Maternity Issue Unites Whole Community

**Bill Fernie** · 27-Nov-03, 11:49

The meeting in the Francis Street Club in Wick last night was packed and standing room only and no doubt the one on Friday night at Thurso Town Hall will be similarly well attended. The arguments rehearsed by eveyone at the last review less than three years ago were all brought out again by speakers at the meeting. The sense of outrage at having to do it all again so soon after the last review has annoyed many people. But rather than take it as inevitable a fighitng spirit hass begun to emerge even greter than last time. Peeople are calling for more action and visible action . The League of Friends of Caithness General has agreed to organise peacefuul protests when Professor Calder arrives for his Flying visit ( not for him four hours in an amulance to Bettyhil)

The League Of Firends - a body of mainly women raising money for good causes within the hospital is to take militant type action!!! Something is definitely wrong. Never in the past have I heard this group talk about making placards and appearing at a demonstration of this kind. It backs up the serious nature with unimaginable consequences for the people of the north of Scotland if services are downgraded as a result of this current review of Maternity and related services. Many of the audience were able to relate their own or a relatives history and how they felt the inevitable consequences of a long trip to Raigmore, Inverness would result in many more deaths of mothers and babies.

It is without doubt one of the few emotive issues that could bind a whole community to protect women and babaies. It touches all our lives and eveyone could relate to the near-death experiences of several people in the audience last night.

All rural areas in Scotland are threatened in some form or other by the current review and similarly are combining to take action against any proposals to downgrade services. With no committments being given from the start to protect services. Many are afraid that the review is nothing more than a cost cutting exercise and that remote and rural populations are to suffer.

David Flear the Caithness area convenor has asked people to send their views to him as he is one of the few people to have been granted an interview when Professor Calder comes to Caithness on 15 December. David Flear can be contacted easily by email and he urges everyone to let him know their views and anything they feel might be relevant aboput retaining services in Caithness. His email address is david.flear.cllr@highland.gov.uk
Or you can write to him at c/o Highland Council Offices and put an M on the left hand corner of the envelope. This will enable staff to divert all communications quickly to him.

More information and updates about any meetings or demonstrations will appear on the web site in the Eye On Maternity pages at http://www.caithness.org/eyeon/healt...ness/index.htm

Have you any stories relating to relatives that they would wish to share here on the Message Board or any comments about the proposals or the way in which this review is being carried out and so soon after the previous one.

Should we be taking into account that there are difficulties with Europan Working Time Directives, difficulties in recruitment and the falling birth rate or do you feel this is all a front for cuts. Lets hear your views on what is likely to be on the front page of our newspapers for many months to come.

Report on Wick meeting of 26 November 2003 http://www.caithness.org/fpb/novembe...nity/index.htm

**Bill Fernie** · 08-Feb-04, 12:01

About 70 people turned out on Saturday 7 February 2004 for a meeting to discuss future action. Carolyn Leckie MSP and local councillor Bill Fernie spoke at the start and then a few suggestions were discussed. See http://www.caithness.org/eyeon/healt...bruary2004.htm for report
The next public meeting is to be held on Wednesday 11 February at 7.30pm and is being organised by the League Of Friends of Caithness General in the Assembly Rooms , Wick. Ideas from the Saturday meeting will be taken to the next meeting as the League of Friends hope to form an Action Group to take matters relating to the Maternty Issue forward.

TB · 12-Feb-04, 14:28

I was at the meeting last night at the Assembly rooms, and felt that the meeting was a bit vague. I think that a lot of Caithness people have spent a lot of time and effort trying to do something about the Maternity, but I think more needs to be done.

Someone mentioned last night at the meeting about the Fort William downgrade, and we would have to try and set up something like Fort William. Well personally I think we need to do more, and something different to catch the health staff attention to the problem.

I feel that a lot of Caithness people don't know the exact situation, and I have heard people speaking about how its terrible that they are taking the Maternity unit away from Wick, but from what I understand that is not the case, and that they are proposing a downgrade, and the hospital will be midwife run, and any difficult cases will be put down to Inverness ?

Anyway from last nights meeting, I think we need more people on the committee that are willing to fight for what they think is right and willing to speak up for Caithness. I think that this is going to affect the whole of the hospital and not just the maternity unit. As a young person of the community that currently has no children, it does worry me the fact that I may be one of the unfortunate people that may have complications and might need to go to Inverness. I know what its like to travel back and fore to Inverness, and also in bad conditions, and its not nice. For instance, last night they were saying that we should speak to staff at the A&E department in Wick who know what its like to travel down to Inverness in an ambulance. Well a few weeks ago I was unfortunate enough to have to take a member of my family to Raigmore Hospital, as the hospital staff said the Ambulance drive to Inverness was a nightmare, and that they would be better to travel to Inverness by car, as its more comfortable. Typical example.......... Need I say more !!!!

