt that it was not done properly and the minister is looking at that.Our papers state that NHS Grampian will make a decision on the issue early in the new year. How early in the new year will that happen? Will the issue go to the Minister for Health and Community Care? How much time do we have to get answers? We have one more meeting before Christmas, but it will be at least January before we get any answers back.
Those are all legitimate questions, but we do not need to ask them of Stewart Stevenson. We will direct them to where they have to go—the Scottish Executive or the NHS must be asked how the decision was arrived at. You have raised several questions that we can legitimately ask the Scottish Executive. Our next meeting is 21 December, so I doubt that we will have a response by then, but we could write with some urgency. Even with the best will in the world, a fortnight's turnaround for a response from the Executive would be asking a lot.
If we wrote to NHS Grampian to ask for the reasons for its decision and the timescale, that would give us a rough idea.
We can certainly write to NHS Grampian and ask for information on the decision, which would allow us to judge how the decision was made and to test that against the consultation and decision-making process that is required. That would be a legitimate route for us to take. We will take that on board and ask the relevant questions.
We have touched on much of this already but, given Mrs Simpson's letter, I am concerned about whether the consultation process has been carried out as it should have been. The importance of consultation was a strong theme of the Kerr report.I am sorry to be site specific, but I am also concerned that it is a 9 am to 5 pm maternity midwife service. What happens through the night? If the minister has signed off the proposals, is he aware of all the issues, which are not peculiar to the area that we are discussing?I see that the Health Committee looked into the issues as part of its workforce planning inquiry and noted that accident and emergency services and maternity services should be provided as close as possible to the point of need. Who has ultimate responsibility—the Health Committee or the Minister for Health and Community Care? Does the minister take note of what the Health Committee says? An accident and emergency unit in my constituency is also affected. The minister needs to provide the bigger picture in his response.
Would you like those questions to be asked when we write to the minister?
Please.
Okay. Are there any other contributions or questions?
Could we write to the Royal College of Midwives?
Yes, we will take its view. It will be worth hearing whether it has any concerns. As ever, we will collect the responses, examine the information and see what else we can do to address the concerns that are raised in the petition. I thank Stewart Stevenson for his contribution this morning.
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