11,548. (Chairman.) You are Schoolmaster at Carloway, near Stornoway ?
—Yes, twenty-two miles distant.
11,549. How long have you been there ?
—I came there in 1881 ; that is thirty-one years ago.
11,550. So you know the conditions of the people very well ?
11,551. You are also Chairman of the Parish Council ?
11,552. The means of livelihood of the people here is crofting and ﬁshing ?
—That is the main thing. The tweed industry was very fruitful for the last ﬁve years, but it is not so fruitful now.
11,553. As to crofting and ﬁshing, I don’t suppose there is much income derived from the croft ?
—I don’t think there is any at all.
11,554. They get a house and fuel and that sort of thing?
11,555. Do the men go to Shetland, and to other places on the East Coast for the ﬁshing ?
11,556. What sort of income do the men make at that—£10 or £20 ?
11,557. Would you put it at £10 or £20 a year ?
—I would put it at that, I think.
11,558. Are they lobster ﬁshermen too ?
—In the island of Bernera they are.
11,559 What do the girls make at ﬁsh-curing when they go to the East Coast ?
—I don’t know. Taking an average, I should say about £15, or thereabouts.
11,560. That is very much the evidence we got in Stornoway. Are there many Militia men and Naval Reserve men with you ?
—Most of them are such.
11,561. We were told yesterday that almost the entire population of Lewis was trained in some form ?
11,562. That is also a source of income for them ?
11,563. You don’t think that the crofters are, even with all these means of income, able to pay full doctor’s fees?
—No, the majority of them could hardly afford to do to do that
11,564. That is to say, if they live a long way of; but, of course, a doctor’s fee for a man who lives ten miles off must be 10s. or 15s. That is a big fee for anybody to pay, and it is quite impossible for a crofter to pay it ?
11,565. But supposing they had the ordinary fees that one pays in a town—2s. 6d. a visit,—would they be able to pay that?
—Yes, they ought to be able to pay that.
11,566, So long as they are able to get medical attendance at the price at which the ordinary inhabitants of the town get it, they ought to be able to pay the doctor?
11,567. You have no club in this parish ?
11,568. Have you ever had any experience of a club anywhere ?
—Not here. In my native place, in the island of North Uist, I had experience of it.
11,569. Tell us about that ?
—All those on the estate rent-roll pay 5s. a year. This has been the custom since I was a little boy. I fancy the cottars and squatters are treated differently. The crofters pay no more than 5s. ; it does not matter whether they require the doctor for a generation.
11,570. It does very well there ?
11,571. What is to prevent it being adopted here?
—I am not aware of it being done here.
11,572. It is more or less compulsory there ?
—Yes. The factor collects it. In issuing his notice for the rent he encloses a notice for it at the same time.
11,573. Supposing a thing of the kind was adopted here, do you think the crofters would fall in with a thing like that?
—I think they would.
11,574. Is that as much as they could pay ?
—I think that would be quite enough for them to pay. One has the feeling that the crofters hesitate, especially if they have to send for the doctor at a long distance. If it comes to about ten, twelve, or ﬁfteen miles they hesitate to send for the doctor because he must charge a reasonable fee. They ultimately send for him when it is too late. This is a distinct hardship.
11,575. That has come within your knowledge ?
11,576. You know of cases where the doctor has gone too late?
—I could not specify any particular case, but I am aware that there have been cases like that. Supposing a fee of 15s. or 20s. is charged, they hesitate sending for
the doctor, especially the honest people—the people that would like to pay him. These are the people I am referring to particularly.
11,577. Of course, a club system would obviate that. Each one would pay the same?
11,578. The doctor supplies medicines, and you say it is adequate and satisfactory?
11,579. And the doctor is himself a first-class medical man?
—Yes. They are all so in Lewis.
11,580. Your nearest hospital is Stornoway. We have heard about that hospital. Is it much taken advantage of?
—Not by our district. Things have not been going on satisfactorily, so far as the Stornoway hospital is concerned.
11,581. You have no cottage hospital here in your parish at all?
11,582. Would that be of any service ?
—Yes. There was a proposal a few years ago to erect one at Carloway.
11,583. It would be of advantage to have one there ?
—Yes, a sanatorium would be advantageous.
11,584. With the class of houses you have here, would a cottage hospital help to improve the housing?
