Official Report 1201KB pdf
The next item of business is a debate on motion S6M-19512, in the name of Jackie Baillie, on Scotland’s maternity services. I invite members who wish to participate to press their request-to-speak buttons.
14:56
The birth of a child is probably the most significant and special event for any mother, but in Scotland today, sadly, that is not always the case. Last week, the BBC’s “Disclosure” programme reported on the tragic case of Jacqui Hunter. Jacqui died in childbirth from an amniotic fluid embolism. She had been given eight times the recommended dose of the drug used to bring on labour. An NHS Tayside review found that higher doses of that drug increase the risk of an amniotic fluid embolism and that the incorrect dose
“must be considered as a major contributing factor to AFE and subsequent death”.
The panel also said that Jacqui should have been informed of the medication error. Her grieving husband, Lori, only found out after her death. Thankfully, deaths such as Jacqui’s are rare. However, for far too many women, childbirth can be a difficult experience. As Lynsey Hamilton, a maternity campaigner, said when talking about her experience of pre-eclampsia:
“You will see the headlines and hear the statistics. Behind them there are families, mothers and babies who are being let down throughout Scotland due to the lack of funding and investment in maternity services.”
Last month, I travelled to Wick in Caithness, where I heard stories of mothers being forced to travel more than 100 miles to give birth, despite Wick having an amazing midwife-led maternity unit. I heard from the Caithness Health Action Team about a mother expecting twins who gave birth to her first child in Golspie and then continued the journey in two separate ambulances for the second twin to be born in Inverness. Nine in 10 women in Caithness give birth in hospital in Inverness—many of them are induced—but, despite the efforts of midwives, that does not mean that they receive acceptable maternity care. That is because Raigmore hospital is bursting at the seams. Women at the start of labour are told to go home and wait, but as home is more than 100 miles away, they end up wandering the streets of Inverness, sometimes at night.
I heard from Ashlyn, who arrived at the hospital to be induced but was told that it was too busy and was asked if she could come back two hours later. That went on and on and, in the end, she waited more than 12 hours to be induced.
Raigmore hospital’s maternity unit was supposed to be upgraded, but the Scottish Government paused the funding days after the unit was approved for development.
Across Scotland, our rural and remote communities want young families to stay and thrive. Instead, mothers are being forced to choose between healthcare and the place that they call home. In Stranraer, the closure of local maternity services means that expectant mothers are forced to travel 140 miles on a round-trip to Dumfries for care.
Claire Fleming, who is based near Stranraer, had children in 2012, 2015, 2019 and 2021, so she has seen the decline in maternity services throughout her four pregnancies. Her first daughter was, unfortunately, stillborn, but Claire says that she received outstanding support. In 2015, when Claire had her second child, she had a named midwife, and she had to go to Dumfries for an appointment only once. By 2021, when she had her fourth child, and extreme morning sickness, she had to make the 140-mile return journey for every single appointment—even appointments that were just five minutes long. The treatment in that instance was a drip in her arm. As Claire has asked many times, why could that not have been done closer to home? Women in remote and rural areas are right to call that out.
We know that services can be better. Orkney, which I know is close to the cabinet secretary’s heart, may be one of the most remote parts of Scotland, but its maternity unit has met the UNICEF gold standard. The unit is run by midwives, who are supported by consultant obstetricians, but mums know that in an emergency they will be transported via helicopter to Aberdeen. There are around 180 births a year in Orkney but, unlike in Caithness, around 80 per cent of them happen at the local maternity unit.
There is more that we can and should do in rural and remote areas, but the centralisation of services for mothers and babies is a nationwide issue. Families from Dundee to Lanarkshire have raised concerns about their specialist neonatal units being downgraded. Of course everybody wants the sickest, most premature babies to receive the highest standard of care. “The Best Start: Five-Year Plan for Maternity and Neonatal Care 2017–2024 Report” outlined the new model in 2017, and it recommended up to five intensive neonatal units. However, the Scottish Government has decided to deliver the minimum of three, meaning that women could be separated from their babies or forced to travel hundreds of miles just to be with them. The Scottish Government must listen to local families and clinicians, working with them, not against them.
The failures in maternity care are not just about geography. Last week, an inspection report highlighted failures at the Royal infirmary of Edinburgh maternity unit, which is less than four miles down the road from where we are now. Expectant mums are waiting as long as 29 hours to be induced, and they have been sent to other hospitals because there simply was not enough room. Only 13 per cent of the charts for patients’ essential observations were fully completed. Women were left alone in pain, with no call system to ask for help. There were delays in the escalation of care, and midwives were in tears because of the pressure.
An unannounced inspection in Ninewells earlier this year painted a similarly damning picture. Across Scotland, women are being let down at one of the times in their lives when they are most vulnerable.
I heard from Julie Keegan, a national health service nurse in Glasgow who works in intensive care, who noticed that her newborn son Mason was hypothermic, listless and struggling to breathe. She rushed to the city’s Royal hospital for children, where Mason died six hours later. A significant adverse event review later found that his temperature had been recorded as 35 degrees, when it was in fact so low that it was unrecordable, while other records had not been completed, leading to a failure to recognise just how sick he was.
Julie believes that a toxic workplace culture played a part in Mason’s death, and she backs a national investigation into maternity and neonatal services. She said:
“It is a complete whitewash. They should be working with families, not fighting them, to ensure that this never happens again.”
Too often, the response to such tragedies is a veil of secrecy. What is more, Mason’s tragic death is not Julie’s only experience of poor neonatal or maternity services. Earlier this year, expecting another child, she was given an appointment to be induced on a Monday. She ended up waiting for four days, because the maternity unit was short staffed.
Experiences such as those are deeply distressing for the mothers and families involved. They are also distressing for staff. Across Scotland, front-line NHS staff are overworked, understaffed and burnt out. The Ninewells inspectors found a 33 per cent shortfall in the number of experienced midwives. The NHS Lothian report found that midwives at the RIE were “emotional and tearful” while they talked about the
“overwhelming feeling of helplessness, frustration and worry for not only patients, but staff safety.”
Will the member take an intervention?
I am happy to do so.
Although patient safety is paramount, does the member accept that the reduction in the number of midwives through poor workplace management has reduced the choice that women have? Women should have a choice about where to give birth that is not based only on safety.
I agree—understaffing is one of the key problems in some of the distressing cases that I outlined and also in being able to provide safe midwifery-led services locally. I will come on to deal with that issue.
Research conducted by Labour found that, in 2024 alone, there were 333,296 unfilled nurse and midwifery shifts. Behind those figures are caring, experienced staff who are forced to make impossible choices due to the Scottish National Party’s managed decline of our NHS. Year after year, the Royal College of Midwives has repeatedly warned about workplace shortages and the lack of opportunity for midwives to develop their skills.
Finlay Carson might remember that, last year, there was the scandal of newly trained midwives facing unemployment. The Scottish Government had spent millions of pounds on their training but could not find the funding to give them jobs—at a time when there were thousands of vacancies.
We have no workforce plan, skills going to rot, mothers not getting the support that they need and experienced front-line staff going off sick or retiring with burnout. Midwives and other front-line staff are trying their best, but they are being set up to fail. I welcome the Scottish Government’s decision to set up a task force to take immediate action, but, by itself, that is not enough. The Government is littered with task forces and recommendations that have not been implemented.
We need a national investigation, not in place of the task force but alongside it, starting now. That is what the families want and what this Parliament should deliver. We need maternity services that wrap their arms around women and babies, rather than expecting women to wait for days on end to be induced because it is more convenient to do it that way. We need transparency, not secrecy. We need the duty of candour to be effective, rather than only words on a page. We need more than three specialist neonatal services to cover the diverse geography of Scotland. We need to learn from the best international practice, to deliver the highest standards of remote and rural care. We need a proper workforce plan that enshrines our investment in the next generation of midwives. That will pay off, so that maternity units are properly staffed. We need to ensure that we hold those at the top accountable, while fostering a workplace culture where staff feel supported and there is openness, transparency and willingness to learn from mistakes.
The United Kingdom Labour Government has delivered record funding for Scotland’s public services—an extra £5.2 billion to spend in this year alone. A fraction of that would have made a difference to maternity services. This is about investing in the next generation, in women’s health, in our rural communities and in Scotland’s future.
Today, MSPs of all parties have a chance to listen to the mums, dads, doctors and experts, and to agree to a national investigation into these crucial services so that mothers and babies can be safe and get the treatment that they need. [Interruption.] I am glad that a baby is having the last word.
Unfortunately, the baby cannot move the motion, Ms Baillie, so I would be grateful if you could do so. [Laughter.]
I move,
That the Parliament is alarmed by the serious patient safety issues raised in recent inspection reports of maternity services, and calls on the Scottish Government to launch a national investigation into the design and delivery of maternity and neonatal services across Scotland.
15:09
I thank Jackie Baillie for lodging the motion for debate. I agree with a substantial amount of what she has put on the record today.
I provided a statement in the Parliament last week in response to the recent concerning reports on maternity services in Scotland. I am aware that families have been impacted by NHS failures and that stories were covered by the BBC “Disclosure” documentary. I have just met one of those families; they are in the public gallery. I put on record my deepest condolences to them and give my thanks for their bravery in speaking up about their personal experiences. I know how difficult that has been, but it helps to ensure that we can learn and make improvements. I am genuinely grateful to them for that, and I would be happy to meet them, if that is possible.
Does the cabinet secretary agree that the experience of women who miscarry needs to be looked at, too? One of my constituents had to wait while two parts of the NHS argued over who should see her, because her pregnancy was at the 12-week point—too late for the early pregnancy unit but too early for the triage unit. She then had to return several times for checks on her pregnancy hormone levels, which were not reducing. She was in an area alongside pregnant women but she had miscarried her baby. Will the cabinet secretary take action now to ensure that our constituents in Lothian get the change that is urgently needed?
I absolutely agree with Sarah Boyack. I expect that to be part of the improvements that need to come through from Healthcare Improvement Scotland’s review, but it can also be considered as part of the task force that Ms Minto is chairing.
I thank the cabinet secretary for taking my intervention. I declare an interest as a practising NHS general practitioner.
Repeated surveys show that obstetric and gynaecology departments have the highest level of bullying of any specialty. Given that culture comes from the top, is it any wonder that there is a culture of secrecy when significant errors happen? It takes brave women to stand up and speak to shine a light on the problems.
I made it absolutely clear in response to questions from Dr Gulhane’s colleague Stephen Kerr last week about my very clear expectation for the culture in our NHS, which is reinforced by what we found in the report by Healthcare Improvement Scotland regarding NHS Lothian. I have put that on the record. I will not tolerate poor culture, and that has been made clear to NHS board chief executives.
Will Neil Gray take an intervention?
I need to make some progress, so I hope that members will forgive me. I will see whether I can come to Mr Kerr later.
I know that members of the Parliament will agree that the safety and wellbeing of mothers, babies and staff must be our priority. I also want to reassure pregnant women and their families that our maternity and neonatal services are safe, although I will talk about situations in which that has not been the case.
Women in Scotland have the right to choose where to give birth, and those who choose to give birth in our hospitals can be assured that they are the safest possible place to give birth, with access to the best possible care. Wherever women choose to give birth, whether in an obstetric-led unit, a midwifery-led unit or at home, they can and should expect the highest quality of care that is tailored to their needs. That is why I accept the initial part of Ms Baillie’s motion and why I am sympathetic to the majority of Mr Gulhane’s amendment.
As I said in my statement last week, I share concerns about Healthcare Improvement Scotland’s report into maternity services in Lothian and those raised by the BBC “Disclosure” documentary. The findings are completely unacceptable, and it is right that the Parliament takes a firm position that improvements must be made urgently, which I welcome the opportunity for today.
I also recognise—not least following the conversation that I have just had with Lori Quate and Willie Rennie, for which I am very grateful to them both—that trust has been broken between families who have been let down and the NHS. I am determined to ensure that families have the opportunity to feed into the improvements that we want to see and to share their experiences candidly. I am therefore exploring whether that can be done through the HIS inspection process. I will also ask the Patient Safety Commissioner for Scotland for her views on how we do that most effectively when I meet her next week.
Will the cabinet secretary take an intervention?
I will try to come back to Pam Duncan-Glancy. I want to make progress, but I also want to ensure that colleagues have the opportunity to have their say.
