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Maternity Eye On Index

Eye On Index

Eye On Maternity Services

7 February 04
Public Meeting Assembly Rooms, Wick
Around 70 people attended a public meeting organised by the Scottish Socialist Party to try to get ideas and agreement as to how action might be taken to carry forward a campaign to maintain consultant led services in Caithness.  MSP Jamie Stone billed as a speaker at the meeting did not make it possibly due to bad weather.  However SSP MSP Carolyn Leckie and councillor Bill Fernie spoke to the audience. Ms Leckie outlined her views of the current situation.  In the morning she had visited the Maternity Unit at Caithness General and had been impressed by the levels of skills and services available at the unit.  A qualified midwife herself it was immediately evident from her speech that she had a very detailed grasp of the serious situation that the people in rural areas find themselves faced with a reduction in maternity services.  She pointed out however that other areas are also under attack and that throughout Scotland these moves to reduce the number of units or downgrade services was a concern for all communities.

Ms Leckie referred to the lack of foresight and planning on behalf of the government and Health Boards on the matters of the European Working Time Directive and the new Consultants contracts.  "These did not fall out of the sky", she said and had been known about for years and they had failed to take any action to deal with the likely shortfalls in staffing.  Training was woefully short in midwifery.  The number of students enrolled in midwifery courses had fallen.  

Councillor Bill Fernie reiterated his support for maintaining consultant led services and without wanting to go over the same ground as at previous meetings wanted to move forward to some of the actions that might be taken.  He pointed to the insufficiency of resources as compared to to other countries such as France and Germany.  The government was in his opinion hiding behind the Health Boards whilst at the same time not giving them the money to deliver the services.  He suggested that higher rates of income tax might be used to obtain the funds to keep services.  Higher rates of taxes had fallen and the 40% band might be raised to 45% if necessary to ensure health services were adequately funded.
Bill Fernie said that the Scottish Executive should not be allowed to hide behind Health Boards who as was pointed out might not survive if they had to stand for election.  Frank Ward who had more to say on the Health Board quangoes who were paid handsomely for their work and would be replaced by yet another quango in the latest reorganisation when the current trust and health boards were merged.

Frank Ward for the SSP who chaired the meeting asked for suggestions or comment from the floor.  Mr Ward made a number of suggestion himself which were put to a vote of the people present.   He outlined the business interests of NHS Highland board members but a suggestion to boycott these businesses was heavily defeated by the audience who could not see how this would promote the arguments or find a solution.  A suggestion to hold another protest on Mothers Day met with much more approval.  A suggestion from a member of the audience that the figures relating to costs of the reduced services taking into account tall the costs of transferring mothers and babies to other hospitals such as Raigmore should be put together  as the government or health boards could not be sure that there would be any savings.   What would the impact be on Raigmore?  When asked if they wanted to form and action committee from the meeting the general consensus was that they wanted to wait on the League of Friends meeting on Wednesday 11 February to avoid fragmentation and have a more united front.  It was agreed that the suggestions would be taken to the Wednesday meeting and put to that audience.

Rachael Robinson representing the local Trades Council who lives in Sutherland pointed out that in Sutherland the situation was even worse with single track roads and a very long journey to Inverness if that was required.  Ms Robinson confirmed that there was strong support for retaining consultant led services and referred to a recent trip to Catalonia where similar rural problems existed were being tackled.  She stressed that the Trades Council could see the problems for workers in the area if services were to be reduced and that they would be backing any initiatives to retain or improve maternity services.

A further suggestion to lobby the next Health Board meeting would be taken to the Wednesday meeting.

Many of the people in the audience intended to be at the meeting organised by the League of Friends.

Next Public Meeting
Wednesday 11 February 7.30pm
Assembly Rooms, Wick

A few of the Motions and Questions Filed by Ms Leckie At the Scottish Parliament on Maternity Issues.
For a full list of questions an motions on all topics See her page at the Scottish Parliament web site

Lodged on 08 October 2003 by Carolyn Leckie; not current as of 16 December 2003
Closure and Rationalisation of Maternity Services—
That the Parliament is extremely concerned at the increasing numbers of proposed closures of maternity hospitals and rationalisations of maternity services with consultations held in isolation and without reference to cross-boundary and pan-Scotland impact; notes that claimed benefits of centralisation in relation to morbidity and mortality are unproven; is concerned that there are no minimum standards for staffing establishments of midwives across the service and that models for calculating staff numbers and ratios are outdated and outmoded; notes that expectations of staff by the public and demands of government have increased dramatically over the years which has created more work for all staff providing maternity services despite a declining birth rate, and considers that the Scottish Executive should implement a moratorium on maternity closures and conduct a review of the provision of maternity services across Scotland that involves the public and all trade union and professional organisations with the aim of establishing agreed minimum staffing establishments in a safe, co-ordinated service that meets the needs of all women and families across the whole of Scotland and maintains the expertise and excellence already established in the provision of these services.
Supported by: Miss Frances Curran, Mr Colin Fox, Ms Rosie Kane, Richard Lochhead, Campbell Martin, Ms Rosemary Byrne, Dr Jean Turner, Tommy Sheridan, Ms Sandra White, Mrs Elaine Smith

S2W-5411 - Carolyn Leckie (Central Scotland) (SSP) : To ask the Scottish Executive what its response is to any public concern over maternity service reviews.
Answered by Malcolm Chisholm (20 January 2004): The review and planning of maternity services is primarily a responsibility for NHS boards.
Both A Framework for Maternity Services (2001) and the report of the Expert Group on Acute Maternity Services (EGAMS 2002) state that NHS boards should make sure that local consultation and public involvement takes place when planning maternity services.

