Nicola Sturgeon and her deputy, John Swinney, were warned of “concerns” about the ear thermometers in Scotland’s Baby Box programme nine months before the digital devices were eventually removed, we can reveal.
Documents released under freedom of information laws show Scottish Government officials told senior SNP figures in May 2020 that they were proposing to switch to an under-arm thermometer.
The move came just a few weeks after our investigation found the government was repeatedly informed of a potential problem with the ear devices and the risk of “misleading” results if they were used on young babies.
But the change was not made until February 2021 after it was decided to wait until stocks of the ear thermometers had run out.
Newly-released memos show the first minister and deputy first minister were sent a report from civil servants who were negotiating an extension to the government’s Baby Box contract on May 26, 2020.
It was also sent to Jeane Freeman, who was health secretary at the time, as well as Maree Todd, who was children’s minister overseeing Baby Box policy.
The ministers were told of a supply issue with the infrared sensors in the ear thermometer caused by Japanese restrictions during the initial stages of the pandemic.
The memo stated: “There have been a small number of concerns about the use of the digital ear thermometer with very young babies, predominantly with temperature readings being potentially higher / ease of use by some families.
“We have highlighted the importance of following instructions on the current packaging and have sought advice from professionals in paediatrics, neonatal and postnatal units, midwifery and health visiting workforce.
‘Suitable from birth’
“Whilst the professional advice was not recommending the discontinuation of the digital ear thermometer in the current Baby Box, the recommendation was to include a digital under-arm thermometer in any future Baby Boxes as this is more versatile and suitable from birth (but can still be used by other family members).”
It added: “We would therefore propose to include under-arm digital thermometers in the Baby Box from December 2020.”
The change did not happen until February 25, 2021, because the stocks lasted longer than expected.
Earlier discussions proposed waiting another full year, until February 2022, to switch devices, but the move was brought forward due to the supply issues caused by the pandemic.
Scottish Conservative public health spokeswoman Sue Webber questioned why senior SNP ministers appear not to have acted immediately.
“It is clear that concerns were being repeatedly raised by those potentially affected, yet it took months for these thermometers to be replaced,” she said.
“Given the nature of this scheme, it is crucial ministers are upfront on any potential safety issues going forward.”
More than 200,000 Baby Boxes have been sent out under the hugely popular scheme, which boasts a 97% satisfaction rate.
The box, which can be used as a safe sleeping space itself, contains essential items such as clothes, a blanket, towels and nappies.
Safety concern raised in 2016
However, we previously reported that concerns were highlighted about the ear devices in the weeks before the launch of the Baby Box initiative in January 2017.
In December 2016, one official sent an email to colleagues to highlight long-standing NHS advice that ear thermometers can give “misleading readings” if used on young babies.
It said: “Our contractors have raised a safety concern about the use of in-ear thermometers based on this NHS advice.
“Please can you and yours let us know if you’re happy for them still to be included bearing in mind that we’ve bought them for the pilot boxes and they’re in all our marketing images!”
In March 2019, it was highlighted to officials at a Baby Box stakeholders meeting that “some paediatricians don’t recommend using digital ear thermometers for babies under six months”.
The safety issue was raised again the following month by a member of the public in a social media conversation involving officials.
The mother said her “baby was a couple of weeks old and this (thermometer) was giving ridiculously high temp readings”.
They were sent to a doctor who in turn told the family to attend hospital, where they were informed that the child’s temperature was normal, and that such mis-readings were “common with this thermometer from the Baby Box”.
‘Inaccurate’
In January 2020, another member of the public contacted the government to ask why ear devices were being included in Baby Boxes, given the NHS advice, and to warn that readings could be “inaccurate” in young babies.
After we highlighted the issue the following month, the government asked its expert advisers about the ongoing inclusion of the ear thermometers in April 2020, a month before ministers were told of the proposed change.
The government’s clinical lead for the National Neonatal Network responded by highlighting that official NICE (National Institute for Health and Care Excellence) guidelines state that under-arm thermometers should be used on infants under the age of four weeks.
“It would seem appropriate therefore to consider reviewing the type of thermometer included within the Baby Box,” they said.
The medic recommended either switching to under-arm thermometers or providing clearer instructions that the ear thermometers were “only suitable for use after four weeks of age”.
The government’s senior medical adviser for paediatrics, meanwhile, did not think it was a “significant issue”.
But the expert added: “Assuming cost is roughly equivalent for tympanic (ear) and under-arm thermometers then it may be sensible to change to under arm to follow NICE, follow the manufacturer’s instructions for the tympanic thermometer and deal with the concerns of whoever raised the issue.”
There is no written record of any of the experts who were consulted in April 2020 suggesting that the change should only be made when existing stocks of ear thermometers had run out.
‘No health or safety reasons’
A Scottish Government spokeswoman said: “Clinical experts stressed there were no health or safety reasons to withdraw the digital ear thermometer from the Baby Box.
“As is clearly set out in the Freedom of Information release, it was only replaced, following discussions with health professionals, with an under-arm thermometer because they are more versatile and suitable from birth, but can still be used by other family members.”