I will not repeat all the points that I set out in my statement last week, but I want to be clear from the outset that the Government remains absolutely open and willing to do everything necessary to improve the services that women and babies use across Scotland. I have been very clear with NHS Lothian about the urgent improvements that I expect to see before the end of this year, and the First Minister reiterated the importance of boards responding timeously to any concerns that were raised about maternity services when we met NHS chief executives last week.
Members will be aware that I intend to convene a meeting with NHS Lothian’s chief executive and MSPs from across the chamber so that they can ask directly any questions that they might have. I hope that we can use the debate to agree the need for members of all parties—the Government included—to work collaboratively together to bring about the improvements that we all want to see.
The Government’s amendment, in my name, is intended to set out clearly that we are open to a wider national review of maternity services. However, a series of local inspections of every maternity unit in Scotland is already under way. It is right that those inspections should continue at pace so that we can make immediate improvements, instead of initiating a review in place of those, which would be potentially lengthy and require us to wait for the findings to identify where changes can be made.
A national investigation would not be in place of the work that is going on—it would go alongside that and would recognise that this issue does not just affect one hospital or one maternity service but is a Scotland-wide problem.
I recognise the point that Jackie Baillie makes. I believe that the HIS inspection regime allows us to get into greater detail at local levels and allows us to consider those reports through the task force. Should that task force recommend a national review, I would be more than happy to accede to that request.
The action that we are taking is robust. It ensures that there can be an immediate, live response to those concerns, and we can see the improvement as the challenges are unearthed through Healthcare Improvement Scotland.
I understand the cabinet secretary’s point, which is that he wants immediate action. However, in his statement last week, he set out a series of investigations and HIS reports that have been conducted over many years, yet we still had that “Disclosure” documentary and that devastating impact. He must surely recognise that the current system of investigation is just not enough on its own.
I disagree. Healthcare Improvement Scotland inspections have only begun this year to uncover the challenges that we have seen in Tayside and in Lothian. They have come as a result of the previous neonatal investigations, and the Government accepted the need for that acute maternity inspection process. That is what HIS is currently embarked on. We expect a significant number of additional inspections to take place before March—eight, I believe—which will give us good coverage across the country and a full picture of the situation. I very much understand the situation that Jackie Baillie and Willie Rennie outline, but the HIS report regime will give us that full picture.
My colleague Marie Tidball MP has started a campaign about the experience of disabled people during maternity on the back of the London School of Hygiene and Tropical Medicine report finding that disabled women are 44 per cent more likely to have a stillbirth than non-disabled women. Will the cabinet secretary confirm that any investigation that takes place will be inclusive of all women, including disabled women?
It absolutely has to be, of course; there is no equivocation on that.
The new Scottish maternity and neonatal task force, which I announced last week, will review the findings of the HIS inspections. Two of those inspections have already taken place in Tayside and Lothian; they are complete and reported. HIS has committed to performing eight NHS acute maternity inspections by March 2026. Following the review of the findings and recommendations of those inspections, if the task force recommends a wider national review, I confirm to the Parliament that the Government will take that forward, giving full consideration to staff and patient welfare. I hope that that makes it clear to members that the Government is not shutting down the prospect of a review, but that the processes that are already under way should conclude in the first instance.
Will the cabinet secretary give way?
I do not know how much time I have left.
We have used up all the time in hand. I expect to extend the debate a little, given the nature of the discussions, but, as I say, we are over time.
If Mr Kerr could be pithy, I will take the intervention.
I will be very pithy. Despite what the cabinet secretary says, I cannot see how, without a national inquiry, we can get to the issues of culture that he spoke so strongly about last week. It is one thing to make pronouncements but another to bring change about. Without a national inquiry and a set of recommendations to do just that, how do we proceed?
I have already said that, should the HIS inspections that we are getting before March, and the task force, recommend that course, that is what I will do. I believe that that culture has been exposed in the HIS inspections; we saw that that was central to the criticism in the Royal infirmary of Edinburgh report.
I will not tolerate that—I expect to see improvements in the culture, and we are seeing management improvements and changes as a result. That is why I have confidence in the situation that is being developed through the HIS inspections. If that changes in any way, I am open to what Stephen Kerr suggests.
With regard to Mr Rennie’s amendment, as I said in my statement last week, I expect the task force to look at rural maternity services as one of its first areas of focus. Members will be aware that NHS Highland instigated a review of services in Caithness in 2016, following the death of a full-term baby in Caithness general hospital. NHS Highland’s review incorporated the findings from two external reviews and recommended the move to the current model of maternity care that is operating in Caithness.
That being said, I am sympathetic to the concerns that are raised in the Liberal Democrat amendment, and the concerns that my colleagues Maree Todd and Emma Roddick have raised in—
Will the cabinet secretary give way?
I will need to conclude—my apologies to Mr Cole-Hamilton.
My colleagues Maree Todd and Emma Roddick have raised their own concerns about the views of women in Caithness; that is why the Minister for Public Health and Women’s Health met local campaigners in the summer. I am happy to confirm that I will ask the task force to review specifically the issues in Caithness and in other rural communities, including Stranraer, and that is why the Government will support the amendment from Willie Rennie today.
We recognise that we must maintain focus on timely and continuous improvement to ensure that mothers and their babies can receive the best possible care. That is why, in Scotland, we have chosen to act now, rather than wait on a lengthy review process.
I turn back to my amendment. Healthcare Improvement Scotland took the decision to commence inspections of maternity services in Scotland following recommendations from the neonatal mortality review. That decision was fully supported by the Government. Following the NHS Tayside and NHS Lothian inspections, three further inspections have now taken place, and the reports will be published in due course.
Healthcare Improvement Scotland has confirmed that it will complete its inspection programme of the remaining 10 obstetric maternity units from April 2026. Once all 18 acute obstetric maternity inspections are complete, HIS will carry out a thematic assessment and analysis and publish an overview report. That will support national learning and build on our continuous improvement over the coming months.
The programme of independent, unannounced inspections is working exactly as it was intended. The inspections have identified where improvements are needed and are holding services and boards to account. The inspections are intelligence led and identify issues on the ground to drive improvements in real time. Healthcare Improvement Scotland works with each board to address the requirements and recommendations, providing improvement support and robust follow-up findings. That process might include engagement with the board, the offer of coaching and mentoring, and support with quality improvement tools and resources. Approximately 18 weeks after the publication of the inspection report, the board is expected to submit a progress report to HIS and, at that point, HIS will determine whether any further follow-up action is required—
You need to conclude.
Healthcare Improvement Scotland will also use the themes that emerge from the findings in its inspections to identify and implement national improvements. Furthermore, we have commissioned HIS to develop national standards for maternity care. The standards are currently open for a public consultation, which closes on Friday. Those standards will be published early in 2026.
As I draw my remarks to a conclusion, I note the comments last week from Jaki Lambert, the director of the RCM in Scotland, in response to the BBC’s “Disclosure” programme. She said:
“Many of the solutions are there in the recommendations of the Ministerial Nursing and Midwifery Taskforce”.
I assure members that the programme for implementing those recommendations is under way. There is a huge amount to do to implement the full range of actions for improvement, and for the full value of the changes to be taken account of throughout the process.
It is right that, as I have outlined today and last week, I assure the Parliament that the Government and I are committed to driving forward improvements across maternity services. I am keen to work collaboratively with colleagues across the chamber to do just that to bring about the improvements that are needed, and I remain open and willing to listen to the views of members on what more can be done.
I move amendment S6M-19512.3, to leave out from “, and calls” to end and insert:
“; agrees that a national investigation into the design and delivery of maternity services should take place if Scotland’s new Maternity and Neonatal Taskforce recommends it, and that it should give full consideration to staff and patient welfare; notes that the taskforce will review the findings of Healthcare Improvement Scotland’s inspections into all maternity units in Scotland; recognises that no neonatal unit in Scotland is closing, and notes that the new model of neonatal intensive care in Scotland was recommended by the Best Start 2017 report, following robust clinical evidence on the safest and best possible model for the sickest babies.”
As I have alerted members, we have exhausted all our time and gone beyond the time that we had available. I am conscious of the business that we have scheduled for later this afternoon and this evening. Therefore, although I have been able to give the cabinet secretary some time back for the many interventions that he has taken, it will be difficult to sustain that through the remainder of the debate unless we are to run seriously over time, which I am keen to avoid if at all possible.
15:25
The debate focuses on one of the most sensitive and vital areas of healthcare: the safety of giving birth and the wellbeing of mothers and babies. The recent inspection report and the harrowing BBC exposé of maternity services are deeply troubling. They show staff shortages, exhausted clinicians and mothers who do not feel safe or heard. From the reactions that we are seeing, it is clear that, across the chamber, we all agree that the current situation is unacceptable. For any Government, that should be a wake-up call. The trouble is that the SNP Government is asleep at the wheel—and has been for years.
We fully agree that there must be a national investigation into the design and delivery of maternity services and neonatal services. The Royal College of Midwives has called for urgent action after the recent BBC investigation laid bare serious failings. Those are not isolated incidents; they are symptoms of a system that is under pressure and a tired Government that has lost control and run out of ideas. When clinicians sound the alarm, the Government must listen. Instead, the SNP Administration ploughs on with controversial plans to downgrade maternity hospitals against the clear wishes of local communities and staff.
Across Scotland, families and campaigners are rightly concerned. In Wishaw, an award-winning neonatal unit faces being downgraded. In Dundee, more than 17,000 people have signed a petition to save the neonatal unit at Ninewells. In Kirkcaldy and Ayrshire, staff and parents share the same fears that vital local services will be stripped away. Centralisation on that scale forces families in rural areas to travel hundreds of miles at the most frightening time in their lives. It separates mothers from newborns and tears parents away from their support networks. That is not progress; it is the abdication of responsibility.
We are told that the change is based on strong clinical advice, but I fear that the centralisation is being driven by workforce failure, not clinical excellence. The SNP Government cannot staff its existing services, which is why units are being downgraded. It is not because clinicians want it but because they are being forced to accept it. Let us be honest: SNP workforce planning is abysmal. We train talented midwives in Scotland, only for many of them to be unable to find jobs. Some are crossing the border to work in England because posts are not available. Morale among staff is at breaking point and now, instead of fixing the workforce crisis, ministers are redesigning services around their failure to recruit and retain. That is not reform; it is retreat and it is surrender.
That is why the Scottish Conservatives are calling on the Government to pause all downgrades of maternity and neonatal services until a full, independent task force has reported and its recommendations are known to the Parliament. No irreversible decisions should be made until we understand the consequences for safety, workforce and access, because once a local neonatal unit loses its intensive care status, it almost never comes back.
Centralisation may look tidy on a ministerial briefing paper, but it is mothers, babies and exhausted NHS staff who will live with the consequences. Even the SNP’s former health secretary, Jeane Freeman, has now admitted that the current crisis in the Scottish NHS is the result of failures of successive SNP Governments—including her own. She said that politicians focus on what needs to be done to
“remain in power, as opposed to what needs to be done to fix”
the NHS. Those words are not ours—they are hers.
The “The Best Start” report on which the plans for neonatal services across the country are based was clinician led and was prepared in consultation with and is supported by the charity Bliss. Does he recognise that that is an endorsement?
Wow. We do not have enough staff under the current resources, we have a toxic culture, and we have had a terrible report and a BBC exposé. That is the why clinicians have been forced to accept the plans. If we had enough staff, I do not think that that would be the case.
Jeane Freeman’s words confirm what clinicians have been saying for years, which is that the Scottish Government’s short-term political approach has left our health service without the long-term strategy that it desperately needs.
That neglect is not confined to maternity care. Across Scotland, one in six people is now on a waiting list. General practitioner access has worsened year after year, following the SNP’s failure to deliver on promises made in the GP contract. Staff are leaving faster than they can be replaced. The Government boasts about record budgets, yet services are being cut, centralised or rationed. The public see through it. They see a Government that cannot match its rhetoric with results.
The Scottish Conservatives believe that every woman should have a choice—a choice to give birth where she feels safest, whether that is at home, in a community midwife unit or in a properly supported local hospital. We believe in care that is personal, safe and as close to home as possible. We believe in listening to the professionals—the midwives, neonatal nurses and obstetricians—whose experience should shape services rather than be overridden by civil servants and political spin.
