Concerns are growing in the far north about the threat to round-the-clock surgical cover at the Caithness General Hospital.
A senior surgeon told a public meeting earlier this week that the area did not need “24/7 on-call surgery”.
But the prospect of downgraded services have prompted anger locally.
The redesign of hospital services, particularly those at Caithness General, were discussed at a well attended meeting in Thurso.
Some members of the public attended the meeting specifically for this item, reflecting concerns around heavy reliance on locum cover and the likely loss of 24/7 surgical operations in the future.
Ron Coggins, general surgeon and clinical director for surgical services in Raigmore Hospital, provided an overview of some of the changes in surgery and why he believed the status quo was not an option.
Mr Coggins said: “While 24-hours surgical emergency care in Caithness has never stopped, we do need to look at what services and skills are actually needed 24/7. In my opinion, some things need to change fairly urgently if we are to provide a safer and more sustainable service for people in Caithness.
“The reason the status quo is not possible is that it requires people with generalist skills, and they are no longer being trained. It also requires a population that can provide enough pathology, whether it’s emergency or elective, to allow a surgeon to maintain his or her skills over a lifetime, and that is not achievable in the current model. I am not speaking on behalf of physicians but I believe the situation is the same for them.”
Mr Coggins added: “If asked, ‘Do we need 24/7 on-call surgery in Caithness?’ then my answer is no. Strengthening the emergency services 24/7 would support a safer model. Carrying out surgery out of hours is very rare and anything serious already comes to Raigmore or to one of the other bigger centres. The most common procedure seen during the out-of-hours period in Caithness is a dislocated shoulder and the surgeon is not trained in this whereas emergency practitioners are.”
Councillor Bill Fernie, Wick, said: “I think a lot of people are still a bit skeptical. Even if the numbers of operations that happen are low, a lot of people think there would still be a danger to those few if they weren’t able to happen.
“Why should people in far flung rural areas have a lesser service than they did in the past?”