A PARLIAMENTARY debate was secured yesterday (Thursday, February 18) by North MSP David Stewart.
In what was his final members’ business debate before retirement, Mr Stewart paid homage to the early pioneers of 1913 who founded and staffed the Highlands & Islands Medical Service, the forerunner to the National Health Service.
Here is the speech in full:
This will be my last Members’ Debate before I retire; could I therefore thank all members who have signed my motion – and for those who have not, I warmly welcome all sinners who repent.
The establishment of the Highlands & Islands Medical Service in 1913 was, in my view, the greatest achievement in the history of the region.
“Picture the scene.
“All part of one great 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.
“Nurses riding push-bikes and motorbikes, cutting across some of the most difficult terrain in the country. Doctors – sleeves rolled up, strong arms at the oars, moving from one scattered and rural population to another, navigating from place-to-place by simple rowing boat.
“Bringing medicines, creams, and critical medical expertise to super rural, isolated estates where there was no care at all.
“And its practices and principles were to become the bedrock, the very foundation 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 that many people all across the Highlands and Islands were receiving no form of health care.
“And all at a time when the region’s healthcare was inadequate.
“Chaired by Sir John Dewar, the Dewar Report of 1912 sought to understand the impact poor housing, health and income was having across the region.
“And this was no armchair exercise.
“His large team travelled across huge swathes of the Highlands and Islands, engaging with, and listening to, communities in Inverness, Orkney, Shetland, Lewis, Skye, Oban, and many other settlements.
“It is difficult to exaggerate the enormity of this task, with the inadequate transport infrastructure available back then in the early part of the 20th century.
“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 spreading from livestock was rife.
“Many people died needlessly.
“Here’s an extract from the evidence of Dr James Reardon in South Uist, published in the Dewar Report:
“What do you blame? To begin with, there is no foundation for the children. 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 Dewar Report was to change lives for the better.
“Its philosophy was that income, class and geography should be no barrier 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 – worth more than a million pounds today.
“Good value for money.
“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.
“These successes were detailed in the Cathcart Report of 1936, a review of the state of Scotland’s healthcare systems.
“On the basis of the family doctor, there has been built up by flexible central administration a system of co-operative effort, embracing the central department, private GPs, nursing associations, voluntary hospitals, specialists, local authorities and others, to meet the medical needs of the people.”
“Additional funding from the Treasury in the 1930s led to a further expansion of the Service.
“Stornoway now had a surgeon, as did Wick, ahead of Shetland and Orkney which had one by 1934. And by 1935 the first air ambulance service was established.
“The first patient lifted by the air ambulance was fisherman John McDermid in 1933.
“He was in urgent need of a stomach operation that couldn’t wait for travel by sea or road. An hour after he was lifted in Islay, Mr McDermid arrived at the Western Infirmary in Glasgow and received treatment.
“By 1948, the air ambulance service was carrying 275 patients a year.
“Some 300,000 people across the Highlands and Islands – half of Scotland’s land mass – were able to experience a revolution in healthcare that greatly improved their quality of life, social mobility and community spirit.
“The Highlands and Islands Medical Service had been running for 35 years by the time the NHS was established by the Attlee Labour Government in 1948.
“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.
“The early pioneers of 1913 deserve our praise, admiration, and recognition. I have no doubt they inspired Beveridge and Nye Bevan in the concept of a national health service – free at the point of use.
“Not for the first time, the Highlands and Islands provided inspiration and leadership with a philosophy of “better to light one candle that to forever curse the darkness”.