A protest campaign is escalating over a postcode lottery operating in Scotland for NHS patient travel allowances.
NHS Highland slashed patient car mileage rate from 18p to 13p for those travelling more than 30 miles for appointments on June 1, while the Western Isles pays 24p and NHS Orkney 18p a mile.
Now critics claim that by allowing health boards to set their own mileage rate the Scottish Government is condoning an unfair system, as parts of NHS Highland have the highest fuel prices in Brtiain.
Unleaded petrol at the only fuel pumps on the isle of Colonsay is currently 150.2p a litre and 152.6 for diesel, while on the isle of Coll motorists are paying 147p for both.
However, petrol and diesel are available in Kirkwall, in NHS Orkney's area, at 121.9p and in Stornoway, in the Western Isles, at 122.9p.
Ian Gillies, of Tiree, a former chairman of the Scottish Islands Federation, criticised the unfairness of a scheme which pays 11p less to a patient who fills up with fuel on Colonsay, than their
counterpart in the Western Isles.
He said: "This sounds like something a mainland council might consider as a budget saving, without considering additional costs of living in island areas. I think it's an ill-conceived idea that has not been consulted on.
"NHS Highland should go out to full consultation to consider the implications of people living in islands and remote areas where there are greater distances, geographical disadvantages and problems of isolation.
"If they do not have the relevant figures themselves, to show these increased costs in the Highlands and Islands perhaps they should consult their colleagues in Orkney and the Western Isles?"
Tiree GP Dr John Holliday claimed: "It is a tax on ill people, a downgrading of payment on remote, sick, people, it is a tax on the sick."
Sheena Nisbet, Chairwoman of Colonsay Community Council said island living is costly and added: "The NHS must appreciate that cuts like this will affect our health and wellbeing and every effort should be made to reverse these decisions."
Argyll and Bute Councillor Donald Kelly, from Campbeltown, claimed the mileage cut was a step too far. He added: "I think it's scandalous that the NHS is taking this line without any formal consultation with the wider community.
It is obviously going to have an adverse effect. The public deserves to have a say, there is no uniformity across the boards."
Retired Islay doctor Jean Knowles believes NHS Highland has decreased the mileage rate because health boards are now being allocated cash in their budget for patient transport costs, whereas before they were reimbursed by the Scottish Government
Ms Knowles, Chair of the Islay and Jura Transport Forum, claims NHS Highland is trying to save some of its patient travel allowance - which totalled £3,033,560 last year - to pay for other things.
But she warned that the reduced payment could deter patients from attending vital appointments and added: "It is being looked at as money, but it isn't only about money, is it clinically wise? This is a new postcode lottery."
Health Secretary Shona Robison said: "Under the Highlands and Islands Travelling Expenses Scheme, patients can have the costs of their travelling expenses either fully, or partially reimbursed. Health boards are responsible for administering the scheme. "With respect to the mileage rate, health boards are free to set an appropriate mileage rate according to local circumstances and is based on either the estimated cost of petrol or the equivalent public transport cost."
An NHS Highland spokeswoman said reimbursement of 13p a mile is based on HMRC fuel advisory rates for a petrol engine 1400cc to 2000cc and confirmed that employees get 56p per mile, which includes wear and tear allowance, for using their car for work appointments.
She said: "The guidance we follow is Scottish Government guidance from 1996. This guidance is still relevant and our policy is based on that."
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