Maternity Unit thoughts

[lynne duncan]

1. It's a pity in this day and age that the likes of bygone days pranks are not allowed. It would be nice to put Professor Calder in the back of an ambulance and transport him south to Inverness instead of allowing him to return by plane.
2. I know Thurso folk don't care much for dirty weekers and if the NHS get their way there will be an awful lot fewer of us about.
3. When the Perth Maternity unit was threatened with closure Ewen Macgregor's mum was involved in the campaign to keep it open who do we know thats famous and able to be contacted would help...

[trinkie]

1. Bygone Days Pranks were not allowed then either, so nothing has changed.
Why not ask Mr Calder if he would like to make the trip to Inverness
not forgetting a Blood Transfusion en route.

2. Thurso folk like the Wick folk fine - they just think they dont.
They will support you.

3. Famous Person ---- Do it yourself Lynne - YOU become that
Famous Person, you can do it.

4. First start a book of Horror Stories of such experiences from days
gone by. Get it published in National Papers and seen on Television.

GOOD LUCK.

[JAWS]

Sorry, but this isn't the time for a Thurso-v-Wick bickering contest distracting from a serious issue! There is nothing Raigmore would like more than to divide and conquer, it would play right into their hands.
I'm sure that Caithness General is needed just as much by the rest of Caithness as it is by Wickers.

No paediatrics department, then no maternity, no money to staff a free scanner, how long before all that is left is a 'super surgery' where all that can be done is to stick plasters on bruises and the odd stitch in small cuts?

Has any of the organisations involved with the hospital thought of inviting BBC Scotland here for their lunch-time programme on the 15th. I'm sure they would issue an invitation to Professor Calder or one of his entourage to take part in the programme. (Almost certainly bound to be refused - and how embarrasing that would be to them!)
I'm sure there will be enought MPs, MSPs, and local Councillors here to interest the BBC. Lets see if the Health board wish to snub them so publically!

After the problems they had over their plans for the hospitals at Lochaber and Fort William I'm sure the last thing they want is more bad national publicity of the same type.

It's time that the faceless ones in Inverness were dragged from behind cosy little offices into the full glare of the national spotlight. It's time the Health board were made to realise that some things are more important than to be left to bean-counters and that they are there to provide a decent service for the people of Caithness and that we are not just here so that they can be kept in their cosy, overpayed little sinecures.

[JAWS]

I thought one of the excuses for closing the Maternity at Wick was shortage of staff.

I've just been looking at the NHS site and checked the recruitment page
http://www.show.scot.nhs.uk/haht/vacancies/index.htm

Staff shortages at Wick Maternity? Then why are there no positions advertised??

[linzy222]

I was just reading in todays courier about Kerry MacKenzie who developed pre-eclampsia 3 weeks before she was due and had to have an emergency section!

I went through the same thing when i had my 1st daughter but that was 17 yrs ago and it was in the dunbar hospital, i had another 3 emergency sections after that all in caithness general and my last one was the worst, my sons heart rate (while he was still inside my stomach) went down to 11bpm and i reckon if they never got him out he would of died!! I'm upset just thinking about it!!

They can't shut down the maternity unit!

There is so many woman out there who need emergency sections!

I know how long it takes to get an helicopter up here from inverness coz my daughter has been flown down 3 times with an asthma attack and if they r busy then it takes even longer, i mind 1 time she was waiting for the helicopter and they were busy and they said it would be over an hour before they could LEAVE Inverness!!!

I think it is terrible what they r doing 1st there is no NHS dentist and now this, whats next?????

[Tristan]

I heard from a reliable source that the helicopter service cannot take a woman on board who is in labour, or who is in imminent danger of going into labour.

They can't take the risk.(?!!!)

So...how is the emergency back-up service supposed to work, if there is no way the woman is going to make it through the 2-4 hour drive to Inverness? Are we going to have emergency birthing procedures being provided by surgeons, who perhaps have not performed these procedures in the last 20 years or so?

