Chamber and committees

Petitioner submission of 2 March 2022

PE1924/B - Complete an emergency in-depth review of Women's Health services in Caithness & Sutherland

I only have two concerns with this:

1. Endometriosis diagnosis and management seems to be focused on those working in specific centres, rather than all Gynaecologists and GP’s.
2. Rural health doesn't feature highly. My fear is that all the effort and funding will funnel to the cities rather than reaching the rural communities who are in crisis.

I truly hope I am wrong and would be happy to be proven so.

The Best Start North Review is fantastic news for obstetrics patients, and I hope it brings change to the maternity facilities in Caithness. Having to travel over 100 miles after a miscarriage, still birth or even to deliver your child is not something you expect to be the norm in a developed country.

All women will need to access a Gynaecologist, but not all women will require an obstetrician or a midwife.

The downgrading of the Maternity Unit in 2016 left the area with no Obstetrician and gynaecology centralised. To my knowledge we have had 0 in-person gynaecology clinics at CGH since 2019.

To have to travel a 200+ mile round journey for simple check-ups, often in pain, means women are often left with no choice but to miss vital appointments until a service comes back to the area.

Community hubs in Caithness are a positive step. I would like to know if the services planned for these hubs include a Gynaecology department. Considering that 51% of the population of Scotland is female, so surely it’s a no-brainer to have a department to treat and manage women's health conditions?

Rotational clinics by Raigmore doctors in Caithness General would be a great first step, but as yet there have been no Gynaecology service changes for Caithness.

The Obs/Gynae team in Raigmore wrote to the Cabinet Secretary, Huma Yousaf recently to express how overworked they are with the rural areas from Moray and Caithness being centralised. This is the main reason there's simply no time for the Raigmore clinicians to do Gynaecology clinics, take part in professional development or visit Caithness.

Average waiting times for Caithness Gynaecology patients for surgery or outpatient appointments have risen from;

• 2019/20 = 10.10 weeks avg
• 2021/22 = 36.80 weeks avg

Road conditions:

Mr Yousaf seems to be unaware of how often our main and back roads are closed due to weather or accidents. My friend wrote her car off coming back from an Obstetric appointment while driving an icy diversion route home to Caithness. She was 28 weeks pregnant at the time and lucky to be alive.

Simply saying that "we plan closures carefully" [paraphrased], is NOT realistic.

100% of Gynaecology cases are being seen over 100 miles away and it’s unethical and unsafe.

Gynaecology is not being treated in the North Highlands as a serious health matter. The distance we travel to access any Gynae service, including miscarriage, is the equivalent to Central Edinburgh to Newcastle upon Tyne. It simply wouldn't be acceptable in the Borders, so why is it acceptable in Caithness?

Gynaecology conditions can be fatal. On boxing day, a local woman lost her fertility and reproductive organs due to the lack of a gynaecologist in Caithness. Her ectopic fallopian tube ruptured, causing internal bleeding, yet she couldn’t be transferred by road/air due to freezing fog. She could have very easily lost her life and the system gambles with patient safety.

Women have been suffering for anything up to 5 years for surgery for Endometriosis and to leave this condition means risking loss of organs or even life.

Increased "awareness of Endometriosis as a disease with substantial morbidity is vitally important" (Yeung et al., 2009)

A specialist nurse of 10 years pointed out to me that the medical description of Endometriosis is the same as cancer.

The ripple effect of this crisis on the economy, mental health, workplaces, financial strain and long-term health is frankly horrific.

So...what would I do about it?

The "Rural Unit" framework is incredibly successful for MRI machines, Breast Screening, Cancer Screening and more recently, Vaccination Clinics.

A rural unit could include appointments with a Gynaecology nurse or consultant, to filter out who needs to be on a surgical list and who could be treated in the short term, reducing waits across the board.

It would certainly ease the workload and waiting lists for patients in Caithness, and as a knock on effect, the patients attending Raigmore.

In a recent survey, I found the following results from 206 residents of Caithness: Results here

These results show a snapshot of the general feeling throughout Caithness. We have a good Hospital, let's use it!

Thank you for your time considering this petition, the thousands of Women in Caithness appreciate it more than you know.