Structural Concerns at Gilbert Bain Hospital
Gilbert Bain Hospital in Shetland has been assigned a "very high risk" rating in a recent report that raises significant concerns about the structural integrity of the building.
Supporting scaffolding has been installed around a section of the hospital, renewing demands for a new hospital facility in Lerwick.
In April, NHS Shetland acknowledged issues with the external walls that could "significantly impact" healthcare delivery, while maintaining that the overall structure remains safe.
The Scottish government stated that investment is under consideration within broader NHS infrastructure planning, which includes measures to ensure the safe use of current facilities.
Gilbert Bain Hospital originally opened in 1961, with an additional section constructed in the late 1980s.
The hospital serves approximately 23,000 residents of Shetland and provides support for fishermen, cruise ship visitors, and workers in the North Sea oil and gas sector.
With three wards, the facility offers day surgeries, maternity care, and diagnostic services. More complex medical procedures require patients to travel to the Scottish mainland.
Risk Register and Structural Integrity
In April, NHS Shetland updated its risk register to include details concerning the structural integrity of the newer section of the hospital.
The register states: "If the external building envelope continues to degrade unchecked, then the external walls of the building could further separate from the inner walls and structural columns."
The report warns that this deterioration could necessitate the immediate evacuation of affected areas, potentially resulting in the loss of over half the hospital's acute care capacity and functionality.
Engineering assessments concluded that the outer leaf's integrity has been compromised, with walls at risk of partial or complete medium to long-term collapse.
The report highlights that these conditions pose risks to services, staff, and the public.
Although scaffolding has been erected around the affected section, the health board determined that existing control measures remain "inadequate."
Historical Assessments and Current Measures
In 2019, NHS Shetland described the building as "not fit for purpose" following a review that found the hospital was designed for a different era of healthcare needs.
Gary Robinson, chair of NHS Shetland and depute leader of Shetland Islands Council (SIC), explained that water ingress has been a persistent issue in the newer hospital section:
"We've taken steps to make sure the risks are reduced,"
"In July, we expect to see a steel mesh fixed around the affected parts, to retain everything in place."
Robinson noted that the risk of structural failure has decreased due to the supporting scaffolding but emphasized the need for ongoing monitoring of the site.
The risk register indicates that a "definitive remedial solution" may not be achievable before 2031/32.
The health board is collaborating with government officials to develop a long-term resolution.
Service Improvements Despite Challenges
Despite structural challenges, Gilbert Bain Hospital has introduced new services and procedures that have reduced the need for patient travel to the mainland.
Lerwick is located 216 miles (348km) from Aberdeen by ferry, and flights can be unreliable.
Chemotherapy, which previously required patients to travel to Aberdeen, began to be offered locally during the Covid-19 pandemic.
In 2024, the hospital installed a permanent MRI scanner.
Joanne Williams, from Brae, was the first patient to use the new MRI facility while undergoing investigation for multiple sclerosis (MS).
"It meant going alone on a very early flight in the morning. It was quite a worrying time,"
she said, referring to a previous MRI scan in Aberdeen.
She added that receiving care locally was "100% better" as she could be accompanied by someone.
"We deserve to have good healthcare in Shetland,"
Williams stated.
Reducing Patient Travel and Calls for New Hospital
Gary Robinson highlighted that the health board has reduced patient air travel by 39 percent.
"We've managed to provide better services for islanders,"
he said.
Calls for a new hospital gained momentum during the Holyrood election campaign earlier in the year.
Shetland's newly elected SNP MSP, Hannah Mary Goodlad, who also serves as the Scottish government's public finance minister, affirmed the necessity of a new hospital.
"The community wants to see infrastructure that is fit for purpose,"
Goodlad said.
She noted there is "cross party desire" to replace the Gilbert Bain Hospital but emphasized that the issue is one of "how and when," given capital funding limitations.
In February 2024, the Scottish government paused plans for new hospital construction and other NHS building projects due to budgetary pressures.
The SNP's manifesto for the 2026 Scottish election includes a commitment to refurbish Gilbert Bain Hospital and other NHS facilities.
Government Response and Future Planning
A Scottish Government spokesperson stated that investment at Gilbert Bain Hospital is being considered as part of NHS-wide infrastructure planning.
"This includes work to support continued safe and effective use of the existing facilities through additional targeted funding for priority maintenance as well as determination of longer term investment priorities."
