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 which succeeded it, fees were set at minimal levels and people could still get treated even if they were unable to pay.
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 five and nine 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.
The service had an uncertain start. An early achievement was the posting of a nurse to St Kilda. The First World War held back developments. The service supported doctors' salaries and their travel expenses. In 1919, administration moved to the Scottish Board of Health. In due course, it provided adequate medical services to the population, and supported 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 in Kentucky, United States, was built on the HIMS model, [1] as was Newfoundland's Cottage Hospital System. [2]
{{cite web}}: CS1 maint: archived copy as title (link){{cite web}}: CS1 maint: archived copy as title (link)The National Health Service in Scotland: Origins and ideals, 1900-1950 Morrice McCrae, 2003, Tuckwell Press ISBN 1-86232-216-3
Improving the Common Weal, Gordon McLachlan, 1987, The Nuffield Provincial Hospital Trust ISBN 0-85224-551-3