ABSTRACT
The provision of healthcare in such a situation would be problematic and extremely expensive. If too little medical provision is provided in the community many more of the population would begin to feel vulnerable and would follow the lead set by the St. Kilda Islanders in the 1930s. Some provision to ensure that patients were properly stabilised prior to take off would be absolutely essential. The remote health care dilemma is probably too big to tinker around the edges and requires radical thought and novel solutions. The development of Island seminars for medical and nursing staff based on video links overcomes the need for an unnecessary journey to the main island. In many parts of the world aero-medical evacuation has been used for years and is an essential part of sustaining communities in remote environments. The cost of providing any medical service to such a community is high, measured by the conventional method of cost per head of population.
