Doctor sounded health warning on maternity cuts
HEALTH campaigners are calling for the suspension of an NHS board amid claims they covered up a consultant’s safety concerns over plans to change maternity services.
Caithness Health Action Team are urging Health Minister Shona Robison to order an independent inquiry into clinical governance at NHS Highland.
The move comes after it was revealed that the health board kept a consultant obstetrician’s fears about moving births from Caithness to Raigmore Hospital, Inverness, hidden from the public.
Dr James Bingham, from Raigmore’s maternity unit, had warned the distance and transfer times for the 100-mile-plus journey were considered unsafe.
Anxious for a public meeting to have all the facts, he cautioned health board members against giving just 48 hours’ notice for the move to be implemented.
He said: “Given the complexities involved, this is manifestly insufficient notice for a hard-pressed service.”
But the massive change was pushed through unanimously on November 29, 2016, with the press and public kept in the dark about the doctor’s misgivings.
Instead, the meeting was told there were “no clinical objections” to the proposal, which came into force with scant preparation time two days later.
The concerns have come to light 14 months later, after Bingham, having failed to get answers over why his views were hidden from the public, handed copies of his correspondence to CHAT.
The group passed the dossier to Robison this month, claiming the health board’s decision to discuss the doctor’s fears in secret session violate the Ethics in Public Life Scotland Act 2000.
Highland councillor Nicola Sinclair, who founded CHAT, said: “We were horrified to read NHS Highland not only failed to adequately respond to serious safety concerns raised by one of their clinicians but that they also appear to have buried any evidence of his complaint.
“There appears to be a toxic culture at NHS Highland and one that has been allowed to go entirely unchecked by Government at the highest levels. Their handling of this maternity information makes a mockery of their calls for the community to trust them. We implore the Government to take action now.”
In letters to NHS bosses, board members and politicians, Bingham conveyed fears Raigmore’s maternity and gynaecology unit could not cope with the extra Caithness admissions.
He warned the Inverness unit was “understaffed” and “under resourced” with a building which was “not fit for purpose”.
Some months later, he claims the extreme pressure to take on the Caithness workload at short notice led to three valued members of staff leaving the consultants’ team at Raigmore.
He also told the board he feared transport systems would not be able to cope with the journeys from Caithness.
Bingham said: “Statements from the board talk of ‘work ongoing with the Scottish Ambulance Service to ensure good communications and rapid access to transport by road or helicopter when it is required’ but this is not equivalent to an established and reliable service.”
NHS Highland claim this week that the latest report on the birthing model, tabled last November, indicates it is “working to plan.” But the Record has learned of instances that demonstrate Raigmore are overstretched.
One mum-to-be endured a long ambulance trip to Raigmore last September, only to be sent to Aberdeen, because the Inverness unit was full.
Another told how she faced waiting hours for transport to Raigmore.
Bingham advised the health board, who were prompted to seek a new birthing model after the death of a baby in Caithness, that they did not have crucial medical data to make a decision on change. He said: “The review examined evidence of suboptimal care and adverse effects but did not examine cases where adverse outcomes for women or babies were saved by the presence of obstetric specialists in Caithness.
“Without this missing data, we have a less complete understanding of how proposed changes to the model of care will impact on risk to women birthing in Caithness.”
He concluded: “The incomplete analysis in the public health report, lack of infrastructure preparation, uncertainty about additional resources and very short timescale for implementation all represent a risk to patients.”
NHS Highland have confirmed the board opted to discuss Bingham’s concerns at a private meeting. But no board member challenged the statement, at the subsequent public meeting, which claimed there were “no clinical objections” to the proposals.
NHS Highland said they welcomed discussion about safe delivery of services.
They added: “On the maternity provision in Caithness, the board of NHS Highland carefully considered a wide range of evidence and on that basis made their decision to transition to a midwife led community maternity unit.
“The evidence included an external independent review by specialist obstetricians and paediatricians, as well as our own public health review.
“Prior to and leading up to the board meeting, members received a wide range of comments and correspondence in addition to Dr Bingham’s letter, which were similarly distributed to all members of the board to inform their decision.
“Board members also had an opportunity to discuss their concerns with professionals closely associated with the services and leading the review.
“At the public board meeting, the chair of the area clinical forum, when asked, stated that no objections had been raised through that formal channel, which would be one, but not the only route for bringing issues to the attention of the board. None were received.”
A Scottish Government spokesman said: “Following the recent meeting with CHAT we have been clear we want the provision of high-quality services in Caithness to continue and we will be seeking assurances from NHS Highland that this is being undertaken.”