11,585. (Dr Mackenzie.) It would not exclude a sanatorium for the whole island, of course ?—
—No. That is necessary
—Yes. Of course one has to bear in mind the population of our parish—there are about 4400 in the parish of Uig alone. We have a nurse in Bernera ; we have one in
this district, with a population of 2200 people, and it is most likely that we will dismiss her, for various reasons. We could do with another one for Uig. There are three at present in the parish. Possibly in this ward, with 2200 people, we would require two, notwithstanding the fact that the doctor's residence here is in proximity to Callernish and Breascleit.
11,587. (Chairman). With regard to your general suggestions, you suggest that a rearrangement of the areas is necessary for the doctors ?
—Yes, I have an opinion upon that.
11,588. If you can get that, of course, you must be able to provide houses for them in various centres ?
—Yes. It is an important matter that the doctor should have a house of his own, and a modern house too.
11,589. You support the view that a Parish Council should have power to build a house for a doctor ?
—Yes. Of course, our rates are very very high. If we could afford to build we would do it, but we have no power.
11,590 Do you think the District Committee would be a better authority to control the doctors than the Parish Council?
—I am not quite sure. We have managed already very well as far as that aspect of the question is concerned. We have full power to deal with the doctor. It all depends on the constitution of the Parish Council. We would require two doctors for the parish.
11,591. How are you going to pay for them ?
—We cannot pay for them.
11,592. While on that subject, I suppose you agree that the doctor is notoriously underpaid just now for the services he renders?
—Yes, that is so. Of course it is very difficult for a doctor to press for his fees. They are kind-hearted and generous in this island.
11,593 Having regard to the nature of the work and what he does, the remuneration is not sufficient ?
—It is not sufficient.
11,594 You suggest that the development of motor traffic would help matters very much in the Highlands ?
11,595 You have your telegraph system very well developed in the form of telephones, but you are not allowed to speak over these telephones. You don’t know about that ?
—No, I could not speak about that.
11,596. Have you ever asked to be allowed to speak over the telephone in your island ?
—I have not had any experience of it.
11,597. (Lady Tullibardine.) You said something about wishing to see a rearrangement of the doctor’s area. Do you wish that rearrangement to be only within your own parish ?
—I was speaking particularly for the parish of Uig, our own parish. My own opinion is this : our parish is divided into three wards, the island of Bernera coming in between two of the wards. My opinion is that Uig should have a doctor there, and that we should have one on this side, and that, say, the township of Shawbost
should be taken off the Barvas parish and added on to the district to be allocated to the doctor on this side, and then there could be an understanding between the two doctors to work the island of Bernera between them. Some of the island people might find it more convenient to apply to the doctor on the other side and others again find it more convenient to apply to the doctor on this side. I would have it arranged that neither of the doctors should be at liberty to refuse to go to the island of Bernera. This is with regard to the parish of Uig. I would take the 800 or 900 people at Shawbost off Dr Ross in the parish of Barvas. Something like that might also be achieved in other parts of the island.
11,598. If your rearrangement meant a readjustment between the different parishes, would it not be an advantage to have the controlling authority a larger body than
the Parish Council, so that the work could be done in the most convenient way and in the most economical way ?
—That would be very satisfactory. I could urge nothing against that proposal.
11,599. Do you think that proposal would be favourably received by Parish Councils?
—There is no reason Why it should not be.
11,600. You don’t think they would feel that they were losing prestige ?
—No, I don’t think so.
11,601. So long as their parish was well served they would be quite content ?
11,602. Supposing the governing body were the district committee, you are bearing in mind that the Parish Councils would be represented on the controlling body ?
11,603. You said earlier in your evidence that you thought the crofters could pay 2s. 6d. a visit for a doctor. Now, do you think that supposing outside assistance was given to the doctor by which he could attend all crofters in his area, however distant, at 2s. 6d. a visit, do you think the people would be ready to send for him at the beginning of an illness rather than wait as they are apt to do at present?
—They would send at once.
11,604. Do you think with a fee of 2s. 6d. they would feel it no burden at all?
—They would not hesitate to send for the doctor, with the certainty of being obliged to pay 2s. 6d.
11,605. Now are there no people near the doctor’s residence whom he attends for 2s. 6d. ?
—I suppose there are down at Callernish.
11,606. Do you find that the Callernish people send for him earlier than the other people who are far away from him ?
—Yes, undoubtedly they do.
11,607. Supposing instead of a system such as that of a modiﬁed payment per visit there was a club system by which householders paid 5s. a year,as suggested, and
possibly a small check fee per visit, do you think the people would send more often for the doctor under that system than if it were a payment of 2s. 6d. per visit ?
