10,632. (Chairman.) You are a graduate of the Edinburgh University, and you are a L.R.C.P. & S. of Edinburgh?
—I am a student of Edinburgh University and the Royal College of Surgeons, Edinburgh. I am a L.R.C.P. and L.R.C.S. Edin.
10,633. You have been twenty—eight years in Stornoway ?
—Yes.
10,634. And you know the conditions very well?
-Yes.
10,635. I see you have got one assistant?
-Yes
10,636.Dr Mackintosh?
-Yes.
10,637. Is he from Skye?
-He is from Farr, Inverness-shire.
10,638. Your population, of course, extends to the country ?
—Yes.
10,639. How far is your furthest away patient from you ?
—Fourteen miles.
10,640. The roads are good ?
—Fairly good ; the surface is broken and uneven.
10,641. You keep a motor and trap, and you ride too?
—Yes.
10,642. Are there any places that you cannot drive to?
—There are four houses in Glen Tolsta to which I cannot drive, but there is a pathway of about a mile leading to them.
10,643. You are Medical Officer for the parish Point district, and you get £143. Have you got 350 paupers to attend to ?
—Yes, with dependants. I get £143 for the combined districts of Point and Stornoway Burgh.
10,644. Do they live in their own houses mostly ?
—Yes.
10,645. You are not paid so much per pauper as some doctors we have had ?
—There are 62 paupers in the town of Stornoway with 84 dependants.
10,646. About vaccinations, do you find that the new arrangement with regard to conscientious objectors has increased the number who are not vaccinated ?
—No. In my parish I have never had a single parent who has objected.
10,647. Are you doctor for the Oddfellows?
—I am.
10,648. Are you troubled with many frivolous calls ?
—If you will allow me I will give you the details; I have noted down a detailed account of a year’s attendance, for the year ending 1911. There were 209 visits; 363 consultations ; 261 bottles of medicine; 52 bottles of lotion and liniment ; 195 dressings; 5 tooth extractions; 82 powders; 87 pills; 15 boxes of ointment: 4 plasters; 1 case of dry cupping, which is supposed to be an extra; 7 car syringings ; and 7 analyses of urine. That is all for the Oddfellows.
10,649. Had you many frivolous calls besides that ?
—That is the full details of my year’s work for the year 1911, the amount paid being £46, 19s.
10,650. They were consultations which involved examination of the patient and prescribing medicine?
—Yes. There is no mention of certificates although many of them required certificates.
10,651. These, of course, are all picked lives ?
—Yes.
10,652. You are paid for the medical examination extra?
—No.
10,653. What is your percentage of bad debts in your general practice—about 25 per cent.?
—It will be much more than that.
10,654. In many cases you don’t charge a fee ?
—No ; ours is a public medical service if ever there was one.
10,655. So that if you were to charge a fee that any doctor might expect it would be very much more ?
—Yes.
10,656. With regard to the suggested club arrangement, you do not approve of it on a crofting and fishing community ?
—No.
10,657. Let me put it this way ; we find it very diflicult to devise a scheme whereby the community might contribute their fair share to the cost of the doctor in any other way. Do you see anything unworkable or unfair in charging all the crofter families in the parish a certain sum per head which they might reasonably pay towards the cost of providing a doctor for everybody. That is to say, the cost of doctoring the invalid should be borne, not by the invalid entirely, but should be shared by other people?
—Yes. I believe there was a scheme of that kind worked in the district of Point of which I am now medical officer. That was a scheme tried by Dr Macdonald some years ago, but he found it practically unworkable.
10,658. Had he to collect the fees ?
—He had collections in the villages.
10,659. But it was voluntary ?—Yes.
10,660. We have had evidence of a club worked in Uist by Sir Arthur Campbell Orde, and it works very well. The doctors in the outlying districts particularly are notoriously underpaid ; they are supported mainly in most parishes by the contributions of the local rates
—That is so.
10,661. The local rates apparently can bear no more, they are apparently at the end of their resources?
—Yes.
