The Highlands and Islands nurses who inspired NHS creation

Some 35 years before the birth of the NHS, a state-run healthcare service in the Highlands and Islands treated patients in Scotland's remotest spots with motorbikes and rowing boats often used by nurses to reach appointments.

A Queen's Nurse with the Highlands and Islands Medical Service on motorbike with friend on the island of Bernera. PIC: Islands Book Trust/Bernera Historical Society.
A Queen's Nurse with the Highlands and Islands Medical Service on motorbike with friend on the island of Bernera. PIC: Islands Book Trust/Bernera Historical Society.

The creation of the Highlands and Islands Medical Service in 1913 was then a unique social experiment launched after the Dewar Report found poor care and treatment in the North and in some cases, no care at all.

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A solution was sought given that large number of crofters and fishermen received no wages and were unable to qualify for the National Health insurance Scheme of 1912.

The service in the Highlands and Islands was to pave the way for the creation of the NHS, which celebrates its 70th anniversary today.

District nurses often worked by the light of tilley lamps and battled the elements to reach their patients, on one occasion saving a toddler who had fallen into a pot of soup.

The district nurses were judged to be of extraordinary pedigree most of them having temporarily left their Hebridean homes to train in Edinburgh and Glasgow as Queen’s Nurses, which expanded their clinical skills and gumption in the field.

Accounts of those working in the new service were recorded by author Catherine Morrison in Hebridean Heroines, 20th Century Queen’s Nurses, published last year.

One former district nursing officer, Christine MacLennan, who served until the 1970s, recalled in the book:

“Nurses had to have the courage and the physical strength to face the black moor walks at night, exhausting battles with wind and rain and journeys by small boats across stormy seas.

“It was the way help must come to save the patient, it was given without hesitation.”

Long, often hazardous journeys were made to see patients, including storm-hit trips on boats to lighthouses and fog-ridden walks on coastal paths.

Horses and motorbikes were used by some of the women, who would often act as GP, nurse and midwife - to get around.

Nursing accommodation was poor, with rats a problem for some, nurses not spared the need to fetch water from a well or light a peat fire after work.

Electricity was not in place for the majority of the islands until the 1950s. One nurse, Rhoda, recalled in the book a difficult call out to a traditional blackhouse, where families lived under the same roof as their livestock.

A girl, aged two or three, had fallen into a pot of soup, with the resident calf proving a welcome distraction for the distressed child.

Rhoda said: “I was called out to a young girl. She was running around at that stage, maybe two or three years old, and she fell into a pan of hot soup.

“They had taken the pan off the fire, and placed it on the floor as they usually did, and the wee one was running around and she fell into it.

“She burnt the whole of her back and word came for me to call. “The wee girl did not want anyone near her or to touch her and when I saw the condition that she was in I understood why.”

“The young girl cried for the calf and she was taken to see the beast by her grandfather. “That is how I managed to dress her wounds. By her patting the calf as I was dressing her burn at the same time, it took her attention away from what she was suffering,” the nurse recalled.

Within a few months of the Dewar report, the Treasury agreed to provide an annual grant of £42,000 to fund HIMS - the equivalent to one shilling and sixpence for each member of the population.

Morrison, in her book, described the impact of The Dewar Report as “seismic” with HIMS to inform the setting up of the NHS in Scotland in 1948.

“The Secretary of State for Scotland introduced the NHS (Scotland) Bill in the House of Commons in 1946 by informing the House that the HIMS had provided the necessary pointers towards a comprehensive service for the whole country,” she said.

The service of the Queen’s Nurses was also to inspire nursing in some of the world’s remotest places, from frontier land in the United States to Newfoundland in Canada and the Australian Bush.

Hebridean Heroines by Catherine M Morrison is published in February by Islands Book Trust.