Warning over maternity services

The report said maternity services will be put at risk

Pregnant womens' safety will be compromised in Scotland unless 100 more specialists are provided over the next five years, senior medics have warned.

A report by the Royal College of Obstetricians and Gynaecologists said the current number of hospital doctors and midwives would struggle to cope.

The report calls for an increase in the number of consultants and trainees.

Deputy Health Minister Lewis Macdonald said regional planning groups would have a key role in maternity planning.

The RCOG said the problems would be created by the restrictions of a 48-hour working week being brought in by the Working Time Directive in 2009.

Unless we reorganise and unless we staff appropriately, the service by 2009 as we wish it to be will not be sustainable Prof Allan Templeton RCOG

The organisation said the 148 consultants working in obstetrics and gynaecology would have to be increased to 250 by then.

The report called for action to improve clinical care for pregnant mothers by increasing direct contact with consultants on wards, and redesigning services to make the best use of "scarce" NHS resources.

Speaking at a press conference in Edinburgh, Dr Laura Cassidy, Scottish chairwoman of the Royal College, said: "We have to look at innovative ways of providing the service.

"But I would doubt very much if there is any way that we are going to be able to continue to provide a seven-day-a-week, 24-hour cover of emergency labour wards unless there is expansion in specialist numbers in the next few years."

Community units

Professor Allan Templeton, president of the Royal College added: "Unless we reorganise and unless we staff appropriately, the service by 2009 as we wish it to be will not be sustainable."

Dr Tahir Mahmood, who led the report, said the 2009 target would not be achieved until around six years later.

He added that one third of the current obstetrics and gynaecology consultants would leave their posts by 2010 due to factors such as retirement.

"Either you have to increase the numbers or import doctors from elsewhere or you have to re-look at how you provide services," he said.

we believe that all NHS staff should enjoy safe working conditions and provide the highest quality of patient care Lewis MacDonald Deputy Health Minister

However, he said he opposed overseas doctor recruitment, adding: "We shouldn't import doctors from the Third World where healthcare is in a bad state."

The report, which raised concerns about a significant shortage of specialists in all areas, backed midwife-led community maternity units.

It recommended that a 24-hour consultant presence would be "highly desirable" at maternity units with more than 4,000 births per year.

It also said gynaecological services should be re-worked to take account of Scotland's geography and the executive's desire to provide more local health services.

Professor Andrew Calder, who is chairing an inquiry into maternity services, said: "We have to make sure that we don't have a loss of services while we get through this difficult period of the next six or seven years and hopefully by that time things may begin to see an upturn."

The RCOG said more specialists would be needed by 2009

Prof Calder said new technology, such as tele-medicine links, must be developed.

Mr Macdonald said the report could be studied by NHS boards, which will publish their workforce plans next year.

He added: "The executive fully supports the working time regulations introduced in 1998.

"Compliance with the regulations is an employer's responsibility.

"Patient safety is of paramount importance and we believe that all NHS staff should enjoy safe working conditions and provide the highest quality of patient care."

He added that ministers were committed to setting up a national maternity services support group.

He said: "It is clear from the information collated by the national maternity services workforce planning group that there is no one solution that fits all for the three regional planning areas.

"That is why regional planning groups will have a key role in maternity workforce planning for the future."