Western Isles health and social care services will become ‘unsustainable’ if demographic trends continue, according to a paper presented to a recent meeting of Western Isles Health Board.
Depopulation is the single biggest risk facing treatment and care services in the Western Isles, it forecast.
Using updated population predictions, the islands are expecting to see a six per cent drop in population by 2028, one of the biggest population decreases in Scotland.
The 2022 census has confirmed previous modelling by National Records Scotland (NRS), that the Western Isles would see the biggest drop in population from the previous 2011 census.
However, comparing recent natural change data to the modelling done in 2018, the population statistics are worsening far quicker than originally thought. This is due to the drop-in childbirth rates compared to deaths.
Working age population is set to decrease by six per cent by 2028, while the over 75s population with the highest levels of co-morbidity is set to rise by 25 per cent.
These population changes will result in a year-on-year reduction in the available workforce to nurse, care and attend to the most vulnerable of people and ultimately on the ability to sustain services.
The NRS projections for net migration and other changes are showing negative figures on average for the next 10 years.
NHS Western Isles director of finance Debbie Bozkurt said: “If you assume the natural loss average for the last three years at 236, then by 2028 the Western Isles population could drop further to 24,784 from the 2022 figure of 26,200.
“This is a further 5.4 per cent drop in six years which is more than what was projected in 2018, which was a population figure of 25,181 by 2028.
“This is further compounded by outward migration being the younger age bracket, mostly school leavers going to university education and the inward migration often being people close to pensionable age or above.
“The Western Isles has been mostly replacing its population drop through the loss of births and the young migrating, with the people mostly over the age of retirement or in the middle age bracket.
“Net migration can now no longer keep up with negative natural change.”
The Health and Social Care services are already feeling the effects of the changes in demographics with unprecedented high levels of vacancies and difficulty in recruitment in all areas and specialities.
The fall in work age demographics is predicted to impact jobs including health care assistants, social care assistants, domestics and catering staff the most.
The workforce population of the Western Isles, those aged between 16-64, is 16,449. Of those, 2,400 are classed as ‘inactive’ and of that number, 2,000 people have indicated they do not want a job.
A large proportion of this number is expected to be those who have retired early, many of which would have migrated onto the islands following retirement from their careers elsewhere and no longer require to work for financial stability.
Ms Bozkurt pointed out: “Without significant inward migration of young families, it is highly unlikely birth rates will recover and reverse the low birth to death rate ratio.
“Since 2007, the number of women aged 25-44 living on the islands has dropped 15 per cent from 3,289 to 2,787.
“There are some areas of the islands that are seeing lower birth rates, high death rates and increasing aging population than other parts. The area that is changing more rapidly than elsewhere is Uist and Benbecula.”
The full report is available at https://www.wihb.scot.nhs.uk/about-us/meet-the-board/board-papers (August 30, Item 9.3).