That means fixing workforce planning, ensuring that every graduate we train has a post in Scotland and supporting staff with the training and flexibility that they need; it means valuing local hospitals, not undermining them; and it means designing services for patients and not promoting election stunts such as the GP walk-in centres—that initiative was proved to be a stunt by the fact that the First Minister, in writing, and the Cabinet Secretary for Health and Social Care, in the earlier question session, were unable to answer basic questions about the walk-in centres. The cabinet secretary says that work is taking place on that, so why not give us the basic information? Such stunts are not real solutions to the serious problems that we face.
This debate is not about ideology; it is about humanity. It is about mothers who deserve reassurance, not risk. It is about clinicians who want to deliver safe care but are stretched beyond their limits. It is about the babies whose first moment should not be defined by postcode or political mismanagement.
The Labour motion before us is sensible and proportionate. It calls for an investigation that really should already have been under way. Tonight, we will support it. Our amendment is also sensible and proportionate, not least because of the dire nature of the report by the BBC’s “Disclosure” programme.
Will the member take an intervention?
I wish that I could, but I have no time left.
The amendments give Parliament time to pause and think. If the Government does not heed our advice, the cabinet secretary will be responsible for any future risk to mothers and babies.
I move amendment S6M-19512.2, to insert at end:
“; recognises that a comprehensive NHS workforce plan is required for doctors, nurses and midwives to address staffing shortages, and that women in rural areas in particular are facing difficult journeys to access maternity services; urges the Scottish Government to swiftly make improvements to maternity services across Scotland and ensure that the recommendations and requirements issued by Healthcare Improvement Scotland following maternity service inspections are fully implemented, and calls on the Scottish Government to pause its plans to downgrade neonatal intensive care units until the national investigation has concluded and the Scottish Maternity and Neonatal Taskforce has reported on it.”
15:32
It is important to begin by recognising that the vast majority of births in Scottish hospitals are managed successfully, and that the mothers and children leave those hospitals safely. We should also thank the thousands of staff who work on those units across the country, because they do a spectacular job in really difficult circumstances.
What we are talking about today is what we do when things go wrong—and things have gone wrong on far too many occasions.
Olivia was stillborn in Ninewells hospital, just over five years ago. Twenty-four hours later, Jacqui, her mother, was gone as well. Members will have witnessed the testimony of her husband, Lori, who is in the gallery today. He uncharacteristically broke down in that documentary. It was quite a rare breakdown for him, because he is an astonishing champion. He is somebody who has fought almost every single day since then to get answers not just for him and his family, who are also here today, but for families across the country, and for the good staff who work in hospitals, who deserve support. He has been determined to get answers ever since that day, in May 2020. He showed that determination in our meeting with the cabinet secretary today, and I think that the cabinet secretary will agree that he did not hold back. He was very straight about the fact that we want a national investigation into the reasons for the number of failings that have been identified.
The case involving Jacqui concerned a drug overdose that was administered, which we believe led to an amniotic fluid embolism. There is a debate about that, but there are wider issues that are really significant. In the event that we held earlier today with other families, it was quite clear that themes were developing involving different health boards in various parts of the country.
The duty of candour is at the centre of this. I know that Stephen Kerr has done a lot of work in that area. In this particular case, there was no adequate recording of the overdose, yet there was no penalty at the end of the process for that failure. We have a situation in which people are perhaps incentivised not to declare because of the fear of admitting that they have got something wrong, but, equally, there are no consequences for their failure to record.
Does Mr Rennie agree that, when, as I have been told, we have multiple instances of only two midwives being on when there should be seven, they simply do not have the time to do the job that they really want to do?
I think that that is true. NHS Lothian has a complement of about 450 midwives, so if 70 midwives had to be brought in, that shows a massive shortfall in the number of staff. Sandesh Gulhane is right, but we should not let the issues of resources and staff hide the fact that there are some issues of culture at the centre of this, which we need to dig into. Even if we had the fullest complement of staff, we might still have issues with the culture of candour, recording and the consequences of failing to record. In Jacqui’s case, that failure of candour led to the failure to allow her agency over her own life and decisions.
The second point that a national investigation, which I think should happen, should consider is the failure to follow standards and guidelines—in this case, because they were considered too long to read. Why on earth would that ever be a barrier? If they are too long to read, we should have guidelines that are succinct and to the point and which can be applied.
The other more difficult point—this is difficult for us, because we are talking about NHS staff, who we admire greatly—is about the cover that some professionals provide for other professionals in times of stress and investigation. I sometimes worry that it is felt that the greater good requires that that individual remains in their post but, when there is an investigation, we must have a situation in which everybody is open and the NHS professionals do not feel that they need to cover for one other. I do not know how often that happens—
[Made a request to intervene.]
I am sorry, but I am short for time.
I do not know how often that happens, but if it happened in the number of cases that I have heard about, it is far too often.
The number of stillbirths in Scotland has dropped quite significantly, but it has plateaued in the past few years. We have not made further progress on the reduction, and we do not have a target like there is in England. We should be aiming to have a target.
My final point to the cabinet secretary is that I can understand the pragmatic way in which he is going about this. He believes that the task force is the best way to proceed, but I think that the issues are bigger. We need somebody with authority from outside the system—crudely—to rattle the cage and to make the necessary changes. I do not think that a task force with representatives from inside the current system will be enough to address all the issues that I have highlighted this afternoon.
The one thing that is for sure is that, for the families who are in the gallery today, we must do everything that we can to make changes so that we reduce the possibility of this ever happening again.
I move amendment S6M-19512.1, to insert at end:
“; notes that, following the downgrading of the consultant-led maternity unit at Caithness General Hospital in 2016, women in Caithness can face a 100 mile trip down the A9 to Raigmore Hospital in Inverness to give birth, and calls on the Scottish Government to commission an independent review of maternity services in Caithness.”
15:38
Every member who has spoken so far has talked about the profound impact on individuals and families who have been failed by the system, and I think that we can all recognise the seriousness of that. I acknowledge Willie Rennie’s comments at the start of his speech about the recognition that we owe to the incredibly dedicated and hard-working staff, who are doing their best. We must also provide reassurance, which Willie Rennie also spoke about, that, in the large majority of cases, services are safe and are being provided to a standard that people can have confidence in. We all have a responsibility not to exacerbate fears but to respond legitimately to failings when they have happened.
Because these issues are so profound, they go beyond party politics. I welcome Jackie Baillie’s motion and the tone with which she presented it. She did not give in to the temptation to make repeated comments about “this SNP Government” or such a thing as “SNP workforce planning”—I am not sure what that even means.
Will the member take an intervention, so that I can explain?
I will make some progress. The motion was presented in a way that reflected that the issue goes beyond party politics and that it should do.
What we have seen and been informed about over the recent period goes beyond what was in just one documentary. Some of the issues that we have heard about in recent weeks go back years. A whistleblower investigation in 2024, which informed the recent BBC documentary, talked about mothers and newborn babies coming to harm because of staff shortages and a toxic culture at Edinburgh’s maternity unit. The whistleblowing report found that patient safety was being compromised by a series of factors, including staff shortages, which led to delays. It said:
“There is no dispute that there have been safety concerns, near misses and actual adverse outcomes for women and babies.”
It talked about a toxic working environment as well.
Before then, a survey of RCM members across Scotland had exposed the scale of the challenges that professionals face every day. There are too few staff, a poor skills mix, inadequate equipment, substandard environments and no time to learn and develop. In 2023, the RCM’s “state of maternity services” report detailed how rising intervention rates, increasing complexity and growing policy and regulatory demands required a larger, more skilled workforce.
Many of these issues go back a significant time and are not news to those who have been working in the system for a long time, but the recent inspection reports have highlighted continued issues with staff shortages, inconsistent training and inequality between regions. All of that leads us to the question that is posed by the Labour motion: does the situation require a national investigation in addition to the steps that were announced last week?
I welcome the steps that were announced by the cabinet secretary last week in relation to the Scottish maternity and neonatal task force. We should recognise the importance of the clinical advice and expertise that will be brought into that, as well as the escalation of the support and intervention framework in NHS Lothian. Those must be seen as first steps.
The question is whether a national investigation needs to proceed alongside that task force, be part of its work or be framed by it. I was interested in the point that Stephen Kerr made when he talked about the emphasis of an investigation into culture. Both investigations would be legitimate, but that is different from an
“investigation into the design and delivery of maternity and neonatal services”,
which is suggested in the Labour motion. Different but equally valid issues are being raised.
The cabinet secretary said—I think that I am quoting him correctly—that he would be “more than happy” for a national investigation to take place if its scope and nature were determined and informed by experts.
Will the member take an intervention?
I think that I have time for one intervention.
Lothian MSPs—including your colleague Lorna Slater—received a briefing in September that spoke of training on culture that was provided to NHS Lothian staff in May 2025. However, in June, when the HIS inspection took place, we heard that nothing had changed. How can we, as elected members, have any confidence that we are not being taken for fools by some of these people?
Always speak through the chair.
I spoke briefly about the Lothian situation, but I have now moved on to discussing the call for a national investigation.
What I need to hear from the Scottish Government—and what it needs to be clear about when it asks the chamber to vote for its amendment—is its intention in framing a national investigation. Yes, there is a legitimate question about its scope—whether it covers maternity services as well as neonatal services or whether it focuses on maternity services—but there are also questions about how the clinical advice that is being sought by Government informs the decision about how a national investigation would take place. Fundamentally, that is what I want to hear about from the Government, including from the minister, who will chair the task force. In chairing that task force and taking forward that discussion, will her role be to define how that national investigation takes place, or will she be asking whether it should take place?
I need to hear, in the Government’s closing speech, a very clear steer that it will be asking how the national investigation will take place, not whether it will take place.
We move to the open debate.
15:45
As we learned from the recent BBC “Disclosure” documentary, maternity and neonatal services in Scotland are lacking sufficient resources to meet the needs of families. I often hear from constituents that, once they are in the care of the NHS, they are blown away by the professionalism, dedication and passion that staff show. However, “Disclosure” highlighted cases in which women could not access the special care that they needed, whether it was women having to give birth in a four-person ward room or the utterly heartbreaking stories of women and babies dying partly because nursing and midwifery staff are not present in sufficient numbers, especially at night and at weekends. I will not be the first person to tell the Scottish Government that, like time and tide, babies wait for no man and do not appear just during working hours.
All of that leads to the planned downgrade of Wishaw general hospital’s award-winning neonatal unit, as part of the reorganisation of nine specialist neonatal and maternity units, which will be replaced by three specialist units in Aberdeen, Edinburgh and Glasgow. I am not belittling the need for a specialist neonatal unit in Aberdeen, as there is a need for something in the north-east and in the Highlands and Islands, but recent data showed that Wishaw’s neonatal unit had the third-highest number of neonatal admissions, ahead of Aberdeen, and the second-highest cumulative number of days that babies spent on a respirator.
I want to provide reassurance to David Russell’s constituents, my constituents and other members’ constituents across the country that the design of the services has been recommended under clinical advice. That advice has been absolutely clear. Those involved were supported by Bliss, which is a UK-wide recognised charity for such matters. It is critically important that we are clear that this measure is about saving the lives of the sickest of babies and those who require the greatest intervention. That is why we are going through this process.
I can give you back the time for the intervention, Mr Russell.
Given that the recommendation in the “Best Start” report calls for between three and five units, it is a disgrace that the Scottish Government has chosen this way forward and opted for three. It could have included Wishaw, to serve the families in the south-west, along with Ninewells hospital in Dundee, which would have served Fife and Perthshire, with a review after a period in order to evaluate the situation. That would have been a commonsense approach rather than the severe approach of downgrading from nine units to three. That irresponsible and cavalier approach is gambling with babies’ lives.
The other problem is the metric that is used to determine where and how many specialist neonatal units are needed, which is to count the number of babies born before 27 weeks. Most babies born prior to 27 weeks come from emergencies and it is often unsafe to move a mum and baby, so they need to remain in whatever hospital they are already at. That can skew the results towards city centres, and it ignores the difficulty in moving fragile newborns and will result in more of what we have seen in “Disclosure”.
It is shocking that the Scottish Government chose to go with three units instead of a minimum of five, which would have at least kept things within the recommendations of the report.