**Bill Fernie** · 14-Feb-04, 14:05

The meeting may have seemed vague to anyone coming into it for the first time. It shoudl be remebered that the purpose of the meeting organised by the League of Friends was to enlist the support and help of others in the county to carry forward what they had started. the ladies relaised that it neede the whole community to get behind the effot and as this was a big job more individuals and organisations should help with the process.
The first committee meeting has beeen agreed for next Tuesday and there will be requests from that new group for the local community to back suggestions. no one is excluded. Nominations were asked for from the floor and everyone who volunteered was accepted on to the committee. The group will call for more help if particular expertise is needed and assistance if more manpower is required. A collection was taken at the door and together with oney collected by the SSP has started a fund to cover some of the expenses that will be involved. I understand over £300 has already been collected. Financing the campagin will be on the agenda. A bank account wil shortly be opened once a name for the new group has been agreed.
The League of Friends are to be congratulated for gviing a voice to the feelings of our local population. They have now handed over to the new group under the very experinced chairmanship of George Bruce who has had long experience from his days as Chairman of the Caithness and Sutherland NHS Trust. Several suggestions have to be looked at involving both local and national efforts.
The group will have to look at not just what is happening in the north of Scotland but also other parts of Scotland where areas are having to deal with threats to their own maternity services. This is a national issue as well as a local one. Building up a lobbying campaign requires a huge effort and will need the backing from local people if it is to have outcomes that are benficial to the north and for the other pars of Scotland where this issue is being dealth with by local communities who feel under threat from a downgrading or total withdrawal of a local service.
The delay that is already apparent in the delivering of Professor Calder's report means there is more time to lobby politicians and Health Boards. And this is precisiely what will be under consideration next Tuesday. The perhaps apperently vague meeting last week will move very quicjly to present a series of positive actions. What no one can predict is the eventual outcome or what compromises might be reached to at least in part go some way to dealing with the problems faced by communities up and down the country and four us parrticularly in Caithness and Sutherland. Perhaps the avalanche of public outcry at the threat to services will carry weight and although it is only specualtion might in part explain why Professor Calder is taking a little longer to consider the options to put back to the Health Board and Scottish Executive.
Finally the meeting may appear on the surface to have been vague but it achieved the main objective of the evening and that was to form an Action Group. To get 100 people out to form an action group is in reality also an amazing thing if you consider how difficult itis to fomr a committee with enough people for many other activites. Ands although only 13 people joined the Action Team most folk at the meeting were also confirming their future support for actions yet to come. In a rural community the ripple effect of that will ensure that everyone in the north of Scotland will be aware of what is happneing. The campagin is managing already to achieve the well nigh impossible on almost any other topic - to unite most political parties in opposing downgrading, bringing together with one voice people from differing backgrounds and in relatively short time gaining enormous publicity and focus on this single issue.
The problems in the health service should not be understated. They are serious and significant changes are underway whatever happens. This does not mean that we ahve to accept the solutions handed out if they are felt by most people to be completely detrimental to the general population and the mainstay of any area - mothers and babies.
A new series of pages will be set up within the Eye On Health section to carry reports from the committee and actions will be announced on the front page as they are agreed by the Action Group. Remember the group will be open to anyone to send in suggestions but wait until after next Tuesday in order that the first suggestions are consdiered and decided upon.

**Mr P Cannop** · 14-Feb-04, 18:03

who is all on the committee and members ??

**lynne duncan** · 14-Feb-04, 18:53

if you have access to yesterday's groat the list of committee members is in it

**Bill Fernie** · 15-Feb-04, 20:11

Members of the group are listed on this page http://www.caithness.org/eyeon/healt...ctiongroup.htm

**lynne duncan** · 17-Feb-04, 23:59

it may be worth checking out this site for ways forward for the NAG group
www.westhighlandhealth.co.uk

**Fifi** · 20-Feb-04, 10:59

That was a very interesting web site Lynne - actually makes the place sound attractive to live and work. It would be an excellent idea to reproduce something like that for North Scotland.

As for the latest consultant resignation (Dr. Thomas) - what the hell is going on??!! Have they been pressured into this or are they just so hacked off and can see no future that they are voting with their feet? It seems very unlikely that anyone else is going to apply for a post when 3 consultants have resigned and the service is under review. What happens now to all the work they have been doing? Is there enough provision within Highland region to cover all the births, rountine gynae clinics and emergencies? Can these questions be added to those already being asked by the campaign committee please.

