Committee
Citizen Participation and Public Petitions Committee 26 November 2025
26 Nov 2025 · S6 · Citizen Participation and Public Petitions Committee
Item of business
Continued Petitions
Specialist Neonatal Units (Centralisation) (PE2099)
Dr Wardle
Watch on SPTV
In terms of the organisation of neonatal networks, there is some evidence that the centralisation of services improves outcomes. We know that the smallest and sickest babies who are cared for in larger, more centralised neonatal services have better outcomes than those who are not. In my written submission, I have documented some of the evidence behind that and the references involved. All that information, and the framework that was produced on behalf of the British Association of Perinatal Medicine, was taken into consideration in the best start review.
The centralisation of neonatal services in larger neonatal units that have all the right resources in terms of people, expertise, equipment and the wherewithal to be able to deal with the smallest and sickest babies helps to improve outcomes. That means that babies of 27 weeks and lower should all be cared for in neonatal intensive care units rather than local neonatal units or special care units.
Do I need to describe the difference between neonatal intensive care units and local neonatal units?
In the same item of business
The Convener
Con
The second item on our agenda is consideration of continued petitions. The first petition is PE2099, an extraordinarily important petition on which the commi...
Dr Stephen Wardle (British Association of Perinatal Medicine)
Good morning. I am a consultant neonatologist and, as you have said, the president of the British Association of Perinatal Medicine, which is a professional ...
The Convener
Con
This is an emotive subject—we can all understand that. Our job is not to ignore that, but to approach the issue in as professional and dispassionate a manner...
Dr Wardle
In terms of the organisation of neonatal networks, there is some evidence that the centralisation of services improves outcomes. We know that the smallest an...
The Convener
Con
It might be helpful if you could explain that on the record. The committee has gone through that previously, but it would not be unhelpful to hear it again.
Dr Wardle
The care that individual babies receive is divided into various levels, and individual neonatal units provide certain levels of care. The highest level of ca...
The Convener
Con
That is helpful. Although there is a pattern to them, a lot of our questions cut across one another and are relevant to various points. Obviously, we are go...
Dr Wardle
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 sic...
The Convener
Con
It is not always the case that the outcome is a happy one. In the scenario that I mentioned, the baby could have been transferred from Wishaw to Aberdeen and...
Dr Wardle
It comes down to how the services are commissioned. If the resources are available, it should be possible to commission sufficient space and capacity in the ...
Davy Russell (Hamilton, Larkhall and Stonehouse) (Lab)
Lab
You have said that travelling is not good for the baby, but you have also referred to appropriate capacity being available in the alternative unit. The neare...
Dr Wardle
I do not know the particular circumstances in Wishaw and Glasgow and what would be required to be opened to ensure sufficient capacity or, indeed, what the r...
David Torrance (Kirkcaldy) (SNP)
SNP
Good morning, Dr Wardle. Does the proposed location of Scottish units raise any concerns about a disproportionate rate of transfers from areas of high depriv...
Dr Wardle
High deprivation can lead to a higher incidence of prematurity and sometimes poorer outcomes. What do you mean by “deprivation”? Are you asking whether trans...
David Torrance
SNP
In areas of deprivation, health is usually poor, so we will probably find more cases of premature babies being born and therefore more need for specialist un...
Dr Wardle
Yes, that is possible and, indeed, is often the case. Again, it goes back to capacity being in the right places and ensuring that there is sufficient capacit...
David Torrance
SNP
On that point about capacity, the central belt has the greatest population density in Scotland; indeed, the whole area of Lanarkshire and Wishaw has high pop...
Dr Wardle
I do not think that I can answer those questions. All those issues were reviewed in the options appraisal, but neither I nor my organisation took part in the...
The Convener
Con
Davy, did you want to follow up on any questions?
Davy Russell
Lab
Just a couple, convener. The review recommended the establishment of between three and five operational units. Obviously, Scotland’s population is 5 millio...
Dr Wardle
That is a good question. Geography would certainly need to come into it, but I would point out that the size of the population, and the number of deliveries ...
Davy Russell
Lab
What do you think would be a reasonable distance for a mother and baby to travel?
Dr Wardle
What is “reasonable”? Sometimes, mothers and babies get moved considerable distances. Ideally, when care is provided within networks, the distance is minimis...
Davy Russell
Lab
How easy is it to identify mothers who might be prone to giving birth prematurely? Is there any methodology that you would use, or pre-work activity that you...
Dr Wardle
Yes, there is. Lots of work goes into that. This is really a question for an obstetrician, but there are tools to predict which mums are going to deliver ear...
Davy Russell
Lab
Thank you.
The Convener
Con
Maurice Golden, do you want to follow up on any of those points?
Maurice Golden (North East Scotland) (Con)
Con
I think that that would be helpful, convener. Everyone will agree that there is already a degree of centralisation, given that we are starting with eight s...
Dr Wardle
Travel for parents is a big issue when care is centralised. It is important that, as well as providing the capacity to look after babies, we provide faciliti...
Maurice Golden
Con
Thanks for that answer, but you have highlighted, I suppose, the nub of the issue. It appears as though the arbitrary methodology behind closing units and re...