Scottish Government accused of ‘conscious’ decision to ‘strip out specialist care in the Highlands’ as MSP slams move as ‘fundamentally dangerous and inadequate’
The Scottish Government has been accused of a "conscious" decision to “strip out specialist care in the Highlands” that “is fundamentally dangerous and inadequate”.
The government’s new “sustainable model” for vascular surgery entails travelling hundreds of miles from home for patients who need surgical treatment for aneurysms, diabetes, vascular trauma and strokes.
The development is a staggering blow to healthcare provision in a region already burdened with long journeys for women to give birth or receive gynaecological care, among other specialities.
But it was also one that has been feared since March of 2024 when a whistle-blower sounded the alarm over vascular surgery cuts due to budget pressures.
Vascular surgical intervention for the treatment of aneurysms, deep vein thrombosis, diabetic foot disease and vascular trauma and strokes is available in Dundee, Edinburgh, or Glasgow.
And until March, it was also available at Raigmore Hospital until the last vascular surgeon there, Bernhard Wolf, quit citing safety concerns over the “unacceptable” standard of care.
Since then pressure has been mounting on the government and the NHS to take action as MSPs Edward Mountain and Fergus Ewing said local services were being “run down” and that is leading to “adverse outcomes” on patients.
The latest decision was taken last month behind closed doors by NHS Scotland’s executive group, a body set up to make decisions “on what services should be delivered over more than one health board area”.
That is despite health secretary Neil Gray telling Mr Mountain: “I fully recognise the gravity of the issues you have raised, and I take them extremely seriously… significant work is under way to address the challenges facing vascular service provision in NHS Highland.
“The outcomes of this work were due to be presented to the NHS Scotland executive group on June 5, setting out plans for implementation of a sustainable operating model, particularly for those in the north of the country, designed to deliver safe, effective, and long-term care for patients in the north of Scotland.”
Mr Mountain has demanded answers at First Minister’s Questions with John Swinney saying “if we struggle to recruit individuals to deliver those services, the government has to address the practical realities of that”.
On the back of that exchange, Mr Wolf responded online, saying: "Your [Mr Mountain’s] message in the parliament couldn't have been more poignant.
“As for the reply by the First Minister, everyone can judge for themselves. I’ve made one more attempt to get into a conversation with the health secretary. I’ll let you know.
"A heartfelt thank you for campaigning for our vascular patients. They deserve it.”
Mr Mountain appears to be losing patience with local and national health authorities. He believes he has tried all he can to “reverse the destruction of our vascular care in the Highlands” but “to no avail”.
“I have raised the issue twice with the First Minister in the parliament, I have contacted the Cabinet Secretary for Health and personally pleaded with him to meet with Bernard but to no avail.
“I believe the inactions of both NHS Highland and the Cabinet Secretary for Health are not acceptable and a danger to all Highlanders.”
He added: “The Scottish Government’s response is hugely disappointing. NHS Scotland’s decision to strip out specialist care in the Highlands and relocate it in other health board areas is clearly a conscious one.
“They are therefore directly condemning Highlanders, who must travel long distances at all hours to access the care they need. This is fundamentally dangerous and inadequate.
“This situation is a real example of health inequalities, and something I will always fight against.”
How much those dangers were taken into consideration by NHS Scotland’s executive group remains unknown publicly, as does the explicit service provision.
A Scottish Government spokesperson said the work undertaken is to ensure “equity of access” and “the best possible outcomes” but “there may be instances where patients need to travel to another health board”.
The spokesperson said: “The health secretary has been taking a close interest in the situation regarding vascular services in NHS Highland.
“Mr Gray fully supports the work that has been undertaken to develop a new model for vascular care and is confident it will result in the long-term sustainability of the service in both NHS Highland and across the north of Scotland.
“This work is focused on ensuring equity of access and delivering the best possible outcomes with a strong emphasis on quality and safety.
“We want to ensure patients are treated as close to home as possible. However, in order to receive the best possible care, there may be instances where patients need to travel to another health board.”
A spokesperson for NHS Highland said: “NHS Highland is fully engaged with national and regional colleagues who are developing a new model for vascular care. We anticipate that the model will include local investigation and treatment as well as giving access to more specialised care which is only available in larger centres.”
