History Doctor on the Island.5 This Was an Event Which Would Influence His Life and Work

Dr Roger McNeill and public health in the Highlands and Islands of Scotland

JW Sheets Professor Emeritus of Anthropology, University of Central Missouri, Warrensburg, Missouri, USA

ABSTRACT Roger McNeill was born in 1853 on Colonsay in the Inner Hebrides, the Correspondence to JW Sheets, son of a cattle herder. He graduated with a degree in medicine from Edinburgh Archives and Museum, University, where he studied with Joseph Lister, among others. After working in Kirkpatrick Library 1470, London during a smallpox epidemic, he received a gold medal and honours for his University of Central Missouri, M.D. thesis in 1881. McNeill returned to Scotland as the Resident Medical Officer Warrensburg, MO 64093, USA at Gesto Hospital on the Isle of Skye. From there, he launched and published the tel. +001 314 660 543 4649 first statistical research about the health of Highland crofters. His was an illustrious e-mail [email protected] yet understated career in public health: he was the first president of the Caledonian Medical Society (1881–82), he earned a Diploma in Public Health from Cambridge University (1889), he was the first Medical Officer of Health for Argyll (1890–1924), wrote The Prevention of Epidemics and the Construction and Management of Isolation Hospitals (1894), and was the first witness before Parliament’s Dewar Committee in Oban in 1912. McNeill and other members of the Caledonian Medical Society testified about medical services in remote Scotland, encouraging a revolution in healthcare throughout the Highlands and Islands. The committee’s report led to the foundation of the Highlands and Islands Medical Service, a forerunner of the National Health Service established in 1948. Keywords Dr Roger McNeill, Colonsay, Edinburgh University, Caledonian Medical Society, Medical Officer of Health, Dewar Committee Declaration of Interests No conflict of interests declared.

INTRODUCTION

In 1850, the Royal College of Physicians of Edinburgh conducted a survey, the Coldstream Inquiry, ‘to determine the proportion which the [Medical] Practitioners bear to the whole [Highland and Island] population and to ascertain whether there be much complaint on the part of the people of the difficulty in getting medical aid.’1 The returns identified only 133 medical men serving 370,000 people over the 14,000 square miles. Like the island of Colonsay, more than half of the parishes had no resident doctor. In 1852, the College presented the survey’s results, A Statement Regarding the Existing Deficiency of Medical Practitioners in the Highlands and Islands, with no recommendations.2,3 It took another 60 years for this issue to come to public and political prominence, and Roger McNeill played a major role in these developments.

In 1853, Ruaraidh (later anglicised to Roger) McNeill was born to Angus McNeill, a cattle herder, and his second wife Margaret Smith at Ardskenish, in Colonsay’s southwest where ‘the sea, as far as the eye can see, rises in stormy weather into foaming masses of roaring breakers…’4 He was the youngest son of his father’s 11 children. In 1859 (when he was six years old), Roger McNeill’s mother died without the services of a resident history doctor on the island.5 This was an event which would influence his life and work. Figure 1 Dr Roger McNeill (1853–1924). Image from the Caledonian Medical Journal 1924; XII.

