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There is no doubt the isles of Barra and Vatersay are beautiful places. On the edge of the Atlantic Ocean, they are home to about 1,300 islanders.

But remoteness also means challenges providing healthcare to a population that is a one-hour flight or a six-hour drive from the nearest A&E.

There has been no permanent doctor on the two Hebridean islands since last summer and while two posts have now been advertised, the community fears it will be a struggle to attract the right type of medical professionals who are a lifeline to the islands.

In 2020, early in the Covid pandemic, Sandy Maclean was working on his tractor when its wheel blew and threw him across the shed.

The explosion was so ferocious, his wife Kirsty, ran out from the house and when she saw her husband, immediately thought he was dead.

Sandy's daughter Ishbel, who lives next door, arrived and realised he was severely injured. She started first aid, bandaging his head in sheets and towels to stem a major bleed.

She told ´óÏó´«Ã½ Scotland: "It was all very quick, and yet not quick at the same time. The paramedics arrived and they could tell it was bad so he got bundled into the ambulance and taken three miles up the road to the hospital."

St Brendan's is a tiny three-bed hospital in Castlebay, the main village on Barra, which is not even equipped with an X-ray machine.

But it is the place where the local doctor tries to keep patients stable in an emergency while awaiting the air ambulance to take them to the mainland.

A trauma team from almost 200 miles away in Glasgow was diverted to Barra but had to refuel meaning it was almost five hours before Sandy was helicoptered off the island.

"The only way the trauma team in Glasgow could describe it, was he was like a bomb victim" says Ishbel.

"The neurosurgeon put a massive question mark over how long it took for him to get to her."

Ishbel added: "If you look at what we do (on the islands) everyone is out working the land or working the sea so the potential for accidents is high here and that doctor is going to be the only person to respond.

"Anywhere else, what you go to your regular GP for, and what you go to A&E for, are two very different things and here it is the same person that needs to be able to do both jobs."

The most recent resident GP left Barra last year and since then cover has been provided by locums. Temporary staff are also providing dental care on the island and plans to build a new hospital are now on hold after the Scottish government pulled the funding.

It has left residents unsettled and worried about the future of vital services.

Margaret Ann Beggs is the manager of Cobhair Bharraigh, a day centre for elderly people.

She says: "The doctors and the nurses are lifeline services for the community of Barra. They really do save lives and keep people alive until such time as they can get off the island for specialist care.

"They deal with everything here on the island and as such they are a fundamental and really important part of the community".

Half of the 16 consultant posts in the Western Isles, which includes the larger islands of Lewis and Harris, are currently filled by locum doctors and the health board spent £3.6m on temporary staff in the past year.

NHS Western Isles chief Executive Gordon Jamieson says he was recently quoted over £1m to fill one specialty post for a year.

He told ´óÏó´«Ã½ Scotland he is optimistic they will find permanent GPs for Barra but there is competition with high vacancy rates across all the islands.

He said: "The single biggest issue, or risk, that the Outer Hebrides faces is population decline.

"If you put on top of that some very clear and obvious general pressures across the NHS then that adds to the challenge for more remote areas. I can't remember a time when it was more difficult to recruit into posts than it is now."

Young families accept that choosing to live in such a remote community means you cannot take access to healthcare for granted. But there are frustrations that people have to leave the island for routine things like blood tests or dental treatment.

Alison Sinclair has two daughters, Emma, aged five, and Sophie who is three.

She said: "Nine times out of 10, the healthcare is great but it's little things, like Sophie needs a blood test and we had to get a paediatrician appointment and you have to go to Uist for that.

"Five minutes before we were due to get on the ferry it was cancelled. So now I've got to go over in a couple of weeks, just for a simple blood test and you can potentially be there all day."

It is a worry for young families too. Anna Maclean's daughter Amy was ill as a baby. She had a high temperature and began fitting.

She said: "If there is an emergency we should be able to come to our own hospital and not be on the phone to 111 for 40 minutes because we are in the Western Isles.

"My kids haven't been to any dentist because we don't have one and it is making me think I want to move because of scares I've had in the past, but I don't want my kids to leave Barra because it is a beautiful place to be brought up."

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