Exclusive:Scotland's maternity services 'deteriorating', official warns

John Harden, the National Clinical Lead for Quality and Safety, told a closed NHS Scotland Executive Group meeting that maternity and neonatal services present a” flat or deteriorating picture”, with a continued increase in C-section rates and associated complications.

Mr Harden also raised “notable changes in neonatal care” and said that transparency and consistency in quality and safety data remained “challenging”.

The admission comes just weeks after the Scottish Government ordered a national investigation into maternity services across Scotland after damning reports into maternity care at two of Scotland’s major hospitals - Ninewells in Dundee and The Royal Infirmary of Edinburgh.

A taskforce is now considering the scope of the national inquiry ordered by Health Secretary Neil Gray, who earlier revealed that he “nearly lost” his wife during pregnancy after "inaccurate assessments".

In February, a separate Ministerial Nursing and Midwifery Taskforce agreed to tackle workforce issues and improve culture, education, attraction, retention and flexible working.

The Royal College of Midwives (RCM) said maternity services in Scotland were under “immense pressure” due to “chronic workforce and skill mix shortages”.

She added: “It's a testament to midwives and maternity staff that national outcomes have held steady, but this comes at a cost to the workforce and to the choices and experiences available to women and families.

"While there has been progress on data availability, we still cannot access national data on homebirths or midwifery-led care, which makes understanding variation and learning from excellence difficult.

"Midwives are working tirelessly in extremely challenging conditions but staffing levels mean services are stretched too thin.

“The Scottish Government recently committed to 'turbo-charge' implementation of the maternity workforce taskforce recommendations.

“This must now result in concrete action - more midwives, a better skill mix with the education to support it, better retention, and proper investment in maternity services."

Mr Harden’s comments were made at the NHS Scotland Executive Group - made up of representatives from health boards and the Scottish Government - on October 15.

The minutes were published two months later, showing Mr Harden had discussed a paper which had been shared with the attendees ahead of the meeting.

Labour MP for East Kilbride and Strathaven Joani Reid said: “It’s appalling that Scottish Government officials are admitting in closed meetings that maternity services are unsafe and may be getting worse, not better.

“The deepest irony is that those same officials complain about a lack of clarity in the safety data while their political masters run a mile from all political accountability.

“Where is the ministerial statement on the dangerous state of maternity services, where is the plan to fix this?

“SNP ministers are more interested in saving their political skins than delivering a better, safer, health service.”

But the Scottish Government hit back at Ms Reid’s comments.

A Scottish Government spokesperson said: “It is untrue to suggest that the Scottish Government clinical advisor has stated in this meeting that maternity services are unsafe.

“Maternity services in Scotland are of a high standard and the majority of women will have an uncomplicated pregnancy and birth and deliver a healthy baby. Where provision of care has been identified as below the high standards we expect, we are taking action and working with NHS Boards to make improvements.

“That’s why we have established The Scottish Maternity and Neonatal Taskforce which will look at the scope of a national review based on the emerging themes and outcomes of the Healthcare Improvement Scotland Inspections of Maternity Units across Scotland, and any other area that the Taskforce might identify.”

The Scottish Maternity and Neonatal Taskforce is expected to have its first meeting next month.

It comes after a damning review found a “culture of mistrust” had led to patients being harmed at one of Scotland’s busiest maternity units.

The director of NHS Lothian apologised after a report from Healthcare Improvement Scotland (HIS) found “serious concerns” about staffing shortages for maternity care at Edinburgh Royal Infirmary.

Patient safety concerns were also found at Ninewells Hospital in Dundee following a report in May.

A Scottish Government spokesperson added: “The Scottish Maternity and Neonatal Taskforce will look at the scope of a national review based on the emerging themes and outcomes of the Healthcare Improvement Scotland Inspections of Maternity Units across Scotland, and any other area that the Taskforce might identify.

“Ministers have already confirmed the Taskforce will look at rural maternity services as one of its first areas of focus, and review the issues in rural communities including Caithness and Stranraer.

“The voices of staff delivering our services, the women and families who rely on them, and the advocacy and third-sector partners who support them, are essential to ensuring the Taskforce delivers for Scotland. We are developing plans to make engagement meaningful and to ensure these voices are heard clearly.

“A full workplan will be agreed by the Taskforce once it has been established, and Parliament will be updated in due course. We expect the Taskforce will have its first meeting in January.”

Scottish Liberal Democrat Willie Rennie MSP said: “The acknowledgement about the state of maternity services from such a senior health service leader makes the case for a national investigation even more clear than when we debated this issue in parliament earlier this year.

“The evidence from families and inspections shows problems are widespread which is why we need an that investigation led by an independent person with authority to lead to lasting improvements."