Published3 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Lisa SummersScotland Health CorrespondentA fatal accident inquiry (FAI) got under way this week into the deaths of three babies, all less than a day old, in Lanarkshire. The death of a baby is an event no parent should endure, let alone in circumstances where – if there were different decisions, procedures, or knowledge – that baby may have survived.To then have the details of that personal tragedy made public is further trauma that no family would want. Mirabelle Bosch died at just 12 hours old on 2 July 2021 at Wishaw General Hospital.Ellie McCormick died at five hours old on 5 March 2019 at the same hospital.And Leo Lamont was two hours old when he died at Monklands Hospital on 15 February 2019.It is important that these deaths are not brushed off as isolated tragedies, and if there are common failings then they should be investigated to prevent anything like this from happening again.That is why three families who were anticipating a joyous turn in their lives are putting themselves through the distress of reliving their worst nightmare. What is an FAI and why has it been called for?This FAI was called by the Crown Office and Procurator Fiscal Service which has deemed it in the public interest for this inquiry to take place.Mirabelle, Leo and Ellie were all said to have died “in circumstances giving rise to serious public concern”.The purpose of this FAI is not to apportion blame, but to establish what happened and prevent future deaths from happening in similar circumstances. A sheriff will hear evidence, and eventually issue a determination of their findings which can include recommendations. Image source, SpindriftWhat have we learned so far?Sheriff Principle Aisha Anwar, who is leading this inquiry, is sensitive to the immense trauma suffered by each family.While there is no way to avoid the distressing detail of what happened, much of their evidence has been submitted as written affidavits to save them the ordeal of being questioned on it in court. All the parents were in court on the first day of the inquiry, but none have been there since.Although very little is known at this stage, it is clear that a key question families want answered is how and whether potential procedural or system errors contributed to their babies deaths. The inquiry is set out in three chapters, firstly looking at the circumstances around Mirabelle Bosch’s death. Her father Eckhardt, told the inquiry they were “led into a dark tunnel” by “misguided” instructions which gave them a “wrong sense of security”.They had believed everything with the pregnancy was normal, with antenatal checks suggesting the baby was healthy and developing as it should. But the court heard that despite a 31-week scan recording the baby as completely breech, three subsequent midwife examinations recorded it as being in a head down, cephalic position. This is the position that typically allows for the smoothest delivery. Even when Rozelle Bosch’s waters broke suddenly on 30 June 2021 and she was examined in hospital, the midwife sent her home to wait for labour to advance. Mirabelle was considered a “low-risk” pregnancy and midwife Michelle Tannahill told the inquiry this week she saw “no red flags” upon her examination. “Everything I had found that night was within the scope of my practice within midwifery. There wasn’t anything concerning,” she said. The details of what happened next are extremely distressing.Husband Eckhardt Bosch said he still feels the trauma in his body over the night of 1 July. After going into active labour at home, paramedics were called but a catalogue of delays ensued. It took five attempts to call the maternity unit at Wishaw General Hospital before anybody answered the phone, and paramedics were unable to deliver the baby themselves.Mirabelle’s head was stuck and by the time mother and baby were taken to hospital, her chances of survival were very slim. She died hours later in her mother’s arms. The post-mortem later noted that if the breech position had been recognised earlier in the pregnancy, then Rozelle would have likely been classified as a higher risk where a management plan for a hospital birth would have been arranged and the outcome may have been different.The pathologist also concluded if there had not been such a long delays transporting the patient to hospital, she may also have stood a chance of survival. What has still to come?Evidence has been heard from health professionals involved in Mirabelle’s death, with expert witnesses who were not directly involved in the case to follow. The FAI will then examine the deaths of Ellie McCormick and Leo Lamont.At this point there is no indication that health professionals in Mirabelle’s case had not followed the protocols or procedures in place at the time. However, there have been questions about whether software used to record details of the pregnancy may not have alerted those involved of potential risks, or may have some limitations in the information it can hold. Issues around the subjectivity of deciding whether a baby is engaged in early pregnancy, and how clear instructions are to mothers on when they come into hospital, have also been discussed.These areas are likely to be explored further when the inquiry examines the circumstances around the deaths of Leo and Ellie.Speaking to BBC Scotland News, the McCormick family lawyer said they believe Ellie’s death was entirely avoidable.Darren Deery, a specialist in medical negligence law, said: “The family’s understanding is that there were potential defects in the system, in that certain risk factors weren’t highlighted in the way they could, and should, have been.”And had the subsequent midwifery and obstetrics staff been aware of those risks, a different course of action would have been taken and the outcome may well have been different.”Ultimately there will be no blame placed here, but it will look in detail at what happened in each case, considering whether systems were at fault, whether individual or collective errors were involved and it will establish what steps, if any, might be taken to prevent other children dying in similar circumstances.