We must consider as inevitable the underresourcing of specialist neonatal units, because underresourcing has happened everywhere else in NHS Scotland. It is also inevitable that my constituents and many others will need to be transferred to Aberdeen, because that is where the spare capacity will be. That is a journey of 150 miles and at least three hours for mum and baby, and it is a 300-mile round trip for other family members. Despite the fact that 80 per cent of the population live in or adjacent to the central belt, the meagre ration of £8.50 per person per day for food and travel is not going to cut it. Neither is the contribution towards reasonable accommodation for a stay of weeks within the vicinity of the neonatal intensive care unit.
Will the member take an intervention?
Mr Russell, I advise you that you will need to wind up fairly soon. I suggest that you do not have time to take an intervention.
I am sorry, but I do not have time.
The SNP Government is asking parents to cover the costs above the level that I mentioned.
An online petition against the closure of the Wishaw specialist neonatal unit—for everyone’s benefit—currently has more than 26,000 signatures. On behalf of those people, I ask the Scottish Government to re-examine and fully review its ill-judged and dangerous decision.
15:51
I remind members of my entry in the register of members’ interests: I hold a bank nurse contract with NHS Greater Glasgow and Clyde.
I am sure that many of us were deeply moved by the experiences that were shared on the recent BBC “Disclosure” programme on maternity and neonatal services. The families who have chosen to share their stories in recent weeks have shown an almost unimaginable courage and resilience. The loss of a baby or child is a pain beyond any of our worst fears.
When the health secretary made a statement to the Parliament last week, after the publication of the report into acute maternity services at the Royal infirmary of Edinburgh and the airing of the “Disclosure” documentary, he shared his family’s experience and his deep personal gratitude to the maternity staff for their care. I know that that gratitude will be shared by many in the chamber. The subject is incredibly emotive and sensitive and will have deeply personal resonance for most members, whether in relation to themselves, their family or loved ones.
Before my election to the Parliament, I specialised for around 15 years in perinatal mental health, so I am only too aware that, although the period around a birth can be one of the most exciting times in a family’s life, it can sometimes be the most challenging—all the more so when events do not go to plan. When that happens, our hard-working maternity care midwives, nurses, support staff, doctors and clinicians do an incredible job in offering families compassionate and supportive care.
In my 30-plus years of clinical practice, there has been significant progress in many areas, including reducing infant mortality. Neonatal deaths and stillbirths reached their lowest level in 2024. In September, NHS Lanarkshire, which provides care to many of my constituents, won the Health Service Journal award for maternity and midwifery services initiative of the year, for its innovation, expertise and unwavering commitment to patient safety. That followed the launch of its holistic antenatal care pathway to provide women with optimal care and evidence-based interventions to reverse an increasing rate of stillbirth that the board had noted during the pandemic.
I am grateful for the opportunity to listen to Clare Haughey’s expertise.
I think that the Wishaw NICU is award winning because of the excellent care by the staff and their close bond with families who have to keep going back there for on-going care.
Does she recognise that that is why the planned changes are so frightening for families, including those who have put the lives of their babies in the hands of that hospital and would not have their babies without it? Does she understand why the calls to pause the review are growing louder and louder, and that we need to do what we can to save that unit?
I will come on to that point at the end of my speech.
Any death or injury in maternity and neonatal services is one too many, is an absolute tragedy and must be followed by a period of reflection and learning.
The SNP Scottish Government is committed to learning from every case, in order to improve care, strengthen safety and support families. That is why the HIS inspection reports are being undertaken and will be reviewed by Scotland’s new maternity and neonatal task force. As the health secretary acknowledged last week, some of the reports might make difficult reading for health boards and the Government, which has agreed that a national investigation into service design and delivery should take place if the task force recommends it.
Around 56,000 Scots have the word “Rutherglen” on their birth certificates. From 1979 to 1998, Rutherglen maternity hospital operated as a stand-alone maternity hospital on Stonelaw Road in my constituency. Many people in Rutherglen, Cambuslang, Halfway, Blantyre and East Kilbride have fond memories of welcoming a new addition to their families in Rutherglen maternity. I worked there during my nurse training, and my oldest son was born in the hospital. The care that mothers and babies received there is still viewed with fondness and high regard by many, who held genuinely and sincerely strong feelings about the news of its closure.
Unfortunately, things did not always go according to plan. Over the years, I have heard of occasions when an emergent issue, such as a cardiovascular or neurological incident, meant that a patient had to be rushed to another hospital in Glasgow to access more specialist care, sometimes just in time to save their life. The decision to eventually close Rutherglen maternity, which was instigated under a Tory Administration and completed under a Labour Administration, ultimately hinged on its stand-alone status.
The clinical experts’ view at the time was that, when there were difficulties or complications, acute hospital services and a full range of further specialist support should be available on site. It was the health board’s view that, when highly complex and specialist neonatal surgery or complex neonatal paediatric care were required, there were clear safety benefits to co-location with main centres of excellence.
I fully appreciate that it is a highly emotive topic for many families today, just as it was 27 years ago. However, it is extremely disappointing that the same points against that very clear and direct argument have recently been rehashed by some Opposition politicians, and that misinformation has circulated in the media about Scotland’s current neonatal service model.
As the health secretary made crystal clear to the Parliament last week, no neonatal units are closing and, where care is being consolidated, it is for the very smallest and sickest babies—in three specialist units—so that those babies have the absolute best chance of survival.
The new model of neonatal intensive care was recommended by the “Best Start” report in 2017, following robust clinical evidence—which the Government would be heavily criticised for not following—on what the safest and best possible model for the sickest babies should be. Together, we must reaffirm our shared and utmost priority—that the safety and wellbeing of mothers and babies is paramount.
15:58
Every mother deserves to give birth feeling safe, supported and close to home. Willie Rennie made a pertinent point in his opening remarks, which is that we are talking about situations when things go wrong, and not about the vast majority of births, which are successful and go well, with mother, baby and family going home safely. However, that is the problem, because too many women in Scotland face the opposite of that—long journeys, understaffed wards, unit downgrades and a system that is stretched beyond limits.
The state of Scotland’s maternity and neonatal services is the result not of a sudden crisis or an increase in the number of births but of years of managed decline. Despite clear evidence, repeated warnings, localised campaigns and countless assurances from ministers, the Scottish Government has failed to address the serious inequalities and safety issues that new parents face in urban and rural settings.
The time for excuses has long passed. The best start plan set out an ambition to redesign maternity and neonatal services across Scotland. Its aim was to reduce separation of mothers and babies, provide care closer to home and support parental presence and involvement in neonatal care. Every single MSP in the chamber can get behind the principles of those goals, but, despite those good intentions, there have been significant failings in their delivery.
A survey that was published by Bliss Scotland found that, for every 10 babies who need overnight neonatal care, only one room is available for a parent to stay in with their newborn. That leaves parents with an impossible choice between finding accommodation close to the hospital, or leaving their baby overnight in the hospital because there is no option for them to stay with their child. That clearly contradicts the promise that is set out in the best start model, which states that parents and carers of those babies must—that is the important word—be supported to provide care alongside neonatal staff.
Last week, I raised that exact issue in the chamber, following the damning findings of the recent inspection of Edinburgh royal infirmary’s maternity unit, which many colleagues have mentioned this afternoon. I appreciate that the cabinet secretary has confirmed that he will write to me on the issue, and I welcome that approach. However, I hope that the letter that I receive will provide a detailed explanation of how the Scottish Government will make urgent changes to ensure that beds are available for parents who want to stay with their vulnerable and sick babies. If babies are in the neonatal department, their parents will want to be nearby, and they need that support. I will not accept anything less from the Scottish Government. We should all be able to support that.
It is not just about overnight accommodation. As we have heard, across NHS Highland, more than 150 pregnant women have had to endure 210-mile round trips because consultant-led maternity services have been downgraded. We have just heard from Clare Haughey that, apparently, MSPs in the chamber are saying that departments are closing. They are not closing; they are being downgraded. That is not spreading misinformation; it is a clear fact. That is the case not just for MSPs who represent rural areas but for MSPs in urban settings.
I have to correct Meghan Gallacher on that point. It has been said that the unit is closing—that misinformation has been spread. I accept that she might not have said that, but that has been reported.
Nobody has said that in the chamber this afternoon. I hope that MSPs understand that, if they say that things are closing when that is not the case, that will continue to spread misinformation, fear and alarm among our communities. That is not acceptable, and we should not tolerate it.
From MSPs who represent rural areas, we have heard harrowing stories of mothers giving birth at the side of the road and of mothers experiencing complications while trying to reach services in Inverness. Why should rural mums have to take on additional risks while in labour? Why has the Government failed to provide maternity services closer to home?
Downgrading has been the Government’s overall strategy. The decision to downgrade the neonatal intensive care unit at University hospital Wishaw is one of the most alarming examples of the Government’s failure to listen to families and local communities. The unit is nationally recognised and, as we have heard, is an award-winning centre that has saved the lives of some of the sickest and most premature babies in my region. Ministers insist that the decision is about saving lives, not saving money, but those are empty words that mean nothing to parents in my region, who face the prospect of their babies being moved to another neonatal department in the future. They will continue to campaign to stop the downgrade, and I will continue to back them every step of the way.
The best start plan promised that parents would not be separated from their babies, but, if a baby is moved from Lanarkshire to Aberdeen because of this downgrading exercise, that is exactly what will happen. The Government cannot continue to centralise care at the expense of communities. It needs to pause the plan, listen to families and staff who know the service best and commit to retaining Wishaw’s neonatal unit as a full intensive care facility. The minister also needs to explain how the Government intends to set up a new task force for maternity and neonatal departments while it continues with the removal and downgrading of services. It just does not make sense.
Every baby born in Scotland deserves the best start, and every parent deserves to be by their newborn’s side. The minister and the cabinet secretary have a tough job today in defending the indefensible, but we need to remember that the problem is of their creation. The centralisation of maternity and neonatal services must be paused, and an urgent national investigation must be agreed to. This is about outcomes. The Government cannot continue to fail mothers and babies, who deserve our support.
I remind members that back-bench speeches can be up to six minutes. There is no time in hand, and any interventions must be absorbed within the members’ agreed allocated speaking time.
16:04
I pay tribute to the families who have come forward to share their experience—it has been heartbreaking to hear it, and I know how hard it must have been, but without their interventions and bravery, we would not have some of the information that has come to light. It is important that we all understand that.
I had prepared a different speech from the one that I will give. I want to mention a couple of points that members have mentioned in the chamber, and to pay tribute.
Pam Duncan-Glancy raised the plight of disabled mothers. In my time in the Scottish Parliament, I have also seen information coming through about discrimination against black and minority ethnic women, who had higher mortality rates than those in other parts of the community. I believe that that is now well understood and has been tackled. The culture in maternity across the world has been changed by some of the research that has been done on those issues.
Scotland is a safe place for most births, although that does not take away at all from anyone’s bad experience. We are broadly in line with the birth mortality rates in the rest of the UK and among our European neighbours, some of which, such as France and Poland, have higher rates. By and large, we are not an outlier in terms of the statistics. However, those are statistics, and this is about individual cases—we cannot forget that. Every failure is one that will deeply hurt a family, a community and the clinicians who have been dealing with that baby and the family. In that regard, I take a moment to thank the staff at the unit in Wishaw, who do an incredible job and have been award winning.
However, I also have concern for my constituents. Wishaw is, of course, in my constituency, but the unit services the whole of NHS Lanarkshire. About 500 babies are born there each year—40 to 50 a month. The estimated number of babies who would have to be moved to the new alignment of specialist units would be two or three a month. For the majority of my constituents, and, indeed, for the majority of constituents in all parts of NHS Lanarkshire, their babies will still go to the neonatal unit in Wishaw, which is not closing, and they will still be served by the exceptional clinicians there.
Clare Adamson mentioned the numbers, which sound small when they are on a spreadsheet or in an email to MSPs. The reality is that there is no capacity in Glasgow or Edinburgh. Families are going to Aberdeen. In Lanarkshire, we have high levels of poverty and inequality, and we are going to separate families at a hugely vulnerable time. The numbers might be few and might sound small, but if we add them up, we can see that a lot of lives will be turned upside down. Surely that is worth fighting for.
