14th September 2026
Maternity services have been a continuing source of concern in parts of Scotland, particularly in rural and island communities where women can already face long journeys to reach specialist care.
The latest exchange in the Scottish Parliament suggests that the arguments are still far from being settled.
On 10 September, MSP Senga Beresford (Reform) asked the Scottish Government when it would provide an update on maternity services in Stranraer and Wigtownshire. The answer was that an independent review of maternity services is now due to begin this month, led by Professor Christine McCourt. The review is expected to take nine months, although the minister said that relevant findings would be shared as the work progresses.
The review is intended to look particularly at the difficulties faced by women in rural areas. Importantly for the Highlands, the minister made clear that its work will include rural and island communities and specifically named Caithness, Wigtownshire and Elgin. It is also intended to take account of the experiences of women, families and NHS staff.
The Government's stated position is that NHS boards should provide maternity services as close to home as practically possible, while maintaining the safety of mothers and babies.
That sounds reasonable, but it does not remove the problem facing communities where local services have already been changed.
The issue was particularly sharp in Wigtownshire. Conservative MSP Finlay Carson pointed out that some pregnant women could face journeys of up to two hours to reach consultant-led maternity services. He questioned what assessment had been made of the clinical and safety implications of those journeys and whether further delays caused by repeated consultations could themselves create risks.
The minister's response was that NHS Dumfries and Galloway had changed its service model following an independently chaired local review and community consultation. She argued that the new national independent review should now be allowed to consider the matter and provide an independent view.
And that is where the frustration comes in.
For communities that have already spent years arguing about maternity provision, being told that another review is beginning can sound like progress. But it also means that a definitive answer is still some distance away.
The Government can argue, with some justification, that maternity services are complicated. There has to be enough specialist staff, sufficient numbers of births to maintain clinical experience, emergency cover and safe facilities. Rural Scotland presents particular difficulties because providing a full specialist service in every community may simply not be sustainable.
But the other side of the argument is equally important. Distance is itself a factor in safety.
A maternity system designed around centralisation may work differently in Glasgow or Edinburgh from one serving communities where the nearest specialist service can be many miles away and where winter weather, road conditions and limited transport options can complicate the journey.
That is why the inclusion of Caithness in the review is significant.
Caithness has experienced its own long-running debate over maternity services. The question is not simply whether a particular building should contain a particular service. It is about how maternity care should be organised for communities that are geographically remote from Scotland's major hospitals.
The September exchange therefore provides some reassurance that the issue has not been forgotten. But it also confirms that there is no immediate resolution.
The independent review is expected to take nine months. It will then have to make recommendations, those recommendations will have to be considered by government and health boards, and any changes requiring additional staff, facilities or money will take still longer.
For women and families currently relying on rural maternity services, that can feel like a very long time.
The bigger question for Scotland is whether it can design a maternity system that recognises that safe care is not only about what happens inside a hospital. It is also about how far people have to travel to get there.
The new review has an opportunity to examine that properly.
But after years of debate, communities will probably judge it less by the quality of the report than by what actually happens afterwards.
Cynically many people would say another review just keeps kicking it down the road.