354 history 355 Gesto Gesto 14

12 published (in three published (in three 17 McNeill, with an Argyll accent with an McNeill, 13 In an 1886 Report to the Trustees of Trustees 1886 Report In an the to 16 with the help of his friend, Donald friend, his help of with the The next year he followed with another he followed The next year THE ISLE OF SKYE TIME ON ’S 15 article, almost certainly inspired by Lister’s work, The work, Lister’s by certainlyalmost inspired article, Group Cresol the and Acid Carbolic of Action Analgetic Compounds. of R THE NAPIER COMMISSION AFTER Scotland George the Secretary for In February 1886, to Bill Holding Crofters’ a introduced Trevelyan Napier after the years almost two Parliament, McNEILL of the Gesto Hospital in Skye the trustees In 1883, Medical Resident its as McNeill Roger appointed bad harvests, harsh weather, In the Hebrides, Officer. and a radical leaders hungry tenants, poor fishing, the island into a had turned nervous government sympathetic were lairds of the Skye Some battleground. of MacLeod Kenneth of them, One to the crofters. at funded Gesto Hospital had privately Greshornish, it was a one-story building Opened in 1878, Edinbane. of patients the reception for institution… ‘a free and all parts of Skye.’ from ended with an election of office-bearers, then then office-bearers, of election an with ended Ship Hospital the board ‘on later days two re-convened newly the by occupied was chair the when Endymion Dr Macneill [sic].’ elected President, unique work a unique place for Hospital was to prove also was Commission Napier The McNeill. Dr by conditions the investigate to in 1883 established and cottars in the Highlands the crofters experienced by and Islands of Scotland. the Edinburgh Medical Journal In 1885, of ‘…the Initial Rashes about research parts) McNeill’s Smallpox.’ the hospital, McNeill included an extensive table of extensive McNeill included an the hospital, unique were These Hebrides. the among rates death in the Edinburgh reference soon which he would data Medical Journal parents born to crofter both were After all, Mackinnon. high academic honours at both achieved in Colonsay, and each distinguished himself to a Edinburgh University, the changed forever work whose Commission Royal public service Mackinnon’s While Islands. and Highlands would McNeill’s startedhad Commission, on the Napier culminate almost thirty later with the Dewar years to protect one sought Where Committee in 1912. lives: crofters’ save to sought the other cultures, crofting knowledge, my to scientific value has, any of account ‘No the public health in the of of the state been given ever in not been classified have Hebrides…The facts available clear idea of the healthiness or any as to give such a way the inhabitants.’ of unhealthiness to his Gaelic, and with sterling credentials from from and with sterling credentials to his Gaelic, ‘I went overwhelmed: felt medical school, Edinburgh’s endeavoured and Mist of Isle the to stranger total a as ability.’ my of to all to the best duty my do to 10 When the When the Oban TimesOban Dr Roger McNeill and public health in the Highlands and Islands of Scotland Islands and the Highlands in health and public McNeill Roger Dr One of the One of the 11 8 The diagnostic value of of value diagnostic The Thomas Grainger Stewart, Thomas Grainger Stewart, 9 The following year he advanced to he advanced year The following 7 2011; 41:354–60 2011; CAREER IN ENGLAND ’S EARLY Roger McNeill studied anatomy under William under anatomy studied McNeill Roger 6 announced more good news in September news good Oban Times announced more J R Coll Physicians Edinb Coll Physicians J R © 2011 RCPE Turner, physiology under John Gray McKendrick, and McKendrick, Gray John under physiology Turner, The surgerysystematic Spence. James under proudly declared in April 1874 that he was the ‘prizeman he was the April 1874 that in declared proudly ‘second-place in Surgery and took Division)’ (Junior honours in Physiology.’ founders, William McNaughton, also worked in London in London also worked William McNaughton, founders, an M.D. epidemic and also received during the smallpox He encouraged the Society to Edinburgh in 1881. from in Square Trevor 16 at meeting general annual an hold The meeting on 7 October 1881. London, Knightsbridge, Physician to the Queen in Scotland, considered the the considered to the Queen in Scotland, Physician ‘the best account with which he was acquainted research of certain in the clinical history points of variola.’ The year after McNeill left Edinburgh, three senior senior three after McNeill left Edinburgh, The year February23 on met students medical 6 at 1878 ‘The created They Edinburgh. Street, Valleyfield a bond of union Caledonian Medical Society… to form any in associated were who workers medical among with the Highlands of Scotland.’ way McNEILL to moved he qualification, his achieving After he entered where Manchester, near Levenshulme, him forced ‘chest trouble’ Persistent general practice. To returned. the practice to which he never from with the British surgeon ship’s he became a recover, In years. a few for Company India Steam Navigation assistant an as appointment an accepted he 1880, Asylums Metropolitan London’s in officer medical was McNeill epidemic, smallpox a During Board. Hospital at Homerton. assigned to the Fever epidemic intensified, the Board shifted new cases onto onto cases new shifted the Board intensified, epidemic Roger McNeill was at Greenwich. old warships docked to Resident Medical Officer of the floating promoted thesis based on studies of an M.D. He wrote hospitals. board, on cases of hundreds the to submitted was which smallpox of rashes initial the Roger McNeill August 1881, On 1 Edinburgh University. class first with M.D. of degree the awarded was medal. honours and a gold When McNeill entered Edinburgh University in 1872, he in 1872, University Edinburgh entered When McNeill Colonsay’s from recommendation had a undoubtedly in graduated who had (no relation), McNeill Sir John laird, had reviewed Sir John (in 1814). Edinburgh medicine from and Crimean soldiers (in 1855), sickness and death among Supervision of to 1845 Board (from Scotland’s chaired 1868). 1877: ‘We are glad to learn that Mr Roger McNeill, son of glad to learn that Mr Roger McNeill, are ‘We 1877: passed his final [Colonsay], farmer here Angus McNeill, ofMaster and Medicine of Bachelor for examination Surgery of Edinburgh.’ in the University study clinical surgery under Spence’s colleague and the study clinical surgery under Spence’s Lister. Joseph figure, most renowned medical school’s summer time studying under him (1874–75, McNeill’s at Edinburgh. last years also Lister’s 1876–77) were 1875, The JW Sheets

