A LARGE part of Scotland already had a state-funded health system in place when the NHS was created 70 years ago.
The Highlands and Islands Medical System, which had been set up some 35 years earlier, covered half of Scotland’s land mass. Poverty was rife in the area and health cover was limited in remote and island communities, leading to the creation of the system in 1913, under which doctors fees were set at minimal levels.
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The Second World War brought further advances in healthcare, with seven new hospitals created and new annexes built at others to treat those injured in German air raids. But when casualty numbers were lower than expected, then-Scottish secretary Tom Johnston put them to use to treat civilian patients who were facing long waits for surgery. By the end of the war, nearly 33,000 people had been treated as a result.
Johnston built on the success of this scheme with the Clyde Basin project, launched in 1942, which saw industrial workers referred to GPs – and on to hospital if necessary – in a bid a to prevent greater levels of ill health.
Former prime minister Gordon Brown has claimed that “Scotland led the way to the creation of the UK- wide NHS”, adding that without Johnston “our history might have been very different”.
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Breakthroughs continued after the formation of the National Health Service, with ultrasound scanners developed in Glasgow in 1958 and the UK’s first nursing studies unit created in Edinburgh the following year. The UK’s first successful kidney transplant was carried out at Edinburgh Royal Infirmary in October 1960, and the Glasgow Coma Scale – which is used by medics across the world to rate patients’ level of consciousness – was developed in 1974.
Breast cancer screening was introduced across the UK in 1988, following a report produced by Sir Patrick Forrest, a professor of surgery at Edinburgh University – with this work building on pioneering efforts in Dumfries, Aberdeen and Dundee to screen women for cervical cancer.
The establishment of the Scottish Parliament in 1999, with health one of the key issues devolved to MSPs at Holyrood, saw more changes.
In 2002, the Scottish Parliament introduced the flagship policy of free personal care for the elderly, while Scotland again led the way in the UK with the introduction of the smoking ban in public places in March 2006.
More recently, the Scottish Government has focused efforts on the integration of health and social care, with plans brought forward in 2015 for local authority leaders and health bosses to work together in new joint boards.
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