Caithness people treated 'appallingly' over pause on health redesign
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The Scottish Government has been accused of treating the people of the far north "appallingly" after the £80 million Caithness health redesign was brought to a halt.
Local MP Jamie Stone said he was "disgusted" at the turn of events and blamed SNP ministers for overseeing "a complete breakdown of proper responsible government".
His criticism came after Scottish health boards were told to pause any new capital projects and concentrate on essential maintenance. NHS Highland acknowledged that the news would be "difficult to hear".
Talks are understood to have been taking place to assess the impact on a number of construction schemes in the NHS Highland area – including community hub and care villages in Wick and Thurso, costing £55 million, and a reconfiguration of Caithness General Hospital.
In March 2022 it was estimated that the overall Caithness redesign cost would be between £76 million and £82m.
Other developments affected in the NHS Highland area include a £9 million plan to increase capacity at Raigmore Hospital's maternity unit in Inverness – for which planning permission was secured earlier this month – and a project to replace Fort William's Belford Hospital.
The Scottish Government described its capital funding position as "extremely challenging".
Mr Stone, the Liberal Democrat MP for Caithness, Sutherland and Easter Ross, said: "I am disgusted that the SNP government in Edinburgh sees fit to treat the people of the far north so appallingly. What we are seeing is a complete breakdown of proper responsible government.
"The stark fact is that the UK government does give the Scottish Government the money to pay for services like health. It is called the Barnett formula.
"When the Scottish Parliament was set up, health spending was 22 per cent more per head than in England. This reflected the cost of serving a more sparse, rural population.
"The SNP came to power in Scotland in 2007 and, within three years, patient premium was down to 10 per cent. Now, we spend just three per cent more than England to deliver healthcare in Scotland.
"Constituencies like mine bear the brunt of these cuts. We need to increase the portion of funds being spent on healthcare in Scotland to improve people's lives and expand opportunities.
"I call upon the Treasury to audit what the SNP is doing with the Scottish taxpayer money it is given – and to report back to the House of Commons as a matter of extreme urgency.
"I also call on all other Highland elected representatives, whatever their political party, to join me in condemning this shocking behaviour."
Earlier reports had quoted the finance director of NHS Lothian as saying health boards had been told they could expect to wait two years or more for new capital investment.
A Scottish Government spokesperson said: “As set out in our draft budget, the capital funding position is extremely challenging.
"The UK government did not inflation-proof its capital budget which has resulted in nearly a 10 per cent real-terms cut in the Scottish Government’s capital funding over the medium term between 2023/24 and 2027/28. Our emphasis for the immediate future will be on addressing backlog maintenance and essential equipment replacement.
“Our Infrastructure Investment Plan (2021-22 to 2025-26) identified the priority health capital projects for funding within that period. As a result of the cut in our capital budget, a revised pipeline of infrastructure investment will be published in spring 2024 and all due consideration will be given to what projects can be included within that revised plan to ensure it is affordable and deliverable, while providing the best value for money.
"In the interim, boards have also been advised to pause any new capital projects.”
A spokesperson for NHS Highland said: "In terms of capital projects, we have been advised to stop any project development spend. Instead, funds available should be focused on the maintenance of the estate and essential equipment and digital replacement.
"The main projects we are assessing are the Lochaber and Caithness redesigns, Cowal Community and the Raigmore Hospital maternity refurbishment.
"Our staff and communities have invested time and effort into these projects and we know this news will be difficult to hear. We are contacting key stakeholders as a priority so that we can work through the implications with them."
Last June it was announced that a design team had been appointed for the community hub and care villages in Wick and Thurso. Three leading consultant firms were brought in by Hub North Scotland, which has been working with NHS Highland on the reshaping of health and social care services in Caithness.
The two sites are near Noss Primary School in Wick and at the Dunbar Hospital in Thurso.
A key aim is to bring together services and teams currently located in multiple sites, with the hubs featuring community and residential care beds, GP practice, outpatient consulting, therapy space and a base for community integrated teams.
The redesign also includes the redevelopment of Caithness General Hospital, to be delivered by Balfour Beatty.
NHS Highland has not responded to a query on how much of the overall Caithness redesign funding package has been spent to date on planning, consultation and other costs.
Councillor Jan McEwan, who represents Wick and East Caithness on Highland Council, said: "It's an absolute disgrace, after the money and resources that have gone into this over the past few years. The Scottish Government obviously doesn’t regard Caithness and Sutherland as being part of Scotland."
