NHS Highland medics lay bare region's health challenges at summit event
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Leading medics have painted a picture of a health service failing in both facilities and the way services are delivered, at a gathering organised by a Highland MSP.
Highlands and Islands Conservative MSP Edward Mountain wants to see a new acute hospital built for the region, believing Raigmore Hospital is no longer fit for purpose.
He also wants to see that established as a teaching hospital, believing that in training medical staff within the Highlands they are more likely to stay on here once they qualify.
He held his Let's Talk Health Summit at Inshes Primary School in Inverness last night as what he said would be the first of a number of "listening events" to hear what people on the ground think of Highland health services and how they could be improved.
Dozens of people who turned out were able to hear directly from medical professionals about what it is like to work in health in the Highlands including one who admitted he was sometimes "embarrassed" coming face to face with patients in certain circumstances and another who said facilities are simply "not fit for purpose".
Sean Kelly, an orthopaedic surgeon, talked about how Highland health is in many ways different from other parts of the country, as often medics are very much more part of the community they are serving.
"I feel extremely embarrassed when I meet people in Inverness, or Caithness, or Fort William, and know that they are not getting the treatment they need as quickly or effectively as ideally they should be," he said. "You feel it personally."
Dr Tracey Sturgeon, service lead manager for gynaecology, said the biggest problem for maternity services at Raigmore is staffing, with not enough people available to replace those who are retiring or leaving.
"In terms of shifts we are frequently one or two members of staff short on a routine basis," she said.
She also said that maternity and gynaecology facilities in Inverness are generally "not fit for purpose".
She spoke of a lack of privacy available for women who may be suffering a miscarriage and said the "indignity" such women had to face at times was "hard to imagine".
"Losing a baby is awful enough without having to be going through that in public," she said. "And it happens quite a lot."
Pressures to provide more beds across the board also meant the service had lost its Butterfly Room, a previously dedicated private space for women waiting for potentially devastating test results or having to be given bad news.
Bed blocking was something the panel spoke about widely as a problem.
Dr Adam Archibald, an obstetrician who previously served on NHS Highland's PICT emergency response team, detailed a vicious circle where patients with no medical nevertheless have to remain in hospital because there is no community or home care provision for them.
It means when ambulances arrive with patients on board there is sometimes nowhere for those patients to go.
They have to be treated in the ambulance – meaning that ambulance, in turnm is unavailable to respond to emergencies.
He also said in his view what was happening in obstetrics was a microcosm of the problems across the NHS.
"We have staffing problems, we cannot train enough people and we also have a built environment that needs addressing at a national level."
Mr Kelly said he had never really seen nurses under so much pressure as they currently are on wards and that recruitment and retention of staff is currently "really difficult".
Thinking back to his own early days in medicine he said that when he applied to join NHS Highland there were 10-12 interviews for the post held in the one day, a situation that would rarely happen now.
"We are not quite as attractive a place to come and work as we were," he said.
On the subject of delivering care over such a wide area one audience member wondered why more use couldn't be made of telecare, so that people didn't always have to travel to Inverness for what could be very short appointments.
Mr Kelly said it was a "really important" issue and that it was a "no brainer" that, where travel is necessary for a "routine" appointment, it should be the surgeon that travels, not the patient.
"Regional general hospitals are a tremendous resource for outpatients and limited inpatient services, that can take the pressure off Raigmore," he said. "It makes no sense not to use them more."
All were clear that while there were potentially things NHS Highland could do better, real improvements depended on moves at a national level.
Mr Mountain said he was not naive enough to think a new hospital for the Highlands could be delivered tomorrow but that it was important to start the ball rolling as quickly as possible.
He said at the end of the discussion: "Among the key things I am taking away is the importance of moving people out of hospital when they reach the end of treatment – either home or to the next place where they can be cared for.
"Staffing is also clearly an issue – how do we keep the health staff we have, how do we attract more staff? And that's about facilities – an environment people want to come and work in – but also about wider issues like housing and transport and the need to train nationally.
"More importantly, though, the need to train locally, which will get people to stay locally."
Speaking about the new National Treatment Centre established at Invernss Campus as a way of "fast tracking" a number of treatment services he said he found it the "most impressive place I have been as far as hospitals go".
"The National Treatment Centre is absolutely superb – the amount of work that has gone into it, the amount of care that gone into its design, and I think we deserve that in the Highlands," he said.
"Can we build it in Raigmore? No.
"We need to find a new site and build a new hospital – and make it a training hospital that will get us the staff we need to make the health service work."
