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Election 2021: Caithness, Sutherland and Ross candidates address the question of how they would best deliver healthcare in the far north amid deep local concerns about the level of provision of a range of services

By Scott Maclennan

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Caithness General Hospital.
Caithness General Hospital.

In our penultimate edition asking the candidates about the key issues affecting the north ahead of this Thursday's election to the Scottish Parliament we hear how each of the Holyrood hopefuls would tackle healthcare in an area as challenging as the Highlands.

Marion Donaldson, Scottish Labour Candidate
Marion Donaldson, Scottish Labour Candidate

Marion Donaldson, Scottish Labour Candidate

The big dilemma is how do we get the model of care right so that we have the appropriate level of hospitals and care facilities with the appropriate level of demand to ensure medical staff are getting sufficient expertise in surgical procedures, and that it is safer for patients to be treated here than anywhere else.

Hospital-based services need to be as ‘local’ as possible and centralised as necessary, but therein lies the conundrum: what do we mean by local, central, and specialised? We need a wider debate to make informed opinions.

A wider issue, however, is the way in which the Scottish Government funds healthcare. The Highlands and Islands has not done well out of this formula and I would be continuing Scottish Labour’s call for that to be redrawn. There is also an urgency to address the problems of poor health.

Covid has, of course, made a bad situation worse. Operation waiting times are sky high, the strain on our precious but overstretched workforce is huge.

Scottish Labour’s NHS Recovery Plan will get cancer services back on track, improve mental health and value our NHS and care staff. And our plan for Rapid Diagnostic Centres would mean that patients with cancer symptoms get diagnosed in a day rather than having to wait for months as they do under the SNP.

Other big issues are drug overspend and the extra costs we have to pay out for out of area locum staff. The obvious answer to this would be to “grow and train our own”, get more local people working in the health service.

I can see more scope for this technological advancement, but I am also aware, from my background as a community pharmacy and then as a city councillor, that we need to watch the delivery like hawks.

We must avoid a digital divide where the elderly or disadvantaged do not have the same access to this digital technology. I do, however, believe, overall, that this digitalised model, coupled with good hospital and care services in the area, can cut the tyranny of distance, which badly affects our region.

Struan Mackie, Scottish Conservative Candidate
Struan Mackie, Scottish Conservative Candidate

Struan Mackie, Scottish Conservative Candidate

In every corner of Caithness, Sutherland and Ross, constituents want the same thing; their physical and mental health services delivered in their community, as close to home as possible.

Under the fourteen years of SNP misrule, the relentless centralisation by NHS Highland is apparent to everyone. Left completely unchallenged by Scottish Government Ministers who chose not to use their powers and intervene, we have seen thousands of additional journeys to Raigmore Hospital for routine appointments undertaken by patients and worrying statistics on local deliveries and treatment times have been reported by health campaigners.

It is unacceptable that successive Health Secretaries have parroted the same statements for the better part of a decade, that our health services are a matter for NHS Highland and not the Scottish Government.

But when serious questions are raised by my colleague Edward Mountain MSP or groups like CHAT or No More Lost Souls, we expect Holyrood and the Minister responsible to take action, not deflect.

The public rallies which I attended back in 2017 against changes to the maternity model at Caithness General Hospital and the threatened closure of local health centres and town hospitals across the North were simply the tip of the iceberg.

It was an opportunity for the SNP Government to take control of the health board and make it accountable to the very people it serves and the fantastic staff that we have relied on so much throughout the pandemic. They failed.

In order to turn the tide on the widespread centralisation and protect our valued services from further centralisation by the central belt obsessed Scottish National Party, we need to see two key changes delivered in the next Holyrood term: A remote and rural communities bill that enshrines the delivery fragile services like health and mental health provision in law.

And the democratisation of our health boards, bringing community members from every county onto the health board to ensure that every corner of the region is represented.

Only then will we see services returned to our communities and the further threat of centralisation lifted.

Tina McCaffery, Freedom Alliance Candidate
Tina McCaffery, Freedom Alliance Candidate

Tina McCaffery, Freedom Alliance Candidate

The Highlands and Islands as we know very well has its own very unique and challenging issues with regards health problems faced by all of us.

Some of these challenges are the sheer size of the Highlands and Islands and limited facilities with people having to travel long distances for appointments and treatments and in some cases incurring additional expenses due to travel and in highly populated areas such as Inverness not enough staff.

Whilst I am not a career politician or health care worker looking in from the outside we need to look at solutions that are accessible, cost effective and can be implemented quickly across all areas. This could involve the use of mobile medical units.