Thank you, Ms Lennon—this is not an opportunity for a speech.
I say to Monica Lennon that we have to look at the clinicians’ analysis of the situation. Research worldwide shows that the best care for very small, very prem babies is done by people who do the job almost day in, day out. That builds their expertise and the expertise of the teams. That will happen at Glasgow. Despite being award winning, Wishaw does not do neonatal surgery. Neonatal surgery for my constituents at the moment will be done in Edinburgh or Glasgow, or in whichever hospital is in a position to do that surgery across Scotland. When that very specialist care is needed, that is where the baby should go.
I admit that perhaps more could be done with the third sector, with charities and with the Government to look at supporting families in that situation, but the vast majority of people will not need that.
People have asked, “Who’s saying it is closing?”, and they have said that, in fact, no one is saying that. However, at the Citizen Participation and Public Petitions Committee in September this year, Ms Baillie said three times on the record that the neonatal unit is closing.
Ms Baillie said:
“the Wishaw neonatal unit was the best neonatal unit in the country—not Scotland, but the whole of the United Kingdom”.
We know that. She then said:
“For some reason, the Scottish Government then decided that it should close.”
That is an incorrect statement.
Will the member take an intervention?
I ask Ms Baillie to let me finish.
She said:
“Lanarkshire, the third largest health board, which covers a population of 655,000 people, would have its neonatal unit removed.”
That is an incorrect statement. She then said:
“It has been said that when the Wishaw neonatal unit closes and mums and babies cannot go to there, to Glasgow or, potentially, to Edinburgh, Aberdeen could be the default.”
Thankfully, the committee’s convener corrected that language, reminding members that we should not
“cause additional alarm to people”,
noting that
“the core aspect of the ... petition is about sustaining the specialist units.”—[Official Report, Citizen Participation and Public Petitions Committee, 8 October 2025; c 18, 20.]
Will Clare Adamson give way?
Ms Adamson has 12 seconds left.
It was not about the closure of those units. Can we please, as politicians, examine the issues, have a task force—
Will the member take an intervention?
Ms Baillie, Ms Adamson will be concluding now.
We should not be causing fear and alarm when that is not required.
I remind members that we are extremely tight for time.
16:11
Centralisation of maternity services has forced mothers to travel long distances, often in dangerous conditions, to reach consultant-led units. We have heard harrowing stories. One woman gave birth at the side of the A96, instead of at Dr Gray’s hospital in Elgin, after being forced to transfer to Aberdeen because the unit was closed. How can that be a safe alternative? I am glad that, after much campaigning, maternity services have been reinstated at Dr Gray’s hospital. Sadly, that is not the case elsewhere.
In Caithness, the consultant-led maternity unit was downgraded in 2016, due to a tragic incident when there was no paediatric support available. There is an excellent midwife-led unit in Caithness, but it is 100 miles away from obstetricians and paediatricians, so the risk of a lengthy transfer has to be factored into decision making. The roads are poor, and they can be absolutely treacherous in winter. Therefore, the vast majority of Caithness births take place in Inverness.
Women are being forced to plan to be induced, with all the attendant risks of more acute labour pain and complications. Giving birth in a delivery unit, hours from home and away from family and friends, is now the norm, sadly, in large parts of rural Scotland.
I want to put on record, for Clare Adamson’s benefit, that the maternity service in Stranraer—the birthing suite, which used to be one of the 10 busiest such services in Scotland—is closed, as a result of a lack of midwives, and women in Wigtownshire are expected to make a 140-mile round trip. That is a fact.
That is the case in many parts of Scotland.
Even when planning takes place, things do not always work out. Jackie Baillie highlighted the case of the twins who were born in separate hospitals, in different counties, during a transfer from Caithness to Raigmore. Were it not for the quick-thinking ambulance staff, who took an incubator with them when they left Caithness, the outcome could have been very different. Halfway through the journey, when the birth of the first twin was imminent, they stopped at the community hospital in Golspie. There are no maternity services there. The first twin was born with the assistance of hospital and community staff, who rallied to the cause. The first twin was then separated from their mother and travelled in the incubator in a second ambulance to Inverness, where the second twin was subsequently born. The trauma of that is unthinkable, yet NHS Highland has not risk assessed that journey, despite being asked about that on numerous occasions.
On another occasion, a woman was turned away at the door of Raigmore hospital after travelling for more than two hours in labour, and she then had to travel on to Aberdeen and Dundee. Being turned away is very common, because women who are not close to giving birth are not admitted to the Inverness maternity unit, due to the lack of space. Instead, they are asked to wait somewhere else—to walk around the retail park while they are having contractions.
Many have been asked to travel many hours back home and return again when they are closer to delivery. Those women live in Caithness, Wester Ross, West Sutherland, Skye and Lochaber—many miles from Raigmore hospital. Surely, driving long distances on poor roads, with someone beside you having contractions, cannot possibly be safe. To travel three hours from Skye, only to be told, late at night, to go home and return in the morning, is inhumane. However, there is not space in the Inverness maternity unit to cater for those who cannot go home. Whistleblowers have said that staffing and accommodation are inadequate, which puts intolerable strain on the staff who work there, yet the Scottish Government has put on hold the capital spending to upgrade the unit, and there is no prospect of that work being carried out.
Recently, I met a young mum who went to Inverness to be induced. She could not get into the maternity unit but was eventually given accommodation. Her partner was also given accommodation, but it was in a totally different building. She had already been induced and was in pain; she was in a strange place, on her own, with no one to turn to. When, eventually, she was taken into the maternity unit and gave birth, she was told that her baby was unwell and needed special care services. There was no space in the unit in Inverness, and she was told that he would have to be flown to another hospital. She was asked whether she wanted her husband to stay with her or to go with their newborn baby. What kind of choice was that? It was made worse, because many hours later, worrying about what was happening, she discovered that her parents were waiting outside the hospital to be with her—and that her husband and baby were in the Inverness special care baby unit, because a bed had become available.
It does not need to be like that. We need to make sure that midwife-led community units are safe. For low-risk births, they are, but when something goes wrong, there must be a plan B.
James Bingham told the Caithness Health Action Team:
“The geographical distance and transfer times between Caithness and Raigmore is greater than that accepted to be safe for a primary birthing unit.”
We need a plan B. There is a plan B in Orkney, which allows babies to be born there, but there is no plan B for Caithness. Should we be using the Scottish specialist transport and retrieval service to provide that?
Presiding Officer, I finish with—
Please conclude—you are over your time, Ms Grant.
I finish with a quote from a mother in Raigmore, who said:
“Women don’t feel safe any more. It’s barbaric. We don’t matter up here. That’s what it feels like.”
Thank you, Ms Grant.
I remind members yet again that they agreed to make speeches of up to six minutes and to the timings for the debate, which the Parliament has approved.
16:17
To start, I, too, pay tribute to the families who have come forward so bravely and who have informed this debate.
At the heart of today’s discussion lies an issue of the deepest importance: the safety, dignity and wellbeing of mothers, babies and families across our country. I acknowledge the concerns that have been raised following recent inspection reports into maternity services. Those reports highlight serious issues in some areas and, as we have heard, the Scottish Government takes the findings extremely seriously. Where any failings have been identified, immediate action has been demanded—and rightly so.
Safe, effective care depends on well-supported staff. That is why this Government has made record investments in our NHS, including funding specifically to increase the number of midwives across the country. The Government has also established a new maternity and neonatal oversight group to provide strategic leadership and accountability for those vital services. The group will ensure that every NHS board is supported and, where necessary, challenged to deliver the safest and most consistent standards of care.
Scotland benefits from a strong, independent inspection regime through Healthcare Improvement Scotland. The Scottish Government has commissioned HIS to develop new national maternity standards, which will be published early next year. Those standards will strengthen consistency and quality across Scotland, ensuring that, regardless of where they live, every woman and baby can expect to have the same high level of safe, person-centred care.
Some of my colleagues have already commented on the recent HIS report on NHS Lothian. The Government is deeply concerned by that report. I take this opportunity to raise concerns for expectant mothers in Lanarkshire that my constituents have brought to me. Like other Lanarkshire MSPs—those who have spoken today have mentioned it—I, too, have had meetings and contact with constituents and hospital staff in relation to the situation at Wishaw neonatal unit. That has included meetings with the minister. It is safe to say that people are generally not happy with the decision. That can be seen from the number of people who have signed the petition.
Opposition parties place a certain narrative on this issue, and the Government another. We have heard that play out today, so I will not go into it again. The Parliament has a responsibility to people. Although Opposition members have a duty to be responsible for what they say about the realignment of services in Lanarkshire and the safety of children, I also believe that the Government needs to be open to working with local communities and be willing to change its mind.
People in Lanarkshire feel that there is a downgrade. I know that the decision is clinically led—and the cabinet secretary made that point—but I do not think that we can tell people how they should feel or that their experiences and views are wrong. I am sure that no one has that intention, but it is what a lot of people believe has happened. It is incumbent on the Government to respond compassionately.
Will the member take an intervention?
I am not going to have time—apologies.
There needs to be more middle ground on the issue, with the Government and Opposition parties moving into positions where more agreement can be found. The issue is far too big for party politics. It is big for my constituents. I will leave my comments on that issue there.
I also want to raise the case of a constituent who I mentioned during the cabinet secretary’s statement last week. She contacted me about her experience of being pregnant, which culminated in a traumatic experience during childbirth and an exhausting fight to be heard. I should also say, for clarity, that the baby is now doing well. I have written to the cabinet secretary on that, and I know that a response is imminent, but I must put my constituent’s case on the record again, as it is imperative that all mothers feel that they are an integral part of their care and in decision-making processes when they are pregnant and giving birth.
Even one case like my constituent’s is one too many, but it is important to acknowledge the significant progress that has been made in Scotland during the past two decades. Rates of stillbirth, infant mortality and neonatal deaths have fallen markedly. Those improvements are the result of sustained investment, innovation and collaboration between clinicians, midwives and the Government.
I should also say, as I did last week in the chamber, that my family has had three fantastic experiences at Wishaw general’s maternity ward during the births of our three children. Each time, we have found the staff responsive, helpful and utterly professional. As Willie Rennie said, although we know that that experience is very much the norm, sometimes it is our job as MSPs to represent constituents who do not experience the norm. It is important that everyone gets the same service, and that when they do not—as in the case of my constituent—lessons are learned.
I hope that I have time to raise an issue involving another constituent who does so much for families across Lanarkshire and Scotland: Julie Morrison from the fabulous Baby Lost Retreat, who wrote to me this week asking for clarification on what regulation or oversight is currently in place for private clinics offering non-NHS pregnancy scans. I put that to the Government, and I thank the Minister for Public Health and Women’s Health for her response, which clarified that independent clinics where services are provided by a doctor, dentist, nurse, midwife or dental technician have to register with HIS, and that any clinics that are registered with HIS are inspected to ensure that they meet the rigorous standards that are expected of their NHS counterparts. I therefore urge anyone who might be considering opting for a scan outwith the NHS, for any reason, to select a provider that is regulated by HIS.
It will not surprise the Deputy Presiding Officer to hear that I had other things to say, but I am not going to have time, so I will conclude by saying that, although we recognise the progress that we have made, the dedication of our NHS staff and the decisive action that is already under way to make services even safer, we must also acknowledge the challenges that have been highlighted in recent reports and in the testimonies that have been shared today and ensure that constituents who come to us with concerns feel validated and heard and, most important, that lessons are learned and that our services continue to be among the best and safest in the world.
16:24
It is a fact that there are huge inequalities when it comes to women’s health. Today, we are considering the failings of one critical element in women’s health—the state of our maternity services in Scotland. The failings in our maternity services have not happened overnight. They are a symptom of years of mismanagement, neglect and lack of investment.
The NHS in Scotland has been under SNP management for circa 20 years, and it is a grim fact that maternity services continue to fail women and families across Scotland. Like many others, I believe that its plans to cut the number of neonatal intensive care units are dangerous. Women in rural areas are already forced to travel long distances to give birth, thanks to the downgrading of local maternity units across Scotland. Journeys that I have made on numerous occasions in my life before coming to Parliament—from Raigmore hospital to Caithness general hospital, or from Dr Gray’s hospital to Aberdeen royal infirmary—are challenging to drive at the best of times, never mind when an expectant father is driving his pregnant partner, with all the pressure that that entails, yet the SNP plans to cut the number of neonatal intensive care units from eight to three. Why three and not five? That would force families to travel to Glasgow, Edinburgh or Aberdeen in order to seek treatment for the most pre-term and most sick babies.