—They would send for him. Of course, they would not hesitate. I don’t think they would abuse it. For example, take our paupers, the doctor, of course, is obliged to attend them. The paupers have not been excessive in their demands for medical attendance ; anything but that.
11,608. I don’t wish so much to ask whether they would abuse it, but rather whether you think that the fact of a 2s. 6d. visit might make them less ready than they ought to be to send for the doctor ?
—I don’t think it would.
11,609. I mean a fee of 2s. 6d. for every visit. I wondered whether you thought there would be more calls on the doctor under a club system with a small check fee
of, say, 1s. a visit than under a system of a payment of 2s. 6d. a visit without any club subscription ?
—I don’t think it would really much matter.
11,610. It would come to about the same thing ?
11,611. Do you think the club system would be unpopular?
—It would all depend on who was to collect the 5s.
11,612. Would it be a mistake if it were to be collected by whoever collects the rates ?
—No, if he had the authority. There would need to be a statutory authority to enforce payment. If that were so, I see no reason why it should not be a success.
11,613. If it were collected along with the rates, would it not be looked upon as an additional rate ?
—No, not necessarily. The people would understand it was something outside the rates. It would not appear in the demand note issued by the collector for the rates.
11,614. Would the people who live near the doctor, and the people who only had him once a year, feel a grieved at having to pay a 5s. subscription ?
—There would not be many. They ought to be prepared to fall in with it.
11,615. For the great majority that system would be a benefit ?
11,616. The other system you think would equally benefit the people ?
—Yes, I think it would.
11,617. (Dr M‘Vail.) You are perfectly clear, I gather from your answer to question 12, that there is room for an additional doctor, even giving attendance in the houses as they exist. We agree that the houses ought to be improved ?
11,618. Independently of that, there is room for the work of a doctor without the houses being altered ?
11,619. With the 4000 odd people, you could employ another doctor among the school children and among the population generally?
11,620. (Dr Mackenzie.) You are aware that the Scottish Education Department has given £20 to each of the three landward parishes for the treatment of school children as the result of medical inspection. Do you think it would be possible to put that to good use in the treatment of the children ?
11,621. From your experience, you ﬁnd that medical inspection is resulting in the discovery of a number of conditions that need treatment ?
11,622. And treatment under the present conditions they are never likely to get, because the parents don’t consider it serious enough to command the attention of the doctor?
11,623. You admit that that £20 is very little ?
11,624. Have you had many ailments of a minor kind, such as eyes, ears, skin, and so on ?
—Not so very much.
11,625. You are a fairly healthy people in the west here?
11,626. You are not free from defects in the eyesight ?
—A fairly good number are troubled with defective eyesight.
11,627. Are you troubled with bad teeth too ?
—Not very much in that way.
11,628. There is a good deal of bad feeding among the children—perverted feeding?
-Yes, more or less.
11,629. Have you taken any trouble to find out what the food of the children when they come to school is?
—It is usually porridge in the morning.
11,630. Is there much porridge used ?
—There used to be, but I am beginning to feel a little afraid that there is
not so much taken now.
11,631. The people can quite well afford porridge ?
—Yes, quite. They are going in a good deal more now for flour than they used to. crofters as a rule are rather fond of oatmeal.
11,632. Do the children get much ﬂesh food at all ?
—Yes, and they get a good lot of ﬁsh down in our district, at any rate.
11,633. You are in a pretty favourable part of the parish?
——Yes, it is a ﬁshing centre. They kill a sheep and a cow too sometimes.
11,634. So that really, any malnutrition that may result is rather a matter of misuse or want of proper use of food—they don’t know what to do with it ?
11,635. You have a paragraph in your statement to the effect that, “There are three nurses employed at present in this parish, and two more at least are required. There
is only one doctor, and, highly qualiﬁed and devoted to his work as he is, he cannot possibly, unaided, give anything like adequate medical attendance to over 4000 people scattered over a wide and difﬁcult area. Two doctors, one on each side of -Loch Roag, are required, in order to secure something like adequate, or at least
reasonable, medical provision for the parish ‘?
11,636. The last witness told us that except for three months except for three months in the year he was not anything like fully occupied. He said he has only had two calls in a fortnight ?
—That is the case when so many are from home at the ﬁshing.
11,637. That does not mean that there is no illness in the parish during these nine months of the year ?—
—That is so.
11,638. We know for a fact that there are at least thirty or forty cases of acute phthisis going on?
11,639. Because there is not a call once in a fortnight, that does not mean that these cases are better. It simply means they are not being looked after ?
11,640. (Chairman.) Is that what occurred to you when you said you needed another doctor? Why did you think you needed another doctor ?