10,662. The Government cannot be expected to contribute unless they help themselves. Have you any serious objection to a proposal of that kind, that a certain sum should be received from the local people, apart altogether from the sum which they receive from the Government?
—It could be tried, but I do not think it would work in this district.
10,663. Do you think the people are able to afford 5s. a year in this district?
—Quite.
10,664. Why do you think it should not work?
—I think you would have difficulty in collecting the fees, and then probably, on the other side, you might find.them rather inclined to make excessive demands on the doctor's time.
10,665. That is a point we would have to guard against. The point has been made that besides this 5s. per visit there should be a small fee, say, a fee of 2s. 6d. for the first call, and then it would be for the doctor to judge whether or not the case was one that was a serious case or whether he should make a small fee for each visit. A combination of the club system in that form has been suggested as a suitable remedy to help the present condition of affairs. Do you see any serious objection to it ?
—I cannot say I see any serious objection to it being tried, but you are dealing with a people who have no commercial instincts at all. I think you would have a difficulty in collecting the money.
10,666. (Dr Mackenzie) Taking the 30,000 people in Lewis as a whole, do you think that a contributory club system as suggested would have any probability of success?
——I very much doubt it.
10,667. It might do in a locality like this, where the feeling is much more industrial, but your feeling is whenever you get away from that their tendency is to fail?
—Yes.
10,668. (Mr Orrock.) You said that some years ago the late Dr Macdonald tried a system on these lines in this district, the Point district, and he found it was a failure, simply on the score that they could not collect the money?
—Yes.
10,669. This is the best earning part of the parish of Stornoway ?
—Yes, it is probably the best off.
10,670. (Chairman.) That points to the fact that a voluntary effort would not do, but would it prevent compulsory contributions ?
—I am afraid that voluntary effort would not do.
10,671. You think that payment for work done might best serve this district ?
—Yes.
10,672. Under the circumstances here, you say they have never sufficient to pay for the work the doctor does—that the people cannot afford to do it. It is manifestly unfair that a man should have a visit at, say, half a crown, and that another man living twenty miles away should have to pay £1 for the same visit?
—Yes
10,673. We are trying to devise a method by which these charges would be more equally distributed?
—Yes.
10,674. Do you think that a combination of the club system and the system of payment for work done would not be worth trying ?——I would not try it with any idea of finality about it. I would rather have it as a provisional arrangement, subject to early revision.
10,675. About the income of the people, can you speak with any authority about the average income in Lewis. They get their croft and they have a certain income from fishing ?
—Yes.
10,676. A good many of them are on Naval Reserve?
——Yes ; there are something like 1800 men on the Naval Reserve. Every man in Lewis is trained man. They are all Militiaman or Reserve man. Every able-bodied man is a trained man.
10,677. They have a considerable income from the Naval Reserve and from the Militia too ?
—Yes, as a retaining fee from the Naval Reserve they get £6, and they have to go every second year on board ship, and they get 10s. a week and subsistence money and travelling expenses. The whole amount coming from the Reserve alone to the island is about £15,000. The whole reserve battalion of the Seaforth Highlanders are Lewis men, and a considerable proportion of the Camerons and the Gordons also.
10,678. Do they bring home £3 to £4 each?
—Yes. In connection with the Naval Reserve, I may mention that at the end of twenty years' service they get a gratuity of £50, when they attain the age of forty years. The average number of gratuities now falling due is a hundred in the year. It will be interesting to you to know that a large number of the improved houses are the result of these gratuities.
10,679. They don't make much out of their crofts, I suppose, but their outside employments yield them a fair income?
—They get a good deal of food stuffs out of their crofts and that keeps the family in food for a large part of the year.
10,680. Can you tell us how the crofter lives; can you tell us their menu for the day ?
—Porridge and milk to begin with.
10,681. Have they much milk here ?
—No. From now onwards to the end of spring their supply of milk is very deficient.
10,682. That is because the cows are dry ?
—Yes.
10,683. That could be improved ?
—Yes. There is great difficulty in Lewis in getting milk for the children.