**JAWS** · 21-Feb-04, 01:11

What is happening is the NHS equivalent of the old 1960's "Planning Blight".

The Councils in the larger town and cities would declare an area "Ripe for Re-developement". Long and indecisive enquiries would be held over a number of years, the public would be "consulted" (and ignored), decisions delayed and massive uncertainty created. People who could moved out and abandonned the sinking ship and who could blame them.

Over a period houses would deteriorate because it wasn't "worth spending a lot on them as they may be demolished next year". Eventually thee council would declair them "unfit for human habitaton", compulsarily purchase them and give the "inconvenient residents" who are "preventing progress" next to nothing for their property and then build a "modern developement" with exorbitant rents and rates all payable to the council.

Does any of this sound familliar about the Maternity Unit?

Those who could have moved out.
Locums taken on at, no doubt, great expense.
Compaints of "wasted money" etc.
Unit downgraded.
"Planning Blight!"

Operating Theatre not being put to sufficient use. (Due to loss of Maternity to Raigmore)
Needs closing for "economic reasons", no doubt after more enquiries etc.

Consiltants not now "gainfully employed". Those who have not "jumped ship" can be moved to Raigmore. Nursing staff can now be disposed of as "no longer required", they can either give up or move outwith the area.

Everything is now centred at our wonderful "Centre of Excellence" (whayever one of those is) at Raigmore.
End of Caithness General Hospital!

Now we don't have to move out of our nice cosy administion offices and have to make that long horrible time-consuming inefficient journey to Caithness!

Oh yes, the people of Caithness? - "THEY CAN ALWAYS GET ON THEIR BIKES!!!"

**Tristan** · 11-Mar-04, 14:23

I just had a peek at the report, and a couple of things struck me right away:

1) 183 out of 303 Caithness/Sutherland births are considered high enough risk at the moment to be sent down to Raigmore already. If we have this many high risk births, isn't this justification enough to merit upgrading our services here?

2) If you look at the weighted scores down at the bottom of the report, they have allocated the "Quality" portion of the Enhanced Service option at least 4 points lower than the "Status Quo" option. It seems to me that if the service was enhanced, the quality scores would be expected to be higher than the status quo, not lower! And, if the quality scores were brought in line, I would bet (although I'd need the formulas to confirm) that "Enhanced Service" would score the highest of all.

This report should be burned like the rubbish it is!!!

**frank ward** · 12-Mar-04, 19:59

Tristan is right to question the methodology used - it is totally subjective and has been thrown in to give this bogus report some kind of scientific basis.
I have circulated an 8-page anti-Calder summary to other online members of NAG and hopefully this can be used as a basis to produce a counter-report and firm-up our arguments prior to the first of several sham consultration meetings on Tuesday.

Births in the whole Highland Region have fallen by oinly 5.5% - hardly enough to justify downgrading on grounds of 'falling birth rate'. It should also be noted that despite the numbers travelling to Inverness, the number of births at Caithness has fallen by only 3.4 % below the average over the last 10 years, and has actually been rising since year 2001.

Frank

**Fifi** · 13-Mar-04, 08:05

I noted from reading Prof Calder's report that of the 5 options listed he dismissed the first 3, pushed hard for the fourth (the midwife led unit) and for option 5 (remove the services from CGH completely) he stated that if 'we' did not go for option 4 then this was the alternative!! No pressure from him them!

Thought others may be interested in the following extract from a study of an experimental midwife led unit in Kirkcaldy. (To save you looking up nulliparous, as I had to, it means a women who has not given birth before). Note that 14% gave birth within an hour of the descision to transfer and another 14% within two hours - that's 28% of babies born in ambulances in our situation!! And these were all considered low-rsik women......

Evaluation of an experimental midwife-led unit in Scotland -T. A. Mahmood
Forth Park Hospital, Kirkcaldy, Scotland,UK

Abstract:

This paper reports on the outcome of pregnancy among 3322 low-risk women managed in an 'experimental midwife-led unit' at Forth Park Hospital, Kirkcaldy, Scotland. All women were allocated to receive midwife-led antenatal and intrapartum care. Of the 3322 women, 1786 were nulliparous and 1536 were parous. Of the 1786 nulliparous women, 532 (30%) were transferred to consultant care antepartum, 488 (27%) were transferred intrapartum and the remaining 766 (43%) were delivered in the midwife-led unit (MLU). Of the 1536 multiparous women, 343 (22%) were transferred to consultant care antepartum, 158 (10%) were transferred intrapartum and the remaining 1035 (68%) were delivered in the MLU. Among the intrapartum transfer group, 14% delivered during the first hour after the decision to transfer and another 14% gave birth during the second hour (28% between 0-2 hours). More than half of the women transferred during the second stage delivered within the first hour. Of the 2447 admitted to the MLU, 32% were seen by obstetric team on more than one occasion. Of the 1801 babies delivered in the MLU, 9% required resuscitation and 2% of all the babies were admitted to the special care baby unit. This study suggests that present antenatal criteria are unable to determine who will remain at low risk throughout pregnancy and labour, especially among nulliparous women. The clinical situation could change adversely during labour, requiring the involvement of medical staff. Commissioners of maternity services may wish to utilise these data to formulate local protocols for stand-alone midwife-led units.

