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Health, the Highlands and Tony Benn’s dad

July 26, 2013
The Dewar Committe, courtesy of Am Baile

The Dewar Committe, courtesy of Am Baile

1913 was anything but a quiet halcyon year, a point well illustrated in Michael Portillo’s recent Radio Four series

Two important Scottish centenaries also came out of it. On August 15, royal assent was given to bill setting up the Highlands and Islands Medical Service (HIMS) the unique social experiment in state funded comprehensive health care well before the NHS.

Its birth was remarkable for the speed of delivery.  Sir John Dewar’s committee spent months taking evidence around Scotland but managed to write its final report in just one day, meeting at the North British (now the Balmoral) Hotel in Edinburgh.

The Treasury signed off its annual £42,000 grant within weeks – such were the power of Dewar’s arguments and the broad political support behind it.

Surprisingly, perhaps, there were links aplenty then between health, philanthropy and the demon drink.  As well as the Dewar family’s whisky operation (in which Sir John played a key part), the family which owned Glengarioch distillery in Oldmedrum spawned Sir Patrick Manson, the father of tropical medicine; and Sir John Usher founded the Usher Institute for Public Health in Edinburgh.

Sir Patrick Manson

Sir Patrick Manson – courtesy Wikipedia

Also remarkable for that time was the influence of women in developing the HIMS.  Katharine Murray, Marchioness of Tullibardine and later Duchess of Atholl, served on Dewar’s committee. She became Scotland’s first female MP and the first  female Conservative junior minister in a UK Government before falling out with her local party over her efforts to help children caught up in the Spanish Civil War.

HIMS was administered by the Board of Health in Edinburgh where civil servant Muriel Ritson served for many years. Her experience proved valuable enough to warrant serving on Sir William Beveridge’s committee.

The success of HIMS was such that it was copied around the world. It was the model, albeit with important changes, for the Frontier Nursing Service in Kentucky and the Newfoundland Cottage Hospital scheme in Canada.  Newfoundland implemented the  cottage hospital system advocated by Dewar but not put into practice.  Unlike in Scotland, Its doctors were also directly salaried.

But the most remarkable feature is that HIMS continues to inspire. Last year a group of GPs, historians and archivists with Wellcome Trust funding, ran a series of meetings and seminars to celebrate the centenary of the Dewar report.

This prompted a debate in the Scottish Parliament with all party support and a new initiative to develop fresh ways of providing modern health care to remote and rural areas of Scotland.  The challenges are still there – just  like Dewar 100 years go.

Some things may never change, but sometimes history offers a constructive shove in the right direction.

Footnote

Oops, almost forgot….. The other centenary was the genesis of St Andrews House, the Edinburgh headquarters for the Scottish Office. A competition to build it was announced in January 1913 by junior Treasury Minister William Wedgwood Benn, father of Tony and grandfather of Hilary.

Benn was a much decorated pilot in First World War who enlisted again in 1939 as a pilot officer at the age of 62 and flew in several operations.

By that time St Andrews House had just opened. This being Edinburgh, it only took 26 years from start to finish but it was from here that the idea for Highland Doctor was hatched and commissioned.

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