10,684. What do they take?
—They get Swiss condensed milk. It is rather rich in sugar, and it does not make as much bone as the ordinary milk.
10,685. (Dr Mackenzie). Have you much rickets among the children?
—Yes.
10,686. (Chairman). What have they for dinner usually ?
—Salt herring very frequently, and then there is fish and the egg.
10,687. Do they use it very much ?
—In our parish they do.
10,688. The children must be very well nourished in this district?
—Yes.
10,689. That is very much better than some menus we have had on the mainland?
—Yes.
10,690. Do they use butter much ?
—Yes; they buy margarine very much.
10,691. Is that in the rural districts ?
—In the rural districts margarine is very much used.
10,692. You don't think there is a large proportion of the non-pauper poor who don’t get attendance?
— No, I never came across any.
10,693. With regard to your serious cases, surgical or medical cases, you deal with them either in the Lewis Hospital or you send them south ?
—Yes.
10,694. Can you tell us about your own hospital? Is it supported by voluntary contributions?
— Entirely by voluntary contributions.
10,695. Has it an endowment fund?
—We have raised one, which amounts to nearly £5000, and it is invested at 4 percent.
10,696. That is about £200 a year?
—We have our maintenance fund, which has always been free from debt for fifteen years since it was opened, and we have kept continually adding to our endowment fund as well.
10,697. You have been able to save £5000 ?
— Yes.
10,698. How many beds have you ?
—Twelve.
10,699. How many cases have you in the course of a year?
—We used to run it up to between eighty and ninety, but I believe for the last two years it has not been so high.
10,700. What sort of cases have you in it. You treat serious surgical cases in it ?
—Yes.
10,701. Many of the cases come from the country ?
—Yes, they come from all parts. We take in everybody, including the sailors who come in here, foreigners, and all sorts.
10,702. How do you remove them ; have you an ambulance?
—They usually send for a closed trap to town, or they come in their own country carts.
10,703. For those from the ships you have an ambulance at the quay?
—Yes.
10,704. What about the sailors ?
—The hospital makes a charge against the owner of the trawler if it is a serious accident.
10,705. Is there quite enough hospital accommodation in the island?
—Yes, quite.
10,706. Could the Committee see the hospital ?
—Yes.
10,707. About tuberculosis, we had interesting evidence from the previous witness in your practice about them. Tuberculosis is increasing?
—I am rather afraid it is.
10,708. And do you find many cases imported from the South, people go to the South and come back suffering from tuberculosis ?
—A large number of cases of that kind occur among domestic servants.
10,709. Do you blame the life in the South, or do you think they had it before and it only developed when they went away ?
—I think it was there and they developed it when they were away.
10,710. Are you satisfied with the nursing for the island ?
—I think it could be extended with advantage to some of the distant parishes.
10,711. You practice in the Eye Peninsula ?
—Yes.
10,712. And there should be a nurse there, we were told ?
—Yes. There is one at Garabost, and there should be another at Portnaguran and one at Tolsta as well as the nurse at Coll. Properly well-trained nurses would be an advantage there.
10.713. As to the present nurses, the ones supplietl by the Association, they are only partially trained. Are you in favour of having properly trained nurses ?
—Yes.
10,714. I suppose there is room for both kinds, or would you like to have them fully trained ?
—Yes, I think it is highly important that they should be.
10,715. (Dr Mackenzie.) Do you train some nurses at your own hospital ?
—We used to.
10,716. Did you drop it?
—Yes.
10,717. Did you find there was no demand ?
—We got situations for all of them. The difliculty was, we had no obstetric work there. I used to take them and train them on my own patients in the country, and give them lessons at the bedside, but still it did not furnish them with a certificate, and we discontinued it.
10,718. (Chairman.) With regard to telephones and telegraphs, the telegraph system is very well developed here ?
—Yes, they are ample in this parish.
10,719. You have not the telephone all over the island ?
—No.
10,720. We have heard that from several doctors ?
—Yes.
10,721. Can you tell us if the telegraph line in your district is managed as a telephone or as a telegraph?
