The Highlands and Islands Medical Service (HIMS) provided state funded healthcare to a population covering half of Scotland's landmass from its launch in 1913 until the creation of Scotland's National Health Service (NHS) in 1948. Though treatment was not free, unlike

NHS Scotland NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, ...

which succeeded it, fees were set at minimal levels and people could still get treated even if they were unable to pay.

Foundation

The service came into being as a direct result of the publication of the Report of the Highlands and Islands Medical Service Committee or " Dewar Report" in 1912. This report exposed inadequate medical and nursing services across large parts of the crofting counties and recommended a new way of delivering state funded medical services. Doctors would be guaranteed a minimum salary and cost of travel would be reimbursed. In return they would be expected to visit all those requesting help, be involved in public health and school work, attend midwifery cases and provide themselves with adequate transport. The service also planned an expansion of nursing services with associated nursing accommodation, provide state support to the hospitals and specialists and purchase ambulances. The service was administered by a Board of between 5 & 9 with the first Chair being Sir John Dewar. After an initial survey they predicted an increase in doctors from 170 to 185 and an additional 100 new houses. They requested and were granted an annual treasury grant of £42,000.

Early years

The service had an uncertain start. An early achievement was the posting of a nurse to St Kilda but the First World War held back developments and was used merely to support the doctors salaries and provide travel expenses. In 1919 administration moved to the Scottish Board of Health and in due course it was seen to be having the desired effect of providing adequate medical services to the population and supporting doctors to live and work in the area. Eventually other aspects of the service were developed including support for specialist surgeons and physicians, a laboratory in Inverness and even the first air ambulance service to the outer isles in 1936. The

Frontier Nursing Service The Frontier Nursing Service was founded in 1925 by Mary Breckinridge and provides healthcare services to rural, underserved populations and educates nurse-midwives. The Service maintains six rural healthcare clinics in eastern Kentucky, the Ma ...

Kentucky Kentucky ( , ), officially the Commonwealth of Kentucky, is a state in the Southeastern region of the United States and one of the states of the Upper South. It borders Illinois, Indiana, and Ohio to the north; West Virginia and Virginia ...

United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...

, was built on the HIMS model., as was Newfoundland's Cottage Hospital System.

Timeline

*1845 Poor Law Act gives limited provision of medical care to remote areas *1885 Poor Law amendment Act directed funds to urban poorhouses and away from rural provision *1910 Dewar Report published describing wholly inadequate medical provision in Highlands & Islands *1912 National Health Insurance Scheme set up but unworkable in crofting communities *1913 Highlands & Islands Medical Service set up. *1914 Provision of travel support provided to doctors and resident nurse appointed to St Kilda *1916 Grant provided to prevent the closure of Belford Hospital in Fort William *1919 Control moved to Scottish Board of Health *1920 MacAlister Report stressed importance of: "... personal service, such as can be rendered to the people in their own homes only by a family doctor who has continuous care of their health". *1924 First consultant appointment -

General Surgeon General surgery is a surgical specialty that focuses on alimentary canal and abdominal contents including the esophagus, stomach, small intestine, large intestine, liver, pancreas, gallbladder, appendix and bile ducts, and often the thyroid g ...

for Stornoway Hospital *1929 73 District Nursing Associations established employing 175 nurses. *1933 first Air ambulance journey, from Islay on a

Midland & Scottish Air Ferries Midland & Scottish Air Ferries was Scotland's first airline, operating from 1933 to 1934. It is particularly noted for pioneering flights to the Inner Hebrides History Foundation John Cuthill Sword started Midland Bus Services in Airdrie, to ...

flight to

Glasgow Glasgow ( ; sco, Glesca or ; gd, Glaschu ) is the most populous city in Scotland and the fourth-most populous city in the United Kingdom, as well as being the 27th largest city by population in Europe. In 2020, it had an estimated popul ...

*1934 Consultant surgeons established in Shetland, Orkney, Caithness &

Lewis Lewis may refer to: Names * Lewis (given name), including a list of people with the given name * Lewis (surname), including a list of people with the surname Music * Lewis (musician), Canadian singer * "Lewis (Mistreated)", a song by Radiohead ...

*1935 Consultant

Physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...

appointed in Inverness *1936

Air ambulance Air medical services is a comprehensive term covering the use of air transportation, aeroplane or helicopter, to move patients to and from healthcare facilities and accident scenes. Personnel provide comprehensive prehospital and emergency and cri ...

service to

Western Isles The Outer Hebrides () or Western Isles ( gd, Na h-Eileanan Siar or or ("islands of the strangers"); sco, Waster Isles), sometimes known as the Long Isle/Long Island ( gd, An t-Eilean Fada, links=no), is an island chain off the west coast ...

established *1936 Cathcart Report: "This service has revolutionised medical provision in the Highlands. It is now reasonably adequate in the sense that for all districts the services of a doctor are available on reasonable terms." *1942 Beveridge Commission included Miss Muriel Ritson CBE of the Department of Health for Scotland. She had previously been an administrator for the HIMS. *1948 NHS took over from HIMS

References

External links

Highland Doctor
a 1943 dramatised account of HIMS, at National Library of Scotland
NHS Scotland
official website 1913 establishments in Scotland 1948 disestablishments in Scotland Medical and health organisations based in Scotland Organisations based in Edinburgh Social history of Scotland NHS Scotland History of the Scottish Highlands Government agencies established in 1913 Government agencies disestablished in 1948

Foundation

Early years

Timeline

See also

References

Further reading

External links