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Election 2021: Inverness and Nairn candidates for Holyrood tell us how they would tackle the issue of delivering healthcare across the Highlands

By Scott Maclennan

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Raigmore Hospital which shoulders a huge burden when it comes to delivering healthcare in the Highlands.
Raigmore Hospital which shoulders a huge burden when it comes to delivering healthcare in the Highlands.

With Covid illustrating issues with the healthcare system as well as creating new problems for hard-pressed NHS staff we asked those seeking your vote this Thursday how they would tackle the challenges of treating patients across the Highlands.

Ariane Burgess, Greens Candidate
Ariane Burgess, Greens Candidate

Ariane Burgess, Greens Candidate

High quality healthcare should be available and accessible for everyone. This is not currently the case, and centralisation is exacerbating this inequality. Both on the mainland and islands, our rural communities are acutely affected by the centralisation of health care services.

Too many are forced to make long journeys to access health care. We have a rural depopulation crisis, and the lack of genuinely local services plays a part in some people’s decisions to leave. If we are to tackle this crisis, we need to invest properly in our communities.

Our health services must be adequately funded to respond to the needs and challenges of rural areas. I want people to live the healthiest lives possible and put prevention and early intervention measures in place to tackle the root causes of poor health, such as poverty, smoking, drug and alcohol misuse, and air pollution.

The struggle to recruit and retain rural healthcare workers exacerbates these issues. We must make rural healthcare work more desirable through increased investment and community integration.

During the last parliamentary session, Green MSPs secured

  • Regular Covid testing for frontline healthcare staff
  • Created a legal duty on government to ensure appropriate NHS staffing levels
  • Ensured the legal right for nurses to funded Continuous Professional Development

We will institute a review of public health spending to ensure it can deliver a national health service that meets the needs of people in rural areas.

Digital health initiatives provide opportunities and offer an extensive range of services, resources, and training to patients and practitioners. We support e-health and e-learning and the possibilities they create but recognise virtual healthcare has limits. We will increase investment in rural and remote health infrastructure and services. Long term, we support the integration of health and social care, moving care from acute services and into communities.

I will be a consistent voice for rural communities in Parliament and ensure that our communities are heard during wider healthcare debates.

The Rural Health Partnership is calling for:

  • The need for further research in rural and remote health and social care
  • The designation of an agency to advocate for the health and social care needs of rural Scotland.
  • Support for rural and island communities to improve resilience

I fully support these calls.

Fergus Ewing, SNP Candidate
Fergus Ewing, SNP Candidate

Fergus Ewing, SNP Candidate

The SNP have pledged in their recent manifesto that they will increase frontline NHS spending by at least 20 per cent, delivering an additional £2.5 billion for frontline health services – setting up fast-track diagnostic centres in every health board area.

Over the recent years, the population of rural Scotland has continued to grow at a faster rate than many other parts and therefore we want to see as much health care as possible provided in the community and closer to people’s own homes.

This means continuing to reform primary care and investing in services. Primary care and GP services will see a greater share of NHS frontline investment over this parliament, with an increase of at least 25 per cent in primary care funding enabling the roll out of more mobile health services for direct delivery of care, particularly in our rural areas, including additional screening services, stroke units and mental health services.

The new elective care centre will deliver surgical care for people requiring hip and knee replacement, foot, ankle and hand surgery. An entire eye care centre will also be created providing a full range of outpatient and surgical care services. This will vastly improve the quality of care and facilities on offer for orthopaedic and ophthalmology patients.

Rhoda Grant, Scottish Labour Candidate
Rhoda Grant, Scottish Labour Candidate

Rhoda Grant, Scottish Labour Candidate

Covid has made a bad situation even worse, it has placed a huge strain on our NHS and put even more pressure on our already overstretched NHS workforce

Waiting time targets for operations were already being broken before the pandemic and after 14 years of the SNP government’s mismanagement of the NHS, and failure to address waiting times, its commitments to patients are just not credible.

New assurances of investment and new targets will not be worth much to people who have already been waiting years for operations or people struggling with their mental health.

Scottish Labour’s NHS Recovery Plan will get cancer services back on track, improve mental health and value our heroic NHS and care staff. Our plan for Rapid Diagnostic Centres would mean that patients with cancer symptoms could get a diagnosis in days - not the months they wait under the SNP.

I know that some patients in the Inverness, Nairn and Grantown areas are being offered treatment or operations in other hospitals out with the area to help clear some of the backlog.

However, I would like to make sure that those being offered this alternative, especially the elderly, are able to travel to access services. Otherwise they should be kept on the list for a hospital or clinic close to home.

Covid has also shone a light on the persistent health inequalities that already existed especially in more deprived areas.

In 1997, premature mortality rates were three times higher in the most deprived areas compared to the least deprived; in 2018, rates were four times higher in the most deprived areas, sadly moving in the wrong direction.