Published3 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, UK COVID-19 INQUIRYBy Lisa SummersScotland Health CorrespondentFor weeks we have heard apologies, finger-pointing, and denials at the UK Covid Inquiry hearings in London. Meanwhile, in Edinburgh, a very different narrative of personal Covid stories is being replayed. It will be at least another year before the Scottish inquiry hears from former First Minister Nicola Sturgeon and those who were in charge at the time but in London a parade of former ministers and the prime minister at the time, Boris Johnson, have already given evidence.This has led to the UK inquiry hearing of WhatsApp exchanges depicting a “toxic” atmosphere in Downing Street and a “flip-flopping” PM who was veering around like a shopping trolley.However, instead of questioning ministers as they are in London, the Scottish inquiry has seen witness after witness arrive in the small inquiry room on George Street to relive those terrible months during which their lives changed forever. Sons, daughters, husbands, wives and parents – all telling heartbreaking stories of guilt and frustration as loved ones died alone in hospital or in care homes.They have told of the virus spreading within families with fatal consequences, of grief-stricken relatives who could only attend a funeral from the car park and of desperate pleas for exemptions to the rules so they could hold a loved one’s hand during their last moments.Image source, PA MediaThe inquiry heard Caroleanne Stewart’s story of paramedics arriving at her brother’s house but refusing to get out of the ambulance. It was told they drove off leaving Derek slumped over the driveway, his lips purple and struggling to breath. A transport ambulance eventually took him to hospital where he deteriorated further. He died in May 2020 in ICU.Gillian Grant’s grandmother died in a Covid outbreak at an East Dunbartonshire care home. Ms Grant said she only found out a “do not resuscitate” order had been placed on her grandmother without her consent, as she was preparing for the inquiry with lawyers.Diane Montgomery’s feeling about the care her mother received was that “more people are dying in care homes because they can’t see their loved ones, than dying of Covid”.Sharon Mair, a former BBC employee, described the “hurt, anger, disregard” she felt on learning that her mother’s funeral took place on the same day as a party in Downing Street.Her poignant testimony was delivered while Boris Johnson sat in another witness box 400 miles away.Image source, PA MediaHere in Scotland the starting point for the chair, Lord Brailsford, is the impact of the pandemic and hearing from those for whom the consequences were the most devastating. This stage is only about marking the horror that people faced in these moments, with witnesses spared a courtroom-style grilling. It is a deliberately softer approach by Scotland’s inquiry underlined by the fact that, unusually for public inquiries, witnesses in this phase are not giving evidence under oath.This is in stark contrast to the evidence from the witnesses called to appear during this phase of the London hearings before Lady Hallett. So-called Module 2 is aimed at discovering how well the heart of government was functioning at key moments. But those testifying have sometimes resorted to desperately defending the positions they took or pointing the finger of blame at others.This week former PM Boris Johnson was asked about 5,000 missing WhatsApp messages from the early days of the pandemic but, in contrast, no-one in the Scottish government has yet appeared to give evidence on why senior figures wiped messages or used an auto-delete function.Nicola Sturgeon has previously told reporters there had been a Scottish government policy on social media messaging which advised their deletion after 30 days.Humza Yousaf, the former heath secretary who is now first minister, said government business wasn’t routinely done over WhatsApp and ministers were not told to delete messages to prevent potential embarrassment for the administration.The inquiry in Scotland will continue to hear evidence from bereaved relatives until Tuesday when it will pause until February.This is to allow the UK Inquiry to come north of the border to continue its investigations. From 16 January, Lady Hallett will chair two weeks of public hearings at the Edinburgh International Conference Centre. That is when the public will be able to hear from former First Minister Nicola Sturgeon, her colleagues and advisors about the key decisions they made. When the Scottish inquiry returns, there will be further impact hearings in the area of health and social care.There was a memorandum of understanding that the two inquiries would avoid duplication but because of its different structure, it will be at least 2025 before the Scottish inquiry takes its turn to question ministers and officials about their actions. Image source, PA MediaBefore that, much of next year will be focused on exploring the further impacts on young people in education, and on businesses. More deeply raw emotion is likely to be expressed.There are recurring questions such as: Why did the rules feel so arbitrary? Why did this system that was supposed to protect people fail for their loved ones? Why did it feel that the desperate needs of the most vulnerable were often less important than others?These are the kind of questions that both the Scottish and UK inquiries aim to address, in their own ways.They want to find out how decisions were made, how they were the implemented and what consequences they had. The end goal of each inquiry is the same, to find out what lessons can be learned, but the route they are taking is strikingly different.More on this storyFive takeaways from Johnson at the Covid inquiryPublished1 day agoContrite, shorn of theatrics – Johnson’s first day at inquiryPublished2 days agoFamily did not approve gran’s ‘do not resuscitate’ planPublished23 NovemberWhat is Scotland’s Covid inquiry investigating?Published24 October’Moronic’: Vicious Covid WhatsApps reveal No 10 battlesPublished31 October

