Chamber and committees

Oh—you are talking about your left, convener.

Thank you for allowing me to come and speak to the petition. As a Mid Scotland and Fife MSP, I will highlight that the units that are suggested for downgrading from level 3 to level 2 include those at Ninewells hospital and Victoria hospital in Kirkcaldy, although other units elsewhere are also being affected. I have had many representations from mums who have given birth and had babies at Ninewells to ask for the units to be kept at their current level.

It is important to note that these are people who have already had this experience; they are not making those representations in their own personal interest, unless they are planning to have more family and the worst happens. They have already been there, and they feel strongly enough to make a representation and say, “Please rethink this.”

The minister has told the committee that the plan is

“deliverable and clinically appropriate”,

but a number of

“outstanding elements”

such as

“cot capacity and patient flow … will be incorporated into the next phase”

of looking at the issue. That seems to me to be a bit back to front. If you do not know what the cot capacity or the patient flow will be, it is hard to know whether it is clinically appropriate. We have seen the same problems in other areas of the NHS, where we have reduced things and then found ourselves short of beds.

As we have seen, centralisation is often not the answer. We need only think about, for example, the maternity unit in Caithness; I come from the north of Scotland, and I sometimes think that people do not know how far it is from the north to, say, Dundee, Edinburgh or Aberdeen. There are many areas of Scotland where people would be many hours away from the three units suggested, if their babies had to be taken there.

I note that the initial report says that babies will be safer in specialist units. That might conceivably be true, but the question is: are they safer if they are having to be taken there in ambulances? How many hours will it take for people to get to those units? Will mothers increasingly be sent to other areas to give birth? That is already happening in Caithness, with mothers being taken 100 miles to give birth in case there are potential difficulties.

More centralisation is definitely not the answer. In one of her submissions to the committee, the minister said that families should stay together and that local care is important, so I suggest that we listen to families and to specialist staff. In other areas of the health service, we have seen that, if we reduce specialist areas, we lose staff—they are motivated to leave or go to other units—and there is a downgrading cycle whereby units are downgraded further as a result of staff shortages.

I ask the committee to consider writing to ask the Cabinet Secretary for Health and Care to reconsider the proposals, particularly in the light of the NHS reorganisation that is about to happen, so that we keep experienced staff and so that local people’s views are taken into account.

I thank everybody for coming today. We have had a good discussion of the subject, and I am sure that we will come back to it as it becomes clearer what the programme for government will bring forward. We welcome submissions from you if there is a specific point that comes up. Everybody is consulting in a three-month period, which is a short time, so if something comes out of that process and you wish to put it forward, please feel free to send it in to us.

Next week, we are taking evidence from the Scottish Government on its priorities across our whole remit of health, social care and support, so the relevant ministers and the cabinet secretary will be here.

That concludes the public meeting for today, and we move into private session.

11:31

Meeting continued in private until 12:19.

Good morning, and welcome to the third meeting in 2026 of the new Health, Care and Sport Committee. We have received no apologies.

I begin by asking committee members whether they agree to take in private consideration of our approach to pre-budget scrutiny, and all future consideration of our work programme and reviews of evidence. Do we agree to do so?

Members indicated agreement.

Jack Middleton has a follow-up question. I do not know whether he wants to address it to anyone in particular.

Jill, I think that you wanted to come in.

That leads me to IJBs, which have not really been mentioned. They provide a critical interface. How should we go forward in that regard? Do people feel that IJBs have worked to a degree? I think that everyone feels that there needs to be reform. I will bring in Jill Laspa first, given that she covers that interface.

Right, okay.

I want to ask—this is for anybody, really—about training our own Scottish people and whether there is a case for expanding further education in this area. Coming back to the point about people getting rewarded, we tend to want a certificate so we can say, “Right, they’ve got something equal to that.” I am talking about people working in care homes but not only them—I will come back to Mr Macleod, perhaps, on his own area. I would just like to hear, from COSLA and others, what you think about whether we need to expand courses in those areas. Coming back to Professor Macaskill’s point, if we think that we need more of those people, we obviously need to encourage them in various ways.

I think that Joe Long has a related follow-up question.

We have run out of time. I give you all a challenge: you can each give us one sentence, or speak for one minute, if you think that there is something that we have not covered. If it is a more detailed point, please feel free to send us something in writing.

I start with Donald Macleod. Is there anything you think that we should be looking at that has not been mentioned? There is probably a lot, but perhaps you can pick one thing.