Recommendation 19

The Committee recognises that it is unrealistic to expect all rural communities, particularly those in more isolated areas, to have immediate access to the full range of health services on their doorsteps. However, the Committee is concerned that some essential health services such as those relating to maternity appear to be being further centralised in regions such as the Highlands. This may lead to situations where expectant mothers are being compelled to undergo procedures which may not be clinically necessary in order to “choose” where and when to give birth rather than having the choice of a natural birth closer to home. We are also concerned that mothers (and their babies) who opt not to travel to major population centres to access maternity services may be placed at greater risk in the event of complications arising in midwife-led maternity units such as in Caithness, and would urge the Scottish Government to provide innovative solutions whereby consultants can be called upon when this happens, rather than moving a woman in labour to another hospital. The Committee calls for urgent action to address this. Moreover, the Committee queries whether the Scottish Government’s expectation that such services “are delivered as close to home as possible” is being realised in practice although we recognise that decisions on the most appropriate place to treat patients should always be based on clinical evidence.