Or do they expect midwives to learn how to perform an emergency c-section? Would you want to be a midwife up here under these circumstances...watch them leave in droves as well...leaving us with...what?

Scary thoughts indeed

[linzy222]

[quote="Tristan"]I heard from a reliable source that the helicopter service cannot take a woman on board who is in labour, or who is in imminent danger of going into labour.

They can't take the risk.(?!!!)

Oh well there u go!!

What happens in the winter when the snow gates r shut??

They will drive 2 the gates make u walk til the next set where an ambulance will b waiting to take u the rest of the way haha (no doubt they will)

I can c it in about 100 years there will b no-one living up here coz woman will b 2 scaried 2 have kids so there will b nobody left!!

[trinkie]

Last few days to write your letters girls.


PLEASE do all that you can to make sure that the best possible Maternity Care is
available in Caithness.

[trinkie]

Yes, I am on my high horse today.


WOMEN OF CAITHNESS DEMAND THE BEST ..
for yourselves and the babies.


KNOW YOUR WORTH.

[JAWS]

So another Obstetician has suddenly decided to leave Caithness General.
Did they fall, or were they nudged?
Perhaps they got got the "Gypsies Warning" about some future certainty which conveniently has not yet been made public. The timing is very convenient, very convenient indeed in view of Monday!

Besides, you ladies have to realise that you cause so much darned inefficiency.
First the nice medical people give you a date around which they arrange everything and then what do you ungrateful ladies do. You take things into your own hands and decide to go into child-birth too early, too late, with too many complications, or with any one of a number of other reasons which throw the proceedures into disarray. You really have no consideration for the economics of the system, all these problems have to be payed for.
This at the moment occurs at two hospitals. Now it would be, of course, far more convenient for the poor, stressed, overworked bean-counters if all this could be done in one place where they could make greater financial savings.

Meanwhile, all you care about is your health and that of your baby, how selfish and self-centred can you get.

Besides, expanding Maternity at Raigmore means more staff, more beds, better carpets and bigger offices to reflect the bean-counter's extra responsibilities.
People, please get your priorities right, you are there for the benefit of the Health Service Mandarins, not the other way round.

In five years time it will, no doubt, be pointed out that the birth rate in Caithness has fallen to almost zero, whilst that if Raigmore has increased proving that the decision to cut services in Caithness was right.

Anyway, whats a few lost babies and mothers between bean-counters, think of the money they will have saved!!!

P.S. Please don't shoot me, I'm only the poor old Devil's Advocate

[JAWS]

OH YES, and I will be there on Monday giving you all the support I can!!!
Lets make them realise that patients are not just statistics, PEOPLE DO MATTER !!!

[Anonymous]

Where is our so called MP is he in hideding or has he got his head in the sand as one might say, and as fae our other so called SMP or what ever he is, I no he is still trying to get cheap Petrol, Lets face it they do not give a dam, they never do untill they want you to vote for them, by then they will have let thems down in Inverness shut our entire hospital let allowen one ward.
One more thing that puzzels me is why spend all that cash on a new A&E, Babies come first, without babies we would not be here, then we would not need a new A&E.
Come the powers that be, Get of your backsides see how long it takes you to get to Caithness on a good dry windless, snowless day, 2 Hours on a good day, thats 2hrs for that baby to LIVE OR DIE. WHAT GIVE YOU THE POWER OR THE RIGHT TO SAY IF THAT BABY LIVE OT DIES WHEN YOU HAVE SHUT OUR UNIT DOWN

[Anonymous]