—I think they are telephones.
10,722. Will the girl in charge of the telephone allow you to telephone over the wire ?
—No.
10,723. Did you ever ask ?
—No; I thought it was against. the rules of the post office.
10,724. It is against. the rules, but I don’t see why it should be, for a doctor at any rate .
—Yes.
10,725. About a sanatorium and a hospital for consumption in Lewis, the medical oflicer tells us you ought to have one for the island. You don’t find the one at Dingwall enough
—They have been exceedingly good to us, but I think the number of beds allocated to the Lewis would not meet the requiremcnts of the present day, under the Insurance scheme. I think it would be a good thing, in the interests of the public as well as of the patients, to isolate the cases in the island.
10,726. You think it would be an advantage to have a properly constituted central medical body. That means as distinct from the British Medical Association .?
—Yes.
10,727. In regard to the last answer you give in your statement, we have got here a paper signed by Dr John Ross; I suppose that is the paper you refer to in your answer ?
—Yes.
10,728. You agree with all that Dr Ross says in this paper .?
—Yes. I was Chairman of the meeting at which that answer was prepared.
10,729. (Lady Tullibardine.) You mention the presence of farms in the area in which you practice ?
—Yes.
10,730. Can you give us any idea of how many of these there are
—There are two just outside the town and there are three in Point district and three in Back District, that is, three in each corner of the Horse Shoe, which roughly indicates the topography of the parish.
10,731. Are these big farms or small farms
—They are not very large ; they have sheep on them all.
10,732. Have you any idea of the rentals of them ?
—The rental of Gress Farm is £125 ; of Coll Farm, £80; and of Tong Farm, £38.
10,733. Have these farmers any difliculty in paying you an adequate fee ?
—Not at all. I charge them just at the same rate as the crofters.
10,734. That is a shilling a mile without any fee for attendance
—Yes.
10,735. They can pay that quite well ?
—Yes.
10,736. Can you‘give us any idea what the fisher people make in a year ?
—It varies so very constantly that nobody can tell. For instance, we have had a succession of very bad years here. Last year was a good one, and they brought in a large amount of money, both the female population and the male population as well.
10,737. Do the women’s earnings vary as much as the men’s ?
—For a number of years back the women have been earning the larger share.
10,738. Are their earnings more steady than the men’s?
—Yes.
10,739. Can you give us any idea what the average earnings of a woman in the year are ?
—I heard it said on very good authority that last year they brought something like £70,000 into the island.
10,740. How many brought that in ?
—Nearly every able-bodied woman helped to bring that in.
10,741. How many of that 30,000 are able-bodied women ?
—About 5000.
10,742. (Dr Miller.) About your Oddfellows arrangement, it is quite obvious that you are insufficiently paid for your attendance ?
—It is a small fee.
10,743. It works out at something like 1s. 6½d. a visit?
—Yes.
10,744. And the amount of medicines and material—how much do they work it out at ?
—I have not worked it out.
10,745. There are something like 350 different items ?
—Yes.
10,746. I think you might gather from the Chairman's statement with regard to a club arrangement, which would be a public medical assistance arrangement, that it would be compatible with that arrangement for the doctor, who has nothing whatever to do with the collecting of the money, to receive payment per attendance and not payment by lump sum ?
—Yes.
10,747. Would that kind of method satisfy you?
—Yes, I would much prefer that.
10,748. I suppose it is a thing that you have not thought of in your own mind, but it would be interesting, I have no doubt, to the members of the Committee, to know how you would get practitioners in a centre like this to participate in a general fund for attendance upon patients in the outlying districts where there is competition between the doctors ?
—The panel system, with free choice on the part of patient and doctor.
10,749. Is that considered a sort of unwritten law ?
—Yes.
10,750. Would the other doctor resent your going to attend someone in his parish ?
—He would not resent it, but I daresay he would have some feeling in the matter.
10,751.. You don’t think there would be much difficulty in the matter ?
—No, I think not in Lewis.