Sue Webber asked why three and not five units. That is because that was the direct recommendation of “The Best Start”, which recommended moving to three units within five years.
It was “three to five”, as in a dash—not the number two, but the letters T and O. You had the choice of three, four or five.
Ninewells hospital in Dundee, Princess royal maternity hospital in Glasgow, Wishaw general hospital in Wishaw, Victoria hospital in Kirkcaldy and Crosshouse hospital in Kilmarnock have all been downgraded under these plans. At least 22,100 people across Scotland have signed a petition to the Scottish Parliament protesting the plans, but the SNP does not listen.
I could continue to list SNP failures across the country, but I want to focus on NHS Lothian in my region. It has been well over a year since an employee at the Royal infirmary of Edinburgh blew the whistle about conditions in the maternity unit there, and nearly a year since the subsequent investigation revealed staff shortages and a toxic management culture. In August 2024, new mother Louise Williamson spoke out about her horrific labour, when she was repeatedly ignored. In December, NHS Lothian said that action had been taken.
The report that was uncovered by the BBC last December upheld, or partially upheld, 17 concerns about safety, and NHS Lothian claimed that work was under way to improve patient safety and the working environment and culture. On 20 June this year, I was among a group of MSPs and MPs who were told in a health authority briefing that the culture was being fixed. However, three days later, there was an unannounced inspection at the unit by HIS, which revealed how much work was still needed.
The depth of the problems that were revealed in the BBC investigation last year—mums and newborn babies coming to harm because of the poor culture and staffing situation in the unit—was such that an instantaneous reversal was improbable. However, the reality is that it has taken an unannounced inspection to confirm that nothing has changed. After many reassurances that the issues were in hand and would improve, I was shocked by the damning inspection into maternity services at the royal infirmary. We now know from the publication of the HIS report last week that it is still in the grip of a crisis. That does not fully explain the “Everything is in hand” message that I was given in June, nor does it give me any faith that the assurances that were given in the wake of the revelations can be trusted.
HIS’s unannounced inspection of the Royal infirmary of Edinburgh revealed a culture of mistrust and staffing shortages that led to delays in the induction of labour process of up to 29 hours. The inspectors also found frustration with staffing levels, which presented a safety risk. Staff were overwhelmed, unsupported and not listened to. There was a reluctance to submit incident reports, and staff described a culture of mistrust.
Following the HIS inspections report last week, I asked the Scottish Government about public confidence in NHS Lothian and delivering the needed changes, because women deserve to know that their maternity services are safe, but NHS Lothian told MSPs last week that those issues would take time to resolve. Do we have time for that?
Professor Hiscox said that 72 additional midwives will be working by the end of the year, with 30 in position to meet basic legal requirements. That is a staggering admission of previous failures, and it exposes how much inequality there is in women’s health provision, because it is hard to imagine any other service being allowed to deteriorate in that way. It should never have got to the situation where undercover investigations and inspections were needed.
The health secretary, Mr Gray, has rightly put NHS Lothian’s maternity services into special measures, and I thank him for that critical intervention. However, what confidence can we offer our constituents that they will see real, tangible changes and improvements in safety?
The BBC’s “Disclosure” programme was a heart-wrenching watch. One woman described how she was made to feel like a nuisance by the staff in her west coast maternity unit. Our maternity services must put families first and provide compassionate and empathetic care and support. They must have safe staffing levels, with staff being valued and given every opportunity to deliver the best care. After all, as I know, having worked in healthcare for nearly 30 years before I was in my current role, that is why midwives enter the profession.
16:30
I am speaking today on an issue that touches the very heart of family life and the values that we hold dear: the safety and quality of maternity services in Scotland. Like Clare Adamson, I have altered my speech notes extensively since the debate began.
The Healthcare Improvement Scotland inspection report into maternity services at the Royal infirmary of Edinburgh has—rightly—prompted serious reflection and urgent action. I, too, begin by acknowledging the experiences of families who bravely shared their stories, and I extend my deepest condolences to them all. Their courage in speaking out will help to drive the improvements that we all want to see.
The HIS report identified 26 areas requiring improvement, including delays of up to 29 hours for induction of labour, staffing shortages, a suboptimal skill mix and gaps in incident reporting. Inspectors also highlighted cultural issues such as staff feeling overwhelmed, unsupported and reluctant to escalate concerns. Those findings are concerning and cannot be ignored.
However, it is important to stress that those challenges, although serious, do not mean that our maternity services are unsafe overall; Scotland’s hospitals remain among the safest places to give birth. The health secretary made that clear in his ministerial statement last week, when he said that the commitment to continuous improvement is unwavering.
The Scottish Government has acted decisively. Following the HIS report, NHS Lothian’s maternity services have been escalated to level 3 of the NHS Scotland support and intervention framework, ensuring enhanced scrutiny and immediate support. That is not a token gesture—the framework is a robust mechanism that brings additional leadership, resources and accountability to drive rapid improvement.
A new Scottish maternity and neonatal task force has been established, chaired by the Minister for Public Health and Women’s Health. The task force will include voices from service users, front-line staff, independent bodies and third-sector organisations. Its remit is clear: to provide national oversight, share best practice and ensure that lessons are learned quickly across Scotland.
Leadership has been strengthened, with the appointment of a dedicated associate medical director for women’s services, and cultural improvement initiatives are under way. Those steps demonstrate that the Government is not waiting for change—it is driving the change.
Although issues are being addressed in Lothian, I must acknowledge the concerns that have been raised in Wigtownshire and Stranraer; I know that the ministers on the front bench will expect me to represent my constituents in that respect. Since the closure of the Clenoch birthing suite at Galloway community hospital in 2018, expectant mothers have faced journeys of up to 70 miles along the A75 to Dumfries and Galloway royal infirmary.
Safety is my primary concern in all this, and choice is also a crucial part of the person-centred approach. I remind members that I was a clinical nurse educator prior to coming to the Parliament. As a perioperative nurse, part of my educational role was to teach midwives and junior doctors how to provide safe care during caesarean sections, including urgent and crash C-sections.
Will the member take an intervention?
I will, if the member is really quick, because time is tight.
I thank Emma Harper, who knows that I always value her professional background. One focus of the task force is on leadership and mentoring and how investment needs to go into that. Would she support that?
I would absolutely support developing leaders and mentors in everything. My 30 years as a nurse was spent mentoring, guiding and teaching people in trauma surgery and trauma-type situations, which are very stressful.
Following the 70-mile journey to Dumfries, some women were told that they had shown up too early and were sent home again. As an MSP, I have called on NHS Dumfries and Galloway to provide holding accommodation while labour progresses, but I cannot see that that is happening at all. I do not think that we should be sending people home when they are in the early stages of labour if their home is 72 miles away.
Women have been having babies in lay-bys and in ambulances because they could not reach the hospital in time. As I said, safety and choice are my primary concerns. Women have described their experience as frightening, exhausting and traumatising, with some even reconsidering pregnancy because of the lack of local birthing provision.
I know that a wide range of perinatal services are provided in Stranraer, but birthing is not taking place there. An independent review recommended having a midwife-led birthing service for low-risk births in Stranraer. Last year 1,054 babies were born in Dumfries and Galloway, and 20 per cent of those births were considered low risk, which means that last year 210 births in Dumfries and Galloway were low risk. Obviously, there are challenges in our rural areas.
I am appealing to the minister in this: I support any progress to help to improve perinatal care and to provide confidence to expectant mums and their families in the west of the south-west region. I know that the Scottish Government has been working on maternity safety for years. The best start five-year plan sets out a vision for maternity and neonatal care that focuses on continuity, safety and family-centred support. More recently, the Government introduced new clinical guidance, a miscarriage framework and an action plan to tackle racialised health inequalities in maternity care, which others have mentioned. Those initiatives reflect a proactive, systemic approach, rather than a reactive one.
It is not just about fixing problems; it is about building a culture of trust, learning and continuous improvement. We owe that to the families who have shared their stories, the staff who care for us and every child who is born in Scotland.
16:36
My constituents in Dundee and the surrounding areas are deeply concerned by the proposal to downgrade the neonatal ICU at Ninewells hospital, which is what the SNP Government is trying to do. I wrote to the Minister for Public Health and Women’s Health about the issue, and I am afraid that the response was an exercise in hiding behind pedantry and semantics when the Government should be levelling with the public. It is a downgrade, and the Government should be fully honest about that. Babies who are born before they are 28 weeks old will not be cared for in Dundee. The idea that the vital service will continue in my community is simply untrue. If the plans go ahead, there will no longer be a neonatal intensive care unit at Ninewells. The facility would be downgraded to a local neonatal unit and the most premature and sickest babies would be treated in Glasgow, Edinburgh and Aberdeen. Those are the facts.
In recent weeks, there has been an outpouring of stories locally, with many of my constituents sharing how the Ninewells neonatal ICU cared for their baby and their family at the most difficult moments of their lives. My constituent Zoe’s son, Archie, was born at 27 weeks and four days, and spent months in Ninewells. She says:
“Without the specialist neonatal care he received, my son would not be here today.”
On the prospect of downgrading Ninewells neonatal ICU, Zoe said:
“It will break families. It will cost lives. It will deepen inequality, especially for those who cannot afford travel or accommodation to be near their baby. Cutting NICU services is not a ‘restructuring’. It is a direct threat to vulnerable babies and their families.”
Zoe is among the 22,108 people who have signed a petition against the downgrading; so is another constituent, Nicola, who paid tribute to the skilled and dedicated team at Ninewells by saying:
“They picked me up and put me back together again to be a good mum for Leo ... They are on top of their game in intensive care for neonates. We don’t want to lose that level of care, skills or staff.”
She went on to say:
“Travelling to another city in an ambulance (if there is one available) for what could be weeks and months in parent accommodation (if there are any rooms) is isolating and expensive. It would be a great shame to put families through this when facilities and trained staff are already in place in Dundee.”
I genuinely fear for the pipeline of future staff—the next generation of nurses and doctors who are training in Dundee, who will miss out on key elements of the training on the most acute emergency cases. Our partnership between the University of Dundee and Ninewells hospital has delivered exemplary training to thousands of doctors and nurses in our city for decades, but without a key element of their training being available in the city of Dundee, can we have confidence that we will deliver the future scale of specialism and expertise that our country needs? Perhaps the minister could address some of those issues in her closing remarks.
The SNP Government says that the issue affects only a small number of babies. However, do those babies—kids like Archie and Leo—not matter? Do the families in Dundee not deserve the same access to care that Zoe and Nicola received?
Ministers say that women can be transferred in advance to neonatal ICUs in Aberdeen, Edinburgh and Glasgow, but they must know that premature births can happen at any time and often occur unexpectedly. A pregnant woman in Dundee would be many miles from the neonatal ICU in another city when she went into labour.
The downgrading of Ninewells neonatal ICU is also part of a trend of maternity services being downgraded and closed in the region. In Angus, there was the loss of the Montrose community midwifery unit in 2016 and, before that, the scrapping of the plan for a replacement Montrose unit for north Angus in 2013. This Government’s pursuit of ever more centralised services is, frankly, dangerous for mothers and babies.
All of that comes on the heels of the deeply concerning inspection report into maternity services at Ninewells that I raised with the First Minister in the chamber on 15 May this year. The report contained worrying details of delays to triage, variation in how women were assessed and delays to the induction of labour of up to 72 hours. It also revealed that staff were unsure of the location of the emergency medication for birthing and the process for accessing it; that equipment was missing leads, meaning that only three of five fetal heartbeat monitors were in full working order; and that hard-working staff were under pressure due to their workload and high levels of sick leave.
It is vital that we rebuild public confidence in the service, so Labour’s call for a national investigation into maternity and neonatal services across Scotland could not be more important. The Government should not hide behind its task force. It is abundantly clear that real change is needed, and it must grip that challenge today.
The director for Scotland of the Royal College of Midwives has stated:
“The RCM has been raising the exact same concerns that the inspections have found with the Scottish Government, and with individual Health Boards, for years. We have urged this Cabinet Secretary and his predecessors to get ahead of the curve and implement the changes we know ... need to happen.”
