1.7 million miles a year: ‘Far too many Caithness patients forced to go to Inverness’
Campaigners have insisted that the need to expand locally available healthcare is “undeniable” after compiling figures on the travel commitments undertaken by patients from Caithness who have to go to Inverness for treatment.
Caithness Health Action Team (CHAT) calculated that those from the county attending outpatient appointments at Raigmore Hospital, together with maternity patients, will have covered some 1,704,268 miles collectively during 2024.
That works out as approximately 142,000 miles being travelled per month, based on an average distance of 212 miles for the return journey. While public transport is an option for some, it is believed cars are used for the vast majority of trips.
CHAT points out that, aside from the “stress, personal expense and general inconvenience”, the combined mileage racked up for hospital journeys between Caithness and Inverness appears to be at odds with the Scottish Government’s ambition to reduce car use to help tackle the climate emergency.
CHAT’s figures for 2024 are based on data obtained from NHS Highland via a Freedom of Information (FOI) request covering the period from January to July inclusive, then projected to the year end. With 215 mothers from the far north having given birth at Raigmore in 2024, the maternity mileage would have been 45,580 on top of an estimated 1,658,688 for outpatients.
The comparable distance covered in 2023, obtained through the same FOI request, was 1,604,628 miles.
CHAT vice-chairman Iain Gregory said: “Putting aside the stress, personal expense and general inconvenience, this surely cannot be a cost-effective way of delivering treatment, and nor can it be considered to be particularly environmentally conscious.
“Once again, the facts are made starkly clear – far too many Caithness mums-to-be, and indeed thousands of other patients, are being forced to undergo the lengthy and, in wintertime, potentially hazardous journey to and from Inverness, and the need for a return to locally provided healthcare services in undeniable.”
Mr Gregory said this had been made “abundantly clear” in a major report last year by the Scottish Human Rights Commission which found that mothers in Caithness and Sutherland felt “unsafe” and “terrified” about going to Raigmore to have their babies.
The UN Committee on Economic, Social and Cultural Rights, based in Geneva, Switzerland, received a detailed submission from CHAT last December, followed by a verbal presentation by Mr Gregory in February.
Committee members were told that mums-to-be from Caithness are being denied their rights through “a policy of centralisation, retrogression and reduction of services”.
In April, after the UN committee reported on CHAT’s concerns, Mr Gregory argued that forcing the vast majority of expectant mothers to travel to Inverness to have their babies had been a deliberately retrogressive step and was “no longer defensible”.
He said at the time: “All patients, whether they are women who are forced to travel for vital healthcare, or indeed anyone who must access services, are entitled to adequate, accessible and equitable healthcare.”
The consultant-led maternity unit at Caithness General Hospital was downgraded in 2016 to a midwife-led facility.
Mr Gregory and fellow CHAT members Maria Aitken and Elspeth Husband met on Wednesday with the Scottish Government’s Equality, Inclusion and Human Rights Directorate to discuss the UN committee’s observations.
CHAT set out its view that “it is vital that the Scottish Government’s response to the concluding observations of the UN committee must outline, in detail, the measures they intend to take to address the undeniable inequities in relation to access to healthcare in Caithness”.
The group called for an action plan, timescales and performance indicators, with ongoing reviews, “until the target of restoring services to pre-2016 levels is achieved”.
A spokesperson for NHS Highland said: “We appreciate the unique challenges that are faced by people in remote, rural and island areas and in providing safe and effective services as close to home as possible.
“Safety and quality are at the forefront of all of our service planning, and we provide as many maternity procedures as is safe to do so in Caithness General Hospital. There are regular consultant clinics in Caithness and we have successfully increased the midwifery team there.
“Local obstetric scanning is provided to reduce the requirement for travel. High-risk or complex cases continue to come to our district general hospital in Inverness – this is the same for all our remote and rural areas in the Highland region.
“We plan our theatre lists to support travel for those travelling longer distances and accommodation and expenses are also provided.
“The 2016 review which recommended the current model of maternity services is available on our website.”
Scotland’s health secretary Neil Gray said: “I am determined to make health and social care services more accessible in the community.
“Through the Service Renewal Framework we aim to shift the balance of care from acute services such as hospitals into community-based settings which are focused on prevention.
“For some specialist treatments there may be a need to travel a bit further to access the best hospital care, ensuring better outcomes, faster access and fewer hospital visits.
“We will work to improve transport options, keep core services closer to home and use technology to reduce travel where possible.”
