Chamber and committees

Petitioner submission of 28 January 2022

PE1915/B - Reinstate Caithness County Council and Caithness NHS Board

Dear Deputy First Minister.

Thank you for your communication regarding my petition.

There are a number of points I would like to bring to your attention.

Caithness traditionally had a wide ranging and substantial range of services available locally, as indeed did Sutherland. Do we still have these facilities? Clearly the answer is that we do not, which is why CHAT {Caithness Health Action Team} exists, why many people are obliged to travel vast distances for treatment – much of it routine – and why we have particular concerns regarding women’s healthcare and maternity.

The ideal model is simply based on what we had before the inception of NHS Highland.

1. A first class General Hospital in Wick, where we had a highly qualified General Surgeon as did the Lawson Hospital in Golspie.
2. The people of Caithness had access to virtually all routine medical services locally.
3. The vast majority of Caithness mothers gave birth in Caithness.
4. The requirement to travel south was the exception whereas now it is the rule.
5. District nurses were in most of our villages.

What we did not have in the past was Mental Health Care, but this has now become a major issue of concern as the suicide rate in Caithness has sky-rocketed this past two years and there are no Mental Health services available locally. People are obliged to travel to Inverness or be seen by video link, when face to face is essential, and there are clear and concerning issues relating to seeing people with MH issues on a remote video link.

You say there are no plans to change the structure of NHS boards. NHS Highland replaced the Caithness and Sutherland Health Board 20 years ago. Since that time we have experienced our local NHS service going through death by a thousand cuts. I challenge you to tell me what improvements we have seen at a local level to our NHS during the past 20 years.

You use the word configured when describing the maternity service in Caithness when in fact the word should be downgraded. My children and grandchildren were born in Caithness under a consultancy lead maternity service. How can the grounds for reconfiguring be safety when NHS Highland withdrew our consultancy lead service? If Caithness and Sutherland still had its NHS board this situation would never have arisen.

Even with all the speculative proposed changes you mentioned there would still be very little in the way of women's health services like obstetrics and gynaecology in Wick and still no paediatric and orthodontic services available. These changes, if they happen, are several years away, so what are the people of Caithness supposed to do now?

We cannot understand how Orkney with a population similar to Caithness has all these services supplied at a local level whereas Caithness has had many of these services at a local level withdrawn by NHS Highland - in my opinion this is tantamount to discrimination!

Your reply does not address the overwhelming support in the north for the return of consultants to Wick, and a midwife led CMU backed up by consultants like Orkney, which fulfils the Best Start criteria, would allow far more births in the new CMU, so the 90% of expectant mums don't have to travel to Inverness. It would also stop babies who develop jaundice or who need a hearing test from having to go back down to Raigmore, and it would also allow miscarriage care.

CHAT has asked repeatedly for a Risk Assessment for expectant mums travelling down the A9 to give birth. This has never come into fruition although this has been backed by campaign groups and MSPs and local councillors.

Patients should not have to travel over 100 miles for services they once had locally.

You state in the principal of subsidiarity that decisions are taken at the right level and as close as possible to those most affected. The decisions that affect Caithness are taken at Inverness 115miles distance from Caithness and at present many of these decisions are detrimental to both NHS and the Council services provided in Caithness. What would be the reaction if decisions that affect Edinburgh were made in Glasgow?

The idea of Caithness and Sutherland being administered from Inverness, with a suggestion of perhaps devolving some functions locally, may sound possible in principle, I think we need to examine what has happened in practice. Ever since Caithness and Sutherland Health Trust ceased, and we entered into the area administered by NHSH, we have - regrettably - seen a reduction in local services. This must be corrected, and I would suggest to the Scottish Government that there is a great need for an in-depth review of the current arrangements, with a view to the re-establishment of a local Health Trust or Board for the far north - this would be far better equipped to reflect the needs, and unique circumstances, of the people in this remote area. 

I look forward to the outcome of “Democracy Matters”. If these new arrangements come into fruition it could well be a game changer for people who live in Scotland’s rural areas and go a long way in reversing the rundown we have experienced since decision making was transferred to NHS Highland and the Highland Council.

We in Caithness look forward to taking part in these discussions as we see it as a start in improving the services supplied at a local level.

Under the SNP policy of centralisation and past and present Scottish Governments, the needs of the people who live in Scotland’s rural areas have been ignored.

I would like the members of the Scottish Parliament who represent the people of the Highlands to take strong and immediate action on these issues.