Published3 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Lisa SummersScotland Health CorrespondentThe nights are drawing in, the schools are going back and a new Covid variant is circulating. It all sounds very familiar.But we are a long way from the autumn of 2020 when the coronavirus dominated our lives and there were different “levels” of lockdown across Scotland.So as we head into this autumn what should we expect?Firstly, the new variant. It’s called EG.5 and is an offshoot of Omicron. The World Health Organization currently classifies it as a variant of interest. The MRC-University of Glasgow Centre for Virus Research has played a key role in monitoring new variants of the disease throughout the pandemic.Prof Massimo Palmarini, who heads the centre, says he is not too worried about what he is seeing but it is important that surveillance continues.”The new variant doesn’t seem to have dramatic differences from the previous one but it doesn’t mean that it is not important,” he says. Pandemic in ‘quieter phase’He says there is a concern that if surveillance is cut back too much it will be hard to predict which variants might emerge and which ones will be more worrying than others.According to Scotland’s national public health body the pandemic is now in a “quieter phase”. That means that from the end of this month, testing will be scaled back. There is to be no more routine testing in hospitals, prisons or care homes. Instead if you have symptoms you will be tested in the same way as other infectious diseases are monitored. Meanwhile, new advice from the Joint Committee on Vaccination and Immunisation (JCVI) means that the Covid vaccine booster programme is also being scaled back. This year it will be offered to people aged 65 and over, as well younger people with underlying health conditions and in groups such as health and social care workers or people who live with those who are immunocompromised. How much Covid is there?Getting accurate data on Covid cases is much harder now. The weekly figures from Public Health Scotland only measure the number of patients in hospital with Covid. It does indicate a slight upward trend since the start of July.But this data does not tell us how much Covid is circulating in the community. That worries Dr Antonia Ho, an infectious diseases consultant and senior clinical lecturer at the MRC – Centre for Virus Research.She says: “We don’t really have a good sense of what’s happening in the community because we don’t have much in the way of community surveillance and largely testing isn’t happening anymore.”That is a worry from a research point of view in terms of being able to look out for potentially more threatening variants. “We are not sequencing anywhere near as much as we were and obviously the more information you have, the better. “And we do need a more complete picture in order to identify potential new variants that might cause problems for us.”Should we treat Covid in the same way as flu?The good news, Dr Ho says, is that because most of the population have hybrid immunity either from vaccination or natural infection then the majority of cases are milder. But she says some people continue to experience complications. There has also been a lot of discussion about considering Covid as a virus that we live with in the same way as flu. Dr Ho is a little wary of that.She says: “In terms of symptoms, they are pretty similar. “It is quite hard to differentiate as a clinician, someone who presents to hospital with flu and someone who presents with Covid. “But there are some important differences. “People with flu are more prone to bad secondary bacterial infections, whereas for Covid, we see a lot more clots like lung and heart clots for example, and long Covid is an important complication. “For example, a recent study in Australia found that in a very highly-vaccinated population infected with Omicron that one in five people described long Covid symptoms. So, long Covid is an important consideration.”Apathy warningThe main warning as we head into winter is not to be too complacent. Vaccine uptake during the spring booster campaign for over 75s dropped significantly. And last autumn only about 50% of health and social care workers came forward for a jag. Dr Ho says getting protected is the best form of defence with the NHS facing another really difficult winter.”Last winter, we experienced major pressure from RSV (Respiratory syncytial virus), flu and Covid and I would anticipate much of the same,” she says. “We often look to Australia’s experience and they’ve had another busy flu season. “This year they’ve seen a lot of influenza B which tends to target children a bit more and 80% of their admissions have been in children so we might see a real pressure on paediatric services for example. “So in an already pressured NHS if we see another big wave with three respiratory viruses that can drive a lot of admissions, albeit they might not be as severe as we saw in the first couple of waves, it may still cause a lot of problems for the NHS.”