THE Maternal Mental Health Alliance’s report that in seven of 14 Scottish health boards women have no access to specialist perinatal services, with only Glasgow meeting standards, is disquieting (“Mental health care lacking”, The Herald, April 19). It raises serious concerns for women suffering mental disorder perinatally, but also for our next generation, given that these problems have lifelong effects on the well-being of children. They may also, tragically, have fatal consequences for mothers and babies. But the importance of perinatal service development has been recognised for years and this report raises concerns about the failure of the NHS to develop services, and its governance at the highest level.

In NHS Lothian a perinatal service was established 10 years ago with a remit to develop services for Lothian and partner health boards. As the specialist consultant I attempted to raise concerns with senior management when it became clear to me that the “specialist” service was seriously deficient. It is my opinion that minimising “reputational damage” to the board and “productivity” was a greater priority than quality of services, or problems in developing them. I escalated these concerns to members of the NHS executive and successive health secretaries, but they simply referred them back to the very health board about which I had raised concerns.

Several adverse incidents and fatalities have since occurred around the perinatal service in Lothian, and must also be occurring across Scotland.

This failure of perinatal service provision is, sadly, not surprising given the deeper endemic problem of NHS executive and Government preoccupations with “throughput”, sound-bites, and a toxic culture of “new public management” that rides roughshod over the experience and expertise of front-line staff. There is a serious lack of managerial accountability and transparency and we still lack any genuinely independent regulatory body. It remains difficult and dangerous for front-line staff to raise concerns about services. These issues are documented in submissions (online) to the Holyrood Health Committee inquiry on NHS governance. The public should be aware why services are deficient and of the underlying managerial and political causes. These require serious scrutiny, accountability and action.

(Dr) Jane Hamilton (Consultant Psychiatrist), c/o Humber Foundation and Teaching Trust, Willerby Hill, Beverley Road,

Willerby, Hull.

SCOTTISH Labour Leader Richard Leonard has been calling for the resignation of Health Secretary Shona Robison in the wake of the NHS Tayside failures. I direct him to NHS Wales, run by Labour, which is reportedly the worst-performing in the UK. Scotland’s NHS has 14 health boards and everyone is fully aware of the constraints and pressures those boards are under on a daily basis.

Health is a massive portfolio which Ms Robison has carried for more than three years and is currently overseeing the ground-breaking integration of health and social care, a massive remit. During her tenure the health budget has risen substantially and we have seen many positives in the continuation of free prescriptions, lifting of the pay freeze and all NHS workers earning the Living Wage and, most importantly, no privatisation of our NHS services. To those calling for Ms Robison to resign, I would say calm down, take a look at the positives our health service delivers on a daily basis.

Catriona C Clark,

52 Hawthorn Drive,

Banknock, Falkirk.