breakthrough as the Health Board announce the Review finds in favour of
keeping services local.
out what Susan Deacon the Health Minister for Scotland said in her September
press release following publication of the Arbuthnott Report
on allocations of expenditure for rural areas. The report has a
short summary of the main points as well as the full report.
The report by Professor Sir John Arbuthnott entitled Fair
Shares For All - The Report of the National Review of Resource
Allocation for the NHS in Scotland.
The report goes into great detail about
the problems of rural areas although it can be difficult comparing areas
of deprivation - of poverty and poor services in large cities
against rural areas like Highland. One of the problems can be the
perception of ideal lifestyles in the Highlands which may be the case if
you have a job and an income to cope with the greater distances.
Also the Highlands is very diverse and the political structure pushes
this vast area into one political region. This has been pointed
out by many members of the public. And it has not gone unnoticed
that the health services under a Caithness set up were in the Black and
the health service as provided by an Inverness based set up is now
heavily in the red. Is Caithness and Sutherland having to bear the
brunt of a debt it did not incur. The people of the north did not
want the present NHS Trust set up to be brought in and they were
ignored. Will the same thing happen to maternity services.
Any downgrading of the services will be to the detriment of local
No one will take it as a victory if it is announced that the Maternity
unit is to remain but the consultant Obstetrician services are lost
pulling down not only maternity but geanaecology services also.
This may set in train other problems as it knocks on problems to other
parts of the hospital such as anaesthesia and GP's who are left to deal
with emergencies that will happen. Or the ambulance service that
till have to take more patients to Raigmore hospital in Inverness
Maternity Review - Thurso Meeting 14
Thurso's people turned out in droves last night to attend the
meeting called by the reference group. Many people were turned
away as the hall was full to overflowing. Jamie Stone MSP and
councillors once again heard the feelings local people about possible
downgrading of maternity services in the county.
The same scenario of the need to keep skills up and possible shortages
of qualified staff were put forward but these were firmly rejected by
local people faced with the prospect of women travelling up to 130 miles
to Inverness especially in winter conditions such as Caithness had in
the last few weeks.
These are the biggest turnouts Thurso and Wick have seen with people
coming from all parts of the county to hear the arguments on what is
seen as a life or death issue for women and their babies. None of
the local people want to see the downgrading of the service they already
have. People want a quality service and it is up to the managers
within the health service and the politicians to see it is
delivered. Thurso has also seen an upturn in its local economy
with major recruitment by employers. This could be put in jeopardy
if it was felt Caithness had second rate health services.
Employees might be reluctant to come to an area with poorer maternity
services especially younger families still having new babies.
The MUMS action committee will be taking things forward.
Maternity Review - Wick
Meeting 13 March
Pull The Crowds In Wick
The meeting in Wick High School
was packed out on Monday night as the people in East Caithness reacted
to the perceived threat to maternity services. The representatives
were grilled and in typical Wick fashion the audience demanded
improvements not downgrading to services. Notwithstanding the
threat to Obstetricians people said they wanted more than just to retain
the services they wanted improvements such as a Pediatrician service
also to ensure better facilities in Caithness. It was standing
room only in Wick with over 500 people so over to you Thurso and the
West side lets hear your voice loud and clear at the town Hall on
Tuesday night. Councillor Deirdre Steven got a huge round of
applause as she demanded that the services of consultant obstetricians
be retained in Caithness. Any hint from the Health Board side of
suggesting that a mid-wife led service would still provide an excellent
service were greeted with howls of disbelief.
Many questions were aimed at the panel and several examples given of how
mothers and babies would have died in the past if it were not for the
expertise available in the county. Recent weather conditions were
highlighted to show how impossible it was to reach Inverness when road,
rail and air services marooned Caithness. Also highlighted were
the increasing employment opportunities now coming to Caithness which
were at least partly based on the good health services available and
this could be put in jeopardy were they to be downgraded.
The chairwoman had difficulty in closing the meeting following John
Rosie's impassioned plea and determination to fight any lowering of the
standards of maternity services.
18 February 2001
Highland Health Board have denied that any of the local staff have
been warned not to talk about the review to members of the public.
Robert MacLennan took up the matter with the Health board following
reports he had received.
Sally Amor, Child Health Commissioner said that their had been no
gagging of NHS staff.
