Plans to replace a “functionally unsuitable” Scottish hospital that has a £1.5 million backlog of maintenance repairs have taken a major step forward.

NHS Highland has approved the initial agreement to replace the crumbling Belford Hospital in Lochaber with a £120-140m facility by 2026, decades after plans were first mooted.

Lochaber MSP and Finance Secretary Kate Forbes said she was “probably a toddler” at that time and welcomed the “significant milestone”.

A report by the health board states almost all aspects of the hospital fail to meet modern building guidelines on minimum size. This has led to significant deficiencies in infection control, patient dignity, flow within the building, and accessibility. 

The Belford was built in 1965 and is now the last of Scotland’s six rural generals to be replaced or upgraded.


Some outpatient services are provided by visiting specialists from Raigmore Hospital in Inverness, while patients must travel to the Highland capital for MRI scans or specialist surgery.

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The health board is proposing to rebuild the hospital at an alternative site on the Blàr Mòr and is considering a number of clinical models. The preferred option is a mix of hospital and community-based services, retaining accident and emergency, general surgery and diagnostic services.

There are approximately 10,000 A&E attendances every year at the Belford and the vast majority are said to relate to outdoor pursuits available locally in the recognised outdoor capital of the UK.

The number of attendances is up to 50 per cent higher in the summer months when tourist numbers swell the local population significantly.

Former head surgeon David Sedgwick said the demands placed on A&E services have led to inadequacies in other services, such as elderly care.

“If you look at the figures for care home provision, Lochaber is basically bottom of the league for everything,” said Mr Sedgwick.

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“We want to have a good home care service, but one of the difficulties for us in Lochaber is that the home care service is competing with the tourist service, as it were.


“What is really important is that we maintain the services that are in the hospital at the moment and that’s the surgical and medical services and rehabilitation but we also develop some of those.

“There needs to be an MRI scanner and possibly a DEXA scanner to test for osteoporosis – there is only one in the Highlands, in Dingwall. It’s thinking about the diagnosis aspect, it’s thinking about the palliative care aspect. The hospice is based in Inverness.”

He said he would also like to see general surgeons being trained to carry out a wider range of low-complexity procedures locally, which are currently done by specialists at Raigmore.

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“That’s why there is a problem with waiting lists for a lot of these minor procedures.”

Ms Forbes said: “I think I would have been a toddler when the local health board first mentioned a new hospital to staff. There has been much discussion since then, and very little action.

“Though there is still some way to go before a new hospital opens, it is a hugely significant milestone to have the initial agreement endorsed by the NHS Highland board.”

Patricia Jordan and John Hutchison, community members of the NHS Highland Project Team, said:   “We are pleased that the NHS Highland Board approved the Initial Agreement today which takes us another step along the way. 

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"We met two Board members recently who told us that the Board was firmly behind the new Belford and today’s decision endorsed that. 

"We now need to hear from the Scottish Government’s Capital Investment Group which will be the real approval but in the meantime the Project Team will press on with the Outline Business Case in anticipation of a positive response from the CIG.”

A spokesman for NHS Highland said the new hospital will provide a “wider range of health and social care services” in a modern and accessible site.

He added:  “This is really good news for the local communities across Lochaber and we would like to thank the wide range of stakeholders (including service users, carers and staff) who have been involved in developing this proposal. 

“NHS Highland is now awaiting approval from the Scottish Government Capital Investment Group to develop an outline business case so that we can take this project forward.  

“We will also ensure there will be ongoing engagement with the local community following Health Improvement Scotland guidance and there will also 
be opportunities for the public to have their input into the project 
as it develops.”