PLANS TO make an overnight ferry journey the default option for NHS Shetland patients travelling to Aberdeen have been discarded after the health board instead agreed to accept a new deal on fares from airline Loganair.
The board unanimously agreed to accept a deal which will save around £300,000 a year from NHS Shetland’s £2.7 million travel budget. It is also hoped a further £250,000 can be saved by reducing the amount of patient journeys undertaken.
It follows a public outcry when the plans to send up to 80 per cent of patients by ferry were first announced in March. The health board initially suggested it could as much as £1 million, but a report that went before a special board meeting on Tuesday afternoon had scaled back those savings to £600,000.
Several public petitions opposing the move had circulated in recent weeks, including one on change.org with over 1,300 signatures started by Hugh Harrop, and feedback from local GPs suggested that around four in 10 patients would be exempt from taking the ferry on clinical or social grounds.
NHS Shetland chief executive Ralph Roberts said the board acknowledged the “points and concerns raised” by the public.
“We feel that we should progress with the revised pricing structure from Loganair as the best way of delivering savings quickly, and it does have the benefit of maintaining patient choice,” he told board members, while stopping short of any explicit mea culpa.
Board member Malcolm Bell, who was among the most vocal opponents of making Northlink the default option, was not able to be present at the meeting but said afterwards: “I am pleased the NHS Shetland board has come to this decision as it was clear the suggested change in policy, to make the overnight ferry the default option, had deeply concerned many patients, carers and relatives.”
Shetland MSP Tavish Scott said it had been an “ill thought out, wrong proposal from day one” and the health board had “done the right thing” in reversing it.
“I hope they will reflect on the worry and concern that has been caused, particularly to elderly people across Shetland,” he said.
“I want to thank Malcolm Bell and others on the board who said this travel policy wouldn’t work and asked why there had been no serious negotiations with Loganair or Northlink before it was publicly announced. I am also puzzled that we were all told that because of the election the health board could not say what they were doing. Now in the middle of the election, their policy position is public.”
Speaking after the meeting, which lasted just under half an hour, Roberts said the board was clear back in March that “we were pursuing the ferry option, but that we were going to continue progressing the discussions with Loganair. If I’m being honest that got lost a little bit in conversations”.
Roberts said NHS Shetland was looking forward to continuing to work with Loganair as it introduces new booking arrangements from 1 September as part of the process of “disentangling themselves from Flybe”.
Now that those talks have borne fruit, NHS Shetland’s climb-down is likely to be warmly welcomed in the community.
But Roberts warned that it now leaves a gap of around £700,000 in the health board’s budget that will have to be plugged.
“We’ve got other savings that we’ll now need to deliver,” he said. “At the moment we haven’t identified where that will be. One thing we can’t do as a service, and as a community, is say ‘we can’t do this, we can’t do that’ – we can’t say no to everything.”
Patients will have the choice of travelling by either sea or air, and the board has also agreed to work with clinical staff to “agree clearer criteria for patients who receive a medical escort” after recognising the criteria “could be clearer and more equitably applied”.
The board also reaffirmed its support for efforts to reduce the overall number of patients having to travel to appointments outside Shetland.
Board chairman Ian Kinniburgh said: “Board members always recognised that this was a difficult issue and our priority has been to provide as much clinical care as possible from our budget.
“I believe that we have now agreed arrangements that are a positive way forward and gives us the right balance between cost, access and convenience.”
Kinniburgh accepted that the aspiration of transporting 80 per cent of patients by ferry was unrealistic, and that even “60 per cent would appear to be optimistic”.
Loganair managing director Jonathan Hinkles said: “We are pleased that the constructive dialogue with NHS Shetland has resulted in a positive outcome for all parties, above all NHS Shetland’s patients, for whom we will continue to provide the best possible service and care during their journeys with Loganair.”
Roberts said Loganair had indicated it wishes to review the offer in 12 months’ time, and he conceded that – with the airline raising fares by four per cent across the board this year – there is “a risk of volatility going forward”.
But the deal does offer guaranteed savings with immediate effect, and Loganair “have not tied it to a set number of people traveling”, whereas if NHS Shetland made ferry the default option “then those prices aren’t on the table”.
Roberts accepted that if NHS Shetland was, in effect, “too successful” in driving people away from Loganair flights “that might cause them difficulties”. But, based on existing feedback, he thinks patients choosing to go by ferry will be “probably a relatively small number”.
He also recognised that the savings generated by reducing patient travel could be partly counteracted by demographic changes, with the ageing population likely to result in a greater number of referrals.
Many critics of the policy have questioned why more research had not been done prior to announcing the plans two months ago.
Asked if there were lessons for NHS Shetland to learn from an episode some will inevitably view as having caused needless consternation in the community, Roberts responded: “You always learn as you go, and it would be wrong to say that we did everything right.
“It’s important that the community also, in a sense, learn on the other side of the coin – are we clear about what we are deciding? The message at that time that we were going to continue negotiations with Loganair got lost… and I think we still need to get into a discussion with the community – if we can’t do that then what else are we going to do?”
He added that public affection for the NHS as an institution also meant “people have very strong attachments to the service as it is currently provided. That can sometimes get in the way of progress, and people see change as always being a negative.”
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