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About the surveys
In 1850 the Royal College of Physicians of Edinburgh appointed a Committee to report on the deficiencies in medical aid in the Highlands and Islands.
This was the first study to demonstrate the extent of the challenges in providing medical aid to the Highlands and Islands, detailing the difficulties of a sparse population, challenging geography and inadequate numbers of qualified practitioners.
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First steps
Initially the Committee contacted the Board of Supervision for the relief of the poor, hoping that they might have information on the number and location of medical practitioners. Unfortunately, the board did not hold this information.
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Church ministers
The College’s next step was to write to church ministers across the Highlands and Islands to collect evidence from them. 320 questionnaires were sent out with these letters to 170 parishes in Argyll, Bute, Caithness, Inverness, Orkney, Ross, Shetland and Sutherland.
These questionnaires asked nine questions, including the number of medical practitioners in the district and experiences of the poor – such as sickness, injury and accidents.
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Medical practitioners
The questionnaires to church ministers also asked for the names and addresses of medical practitioners in each locality. This then enabled the College to send out a subsequent letter and questionnaire to all the practitioners they had identified. This questionnaire was shorter, with only seven questions, but was laid out in such a way as to encourage more detailed responses.
Questions included the distances they had to travel in order to visit patients, what their means of transport was and the state of local roads.
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The final report
The subsequent handwritten report, summarizing the findings of all the surveys, is 24 pages long. This report noted that of the 155 parishes who responded to the questionnaire, 62 were ‘adequately supplied’ with medical aid, 52 were ‘partially supplied’ and 41 were ‘never, or almost never’ visited by a regular practitioner. The worst affected parishes were situated mostly in Ross, Sutherland and the islands.
Also included in this report was reference to Mr Allan Stevenson, Engineer to the Commissioners of Northern Lighthouses. He had written a report six years earlier on medical provision to Highlands and Islands lighthouses and this report was appended to the College report.
The final public report was published in 1852. This took the form of a shortened summary of the handwritten report. Overall, it recommended that outside support was needed to ameliorate the deficiencies in medical aid – the local population simply did not have sufficient funds to pay medical practitioners for treatment. The Highlands and Islands were very reliant on non-qualified individuals to carry out medical work and many of the doctors who were available were older and had not kept up-to-date with medical practice and theory.
