Fears have been raised about the future of health provision in key rural areas after a review was launched into a hospital struggling to recruit consultants.
The mix of services at Lorn and Islands hospital in Oban, which looks after 45,000 people, is being reconsidered, with managers saying that they are unlikely to be able to replace surgeons and physicians when they retire.
It has prompted fears over the future of six rural general hospitals in Scotland. The cost of paying locums to fill vacancies is already a concern and the need to save money is also being cited as a trigger for the rethink. One experienced medical worker said privately: “I think there is a threat to the whole rural general hospital system.”
“When I asked what was under review they said ‘everything’
Gordon McFarlane, a surgeon in Shetland and lead author of a report on rural surgery, said: “We are facing a situation at the moment, looking around the rural hospitals as we never have before.”
About 400 people attended a public meeting in Oban about the future of Lorn and Islands hospital on Friday. The hospital serves residents from a number of islands and remote towns, including Campbeltown and Tiree. The nearest major hospitals are in Glasgow and Inverness 100 miles away.
Advertisement
Marri Malloy, chairwoman of Oban community council, said: “We used to be a district general hospital, we are now downgraded to a rural general and we have a review going. When I asked what was under review they said ‘everything’.”
The review had been set up in secret and she had only learnt of it by chance, she claimed. “They did not want the public to know.”
An action group had been set up because NHS managers were only offering “platitudes”, Ms Malloy said.
David Sedgwick, an experienced rural surgeon, said reducing cover could mean patients travelling for four hours in dangerous conditions just to have abdominal pain assessed. It also raised questions about people taking part in sports in the valleys and hills.
The Oban hospital has three physicians, three surgeons and three anaesthetists working with advanced nurses, paramedics and GPs. One of the physician posts is occupied by a locum as efforts to recruit permanently failed.
Advertisement
Mr McFarlane and Mr Sedgwick say that for years medical and surgical training has directed junior doctors towards specialising in narrow fields and there is a view that treating larger numbers of patients improves results.
Caithness General in Wick has one surgeon, from Poland, supported by others travelling from Inverness. Rural hospitals in Fort William, Orkney and the Western Isles all rely on locum surgeons. Shetland is the most stable with three permanent surgeons, including another from Poland.
Argyll and Bute Health and Social Care Partnership, which runs the Oban hospital, stressed that it would be kept open, including round-the-clock accident and emergency cover. It added that the review was at an early stage.