10,752. With regard to the Lewis hospital, you run it at an income of £300 a year ?
—About that.
10,753. Your average number of patients is eighty or ninety ?
—Yes. That has been the average number for a number of years.
10,754. And the beds are fairly fully occupied ?
—Up to within the last year they were.
10,755. So that you have been running it very cheaply?
—Yes, we have been doing it very cheaply.
10,756 (Chairman) You get £200 of an endowment; that only leaves £100 to be collected from outside subscriptions, is that so ?
—Yes.
10,757. (Dr Mitchell) You say that the numbers are falling off; how do you account for that ?
—Speaking for myself, I have not taken the same interest in the hospital in the last year as I did in the years ‘previous to that.
10,758. (Dr Mackenzie.) What was the arrangement for medical attendance at the hospital ?
—I went there every day when I had a patient there.
10,759. You are the sole physician ?
—No, it is open to the other doctors in the town.
10,760. (Dr Miller.) The doctor sends his patient in and attends him while he is there ?
—Yes.
10,761. He is not entitled to charge a fee while the patient is there ?
—Not except lately when I had a lot of wealthy trawlers’ patients in. The hospital authorities suggested the doctors should charge under these circumstances.
10,762. In regard to the nursing system, you are fully satisfied that a fully trained nursing system is desirable ?
—Yes, and I should add to that that they should be strictly held by the rules approved of by the British Medical Association for District Nursing Associations.
10,763. That is to say, that they should be under the control of the doctor ?
—Yes, and other recommendations as to the conduct of their work.
10,764. (Dr Mackenzie.) You are satisfied that a nurse can never be a substitute for a medical man ?
—Yes.
10,765. (Mr Orrock.) A nurse would be most helpful ?
—A fully trained nurse acting under the doctor would be most helpful. .
10,766. (Dr M‘ Vail.) Not very many medical men keep their books so as to yield the very valuable information you have submitted as regards the Oddfellows. What occupations do these Oddfellows follow?
—Coopers; shoemakers and tailors, etc.
10,767. Are there a large number of them away for a large part of the year ?
—Not many of them.
10,768. That is the only society that is in the locality?
—Yes.
10,769. So that there is no duplication of membership?
—No. There are no other societies in Stornoway except the Oddfellows.
10,770. So that the attendance you gave them represents the complete attendance they got? —Yes.
10,771. And do they send often needlessly; do they ever trouble you when they ought not to, to any great extent ?
—Well, there is a fair number of them come when one hardly knows the reason why they do come.
10,772. But, as a matter of fact, one need hardly ask you the question—do you give them justice—you give them the attendance they require ?—Yes.
10,773. The attendance you have given them really represents the attendance they require?
—Yes.
10,774. You had 209 visits and 163 consultations
—Yes.
10,775. Do the consultations include these five tooth extractions ?
—No.
10,776. They have to be added to the consultations?
—Yes.
10,777. And that dry cupping ?
—Yes, that is in the consultations.
10,778. So that all that is to be added to the consultations are the tooth extractions ; that makes 209 visits and 368 consultations, including the tooth extractions as consultations?
—Yes.
10,779. Then there were 313 Oddfellows at 3s. per annum. The charge was 3s. each ?
—Yes.
10,780. Adding the visits to the consultations, they come to 577 ?
—Yes.
10,781. And the total amount is 313 times 3s., that is 939 shillings ?
—Yes.
10,782. That comes out at ls. 8d. per attendance?
—Yes.
10,783. I see that in the statement on behalf of the medical practitioners, 2s. 6d. per visit is proposed. The statement does not mention the amount per consultation. Was there any figure thought of for that in this statement when you were in the chair? —No. There was no reference made to it. We merely accepted the circular sent to us by the Ross and Cromarty Branch of the British Medical Association.
10,784. What would you have yourself for a consultation, 1s. 6d. ?
—That is a very small fee, but one would have to be satisfied with it.
10,785. 1s. 6d. would represent what you think would be reasonable for a consultation for the class of people to whom the work referred ?
—Yes.