This knackered SNP Government always seems to be behind the curve. It has broken our national health service and put mothers’ and babies’ lives at risk. We need the report that has been called for, and we need to make sure that there is an investigation—it needs to happen now.
16:42
I want to start by acknowledging everyone who has been let down by our maternity or neonatal services. Those families have suffered greatly, and every death or injury is an absolute tragedy. That any concern that is raised is not acted upon is simply not good enough. People who live with such experiences deserve to be heard, believed and shown what is changing because they made the effort to speak up.
The Scottish Government has been clear that it will ensure that it learns from every case in order to improve care and strengthen patient safety. I am glad to hear that, but parents and families need to feel that and see it in action, not just hear it in words spoken in the chamber today.
I come to this debate with a little bit of my own experience. I have had six babies, and I was lucky enough to be at the birth of my first grandchild. I have seen the difference that good care makes, but I have also seen poor care—I have seen poor practice that leaves a lasting mark. I understand the difference that it makes when people are listened to, when plans are explained and when people are treated as partners in decisions. That should be the baseline everywhere and every time.
In recent weeks, following the difficult coverage that we have seen, families have contacted us. They want straight answers, but they also want visible action. We should be honest about where culture has fallen short, and we should also be clear about the work that is already under way. Independent, unannounced inspections by Healthcare Improvement Scotland are finding issues on the ground, but they are also driving immediate improvements.
That is scrutiny doing exactly what it should. However, it builds trust only if boards act quickly and report openly so that families can see that change. National standards for maternity care have been commissioned to make expectations clear for everyone, and ministers have said that inspection findings will be acted on decisively. Delivering clear standards, honest inspection and rapid local action—that is how we build confidence.
Feeling safe is not only about what happens when something goes wrong but about the care that people receive every day. I am glad that the Scottish patient safety programme’s perinatal improvement programme and the best start supporting boards are there to improve day-to-day practice by achieving better handovers, clearer communication and stronger teamwork, particularly in emergencies. That is how care becomes more personal and more reliable, and not just the subject of a postcode lottery.
Continuity matters, too. Women should have a named midwife and a small team that they see regularly, without being passed from pillar to post, because experiencing such an approach lowers stress and improves outcomes. I have believed that for many years, and—perhaps I should declare an interest here—when I was expecting my fifth child I signed a petition in favour of such an approach, because I knew how important continuity was through my lived experience. I still believe that now. Let us make continuity real for the women who need it the most—in particular, for those who have high-risk pregnancies, as I did—and then build it across the service so that it is the norm and not an exception.
When something goes wrong, families should get a plain-language explanation and be able to see what has changed as a result. Staff should be supported to speak up and be heard, and boards must act immediately when concerns are identified. Families should be able to see that action and not have to chase it.
We should also keep sight of progress. Over the past two decades, Scotland has reduced infant mortality, neonatal deaths and stillbirths, through the support achieved by having more midwives and consultants. That does matter, but progress never represents a finish line—it creates a responsibility to keep moving. When inspection flags risks, action must be quick and visible. When the culture falls short, leadership must step in. When families ask for clarity, they should not be met with jargon. When improvement is working, we should scale it and sustain it. A new early pregnancy, maternity and neonatal oversight group will keep an eye on delivery of those aims, but what matters most is that families feel the difference when such care is given.
Birth trauma needs plain speaking. If someone was ever dismissed, not believed or left without answers, that should matter. People should not be regarded as making a fuss if they still feel an aftershock months or even years after their experience. Services must be trauma informed and include postnatal debriefs that answer questions, easy routes into perinatal mental health support and care that recognises how poverty, disability, rurality and language can compound risk and fear. Equity should not be simply part of a slogan—it must be a part of safety.
We must keep the focus on what happens to women in the room, in that moment. It is important to listen early, act quickly and be clear, to provide real continuity and to keep instructions sharp and updates plain so that families can see progress without having to fight for it. That would set us up in those early days for achieving a society that is truly founded on wellbeing.
I will finish simply: this is about creating trust and providing care that people can rely on. If we hold to those basics, we will not just talk about having safer, kinder and more consistent care but deliver it—excuse the pun—for every family in Scotland, as we absolutely should.
We move to closing speeches. I call Alex Cole-Hamilton to close the debate on behalf of the Scottish Liberal Democrats.
16:48
I am very grateful to the Labour Party for giving its time to this important debate this afternoon. I rise in support of the amendment in the name of Willie Rennie. It speaks to one of the most geographically punishing health inequalities in the British Isles.
The maternity services at Caithness general hospital were downgraded in 2016—the year that I, and many others, entered the Parliament for the first time. That decision has forced pregnant mums, who are sometimes in active labour, down the arduous and treacherous stretch of the A9—the 100 miles that it takes them to get to Raigmore—sometimes through the snow or the dark, and sometimes dealing with deer on the road and attendant concerns about vehicular crashes. Every day, from that day to this day, my party has stood with community campaigners—in particular, the Caithness Health Action Team—in support of restoring those services.
That decision to downgrade denies expectant mums fast access to obstetric expertise and care in the event of rare or serious issues. It demands arduous travel and delay, heightening risk and stress on what is perhaps the most vulnerable day in that person’s life. It is a situation that has commanded the attention of the United Nations, which regards the situation as an abject failure of the right to health for mums in rural parts of the country.
That denial of human rights is measured in near misses and negative health outcomes. We have heard from Jackie Baillie and Rhoda Grant about the split-site twins who were born at either end of the northernmost leg of the A9. There was also a newborn who suffered brain damage in October 2022 as a direct result of the three-hour journey that it took to get the mum to Raigmore. That is a concrete example of an adverse neonatal outcome if ever there was one.
What the Liberal Democrats have put in their amendment is extremely valuable, which is why the Conservatives support it. Is there also a need to look at Scotland’s neonatal transport service? It has three bases across the country, but the one that covers the north, including Caithness, might have its response team situated in Shetland or Tayside when it is needed in Moray or Caithness.
We need to consider provision for expectant mums in the round, so I welcome Douglas Ross’s intervention.
There is also the case of Shelley Mowat, who in 2018 developed a potentially life-threatening blood clot as a result of the protracted journey that she faced to get to Raigmore. In her remarks, Jackie Baillie was right to touch on the many mums who, when they have completed that arduous journey, are turned away at the doors of Raigmore because of staffing and capacity pressures at the hospital. That sometimes increases their journey time to up to 12 hours, which comes with excessive waits and complications.
All that Willie Rennie’s amendment asks for is that mums in the far north be offered the same consideration that was offered to those in Moray who, following an independent review of the kind that we are calling for, have now seen their access to a full spectrum of maternity services begin to return at Dr Gray’s hospital.
Today, we are witnessing a welcome departure from the refusal and denial that traditionally come from SNP ministers. I welcome that. It has been a long time coming—nearly a decade. By agreeing to our amendment—as I am so glad that the cabinet secretary has signalled the Government will do—he will hand a victory not to the Scottish Liberal Democrats but to the campaigners, the patients, the mums and the midwives in the far north who have been crying out for an independent review for many years. I hope that, as the Government concludes the debate tonight, it will give us some detail on that review. It is clear that the Parliament will, by a majority, vote for our amendment. By so doing, it will instruct and commission an independent review into maternity services in the far north.
I have never accepted that this issue presents a binary equation of either leaving mums unsafe in the far north or forcing them to come to Raigmore. There have been many examples of effective models that work in other remote and rural parts of the country, such as in Orkney or other parts of the Highlands and Islands.
In agreeing to the amendment, the Parliament will have a responsibility to hold the Government’s feet to the fire. If we agree—as it seems we will do—to commission that independent review, that cannot be the last that we hear of it. The Government must, in short order, explain to the Parliament when the review will be commissioned, when it expects it to report, and how and by what means the campaigners and the communities of the far north can feed into it. It should be the case that only those with lived experience can feed into it—the lived experience of the mums who, right now, might be travelling that treacherous 100-mile journey that takes more than two hours to cover, as they do battle with sightseers on the north coast 500 on the most important day of their lives. We should not expect them to face such a journey, which they sometimes do alone.
I am grateful to the Government for supporting our amendment. It is a victory for the campaigners in the far north. It has been a long time coming—it has been far too long coming.
16:54
In closing for my party, I begin where I started with my opening speech and recognise the tone that many members have struck in taking part in this debate. Jackie Baillie might forgive me if I say that, on another day and on another topic, she is capable of party political point scoring as much as anybody is, but she clearly recognised that that was not the way to take forward today’s debate. A number of members have taken that approach. In fact, both Jackie Baillie and Neil Gray recognised the profound human impact on families who have been failed and our shared responsibility to them.
As well as reflecting on issues in the inspection reports, the BBC documentary and their own case loads, members across the chamber have spoken up on behalf of people they have met, as well as reflecting on their personal experience and offering views on the overall provision of service in different parts of the country.
It is important and legitimate to reflect the fact that members can disagree in good faith on some of the delivery questions about the nature and design of services, and that they have a responsibility to speak up for their constituents, but a debate such as this one should not be about assigning blame. It should be about seeking to restore trust with those families and NHS staff who feel that they have been failed.
A number of members spoke with professional expertise, as well as with deep compassion and personal experience. There are too many to mention, but I pick out Clare Haughey’s speech, which brought together those different elements. It is significant that we have someone chairing the Health, Social Care and Sport Committee who is able to do that.
That kind of content and contribution should have characterised the whole debate. Those listening will have heard serious, thoughtful and informed debate, but they will also have heard a fair amount of political accusation and counter-accusation. I do not imagine that that is what they wanted to hear when they started listening.
Staff, patients, inspection reports and documentaries have all brought to us the severe challenges that are felt throughout the system, as well as the many cases in which there have been unacceptable failings and the human impact on people in those situations. Our job—that of the Parliament and the Government—is to decide what to do about it.
I have heard a very clear demand from across the chamber for a national investigation. I have not heard any reason to reject that on principle. I see a case for allowing clinical expertise to shape that national investigation and to define its scope and timing. I am willing to allow the Government to go through that process if it can give us an assurance. The minister will be chairing the task force, so it is not simply a question of waiting for the task force to form a view. She will have a view in shaping the approach of the task force in the way that she leads it.
I would like to hear from the minister in her closing speech a clear sense from the Government that it intends to use its leadership of the task force to ensure that the question of a national investigation, which is sought by members across the chamber, involves what the investigation will be and how it will be carried out, and not whether it will take place. I did not hear that confirmation in the opening speeches; I hope to hear it in the minister’s closing speech.
Presiding Officer, I will return the remainder of my time to you.
Thank you, Mr Harvie.
16:58
I hate to disagree so openly with Patrick Harvie, but this is a Parliament and there is such a thing as political accountability. The situations that we are discussing lead on inexorably from political decisions and priorities. For us to ignore that and somehow seek to deconstruct the issue and hide behind fake unanimity in the chamber about where culpability lies would not be honest of many of us.
At the end of the day, I appeal to Patrick Harvie on the issue of the national investigation. We cannot divorce culture from any operation, whether we are talking about the design and delivery of maternity services or any other subject. When it comes to the execution and delivery of anything, culture is at the very heart of whether it succeeds. So much of what we have said in the debate this afternoon comes down to an issue of culture and what impact that has on the way that services are being delivered.
It sounds as though Stephen Kerr thinks that I have just argued against a national investigation. I have argued very clearly in favour of one and I want the Government to say that it is in favour of one as well. That is the commitment that I want to hear, and I will hold the Government to account as much as anybody else in the chamber if it makes that commitment.
I respect what Patrick Harvie has just said.
Will Stephen Kerr take a brief intervention?
I will—a brief one.
Will Stephen Kerr acknowledge that the Government’s amendment uses the word “if” and does not say that an investigation will take place?
It is now impossible for the minister to change the wording of the Government amendment. I therefore appeal to Patrick Harvie to join others in the chamber who, rightly, are going to demand a national investigation into maternity services in Scotland. I hope that he will consider the importance of that to so many people, including people who are present in the public gallery.
