Lest We Forget - Statements On Maternity By Scottish Government That Do Not Seem To Work For Caithness

10th December 2024

From the Programme for Government 2024-25: Serving Scotland
First Minister John Swinney announced his first Programme for Government on 4 September 2024.

Ensuring we give every child born in Scotland the best start in life, we are committed to reducing developmental concerns at 27‑30 months by a quarter by 2030 - resulting in the lowest levels recorded - and supporting babies, children, and young people through the early, formative years of their life. This year we will:

Ensure more women receive care and support from the same midwife from pregnancy through birth, prioritising those who are most likely to benefit, such as minority ethnic women and women with additional social needs.
Source - https://www.gov.scot/publications/programme-government-2024-25-serving-scotland/pages/2/
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But But But - We Have Seen it written in plans before without any action other than reviews and always referencing the so called safety issues used as an excuse to reduce the services in Caithness.

From - The best start: five-year plan for maternity and neonatal care
20the January 2017

5.1 Continuity of carer

Implementing a continuity of carer model challenges traditional approaches to NHS maternity care provision, requiring a substantial shift in resources to community services to deliver care which follows the woman and family.

'It worked on a team system, so although I didn't see the same midwife every time, I saw one of four on the team and this team followed me up after birth as well, so you got to know them all.'

Scottish Maternity Care Experience Survey: 2015

5.1.1 Proposed continuity of carer model

In the redesigned continuity of care model, all women will have continuity of midwifery carer from a primary midwife. The primary midwife will have a buddy midwife who can support her and provide cover for annual, and other, leave and by a small group of local community midwives who will support labour and birth, unless elective operative delivery is required.

Midwifery and obstetric teams will be aligned with a caseload of women and be co-located for the provision of community and hospital-based services. GP practices will nominate a link GP from the practice to provide a liaison point for the midwifery and obstetric team and will also provide some continuity of support and advice as needed to community midwifery and health visiting teams.

Specific details of the way in which continuity is managed are likely to vary across settings (e.g. urban or rural) and population groups (e.g. women with particular social vulnerability). Different ways of providing continuity should be audited and evaluated.

The primary midwife will normally have a caseload of approximately 35 women at any one time and be the first point of contact for women in pregnancy. She will undertake the booking history, then plan and provide the majority of the woman and baby's care across antenatal, intrapartum and postnatal care working from the community setting. The midwife will link in with the wider health and social care team as required.

Source - https://www.gov.scot/publications/best-start-five-year-forward-plan-maternity-neonatal-care-scotland/pages/8/

Women and families seem to get left out of he plans and reviews other than conveniently to keep the same position since 2016 when the maternity services were down graded.

So could it be that for all the reviews and plans still keeping on with the same argument does now wash with the pubic in the north.

Generally several things are not working affecting families - child poverty, lack of affordable housing, proper wages, cost of living. So lets make having a baby harder or at least less pleasant for many women in the north. Nothing wrong with the midwifery care but its split between Caithness General and Raigmore in Inverness.

Orkney had this fixed better ages ago so how hard can it be to copy the model. Well and independent review might comeback with another answer but some may decide it is not worth a candle to wait and either leave the area not move north at all.

Passing the buck between Heath Board and Scottish Government for years has not solved the problem. So can we believe John Swinney (see above) - Ensure more women receive care and support from the same midwife from pregnancy through birth....

Caithness Health Action Team has highlighted the issues so many times but so far other than statement like those above nothing much has changed and it is still over 100 miles to Raigmore Inverness.

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