I have made it clear that the decision was based on clinical evidence from clinical experts. We need to take account of that evidence.

Babies who are born at highest risk are defined as those who are born at fewer than 27 weeks’ gestation, weigh less than 800g or need multiple complex intensive care interventions or surgery. It should be understood that no neonatal units will close, and that local neonatal units will continue to provide a level of neonatal intensive care for sick babies in their areas. However, the most preterm and sickest babies will receive their specialist complex care in one of our specialist NICUs and will—which is important—return to their local area as soon as is clinically appropriate.

The process of determining which units should provide neonatal intensive care followed an options appraisal that was undertaken by an expert group, including clinical leads and service-user representatives. That model is supported by a range of stakeholders and clinicians, including Bliss, which is the leading charity for babies who are born premature or sick. It recognises that the new model of care is based on strong evidence and will improve the safety of services for the smallest and sickest babies.

I will not take an intervention; I would like to make some progress, thank you.

In reference to the petition that has been highlighted today, I appreciate that local people will have concerns about the announced changes. I would like to clarify that those changes will affect a small number of families in Lanarkshire. I appreciate that, for any family affected, that is probably difficult to cope with.

I will also highlight a range of other features of the new model of neonatal care that was outlined in “Best Start”. The new model of care positions parents firmly as partners in their baby’s care. It includes expansion of transitional care, which will allow for mothers and babies who need some additional neonatal support to stay together in a postnatal ward, improved facilities and support for parents, and expanded neonatal community care, which will allow babies to get home sooner.

Members will be aware that we have begun to address the financial concerns of parents with babies who are in neonatal care through expansion of the neonatal expenses fund, which is now known as the young patients family fund. The fund continues to support many parents with the cost of travel, meals and accommodation while they are partners in the care of their babies. I say to Meghan Gallacher that £8.50 is for meals—all travel is compensated in full.

We are rolling out transitional care across Scotland, with all units being on track to have that in place next year. In addition, all our units are working towards implementation of the Bliss baby charter, with almost all units at silver or bronze level, two units having achieved gold standard and four more golds expected this year.

I thank all the members who have taken part in the debate. I appreciate that some of the contributions will have been emotional and difficult, but I very much appreciate that honesty.

I need to set out that the Government has acted based on expert clinical advice on where the smallest and sickest babies will get the best treatment and will, therefore, have better chances of survival. As I have outlined, the evidence is clear that the chances of survival are better for the highest-risk babies when they are cared for by clinicians who see more of those babies and when they have closer access to specialist support services.

Maintaining high standards of neonatal care is an on-going challenge.

I would like to make some progress, thank you.

Stranraer was mentioned by Finlay Carson and Emma Harper. The midwife service there was temporarily withdrawn because of staffing. As has been pointed out, there has been a review by NHS Ayrshire and Arran, and the IJB will be considering the issue, I believe, at the meeting at the end of September.

I thank all the members who have taken part in the debate.

The new model of neonatal intensive care recommended by “The Best Start” outlined that Scotland should move from the current model of eight neonatal intensive care units to a model of three units supported by the continuation of current NICUs redesignated as local neonatal units. The evidence is clear that the highest-risk babies are more likely to survive when they are cared for in units by clinicians who see more such babies and with access to specialist support services.

“The Best Start” report was underpinned by evidence. Eight evidence reviews are detailed in the report, which was led by Professor Mary Renfrew of the University of Dundee. The evidence is clear and is set out in the report.

I will continue.

The Lanarkshire petition has been highlighted today, and I appreciate that local people will have concerns about the announced changes. I would like to clarify again that the changes will affect a small number of families in Lanarkshire. For families who have the very smallest and sickest babies, I would like to reassure them that the change is based on evidence and will improve those babies’ chances of survival and give them better life chances. I know that parents would want to act on that evidence.

There has been a lot of discussion about the young patients family fund and the important support that that gives to families to ensure that they can spend the right time with their parents. It provides assistance with travel, subsistence and overnight accommodation.

