Citizen Participation and Public Petitions Committee 26 November 2025
I understand all those issues. It is difficult to provide local services that are as specialised as they need to be in order to care for the smallest and sickest babies.
As I have said, the optimal way of providing the right level of care for those babies is by ensuring that care is centralised and that units are large enough to be able to care for enough babies to maintain expertise. That can be difficult, and the movement of mothers and babies as a result of centralising care is inevitable.
It is important to avoid the movement of babies as much as possible. Ideally, sufficient capacity should be provided in all of the units that are providing the intensive care. In any review of the designation of services, it is important that the neonatal intensive care units that will be enabled to take all of the activity have sufficient capacity in terms of staff and space to be able to care for those babies.
If all those things are provided, it should be possible to transfer mothers antenatally—that is, before birth—when a pre-term delivery is expected. That should avoid mothers and babies being separated. It might mean that care is provided slightly further away from home for some families. That means that the capacity has to be in the right places, so that those journeys are minimised as much as possible.
In the first stages of neonatal intensive care, babies are very sick and need lots of expert intensive therapies and treatment. Later in their care, many babies can be transferred back to their local units. It is a system that seems to work well when networks are well organised. If the right capacity is in the right places, it should be possible, in most instances, to anticipate when women are going to deliver prematurely and ensure that the smallest and sickest babies are born in the right place, where intensive care can be provided on site, so that the baby does not need to be transferred. Following that, when those babies have progressed and done well, they can be transferred to their more local units.
You also mentioned local expertise and the excellence of some units. It is important that expertise is maintained, and I appreciate that the approach that we are discussing can be difficult in some units that are providing a higher level of care, particularly if the change is seen as downgrading the care that is provided by moving the facility to a lower level. However, the changes are not about individuals. The issue is not about which individuals can provide the best care; it is about making sure that the right people are in the right place to provide the right care for the babies, and that that care is provided in large enough centres.