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Eye On Health Services In Caithness

10 March 04
Letter From Amicus AEEU Trade Union


Malcolm Chisholm MSP
Minister for Health and Community Care

Dear Mr Chisholm,
At a recent branch meeting our members expressed concern about the ongoing review of maternity services within the Highland area and the effect it will have on the existing services provided. Our local unit at Caithness General Hospital is at present under going a review by Professor Calder. It has been suggested that the outcome of this review may lead to the present consultant lead service being downgraded to a midwife lead service. Our members see this as a very unsatisfactory situation for several reasons.

Given the distance between the Caithness General unit and the nearest alternative unit in Inverness, a minimum of 110 miles South but usually more depending on where the mother lives. The time taken to travel South along the A9 and the condition of the A9 makes this a nightmare journey for any patient, never mind one having a complication during the birth of their child.

The effect on families would also be disastrous with some fathers not being able to take extended time off work to be with their partners during the birth or if they require to be kept in hospital for observation for any length of time. The cost of staying in Inverness and keeping the family home in Caithness running would also be a major restriction to many families being in Inverness to give support to the mother and child when they most need it. Families would not be able to pop in to visit and this would lead the mother to feel on her own, more anxious and therefore possibly cause further complications.

The cost to the health board of transferring patients to Inverness early and keeping them under observation in Inverness would also be high and make the economics of any change suspect. Concern has also been expressed in that Inverness may not be able to cope with an increase in maternity referrals with out major investment to extend the maternity ward to cope, again bringing into doubt any economic benefit of any change.

The removal of the consultants also leads to the loss of other back up services provided to local women meaning a trip to Inverness or a wait until a consultant visits to have other gynaecological procedures carried out.

The reduction in ambulance and helicopter cover during patient transfers must also be taken into account and Caithness not made to suffer a poorer ambulance service because of any changes to the provision of maternity services.

It will be a fact that if changes are made to the provision of maternity services in Caithness that mothers or children will die. It is only a matter of when the first death will occur and what is an acceptable level of deaths for the health board to bear. The local community will not tolerate any deaths as a consequence of changes to maternity provision and will fight to ensure that Caithness is not deprived of a core service to any area.

We also understand that changes will require to be made to maternity provision in Caithness to allow it to conform with modern practice and legislation, but this should be seen as a challenge on how to improve the service given, and not taken as an excuse to close and centralise an essential core health provision to save money and justify the scale of spending at other hospitals. Consideration must be given to looking ‘out of the box’ to solve problems in this modern age, and a link up where by Caithness General provides consultant services to Orkney must be considered as it answers two fundamental problems of, low occupancy rates in Caithness General and the reduction in travel required by Orkney patients and families. This idea may cross health board boundaries but it does highlight the ‘out the box’ thinking required to solve problems.

We consider where life is at risk and the provision of basic core health services are concerned that cost is most definitely not an issue, but the level of service to the patient must always come first.

We hope when Professor Calder’s report is published that you will support any ideas that the health board bring forward to retain consultant services in Caithness General Hospital and refuse to accept any health board proposals that will reduce the level of maternity service to be provided to the North Highland area.

John Crowden
On Behalf of AMICUS – AEEU
Thurso Branch (0915)