Commission reported on conditions in the Highlands Scotland’s Local Government Act of 1889 protected the and Islands. In May, Donald Mackinnon, the Professor of job of a county’s MOH, providing more security for those Celtic Languages at Edinburgh University, and youngest entering the field. member of the Napier Commission, chose The Scotsman newspaper to present his current view of the debate. To ARGYLL’S FIRST MEDICAL OFFICER OF HEALTH describe conditions in the Hebrides – Inner and Outer, north to south – he cited the tables prepared by Roger McNeill revised and expanded his Remarks on the Public McNeill which demonstrated that ‘the standard of health Health of the Insular and Inland Rural Districts of varies greatly in the different islands.’ Inside the many Scotland in 1890. At the same time, Argyll County one-room houses on Islay or among the ancient Council advertised for its first County Medical Officer. cottages in Mull, it was still a precarious life where ‘a The successful applicant would ‘be the Medical Officer of single bad harvest or an unsuccessful fishing affects the Health for each of the county districts and to be allowed mass of community.’ For Parliament, Mackinnon went on, to act as medical officer of health or consulting medical ‘facts and figures such as these should afford guidance in officer of health for any of the county burghs.’21 The framing remedial measures for the permanent Oban Times announced the Council’s choice with his improvement of the people.’18 many credentials, accomplishments, and honours: ‘Dr McNeill is also author of several able papers in medical To elaborate and expand upon the Gesto Report, Roger subjects – “papers of conspicuous merit,” according to McNeill presented ‘Remarks on the Public Health of the Sir Joseph Lister.’10 Insular Rural District of Scotland’ in the Edinburgh Medical Journal, in two parts in July and August 1887. He The Caledonian Medical Society expanded its early cited the Gesto Report and the table showing yearly and Journal in July 1891, and Roger McNeill took full average death rates in the Hebrides. He quoted average advantage. In Volume I he published The Housing of the mortality rates of the islands and registration districts to Poor in the West Highlands by a Member of the support the ‘apparent healthiness of the insular rural Caledonian Medical Society anonymously but astute district.’ But he highlighted a glaring exception. The readers were left in little doubt as to the author. The islands’ percentage of deaths of women at childbirth paper vividly described the lack of drainage and exceeded even that ‘in the most unhealthy group of the ventilation in crofters’ cottages, coupled with their towns.’ He stated that ‘This is probably owing to the attitudes about disease which ‘put this down to the paucity of medical practitioners or even skilled midwives’ mysterious will of Providence into which they should throughout the Highlands and Islands. Otherwise, his not spy.’22 Because he could not supply the Highlands and focus was the numerical variation of the mortality rates Islands with more doctors, McNeill proposed an in the Hebrides. A mortality rate appeared to depend on alternative strategy in his 1894 book, The Prevention of a complicated blend of geology, climate, age-structure, Epidemics and the Construction and Management of sanitation, medical attendance, ‘the social condition, Isolation Hospitals.23 It received favourable reviews in The habits, and occupation of the population, as well as the Lancet24 and the British Medical Journal.25 The Edinburgh communication between them and centres of disease.’ In Medical Journal noted that ‘the Corporation of Edinburgh conclusion he wrote, ‘There is no constituted organisation has presented copies of this book to the members of its to look after the public health except in name [i.e. Health Committee, and we should counsel all Local Scotland’s Board of Supervision]… the causes which Authorities to follow such an excellent example.’26 bring about the difference in mortality are more or less remediable, and might be brought under control.’19 Meanwhile, Professor Donald Mackinnon looked at some of Scotland’s oldest documents to resurrect the Roger McNeill wanted more formal qualification in the tradition of caring for the public health. In his opening emerging field of public health. He had studied medical lecture to the Celtic class on 30 October 1894, he jurisprudence as a student at Edinburgh in 1876, witnessed chose The Gaelic Medical Manuscripts and Their Authors. the legendary efforts of that city’s first Medical Officer of He described King James VI’s confirmation of the last Health (MOH), Dr Henry Duncan Littlejohn, served Physician of the Isles almost three hundred years before; during London’s smallpox epidemic in 1880–81, and the monarch expected Fergus McBeath to promote published papers about Highland mortality. He prepared applications and cures throughout Argyll. Mackinnon for the examination with his friend, colleague, and fellow believed McNeill to be a successor in this line of member of the Caledonian Medical Society, William physicians tasked with caring for the public health, McNaughton. Cambridge University awarded each of following in the Celtic tradition: ‘Public opinion has them its Diploma of Public Health in 1889.20 This was an recently awakened to the importance of public health. opportune time for a qualified doctor with ambitions in The County of Argyll has appointed as its first officer a history public health. Up until this point, choosing public health as distinguished graduate of this university, a man in the a career meant acting as a ‘medical policeman’ with little front rank of his profession… my friend Dr McNeill…’27,28 remuneration and less security than a general practitioner.