10,786. Do you attend them within three miles?
—Yes.
10,787. For this you give also medicine ?
—Yes.
10,788. If you had a capitation fee of 4s. 6d. per member per annum instead of 3s., and if the 4s. 6d. per member was wholly devoted to medical attendance, I think it would work out at 2s. 6d. per attendance including consultations.
Have you happened to calculate it out in that way?
—No.
10,789. Well, I think you may take it that a capitation fee of 4s. 6d., exclusive of medicine, would yield you 2s. 6d., not merely per visit, but per consultation, and that the medicine would be paid for over and above. That is a very great deal better than what you have now?
—Yes.
10,790. And it is fully better than what the doctors have been asking at this meeting. You see it allows the half crown for the consultation to be equal to the half crown for the visit?
—Yes.
10,791. Do you think it would be right to represent to the Chancellor of the Exchequer that even the 4s. 6d. was a bit too much ?
—No.
10,792. And assuming that the talk that one sees in the newspapers—and I hope it is true—that he is prepared to give something more than the 6s. is true, you would actually under the Insurance Act be getting a good deal more than your association is asking ?
—Yes.
10,793. Do you realise that ?
—Yes.
10,794. And think that is satisfactory ?
—Yes.
10,795. (Dr Miller.) And they are picked lives?
—Yes.
10,796. (Dr M‘Vail.) You give them an examination before they enter the Society. With regard to insured persons, you are aware that if there were a panel formed you would have the right, subject to distribution of the rejected, of refusing anyone you did not like ?
—I do not think so.
10,797. (Chairman.) It has been said to us more than once that the Insurance for the head of the household is not of so much importance in the Highlands, because the head of the household needs very little medical attendance?
—As a rule.
10,798. Your figure about the Oddfellows seems to indicate that they need a good deal of attendance
—They do in the town here. There are very few crofters in this lodge at all.
10,799. (Dr Mackenzie.) Have you had any difficulty in getting nurses for infectious cases in your area ?
—No.
10,800. In point of fact, you have been able to get a nurse when you wanted one ?
—Yes.
10,801. Does your hospital take in children ?
—Yes.
10,802. Are there many children ?
—A fair number.
10,803. You have no set hospital or children’s ward for tuberculosis?
—No.
10,804. Do you think that is called for in the island, considering it has so high a death-rate for tuberculosis ?
—Pulmonary tuberculosis is not so common among children. We take in the non-pulmonary cases.
10,805. Do you think the number of beds you can keep for children is adequate?
—Quite. I think we have never had any difficulty with them.
10,806. It would be a good thing to develop your hospital along that line, especially if it could be subsidised from public sources so as to develop a children’s hospital from it?
—Yes, it would be a good scheme.
10,807. What one knows from the death-rate of tuberculosis and the prevalence of it, one feels that you need a children's institution. Would you approve of that ?
—Yes.
10,808. And you would say that there is real cause for it?
—Yes.
10,809. (Mr Grierson.) With regard to security of tenure, what is your idea about it, with regard to parish councils?
—I never had any trouble with them.
10,810. You say here in this suggestion of yours that you are in: favour of security of tenure. What would you call reasonable security of tenure ?
—I suppose ad vitam aut culpam.
10,811. Would you think it would be safe if you had the right to appeal to the Local Government Board ? Suppose a man was dismissed for frivolous reasons, would you say he should have the right of appealing to the Local Government Board. Do you think that would meet the requirements of the parochial medical officer ?
—I doubt very much if it would in all cases. I would feel quite satisfied personally with such an arrangement.
10,812. The question could arise that you might have a doctor who was not a reasonable man and a Parish Council which was not reasonable. It has been suggested that in the event of the Parish Council not being unanimous about the doctor that there should be an election of a new Council, so that all his patients would have an opportunity of expressng their opinion as to whether he should be dismissed or not. Has that ever occurred to you as the ground on which the doctor should have tenure of office ?
—No. I never thought of it on that line.
10,813 This hospital of yours here—you seemed to imply that it was not being used to the full extent it might be. Is that owing to the management ?
