Meeting of the Parliament 16 January 2025
I thank Tim Eagle for raising this important topic in the chamber. In addition to the list of facilities that need replacement that is included in the motion, I once again raise the need for a new-build Gilbert Bain hospital to serve residents in Shetland. The hospital also serves a wide maritime area because of Shetland’s geographic position. It is often the closest available medical facility for fishing vessels, offshore energy sites and passengers from cruise ships in the North Sea.
Last year, 134 ships carrying more than 138,000 passengers visited Shetland, and some had to visit the Gilbert Bain hospital. The coastguard rescue helicopter regularly flies to Lerwick to land patients who have been airlifted from vessels or oil rigs for treatment at the hospital. It is long past time that the 1950s-designed hospital was replaced with a modern, fit-for-purpose facility. I once again put on the record my call for progress on a new hospital for Shetland.
There is much that could be said on the subject that we are debating this evening but, as time is not on my side, I will limit my remarks to some of the issues that Shetland patients face. The first is travel. NHS Shetland has arrangements with mainland health boards, such as NHS Grampian, to provide the healthcare that is not available in Shetland. However, the impact that communication, or miscommunication, between different hospital departments can have on island patients was raised with me recently.
One of my constituents was required to stay in an Aberdeen hospital for a night longer than necessary because they were waiting for a prescription from the hospital pharmacy. Had there been a more pragmatic approach, they could have been discharged and the further night in a hospital bed in Aberdeen would have been avoided. The script could have been handed to the patient and they could have taken it to a pharmacy in Aberdeen and been able to fly home that evening.
The rules on the reimbursement of travel costs also impact on access to healthcare. For Shetland residents on the island of Bressay, the only way to reach the hospital or health centre in Lerwick is by ferry across a mile of water. The current travel rules allow reimbursement only when patients travel more than 5 miles by sea, which raises the question of why 5 miles was set as an arbitrary limit. Either there is a stretch of water that needs to be crossed or there is not.
That, too, needs a pragmatic approach. I welcome the fact that NHS Shetland is running a six-month pilot scheme in which Bressay residents may claim for a trip to the Lerwick health centre. That follows both the community council and I raising the financial impact on patients, which can be significant when a series of frequent and recurring appointments is necessary.
Underlying all those issues are the challenges of depopulation that rural and island Scotland faces, which are highlighted in the motion. The lack of infrastructure, housing and digital connectivity impacts on recruitment and retention of NHS staff and, in turn, the reduced healthcare provision exacerbates depopulation.
Technology allows us to embrace new forms of healthcare, which can be transformative for healthcare provision, particularly in rural and island areas with small populations, but the lack of reliable digital connectivity makes the credibility of that prospect distant until real action is taken to improve rural and island high-speed broadband. Age Scotland found that, in Scotland, 25 per cent of people aged over 60 do not use the internet, which is another barrier to healthcare through technological means when we consider that 27 per cent of the population in rural areas are aged 65 plus. Addressing healthcare needs in rural and island healthcare includes investment in infrastructure.
I just about have time to let members know that, when I visited the Out Skerries community last summer, the poor information technology connection at the nurse’s house was the subject of debate. I had been told that, when the general practitioner had been in the isle a few days previously, they were unable to get online.
I am out of time.