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Eye On Index  

Eye On Maternity Services
2000 - 2001

7 August 2001
A breakthrough as the Health Board announce the Review finds in favour of keeping services local.

Check 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 people. 
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 March
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
MUMS 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 far.
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 paper.

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 expectant mother.
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 concern.

10 November
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.

25 October
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 deficit.  
Again this is a front page story in the Courier this week.

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  info@caithness.org  

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 Council.

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 outcome.

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 months.

Press Release Susan Deacon 7 September 2000

What the Papers and Others Say

9 February 2001
John O'Groat Journal

31 January 2001
Caithness Courier

9 December 2000
John O' Groat Journal

1 December 2000
John O'Groat Journal

10 November
John O'Groat Journal

25 October
Caithness Courier

20 October
John O' Groat Journal

18 October
Caithness Courier

13 October
John O'Groat Journal

6 October
John O'Groat Journal

4 October

29 September
John O'Groat Journal

27 September

27 September
Highland Health Council have issued a statement on 22 September. 
Click Here For Statement

27 September
Assoc of Caithness Community Councils - Press Release

20 September
Chair Caroline Thomson
Highland Health Board

Press Release