356 J R Coll Physicians Edinb 2011; 41:354–60 © 2011 RCPE history 357 Progress had slowed on slowed had Progress AR ITTEE COMM 34 35 McNeill still believed that more that more McNeill still believed More than enough members enough than More 37 36 DEW O THE 38 arrived at the Cameron Campbell Library Cameron the at in Fort arrived a cast The Society had 1910. 23 September William on to One went invitations. special wide net of official and an nurtured who Inverness, for MP Dewar, Sir John medical services in the Highlands abiding concern over his absence.apology sent an he for Islands; and report in his annual news little good McNeill delivered with managed 54 Argyll barely The county of 1911. for per 1,289 doctor or one the 69,603 people, for doctors or crofting With most of the population inhabitants. a fostered cottages remote and work their hard fishing, the Throughout change. to resistant almost self-reliance that convinced yet not are ‘many Islands, and Highlands the or disease, and ill-health, of poverty, the prevention man which over matters are lengthening of human life, control.’ any has really doctors, with adequate salary, reasonable territory, state territory, reasonable salary, with adequate doctors, enforce would could and authority, more and support, health. the public’s of better standard a policies toward these with agreed George Lloyd Minister Prime National the when he introduced recommendations the improve to aimed He Bill in 1911. Insurance Health a more health of wage-earners and thus create particularly keen time of a at workforce, dependable especially Continent, with the competition economic crofters But his scheme excluded Scotland’s Germany. wages. received rarely and money any who seldom had unrest provoke to desire no had The government rents over fights the similar to the Highlanders among mindful that it was also were and rights in the 1880s, and into the militaryin a prime territory recruiting for Medical when the worsened situation The services. severely was Islands and Highlands the to Relief Grant cut in 1912. PRELUDE T of the Scottish more needed, and wanted, McNeill Roger the Gaidhealtachd of more to see medical community the where of Scotland) area (the Gaelic-speaking At low. teachers were and nurses doctors, of numbers he Society, Medical the Caledonian the 1909 meeting of William. be held in Fortmeeting the 1910 that proposed Council appointed Society’s the and president-elect The McNeill and the arrangements, sub-committee to make a The to be a member. chosen three the one of was ‘that William a stipulation about Fort Council added write at least fifteen members 1910, 15th March before Honorary the or Secretary President the either to attend.’ promising question. Even Argyll’s larger towns of Campbeltown, of Campbeltown, towns larger Argyll’s Even question. accommodation‘no and Lochgilphead showed Dunoon, tuberculosis.’ for available another front too. By 1909, only 10 of 166 schools in thein schools 166 of 10 only 1909, By too. front another part any of Domestic‘cookery classes’ as county offered Science in the curriculum.

31 Dr Roger McNeill and public health in the Highlands and Islands of Scotland Islands and the Highlands in health and public McNeill Roger Dr 32 ORS and summaryBritish in the 30 29 2011; 41:354–60 2011; The speech merited publication in thein publication merited speech The In 1906, when the Local Government when the Local Government In 1906, since ‘the elements of hygiene and and hygiene of elements ‘the since 33 Y’S FIRST DOCT . It was a compendium of vital statistics, schools, schools, vital statistics, of compendium a was It . applauded the report. The editor knew knew editor The report. the applauded Oban Times J R Coll Physicians Edinb Coll Physicians J R © 2011 RCPE Board in Edinburgh circulated an inquiry ‘with regard to regard ‘with inquiryan circulated Edinburgh in Board the [sic],’ in pulmonary control phythisis administrative County Council assigned Dr McNeill to consider the physiology, the theory and practice of cooking, laundry the theory and practice of cooking, physiology, housewiferyand householdgeneral or dressmaking, work, curriculum. school’s into every management’ should go Medical Journal Medical Likewise, he never lost sight of the challenges in the rural he never Likewise, to get a resident Argyll the struggle where districts of These one. keep doctor often became a struggle to in Colonsay. evident clearly challenges were the in January 1897, in Colonsay The first doctor arrived doctorA female April 1901. in regret’ ‘with much second left becould which contract a under year that of June in began She was either party. months’ notice by terminated at two doctors until 1909, female a succession of four by followed becausethat ‘regret their recorded Council Parish the when Officers do Medical able to offer, of the small salary are they When than a couple of years.’ more on an average not stay it 1910, April in holiday week three a requested doctor a to be‘on condition that she will continue was approved She almost met the a year.’ Medical Officer in the Parish for in February 1911. but resigned obligation, Despite the Public Health Act of 1897, Roger McNeill’s Roger McNeill’s Act of 1897, Health the Public Despite epidemics and construct hospitals to prevent campaign District Committee Islay the 1900, In Argyll. in poorly fared ‘hospital on such a scale is superfluous.’ an isolation believed ‘such a that Six months later the Committee repeated be of no benefit to the would hospital [near Bowmore] to the long distance which patients would Parish owing to travel.’ have Caledonian Medical Journal COLONSA practitioners lost touch with fellow Roger McNeill never he 1899, In September in the field of public health. of the Institute of the Congress to Blackpool for traveled Teaching The Importance of Public Health and presented of Improvement the Aid towards Domestic Science as an . Health Public the Not always popular with the public, Roger McNeill was McNeill Roger the public, popular with always Not health of the the effortsin his ceaseless to improve the Annual he issued Report 1896, In May Argyll. people of Sanitaryof the Health and County and Condition of the Districts ‘progress and houses, new disinfection, hospitals, nurses, editorials, successive In three wanted.’ improvements and the ‘The the public: by was often ignored work that McNeill’s when he tries to task Medical Officer sets himself a hard which he is authority to the heterogeneous convince after due allowances it is amazing, responsible… primarily the simple of many how permissible difficulties, for persistently so urge are and suggest he may reforms shelved.’ and ignored JW Sheets