9 February 2001
The winter weather has forcefully convinced Caithness people that
what they have said all along is true. that an area as far away
from the main centres must have its own dedicated services especially in
vital areas of health like maternity where emergencies do and will
happen when the weather cuts the county off. Caithness was all but
marooned this week with roads blocked and train and air services
halted. This makes the point better than many arguments put so
But still people must make their views known and write to the people
carrying out the review.
31 January 2001
Jamie Stone MSP Urges Everyone to Get In Contact
Mr Stone called on all constituents, as many as possible to in
Caithness & Sutherland to write and make their views known.
The Caithness Courier article today set out Mr Stone's view on the
matter and made it clear that now was the time for people to put pen to
12 January 2001
New Plans For Threats To Maternity Services
Graeme Smith a member of the Wick Community Council and Highland
Councillor is encouraging people to think more about how a concerted
campaign might affect the outcome of the Review into Maternity services
in the county. He encouraged people to think in terms of a
campaign involving community councils and the Association of community
councils acting in concert with MUMS (Maternity Unit Must Stay).
Tww members of the local maternity unit have been asked to be on the
Maternity Services Advisory Group allaying Mr Smith's fears about under
representation from Caithness in the process.
Alan Ferrier, Chairman of Wick Community Council still fears that the
threat to the maternity unit would just be the start and add to losses
of ancillary services.
9 December 2000
As reported in the JOG this week a review is to be started in
January. A reference group and very wide consultation is to be
carried out. Have a look at the article and lets all wait and
see. However people in Caithness are very sceptical folloing the
wide public consultation for the reorganisation under "Designed To
Care" when the New NHS Trusts were brought in. Despite local
opposition and after "Widespread Consultation" the changes
went ahead anyway. Keep your eye on this one and see if anything
is different this time round. Counsultation may become a
dirty word if it means people are told theri views have been noted but
the changes are "Necessary", Best Practice" Required for
Reasons A B C etc.
Note the Swimming Pool debate also - new rules being enforced
against local wishes. We will see.
Keep your EYE ON IT.
1 December 2000
Well if things were looking quieter on the public outcry front about
possible downgrading then the latest drama in Caithness certainly
underlines the need for people to be concerned. Fortunately for
all concerned the skills in the maternity unit were able to deal with
the problems. Fears are that things would not have turned out so
well in a downgraded unit. With the air ambulance not available
and the road south blocked at the same time it is just this type of
problem that people are afraid would happen. With wick also not to
get its second runway upgraded even this lifeline might not be available
in if the wind is blowing the wrong way. Helicopters cannot fly in
foggy conditions and Wick has plenty of years where it is bad for
flying. There are not many roads south and if the main one is
blocked a three hour drive south could become a real nightmare for an
Surely this requires some statement to assure people in the north that
these vital services will not follow so many others south. This is
life and death - much more than just economics. Can we please have
some confirmation that notwithstanding the need to kep skills up to date
the unit will retain the present cover. Surely it is not beyond
ingenuity to come up with a solution if maintaining skills is the only
The Maternity Review is certainly going to stack up the
reports with the Caithness Economic Partnership going to carry out an
economic assessment of the impact of changes to the service if any are
brought in. This seems sensible but can it be taken in
isolation. There is a general feeling that is growing that
services in general for Caithness are longer so important as cost
savings. Will the north always suffer when the Highland structure
requires to cut costs. We already have plenty of evidence that
since "Designed to Care" abolished the Caithness &
Sutherland NHS Trust and split into Acute and Primary Trusts with
management control effectively shifted to Inverness that decisions taken
have an adverse effect on Caithness & to a lesser extent
Sutherland. The imminent closure of the laundry in Caithness to
have all the linen transported to Inverness is yet another
example. All of the decisions are being taken independently
without it seems thought to the overall cumulative effect.
Loss of managerial posts, closure of the laundry, downgading of
maternity seems to be a drip drip downward spiral each one leading
inexorably to the next. The maternity unit is a domino in another
set. If it falls other services will go as that knocks on into
other professions within the hospital. Before long the necessity
for a range of other services will be brought into question on cost
grounds. Health services in rural areas will always be more
expensive on a unit cost basis - they always have been. The
quality of care is expected to be the same for everyone but if that
quality is said to be the same by the population making ever more trips
to Inverness then something is going seriously wrong. Dirty linen
trundling up and down the road from Caithness is bad enough but patients
is even worse.
