Dewar Report facts for kids
The Dewar Report, officially known as the Report of the Highlands and Islands Medical Service Committee, was published in 1912. It was named after its leader, Sir John Dewar. This important report showed how difficult life was for people in the Highlands and Islands of Scotland and how poor their healthcare was, especially in rural areas.
The Dewar Report suggested a new, centrally planned way to provide medical care. Within 20 years, this idea completely changed healthcare in the region. The new organization, called the Highlands and Islands Medical Service, later became a key example for creating the NHS in Scotland. The report was written clearly, and many of its ideas are still important today for how healthcare is planned and paid for in Scotland and beyond.
The report was asked for in 1910 because it was hard to put the new National Insurance Act 1911 into action in crofting communities. In cities, workers paid money from their wages into a fund for medical care. But in the Highlands and Islands, most people were crofters with little regular income, so this system wouldn't work. The Dewar Report followed earlier reports, like the Coldstream Report from 1852 and the Napier Report, which also showed how bad medical services were in the area. The committee's job was to look at areas like Argyll, Caithness, Inverness, Ross and Cromarty, Sutherland, Orkney, Shetland, and parts of Perthshire. These were places where people faced isolation, tough landscapes, bad weather, and financial problems, making good medical care a huge challenge.
Contents
How the Committee Gathered Information
The Dewar Committee collected information in several ways. They sent out questionnaires to 102 doctors and 158 other people. After that, they traveled around to see things for themselves. They visited many places, including Inverness, Thurso, Kirkwall, Fair Isle, Lerwick, Lairg, Bettyhill, Rhiconich, Stornoway, Garrynahine, Tarbert, Lochmaddy, Dunvegan, Portree, Kyle of Lochalsh, Perth, and Oban. They also held meetings in Edinburgh and Glasgow and looked at other reports and papers that had been published.
A Look at the Past: Social Changes
The Highlands and Islands had gone through many big changes over the years that affected people's lives and health:
- The old Highland Clan system started to break down in the 1600s, speeding up after the 1745 Jacobite rising.
- New farming methods during the Scottish Enlightenment led to people being forced off their land.
- Many people continued to leave rural areas.
- After the Battle of Waterloo in 1815, the end of the Napoleonic war caused the kelp industry to collapse and beef prices to drop, hurting the economy.
- The Highland Potato Famine in 1845 caused widespread hunger.
- The Highland Clearances saw many people removed from their homes.
- In 1845, the Poor Law (amendment) Act gave poor people the right to medical help, paid for by local councils.
- Earlier reports, like the Coldstream Report (1850, 1852) and the Napier Commission Report (1884), had already pointed out the poor state of medical services.
- The Crofter's Holding Act in 1886 tried to help crofters.
Healthcare in 1912: A Difficult Time
Earlier reports had already shown how bad medical care was in the Highlands and Islands. The Dewar Report quoted Dr. Mackenzie of Uist from a 1904 report, who said:
"The lack of enough medical care and nursing greatly harms the well-being of the area. The loss of life, hardship, and sadness this causes cannot be measured. The physical problems are clear, and it makes people less sensitive to suffering and death. This is especially clear in the number of deaths that doctors haven't officially confirmed, particularly among older people."
Why Special Help Was Needed
The report explained why the Highlands and Islands needed special attention. It described an area with few people, wild landscapes, and very basic roads. Many people lived miles from their doctor. Doctors often risked their own safety to visit sick patients. On top of this, people were very poor, didn't eat well, and their homes were often unhealthy and too crowded.
The report described homes that were: "...practically only one room, with damp walls, damp clay floors, dark insides, smoky air, and cattle living under the same roof as the people. The areas around the houses were usually badly drained, and the ground was often wet. When someone got tuberculosis in one of these houses, it was impossible to keep them separate. Too often, patients would spit on the floor of churches and meeting-houses, spreading the germs. When you also think about the chance of cattle having tuberculosis under these conditions, what else could we expect but a lot of the disease?"
Also, people continued to move away from the area, and local taxes weren't enough to pay doctors properly. The new Insurance Act didn't help much because so few people had regular paid jobs.
The State of Medical Services
The report found that many doctors had no job security, lived in poor housing, and didn't earn enough money. Because of this, they couldn't afford proper transport, and the telephone system was not well developed. Doctors couldn't pay for someone to cover for them, so they didn't get holidays and couldn't get more training.
Proof of Poor Medical Care
One of the most shocking findings was the number of deaths that doctors had not officially certified. In the County of Ross, for the 10 years before the report, 47.5% of all deaths were uncertified. The worst area was Coigach, where 81% of deaths were uncertified because no doctor had attended. In contrast, the rest of Scotland had only a 2% rate of uncertified deaths.
There were many stories of doctors being called too late or not at all. It was clear that many people couldn't afford a doctor's fee. School medical inspectors also found illnesses that would not have been seen by a doctor otherwise. Instead, people often used "quack medicine" (fake cures) or relied on old "cures" and superstitions.
Nurses and Hospitals
The report noted that there were too few nurses, and their organization was messy. This was partly because charities often provided nurses in some areas. The report stressed how important nurses were for helping with births, continuing treatment, and teaching people about personal and home hygiene.
What the Dewar Report Suggested
The Dewar Report made very detailed recommendations. It suggested that the government should provide money to completely reorganize medical services under one single organization. Patients would pay a small fee for services, and doctors would receive a minimum salary, plus extra money for travel costs. The report also recommended reorganizing nursing services, building community hospitals, improving telephone systems, and setting up an ambulance service. Over time, these recommendations were put into action with the creation of the Highlands and Islands Medical Service.
Committee Members
The committee was made up of several important people:
- Chairman – Sir John Dewar
- Secretary – Murdoch Beaton, an Inspector from the Health Insurance Commission.
- J. Cullen Greirson, Esq., who was in charge of the County of Zetland.
- Andrew Lindsay, Esq., who was in charge of the County of Sutherland.
- Dr Leslie MacKenzie, a Medical Member of the Local Government Board of Scotland.
- Dr J. L. McVail, Deputy Chairman of the Scottish Insurance Commission, known for his work in public health and vaccination.
- Dr A. C. Miller, a Medical Officer for the Parishes of Kilmallie and Kilmonivaig, who spoke Gaelic and worked in Fort William.
- Charles Orrock, Esq., who managed the Lews for its owners.
- Dr John L. Robertson, a Senior Chief Inspector of Schools for Scotland, who was highly respected in education.
- Marchioness of Tullibardine
Images for kids
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The Dewar Committee members.