Over the last decade there has been a desperate need to find better ways to tackle health inequalities. Covid-19 has brought into sharp focus that this has not happened and it is shameful, our recovery must be borne out of greater equality.

Dr David Gregg, Scottish Liberal Democrat Candidate
Dr David Gregg, Scottish Liberal Democrat Candidate

Dr David Gregg, Scottish Liberal Democrat Candidate

My first job as a doctor was in NHS Highland, so I understand what an immense challenge it is to provide healthcare over such a large region. I know how difficult it is for patients to get to far-away appointments, and how this impacts on their quality of life. Covid has shown how much we need to value our NHS. We need to put recovery first to build back to a better place than we were in before the pandemic when 200 people each day were missing their legal treatment time targets across the country. This simply isn’t good enough.

The Highlands is going through a mental health crisis. I've lost count of the patients I've seen in A&E needing urgent mental health attention. The Scottish Liberal Democrats have been talking about the need to improve mental health services for long before any other party. We would grow mental health care with more specialists in GPs and schools. We would double the number of people training as counsellors. We would provide training for mental health first aiders in every workplace.

We want a wider range of specialists, diagnoses and treatments into our local Highland communities. Some GPs are already employing a physio to see muscle and joint complaints without the need for a GP referral. This is a simple idea, but it gets patients what they need quicker and reduces GP workloads.

We would recruit more pharmacists, advanced nurses, and mental health professionals into similar roles all across the Highlands. This needs proper investment from the government to expand across our region. If we can free up enough GP time doing this, they can offer longer appointments. It's what my patients want, and it’s what doctors want.

Raigmore Hospital covers the biggest catchment area of any hospital of its size in the country. But this means demand is very high. We can reduce this demand by expanding what our remote and rural doctors can offer elswhere such as in Wick, Fort William, and Nairn. The Scottish Liberal Democrats would work with professional bodies to set up bespoke training to allow this expansion.

For example, a GP with an interest in cardiology in Aviemore could be dual trained as a cardiologist. This would give patients easier access to specialists in rural areas, and reduce pressure on Raigmore. Under the SNP, we've seen our rural areas lose services like the loss of consultant-led maternity care in Wick. We want to see this reversed.

Andrew MacDonald, Restore Scotland Candidate
Andrew MacDonald, Restore Scotland Candidate

Andrew MacDonald, Restore Scotland Candidate

The highlands and islands region poses unique challenges for health provision. A burden on services through oversubscription is not so much of an issue for our region as it is in other areas of Scotland. We are a bit more spread out up here! The difficulty is ensuring that patients across the region can access the care they need as quickly as possible.

Patients in more isolated communities make long journeys to access specialist care. For some, this is an inconvenience but for others, it is a great source of anxiety. Part of improving access to health care will mean putting the transport infrastructure in place to help patients make the required trips, as well as incentivising health providers to go to the patient wherever possible.

Another key step to improving healthcare will be securing good, reliable broadband in the highlands and islands to enable telemedicine consultations. For older patients who are less tech-savvy, telemedicine sessions could be provided in local surgeries, with assistance. We need to bring health provision into the 21stcentury. Telemedicine saves money and time.

Finally, although it is not strictly linked to healthcare, we need to market our region as a fantastic place to live, work and bring up a family. It is vital that more people come to call the Highlands home. That way, we can build our economy up and see more investment from central government to improve infrastructure and services. We will all benefit from this, not least in health terms.

Edward Mountain, Scottish Conservative Candidate
Edward Mountain, Scottish Conservative Candidate

Edward Mountain, Scottish Conservative Candidate

Our Highland healthcare professionals rightly expect and deserve the best leadership we can give them.

That leadership should not forget that their predecessors spent a huge amount of time localising our health services. They did this because they recognised the benefits of community based medicine. Sadly this SNP Scottish Government has spent the last 14 years squandering and dismantling their legacy with a centralising agenda.

Regional hospital wards have been closed and our cottage hospitals downgraded. That has put impossible pressures on our hardworking health care professionals to deliver more from Raigmore, which is bursting at the seams.

This target driven centralised model is no longer sustainable. If the SNP keep taking health care services away from the rural communities they serve it will cause long term damage to those communities.

We need to find the right balance between localism and centralism and we haven’t. Whilst I welcome the construction of the delayed Elective Care Centre we have to recognise that all corners of the Highlands and Islands need health care. Ensuring expectant mothers in the North and those with mental health problems don’t routinely have to travel to Inverness is not just sensible, but is also caring.

And by building community based health care we ensure that the teams who deliver this are part of the community they serve. Ensuring a local approach and also better management which is free from the culture of bullying that we have seen within NHS Highland. This complimented with online access to specialist doctors and nurses through the ‘Near Me’ programme is the way forward providing we don’t forget the importance of face-to-face engagement as well.

It is estimated that it will take six years to rebuild our health care post the pandemic and to speed this up we must use our local resources. Not to do so would be foolish in the extreme.

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