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Doctors in Scotland have raised serious concerns over delays in restructuring neonatal care, warning that the wellbeing of the most vulnerable and premature infants is being jeopardised. The Scottish government’s controversial plan, first announced in 2017, aims to reduce the number of neonatal intensive care units (NICUs) from eight to three, centralising specialist care. Despite backing from some medical professionals and charities who argue the reorganisation would save lives, progress has stalled, with critics citing insufficient bed capacity and staffing as key obstacles to a safe transition.
Currently, the plan designates three main NICUs located at Aberdeen Maternity Unit, Edinburgh Royal Infirmary, and the Royal Hospital for Children in Glasgow. The remaining five units, situated in Dundee, Wishaw, Kirkcaldy, Kilmarnock, and Glasgow’s Princess Royal Maternity Hospital, are to be converted into local neonatal units offering limited intensive care. This model is intended to serve babies born before 27 weeks of gestation, those weighing less than 800 grams, or those requiring complex specialised care. Though the target implementation year was initially set for 2026, the timeline remains uncertain as the necessary expansion of cot numbers and staff complements has yet to materialise.
The British Association of Perinatal Medicine (BAPM) has criticised the sluggish pace, highlighting Scotland’s lag behind England, where a similar centralisation occurred in 2003. Dr Stephen Wardle, BAPM president, stressed that larger centres enhance survival rates by concentrating expertise, equipment, and surgical capabilities. He condemned the delays for putting infants at risk, remarking, “Ten years is an awfully long time to wait for these changes.” Alongside concerns about physical capacity, Health Secretary Angela Constance has acknowledged the need to proceed without further postponement, stating, “These changes will be made,” while emphasising the importance of proper resource allocation.
Amid this healthcare reform, parents have expressed divided opinions. Some campaigners oppose the plans, particularly over the impact on the neonatal unit in Wishaw and doubts about clinical evidence. Lynne McRitchie, representing petitioners against the changes, cited unresolved questions concerning the number of affected babies and adequacy of published data. Parents such as Lauren Bruce, whose daughter Grace was admitted to Ninewells Hospital’s NICU, fear reductions in local intensive care cots will exacerbate existing capacity strains. Bruce recounted how multiple babies required intensive care simultaneously, but no additional beds were available, questioning, “What’s it going to be like when it’s only one?”
Conversely, other families support the centralisation. Euan Duff shared the experience of his daughter Nula, born prematurely and treated at Aberdeen’s neonatal unit. He highlighted that specialised care is crucial and often necessitates transferring babies to higher-level centres for operations and treatments. Duff remarked, “Even though it was a really traumatic experience with Nula, I would want my baby taken care of in the best place… you can’t expect to have all of the most specialised staff in every unit.” Charities such as Bliss also advocate the reorganisation, pointing out that Scotland’s birth figures and intensive care needs are too low to sustain eight fully equipped NICUs. Bliss CEO Caroline Lee-Davey described the continuing delays as “hugely frustrating” and called for assurances on staffing, bed numbers, transport, and parental accommodation within units.
Health Secretary Angela Constance reaffirmed the government’s commitment to implementing the reforms, emphasizing adherence to clinical evidence and ensuring resources and organisation are adequate. While she declined to provide a specific timetable, Constance stressed that further delay is untenable. She reported having received assurances from health leaders regarding the capacity to expand services in a “phased, planned way,” underlining the urgency and importance of these changes for Scotland’s most fragile newborns
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