Earlier this month, 12 December, NHS Orkney and Orkney Islands Council, submitted proposals to the Scottish Government to explore how their services can work more closely together. The idea is to cut down on ‘duplication’ of services and be more ‘efficient.’ Just to explore this plan will require £300,000 of funding.

Readers will be aware that in Orkney we already have an Integration Joint Board (IJB): “The Integration Joint Board became legally responsible for the effective delivery of a large range of services within health and social care in April 2016.”

The ‘Routemap to Reform’ as the new plan is titled will require the recruitment of  two temporary officers and some community engagement events to explain to islanders why it is needed even though we have had the IJB for almost ten years.

NHS Orkney has been engaged in a wide range of cost cutting measures. These include severely limiting what the staff can do. Measures ranging from no colour printing to not filling vacant admin positions resulting in higher paid professionals having to put aside the work they are doing to make up for the admin gap in the staffing. Also included in the measures are strict restrictions on travelling outwith Orkney.

Whilst some of these measures may make sense, others do not, and nothing seems to be thought out in a logical long term way.

Take for example the position of NHS Orkney’s current Director of Finance – a crucial job when the organisation is undergoing such severe problems and with the ‘Routemap to Reform’ at the top of the agenda for change. The position of Director of Finance for NHS Orkney is currently an ‘Interim’ post. Melanie Barnes has been seconded from the Scottish Ambulance Service and was only to be in post until September 2025. That has now been extended to March 2026.

Melanie Barnes, as Interim Director of Finance, is drilling down through the inefficiencies she has found in NHS Orkney and ensuring that all staff are adhering to the cut backs and restrictions. Melanie Barnes does not live in Orkney and so is required to travel from her home in Scotland when required to physically attend meetings. The Orkney News found out through a Freedom of Information request that by November 2025 she had taken 18 individual flights at a cost to NHS Orkney of £8,662.53.

That might not seem much but NHS Orkney is the smallest Health Board in Scotland and when such significant cuts are being made to the staff who live and work in Orkney, it makes no logical sense.

In addition to this NHS Orkney has a requirement to sustainability and reducing its carbon footprint. In December of this year NHS Orkney was awarded The Sustainability Award at the Scottish Public Service Awards 2025 for leading the way in reducing emissions and improving the NHS’s effect on the environment.

The award is due to the hardworking efforts of the staff working here in Orkney. However, it makes no logical sense whatsover that whilst staff are going all out to achieve these sustainability goals that regular flights are transporting the Interim Director of Finance to and from her home in Scotland. Efforts to fill the position permanently have so far been unsuccessful.

The Orkney News in its FOI request also tried to find out what accommodation costs were accrued by the Interim Director of Finance when coming to Orkney but “that in terms of Section 17 of the Freedom of Information  (Scotland) Act 2002, the information sought is not held. “

Everyone in Orkney, and many who visit these islands, have benefitted from the fantastic work of NHS Orkney. The provision of Health Care free at point of need, which we pay for through our taxes, is the greatest achievement of this country. It is something we should be vigilant in protecting from those who would wish to destroy it. However, it is under great pressure and how it, as an organisation, responds to that pressure is vital to its future. That response needs to be with a long term view of a sustainable future.

Is that possible in the ‘Routemap to Reform’ and the current level of decision making which does not seem to understand the implications of some of the cuts it is making and the additional costs it is accruing?

Fiona Grahame

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