Caithness women denied ‘basic human rights’ over healthcare, UN committee is told
The fight for better access to healthcare in Caithness is going all the way to the United Nations.
Caithness Health Action Team (CHAT) argues that women from the far north “are denied their basic human rights in relation to fair, equitable, adequate and accessible healthcare” because so many have to travel to Inverness to give birth.
The group claims that many other patients from Caithness are also “denied their rights to accessible and adequate facilities”.
CHAT this week sent a detailed submission to the UN Committee on Economic, Social and Cultural Rights in Geneva, Switzerland, and it is due to be considered early in 2025.
The move comes just two weeks after a major report by the Scottish Human Rights Commission (SHRC) found that mums in Caithness and Sutherland felt “unsafe” and “terrified” about going to Raigmore to have their babies.
CHAT’s submission states that healthcare access for people living in Caithness “has been substantially curtailed over recent years… with maternity care suffering particularly badly”. It declares: “Citizens face disenfranchisement, and are unable to enjoy their basic human rights in relation to medical care.”
The consultant-led maternity unit at Caithness General Hospital was downgraded in 2016 to a midwife-led facility and the vast majority of local women now give birth in Inverness.
CHAT says its submission to the UN is an unprecedented move by a small local campaign group.
Before the launch of the SHRC report – Economic, Social and Cultural Rights in the Highlands and Islands – CHAT vice-chairman Iain Gregory and secretary Maria Aitken met with its author, Dr Luis F Yanes. A second meeting has since taken place, attended by CHAT and groups from Skye and Galloway.
Mr Gregory said: “CHAT has been convinced for some time that the present situation facing mums-to-be, and indeed many other patients who are required to undergo the 200-mile-plus round trip to Raigmore, at all times of the day and night, sometimes in seriously dangerous weather conditions, and often in pain and distress, simply had to amount to a breach of their human rights, and the findings of the SHRC report strongly supported our viewpoint.
“Indeed, in the introduction to the report, Professor Angela O’Hagan, chair of SHRC, said that ‘many feel unheard, disenfranchised, abandoned and forgotten, with their concerns discarded or minimised’ – words which echo what we at CHAT, and indeed Caithness Roads Recovery, and many of those whom we represent, have said frequently.
“In our second meeting with Dr Yanes, we discussed the possibility of taking our case to the United Nations in Geneva, and it was agreed by CHAT members that I would produce and submit the report.
“I duly registered our campaign group with the UN office, allowing us to then present a submission outlining our case. This was sent on December 11 and acknowledged by the UN.”
The submission is due to be considered by the UN Committee on Economic, Social and Cultural Rights in Geneva in February.
Mr Gregory added: “CHAT has been campaigning for many years now. Countless meetings have taken place, including [in 2022] a face-to-face discussion with Scotland’s then health secretary, Humza Yousaf, when we called for an independent review.
“Countless news stories have been written and TV and radio interviews given, and yet, eight years on, we still await affirmative action to ensure that the human rights of the people of Caithness are recognised and acted upon.
“We hope now – having taken the matter to Geneva – that we may, at last, ensure that our case is recognised and upheld and that the state, who are ultimately responsible, will be called upon to act.”
The CHAT submission explains that the group is seeking “equitable access to health services and medical care” for people living in Caithness.
It states: “Such access has been substantially curtailed over recent years – retrogression has been evident in many areas of health provision – with maternity care suffering particularly badly, leading to consequent risks and distress being occasioned to expectant mothers, and to many patients. Citizens face disenfranchisement, and are unable to enjoy their basic human rights in relation to medical care.”
It goes on: “In recent years, particularly since 2016, local access to healthcare, most notably maternity care at or near time of delivery, has been severely curtailed, with the overwhelming majority of women being required to undergo the journey to Inverness to have their babies, despite the presence of a modern facility – Caithness General Hospital – in Wick. Many thousands of other patients are forced to make the same journey to access clinics and other vital services in Inverness – services which were formerly available, in many cases, in Caithness, before centralisation took place.
“CHAT seeks to correct this situation in order to ensure the health and safety of local people; to restore facilities which have been removed, or curtailed; and to protect the human rights of all residents in Caithness.”
Part of the submission covers the “diminution” of local services over many years.
“Until 1999 we had our own local health trust, which strived to achieve and maintain local healthcare delivery wherever possible, but, as centralisation became popular with government, this was dissolved, and Caithness fell within the remit of the centralised and frankly over-large and unwieldy NHS Highland,” it continues.