Sit down and make a list of all the withdrawals of all of the
withdrawals of government departments, local authority cut backs over
the last 10 years - look at the numbers of jobs gone and you will
understand how the economy is also tied to these decisions. The
list is long and getting longer. Thurso has been saved from much
of the impact by the new firms attracted and the continuation and recent
expansion of work at Dounreay but the drip of other jobs in the health
service has a definite economic impact as well as for services to people
on the area. Anyone can put their comments on to the Caithness.org
Message Board - lets hear them.
Castletown and District Community Council have now discussed the
review with its implications for downgrading services in the maternity
unit. The references they made concerning the abolition of the
Caithness NHS Trust show that Caithness people feel they were right to
be concerned about the abolition. Now that the moves on units like
maternity are being made and the trust controlled from Inverness has a
budget deficit peripheral areas will suffer. Caithness and other
outlying parts of the Highlands already feel powerless to control their
own destiny in important matters. Is it any wonder that their is
less and less interest in decision making which seems to take for ever
and invariably goes against the wishes of people in the furthest rural
areas. Many people already have extreme problems with transport
and are used to making ever more journeys to Inverness. This is
one journey no woman should be forced into making with all the
difficulties for families in visiting a hospital for some over 130 miles
away. This would be a real retrograde step. And what's next
if this is allowed to happen. There will always be another crisis
as an excuse to close or downgrade. Skill shortages, lack of
staff, too few patients and so on. This does not give any feeling
of confidence in local structures once thought of as reliable.
This continuing struggle to retain good services in rural area does
nothing for confidence that rural is a good place to be. It may
all be part of a national picture but as Post Offices, petrol stations,
primary schools continue to close this will just be another nail in the
coffin of rural life.
20 October 2000
Last nights meeting of MUMS the campaign to ensure maternity
services in Caithness were not reduced held one of its now regular
meetings. The meeting brought together members of other
organisations to decide upon future strategies to combat what is seen as
the threat to services in the county.
The group are now looking to expand the membership of the group to
drive forward the campaign. The decision to delay the review by
the Health board looks as if it is giving the group time to mobilise
public opinion and consider many of the factors seen as detrimental to
the area if the review suggests down grading the service - particularly
less cover at consultant level.
19 October 2000
Monica Mouat has stood down from her position as chair of the review
group looking at maternity services. A new chair will be
appointed. Ms Mouat is a representative on the Highland Health
Council and did not feel that the two roles were compatible when she was
expected to represent the views of patients.
13 October 2000
This week saw Deirdre Steven talking to her fellow labour party
member Health Minister Susan Deacon. Following a meeting in Inverness
Mrs Steven put the local view to the minister. No announcements
have as yet been forthcoming. The review appears to have been put
off until next year and local opinion is still that it is a delaying
tactic waiting on public opinion to subside. Perhaps the onset of
a general election may have some influence on this as the outcome of the
review may not be available until after the election now that it has
been delayed. If you have any thoughts on this manouvre perhaps
you might like to put them on the Message Board.
6 October 2000
The Campaign Pressure Rises Steadily.
No one in Caithness can be unaware of the mounting pressure being
built up by the MUMS campaign in Caithness. Local opinion is being
guaged by petition in every part of the county now. Every group
where mothers meet is discussing the topic and every person in Caithness
is being made aware of the threat not just to the maternity service
itself but the possible knock on effects of other hospital based
services. People are beginning to realise that several services
provided in the hospital might be no longer considered viable and so
like dominoes they would fall on e after another - maternity first, then
possibly anaesthetics and who can guess next as one tier knocks on to a
reduction in the next and so to it also coming under threat in turn.
The campaign team are speaking to politicians in all parties and at
all levels. Letter writing is going on and no post bag is going to
be empty for long on this topic until it is resolved. The Health
Board decision to delay the review which was to have started
shortly is seen as a delaying tactic by many people in the hope that the
campaign may die out. This is unlikely as several politicians of
several parties are now swinging in behind the campaign. This is
too close to people to be left to chance and everyone in Caithness is
likely to support this highly local issue for any number of reasons.
Perhaps the minister should consider whether months of campaigning
is really necessary if assurances could be given not to down grade the
service but put all the energy which will be required to take on the
whole Caithness population into finding a solution to ensure that
clincal standards and training of medical staff can be kept up to
acceptable levels. No one doubts that the low birth rate now
evident in the north is a problem for the staff in maintaining their
skills. This is in part to other outside economic forces as
unemployment and education takes young people away from the area.
