Maternity is the front line of NHS centralisation

Written by Tom Freeman on 13 January 2017 in Comment

As Glasgow's super hospital turns away women in labour, why would you shrink local services? 

Pregnancy - PA

Maternity services have once again become a hot topic in the politics of health.

Centralisation of services has been the direction of travel for many years now, which has led health boards to propose the closure or 'downgrading' of maternity services in local hospitals to consolidate consultant-led facilities in the nearest 'super hospital'.

Today the biggest super hospital of them all, the Queen Elizabeth University Hospital - also peculiarly given the rather dubious moniker of 'death star' - has had to apologise for turning women in labour away because it was full.


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A GGC health board representative said: "We arranged for three women to be admitted to other maternity hospitals in our area and a further two women had their planned procedures safely deferred for a matter of hours.

"Patient safety was maintained at all times. We would like to apologise to anyone to whom this caused any distress."

It wouldn't be so bad if there weren't proposals to consolidate even more maternity services there. If the hospital cannot cope now, what hope for the future?

Scottish Labour Health spokesperson Anas Sarwar has written to the health secretary asking for her to intervene in the proposals to cut or downgrade maternity services at Vale of Leven Hospital in West Dunbartonshire and Inverclyde Royal Hospital.

"The last thing we need is a reduction of capacity in the area. The uncertainty must stop,” he said.

Of course centralisation in health was advocated by Labour in the first place and continued by the SNP.

It is supposed be about clinical excellence being maintained in a hi-tech location, while midwife-led services deliver less complicated births closer to communities. Oh and ‘efficiency’, obviously. Midwives argue they should be the leading clinician anyway, and in Perth fears of a phased closure appeared unfounded when many people grew to love their midwife-led service. 

In reality though, this is about cuts. As campaigners who failed to keep the consultant-led service in Caithness alive have pointed out, when labour gets complicated - and dangerous - how far will women have to travel?

And as more local services are scaled back, how will the big hospitals cope with increased demand when they are already turning women away? How far will that ongoing journey be?

Could a woman from Wick who suddenly develops complications with her labour travel over 100 miles to Inverness only to be told there is no room at the inn, then be transferred to Aberdeen, Dundee or even further afield? It is hard to see how that is good for her or her baby’s safety.

If all this really is about clinical excellence and not cost-cutting, why doesn't the consultant travel to the woman in labour, rather than vice versa?

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