A senior doctor at Scotland's busiest rural general has challenged the health secretary to visit the crumbling and "functionally unsuitable" hospital before deciding if it will approve the funds to rebuild it.

Plans to replace the Belford in Fort William are at an advanced stage but last week staff and the community were dealt a crushing blow after the Scottish Government announced it may not be able to sanction the cash needed to fund the £160 million project.

The Lochaber community was promised a new hospital would be built by 2002. A community protest is already being planned.

In an exclusive interview with The Herald in Fort William, clinical lead Dr Steve Gilbert, said staff morale had "taken a big hit".

The 34-bed Belford deals with around 10,000 A&E cases a year, including mountain and road accidents on the A82 as well as routine emergencies including heart attacks and strokes. Numbers spike during the Summer months when there is a huge influx of tourists. 

The Herald: Belford Hospital deals with a lot of mountaineering accidentsBelford Hospital deals with a lot of mountaineering accidents (Image: Colin Mearns/Newsquest)

He said most people would be surprised to see the hospital's "tiny A&E waiting room and handful of emergency cubicles" given the volume of patients it sees.

"We want to be able to offer the same care as a hospital in Glasgow," said Dr Gilbert, who is also a consultant in anaesthetics and pain medicine.

The Herald:

"We've got to nearly the end of planning the new hospital and so it was a massive blow that the Government said there is no money left.

"The hospital is a year older than me (it was built in 1965). There is one reasonably sized resuscitation room and one that is too small and the other rooms are just cubicles.

"We get about a third of the accident and emergency patients here that they get in the big hospital in Inverness," he added.

The Herald: The current hospital was built in 1965 The current hospital was built in 1965 (Image: Colin Mearns/Newsquest)

"There is a massive increase in the population in the Summer with tourists coming.

"We've got a fantastic maintenance team who are always fixing things. If it is bad weather the roof leaks and the heating will break down. The lift has been broken for about a month."

He said it was difficult to "infection-proof" the hospital because there are only a few single rooms.

"We have to be able to do the same service that you would get in Raigmore or a hospital in Glasgow," said Dr Gilbert.

"I'd like to invite Michael Matheson to come up."

He said senior staff would continue to work on the outline business case, which is due to be presented to the Scottish Government in the Summer, despite the question mark over funding.

The Herald:

"It is then checked by the Scottish Government to make sure we aren't going to build another rubbish hospital with infection in the water or anything like that," said Dr Gilbert, who was previously living in Glasgow.

The new net-zero hospital is due to open by 2028 and will double surgical capacity with two operating theatres and capacity to care for high-dependency patients. It will also have a mobile MRI scanner, a service not currently available to patients.

"It would be state-of-the-art," he said. "We've got to be realistic that you can only provide some care here and if you need intensive care or major surgery you go up to Inverness.

"We will easily pleased because it's been so long since they said they would upgrade the Belford."


Dr Gilbert spoke to The Herald earlier this week as part of our five-day series looking at depopulation in the Highlands and Islands.

Another doctor, who worked at the Belford in the 1980s as a locum, said the hospital was “not fit for purpose” at that time. 

"All hope is not lost," added Dr Gilbert. "Kate Forbes has been really interested but ultimately it's up to the government if we get the spend the cash or not.

The Herald: Dr Steve Gilbert, clinical lead at Belford hospital with Herald senior reporter Caroline WilsonDr Steve Gilbert, clinical lead at Belford hospital with Herald senior reporter Caroline Wilson (Image: Colin Mearns/Newsquest)

"The Belford has actually saved off its budget more than the rest of the NHS Highland and we are quite a small fraction of the total NHS deficit."

He said he didn't believe there was any truth in rumours that there is a longer-term plan to downgrade the Belford to a cottage hospital, which delivers only day-care, and rebuild Raigmore.

"I don't think that would be possible because it's an hour-an-a-half to Raigmore," he said. "The Belford was the prototype for the rural general hospital."

The Herald: New Highland Clearances

Despite the challenges, he said staff were delivering a high standard of care, mentioning that patients were sometimes transferred from Inverness for specialist pain-management care.

He arrived at Belford Hospital in 2020 after a time working in North Queensland in Australia and said recruitment of doctors to Lochaber continued to be a challenge.

"If you are a consultant physician in Raigmore, your on-call might be on in 20, whereas you are one in four nights here," said Dr Gilbert.

"I think it makes a difference to some people but we've been able to attract a younger anaesthetist, mainly because he likes running up and down the Ben.

"You've got to think, do I want to be in a big teaching hospital with people running around after me or do I want to be more hands-on and part of a team.

"It's a great place to work," he added. "You are part of the community and Fort William has got a great spirit."

A Scottish Government spokeswoman said: “As set out in our draft budget the capital funding position is extremely challenging.

"The UK Government did not inflation-proof its capital budget which has resulted in nearly a 10% real-terms cut in the Scottish Government’s capital funding over the medium-term between 2023-24 and 2027-28. 

“As a result of the cut in our capital budget, a revised Infrastructure Investment Plan will be published in Spring 2024 and all due consideration will be given to what projects can be included within that revised Plan. In the interim, boards have also been advised to pause any new capital projects.”