Health board’s ‘moral decision’ to alter patient travel rules slammed

The daughter of an 89-year-old woman has criticised NHS Shetland and called for the health board to reverse a new travel policy that means patients are only able to book return flights a maximum of two days either side of an appointment.

Previously, the patient travel scheme allowed return travel at any point after a hospital appoinment. But health board chief executive Ralph Roberts said that approach had been inconsistent and there were issues about “fairness”.

The policy was brought in in September – amid concerns some were exploiting the system to take holidays – but for many it is only just coming to light. The first Joan Paterson knew about it was when she tried to book transport for her elderly mother, Mina Anderson, from Aith.

Mrs Paterson has called for the health board to reverse its “moral and judgmental” decision.

In a letter to NHS Shetland finance chief Colin Marsland, she blasted the health board for the move after trying to book flights for her mother.

Mrs Paterson said her mother needed to attend the eye clinic in Aberdeen on a Monday and she wished to book the return flight on Friday. However, this was outwith the two-day window.

Mrs Paterson, who lives in Aberdeen, wrote: “This was the first I had heard of this change. No consultation or notice appeared to have been allowed for patients. I have spoken to some other patients who travel to Aberdeen for hospital appointments and they did not know of this change either.

“My mother is 89 years old, lives on her own and has to attend the eye clinic every four to six weeks. She stays in Aberdeen with me for a few days each time as this allows me to look after her and give her company that she does not have at home on her own.

“I work and therefore cannot spend long periods of time in Shetland although I do try and travel with her as much as possible to assist her travelling and to assist her at home. You told me that the reason for the change was that some people had complained that a small number of patients attending hospital appointments were also going on holiday and therefore using the hospital appointment flight for the holiday also.

“My response was that this was an extreme change to deal with an issue which was a minor one and which did not cost NHS Shetland any more money.”

Mrs Paterson argued that there was no “abuse of a system” as long as the patient had a letter proving they needed treatment in Aberdeen.

“This is a perception of abuse by those who have not thought through all the issues.” she said. “This decision is a moral and judgmental one and not one based on health needs and this does not seem to have entered your consideration.”

Mr Roberts said he could not comment on individual cases. He said if “an individual felt they had a particular reason why they should be exempt [from the new policy] we would certainly look at that”.

The chief executive said the shift had come on the back of work on patient and staff travel, which has included reviewing its patient escort policy to tighten its belt.

Mr Roberts said there had perhaps been a lack of clarity and inconsistency when it came to the health board’s view on timescales around journeys and appointments.

The move was about “fairness and perception of fairness”, the NHS chief said.

“It’s clear the Highlands and Islands Travel Scheme is for people travelling to an appointment,” Mr Roberts said. “If you said to somebody ‘would it be appropriate for somebody to go down to an appointment and then go away for two weeks holiday and the get us to pay for the flight after the holiday?’

“I think most people would say ‘no that’s not an appropriate use of public money’… It’s important we put a timescale on it so we treat everybody the same.”

Mr Roberts said the health board felt it was appropriate to provide the clarification, adding “in a sense it’s not a new rule”.

He said that was because staff would have a discussion with patients if they were wanting to be away for a longer period and if it looked “a bit odd”.

He said: “We think 48 hours is reasonable. If somebody has a reason to go down that does give them the opportunity to be down for four days either side of the appointment.”

Mr Roberts did admit, however, that he had not seen “strong evidence” that flouting the scheme to get a cheaper holiday was a big issue. There had been “anecdotal suggestions” about using flights for a longer trip, he said.

And if that led to people being keener for an escort, and people keener to go for an appointment south “you can see how it would be a point of concern”.

Mr Roberts added: “Arguably it doesn’t cost us any additional money.” That is because there is an agreement in place with Loganair and prices do not fluctuate depending on how close to an appointment the travel booking is.