I think we have had the wool pulled over are eyes good and proper,over the maternity unit in Caithness General, we have lissened to excuse after excuse from the parts in power, but none of tehm are telling us the truth about this unit.
The thing we have all over looked is the little matter of closing down Dounreay, after all thats why they spent all that cash on a new A & E unit, but if there is a big accident then where would they get all the needed beds from, as it stands now?. Thats right, i think you may by now have the answer .
Shut the baby unit down and reopen it as an A & E wrad with specil decontamination unit, because lets face babies and Dounreay do not mix very well. Just imagin you are just about to give birth to ones ofspring and suddenly a bloke walks in glowing green with Radiation, Now thats not quite the right way to start of ones life is it?.
But no one will come out and say thats why they want the unit shut down for, because they can not tell the truth, as they do not no what might happen when they start to shut down the hell they call "Dounreay".
So think about it, if you think long and hard it makes sence, and sending a prat from down the line is all a cover up.
Any how if he was here to make good recomendation, then why fly up?, why not drive from Ragemore to see how far it is, No they are just pulling the wool over are eye's.
Well some of us any how.
Merry Christmas & A Very Good New Year.
To one & all, where ever & who ever you are.
Cheers GEORGE. XXX

[Caledonia]

Does anyone know the figures involved? What is the balance between what is 'sutainable' for the trust to provide, and what is required?

If there is a figure, why doesn't someone raise it? Why not put the Town Hall project on hold? Why don't some of the local employers make a direct investment in their emplyees, if you can award multi million contracts to companies for decommisioning why not?

They are spending 25K on consultation on the Town Hall. My God, surely a 20K bonus tied into a consultant taking a three year contract would get one here, and how about Pentland Housing offering them a house to live in?

[Bill Fernie]

I am not sure what the curent costs are but when I was a member of Highland Health Council a couple of years ago we were told that a consultant in a hospital cost in the region of £250,000. It will be much higher now and with the Working Time Directive cutting their hours signifcant extra costs are coming. But even on the old figures three consultants would be well over £750,000. Why so high? Well it is the other staff and infrastructure to support a consultant that pushes up the costs. Getting rid of three consultants might save over a million pounds a year. But no one will admit that thiere is any cost cutting exercise going on. Perhaps there is not ...........................yet.

An extra £20,000 over three years will not do it. There is a worldwide shortage we are told and as related in another post we as a country have not been training enough doctors.
It would be nice to think that extra money would quickly solve the problem but in this case it requires along term spend and what will we do in the six or seven years while the new doctors are training. People need to know when they start training that there willbe a career at the end of it all. There needs to be a significant commitment from government for the longer term and possibly some new ways of working . Can we rotate doctors round hospitals? Will they be willing to work in that situation. If not they will vote with their feet. Caithness General has lost two obsteriticians in a matter of weeks. Are they moving for normal reasons or are they leaving because they fear the worst?
I have yesterday received a reply to my letters to the First Minister and the Health Minister from the Deputy Health Minister Tom McCabe MSP. He states -

"Mothers' and babies safety must be paramount in considering appropriate arrangements for any maternity service. In exploring the current arrangements for any maternity service. In exploring the current arrangements, I understand that the professional team's assessment will cover all the factors likely to have an impact on safety, including non-clinical ones such as geography, weather and transport."
"It will also be for NHS Highland to consider any recommendations arsing from the assessment. If it considers that there is a need for any significant change to the current arrangements, the NHS Boardwill have to consult publicly on its proposals. We have consistently flagged up how important it is for Boards to involve all stakeholders - staff, members of the local community and their representatives included - in designing thier health services."

This throws the onus back on the Health Board and what worries me is that currently their are significant deficits in the Health Board's funding. They are at present sitting on a £6million deficit in thieir budget. The Health Board cannot borrow money like local authorities can to get out of a problem in a particular year. They require to delive a balanced budget annually. Anyone might reasonably ask how this is to be achieved in the face of dranmatically rising costs on shortening doctos hours in hospitals - junior doctors have already had their working week capped and the current pay agreements means significant rises for GP's and consultants. The increases in costs for th Helath Boards are huge.