—In order that the people should have ample medical attendance.
11,641. Even although the doctor tells us that they don't send for him, do you say that ?
—There is just that hesitancy on the part of the people to send for him that I spoke of.
11,642. (Dr Mackenzie.) You think that is due not to the absence of disease but to the expense of sending for the doctor ?
11,643. Even for people near at hand ?
11,644. Have you ever had Dr Ross discussing that with you ?
11,645. (Chairman) It would not remove the objection you have—there would still be a charge—although we put down another doctor here ?
—Yes, there would still be the hesitancy, but of course there should not be so much
because the doctor on this side would not have to go twenty or thirty miles as at present, and the charges would thus be less.
11,646. It is the fact that you have genuine complaints from the west ward of Uig that sufﬁcient medical attention is not given ?
—Not only from the west side, but from my own district too.
11,647. Are there any complaints from the island of Bernera ?
—No. The doctor on his way to Uig can drop in at Bernera.
11,648. Take this whole matter of phthisis and tuberculosis generally, do you think that any increase in the number of doctors would be a real solution of the difficulty, of dealing with phthisis, considering the design of the houses ?
—No, possibly not, but there would be this to say that these cases would be detected very much earlier.
11,649. If you had more medical service you would have more patients going to the doctors, and you would have more opportunity of discovering earlier cases ?
11,650. And if there was a district sanatorium, a district tuberculosis hospital for the island of Lewis, that you could get the full beneﬁt of, then your increase of medical practitioners would be a real beneﬁt to the island ?
11,651. I notice also that although you made a modified statement about the small cottage hospitals, that you are of the opinion that, “The extension of hospital provision in the form of cottage hospitals in suitable rural centres is much needed and worthy of consideration "?
—That is so.
11,652. That is all, but I should like to say that Mr Macdonald, when this parish was in great difficulties, did all the calculations, adjustments, etc., and kept the the whole thing going, and took the parish through the difficulties, in the last five or six years, that the parish weathered. At one point the whole Parish Council was going to resign because of the difficulties, but they did not do it. It is really to Mr Macdonald and to one or two other people in Lewis, that the Board owe a tremendous lot. Have you any ﬁnancial difficulties now ?
11,653. You need no guarantee from the Treasury to let you go on paying your doctor?
—Not this year. We have had such splendid assistance from the officials of the Local
Government Board during these years of straits that that we are now in a fairly good position.
11,654. (Dr Miller.) If the appointment of a second doctor for this parish were authorised, you would be satisﬁed if he were made assistant to the present doctor,
to the senior doctor in the parish ?
—Yes. Of course it is only a qualiﬁed assistant that is wanted.
11,655. They would live apart ?
11,656. (Mr Lindsay.) You propose two doctors this parish, and you make another suggestion, that there should be a rearrangement of the areas. I suppose in making that proposal for two doctors, you include this rearrangement of the areas ?
—Yes, I meant that. I think it would not be too much for our doctor on this side to manage from Garynahine to Shawbost. I put in that rather to meet the case in Barvas, because it is even a bigger parish than the parish of Uig, and taking 900 people off the hands of Dr Ross at Barvas might ease the situation with him and at the same time not overburden the doctors in the parish of Uig.
11,657. I asked that because Dr Ross distinctly stated here that he was not fully employed When you suggested the two doctors, did you think of having a doctor as an inspector of families, one to look after the health of the district, and to pay regular visits to see what the conditions of the families were. Dr M‘Vail and some of our friends mean to have a medical inspection of the families in every district——a visit twice a year by the doctor independent of any visit for an illness. I am making that suggestion to reconcile the statement you made. You say more attendances are necessary, and Dr Ross says he is not continuously employed. Would the people resent what you might call a family inspection ?
—No, they would not resent it.
11,658. And arising out of that, could not you possibly combine all your forces together for a social crusade on the the conditions of this parish of Lewis in general? You could not arrange that with all your inﬂuence in the parish?
—I am afraid I should hesitate to tackle that.
11,659. You might manage your Parish Council, but not the ministers ?
—I am not afraid of the ministers. They are sympathetic and interested.
11,660. (Mr Grierson.) You have had a large experience of Parish Council work ?
—Yes. I have been in the Parish Council for some years.
11,661. Don’t you think that the doctor should have some appeal to some central body with regard to his being dismissed?
11,662. We have had evidence that there are unreasonable doctors as well as unreasonable Parish Councils. You would not object to them having an appeal ?
—No ; I rather approve of it.
