Quite a number of hospitals are facing more questions over the standard of maternity services in Scotland’s hospitals after an NHS board apologised for the “potentially avoidable” deaths of another five babies.
A report into the deaths at Caithness General Hospital in the Highlands found signs of illness were missed, midwives delayed seeking specialist help and labour was not properly supervised.
NHS Highland offered an “unreserved” apology to the families of the babies, who were either stillborn or died soon after birth, and said the “model” for providing maternity care rather than staffing shortages was responsible.
But the disclosure of the Caithness cases came less than a week after it emerged six babies had died “unnecessarily” at Crosshouse Hospital in Kilmarnock, Ayrshire.
It was also reported that Shona Robison, the SNP Health Minister, was warned about problems in the latter’s maternity unit on at least 12 occasions before she ordered a review into its cases.
Donald Cameron, the Scottish Tories’ Shadow Health Minister, said: “These revelations are very alarming, and will give cause for concern to people all over Scotland. It’s an incredibly sensitive area, and it now requires the utmost attention.
“Shona Robison is in charge of the health brief, and she must quickly set out in detail what action the Scottish Government is going to take.”
Anas Sarwar, Labour’s health spokesman, said the Caithness and Crosshouse reports were “heart-breaking” and called for a national review of staff and workforce issues across all maternity units.
The Scottish Mail on Sunday reported the findings of the 128-page report into neonatal and maternity services in Caithness, which will be discussed at an NHS Highland board meeting on Tuesday.
The review was ordered after medics failed to spot the early signs of blood poisoning in a two-day-old girl last September. The delay in seeking specialise help to deal with the sepsis infection, caused by E.coli, was found to have contributed to her death.
Four other perinatal deaths involving “sub-optimal care” and “avoidable factors” were discovered to have taken place at the hospital between 2010 and 2015.
In one case a “high risk” young mother suffered a stillbirth when ten days overdue after the health board could not fund a bed for her. Another lost her child after giving birth at home, with medics failing to recognise the danger of her going into labour prematurely.
NHS bosses will recommend the maternity unit is downgraded to a midwife service for “low-risk” mothers, with more complex cases being referred 100 miles away to Raigmore Hospital in Inverness, where there is 24-hour specialist cover and high dependency care.
Dr Roderick Harvey, the board’s medical director, said: “Families do rightly put their faith in the health service and the fact that infants died possibly as a result of sub-optimal care is unacceptable and I apologise unreservedly for these past failings.”
He said there had been no legal claims tabled by the families of the deceased babies and no staff had been disciplined as the problems identified “did not reflect on individual clinicians, but rather the system they work in.”
With only 165 local births per year, he said that the hospital’s three obstetricians “cannot maintain their skills” as they only intervene very infrequently and this is compounded by a lack of specialist neonatal support.
Dr Harvey concluded that they face an “impossible” situation of being pressurised to undertake specialist procedures “in a hospital that cannot provide that care” and predicted more avoidable deaths would happen if complex cases were handled there without the proper support.
It was also alleged that Ms Robison was repeatedly told about problems with maternity care in NHS Ayrshire and Arran by grieving relatives, campaigners and an SNP member. However, she was accused of failing to act until BBC Scotland reported last week on the six cases at Crosshouse Hospital.
The Scottish Health Minister said: “The safety of mothers and their babies is of paramount importance, which is why we must do everything we can to mitigate against similar incidents happening again. Our deepest sympathies go out to the families who have been affected.
“We want to ensure that every woman and baby in Scotland gets the best maternity and neonatal care and that is why we initiated a review of maternity and neonatal services across Scotland, which will report shortly.”
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