HIGHLANDS AND ISLANDS (MEDICAL SERVICE) BILL. (Hansard, 12 August 1913)

§ EARL BEAUCHAMP

My Lords, this is a Bill germane to the subject your Lordships have already been discussing, because it arises out of a Report of the Committee appointed by the Treasury to consider the best methods of applying the National Insurance Act in certain districts of Scotland of somewhat an exceptional character. The remote areas of the Highlands and Islands of Scotland will be readily admitted to present special difficulties with regard to the adequate supply of medical service, or of nursing. A Committee was appointed which travelled over the area referred to, and the Report which they presented and which has been printed—those of your Lordships who take an interest in the subject no doubt have read it; it is Cd. 6559—reveals conditions in many of the Highland parishes which demand very serious and urgent reform. It is obvious to any one who reads of the present conditions of some of these parishes that something should be done with the least possible delay in order to improve them.

On page 13 of the Report your Lordships will find the summarised findings of that Committee. They say that medical attendance is uncertain, exceptionally onerous or even dangerous for the doctor, and generally inadequate; that the insanitary conditions render medical treatment difficult and largely ineffective; that recourse is often had to primitive and 1897 ignorant methods of treating illness; that some of these methods are even a source of danger, especially in maternity cases; that the local rates in many cases are over-burdened; and that, generally speaking, the combination of difficulties in these districts demands exceptional treatment. As a result of the Report the Treasury agreed to make a special grant in aid of the medical service and nursing in the Highlands and islands, and the conditions under which that: grant is made form part of this Bill. The amount is £42,000 a year.

There was a great deal of discussion with regard to the meaning of "the Highlands and Islands" in Scotland, but eventually it has been defined as covering the crofting districts with the inclusion of the Highland district of the county of Perth; and your Lordships will see that referred to in the first paragraph of the Report. It was proposed in another place that other districts should be added, but His Majesty's Government decided to resist those proposals on the ground that they were not specially referred to in the Committee's Report. The general scheme by which the money will be administered is that a Board is set up under the Bill, as your Lordships will see in Clause 2. The schemes which will be presented by the various local authorities will have to be approved by the Board, who will also have authority to combine local authorities or to make additions where they think necessary. They have full powers to vary the conditions in cases where it is necessary that there should be some change from what one might call, perhaps, the normal condition of things. In view of the general acceptance of this Bill, and the urgent need that there is for a measure of this kind and for an improvement in the medical service, I venture to hope that your Lordships will give the Bill a Second Reading.