Dewar Report

[1] The report presented a vivid description of the social landscape of the time and highlighted the desperate state of medical provision to the population, particularly in the rural areas of the Highlands and Islands of Scotland.

The report recommended setting up a new, centrally planned provision of care that within 20 years transformed medical services to the area.

This organisation, the Highlands and Islands Medical Service was widely cited in the Cathcart Report[2] and acted as a working blueprint for the NHS in Scotland.

The report is written in clear language and many of its findings continue to have relevance to how medical services are planned and financed in Scotland and beyond.

The report was commissioned in 1910 to overcome the difficulties of implementing the forthcoming National Insurance Act 1911 in the crofting communities.

In industrial areas the working population were expected to contribute a proportion of earnings to a central fund to provide medical care when needed.

The remit of the enquiry was settled to be "...the counties of Argyll, Caithness, Inverness, Ross and Cromarty, Sutherland, Orkney and Shetland and from the Highlands of Perthshire, comprising the area in which isolation, topographical and climatic difficulties, and straitened financial circumstances are found most generally in combination, and, therefore, the area generally within which the question of adequate medical provision is most pressing."

When one considers also the probability of the cattle being affected with tuberculosis, under the conditions prevailing what else could we expect than a wide prevalence of the disease."

In addition the area continued to suffer from depopulation and local rates were inadequate to cover the cost of doctor's income.

Their importance to an area in attending births, following up and continuing treatment and as a source of information on personal and domestic hygiene was emphasised.

He rose to the rank of Lt.-Colonel in the Queens Own Cameron Highlanders during World War I and then continued as a civil servant in Inverness and latterly in Edinburgh where he died in 1948 J. Cullen Greirson, Esq., Convener of the County of Zetland Andrew Lindsay, Esq., Convener of the County of Sutherland Dr Leslie MacKenzie, Medical Member, Local Government Board of Scotland Dr J. L. McVail, Deputy Chairman of the Scottish Insurance Commission.

His painstaking investigations, his lucid reports, and his wisdom in counsel displayed during the period of his appointment placed him in the front rank of public health officers.

Dr McVail's attention was turned to vaccination by the study of the mortality statistics of Kilmarnock for the years 1728 to 1764 which revealed appalling evidence of the great prevalence of smallpox among children in the eighteenth century.

Charles Orrock, Esq., Chamberlain of the Lews, on the behalf of the owners, the Mathesons Dr John L. Robertson, born in 1854, was Senior Chief Inspector of Schools for Scotland.

When he died in Inverness, six years after his retirement from the post, his popularity was clear in the extent of the activity surrounding his funeral; when his body was returned to Lewis the flags on the island were at half mast and all businesses were closed at noon.

Sir George Macdonald, the Secretary of the Scottish Education Department, extolled his virtues and said 'Few men in our time have laid their native country under so deep an obligation as he has done'.