THE HIGHLANDS AND ISLANDS MEDICAL The Dewar Committee held public meetings at SERVICE COMMITTEE (THE DEWAR COMMITTEE) Inverness, home of Sir John Dewar, and at Oban, Dr Roger McNeill’s base. As Argyll’s MOH, he orchestrated In 1912, Lloyd George appointed the Highlands and a series of witnesses who outlined the unacceptable Islands Medical Service Committee under Sir John levels of crofters’ health and medical services in the Dewar. He charged the Dewar Committee ‘to consider county, and beyond. He began the testimony session at an early date how far the provision of medical in the County Council Chambers, followed by five attendance in districts situated in the Highlands and general practitioners from Argyll, colleagues, protégées Islands of Scotland is inadequate, and to advise as to and members of the Caledonian Medical Society. They the best method of securing a satisfactory medical consistently blamed the scarcity and high turnover of service therein…’39 The nine-member Committee county general practitioners on low salary; their (including three doctors) wasted little time between direct solution was a minimum salary under a state the announcement of its establishment in July to its medical service. McNeill and his colleagues addressed first public session in Edinburgh on 15 August 1912. the usual complaints of ‘difficult travel’ and ‘lack of Witnesses from the Local Government Board, the communications’ with a direct solution: the scattered Office of the Registrar General, and the General doctors and nurses in Argyll needed motor boats, Medical Council testified about the low number of motor cars, motor cycles and telephones. doctors and nurses in the Highlands and Islands, the high number of uncertified deaths, low salaries, In order to portray the life-and-death situations in the substandard housing and transportation, and the Highlands and Islands, Roger McNeill shared a very reduction in the Relief Grant. personal memory about childbirths: ‘I know myself of two such cases which occurred in the island of The Committee travelled to Inverness for three days of Colonsay, before a resident doctor was provided, public meetings. On 19 August, the MOHs for Inverness- where two married women died before a doctor shire and for Ross and Cromarty joined general could be got from Islay – leaving two young families of practitioners in giving opening testimony. They described seven and five, ranging in age from birth upwards, and reinforced the difficulty and expense of travel which uncared for.’45,46 According to the full coverage in the discouraged the crofters from seeking care. By the third Oban Times, ‘Dr Roger McNeill gave an exhaustive day, the Committee shifted its focus onto tuberculosis. account of the efforts made by the public authority to Both the benefactor and the superintendent of the combat tuberculosis in the county.’47 The day ended Seaforth Sanatorium described the ideal of a modern with a tour of the Argyllshire Sanatorium. Next day, facility free-of-charge to the people of Ross and the committee heard that in South Uist and Barra Cromarty and to the island of Lewis. With a stop on the deprivations prevailed, with a lack of food for infants remote Fair Isle, the Committee concluded its first and no nurse for a population of 5,000. There and round of travel and hearings at Lerwick in the Shetlands elsewhere, tuberculosis predictably preyed upon the on 28 August. The same themes of poverty, isolation underfed and the undernourished at all ages. and untreated diseases pervaded these sessions held over 14 days.40,41 The last day of evidence in Glasgow featured distinguished guests well-known in public, political The public sessions resumed in Sutherland, at Bettyhill, and social circles. The Duchess of Montrose testified on 7 October. The Committee and staff crossed to as President of the Govan Nursing Society about Stornoway for a Town Hall meeting on 11 October. The placements in rural areas. The presence of, and parish of Uig provided statistics, with ‘one doctor for proposals by, Sir Donald MacAlister, Principal of 4,500 inhabitants’, and from Barvas, ‘7,000 living in Glasgow University and President of the General hamlets scattered along a seaboard of 27 miles, and Medical Council, were ‘regarded as of the greatest there is but one doctor’; the 1911 Argyll ratio of ‘one importance.’ He called for a state medical service to per 1,289’ paled in comparison. At the second govern salaries, appointments, holidays, postgraduate meeting in Stornoway, the need for a healthy courses and retirements. Glasgow’s Inspector of the population was reiterated: ‘…between the Royal Poor, who knew some of the worst conditions in Naval Reserve, the militia, the Territorial Force, and Scotland, showed that improvements to services were the regular army, over 4,000 Lewis men were being possible, providing evidence of ‘2,146 boarded-out trained in the defence of the country.’42,43 The children’ receiving voluntary medical and dental care. committee sailed to Dunvegan for morning hearings Undoubtedly, the Glasgow children were ‘much better on 18 October, then stopped at Gesto Hospital in off than the native children of the Highlands and Skye. They found that, by 1912, there were only 18 Islands.’48 The Dewar Committee had examined over history general hospitals in the crofting counties.44 200 witnesses in more than 20 sessions, at more than 15 sites, over approximately six working weeks.

