"Some people see anybody showing up in their community and looking at their health services as a threat," Professor Farmer said.

"We are accused of being NHS spies or being used by the Government."

Instead, Jane's job as co-director and chairman of rural health policy and management at the Centre for Rural Health requires her to be as objective as possible.

"A lot of what we do is try to present to each group the other side's dilemma," Jane, who is based at the new Centre for Health Sciences at Raigmore, explained.

It is not just Jane's surname which makes her a suitable candidate to study rural health issues.

Brought up in Invergordon, she is a native Highlander herself, though she revealed that she had come into the specialised study of rural health issues almost by accident, first at Aberdeen University, where she was asked to develop a rural health programme.

"I think that's when people decided things were not too happy out there," Jane added.

"It's still difficult to get the right staff doing the right things in these places. There aren't that many people in Scotland or the UK studying rural health and coming back to the UHI seems the perfect place. The ethos of the UHI is to do stuff that's very community orientated, so the whole rural health thing fits in very well."

Jane's work also complements other areas of the UHI and she has been working with historians on the story of Highland hospitals, something which still has relevance for Jane's modern day work, giving her insights into why a hospital was built in a certain area, the services it provided and the strong allegiances felt by the local population.

Jane believes a lot of positive changes have taken place in the Highlands since she left Ross-shire, especially in Inverness where she is part of the life sciences sector growing up around the LifeScan factory and Raigmore Hospital and, of course, the UHI itself, which is at a crucial stage of its journey to full university status.

"It's important that UHI develops research that is close to its mission, that's relevant not just to the Highlands, but to rural areas more generally," she commented. "That's the way we can develop ourselves and get into the research game."

Jane admitted it could be difficult to attract academics to the work in the UHI.

"We have to persuade them that we do things here that we do things they can't do in St Andrews or Aberdeen," she said.

"As someone born in the Highlands, I really believe in UHI. It's so important to have a university. We need young people to come into the area. It's not just about the young people here."

When it comes to rural health, however, there are still a number of challenges to be met, of which access to services is just one.

Though people in the countryside generally remain healthier than the urban population, a rising proportion of elderly people means an increase in the number of complicated chronic illnesses and the problems associated with old age.

One of Jane's projects is a European Union programme which looks on elderly people as a positive force within the community and looks at ways of helping them remain in their home area, such as the handyperson scheme which provides help with those small but vital household tasks older people may not manage themselves.

Jane Farmer, chairman of rural health policy.

However, it is not just the general population that appears to be getting older.

"Doctors themselves are retiring," Jane said.

"The type who were in with the bricks doing everything. It comes time to retire and the community says: 'Can we have another one please?' But of course that's not going to happen. They don't make them like that any more."

Jane understands why communities can be suspicious of someone coming in from outside and looking at their health care provision, just as she appreciates why they are resistant to any form of experimentation which makes them feel like "guinea pigs" and she can sympathise with NHS boards and councils having to work with tight budgets. However, she stresses the purpose of her work is to ensure any change is done in co-operation with the affected communities and not something that is imposed on them from above.

"It's not about taking away or replacing things. It's about you having some input into what is done in your community in the future," she said.

"One of the things that gets me is that communities have a lot of power and if they grasp things in a positive way they could have a really great service."

Jane, who has seen staff numbers at the Centre for Rural Health rise from just her two years ago to nine with two PhD students, added that though people were not really interested in the health service until they needed it, in rural areas there was an awareness of when things did not go right; such as when it takes a long time for an ambulance to reach an accident victim or a long wait for treatment.

"They want the security that if something happens in the middle of the night, they will be alright. Most people associate that with a GP or whatever if they have had a successful service," Jane continued. "In some places they had a nurse, so if you ask them what they want, they'll say a nurse and you are going: 'So why wouldn't they want a GP?'

"There are things we can do with telemedicine, but there are issues of access and the infrastructure has to be there. Mental health is something we should be doing more about.

"There's not a lot of research in that area, but it's actually quite difficult to have a focus."

The Highlands are not out on their own, however. There are links between the UHI and other professionals dealing with rural health around the world, from Canada and Scandinavia to Tasmania, where Jane herself spent three months working and found an environment similar to the Highlands.

If possible she would like to see this international relationship developed even further.

"I get e-mails from people in Scotland and other countries saying things like we really need, for example, a good model of rural maternity services," Jane said.

"I'd like to get big funding for an international rural observatory, a network where we can compare what we have been doing in each other's countries, so NHS Highland is not just sitting there wondering 'How do we solve this problem?' But Highland is doing it; Tasmania is doing it, Ontario, Greenland...

"That's my big project. That's my dream for what I want to do next.

c.macleod@inverness-courier.co.uk 

Printer friendly version

Email this article to a friend

Bookmark this

---