Caithnessians are having babies but they are having them in every other
part of the country or indeed the world as they leave to get work.
Just look at the reunion pages on this web site. We already know
of young Caithness families in Australia and elsewhere with up to four
children. The primary schools in Caithness certainly wish they
were here. But that problem cannot be solved quickly despite years
of trying by the authorities.
The fact is that if the services are down graded they will probably
never be reinstated and Caithness will become even less attractive to
people thinking about bring their young families to the county when
mothers would be faced with over 240 miles round trip to see consultants
or feel insecure in the knowledge that expertise was only available at
the end of a phone.
4 October 2000
No assurances from the Health Board at the Wick community Council
meeting this week does not give any comfort to people who are worried
about the future of maternity services in the county.
The delay in commencing the review - it has been put back to January
2001 looks to councillors like a way of trying to allow the very public
campaign to die out according to Graham Smith - Wick Councillor.
Deirdre Steven - Wick West Councillor is also on the case pointing
out that the people in Caithness were given assurances about services in
the county not long ago when the new Trusts were set up. Although
the review is about clinical matters there is deep supicion fueled by
leaked reports about possible savings which could alleviate the budget
Again this is a front page story in the Courier
29 September 2000
There has been huge publicity on the maternity services in Caithness
since the news leaked about the review and then the financial problems
of the Trust. Given the assurances given at reorganisation under
the "Designed to Care" proposals less than two years ago
people in Caithness would appear to have been right to worry about the
changes that many did not want. The drive towards centralisation
yet again appears to threaten services in peripheral areas strengthening
the view that the former district councils and locally based hospital
trusts gave a better safeguard for locally based services.
A clinical review as now being undertaken by the Health Board will
undoubtedly conclude that the doctors skills cannot be maintained in
Caithness under present arrangements as the birth rate is too low.
This means that doctors in hospitals cannot get the experience and
practice to maintain their skills and therefore are not persuaded to
take postings in remote areas. The arguments may well follow that
mothers and babies are put at risk by this factor and this line of
reasoning may take us back to proposals to provide the service from
Raigmore one way or another.
Watch out downgrading by another route and for other reasons than the
financial ones. A clinical review could be another name for all of
what has gone before. We will see....
26 September 2000
The public anxiety surrounding the effects of the review of maternity
services in Highland have given us the impetus to make information on
the issue easily available. If anyone would like to forward
information for inclusion in this section please get in touch with us at
01955 609288 or email email@example.com
Following a review nearly three years ago fears were
allayed about possible down grading of the services at the Caithness
General Hospital. The matter is again to be looked at and the
maternity services review committee will start its work shortly.
The committee is to be chaired by Monica Mouat from Highland Health
There is a feeling from the Health side that the public disquiet is
somewhat premature as the committee has not even started its work.
However there is considerable local fear that the current financial
problems of the NHS trusts may have some bearing on the eventual
A local committee to fight closure (which is not suggested as an option)
or down grading to midwife only service, has been formed and is led by
local councillors. There has been a series of stories running in
the local and other Highland papers. The John O'Groat journal
deveoted its whole front page to the matter last week. Letters
from members of the public expressing their fears about the long journey
to Inverness (100 - 140 miles) 3 to 4 hours by road. Also letters
from mothers who have experienced problems with childbirth and the
possible consequences if expert medical treatment had not been available
locally. This issue is growing in the public mind and is a wide
spread topic of discussion in many quarters. A petition has been
in shops and offices for the last two weeks. The committee were
out on the streets of Caithness getting signatures on Saturday.
The Caithness Courier again has it as its front page story. Last
week the John O'Groat Journal and the Press & Journal ran stories
revealing a secret cost cutting plan to try and tackle the Acute
Hospitals NHS Trust. the maternity unit was specifically mentioned
as being inefficient and recommended the relocation of specialist staff
to Inverness. The inefficiency comes not from any short comings of
the staff but from the low birth rate in recent years in
Caithness. The fact is that people of child bearing age are
leaving the area and many reports point to demographic changes in the
age structure of the population due in part to economic factors.
More stories are coming forward almost daily of the problems women have
had in the past which would not have been coped with if they had had to
go to Inverness. Everyone is waiting for developments or
statements but to date no assurances about the services have been given
by either the Trust or the Health Board.
If anyone has information or would like to say what they think on the
matter the Message Board already has a section to use. Any
significant details will be transferred to these pages over the coming