Scotland’s Health Secretary has insisted the model to centralise neonatal intensive care services “is the right one”, despite a backlash from worried parents and campaigners including those fighting to stop the downgrade of University Hospital Wishaw’s Neonatal Intensive Care Unit.
The Scottish Government published The Best Start: A five-year forward plan for maternity and neonatal care in Scotland in 2017. The report set out to place the current and future needs of women, babies and families, and person-centred, relationship-based care, at the heart of redesigned maternity and neonatal services. One of its key recommendations was to centralise specialist services by reducing the number of neonatal intensive care units (Nicus) from eight to three.
Health Secretary defends clinical evidence
Speaking on BBC Scotland’s Breakfast Show on Tuesday, Angela Constance said: “It’s really important that as the Health Secretary that I continue to be very clear about the central importance of following clinical advice and clinical expertise. The model, I believe, is the right one, and it is well evidenced.”
Ms Constance acknowledged concerns about the need to travel, but said the evidence shows the proposals will have the best outcome for the sickest babies. “I understand that people want to be near their babies, they want their babies to have the best prospects,” she said. “What the evidence also tells us is that clinical care, and for these smallest babies, that if they are in units where there is the highest level of expertise around intensive care, that there are the right facilities for surgery, perhaps life-saving surgery. That improves the prospects of these very sickest babies, babies born less than 27 weeks gestation, less than 800 grams, who need those multiple complex intensive care.”
Wishaw unit among those to be downgraded
University Hospital Wishaw is amongst the hospitals that will see its unit downgraded. It was named neonatal unit of the year in 2023 and serves a population of 655,000 people. Under the changes outlined by the Government, only the units at Edinburgh Royal Infirmary, Queen Elizabeth University Hospital in Glasgow, and Aberdeen Maternity Unit will retain top-level intensive care status for babies born under 27 weeks or weighing under 800g.
Ms Constance said: “What our advice said in the best start review was that in the short term we should move to three to five, but the longer term position was to move to three specialist units, and that is based on the need for clinicians to maintain their expertise. For them to maintain their expertise they have to be regularly dealing with particular patients.”
Campaigners call changes 'catastrophic'
A campaign against the Scottish Government’s plans, led by the Wishaw Neonatal Warriors group, said the changes would be “catastrophic”. An online petition against the downgrading of the unit has so far received more than 26,000 signatures. At the end of last year, a public meeting heard from parents, clinicians and campaigners to oppose the planned downgrade of Wishaw Neonatal Intensive Care Unit. People packed into the town’s Jim Foley Community Centre for the gathering, which was organised in collaboration with the Wishaw Neonatal Warriors campaign group.
Dr Caroline Delahunty, former consultant neonatologist at Wishaw General, added: “During my time as a consultant, Wishaw served the third largest health board population in Scotland, with care delivered by a specialist multi-disciplinary team of consultants, neonatal nurses and allied health professionals. In my opinion, shared by other clinicians, Wishaw Neonatal Unit should remain in a position to care for Lanarkshire’s babies.”
Previously Scottish Labour’s deputy leader Dame Jackie Baillie said: “The Best Start report into neonatal care recommended developing three to five neonatal intensive care units, yet the Scottish Government has agreed to reduce the number to three. Aside from the impact at Ninewells in Dundee, this will result in the downgrade of the award-winning Wishaw neonatal unit. We also know that the lack of capacity in Glasgow means mums and the very sickest babies may have to travel hundreds of miles to Aberdeen.”
