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"Survey return from Dr. MacRae"
Stornoway.
1851.
RCP/COL/4/8/246
Dr. MacRae was a medical practitioner in Stornoway.
Stornoway was a parish, town and seaport on the Isle of Lewis in the historic County of Ross and Cromarty. It also contained the quoad sacra parish of Knock and the village of Back. The population in 1831 was 5491. The main industry was agriculture with a little livestock breeding.
[[Addressee]]
Dr. MacRae
Stornoway.
[[Survey]]
QUERIES
1. How long have you practiced in the locality you at present occupy?
Nearly 3 years
(conjointly with Dr. Millar)
2. What are the ordinary and what the greatest distances which you have to travel in visiting patients?
In Stornoway Parish wherein I reside, ordinary distances = 2 miles, great-
=est = 20 miles. Greatest distances to other Parishes 55 to 65 miles (to & fro)
3. What means of conveyance do you employ in going long journeys?
Riding (horseback), Boating at
times, & when roads are awanting walking. In some directions the three modes
are indispensable.
4. What is the state of the roads in your neighbourhood?
Improved of late years.
5. Is the position of medical men in general in your quarter improved, or otherwise, of late years?
Since the Parochial
Boards1 availed themselves of the Parliamy medical Grant for the Poor, the payment from
that source is more certain, though it has deprived us of the Fees for Vaccination,
which is here necessarily extensive, & in an Island so intersected by arms of the
sea, & so populous, entails much extra labour. In other respects, our position
is by no means improved, but the reverse. Owing to the increasing poverty of the
people, little or no remuneration can be got, & a very large class not Paupers
receive medicine & laborious attendance gratuitously.
6. Supposing the people of the Highlands and Islands were generally able to pay for medical
advice, according to rates usually observed in other parts of the kingdom, what extent of
country in your locality would you regard as sufficient to occupy a single practitioner
fully?
If Practitioners were liberally paid, & could thus afford to furnish themselves
with all locomotive facilities & auxiliary appliances, & be enabled to devote themselves
almost exclusively to itinerant practice, three medical men would nearly overtake the
demands of the country; but to give any thing like the efficiency of attendance en
-joyed elsewhere, Five would be indispensable, that is Two for Stornoway Parish
& One for each of the other three parishes.
7. Mention, if you please, any special hardships incident to your situation, such as you think
might be remedied by some general measure or enactment?
The principal hardship undoubtedly
is the nonpayment of Fees, which seems not unlikely to become an unexceptional rule. The
extent of nonremuneration may be estimated from the fact that for the last two years & a half
my Partner & myself have travelled in one Parish upwards of 2000 miles on Express visits
exclusive of the Visits to Paupers & on Vaccinating tours, without obtaining any payment
whatever, not even in most cases for the medicines given. It may safely be stated that
the practice of the three Landward Parishes would not nearly cover the expense of Horse
hire, or that of keeping one horse, (as each Practitioner must do at a cost of £30
per annum in Stornoway.) It is proper to mention that our enactions in the way of Fees are
not pressed, for the simple reason that if punctually sued for, our attendance would not
be sought to many cases of even extreme urgency. It may surely be deemed a hardship
that disadvantages & discouragements of such a nature exist sufficient to chill and
repress the enthusiasm of most professional men; difficulties against which none
but a genuine Philanthropist of ample independence could heartily sustain
a protracted interest in his Patients & prosecute his profession with ardour
and success. While the utter inadequacy of remuneration is the master griev-
-ance here which must damp the zeal of any well qualified practitioners –
there are several other drawbacks which might be noticed, did space permit
- such as the great fatigues consequent on the long journeys to be travelled,
the exposure to vicissitudes of weather, & sometimes to danger by sea, together
with the discomforts from want of accomodation2 &c &c which though minor
grievances are however much felt, but which as well as the others complained
of, admit of remedy to a great extent by “some general measure of
enactment”.
Explanatory notes:
1. Following the Poor Law Amendment (Scotland) Act of 1845 parochial boards were set up in each parish to administer poor relief.
2. Misspelling of “accommodation”.
Remote & Rural Remedies
