The Scottish Parliament’s Health, Social Care and Sport Committee is calling on the
Scottish Government to take urgent action to address the specific challenges faced
by rural communities in accessing and delivering healthcare services.
The committee’s inquiry found that recruitment and retention of staff is one of the
key challenges to effective delivery of services in rural areas.
Its report highlights the availability and affordability of housing, and access to
education and training as significant barriers to recruiting and retaining staff.
The committee urges decision-makers to recognise the extent to which a lack of available
and affordable housing is acting as an indirect barrier to healthcare provision in
rural Scotland, by making it very challenging for healthcare workers to locate themselves
within the communities they wish to serve.
It calls on relevant NHS boards, local authorities, professional bodies, trade unions
and other key stakeholders to work together to find practical solutions to these
problems.
Another barrier highlighted is the lack of locally available training and development
opportunities for staff. The committee wants the Scottish Government and the new
National Centre for Remote and Rural Health and Care to set out how they will improve
the availability and suitability of local training and development opportunities.
Difficulties with accessing healthcare services in rural areas were repeatedly raised
during the committee’s evidence gathering. These include practical challenges for
patients attending in-person appointments and the often substantial additional travel
and accommodation costs, which the committee say must be addressed.
The report highlights significant variations in policy on reimbursement of patient
travel costs, depending where an individual lives and whether or not they are in
receipt of benefits. It calls for a fairer and more consistent policy for reimbursement
of travel and accommodation costs to be developed.
The importance of technology and digital infrastructure in facilitating access to
healthcare was also raised repeatedly during the committee’s evidence gathering.
While recognising that some will continue to prefer face-to-face appointments, the
committee is calling on the Scottish Government to set out the specific actions it
is taking, or that may be required at UK Government level, to improve digital access
to healthcare services in rural areas.
The committee commended existing good practice in the provision of rural healthcare
services, including that demonstrated by third sector organisations. However, it
concludes that more action is needed to ensure this good practice is more consistently
and widely shared across different organisations and areas.
Clare Haughey, convener of the Health, Social Care and Sport Committee, said: “Our
inquiry has shone a light on the unique challenges facing remote and rural healthcare
services, both for those accessing and those delivering those services.
“The evidence suggests that often healthcare policy is developed as ‘one size fits
all’, which fails to address the particular needs of remote and rural communities.
“We want to see a whole system approach which designs services in a way that is more
flexible and responsive to local needs – while systematically learning from the good
practice that is out there.”
She added: “We believe that developing a tailored approach to healthcare service
delivery that reflects local challenges and circumstances should be an overarching
priority of the new National Centre for Remote and Rural Health and Care.
“We also look forward to the forthcoming publication of the Scottish Government's
Remote and Rural Workforce Recruitment Strategy and how this strategy will address
some of the workforce-related issues our report highlights.
“The voices of people who live in remote and rural areas and work or receive care
in these settings have been at the centre of our inquiry and we thank them for their
vital contribution to this report.”
The committee also highlighted evidence of acute pressures on the provision of social,
palliative and end of life care services in rural areas and warns that the tendency
of an ageing population increasingly living in more remote and rural areas of the
country will mean demand for these services will increase significantly in the years
ahead.

‘Urgent action’ needed to tackle rural healthcare challenges
7 October 2024