and Islands Medical Service (HIMS)
|Our old photo shows the official opening of the extension of the Lewis Hospital on 10th May 1928; some 15 years after the start of the Highlands and Islands Medical Service.
Highlands and Islands Medical Service was a unique social experiment in
Britain long before the NHS.
It was formally set up in 1913 with a Treasury grant of £42,000
in the wake of a report by Sir John Dewar's committee.
and nursing services were either poor or non-existent in many areas within
the crofting counties. Crofters did not qualify for services under the
new National Insurance scheme.
Doctors struggled to make any living in such sparsely-populated areas
- apart from occasional summer visitors from the south on sporting holidays.
War delayed the introduction of the service although a resident nurse
was found for the island of St Kilda in 1914.
A model for others
Doctors had a basic income but could continue to treat private patients.
Fees were set at minimal levels but inability to pay did not prevent people
from getting treatment.
State resources were directed to basic needs - providing a house, telephone,
car or motor boat to get around and cover for further study and holidays.
By 1929 there were 175 nurses and 160 doctors in 150 practices.
Working in the most remote communities became an attractive career option
for nurses and doctors. Not only was care being delivered to all sections
of the community, it was of a standard higher than much of the rest of
The American pioneer Mary Breckinridge visited Scotland in 1924 and on
her return built the Frontier Nursing Service in Kentucky on the HIMS
"The combination of doctor and nurse is extraordinarily impressive.
Many of the doctors say that practice in their areas would be impossible
without the services of the nurses, and everywhere we are told that co-operation
between doctor and nurse leaves nothing to be desired."
Cathcart Report 1936
Sky is no limit
were extended to hospitals in the 1930s with further Treasury funding.
Stornoway already had its first surgeon in 1924. Wick gained its first
in 1931 with the support of Aberdeen University. Shetland and Orkney followed
by 1934. Close links were developed with the other medical schools.
By 1935 it was really taking off with the first air ambulance service.
Eight patients were airlifted to specialist mainland hospitals under a
contract with Scottish Airways Limited based at Renfrew.
The first actual flight was in May 1933 for fisherman John McDermid in
urgent need of an abdominal operation but much too ill for the sea and
road journey. He was at the Western Infirmary in Glasgow just over an
hour after the aircraft had left Islay.
HIMS and local councils provided the funding for those who could not afford
to pay and by 1948, the air ambulance service was carrying 275 patients
The Highlands and Islands Medical Service revolutionised care for more
than 300,000 people on half the land mass of Scotland. Unlike other local
medical schemes, it was directly funded by the state and administered
centrally by the Scottish Office in Edinburgh working with local committees.
By 1948 it had been providing comprehensive care for 35 years. The rest
of Britain was about to experience it for the first time.