RECENTLY a Glenluce member of the Galloway Community Hospital action group (GCHAG) shared her childbirth experiences with the Secretary of State for Women's Health. Her emotive account of 7,500 miles to receive maternity care hit home. The eighth-largest of Scotland's 22 community midwifery units has closed with no local deliveries in the last four years. Out-of-hours community midwifery requires a 150-mile round trip. GCHAG has requested an immediate independent review.

The 1912 Dewar Report into rural and remote healthcare pre-dates the NHS but is as valid today as ever. Starting with a narrative of unnecessary suffering, a pernicious interaction between deprivation and rurality, the importance of ensuring that professionals have good work conditions with the resource to provide necessary services while advocating local not national solutions, Dewar formed the basis of rural health improvements over 90 years. In the last decade we have seen the progressive centralised dominance of new public management (NPM). A century later women again hesitate to embark on pregnancy, terrified at the prospect of travelling while in labour, roadside delivery, or unnecessary labour induction; not to mention travel and subsistence costs. Midwives trained to deliver babies send people in labour on an avoidable, hazardous 75-mile journey to be over-medicalised; who would choose that?

Another proposed centralised policy is likely doomed. Local policy, informed by a narrative as in the Dewar Report, worked for 90 years, enhancing quality and recruitment. Current policy has reversed that. NPM mistrusts factual narrative, replaced by centrally biased and misleading data.

In the 1920s my grandfather put a labouring woman on the train at Glenwhilly station for the first Caesarean section in Wigtownshire; in under three hours. The mean time for helicopter transfer exceeds this and the neonatal retrieval team can take several hours more. Progress, but in the wrong direction. Today ambulance availability is far from assured. Dumfries midwives regard the decision to request an ambulance in Galloway as outside their skillset. I have personally accompanied a labouring patient in the ambulance to Dumfries in a little over an hour. In the 1930s, unlike now, there was a scheme to reimburse Galloway travel costs. Highlands and Islands patients still receive non-discretionary payment for much shorter journeys, but not Galloway, an inequality that is a national disgrace.

My father celebrated a dedicated local maternity unit in the late 1950s. In 1998 managers threatened closure of the unit until a BMJ published audit of 997 Wigtownshire births confirmed safety and an effective transfer policy. In the last 10 years, senior clinical and management service cuts erode both patient and professional confidence. Today other CMUs thrive while our patients, harmed by service reductions, report symptomatology that suggests PTSD. A clinical disaster seems inevitable. Caithness is on the same pathway and others will follow. I hope they instruct an independent review soon and read the Dewar Report before they start. History has lessons for us all.

Gordon Baird, Sandhead, Wigtownshire.


IT seems the news is filled with how good or bad our national governance is and how incompetent our political leaders are. Meanwhile for the rest of us life goes on, with us voters interested not just in the large issues but the small daily irritations that affect our daily lives.

I returned to our little East Neuk village to find that our council had taken action to brighten things up. Double yellow lines and white lining everywhere, including cycle paths. Wow. Sadly the omnipresent potholes still abound.

At the recent council elections the various parties made many, usually undeliverable, promises but I never came across the promise or demands that road lining would be the number one priority. Most told us that they, and they alone, would fix potholes and the road infrastructure. But no less than three months later road painting has suddenly become the most important priority. Potholes ignored.

I fully sympathise with the financial cuts councils are having to endure, but have they never heard of prioritisation of short cash. Do our councillors who make election promises actually talk to the council?

Please drop the paint brushes and fix the potholes, blocked and broken drains and at least make an effort to deliver the election priorities and promises.

Ian McNair, Cellardyke.


I WAS most impressed by the innovative idea of a pub within the environs of a care home ("I’ll have a sherry: Care home’s new ‘pub’ helps boost residents’ health", The Herald, July 23). Many years ago, we had a similar idea in the cardiac wards at Stobhill Hospital.

Where appropriate, patients were offered a small whisky, sherry, glass of wine or beer at 9pm only on a Friday and Saturday evening. This was initially provided through pharmacy and then the relatives would donate, to maintain supplies without cost to the NHS. The nursing staff constructed a special drinks trolley to take round the wards.

The patients greatly appreciated this, feeling a sense of normality and relaxation. The service was never abused and a second drink was not offered or sought. We continued this policy for at least 20 years, until the inpatient facility closed.

The hazards of alcohol have to be recognised. However, for many patients, a small libation can improve their hospital or care home experience. The pub setting for care home residents provides a focal point to meet, to enjoy various activities, and to benefit from the companionship of fellow residents.

Frank Dunn, Lenzie.


ALL the tarradiddle and mystique instanced by Doug Marr over a simple cup of coffee ("It’s time to wake up and smell the coffee", The Herald, July 2 ), now dispensed as flat whites, macchiatos, cappuccinos, americanos, cortados, lattes, red eye, etc, took me, growing up in a household in the 1940s/50s where the only chocolate left in the box by either parent was always the coffee one, to my first coffee hit in a friend’s house of Camp Coffee, a mixture of coffee, chicory and sugar, invented in Glasgow in 1876, and enjoyed by the Gordon Highlanders in India; and I understand now available mainly in the baking section of supermarkets.

I’ve never looked back, although most days an instant coffee hits the spot. For my sins I admit to occasionally challenging the aspiring barista with a barraquito (Canary Islands’ coffee liqueur); and any association with “red eye” is more likely related to barley than genus coffea.

R Russell Smith, Largs.