The perinatal sub-group of the best start implementation programme’s options appraisal report was also raised in the debate. Skills maintenance is a key concern for the units that are no longer categorised as NICUs. Small and sick babies will continue to be delivered unexpectedly outwith NICUs, and some babies in local neonatal units and special care units will deteriorate in smaller units and will need stabilisation and transfer, so those skills need to be maintained.

All local neonatal units will continue to deliver intensive care and care for babies who are born from 27 weeks and who need stabilisation and treatment, so nursing and medical staff will continue to have experience in delivering those aspects of intensive care. The Scottish Government will work with the Scottish Perinatal Network and NHS Education for Scotland to take forward a number of actions to ensure that appropriate learning and development opportunities are available for staff who are impacted by the changes. Modelling work is currently being commissioned by the Scottish Government to inform capacity requirements. That work is expected to conclude by the end of this year.

In the meantime, discussions are under way in the regional forum to prepare and plan for the changes, which will be further informed by the modelling. As I said in my opening speech, there will be focus groups in NHS Lanarkshire. In addition, we will continue to provide funding to health boards to help them to transition to the new model.

I thank everyone who has taken the time to speak with us to inform our picture of what more needs to be done to reassure parents and staff in our neonatal community. I thank all those who have worked with us to look at how we can best deliver the changes that are recommended by the best start report. Their experience has been invaluable in informing our approach to date. It will continue to be invaluable as we take forward our work, through ensuring that the Government does as much as we possibly can to increase the chances of survival of these very special babies.

I have a lot to get through, if the member does not mind.

The process of determining which units should be providing neonatal intensive care followed an options appraisal process that was undertaken by an expert group that included clinical leads and service user representatives. In NHS Lanarkshire, those representatives included the best start perinatal sub-group.

I am not going to take any interventions.

Like Jackie Baillie, I welcome the opportunity to congratulate Wishaw General’s neonatal multidisciplinary team on being named the UK neonatal team of the year in 2023. The work that the unit does is remarkable, and hearing the words of parents who have written to me confirms that the care that it is providing is inspirational.

The “Best Start” document recommended that the new model of neonatal care should be based on the British Association of Perinatal Medicine definitions of levels of care. That moves us away from the previous descriptions of units as level 1, 2 or 3, and it describes units as neonatal intensive care units, local neonatal units and special care baby units.

I would like to reassure everyone that, under the new model, the scope of the practice that the local neonatal unit will be able to undertake is wider than the previous level 2 definition. The units will continue to provide a level of intensive care and will be able to care for babies born at greater than 27 weeks’ gestation.

The intention with the new model of care is that mothers in suspected extreme pre-term labour will be transferred, before they give birth, to maternity units in the hospitals that have neonatal intensive care units, allowing them to be cared for alongside their baby. It is recognised that that will not always be possible, and, in those cases, our specialist neonatal transport and retrieval service—ScotSTAR—will transfer those babies in specialist ambulances that are equipped to care for neonates. That has been established practice for many years. Babies receiving intensive care will then be transferred back to their local neonatal unit for on-going care as soon as possible.

The parents and carers of those babies must be supported to provide care alongside the neonatal staff. The new model of care positions parents firmly as partners in their babies’ care. It includes expansion of transitional care; improved facilities and support for parents; and expanded neonatal community care, allowing babies to get home sooner. In addition, we have already introduced the young patients family fund—formerly the neonatal expenses fund—which continues to support many parents with the costs of having babies in neonatal care.

We will now work with all health boards affected to plan for and implement the service change over the course of the next year. However, it is also important that we hear the voices of families in the affected areas. Therefore, we will also be consulting with families, so that we can take account of their concerns when the pathways and processes for the new model of care are designed, and we will set up focus groups to support that.

As I understand it, Mr Ross was given enough time to know that the meeting was happening—we had given him that notice.

We remain committed to ensuring that maternity services continue to be developed in a flexible and innovative way, recognising local population needs and geographic challenges. Over the past five years, the Scottish Government has invested more than £25 million to support implementation of the best start programme, which includes recommendations for continuity of carer and the delivery of community hubs. We also published the “Continuity of carer and local delivery of care: implementation framework”, which is designed to assist national health service board implementation. That will be based on a local assessment of the viability, scope and potential impact of hubs. Community midwives also deliver care in women’s homes, as necessary.