This paper has two main elements. It is a substantial revision of the paper ‘Your life in Their Hands’, initially published in 2016, necessary because many if not all of the substantive and objective issues relating to the redesign of health and social care in Skye, Lochalsh and South West Ross (SLSWR) remain unaddressed, although they clearly need to be and urgently. The redesign – labeled solely ‘rural’ by NHS Highland (NHSH) despite the reality and nature of the area- proposes closure of Portree Hospital as an emergency and inpatient facility along with its rural A and E, with a new build single community hospital built, replacing both existing hospitals and unifying their rural A and E, in Broadford.
Additionally, the paper considers the ‘bigger picture’ concerning the redesign, namely what is the optimal redesign of health and social care to meet the needs of all of the people that live, work and spend their leisure time in the artificial geographic area created by NHS Highland? This question has never been asked by NHSH at any stage in the redesign process and their much narrower focus, as revealed in their model options appraisal, boils down to the refurbishment of buildings and, specifically, the need, as they have determined it, to completely refurbish Broadford hospital by a new build, paid for by closing Portree Hospital and its associated rural A and E.