A health board's new patient travel scheme has been criticised as 'draconian' amid fears the initiative will put the sick off from attending vital medical appointments.
NHS Highland patients' travelling over 30 miles could claim car mileage of 18p a mile - a rate which users complained was far too low to cover costs, over the past financial year.
Now the board's new policy implented this week has slashed the mileage rate to 13p and the first £10 of costs cannot be claimed.
The new policy goes on to dictate that, unless there is a medical reason, road and ferry travel must be taken if they are cheaper than air travel, meaning enforced longer journeys.
Retired Islay GP Dr Jean Knowles, explained that the absence of locally based day clinics meant islanders had to make regular journeys to Glasgow for appointments.
She said that distance and ferry timetables could mean three days off work for many people, instead of the past routine of a one day return trip by air.
Dr Knowles claimed: "The new policy will engender great anxiety, even before you have gone and made an appointment, people will be reluctant to go.
"There have been complaints for a long time that it (the 18p rate) wasn't keeping pace and the new rate of 13p is so little."
She added: "It's a dogmatic policy and to the best of my knowledge there has been no consultation either, the community council didn't know about it, the transport forum didn't know about it.
"There is a push within the NHS to day care treatment, now you have got this push from NHS Highland where outpatient appointments will require three days away. It's implying that it's only about money.
"This is a one way exercise, there is no suggestion that any money saved will be invested in local provision of services, they are making it more difficult for people."
She slammed the new policy as "draconian" giving an example of the way it dictates travel arrangements and criticised a rule that only one escort would ever be allowed for any one patient, when doctors know that some patents, such as an autistic teenager, need two escorts.
Dr Knowles said: "They are being proscriptive about things, it can't be anybody with any clinical insight that has written this policy."
She added: "There have been lots of enquiries asking what was happening, then this policy, dated May 22, says the new policy will be implemented on June 1, there has been no input, no discussion, no consultation."
Dr John Holliday, the resident GP on the isle of Tiree criticised the new car mileage rate as totally unfair.
He said: "Patients in very remote and rural parts of Argyll, particularly the islands of Tiree and Coll, are disadvantaged when it comes
to distance from facilities and any reduction in reimbursement to patients going to hospital by surface (car and ferry) means is going to have a severe consequence."
Argyll SNP MSP Michael Russell said: "I am very concerned that these new patient transport regulations have been brought in without
local discussion and run the risk of severely disadvantaging island residents as well as many others."
A spokesman for NHS Highland said the new policy was based on Scottish Government guidance and said: "All patients are entitled
to help with travel if they are in receipt of certain income based benefits. The Highlands and Islands Travel Scheme also recognises
the distances sometimes needed to travel given our board's geography and, as a result, all our patients are entitled to financial assistance if they live more than 30miles from the hospital they are attending.
"Patients and escorts are expected to use the most cost effective means of transport suitable to their needs, taking into account the
overall cost of the trip.
"Anyone with any questions about travel claims or travel booking can contact our Patient Travel Administrators. Details are on our website."
The mileage reimbursement rate of 13p per mile is based on HMRC fuel advisory rate."
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