I do not know the answers and I suspect nor do the Health Boards or the Scottish Executive and the MSP's who ultimately must decide no matter that the reviews like the maternity services review will go back to boards. There are no easy answers but I think it will be necessary for a political decision to be involved and not leave it to the cash strapped Health Boards to make a decision without access to the means to have a choice. Unless there is some way of directing more funds into health services then it seems likely that not only maternity services will face a bleak future but other rationalisations will be considered and the public will find they have to take on more campaigns like the current one in not just Caithness but all over rural areas of Scotland.

I would like to think that an extra £20,000 - a lot of money for the average worker would help. Or that a house being availabel would tip the balance in favour of an area like Caithness but unfortunately it will not and the funding required will shock most people if figures were made available.

The Helath Board will no dounbht come up with a solution but it may be that the solution is that the services are unsustainable in rural areas and if so then as the Deputy minister has said there will need to be a public consultation. We require to watch carefully what the consultation is actually about. There is often confusion in the language that people use -. for example I often hear people loosely talking about the "Closure of the Maternity Service in Caithness " but that is misleading when what they mean is "downgrading" - ie not a consultant led service.. simlarly when a public consultation comes along - if it does then everyone has to be clear about what is they are being consullted on.

Difficult decisions are coming no matter what the outcome of the current enquiry into matternity services -
How to maintain services and at what level in all of our rural hospitals. No one wants to give up what they already have. We have not been offered as yet any choices and the review when finalised will not tell us that we can have our maternity services if we close say two schools or stop another service. but unless there is some way of finding sginicant sums of money or and possibly even as well as some laterla thnking to find a new way of working in the NHS then policians will have to coome up with an answer.

The stauts quo is unlikely to be the end result. Even if the decision is to keep the services in Caithness - and I hope that is the outcome - there will still be a need to make changes to something as the lack of concultants in the required disciplines may not be easy to find. Hospitals like Caithness are in a very tricky situation and often require locum cover for a missing doctor - that is very expensive.

The Highlands and Islands are an attractive place to live but can a doctor find the career progression that they might be looking for. It would appear not in Caithness as the turn-over is high. But like any work group if the offers elsewhere are more atractive then they will move for all sorts of reasons. This might include housing - doctors can afford quite expensive houses in high cost areas which Caithness definitely is not. Services for them and their families may be a major consideration and unfortunately the results for Wick High school currently on the new web site launched by the Scottish Office a couple of days ago do not make good reading. These an many otherfactors may be inflencing decisions. But it is not just in Caithness or Fort William. All over the UK there is a shortage of consultants and although adverts may not appear in the newpapers ther are many gaps. Is this for financial reasons. It must be tempting to solve a budget problem by not filling posts. but here we are entering a complex debate and without a huge range of financial information and facts it is difficult to see a way to an answer.

For these reasons i think it needs not just review of materity but the whole NHS. We may yet have this. We surely cannot stagger from review after review and crisis after crisis every couple of years as we appear to be doing in Highland and elsewhere. The sytem is creaking and I am fraid that patching up will no longer work without significant decisions. The power to take them rests in Edinburgh. Let us hope they have the will to take it on or we will return here in another two years for the next helath servie crisis.

It might be interesting to hear from some of you in other countries on how your health services are dealing with getting consultants or othe rmedical staff at the moment. Do you hear of big staffing shorrtages. Is your helath service facing simlar threats. It would help us confirm that there is in fact a shortage worldwide as we are told. Or could adverts for doctors be placed int he press elsewhere with the hope of getting a repsonse. Do Australain, American , Canadian doctors wish to try the Highlands for a few years. Certainly plenty from the UK have gone overseas and the UK gets many doctors from India, Africa and so on. Knowing that the problem is worldwide will not help our situation but at least we will be more aware of the scale of the problem facing the NHS and Health Boards as well as the politicians.

Perhaps the answer will come over a number of years and pay for doctors go on rising until enough people are attraced into the profession. There must be n improving situation for doctors with reduced hours , increased pay and so on coming in now. but trainig new doctors will take years. Are we seeing a significant recruitment drive - I myself am not aware of one but then I am not looking at the medical press.

Plenty to think about and no doubt much more will be along before the current crisis - err........... review is finalised.

