A rural approach, suitable for the area is what is required- and this is likely to be different for each remote and rural area- which is what makes it complex and then the perception of being unachievable. Whilst its probably said that flexible services are provided in rural areas this doesn't seem to happen in practice. The examples below demonstrate some of this. A care home requires 30 or more beds to be financially secure. This is more likely to be achieved in an area of greater population. Therefore remote and rural areas are not allowed to have or are unable to have a local care home. Levels of pay for personal assistants ( for example) allow individuals to earn sufficiently in an urban environment, but when you could travel an hour between clients it is insufficient to support yourself. This would be similar in other roles and demonstrates the cost gap of travel in time and money- which seems to be ignored. Childcare is more haphazard or non existent in remote rural areas so working hours have to be very flexible. Traditional health and social care jobs dont always allow for this. Training available in rural areas is limited, requirement to 'go away' for significant study rather than new models of training from home, in your area.
All too often policies are urban led and not at all appropriate for the rural sparse population in many parts of Scotland and particularly in the Highlands. Poor provision locally means we have to travel and there is no effective public transport, many roads are single track (with summer visitors having little knowledge of how to drive on them). If you are in poor health, old or infirm the last thing you want is to be driving 80+ miles each way for health care. Many rural medical practices are short of staff and facing higher demands for their service. This means that doctors don't know their patients as they used to and getting appointments is getting more and more difficult. Our local nursing home has closed with no early solution
Rural is not just urban with a lower population density. For example, transport needs are quite different e.g. you can’t simply swap a car for walking, cycling or even the bus).
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