11,689. (Chairman). You are a. farmer at Timsgarry in the parish of Uig ?
—Yes.
11,690. What is the extent of your farm; what is the rent of it?
—£45.
11,691. You are a crofter now ?
—I ought to be, but according to the lease I am not.
11,692. You are. What area is it ?
—It is a fairly large area, composed largely of moors.
11,693. How many sheep have you ?
—About 400.
11,694 Are there many farms of that size in your district?
—Not many.
11,695. They are mostly small holders ?
—There is a large farm within my place, three times my rent, I should think.
11,696. Crofting and fishing are the main industries in your district?
—Yes.
11,697. You think the people in the district are able to pay adequate fees for doctors’ services ?
—No ; the majority of the people, I don’t think, are able to pay adequate fees.
11,698. The ones beside the doctor are able to pay, but if the doctor has to go ten or twelve miles, the people are not able to pay for him going that distance ?
—No.
11,699. Do they suffer much from want of medical attendance?
—I believe they do.
11,700. You have no hospital in this parish. Stornoway is the nearest one ?
—Yes.
11,701. Would a cottage hospital be of service to the people in the parish ?
—Yes, I should think it would.
11,702. Would they go to the hospital, do you think ?
—Of course it has not been tested. There is a lot of tuberculous disease, and in these cases isolation, I think, would be helpful.
11,703. You think there is a considerable proportion of illness among the people that -is not seen by the doctor ?
—Yes. It occurs in this way: in cases where they are far away from the doctor they put themselves in the hands of the local nurse, and when the thing becomes serious they send for the doctor and the doctor has no chance then. There are a number of cases that are not attended to as early as they should be on account of the poverty of the people. They are afraid of the fee.
11,704. You have had experience of that yourself ?
—Yes.
11,705. And you know that that is the case ?
—Yes.
11,706.You have three nurses in this parish, and the nursing is very satisfactory?
—Yes, very satisfactory indeed.
11,707. Have you room for more nurses ?
—Yes. We would certainly require another nurse. It is a very wide district. It extends from here away up to the other end it is something like thirty miles—and there is only one nurse. I think we require two.
11,708. Could you tell us in your own way in what way the nurses benefit the people?
—Well, the greatest benefit they are to the sick people is in the way of dieting ; again, in maternity cases they are a great benefit.
11,709. You think they have considerable effect on the habits of the people in teaching them how to live properly ?
—Yes.
11,710. Can you give us any indication of how a crofter lives? Can you tell us what sort of diet they live on ?
—Yes.
11,711. What have they for breakfast ?
—As a rule they have oatmeal porridge and milk.
11,712. Do they still take porridge and milk ?
—Yes, and when they have it they use fish and potatoes.
11,713. About the milk supply, that, of course, is not available in the early spring ; the cows are dry ?
—No, they will have a little. It is not generally in the spring or the winter months that they are in want of milk.
11,714. Is it because the cows are dry ?
—They generally calve early in the summer, and about the harvest there is a fairly good supply of milk.
11,715. Does the feeding of them reduce the supply of milk? Are they well fed ?
—Yes, in the summer months they are.
11,716. Do the crofters make butter and cheese ?
—They do a little, but not enough to help them in winter.
11,717. Do they buy butter ? It is margarine, I suppose ?
—Yes.
11,718. They don’t make butter for themselves ?
—They do a little. They use more margarine than butter.
11,719. Are the cows West Highland cows entirely ?
—Nearly.
11,720. You have no Ayrshires ?
—There are a few, but the crofters don’t have them.
11,721. Has the stock been improved much by the Congested Districts Board ?
—There is a considerable improvement in our parish.
11,722. You say that you consider the present medical provision inadequate ?
—Yes.
11,723. You think that one doctor to attend 4400 people is not sufficient ?
—Yes, especially on account of the long distances. If they were in a central place near the doctor it would not be so bad. The people are so far off that they don’t get the medical service that they require.
11,724. Even in a town, 4000 is considered too much for a doctor to attend to?
—Yes, I think so.
11,725. Dr Ross told us to-day that except for three months in the year he is not nearly sufficiently employed. He said for a fortnight he had had only two wires?
—Yes. That looks like as if the man had not been paying the doctor. He cannot send for him continuously. It is not because there is no work for the doctor.
11,726. As you have pointed out, the fear of running up a bill prevents them sending for the doctor ; it is also manifestly unfair that a man living twenty miles away from the doctor should pay £1 or 25s. for a visit, while the man next door to the doctor gets a visit for 2s. 6d. ?
—Yes.
11,727. It has been suggested that that might be obviated in some way, that a uniform fee might be charged to every crofter ?
—Yes.
11,728. So that the cost of the doctor could be spread over the whole parish instead of being borne by the invalids and by the people who are far away ?
—Yes.
11,729. How do you think the. people in your parish would take a proposal of that kind ?
—We have often been considering that in our parish. It never has been tried with us, but it has been tried elsewhere in Lewis, and they found a difficulty in collecting the money. There was also another point. After this money was paid the people thought that the doctor would require to be at their beck and call when there was little excuse for calling him.
11,730. With regard to the first point, you found that they would object to pay this fee; but if it were made compulsory, would not that overcome that difficulty ?
