A Highland GP on life the universe and anything…

Posts tagged ‘Highlands’

Dewar 2012- an outline for an qualitative research project in Remote and Rural General Practice

“What are the factors that make remote and rural General Practice a rewarding and satisfying career choice and what more could be done to increase that reward and satisfaction to ensure a sustainable future for remote and rural healthcare”.

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Murdoch Beaton, Secretary to the “Dewar Report” 1912

Murdoch Beaton MA, TD, ISO*

I am part of a group who is keen to see the centenary of the publication of the Dewar Report commemorated in 2012.

The report detailed the state of medical services in the crofting counties of the Highlands and Islands in exquisite detail and its recommendations led to the formation of the Highlands and Islands Medical Service, the first state funded comprehensive health service and the forerunner of the NHS by 30 years.

The committee was made up of real characters but I was interested to find out more about the secretary to the committee, Murdoch Beaton. I was very grateful to @iGrannie for giving me the contact details of his grandson, Iain Beaton and so this week I headed of to Uig to find out more. I was not disappointed!

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CBT in General Practice

This blog was written to support the session I run for GP Specialty Trainees in the North of Scotland.

During these sessions I hope participants will: –

  1. Be able to describe a cognitive behavioural model
  2. Know who it may benefit and how to access formal CBT
  3. Develop a framework for diagnosing, assessing and treating commomn mental health problems in GP.

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An everyday story of threatend closure of a Community Hospital

Ross Memorial Hospital, a proud past but what of the future?

Talking to my patients, it is clear that the majority of older people would wish to be cared for in our local hospital if at all possible. This is entirely understandable as the nurses there provide a caring and professional local service, with excellent aftercare following their discharge home. Unfortunately it is becoming harder and harder to make this happen.

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Proposal for an exhibition to celebrate Dewar Report Centenary

An exhibition exploring the social conditions in the Highlands and Islands as described in the Dewar Report of 1912 and to celebrate the achievements of the Highlands and Islands Medical Service and its role as a prototype for the NHS.
Introduction
In 1912 a report of the Highland and Islands Medical Service Committee, chaired by Sir John Dewar (the Dewar Report) described vividly the living conditions of the people in the rural areas of the Highlands and Islands. Roads were extremely poor, phone connections rudimentary and the medical and nursing provision severely lacking. In fact at that time it is recorded that in Ross-shire 47% of deaths were uncertified, rising to 80% in Coigach, for lack of a doctor. The rest of Scotland had an uncertified rate of 2%.
A group, headed by the North of Scotland Faculty of the Royal College of General Practitioners (RCGP), is keen to celebrate the centenary in 2012 with conferences, publications and public meetings throughout the area. The group includes GPs from Argyll, Inverness, Ross-shire, Lochaber, Speyside, the Western Isles and as well as historians from Glasgow Caledonian University and the University of Dundee and the Chair of RCGP Scotland. Medical artefacts from the period are available from four separate private collections. There is also a film “Highland Doctor” made in 1942 that tells the story of events told by contemporary medical practitioners.
As part of the celebration we would like to propose an exhibition to tell this story in an accessible format and bring the period to life.

Proposal
The central display could be a doctor’s consulting room of the period and a display of the doctor’s bag that was an integral part of his trade for the many home visits that were required. A waiting room type area would provide space for further information boards and displays. Artefacts would be linked to specific pieces of evidence within the report for instance maternity instruments alongside a description of the situation many women faced of giving birth with no medical or midwifery supervision. In fact in one case it is recorded that a woman was reduced to reading out instructions to her husband as he assisted in her confinement. Collections of medicines, trauma, surgical and anaesthetic equipment would lend themselves to similar treatment drawing upon other anecdotes. They are often linked to specific communities and descibe the population’s hardships and struggle with disease.

In addition: –
• We could provide significant detail regarding the history of Highland Hospitals
• We have posters and leaflets from the Highland archive relating to the introduction of the Highland and Islands Medical Service
• The film “Highland Doctor” is an accessible and vivid representation of how things changed in 30 years from 1912 to 1942
• We are the custodians of David Wright’s Medical Memorabilia collection of medical instruments and equipment from across the 20th Century
• Future developments could look further back at the fascinating story of the “Medical Beatons” a family of highly trained medical men who attended the highland clans until the clan system was dismantled.
The Highlands and Islands Medical Service also had a strong influence on the formation of the NHS. The Beveridge report took evidence from the Scottish Department of Health and Miss Muriel Ritson CBE, an administrator for the Highlands and Islands Medical Service sat on the Beveridge Committee. Much of the powerful language of the report has been credited to Jessy Mair, from time Beveridge spent with her in Edinburgh. They were later married.
An exhibition would be able to give an idea of the continuity from the report to the present day with a display of the similarities in the HIMS contract, the contract issued to GPs in the early years of the NHS and those parts of the contract that live on to the present day. This could be reinforced with pictures or examples of the specialist equipment carried by present day GPs when on call with minimal support out of hours in the remote and rural areas of the Highlands.
Partner Organisations
The group has made many links with other organisations. They include: –
• NHS Highland,
• NHS Education Scotland
• Royal College of General Practitioners,
• Remote Practitioners Association of Scotland
• The Welcome Trust,
• University of the Highlands and Islands
• Remote and Rural Healthcare Educational Alliance.
An exhibition to tour the Highlands and Islands with a view to finding a more permanent home would seem a fitting way to celebrate this report and its ongoing effect on the present NHS in Scotland.
Miles Mack
May 28, 2011

Further reading: –
Our website is at an early stage of development but is at: –

http://www.dewarcentenary.org.uk/wp/

Other links of interest: –
http://en.wikipedia.org/wiki/Dewar_Report
http://en.wikipedia.org/wiki/Highlands_and_Islands_Medical_Service
http://scotlandonscreen.org.uk/database/record.php?usi=007-000-002-003-C
http://www.elib.scot.nhs.uk/Upload/Dewar_Report.pdf