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Praise in parliament for Highland forerunner of NHS

By David G Scott

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A parliamentary debate has been secured for later today (Thursday, February 18) by a North MSP to commemorate the Highlands and Islands doctors and nurses who inspired the creation of the NHS.

At 5.45pm today, MSP David Stewart will tell colleagues at Holyrood about “our greatest achievement as a region – the Highlands and Islands Medical Service”.

Mr Stewart, who is Labour’s Shadow Minister for Health, will describe this forerunner to the NHS scheme, founded in 1913, as “one great big awe-inspiring effort” to roll the tentacles of care all around the region, bringing vital treatment to rural settlements where health and deprivation levels were so low, the cows were better fed than the children.

An early release of the MSP's speech outlines its content. He will say: “I am absolutely thrilled to bring this motion before the chamber today, recognising and celebrating the Highlands and Islands Medical Service.

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

David Stewart MSP is praising the Highlands and Islands Medical Service in a speech tonight (Thursday, February 18). He released the text of his speech earlier today.
David Stewart MSP is praising the Highlands and Islands Medical Service in a speech tonight (Thursday, February 18). He released the text of his speech earlier today.

“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.”

He will continue: “The practices and principles of Highlands and Islands Medical Service were to become the bedrock upon which our National Health Service was created.

“The Highlands and Islands Medical Service came into being after it was discovered that crofters were exempt from the 1911 National Health Insurance Act. This meant many people all across the Highlands and Islands were receiving no form of health insurance.

“And all at a time when the region’s healthcare was appalling.

“Chaired by Sir John Dewar, the Dewar Report of 1912 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.

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

Mr Stewart will draw on contemporary evidence from the Dewar Report which includes quotes from Dr James Reardon in South Uist who said: “What, do you blame? To begin with, there is no foundation for the children.

"The mothers don’t nurse their children, and at the age of three months they are supposed to be able to take porridge and sops. The reason for that is that the milk of their cows is given to the calves, and there is no milk for the children. It is a case of the survival of the fittest.”

The MSP compares the work of the early medical service with the NHS and its current battle against Covid-19.
The MSP compares the work of the early medical service with the NHS and its current battle against Covid-19.

The MSP will then talk about how the Dewar Report "changed those people’s lives [and] recommended 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 these recommendations, and the Highlands and Islands Medical Service was swiftly established in August 1913 – and handed an annual grant of £42,000.

“The Service was a rousing success. The grant provided accommodation, transport, further study and holidays for healthcare workers, and the standard of healthcare began to exceed the rest of Britain.

“Further funding from the Treasury in the 1930s led to a further expansion of the Service. Stornoway now had a surgeon, as did Wick, before Shetland and Orkney by 1934. And by 1935 the first air ambulance service was established."

Mr Stewart will say that by the time the NHS was established in 1948, the Highlands and Islands Medical Service had been running for 35 years and the rest of the UK was able to learn from its success.

“I feel really strongly that this predecessor to the NHS should be commemorated by the Parliament. 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. 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.”

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