Health chief warns of age timebomb facing the Hebrides

Exclusive: Mike Merritt

30 May 2010

The Western Isles’ director of public health is warning the Outer Hebrides faces a population timebomb, with the young leaving in droves and the area becoming an enclave for the elderly.

In her annual report, Dr Sheila Scott says that of all 40 community health partnerships in Scotland, the isles have the lowest percentage of men and women of working age.

And it has the second highest percentage of those aged 65 and over.

Over the last decade, the isles have lost nearly a sixth of their young and those up to early middle age – and even greater falls are predicted.

Latest projections from the General Registrar’s Office Scotland predict there will be an overall 5% decrease in the population between now and 2031.

This will include: a decrease of 23% in the population aged 0-16 years; a decrease of 18% in the working age population plus an increase of 47% in the population aged 65 and over.

Dr Scott said the isles’ population had fallen to just 26,200. In the last decade there has been a decline in the number of people aged 0-14 and 25-44 years – drops of 16% and 15% respectively – while the number of those aged 45-plus has risen by 8%.

Looming job cuts in the dominant public sector on the islands would exacerbate the population problems.

There are fears 450 jobs could be lost due to council cut-backs, and NHS Western Isles has to make over £13m of savings in the next five years. A further stress is the lack of cheap housing, with the isles having one of the highest totals of holiday homes.

An Outer Hebrides Migration Study predicted a decline in the number of women of child-bearing age from 4,500 in 2004 to 3,500 by 2019, a fall in the numbers of primary school-aged children from 2,100 to 1,800, a secondary-school population drop from 2,100 to 1,900 and an increase in the average age of the population from 42.4 to 45.3.

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Plans to replace consultants with nurses in NHS Scotland

  • Medical staff
    Nurse in A&E

Exclusive: Kate Foster

30 May 2010

Patients will be assessed by nurses instead of consultants and spend less time in hospital under controversial cutbacks to meet waiting time targets in Scotland.

Many follow-up appointments will be scrapped altogether and patients could be discharged from hospital at weekends under the scheme.

The groundbreaking plans to “streamline” the NHS have been revealed as hospital managers prepare to meet an ambitious target that no patient should wait longer than 18 weeks from a GP referral to the date of their operation.

The move will allow thousands to be treated faster but last night doctors and politicians raised fears it could compromise patient care.

The sweeping changes have emerged in official advice to NHS managers from the Scottish Government’s 18-week Referral to Treatment Time Programme, staffed by doctors and health officials.

Key changes proposed by the experts, revealed in a briefing to health boards, include using specialist nurses and health professionals such as physiotherapists to “reduce consultant appointments” by assessing whether the patient needs a specialist or just requires advice.

Nurses will also be trained to carry out some follow-up appointments and many outpatients will be seen at weekends.

The advice also states day surgery should be “the norm” rather than traditional overnight stays and patients discharged “as soon as they are ready”, including weekends which previously hospitals have avoided due to scarce community services. Health boards are also told to eliminate unnecessary follow-up appointments by scrapping them or replacing them with phone calls.

The move applies across all specialties for non-urgent patients as part of a £230 million three-year scheme to improve NHS infrastructure.

Managers must consider making the changes to free up consultant appointments and hospital beds.

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