To think mothers shouldn't have to travel for 60+ miles to give birth?

[Iknowimnot]

I know I'm not but a hospital here thinks it's fine. They shut their maternity ward and expect mothers to go to either one of two hospitals to give birth. Both on busy, slow roads, 60 miles away at worst.

Another hospital makes mothers travel 120 miles to give birth.

And the snp government does not give a shit. They do not care.

I live in a city of just over 100,000 in Northern Canada. We have a health centre (it can’t be called a hospital). If you’re less than 36 weeks it’s a 4.5 hour drive or a medivac flight to the nearest big city.

No midwives here either. You see the nurse at your doctors office and get referred to the OB at 36 weeks if it isn’t complicated. The nurses handle delivery and the OB turns up at the last minute. C Section rate is 1 in 12 births.

Pregnant moms in outlying towns have to find family or stay in a hotel as they approach their due date

The problem in the Highlands was caused by the EU working time directive. We used to have tiny maternity units staffed by two obstetric doctors working 100 hour weeks, each covering every day, every second night and every second weekend. Because the units only had a few deliveries, they often got a decent amount of sleep on call nights, so it was manageable.
Once the EU made that illegal, we couldn’t afford to have four or six doctors hanging around each unit to make the rota compliant. And none of them would be getting enough delivery experience.

The only way they could make it work was to close the small units and centralise the staff in big maternity departments in city hospitals. Labouring women now face the prospect of a 60 mile journey on single carriageway country roads in snowdrifts, to reach a hospital.
Even some towns have had to lose their obstetric units. Mothers in Perth now have only a midwife unit, with no obstetric cover. If they need an emergency section or forceps they have to be shovelled into an ambulance and transferred 25 miles away to the maternity unit in Dundee. At least one baby has died en route. (Undiagnosed breech)

"How do you suggest the Scottish government fix it?"

Reintroduce prescription charges, and prioritise maternity budget?

Change the amounts in each pot if the devolved budget to match he electorate's priorities?

Raise income tax, now that they can?

Ration other procedures to fund maternity services?

Apply the practices of other sparsely populated areas, to nick the best ideas for sustainable service levels, and fund those as the first priority?

user139328237
The Scottish government could start by reversing perverse tax rises that mean people on the same salary in Scotland have lower take home pay than those in England.

Frankly, I'm happy to pay the extortionate sum of £200 extra per annum so that low income families get more money, my prescriptions are free, NHS staff get a pay rise, nurses continue to get bursaries so there's someone to nurse me when the Englandshire Anti-Immigration Non-Service throws all the "foreign" staff out. It's improving society so I gain from it. I have a decent salary so it is right that I support society more - a Scottish way of thinking since at least the 16th century.

And the local maternity unit where I grew up was shut before devolution, when Westminster was running the whole show. The maternity unit where I live now was shut during the Labour government both at Westminster and Holyrood.

But I suppose that's the SNP's fault too?

Yeah it is nhs g. The way everything is run recently is a disgrace.

We are getting everything cut, libraries shut, schools shut, bin collections reduced, told to run our own community centres in towns or lose them, roads are very rarely fixed and now they cut the maternity ward. Is A&E next because it's not always busy? Very rarely busy and I've been in a lot. But we get taxed more because they keep running out of money? What exactly are they spending it on if none of these services?

Yeah it's a rural area, but they've been able to run it fine for many decades before. Suddenly its a problem?

Frankly, I'm happy to pay the extortionate sum of £200 extra per annum so that low income families get more money, my prescriptions are free, NHS staff get a pay rise, nurses continue to get bursaries so there's someone to nurse me when the Englandshire Anti-Immigration Non-Service throws all the "foreign" staff out. It's improving society so I gain from it. I have a decent salary so it is right that I support society more - a Scottish way of thinking since at least the 16th century.

It’s so refreshing to hear this! I’ve been trying to convince my family to move to Scotland for years

Some good ideas there, RoseAndRose, but it's cheaper to have free prescriptions for all than to have means tested charges. And how sure are you that maternity provision for rural areas is a priority for the electorate, over and above elderly care, cancer treatments and everything else the NHS covers? Which areas of the NHS would you ration, that would be supported by the rest of the population, so that high risk pregnancies in rural areas can get the first class care they need and deserve?

Perhaps we could provide free/heavily subsidised accommodation near large mat hospitals for the last month or so, but then there would be knock on effects on fathers, other dc...

Agree that studying best practice in other countries with similar demographics/geography would be helpful. As would WM cancelling HS2 and Trident renewal, which would free up billions for the NHS in the whole of the UK.

If the SNP stopped giving free prescriptions and tuition fees to the rich, maybe the poor wouldn't have to suffer

I'd rather give birth at home than risk Aberdeen if I was on the green pathway. Two midwives, birth pool, gas and air, diamorphine with a GP prescription and an ambulance if required are all available at home.

Well they don't have to though. They canove closer to a hospital or have a private induction/elcs if they prefer that. It's not ideal and not easy (in some circumstances) but people can't expect a hospital near to where they live. Of they want a hospital nearby then they need to live closer to one.

Means testing prescrptions costs more than giving them free, there would be no savings there. And tuition fees is a different budget.

And I'm not entirely sure that only poor women have high risk pregnancies in rural areas.

More than the journey into hospital to give birth is the journey home with baby in a car seat. You arnt supposed to keep a newborn in a car seat for long and there's nowhere to stop on the A9.

At least if you're from the islands there's accomodation for partner to stay at Aberdeen and Raigmore. Maybe need that for more areas.

For those saying it's what you expect when living rurally these are areas which were covered by maternity units. What has led to the understaffing though isn't clear. I think if you're low risk in these areas you're best having a homebirth.

Are NHS Grampian still opening a new unit in Inverurie?

Hirples Not sure where your info is from. The Scottish Government reckon free prescriptions cost £57 million a year (2011) data compared to the Engish charging system

Yes, free prescriptions have a cost. However, you reduce admin costs (no-one has to check the boxes ticked to say you don't have to pay) and more importantly you reduce costs further down the line. For one example, the cough for which you are prescribed antibiotics doesn't turn into pneumonia and weeks off work and/or a hospital stay because you can't afford the charge the same month the car needs MoT'd and the gas bill is unusually high. And yes, I know people in receipt of some benefits, children and the elderly get free scripts in England anyway, but there are many people just getting by for whom charges do matter. I'm not sure those stats are even collected.

Though then there's this, showing the Scottish NHS is getting a far better deal on drugs than our neighbours down south.

Hirples I did not say there were no admin costs, I said the Scottish govt says free prescriptions cost £57m a year. This benefit is largely to the well off, as they pay disproportionately for prescriptions under the English system.
As for a better deal on drugs, that is flawed for a number of reasons:

1. Branded drugs prices are negotiated across the UK, not regionally
2. The Scottish numbers quoted are GP prescribed drugs only, the England figures include hospital prescribed drugs
3. No one knows the detailed rebates obtained from suppliers in either region, so gross costs are a useless metric
4. Neither costs include those provided by service providers where the drug cost is included in the service charge.

God, that is awful. Maternity care is pretty dreadful everywhere these days, but having to travel that sort of distance is shocking.

I would have had all my children at the road side if I had to travel that far. My third labour was one hour, start to finish. I just made it to the hospital - middle of the night, 4 miles away and no traffic.

When I was working, decades ago, I delivered a baby in a car, luckily in the hospital car park, so we managed to get mum and baby into the labour ward for the third stage. Had a few sprints with a wheelchair and a few unexpected home births. This was in a city hospital where our patients only had a few miles to travel.

Having to travel that distance is dangerous and terrifying.