[A_Usher]

Hi there,
I want to add some views. I am Andrew Usher, Practice Manager of Dunbeath Surgery and husband to Dr Natasha Usher, Dunbeath GP Principal.

I have been reading with interest the views on the maternity issue and the old chestnut of how to get doctors to Caithness etc.

Firstly, we believe its imperative that the maternity unit remains open. Inverness is a long way with any complication during pregnancy and has the potential to cost lives.

Secondly, lets dispel the myth that Doctors get paid huge amounts of money, and can buy houses etc, etc. My wife gets paid a reasonably sum, but when you take into consideration she works 24 hours a day 7 days a week, minus time off for paid locums and cross cover her hourly rate isn't much more than £6 or £7 per hour. Not great for permanent on call and high responsibility. Urban counterparts do get paid more. There are reasons for this, too long to go into on this board.

Consultants in cities earn the same income however they have much more facility to earn external private income, hence increasing their income in some cases to double. The difference between an obstetric consultant here in Caithness is that they have no junior staff so have to take every call coming in and as their numbers are small have to be on call more for no extra pay. We are living in a social climate where doctors do not want onerous hours on call, want to be close to the city for diverse amenities and be close to family and friends, and have a solid and reliable infrastructure. Is that too much to ask?

Bill Fernie wrote: "When I was a member of Highland Health Council a couple of years ago we were told that a consultant in a hospital cost in the region of £250,000"

I would severely doubt this, as reported in this weeks BMJ the average consultant earns an average of between £54,340 (starting salary) and £70,150 (unless discretionary points). It may cost the NHS £250 000 to put into place an infrastructure for a consultant, due to nursing costs, secretarial costs, theatre costs etc , but they DO NOT earn £250 000.

Bill also wrote:
"This might include housing - doctors can afford quite expensive houses in high cost areas which Caithness definitely is not."

Again you are assuming doctors have surplus income. You would need to have a partner earning equal amount of money to own a house in the south of England. However lets not forget that a consultant or GP's partner may not find work here in the North, and therefore purchasing a house is just as financially difficult. Especially when people moving from the south with cash in hand are able to purchase easier. In our own case we have only of late found property to buy, and have had to rent, and move home on two occasions to stay in the area. So please, lets not make large assumptions that GP's and consultants are able to buy property at will due to large incomes.

Recruitment is the crux of the problem, we need more graduates. Graduates don’t come to remote and rural areas, why, well because they don’t get a real taste for the benefits of it. What is required is a form of undergraduate rotation, placing undergraduates in areas such as this to see the benefits of continuity of care, quality of living etc.

But be warned, the NHS is changing and in my opinion not for the better. The new contract is NOT and WILL NOT enhance the quality of remote and rural practices, in fact the Scottish Executive STILL DOES NOT have a solution for practices such as Dunbeath (known as inducement practices) and the financial package may force practices such as this into decisions which may spell the end for the practice. Worrying times ahead........

What I would like to see is that people be they the Scottish executive, msp, councillors etc, come and speak to local doctors and consultants and ask them what their situation is and how it can be supported or modified and NOT to make large assumptions based upon more assumptions that civil servants and urban doctors make which has little if any relevance to their remote and rural counterparts.

We are always keen to have a chat to interested parties......

Regards,

Andrew Usher

[Anonymous]