Since the mobilisation of mobile Covid test/vaccination units it would be relatively easy to upgrade these mobile units to include minor surgeries and tests for other medical problems. This would ease the pressure on waiting lists for minor treatments at hospitals such as Raigmore freeing them up for other treatments that mobile units can't deal with as well as making it much easier on patients.

There also needs to be more funding given to the NHS over the next five years that takes in to account the geographical size and transport issues within the Highlands and Islands that face not only the public but staff. We also need to look at increasing staffing within the NHS from carers, nurses to consultants and surgeons, the amount currently being given is clearly nowhere near sufficient.

However, we also need to look at mental health issues which have grown horrendously over the past year and in many circumstances been exacerbated due to Covid and what we are starting to see is only the tip iceberg which is predicted to get worse over the next few years.

We need to urgently engage with mental health charities and workers to understand the extent of the problems facing people within the Highlands and Islands and how much money is required moving forward to ensure we can provide those services efficiently. Some of the ways this can be done is to ensure organisations both the NHS and private are able to offer remote counselling sessions with equipment such as Ipads/phones for patients that can be loaned out to those in need, since Covid the majority of counselling has been done via Webex/Zoom and whilst not ideal it has proven successful over all. Long term we need to increase mental health workers, to do this we need to look at funding options for things such as training more people to become counsellors.

As a Freedom Alliance candidate if elected in one of my priorities will be to enter discussions with those both in the public and private sector to fully understand what is required, what has been going wrong and then look for solutions to enable everyone in the Highlands and Islands to benefit over the next five years.

Molly Nolan, Scottish Liberal Democrat Candidate
Molly Nolan, Scottish Liberal Democrat Candidate

Molly Nolan, Scottish Liberal Democrat Candidate

When it comes to providing effective services in the Highlands we need a culture shift in the Scottish Government, away from central diktat and towards more local autonomy. Unfortunately, as a party of government the SNP has tended towards centralisation, and as a result the changes it has made to rural healthcare have had hugely corrosive effects in remote and rural communities. In the Highlands it has meant that local healthcare provision has really been gutted in places like Caithness, Sutherland and Ross, including the downgrading of the Caithness maternity unit which is still keenly felt.

Digital services like NHS Near Me work well for some patients, but they cannot and should not fully replace face-to-face healthcare provision. In addition to the benefits of seeing a medical practitioner in person, many people I speak to do not have the broadband capabilities to conduct video chats and so cannot access this technology – another disadvantage for many living in remote and rural areas.

Ultimately, we need a healthcare strategy that focuses on investing in local healthcare provision. That means increasing the numbers of GPs and nurses in Scotland, imbedding more specialists into GPs, and expanding the services available in GP surgeries, so that people can get a wider range of diagnosis, treatment and follow-up care within their community.

To aid this goal we should be creating strong clinical networks to give peer support to professionals working in remote and rural communities. Supporting this change will require adapting professional education to support this new decentralised model, but it is a more sustainable approach and will ensure that communities in Caithness, Sutherland and Ross do not miss out on high quality local treatment.

If elected I will challenge the government to adopt a decentralised Highland healthcare strategy and rectify the serious mistakes that have been made here over the past five years.

Maree Todd, SNP Candidate
Maree Todd, SNP Candidate

Maree Todd, SNP Candidate

After spending most of my working life in frontline healthcare, I have seen first-hand the benefits of localised services.

We know that patients want to see as much health care as possible provided in their own community and I want to see that too.

It’s important to remember that one size does not fit all, what works in Wester Ross for instance, might not be suitable for the far north. Going forward, we need to look at safe and sustainable methods of delivering health care.

The SNP has already made a number of commitments to improve rural health care. We will roll out more mobile health services for direct delivery of care, including additional screening, stroke and mental health services. We will also create a new centre of excellence for rural and remote medicine and social care, to provide expertise and advice on the delivery of care in different rural and remote settings.

Social care is also a vital part of the picture when it comes to addressing health inequalities. Our plans for a National Care Service will help to level the playing field, ensuring every person and family has access to care, should they need it.

Digital care has supported our NHS throughout the pandemic and as we come out the other side of Covid, it will remain a fundamental component in our health service. I acknowledge that video consultations are not suitable for everyone, but where they are, it works to vastly improve the accessibility of care - a major issue we face here in Caithness, Sutherland & Ross. Where the service is right for the person and they are comfortable in using it, digital care will become the default option.

We face significant challenges when it comes to addressing the health inequalities in Caithness, Sutherland & Ross but I’m committed to fighting for improved provision of services.

Harry Christian from the Scottish Libertarian Party did not submit a response to this issue.

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