—There has been a little friction.
10,814. Do you think there could be better management, or is it of our power to help you in the management of it?
—It is managed by a committee selected by the subscribers.
10,815. Why is it not fully taken advantage of ?
—I am not personally taking advantage of it as I used to.
10,816. (Mr Lindsay.) About the payment per family—I am not speaking of your own particular position in this town—do you not think, if there was a minimum salary guaranteed to the doctor, say, of £300 to £350 a year, that a capitation grant per family with a check fee of a shilling or 2s. 6d. a visit would meet the case just as well as a payment per visit, from the doctors’ point of view?
—Would you apply that sum to insured people only ?
10,817. I am not speaking of insured people ; I am talking of the Highlands and the Islands medical service. A modified system is necessary for the Highlands. It has been suggested by Sir John Dewar that a scheme should be devised whereby by a payment of 5s. per family the people could have attendance on the family, with a check fee to protect the doctor from frivolous calls, and that the doctor should be guaranteed a salary of £300 to £350 net. That is the point. It would be a minimum or net salary, less travelling expenses, less the house rent, and in return for that the doctor would be bound to visit the people for that sum, with a protective fee of a shilling or 1s. 6d. per visit, or any sum that might be arrived at as reasonable. Don’t you think that would be fair both to the public and the doctors ?
—Yes, provided you guaranteed the doctors a living wage.
10,818. It has been put before us that increased facilities for travelling is something that is actually necessary in the Highlands. That would be provided for at the same time. It would be a contribution from the people who are to be served, in the shape of 5s. a family ?
—Yes.
10,819. Would not that be a reasonable proposal altogether ?
—I have not much faith in the contribution per family arrangement.
10,820. The contribution per family would not be payable to you. The doctor would have his income guaranteed to £300 or £350 a year in these outlying parishes ?
—Do you mean to include everything ?
10,821. He would have his check fee ?
—Would he have private practice? Would you supply him with drugs?
10,822. Would you be satisfied if his net income was not less than £350? Would you consider that a fair proposal? What is your objection to it ?
—Well, these men have great expenses in the country. A substantial check fee would be absolutely necessary.
10,823. But an allowance will be made for his expenses?
—I think that might be acceptable to my colleagues in the country.
10,824. (Chairman.) Your objection, and the objection of a good many other doctors, is that there would be a danger of the doctor being called for unnecessarily ?
—Yes.
10,825. And if the people got what is practically free medical service, then the doctor would have a great deal more to do, and otherwise they would prefer that payment should be by visit ?
—Yes.
10,826. And if it is impossible to get an adequate fee to be paid by visit, have you any objection to this other method being adopted?
—No. It might be tried for a year or two.
10,827. ( Mr Lindsay.) I was only going to ask you one other question further. Evidently you have no need for security of tenure ; your relations have been very pleasant with the Parish Council ?
—Yes.
10,827A. Do you not think it is a fair way to put it, that when it came to the question of a doctor being dismissed, there should be an appeal to the electors? Would not that satisfy all the doctors?
—( Chairman.) A Referendum.
10,828. (Mr Lindsay.) Would it not be much safer to appeal to the people you are living amongst instead of appealing to people in Edinburgh ?
—No. I would prefer the latter way.
10,829. An appeal to the Local Government Board ?
—Yes.
10,830. You would prefer an appeal to the Local Government Board in Edinburgh rather than to the people in the place you are living in ?
—I would prefer an appeal to the Local Government Board.
10,831. (Mr Orrock.) So far as you know, there has been no friction between the three parishes and their doctors ?
—No.
10,832. And the present doctors have been there for a long time. The doctor at Barvas succeeded his father, and they have been there for nearly thirty years—old Dr Ross in Barvas, and his son?
—Yes.
10,833. So that there is no question of difference between the doctors and the Parish Council there ?
—That is so.
10,834. (Dr Mackenzie). You are medical officer to the Poorhouse ?
—Yes.
10,835. You have security of tenure under the Poorhouse?
—Yes.
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