IT is a fragile island community whose members have relied on the security of having a nurse based locally since the 19th century.

But Raasay, which lies between Skye and the Applecross Peninsula on the mainland, is now facing being left without any medical provision at all as it becomes the latest rural area to experience problems in recruiting staff.

There is currently no out-of-hours or unscheduled community nursing cover on the island and NHS Highland said there had been no interest in the vacancies advertised. The health board has also been unable to attract bank staff to provide cover.

A crucial meeting between NHS Highland and representatives of the 170 people who live on the island is scheduled for Monday.

Lyn Rowe, founding director of the hotel and outdoor activity centre based at the historic Raasay House, rebuilt after a major fire, said: “We started the business here in 1984 and for 30 years have had 24-hour nurse cover for our guests, their families and staff.

"We have in-house first aiders, but rely on professional medical care and access to medical equipment in an emergency. It has severely impacted on our business since cover has been reduced.”

The island, served by a car ferry to Sconser on Skye, is the latest rural community which has seen its medical provision radically altered in recent years, with local people mounting campaigns from Highland Perthshire to Ardnamurchan in protest.

But recruitment and retention of nurses and doctors in remote areas remains a serious problem.

GPs from Portree hold a surgery on Raasay once a week, but in an emergency Portree lifeboat or air ambulance can be called out with Broadford Hospital on Skye the first stop.

Most recently a nurse has been based at Raasay Clinic in Inverarish village. Opened by NHS Highland in 2011, it provides built-in overnight accommodation for a nurse.

But it has been virtually unused since July. Locals are concerned it means lifesaving equipment and medication are inaccessible out-of-hours.

Margaret McVicar, chairwoman of Raasay Community Council, said: “NHS Highland are just totally unwilling to accept that the current model can work, and yet we have instances of nurses saying ‘Oh, I didn’t know there was a vacancy here’.”

She questioned where the health board had advertised for a replacement nurse.

Raasay’s population has stabilised in recent years, with several new families setting up home and new businesses being planned, including a distillery which will employ 11 people.

But Lloyd Gudgeon, development officer for Raasay Development Trust, said: “Millions of pounds of public money have been spent on the new harbour, the new community hall, and the Raasay House refurbishment and all that will be wasted if NHS Highland seeks to save a few thousand by cutting the nurse cover.”

A spokesman for NHS Highland said: “Two community nursing vacancies and one long-term sickness have meant that there is currently no out-of-hours or unscheduled community nursing cover on the island.

"We have advertised the vacancies on two occasions without attracting any interest. We have also not been able to attract ‘bank’ staff to provide out-of-hours cover on Raasay. The current situation is clearly unsatisfactory which is why we are determined to find a sustainable solution. “

He said the situation on Raasay was similar to that in many remote and rural communities, presenting a challenge to health boards across the country.

NHS Highland has already targeted advertising for doctors in Holland and on the back of buses in Leeds. It is also known to be working on a project funded by the Scottish Government to devise ways of addressing the long-standing problem of the recruitment and retention of medical staff in remote and rural communities.

The three-year programme, "Being Here", involves four test areas: Kintyre, Islay, West Lochaber and the Small Isles of Eigg, Muck, Rum and Canna.