Hansard

The birth of a new baby is one of the most exciting times in a family. There is nothing more precious than the birth of a baby, and for parents and families, concerns for safety around that time are huge. As a mother and a step-grandmum, I understand those concerns only too well, and I share the concerns of my constituents in that regard. However, for people who have had to go through the most difficult experience of pre-term birth, when their hope is simply to celebrate a new family member, it must be heartbreaking, and I can only imagine their stress and worry.

I am very proud of the record of the team at the neonatal unit in University hospital Wishaw, in my constituency. The care and support offered during an acutely difficult and uncertain time is invaluable to families, so I know why the issue brings up such strong feelings and can be emotive.

Nevertheless, we have a responsibility not to add fuel to the fire of that anxiety. We all want the best outcomes for constituents, and for new families at an uncertain time. I know without a doubt that every one of my colleagues, whatever their party affiliation, wants the best for their constituents. As policy makers, however, we have to be guided by the evidence. We cannot ignore the clinical expertise; the Scottish Government cannot do so either, and nor should it.

I agree with many of Meghan Gallacher’s points, and I know of her commitment in this area. I agree with the substantive points about implementation, and the need for assurance and certainty about the way forward. We all want a new model of care to have the very best standards, driven by clinical recommendations that seek the best life chances for babies, including the best chances for the sickest babies and for those for whom an early pre-term birth is predicted.

The clinical analysis with which we have all been presented shows that, in order to achieve the best outcomes for the small number of very premature babies, care is best delivered in units that regularly see the most complex cases and have ready access to specialist support services. Without a doubt, the new model must be underpinned by adequate and sustainable funding, as must all our public health services. Providing reassurance to new parents is critical, too, and in that respect, issues such as overnight accommodation, access to specialist support and certainty that their baby will receive the best possible care will all be crucial to making a success of the new national model.

In 2017, the “Best Start” report was published, with recommendations on a new model of neonatal care based on the British Association of Perinatal Medicine’s definitions of levels of care, and proposals to move from the current model of eight neonatal intensive care units to a model of three units, supported by the continuation of the current units. That is important: the three specialist intensive care units are to be supported by the current neonatal units, including the one at Wishaw. It is a redesign of the system, and Wishaw will be designated as a local neonatal unit, still providing care for neonatal babies.

The three proposed neonatal intensive care units in Edinburgh, Glasgow and Aberdeen are units that have already conducted specialist services, including neonatal surgery, which is not available at Wishaw, as it has neither the capacity nor the expertise to facilitate it. The redesign of services will not affect the vast majority of those attending the local prenatal unit at Wishaw.

In the example of Wishaw, the changes have been said to apply to a tiny minority of one or two babies per month, who are most at risk and whose survival chances would be improved in one of the three specialist units. All local neonatal units across Scotland will continue to provide that care for babies born later than 27 weeks.

The options appraisal happened in 2023, and the recommendations for the new neonatal model of care are underpinned by strong evidence that population outcomes for the most premature and sickest babies are improved by delivery and care in units that look after a critical mass of such babies. Under the new model of care, it is intended that mothers who it is suspected will have an extreme pre-term labour will be transferred before labour—and preferably before giving birth—to the maternity unit at one of the hospitals with intensive care expertise, allowing mother and baby to receive the best care.

We know that, practically, that will not always be possible, and reassurance based on other cases is vital. In the circumstances where that has not happened, a specialist neonatal transport—