Mr Usher hit the nail on the head, but no one ever lissen, it was all done and dusted before that prat from Edinbrough came up last week on his wural wind tour of our hospital, Like is said before, if he had an open mind then ahy did he fly up here? in the first placse, why did he not come by road just to see what our new babies will have to put up with.
The road up is not abd at the moment but soon it will be a right mess when they strat widerning it ( "george your spelling is worst". Oh sorry ), also they still have not got the bottle to come out with the truth of why they want to shut this unit down, its nout to do with doc's or cash in the hospital or staffing leavels. ITS all to do with Dounreay and if some thing goes bump, then no matter how many wards they shut and tehn reopen under a new name, we will all be glowing in the dark.
So come on the powers that be [u]TELL THE TRUTH IF YOU CAN FOR ONCE.[/uAs for rural doctors we would be in a right mess with out there deadication, the hours our Doc here in Dunbeath puts in a day, is more than them Prats down in Edinbourgh put in in one week.
She and her team are just pure magic, i for one hope we never loss her becuase of Cash.
But its no good putting all this, some folks down in Inverness do not even no where Caithness is so how will a prat in an office now what its like to live here, work here, been born here. and just when you think you have won you go and die, then they want to take you and put you up the chimney becuase there is not grond left or no cash fae whole diggers, say the the prat in his new 3 pice sweet and his big fancy car.
We all got to wake up, or one day we will all DIE (in Ragemore)
All the best. George

[Bill Fernie]

Re the £250,000 costs for a consultant. I did not say a consultant earned £250,000 - I said it cost £250,000. A couple of sentences on I asked the question and answered it to make the point. - Why so high? Well it is the other staff and infrastructure to support a consultant that pushes up the costs.
I think it is misleading to quote hourly rates based on 24 hours. What is the annual amount earned? Many people earn more if they work over time. The self-employed may work "All Hours" but no one ever looks at their hourly rate only whether they drive a Range rover or a second hand cortina.
Perhaps what is also required is a management review of how everyone in the Health Service spends their time. It is not that anyone doubts that everyone works hard but maybe it needs to be done differently. With all the changes coming most folk are going to have to get used to that.
It is certainly not in anyone's interest to have staff working endlessly on call leading to tired workers. No doubt the situation has been exacerbated over the years as the pace of change has speeded up - more paperwork, more reports etc and pressure to deal with more and at the same time we the public have become ever more demanding in our requirements and expectations.
I think what might give people the wrong idea are earnings from locum doctors who can apparently now earn a fortune. For example the locum covering the practices in Wick recently has scale charges that would indicate an excellent remuneration and they can be seen at http://www.coull.net/rates.html

Doctors Pay Scales in 2001 can be found at http://society.guardian.co.uk/NHSsta...620640,00.html

A bit more research brings the fact that Robbie Coull also runs a web site Locum 123 http://www.locum123.com/index.shtml
At the rate it appears to be expanding there will soon be no permanent GP's - they will all be locums earning a huge amount. Is this an exaggeration - Let us hope so or the NHS pay bill is going to go through the roof. Any solutions anyone?

[A_Usher]

Hi Bill,
I don't think its wrong to quote an hourly rate, especially when you work 24 hours a day. The fact of the matter is many people, district nurses, paramedics etc work on call, and receive very little remuneration at all for the service. However many do their own on call because they wish continuity of care, and to be available to the community. In fact 67 remote inducement practices are subsidised practices and aren't allowed to make external income, as this comes off the subsidisation and therefore unlike others there is no extra income to be made.

There is no doubt locums earn a lot of money, and what has to be remembered is that some practices have a set budget and locums who have exploited the short fallings in recruitment have caused practices enormous difficulties as a practice which is due set amount of weeks holiday may find due to increases that it simply cant afford to. What is also forgotten is that many GP's especially in our remote areas are in fact self employed, and merely a contracted service and therefore have the same problems as self employed individuals. However the general trials and tribulations of remote and rural practitioners is one often forgotten and we have a very worrying situation.

Management in principle is a good ideas, however part of the problem with the nhs is the number of managers, there are probably more managers that there are nhs beds. Things are going to change, no doubt about it, but my feeling is to the detriment of existing services. Lets take an example and look at the issue regarding out of hours. There is an ideological theory that one GP with some auxiliary staff will be able to be on call and cover the whole of Caithness for out of hours, using the two wick ambulances to ferry patients. Considering the demographics, is this a great idea? What if one patient at Berriedale has a Myocardial Infarction, and another at John O'Groats is attending a car accident, and then a pregnancy were to develop complications. What happens?

