[Contents] [Next]

Implementing A Framework for Maternity Services in Scotland

Foreword

Our National Health Service is changing fast and rising to the challenge of providing modern health care in the 21st Century. It is responding to a rapidly changing environment in which new learning, new technology, and new skills can revolutionise how we care for Scotland's people. Giving every child in Scotland the best possible start in life is a top priority for the Scottish Executive. And that starts with our maternity services, before, during and after childbirth. The care and welfare of women during pregnancy, childbirth and post-natally has a profound impact on the wellbeing of our nation, not just in terms of delivering healthy, happy babies, but also in determining the profile of our national health for a very long time thereafter.

As in the rest of the developed world, the Scottish birth rate is falling. The age at which our women become pregnant for the first time is increasing. Increasing medical specialisation, necessary restrictions on the number of hours doctors and nurses work during shifts, and improvements to training for doctors all impact on the shape and size of our workforce. Fewer births, shifting patterns of need and a changing workforce - all these factors have significant implications for the shape of our maternity services in future.

In February 2001 the Executive launched A Framework for Maternity Services in Scotland.
That was based on consultation with maternity services' professionals and users. It set out principles and practice for a modern, responsive and effective service and reflected the views and wishes of the women and their families who use that service. We have made much progress in taking forward implementation of the Framework. But we still have more to do.

I set up this short-life Expert Working Group on Acute Maternity Services (EGAMS) to examine how we should apply the principles set out in A Framework for Maternity Services in Scotland to maternity services during childbirth. The Group comprised representatives from the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists, other medical and nursing professionals, NHS Board and Trust management, the Scottish Ambulance Service and the Scottish Executive Health Department. I attach great importance to our maternity care and chaired the Group myself.

The EGAMS' report concludes that the current configuration of acute maternity services is no longer sustainable. This is not about saving money. It is about making the best use of the skills we have available in the face of the falling birth rate and workforce pressures in obstetrics and paediatrics. We need to realise the full potential of our midwives. We need to think across professional and organisational boundaries when planning and shaping our maternity services. And we need strong leadership and commitment from both managers and clinicians to carry forward continuous improvement.

The EGAMS' conclusions and recommendations are based on the best available evidence.
After much hard work, this group of clinical leaders in the field arrived at a strong professional consensus about the direction for our maternity services. The Executive is guided by that consensus. We accept that the Group's conclusions are right for Scotland. We must now begin the important debate with all our stakeholders in the NHS and beyond about how this vision can be taken forward.

Mary Mulligan, MSP
Deputy Minister for Health and Community Care

[Contents] [Next]