—Yes, I think so.
11,731. We find when it has been tried in a voluntary way that it has invariably broken down ?
—Yes.
11,732. The only parish where it is compulsory is North Uist. It is collected there with the rent and it has worked admirably for a good many years. If it were made compulsory, do you think it might work well here ?
—I should think it would. Certainly there are a number of people who have enough to do to keep themselves.
11,733. What sum do you think a crofter family could pay without it being a hardship on them ?
—It is very hard to say. Some could pay all right and others would find a difficulty in paying. It depends on how they succeed. I don’t believe that a crofter, a pure and simple crofter, could exist with us.
11,734. I am speaking of the population you have got— fishermen and crofters. What do you think is a fair sum to ask each family to pay ?
—I would not think that 4s. or 5s. a year would be too much.
11,735. 13s. in the year is too much ?
—It is too much for the crofters. There may be three months in the year that they will never see brass. When they do get it it vanishes in tea and sugar, and so on.
11,736. You think they could pay 5s. a year ?
—I think as a rule they ought to be able to pay 5s. a year.
11,737. In regard to the other point, you thought that it they got medical attendance the same as they get education that they would constantly be having the doctor. Do you think that that might be prevented or modified by having a small fee to be charged over and above the subscription
—Yes, because I know that they would certainly send on the least occasion. If there was a fee, a modest sum, that would cause them not to send for the doctor unless there was occasion.
11,738. Such a fee that would not prevent them sending for the doctor if there was occasion. Would that meet the difficulty ?
—Yes.
11,739. If that could be done, a small fee such as they pay in a lighthouse, 10d. or 1s., would be sufficient?
—I don’t know that 10d. would be much of a deterrent. I should think it should be something like 2s. for the first visit.
11,740. 10d. or ls. for each visit, or 2s. 6d. for the first one, and after that the doctor could judge whether there was occasion for him to go again ?
—I don’t think he would find many unnecessary visits if that was the charge.
11,741. It would help to make the service more thorough and more satisfactory?
—Yes.
11,742. That is to say, that the doctor would be readily available for anybody who needed him ?
—Yes.
11,743. And it would be within the resources of them to get him ?
—Yes.
11,744. You say, very properly, that you approve of the doctor having a decent holiday ?
—Yes.
11,745. At present the doctors in the Highlands are not able to afford a holiday?
—That is so.
11,746. They cannot pay for a locum ?
—That is so.
11,747. We have found that their salaries are so inadequate that they cannot afford it ?
—For doctors and nurses, they really ought to have holidays, I think.
11,748. (Lady Tullibardine.) If instead of the club system that Sir John Dewar was mentioning to you there was a system of payment per visit, payment being fixed at
a low fee, do you think the people would send as readily for the doctor under that system as they would under a club
—I don’t quite understand your question.
11,749. Sir John Dewar was discussing with you a club system——a system whereby each family would pay 5s. a year with a possible small fee for each visit, or, as you suggest, a check fee of 2s. for the first visit. Now, instead of that system, there might be another system by which if the doctor got financial help from an outside source he could fix his fees at 2s. 6d. all over the parish Do you think the people would send as readily for the doctor if they had to pay 2s. 6d. each time they saw him as if they had joined a club and paid 5s. at the beginning of the year to cover their whole family?
—As you say, 2s. 6d. each time they had to send for him, I believe, would deter them sending for him unnecessarily. I don’t think it would prevent them from sending for the doctor if there was a serious illness.
11,750. In different cases it would work out differently?
—Yes.
11,751. In a serious illness it might come to a good deal more than the club subscription ?
—Yes.
11,752. And in other cases, in a healthy family, for instance, it would come to less ?
—Yes.
11,753. Would the people like that system better than the club system ?
—Of course they have never had any experience of it, and it is hard to say how they would like it. Take, for instance, a case where a fee for the first visit is charged of, say, 2s. or 2s. 6d., and that visits after that were not charged for, and the doctor had to come a long distance, it would be very difficult. If it was a case of pneumonia or any serious illness, there might be a call for him somewhere else at a distance, and that would be another difficulty.
11,754. There really is more of a population than the doctor can thoroughly attend to ?
—That is so.
11,755. You have told us of the difficulty that the people find in paying the doctor when they live at a distance from him. Is that difficulty also felt by the small farmers that you mentioned to us ?
—By very few. I don’t think here are any of the farmers who suffer without sending for the doctor.
11,756. They are able to pay a 15s. fee if they live at a distance?
—Yes.
11,757. You don’t think if there was an arrangement of this kind that it should include the farmers ?
—I don't suppose it should.
11,758. You would just have them paying an ordinary fee if they lived twenty miles away from the doctor ?
—That is so.
11,759. You don’t think it is a hardship?
—I don’t suppose it would be. I am just saying what I think about the population of the parish as a whole.
11,760. They recognise that the crofters are less able to pay than they are ?
—Yes.
11,761. (Dr Miller.) There is just this question I want to ask you: I suppose that in this parish you find the nurses are utilised as sort of doctors ?
—Yes, that is so.
11,762. So as to save the expense of sending for the doctor ?
—Yes.
11,763. And if the doctor was more available at less expense, he would be asked to attend oftener than he is at present ?
—Yes, that is so.
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