**Mr P Cannop** · 13-Mar-04, 09:55

if we lose this babies and mother's will die

**frank ward** · 13-Mar-04, 12:01

Fifi can you give us a web source for this extract and/or the date it was published?

**JAWS** · 15-Mar-04, 02:38

What is the position with respect to Human Rights Law and the provision of adequate Medical Care.

Surely, in this day and age, it is totally unacceptable for any sizable population to be expected to travel over 200 miles for routine Medical Treatment.

This is Europe, not some impoverised Third World Country!

Has the law regarding Corporate Manslaughter been enacted yet?

If so has anybody looked into the position of the Health Authority both as a body and as individuals?

What is the positon regarding bereaved families obtaining substantial compensation for the loss and distress caused by the deaths which will inevitably occur as a result of the proposed changes?

One thing which must not be allowed to happen, and the Authority will try, is that responsibility is transfered to some poor scapegoat.

In any medical proceedure there will always be risk and unfortunately occasional slip-ups will result in unnecessary death, such is the nature of things.

But to deliberately introduce a policy which will inevitably result in death is totally unacceptable.

However any of the reports produced are worded, and I am sure some wonderful "meaningless" words have been carefully inserted in order to impress, the bottom line is that the whole thing is nothing more than a "penny-pinching" operation.

And the odd death? Well tough, provided savings are made who cares!

The only way to make them sit-up and take notice is to make the Health Authority Members understand that they are not immune to responsibility for their decisions and that saving money is not their only consideration.

Make them sweat!

Make them understand that "penny-pinching" will only lead to huge holes in their budgets from long and costly compensation claims.

Make them understand that their decisions carry responsibilities!

Make them understand that they are not anonimous quango members.

Name names!

If they are happy to sit and make life and death decisions which affect the people of Caithness let's know who they are.

Make them stand up and be counted.

They should each, individually, be made to explain just why the mothers and babies of Caithness do not matter!

**frank ward** · 15-Mar-04, 10:30

The possibility of legal action is not a course that should be comnsidered at this stage.

Firstly, the personnel involved in thesec decisions are well protected by statute and legislastion so that they cannot be held responsible for the consequences.
Only a case of professional negligence is possible through the courts.

Secondly, the costs of such action will firstly have to be carried by an individual and can be heavy, especially if you lose.
But the Trusts carry insurance and may even be guaranteed - and encouraged - by the Government to fight any such case to the wire.

And even if such a caes was won it would be years down the line and even then there would be no obligation on the State to restore the service.

Some people might think that legal ction should be initiated before a deasth occurs, or as soon as Calder's Review is implemented, but really this is sidestepping the real fight which is political.

Frank

**Fifi** · 15-Mar-04, 11:12

Frank,

The extract came from a report which can be found at http://taylorandfrancis.metapress.co...N4AJ5RGWDL.pdf

It came from
Journal of Obstetrics & Gynaecology
Publisher: Taylor & Francis Health Sciences, part of the Taylor & Francis Group
Issue: Volume 23, Number 2 / March 2003
Pages: 121 - 129

The full article is available by subscription.

Keep up the good work!

**JAWS** · 15-Mar-04, 22:52

Just as I suspected. Provided the Board tugs it's forelock to Government policy (It matters not which party that is) then they are free to take whatever course of action they wish.

I thought we had advanced from the days when the local Laird could treat the peasants as he wished provided he kept doing the Kings wishes but obviously not!

Medical negligence? All that means is that the 'poor bloody infantry' are thrown like lambs to the slaughter to deflect from deficiencies created by administrative policy.

I know litigation is long, costly and dangerous, especially when dealing with a Government sponsored organisation with almost unlimited funds and a Government policy to defend.

I was just throwing some ideas into the ring to see what came up in case it triggered more practical suggestons from someone else.

I understand that any solution has to be political rather than legal or they will just find another way to achieve the same result and as you say once the unit goes then end of story.

Lets hope some way can be found to shake their arrogance.

Keep at it and thanks!