The Royal College Royal The

58,59 staff, staff, Oban Times 49,38 The National Health Service in Scotland: origins and The National Health Service in Scotland: The case for state medical services for the poor: the servicesmedical state poor: the for case The for 1998; 28:51–66, 207–17. 28:51–66, Edinburgh 1998; Coll Physicians Roy Proc McCrae WM. McCrae WM. 2003. Press; Tuckwell Linton: ideas 1900–1950. East Douglas; David One of the Hebrides. Edinburgh: Colonsay. McNeill M. 31. p. 1910. Register General (1859/539/2/11): Register Death Colonsay Edinburgh. (GROS); Scotland Office for http://dx.doi. 2:977–79. Br Med J 1910; A medical diplomatist. org/10.1136/bmj.2.2596.977 McCrae WM. WM. McCrae Edinburgh: [Internet]. 1850 Islands and Highlands of Physicians of Edinburgh; 2011 [cited 2011 Oct 18]. Available from: from: Available 18]. Oct 2011 [cited 2011 Edinburgh; of Physicians of http://www.rcpe.ac.uk/library/read/scotland/highlands/highlands.php of a survey enquiry Report: to Dewar physicians’ From Blackden S. Highlands and islands of Scotland, West medical services in the 1852–1912.

3 4 5 6 Acknowledgements Acknowledgements of Emeritus Regius assistance the advice and I appreciate Aberdeen, EJ Clegg and Sheila Clegg in Professor Ferguson Irene William Gillies in Edinburgh, Professor Carol Library, University Edinburgh at Boyd Tricia and and Surgeons Parry College of Physicians with the Royal ArgyllBute and with the MacDonald Murdo of Glasgow, the in Lochgilphead, Archives District Alastair and Byrne Kevin in Edinburgh, Alison Mowat Joy and Vivian Richardson MacNeill Scouller in Colonsay, cited are sources Selected Warrensburg. in Stevenson for General Registrar the of permission the with Currie, Jo to indebted I am Edinburgh. Scotland, Edinburgh University Special Collections, Librarian (ret), at the Edinburgh enrollments McNeill’s Roger for Library, medical school. REFERENCES 1 Roger McNeill did not live to see the progress made by by made see the progress to live did not McNeill Roger on had the impact his work and its Board, the HIMS and of assisted the evacuation nurse a resident public health: in was appointed surgeon a consultant St Kilda; faraway laboratory a came specialists built and was Stornoway; after the Depression Despite the Great to Inverness. an air ambulance service the Hebrides to from war, Cathcartthe Report 1937, In 1936. in began Glasgow service’‘national health all of Scotland for a proposed Islands and of the Highlands upon the success based consequence and unintended, An ultimate, scheme. post-war Britain’s in 1948. HIMS the of end the spelled of its conception to much Health ServiceNational owed principle ‘the Thankfully, Islands. and Highlands Scotland’s of regardless human right, is a basic that health care in the conceded been had or geography, class, income, Report.’ Dewar 2 Caledonian Medical Society, and the first Medical Officer the first and Society, Medical Caledonian genuine In a Argyll. of the County Health for of the British merely Medical Journal understatement, men who… of ‘the group him among remembers undertook health servicea public of instituting the task time that before which Scotland of in certainareas rural without sanitation.’ practically been had

