Members of Bute Community Council had many searching questions for NHS Highland's Bute and Cowal locality manager Viv Smith, Bute area clinical director Dr Colin Boyd and Argyll and Bute Council's community care resource service manager Anne Austin - particularly on the future of the Victoria Annexe in Rothesay.

Beginning the round of questions at BCC's January meeting this week, chairman Donnie MacLeod spoke of persistent local concerns about bed numbers at the Annexe, and the lack of care facilities for people unable to stay at home.

"We have 16 beds at the Annexe," Ms Smith said. "We did reduce bed numbers down to about ten recently, but that was for refurbishment work, and we're back up to 16 now.

"Historically the Annexe has become an interim residential care placement facility, but since legislation changed in 2006 it has been made very clear that the threshold for NHS continuing care is very high - it is only suitable for people who have a very severe disability which requires 24-hour medical and nursing care.

"However, we haven't said to anyone living in the Annexe that they're going to have to move on."

Local Argyll and Bute councillor Isobel Strong suggested that the Annexe be converted into a 'single care home' facility to provide the 24-hour care required by so many local residents.

Ms Smith said that would only provide eight bed spaces, to which Cllr Strong observed: "That would be eight more than we have at the moment."

Dr Boyd warned against assumptions that the Annexe was a desirable option for any elderly resident of Bute and suggested there was much more to long term care than simply being nursed.

"The quality of life that people have at the Annexe can't really be compared to somewhere like Craigard, for example," he said.

"In comparison the Annexe, is not a pleasant environment in which to live your life. You really shouldn't hold out the idea that the Annexe is a nice place to be. You all would want to be in a place like Craigard."

Dr Boyd said using the Annexe as a single care home was "a very sensible suggestion", and said he hoped private care providers could be made aware that there was a business opportunity for them on Bute.

Ms Smith acknowledged that the lack of 'single care home' facilities on Bute was a major shortcoming in healthcare provision on the island - but that measures were being put in place to at least partly improve the situation.

"We are going to have to be creative in difficult circumstances," she said, "because there is no sign of a care home coming here soon.

"What else can we do? One of the things we can do is we will put in place in April an overnight care team on Bute, with two care workers on duty overnight and available for planned care for those who need it overnight.

"Basically that's someone to pop in and check that the patient is okay and that their care needs are being met. They can also respond to crises that may occur out of hours."

April will also see Bute's first 'integrated care team', comprising community nurses, physiotherapy, occupational therapy and social workers, start work - though Ms Smith said changes on a bigger scale would have to wait for the outcome of Argyll and Bute Council's review of older people's services.

"I'm very clear that we absolutely need a 24-hour care facility on the island for the population that we have," she said.

"That's missing in this model, and we're hoping a private provider will be very interested in providing it."

The meeting also heard concerns over patient ambulance transfers taking place in the open air on Rothesay pier, the length of time taken by the older people's service review, and the difficulties experienced by some islanders in visiting loved ones at Inverclyde Royal Hospital during the day.