The health secretary has vowed to meet Caithness campaigners pressing to improve maternity services to prevent pregnant women travelling to Inverness to give birth.
But he would not commit to an independent review along the lines of that held in Moray to address similar concerns.
He also rejected a call for him to make the journey of over 100 miles to Raigmore Hospital, saying it would be “tokenistic”.
The offer to meet was welcomed by the Caithness Health Action Team (CHAT) which said it felt “forgotten about” having raised issues for six years.
Why was the health secretary in Inverness?
Humza Yousaf was in Inverness to speak to NHS Highland officials and clinicians about maternity services in the north.
He will announce the Scottish Government response to an independent review of maternity provision in Moray next week.
The review recommendations published in December favoured emergency patients being sent to Raigmore in the short term.
The meeting followed a strongly-worded letter from clinicians to Mr Yousaf saying plans to send more mums-to-be to Inverness is unworkable.
The 18 consultant obstetricians and senior charge midwives said Raigmore doesn’t have the facilities or staff to deal with extra births.
Mr Yousaf said he got a “very strong message” from the clinicians that they need investment in infrastructure and to recruit and retain staff.
He said: “They said to me pretty frankly they need investment regardless of what happens in Moray.”
He said the future of Moray maternity services is not a fait accompli and that he heard the concerns “loudly and clearly”.
The meeting also discussed the situation in Caithness where an independent review is being called for.
What is the situation for expectant mums in Caithness?
Since 2016, the majority of pregnant women in the county have had to give birth at Raigmore due to a lack of consultants at the local maternity unit.
Births at Caithness General Hospital have fallen by more than 90% between 2015 and 2020.
Chat said last year 175 births happened outside Caithness, of which 170 were at Raigmore, with just ten in the county.
The midwife-led community maternity unit in Caithness General offers a birth service for mothers of low risk pregnancy and childbirth.
But the hospital has no special baby care facilities and expectant mums with medical or pregnancy complications, or whose baby needs specialist support, are advised to go to Raigmore.
Asked if there would be an independent review of maternity services in Caithness Mr Yousaf said NHS Highland is carrying out a review of maternity services across the area.
He added: “The safety of women and their babies will be front and centre of any decisions made in terms of future provision of services.
“Before I’m health secretary I’m a father and a father whose wife had an emergency Caesarean section.
“For us, thank goodness, it was a really worrying time but an easy journey for us.
“I absolutely appreciated that is not the case for many women up and down the country, particularly in remote and rural areas.
“As a father I don’t dismiss their concerns in the slightest. But their safety and the safety of their unborn child is our number one priority.
“That could mean making really difficult decisions that are unpopular and people don’t like.
“But I won’t apologise for putting their safety front and centre.”
‘Happy to meet campaigners’
Mr Yousaf was also asked why Chat was not part of the meeting.
“I’m here in Inverness talking about Moray maternity services.
“I’ve no problem at all meeting in future with that campaign group. I’d be happy to meet them.”
But he will not take up an invitation to make the journey from Caithness to Inverness himself to experience what expectant mothers face.
He said: “I’m not an expectant mother. So to suggest I would know what an expectant mother would be going through simply by driving up and down that road frankly is a bit tokenistic.
“I’m happy to speak to expectant mothers, happy to speak to women who have had to make that journey.
“I think that’s far more value than doing the journey and getting a couple of clips for the camera and doing some media stunt.”
Chat chairman Ron Gunn was disappointed not to have met the health secretary on Monday.
He said: “I would have thought that we would have at least got an invitation to put the Caithness side of the situation across.
“We are very disappointed that he doesn’t seem to be interested in having an independent review of the situation in Caithness like Moray got.
“If he’s willing to meet us we will write again and ask him.
“We did it once and it was ignored.”
Significant investment needed
NHS Highland chief executive Pam Dudek said she is encouraged following the meeting and that Mr Yousaf had listened to concerns on required investment.
“It’s significant investment staffing wise, with reasonable investment in infrastructure to make it viable for years to come.
“We would have to do that anyway as our environment is not future proof at the moment.
“Even if you took Moray out of it, the status quo is not the right place for us anyway.”