50 In 52,53 55 Dr Roger McNeill and public health in the Highlands and Islands of Scotland Islands and the Highlands in health and public McNeill Roger Dr There There were 49 ; the blacksmith’s wife wife the blacksmith’s ; 54 supportedpraised and , the first President of the of the first President , 57 2011; 41:354–60 2011; Roger McNeill was a pioneer in the 56 Some of the most crucial witnesses were Some of the most crucial witnesses were 51 RT AR REPO ’S LEGACY captured his essence: ‘Up to the ‘Up to essence: his captured Oban Times Caledonian Medical Journal J R Coll Physicians Edinb Coll Physicians J R © 2011 RCPE died of phthisis pulmonalis three months later. months phthisis pulmonalis three of died The report reflects the research, publications, and efforts publications, the research, The report reflects the 1880s onward. of Roger McNeill from The the Dewar Committee in a 1913 editorial: ‘The Report Committee in a 1913 editorial: the Dewar pathetic a most in places, and, convincing is a thoroughly of member every It should be in the hands of document. the from with quotations copious It tells, this Society. the appalling witnesses, of trustworthy testimony service medical of defects difficulties and within the Celtic fringe.’ study of public health and medical services for Scotland’s services medical and public health of study Scotland’s for Officer He was a Resident Medical in the crofters. Hebrides’ first hospital McNEILL McNeill War, Great the after and during, Before, the County for reports annual produce to continued Council and serveHonorary as Medical Consultant in When McNeill died Sanatorium. Argyll’s Officer to the 1924, work… in his appointed last he was zealous and active in conscientious and accurate painstakingly was He carryingremembered will be public duties…He his out in who follow those example to an as pioneer and a as his foot-steps.’ Today, as Hamilton put it, ‘the full Report, with its verbatim verbatim with its Report, ‘the full put it, as Hamilton Today, document.’ is still a remarkable evidence THE DEW sections on the poverty of the crofters, their insanitarytheir crofters, the of poverty the on sections beingcouncils parish survival superstition, of dwellings, the incomes, the smallness of doctors overburdened, theof effect the uncertified of deaths, percentage the inadequacy of existing subsidies. and insurance act, included press the in reported widely Recommendations of provision the hospitals, trained nurses, the need for fees. of scale suggested a and treatment, dental medicine, November, McNeill failed to convince the Colonsay Colonsay the convince to McNeill failed November, for son his eight-year-old blacksmith to let him treat the by covered were costs any though even tuberculosis, Act Health Insurance National the county MOHs, and members of the Caledonian the Caledonian of members and MOHs, the county uncharacteristic With McNeill. Roger like Society, Medical the Highlands Parliament passed consensus, and speed 1913; August 15 Act on ServiceMedical Islands and and a substantial nursing for provisions included were chair the Highlands would Dewar Sir John grant. annual Service Medical Islands and Sir and (HIMS) Board doctors to serve with two MacAlister agreed Donald Roger set to work, While they the Committee. from local scale. a on face drama to home McNeill returned where Colonsay ‘invaded’ Navy the Royal In September, stood Churchill, Winston Admiralty, the of First Lord the on the neighbouring island of Oronsay Beinn Orasa atop war. to watch gunnery for practice and rehearse JW Sheets