11,663. I was rather surprised to hear that your doctor had been away ill and had had to get a locum tenens, and you did not make any effort to pay for his locum tenens?
—No, and his illness was brought about by his work.
11,664. You are aware that you can pay it ?
—Yes, but we could not afford it.
11,665. (Dr Mackenzie.) What were your rates then?
—About 17s. in the £.
11,666 (Mr Orrock.) The taxes in the parish of Uig were 15s. 3d. on the gross rental, without making any deduction. The total amount was 22s. 9¼d. ?
11,667 (Mr Grierson.) So that if you were to allow something for a holiday for the doctor you would require, so far as your parish is concerned, an outside subsidy.
You have no means?
—We have no means.
11,668. You approve of the doctor having a holiday ?
11,669. And you think it would be an advantage to your parish that the doctor should go away regularly to get a holiday?
—Yes, and he might also go into an hospital and see the work there and so acquire more modern methods. Every professional man when he gets a chance of going on
holiday does not spend that holiday idling.
11,670. You approve of that ?
—Yes. I think he should have a month's holiday in any case.
11,671. You have had experience of a club system. Did you find anything the matter with the medicines, or were the medicines as good in your club practice as you have ever got?
—I never heard any complaints in North Uist.
11,672 You approve of the doctor dispensing—or do you think that the chemist ought to dispense ?
—It would just all depend on the doctor. We here approve of the doctor dispensing. The people have the most absolute faith in the kind of medicine given to them by Dr Ross.
11,673. You don’t think there is any real necessity for a chemist to be brought in to dispense in the Highlands. The thing is quite safe in the hands of the doctor?
—Yes, so far as my experience goes. We had a Dr Macpherson before Dr Ross came, and he was a trained chemist, and Dr Ross followed him. I could not speak of anything
previous to the time of these two doctors.
11,674. (Dr Mackenzie.) You are aware that every medical man in the Scottish universities is a qualiﬁed pharmacist and is authorised and licensed to supply drugs?
11,675. (Mr Grierson.) As regards the second doctor, you don’t think that increased facilities for the doctor travelling about, and ability to speak over the telephone,
and that kind of thing, would be sufﬁcient in this place? You don’t think that that would take the place of a doctor?
—No, owing to the distance of the doctor from the upper end of the parish.
11,676. If he had a motor and if you could speak through the telephone to him, would the one doctor not be able to do all the medical service you require ?
—No, I hardly think so. Dr Ross has a motor bicycle and it is of great service to be sure. It certainly enables him to visit more patients than one was able to do in the past, but all the same, my great point is this, that the people would receive
more adequate medical attendance if there were two doctors, and at less expense.
11,677. (Mr Orrock.) You said that by taking in the Shawbost district and throwing it in with Carloway that that would be sufficient for one doctor alone, with part of
the island of Bernera ?
—Yes, Carloway to Callanish.
11,678. And there would be another doctor here and another in the upper end of Uig. That would be three doctors ?
—No, I mean two doctors, taking in the 900 people of Shawbost.
11,679. You, by taking in the 900 of a population off the Barvas doctor, would not want his salary to be reduced on account of that?
—Not by any means.
11,680. You would leave the salaries standing as they are ?
—Yes ; they are little enough for them.
11,681. I think you said that you favoured a fee of 2s. 6d. a visit rather than the existing rate, which is probably ls. a mile. You said that a crofter would be better
able to pay 2s. 6d. a visit rather than have to run the risk of paying 1s. a mile?
11,682. In speaking of the club system, you referred to North Uist where 5s. was charged along with the rent. Have you thought that a 5s. fee might be collected along with the rent here ?
11,683. But would that not only affect those that were on the rent roll ?
—That is the position of North Uist, so far as I am aware. It would be the case here also.
11,684. What about the cottar and the squatter population? They would escape, would not they ?
—Yes. Some other arrangement would have to be made to meet their case.
11,685. (Dr Mackenzie.) What proportion of the families are squatters here ?
—About a third, I should think.
(Chairman.) In any case, they are neither on the rent roll nor the rate roll ?
—No. (Mr Orrock.) That is so.
11,686. (To Witness.) In answer to Dr Leslie Mackenzie you referred to a loan or a guarantee you got from the Local Government Board ?
11,687. Did you pay that loan back ?
—Yes. Our parish was the ﬁrst to pay it back. We got £1200 from them.
11,688. It was little enough for the Local Government Board to come to the rescue of the parish. I mean, you paid that back with interest ?
—We paid them back. We were quite impatient to get free.