I have made it clear to NHS boards that when considering proposals for reconfiguration I will have to be satisfied that they are consistent with the recommendations of these national policy documents.

S2W-4684 - Carolyn Leckie (Central Scotland) (SSP) : To ask the Scottish Executive, further to the answer to question S2W-4248 by Malcolm Chisholm on 3 December 2003, whether changes to the nature of demand on the service arising from the review of maternity services in the area will include an assumption that births in transit will increase.
Answered by Malcolm Chisholm (16 December 2003): Included within the expected changes to the nature of demand on ambulance services in the area is the assumption that more expectant mothers may require to be transferred to the Royal Alexandra Hospital in Paisley. Additional ante-natal assessments will be carried out to determine which mothers should have a consultant-led delivery. The assessments are designed to minimise the incidence of late/urgent transfers. Where a late hospital transfer to Paisley is indicated then the arrangements provide for a midwife to support the expectant mother in transit

S2W-4248 - Carolyn Leckie (Central Scotland) (SSP) : To ask the Scottish Executive, further to the answer to question S2W-3774 by Malcolm Chisholm on 14 November 2003, whether additional funding to the ambulance service in the NHS Argyll and Clyde area was allocated specifically to take account of any increase in demand and any higher likelihood of births in transit.
Answered by Malcolm Chisholm (3 December 2003): Some of the additional funding will be used by the Scottish Ambulance Service to respond to the changes to the nature of demand on the service arising from the review of maternity services in the area.

S2W-3778 - Carolyn Leckie (Central Scotland) (SSP) : To ask the Scottish Executive which NHS boards are meeting the standard set by the Expert Group on Acute Maternity Services Reference Report on one-to-one midwifery intrapartum care.
Holding reply by Malcolm Chisholm (14 November 2003): I shall reply to the member as soon as possible.
Answered by Malcolm Chisholm (25 November 2003): The report of the expert group on acute maternity services (EGAMS) stated that one-to-one midwifery care should be the norm for all women during labour and childbirth. It also stated that professionals at all levels of maternity care must have appropriate training.

As such all NHS boards are working towards achieving this standard to ensure that all women receive one-to-one skilled, evidence-based midwifery care whilst in labour. However, at present the information regarding which boards have achieved this is not centrally held.
EGAMS stressed that all midwives caring for women in labour should have identified core competencies and skills. The Scottish maternity development programme provides local maternity courses which will help to achieve this.
The Executive is developing a maternity services performance assessment framework for NHS boards that will take into account the standards set out in the EGAMS report.


S2W-3777 - Carolyn Leckie (Central Scotland) (SSP) : To ask the Scottish Executive what steps it will take to ensure that a regional planning perspective is taken in all current NHS board consultations and decisions on rationalising maternity services.
Holding reply by Malcolm Chisholm (14 November 2003): I shall reply to the member as soon as possible.
Answered by Malcolm Chisholm (2 December 2003): I refer the member to the answer given to question S2W-3775 on 25 November 2003. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.scottish.parliament.uk/webapp/search_wa.


S2W-3776 - Carolyn Leckie (Central Scotland) (SSP) : To ask the Scottish Executive which measures it will take to ensure that regional planning, including full consultation with the public, trade unions and other relevant groups, takes place before recommendations to rationalise maternity services are put forward by NHS boards.
Holding reply by Malcolm Chisholm (14 November 2003): I shall reply to the member as soon as possible.
Answered by Malcolm Chisholm (9 January 2004): I refer the member to the answer given to question S2W-3775 on 25 November 2003. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at:
http://www.scottish.parliament.uk/webapp/search_wa.


S2W-3775 - Carolyn Leckie (Central Scotland) (SSP) : To ask the Scottish Executive which NHS boards have implemented the recommendations of the Expert Group on Acute Maternity Services Reference Report in relation to regional and national planning in maternity services.
Holding reply by Malcolm Chisholm (14 November 2003): I shall reply to the member as soon as possible.
Answered by Malcolm Chisholm (25 November 2003): The planning and provision of maternity services is in the first place a matter for NHS boards.

The report of the expert group on acute maternity services (2002) makes it clear that acute maternity services should be planned and commissioned in a regional context whilst taking account of local needs, priorities and facilities. I emphasised the importance of this approach when I responded to the proposals made by NHS Argyll and Clyde.

To facilitate this, we have provided funding for a regional maternity services co-ordinator in each of the three regional planning groups which should ensure that all NHS boards are adopting a pan-regional approach to planning maternity services. Each region is about to or is currently scoping existing maternity services, taking account existing infrastructures and current and recent NHS board maternity service reviews. Boards which have recently reviewed or are reviewing their maternity services include Highland, Orkney, Shetland, Tayside, Forth Valley, Glasgow and Argyll and Clyde.

A Framework for Maternity Services (2001) also notes the importance of cross-boundary planning and states that NHS boards should make sure that local consultation and public involvement takes place when planning maternity services.

I have made it clear to NHS boards that when considering proposals for reconfiguration I will have to be satisfied that they are consistent with these national policy documents.