Maree Todd has described the Caithness redesign as "essential" and emphasised that she shares the desire of local people to see it delivered.
She has requested an urgent meeting with NHS Highland management over the "temporary pause" on new capital projects.
The SNP MSP for Caithness, Sutherland and Ross said: “Like many of my constituents, I am disappointed with the news that Scottish health boards are halting new construction – which follows the UK government’s real-terms cut of 10 per cent to the Scottish Government’s capital budget, combined with an increase in construction costs due to inflation.
"For NHS Highland, this means a review of several projects, including the redesign of Caithness health services.
“I believe the Caithness redesign project is essential. The modernisation of both the healthcare estate and local services is needed to deliver high-quality health and social care, support staff and enhance community resilience across Caithness.
"Local people have worked exceptionally hard to develop this model with NHS Highland and, like them, I want to see it delivered.
“The Scottish Government approved the initial agreement for the Caithness redesign project in February 2022 but since then NHS Highland's timeline for progressing the application has slipped significantly, leading to delays in reaching the construction phase.
"I am keen to work with NHS Highland to identify what progress can be made whilst awaiting funding to minimise further delays.
"I have requested an urgent meeting with NHS Highland managers to discuss this, along with the impact on my constituents in Caithness. I will be looking to understand which aspects of the service redesign might be able to progress in the interim."
Ms Todd added: “This temporary pause is disheartening, and I completely empathise with the concerns that have arisen since this announcement. I am determined to see services improve in Caithness and I will continue to do everything I can to ensure progress is made as soon as possible.”
A Caithness healthcare campaigner warned that the pause on new construction projects would contribute to a modern-day version of the Highland Clearances.
Iain Gregory, of Caithness Health Action Team (CHAT), said he was disappointed but not surprised that major investment in the far north was now on hold, or at risk of being lost, and urged elected representatives to speak out.
In a social media post on behalf of the campaign group, Mr Gregory wrote: "Sadly, I have to say that I am not at all surprised to hear this news. Disappointed, yes – surprised, no.
"From about 1750 to around 1860 the Highlands suffered under the rule of greedy and avaricious landlords who cleared the people from the glens to make way for more profitable sheep – one of the most shameful episodes in the history of Scotland.
"And today, in 2024, just a few generations later, the people of the far north face a new clearance, and it is – once again – economic.
"Remove the vital services, healthcare, social support, infrastructure, employment, the basic structures needed for a community to be sustainable, allow our roads and streets to crumble, and the population will again be forced to move to the faraway cities, leaving this once beautiful and vibrant county to become nothing more than a vast wind farm.
"The road to Bute House [the First Minister's official residence] is indeed littered with broken promises. I await with great interest the reaction of our elected representatives.
"Kate Forbes [SNP MSP for Skye, Lochaber and Badenoch and former finance secretary] has spoken. Can we now hear from the others? The people are waiting – and their patience is at an end."
Highlands and Islands MSP Edward Mountain has insisted that frontline care must not bear the brunt of health service cuts.
He described the pause on capital projects as "highly regrettable", but said he was not surprised after it emerged last July that NHS Highland was predicting an overspend of £55.7 million by the end of that year.
The Conservative MSP said: “I have been constantly warning that, due to the overspend of over £55m, services would be at risk.
"Whilst I understand that capital projects may need to be paused, which is highly regrettable, I am absolutely adamant that no frontline care – including elective and non-elective surgery – should bear the cuts.
"Waiting lists are already excessive and delaying operations to save money would be completely unacceptable.
"I have asked NHS Highland to provide an urgent briefing to MSPs so that we can fully understand the situation and liaise with our local communities to ensure patient views are properly heard by the board.
"I have also contacted the cabinet secretary for NHS recovery, health and social care [Michael Matheson] to seek assurances that no frontline services will be impacted.”
The £9m overhaul of maternity services at Raigmore was given the go-ahead earlier this month. It was hailed as a “transformational” investment in an extension for new wards.
Planning permission was granted by Highland Council under delegated powers after the application was made in March 2023.
NHS Highland said at the time it would lead to a major expansion in maternity and neonatal care services at the Highlands’ biggest hospital and enable more women from Moray and Caithness to give birth in Inverness. A move by NHS Highland to reassure campaigners in Caithness over the future of the county's community midwifery unit was described as an insult by CHAT.
