Head of maternity review promise: 'We will listen to parents'

By

Scotland health and social care correspondent

BySusie Forrest

Scotland health producer

The head of a major review of maternity services has reassured bereaved parents their voices will be heard as part of her work.

Families had expressed concern the forward-looking national review of services in Scotland would not take into account how they felt failed by the NHS.

But Prof Christine McCourt told BBC Scotland talking to a range of people would be valuable in "drawing the right lessons for improvement".

The Scottish government said the review, which got under way this week and is due to report back next summer, would consider the "direct experiences of women, families and staff at every level of care".

The review was ordered by ministers a year ago following a BBC Disclosure investigation highlighting failings in maternity care across Scotland.

In the film, Lori Quate shared his experience of losing his wife Jacqui Hunter in 2020.

Jacqui died at Ninewells hospital in Dundee while giving birth to their stillborn daughter, Olivia.

She had been given an overdose of a drug to bring on labour, and an NHS review found that it could have been a factor in her death.

The Scottish government announced an independent national review of maternity care a month after the documentary heard calls from families, NHS staff and experts for urgent action to improve safety.

As the review got under way this week, Lori said it was not clear what would feed into its findings.

"The biggest concern was that the phrase 'forward-looking' seems to necessitate a limited involvement of families who have been through the mill of this culture of failings," he said.

"How are they going to face forwards if they're not willing to hear from the families?"

"I understand you can't go looking at every single individual case if it's about changing the system," he added.

"But a case like Jacqui and Olivia's is almost exemplary of the systemic rot and failings that prevail throughout the entire system."

McCourt, a professor of maternal and child health at City St George's at the University of London, is chairing the review.

She said it was important to hear from parents with both negative and positive views.

"It's not part of our remit to investigate individual cases," she said. "But there's a great potential to learn from people's experience, especially if you actually talk to a range of people.

"You can draw out the patterns in the general lessons. What led to a poor outcome in the first place, and then what happened afterwards?

"Are parents getting honest, useful explanations? Are they getting support?"

The review will also build on themes that have emerged from safety inspections of maternity units, including the need to listen to families, investigate serious incidents fully and learn from mistakes.

McCourt said she wouldn't shy away from identifying pressures in the system such as staffing shortages.

"We're completely independent, so we have that capacity to feel totally free to say what we need to say," she said

"You can't run an effective health service with staff who are excessively anxious, as well as not having the right mix of staff and the right numbers of staff."

While she said she would take into account lessons learned by previous inquiries in England and other parts of the UK, McCourt said Scotland had different challenges.

"You've got a much more dispersed population in Scotland. So thinking about how to cater for the more rural areas where you've got long distances, and you've got a smaller population concentration, that's quite different from most of England.

"So there are going to be things that are quite distinct about Scotland, as well as the fact that you do have devolution in the health system."

Announcing the beginning of the review earlier this week, the Scottish government said it would look at inequalities such as the higher rates of maternal death among Black and Asian women.

The review will also have a "specific focus" on maternity services in Caithness, Elgin and Wigtownshire, where there are longstanding campaigns to improve local services.

Claire Fleming's third child Andrew was born in Dumfries, 70 miles from her home just outside Stranraer, after the local maternity unit closed in 2018.

She travelled that distance even for short antenatal appointments.

She does not expect the review to lead to the full reinstatement of a 24-hour maternity service in Stranraer.

"I understand there are constraints and problems in recruiting midwives and staff, so I'm not asking for that. But what I do think is really important is that the absolute basics are covered here, and they're not getting done just now," she said.

"So when they find out what is going on down here in Wigtownshire, they need to act on it.

"I have been campaigning for more than five years, and I have met every MP and the first minister. I've spoken to them all and nothing's changing, so I am praying this is the thing that changes something."

Health Secretary Angela Constance said the independent review would sit alongside ongoing inspections of every acute maternity unit in Scotland.

"While the vast majority of mothers receive good care, I have heard from families who were let down," she said.

"Their experiences must shape improvement."

McCourt said she wanted to hear from people in different areas across Scotland.

"We need to take account of the different mix of services and how best to make sure that people have good access, that people feel that they have safe access as well.

"Anybody that wants to talk to us, that's very welcome."

Patients and staff who want to contribute to the review can find the details here, external.