Not all change is good, and this is something that concerns me greatly. I would like to see the sway go away from how much a GP earns and to move towards what services do we have, what is going to be reduced, what the long term objectives are, and most importantly how does it affect the individual patient.

My concern is that those supposedly in the know regarding nhs care don’t seem to know what is required, nor have spoken to those on the ground that do the job. This is something that surely must change.

Regards,

Andrew Usher

Editited part:
Footnote.
Robbie Coull has undoubtedly pushed locums cost up in the last year, and my own opinion has been, and i have voiced this before that this is to the detriment of small practices. However Dr Coull will find himself in a very different position next year when the locum budget is cash limited, and inflated locum costs will not be acceptable.

[Bill Fernie]

The cuts of earlier years are certainly coming home to roost now. The fact that locums can earn significant sums is like any other business due to supply and demand. As country we appear to have fallen down on the training of enough new doctors and other staff in health services. And this despite the huge fall in the number of beds n hospitals over the past few years.
The shortage of Dentists, GP's and Nurses - the frontline seen by patients is exacerbated by the shortages at least in rural areas of the Professions Allied to Medicine (PAMS) Caithness specifically seems to have had endless problems in recruitment for speech therapists, and other posts. In addition there has been permanent list of vacancies at Social Work Services including Children's Services. The general lack of people in many posts has to have a knock on to other professionals trying to fill gaps and working without the support that might be expected in other areas.

Public services seem to have been on a continual run-down for some years despite the increases in spending that we are told has gone on. It apparently is not enough - to attract staff with the correct qualifications, to retains staff or to adequately train replacements.

Other services are also under pressure from new regulations and lack of money. I would cite the recent decision by highlands and Islands Fire Brigade to suspend the attendance of non=mobile Auxiliary units to Road Traffic Accidents. As in other places a set of regulations is being applied that may work well in the urban situation but hits a rural area hard unless significantly more resources are applied. The Integrated Risk Management planning process is being used to stop local crews attending Road Traffic Accidents. the Auxiliary fire crew at Lybster will no longer be allowed to attend Road Traffic Accidents in the area. Although only a few accidents happen per year in the area the local Lybster crew could be the first at the scene of a road traffic accident and give emergency first aid as well as effect a rescue from a crashed vehicle.
whilst the risk assessment has identified problems in respect of safety of personnel, lack of equipment and not enough training the net result of applying this risk assessment is to withdraw this possibly life saving service manned by local volunteers.
The immediate withdrawal of the service seems like hasty decision and the service will no doubt have to be covered by crews from Wick or Dunbeath adding to the time taken for the arrival of assistance.
I cite this as yet another example of how many services seem to be under great pressure and it seems like a knee jerk reaction to Risk Assessment without to date any mention of how the noted lack of training or other requirements will be addressed.
At least in the health service we are getting reviews over a longer period.
But I wonder if anyone in Edinburgh is taking account of how the sum of these many decisions and lack of staffing in our public services is impacting on the ground.
For example in the case of a rural GP. Will the rural GP turn up at road traffic accident now have to wait longer for any assistance - ie a fire crew from further away to help remove people from a crashed vehicle.
How frustrating is it for a GP to refer a patient to a service to find there is a long waiting list due to lack of people in other departments. Does this lead to a lack of satisfaction with the job and perhaps deter others from applying for posts.
In many cases we appear to have reports on all sorts of areas and disciplines with very high expectations and standards and then not the money to ensure they are actually delivered. I think this is partly why many changes are coming.
We are in this country very good at applying regulations but as many of these are emanating from the European Parliament it would be interesting to see if other countries are applying the regulation as fast and as assiduously as we appear to be in this country.
Does France have a lack of GP's in rural areas? Are they short of Social Workers? Are the Germans or Italians telling their rural auxiliary fire brigades not to attend accidents due to Integrated Risk Management. Does this make sense?
Lots of questions here and I do not think anyone has the whole answer.