I thank everyone who has spoken in the debate, but I will specifically mention something that Willie Rennie said. Rightly, he mentioned a duty of candour. On a related matter, I wrote to the First Minister yesterday about the Public Office (Accountability) Bill—the Hillsborough law—which will enshrine the duty of candour in law. I am asking the Scottish Government to lodge a legislative consent motion so that all the provisions of that bill will apply to Scotland, including the right to legal representation and legal aid for families who are impacted by service failure.
I think that we all know why that bill is called the Hillsborough law. It was introduced in the House of Commons in September. It seeks to establish a statutory duty of candour and it is also about guaranteed parity of arms when it comes to legal representation, as I have said. It has real implications for everything that we are talking about here and now. It is about not just a legal change but a culture change in our public services that affirms truth telling, transparency and responsibility, with an expectation on those who hold public office to adhere to the Nolan principles not just as a concept but in practice.
Willie Rennie mentioned how important it is that someone from outside the system is involved in the national investigation. Some of the things that we have been talking about today are, by definition, systemic. To understand the system, a person sometimes has to step well outside it. Someone who does not, if I may coin a phrase, have a dog in the fight has to look at the matter fairly and squarely without prejudice or bias. I hope that, when we get the national investigation—given that I hope that we will vote for it this evening—its leadership will have an “outside the system” element.
On Michael Marra’s comment about Ninewells hospital, let us not lose sight of the fact that, after HIS did its initial investigation and published its report, it went back to Ninewells and discovered that not much had been done—not much progress had been made. That is the issue that demands a national investigation. That is why we have to talk about the culture as a whole and it is why, this evening, the Parliament must instruct the Government to get on with the delivery of that national investigation.
Nothing goes to the heart of our conscience as parliamentarians—or even as Scots, if I may put it as broadly as that—more than the safety of mothers and babies. What we have heard today and what we have read in recent weeks and months—the reports and documentation that have accompanied the work that has been done in Edinburgh and at Ninewells—is indefensible. In Edinburgh—
Mr Kerr, please bring your remarks to a close. You are over your time.
Let me conclude by saying again that I urge everyone, as parliamentarians with a duty to their constituents, to support the motion as it will be amended. Let us act and not posture. Let us make things better. Let us not hide behind the inconvenient myths that we sometimes tell ourselves.
Thank you, Mr Kerr.
Let the safety of women and babies in Scotland be something—
Thank you, Mr Kerr.
—that does not wait another day.
17:05
I, too, thank Jackie Baillie for bringing the debate to the chamber, and I am hugely grateful for the thoughtful and heartfelt contributions from members across the chamber. This subject goes above party politics.
Please allow me to echo the cabinet secretary’s opening remarks. I do not underestimate how difficult today’s debate will have been for the families in attendance who have been affected by the issues. I thank them, too, for so powerfully sharing their experiences in the “Disclosure” documentary in order to enable change. I extend my deepest condolences to you personally and to anyone affected by those issues.
There is no doubt that we all agree that delivering safe, high-quality maternity care for all mothers, babies and families in Scotland must be a priority.
Will the member give way?
I want to make some progress.
I reiterate the assurance that we gave to women and families last week that maternity and neonatal services are safe. As others have noted, the vast majority of the women and their families have very good experiences of their maternity care and have high praise for the caring, compassionate and professional staff and those who look after them.
Over the past two years, I have had the privilege of visiting maternity and neonatal services across Scotland, from some of our largest units to our smallest, and of meeting the staff, service users and service leaders. I have seen at first hand the tremendous work that is delivered by our maternity and neonatal service staff. However, there is room for improvement—there always will be.
Our approach to maternity and neonatal services is firmly grounded in evidence. Together with the other UK nations, we commissioned the national maternity and neonatal audit programmes and the MBRRACE-UK—mothers and babies: reducing risk through audits and confidential enquiries across the UK—confidential inquiries, which have given us rich data about our services and have allowed us to benchmark.
The minister rightly paid tribute to those who are in the public gallery today, but they have made it pretty clear that they want a national investigation. In an interesting contribution, Patrick Harvie said that, although he is prepared to accept the process, he thinks that it should be a matter of when, rather than if, we have a national investigation. Will the minister agree to a national investigation now?
We have to be clear that the reports that we rely on illustrate the growing complexities around birth and the changing demographics across the UK, which means that it is more important than ever to ensure that all the women receive care and support that is tailored to their changing needs and that our services adapt and evolve to meet them.
I want to say a little more about the Scottish maternity—
Will the member take an intervention?
I would like to continue.
I want to say a little more about the Scottish maternity and neonatal task force, which I will chair. As the cabinet secretary identified last week, it will provide strategic national leadership and will include senior figures from across our health system and independent bodies, as well as third sector and advocacy organisations. I have also made it clear that I want the voices of women and families—as well as those of front-line midwives, nurses and doctors—and their experiences of maternity services to be heard by the task force. Their voices will be at the heart of the group.
I thank Patrick Harvie for his speech. He was correct in suggesting that the work that is being progressed by Healthcare Improvement Scotland in its inspections and by the task force are first steps. I also agree with Stephen Kerr that culture is at the centre of how any organisation operates.
Mr Harvie asked specifically how the Government will ensure that a national review is not only about the design and delivery of services but also about the wider issues that have been raised. I listened carefully to his points about important issues such as culture, staffing and the need to ensure that the scoping of what is part of a national review is designed by experts. I can confirm to him and others on the record that, as chair of the new task force, I will seek to define—from the task force—how an investigation can take place.
My view is that the findings of the HIS inspections of all maternity units must form part of the task force’s consideration. For example, we know that the inspections will bring to light similar emerging themes across Scotland, so it would be right for the task force to consider what should be the specific focus of a national investigation. Mr Harvie and others have my assurance that I will take that work forward, and I will be happy to update the Parliament on the specific work of the task force as it progresses.
As the cabinet secretary’s amendment makes clear, no neonatal intensive care units are closing. All local neonatal units in Scotland will continue to offer neonatal intensive care for their populations.
Will the minister take an intervention?
I have only one minute left.
The new model of neonatal intensive care was recommended by the “Best Start” report in 2017, and the impact that that will have on babies is clear, as members have said in their contributions. The 2017 report says that
“three to five neonatal intensive care units should be the immediate model for Scotland, progressing to three units within five years.”
As our amendment notes, Bliss, the UK’s leading charity for supporting families with premature or sick babies, has reassured families that the model in Scotland is the safest and best possible one for sick babies. It is also important to recognise that, as soon as babies are well enough, they will be repatriated to their local neonatal unit. I know that there is no place for complacency when it comes to the care of women and babies in our maternity services.
Minister, you need to bring your remarks to a close.
The Scottish Government is committed to timely and continuous improvement. We will hold boards to account to ensure that every woman, baby and family across Scotland receives the high-quality care that they deserve.
17:11
I offer my deepest condolences to all those affected by what we have heard about today. I commend the families who have bravely shared their stories and have spoken out about their experiences, and I thank them for sitting with us in the public gallery today. I also thank the families who are watching the debate at home. I understand that speaking about this will not have been easy, and I offer my personal thanks to them all for telling their stories. We have heard their call for a national investigation, and I hope that the Government has, too.
Jackie Baillie and Willie Rennie have shown that this is not an either/or situation. The cabinet secretary can support our motion, so I ask the minister to come back to me, through an intervention, with an answer to this question. Is your position that there will be an investigation, or is your position, as your amendment suggests, that it is a case of “if” there is an investigation? I would be happy to take an intervention.
I have been clear in what I have said. Through the task force, we will work towards how we start to look at an investigation.
I remind members of the requirement to speak through the chair at all times.
I do not think that what the minister has said is clear.
I hope that Patrick Harvie has listened hard to what has been said, because we thought deeply about what to ask for. We understand what has been said about the task force, but it has not been implemented. We understand that the task force will be headed by the minister, but how can we be sure about what will happen?
Once again, I pay tribute to Labour for lodging its motion and making the argument for a national investigation. However, in the minister’s closing speech, we have heard a clear statement that this is now only a matter of framing the investigation and of how it will be taken forward, not whether it will be taken forward. [Interruption.]
Let us hear one another.
It would feel inappropriate if the Parliament as a whole was not willing to take yes for an answer.
I hope that Patrick Harvie will vote for our motion, which is absolutely clear about what the Parliament is looking to deliver today. Any loss or harm in maternity and neonatal services is tragic, especially when deaths could have been prevented. As others have said, such incidents are rare and the majority of the women have a safe and good experience when giving birth, but that does not diminish the experience of those who do not.
I thank my friend for giving way. We met earlier with my constituents, the Keegan family, who lost their baby, Mason, to sepsis at just three days old. That was entirely avoidable. The significant adverse event review in NHS Greater Glasgow and Clyde recommended measures that needed to be implemented, but the family does not have confidence that they have been. We do not need to wait for a task force to tell us what we already know. It is the minister’s job to ensure that the implementation is done. Does Carol Mochan agree that the minister should get on and do that now?
I fully agree, and Paul Sweeney will agree with me that we must have a culture of transparency, not secrecy. That comes from the top. Agreeing to our motion would show clear leadership from the top of the Scottish Government.
Will the member take an intervention?
If it is short.
It will be. I have the “Best Start” report in my hands, and I will quote from section 6.4 of the report, which is entitled “Proposed levels of neonatal care in Scotland”:
“It is proposed that the current total number of 15 neonatal units is retained, with three to five units being re-profiled as neonatal intensive care units and the remaining 10-12 units being designated as local neonatal units or special care units.”
I question why the minimum of three units was chosen rather than five. Does Carol Mochan agree that that is unacceptable? [Interruption.]
Let us hear one another.
I know that many members were shocked to read the findings of last week’s Healthcare Improvement Scotland report, on which many contributions to today’s debate concentrated. It revealed major concerns around culture, oversight of patient safety, and staff wellbeing. Staff reported feelings of frustration, burnout and being ignored. The culture of mistrust that has developed should never be allowed in our NHS. Staff should feel supported, appreciated and listened to, and they should never—ever—feel that they cannot escalate concerns. The duty of candour must be real, and the Government must show leadership in that area.
We have heard about the challenges of maternity services—in the interests of time, I will not go over them again. However, in my South Scotland patch, challenges in the Wigtownshire area are beyond what women should have to accept. The Galloway community hospital action group, some of whom are listening to the debate today, have fought a powerful campaign against the closure of the maternity unit in Stranraer. That closure means that people have to travel 70 miles to Dumfries, and I have heard from a constituent that the road was flooded and therefore closed today. That causes extra strain and stress to mothers and families in the area. The Patient Safety Commissioner for Scotland met the group only a couple of months ago and felt that there was a gap in the service. That is not what 21st century midwifery care should look like.
The Scottish Government has failed to provide adequate oversight for the decision in Wigtownshire. It must look at how it interacts with the integration joint board, and it must listen to the community. Much of what has happened there is due to the Scottish Government’s inability to workforce plan effectively, which has left mothers and babies in Stranraer without a maternity unit.
Before I close today’s debate, I will take a moment to reflect on some of the calls from the Royal College of Midwives. In response to the Healthcare Improvement Scotland report, the RCM warned that
“staff shortages, rising workloads, and a lack of specialist and educator roles in maternity services are placing unsustainable pressure on staff and risking the long-term quality of care.”
As other members, including my colleague Michael Marra, have said, the RCM has been urging the Scottish Government to make changes—it has been raising the issue with the Government for years. Systemic challenges are letting down women, their families and the maternity staff. Many midwives feel that they are at breaking point, and the union is strongly urging the Government to invest in its maternity staff. The task force recommendations need to be implemented, and some investment needs to be put behind that. I urge the Scottish Government to listen to that.
Our calls today are clear. For the staff, improvements to workforce planning are desperately needed, to ensure that the maternity wards are sufficiently staffed. We need investment in leadership and in mentorship within midwifery. Many of the solutions already lie with the nursing and midwifery task force, and we support the task force. We want the solutions to be delivered, but that does not need to be done by the task force alone.
For the mothers, the babies and their families, a national investigation is required into the design and delivery of maternity and neonatal services across Scotland. It is clear that members must vote for the Scottish Labour motion tonight if we are to protect mothers, babies and families in Scotland.
Again, I offer my deepest condolences and gratitude to those who have shared their stories and experiences. Without you, change cannot happen. We want change to happen, and it is now over to the Scottish Government.
That concludes the debate on Scotland’s maternity services.
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