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Highland doctors and nurses who inspired the creation of NHS to be commemorated in Scottish Parliament


By Val Sweeney

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Highlands and Islands MSP David Stewart.
Highlands and Islands MSP David Stewart.

The doctors and nurses of the Highlands and Islands who inspired the creation of the NHS will be commemorated in the Scottish Parliament today.

Labour MSP David Stewart has secured a debate to highlight the Highlands and Islands Medical Service which delivered health care to scattered and remote communities after being founded in 1913 – long before the creation of the NHS.

Using all manner of transport from motorbikes to boats, the doctors and nurses took vital treatment to rural settlements where health and deprivation levels were so low, the cows were better fed than the children.

Mr Stewart, who represents the Highlands and Islands and is Labour’s Shadow Minister for Health, described it as the greatest achievement as a region.

"It is the last motion that I will be able to bring for debate as an elected member and one that I felt was fitting," said Mr Stewart who is stepping down at May's elections.

He said he was thrilled to be putting forward the motion at Holyrood to celebrate and recognise the medical service.

"Probably not many that people know about this – and it was probably our greatest achievement as a region," he said.

"Widely believed to be the first of its kind, nurses riding side-saddle, pillion passengers on motorbikes cutting across some of the most difficult terrain, and doctors, with their trousers and sleeves rolled-up, strong arms at the oars, moving from one scattered rural population to the other, navigating from place-to-place by simple rowing boat - all part of one great big awe-inspiring effort, to bring care and treatment to people in what would later become recognised as the world’s first provision of state funded healthcare.

"Bringing medicines, creams, and bandages, to the back-of-beyond, to places where there was no care at all."

The Highlands and Islands Medical Service came into being after it was discovered that crofters were exempt from the 1911 National Health Insurance Act.

It meant many people all across the Highlands and Islands were receiving no form of health insurance at a time when the region's health care was appalling.

The Dewar Report of 1912, chaired by Sir John Dewar, sought to understand the impact no health insurance was having across the region.

His large team travelled across huge swathes of the Highlands and Islands, engaging with communities in Inverness, Orkney, Shetland, Lewis, Skye, Oban and many other settlements.

"It is difficult to exaggerate the enormity of this task, with the transport that was available back then in the 1910s," Mr Stewart said.

"Doctors, crofters, fishermen and others were consulted across the region.

"It was found that the geography of the Highlands and Islands was proving problematic, both for doctors to reach people and for patients to travel to receive treatment.

"Poverty meant diets were poor, homes were damp, and disease was rife, spreading from livestock – many people died, needlessly."

The Dewar Report changed people’s lives, recommending that income, class or geography should not be barriers to receiving healthcare.

It recommended the establishment of a minimum wage for doctors, funding for more district nursing associations and the standardisation in the cost of a doctor’s visit- regardless of distance.

Parliament approved the recommendations, and the Highlands and Islands Medical Service was established in August 1913 and handed an annual grant of £42,000.

"The Service was a rousing success," Mr Stewart said.

"The grant provided accommodation, transport, further study and holidays for healthcare workers, and the standard of healthcare began to exceed the rest of Britain."

The 1936 Cathcart Report, which reviewed of the state of Scotland’s healthcare systems, praised the co-operative effort involving doctors, nurses and others to meet the medical needs of the people.

Further funding from the Treasury in the 1930s led to further expansion including the establishment of the first air ambulance service.

The first patient lifted by the air ambulance was fisherman John McDermid in 1933. He was in urgent need of an abdominal operation. An hour after he was lifted in Islay, Mr McDermid arrived at the Western Infirmary in Glasgow and was treated.

"By the time the NHS was established in 1948 by the Attlee Labour Government, the Highlands and Islands Medical Service had been running for 35 years - and the rest of the United Kingdom was able to learn from and be inspired by the successes of communities all across the Highlands and Islands," Mr Stewart said.

He felt strongly the predecessor to the NHS should be commemorated by the Scottish Parliament.

"We should never lose sight of the importance of this service, which was only made possible thanks to the herculean efforts of those doctors and nurses who, in similar vein to the medics at the forefront of today’s pandemic-ridden world, put the need of those they care for, first," he said.

The debate starts at 5.45pm.

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