7 Oban Times, 25 April 1874. 35 Moore L. Educating for the ‘woman’s’ sphere: domestic training 8 Oban Times, 1 September 1877. versus intellectual discipline. In: Breitenbach E, Gordon E, editors. 9 Roger McNeill [obituary]. Caledonian Med J 1924; XII:229–32. Out of bounds: women in Scottish society 1800–1945. Edinburgh: 10 Oban Times, 29 November 1890. Edinburgh University Press; 1992. p. 10–41. 11 Caledonian Medical Society. Caledonian Med J 1905; VI:80. 36 Caledonian Medical Society Annual Meeting 1910. Caledonian Med 12 Minute Book of the Caledonian Medical Society (RCPSG 36/1). J 1910; VIII:101, 289, 294–95. Glasgow: Royal College of Physicians and Surgeons of Glasgow. 37 Ferguson T. Scottish Social Welfare. Edinburgh: E&S Livingstone; 1958. 13 Scotsman, 19 October 1912. p. 449–50. 14 Oban Times, 14 February 1891. 38 Hamilton D. The Highlands and Islands medical services. In: 15 McNeill R. The diagnostic and prognostic value of the intial rashes McLachlan G, editor. Improving the common weal: aspects of Scottish of smallpox. Ed Med J 1885; 29:251–58, 438–43, 610–14. Health Services 1900–1984. Edinburgh: Edinburgh University Press; 16 McNeill R. The analegetic action of carbolic acid and the cresol 1987. p. 483–90. group of compounds. Ed Med J 1886; 31:1115–19. 39 Scotsman, 16 August 1915. 17 McNeill R. Remarks on the public health of the insular rural 40 Medical conditions in the Highlands. Br Med J 1912; 2: 517–18. district of Scotland. Ed Med J 1887; 33:25. http://dx.doi.org/10.1136/bmj.2.2696.517 18 Scotsman, 13 May 1886. 41 Br Med J 1912; 2:658. http://dx.doi.org/10.1136/bmj.2.2698.658 19 McNeill R. Remarks on the public health of the insular rural 42 Br Med J 1912; 2:1078–79. http://dx.doi.org/10.1136/bmj.2.2703.1078 district of Scotland. Ed Med J 1887; 33:25–30, 134–40. 43 Br Med J 1912; 2:1163. http://dx.doi.org/10.1136/bmj.2.2704.1163 20 The Medical Directory 1920. 76th ed. London: J and A Churchill; 44 Day JP. Public Administration in the Highlands and Islands of Scotland. 1920. p. 1414. London: University of London Press; 1918. p. 308. 21 Index to the Minutes of the Argyll County Council 1890–1904; 45 Highlands and Islands Medical Service Committee. Report to the I:36–7. Lochgilphead: Argyll and Bute District Archives. Lords Commissioners of His Majesty’s Treasury 1912 (Cd 6559) 22 McNeill R. The housing of the poor in the West Highlands. [Internet]. [cited 2011 Oct 24]. Available from: http://www.elib. Caledonian Med J 1891; I:147–60, 328. scot.nhs.uk/Upload/Dewar_Report.pdf 23 McNeill R. The prevention of epidemics and the construction and 46 Colonsay Death Register (1881/539/2/1 and 1894/539/2/5): management of isolation hospitals. London: J and A Churchill; 1894. General Register Office for Scotland (GROS); Edinburgh. 24 [Book Review]. Lancet 1895; 3723:36–37. 47 Oban Times, 2 November 1912. 25 [Book Review]. Br Med J 1895; 1:256. http://dx.doi.org/10.1136/ 48 Br Med J 1912; 2:1335–37. bmj.1.1779.256 49 Hamilton D. The early history of the Highlands and Islands medical 26 [Book Review]. Ed Med J 1895; 40:1006–8. scheme. Scot Med J 1979; 24:64–68. 27 Mackinnon Collection B1(38): Centre for Research Collections, 50 Scotsman, 7 January 1913. Edinburgh University Library; Edinburgh. 51 Caledonian Med J 1913; IX:233–35. 28 Sheets JW. A bibliography of Professor Donald Mackinnon (1839– 52 Loder JV. Colonsay and Oronsay. Edinburgh: Oliver and Boyd; 1935. 1914). Scottish Gaelic Studies 2009; 25:235–61. p. 189. 29 Oban Times, 9, 16, 23 May 1896. 53 Scotsman, 12 September 1913. 30 McNeill R. The importance of teaching domestic science as an aid 54 Islay District Committee Minute Book: 6 and 28 November 1913. towards the improvement of the public health. Caledonian Med J Lochgilphead: Argyll and Bute District Archives. 1899; IV:91–106. 55 Colonsay Death Register (1914/539/2/2): General Register Office 31 Importance of teaching domestic science. Br Med J 1899; 1123–24. for Scotland (GROS); Edinburgh. 32 Parish of Colonsay and Oronsay Minute Book: 30 January 1897, 28 56 Oban Times, 26 April 1924. April 1899, 5 April 1901, 20 June 1901, 23 October 1903, 23 57 McNeill R. On the public health of the insular and inland rural districts October 1906, 25 June 1907, 24 September 1909, 21 December of Scotland. Edinburgh: Oliver and Boyd; 1890. p. 16. 1909, 18 March 1910, 3 February 1911. Lochgilphead: Argyll and 58 Storm houses. Br Med J 1924; 1:831–32. Bute District Archives. 59 Roger McNeill [obituary]. Br Med J 1924; 1:843. http://dx.doi. 33 Islay District Committee Minute Book: 27 September 1900, 7 org/10.1136/bmj.1.3306.843-b February 1901. Lochgilphead: Argyll and Bute District Archives. 34 Minutes of the Argyll County Council 1904–07. Lochgilphead: Argyll and Bute District Archives. history