“In 2016, following a review, it was decided by the board of NHS Highland that maternity services at Caithness General Hospital would, from then on, be delivered via a Community Midwife Unit (CMU), with the removal of consultant obstetrics being agreed by the board, and women deemed to be at risk of ‘birthing complications’ would henceforth be taken to Raigmore Hospital in Inverness. This decision was endorsed by the Scottish Government.
“Over the intervening years between 2016 and 2024, representing the views of the overwhelming majority of local women, CHAT has fought for their undeniable right to have their babies locally – a right enjoyed by their mothers, grandmothers and antecedents for generations past.
“CHAT has constantly called for a consultant-led maternity unit, with arrangements similar to those enjoyed in Orkney. There have been countless media stories, TV and radio interviews, and representations made to politicians – indeed in 2022 the then health secretary (later First Minister of Scotland), Humza Yousaf, visited Caithness and met with CHAT, promising that a new review would take place. Sadly, this has never been actioned.
“In 2022, an astonishing 202 Caithness mothers were forced to undergo the dangerous journey to Raigmore Hospital to have their babies, whilst only eight were able to give birth in the Caithness CMU. In 2015, prior to what we class as the downgrading of Caithness maternity services, 164 women had their babies locally.
“We consider this to be incontrovertible evidence of the denial of equitable treatment of women in Caithness.
“As well as maternity issues, thousands of Caithness people are forced to undergo the 200-mile-plus round trip to Inverness each year, in all weather conditions and at considerable personal expense, simply to access clinics and appointments which should be – and which in many cases previously were – available in Caithness.”
On the SHRC report, CHAT states: “It is important for us to highlight some of the findings, supporting as they do our case that people in Caithness are denied the ‘right to access all the conditions and services necessary to achieve the highest attainable standard of health’ with so many services having been removed from local access, and with women being forced to undergo dangerous and traumatic journeys to have their babies.
“This has resulted in anecdotal evidence of women deciding to forego their right to have more children due to the stress, trauma and risk involved, as a consequence of the lack of access to local maternity care. Retrogression is clearly a major factor in our current situation.”
The submission concludes: “It is the position of Caithness Health Action Team that women, in particular, in Caithness are denied their basic human rights in relation to fair, equitable, adequate and accessible healthcare, and therefore – by definition – their babies are similarly denied their equivalent rights. Many other patients – indeed many thousands per annum from Caithness – are also denied their rights to accessible and adequate facilities.”
The SHRC report, published at the end of November, found that some mothers in Caithness and Sutherland were choosing not to have more children, or moving out of the area to avoid giving birth at Raigmore.
It also noted that some women were said to have lost their fertility due to delays in getting to hospital in Inverness in emergencies.
It said centralisation has meant that more than 14,000 patients a year from Caithness and Sutherland now have to travel to the Highland capital for different aspects of care.
The SHRC noted that many people in the Highlands and Islands had expressed frustration about their human rights. It stated: “Critical issues include an apparent failure to meet the most basic international obligations related to the right to health, the right to housing and the right to food.”
After the SHRC report came out, a Scottish Government spokesperson said: “We recognise the rights to food, housing and health and that is why we have taken action to advance human rights in practice now, as well as to prepare the public sector for new duties in the future in relation to the rights highlighted in the report.
“We believe that no-one should have to compromise on food or other essentials and have published a plan, grounded in human rights, to tackle this. We are taking forward nine actions to improve access to food, using a cash-first approach so that fewer people need to turn to food parcels.
“Scotland has the strongest protections across the UK nations for people experiencing homelessness and local authorities have a legal duty to provide accommodation for anyone facing homelessness.
“From April 2016 to March 2023, the Scottish Government has supported the delivery of more than 10,000 affordable homes across rural Scotland. Our commitment to deliver 110,000 affordable homes, of which at least 70 per cent will be for social rent and 10 per cent in our rural and island communities, is backed up by our Rural and Islands Housing Action Plan.
“We have established a National Centre for Remote and Rural Health and Care to support health and social care providers to establish long-term sustainable healthcare in rural and island areas. The aim of the centre is to help reduce remote, rural and island health and wellbeing inequalities through focused work on improving sustainability, capacity and capability of remote, rural and island primary care and community-based workforce and service delivery.”
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