After a short period as a
locum in a North Uist practice, which was itself under the aegis of the
Highland and Islands Medical Service, Dr Robert McIntyre obtained a
position with Stirling County as a Tuberculosis Officer responsible to
the Medical Officer for Health. This appointment renewed contact with Dr
Edward Neil Reid who was the MOH for Stirling.
Although the Labour
Government had great plans for the reform of the health service, the
immediate post-war years were a period of shortages of resources, and
currency restrictions meant the drugs which had been developed to
control and cure diseases of the chest were extremely scarce.
Streptomycin, discovered in 1944, was one such drug and, on occasions,
exceptional measures had to be undertaken to obtain supplies. For
example, the life of a patient could depend on being able to make
contact with friends in the United States who could purchase the drug
and have it sent to Scotland. Robert recalls one such experience when a
young girl’s life depended on making such contacts. A supply of
streptomycin was sent by American friends to Prestwick and hurriedly
transferred to Stirling in order to treat the child. This mercy mission
had a happy ending in the girl’s recovery and restoration to health
and is remembered with more than a little pride by Dr McIntyre who
rounds off the tale by stating that she became dux of her school.
Direct links between Dr
McIntyre’s hospital work and that of the Medical Officer of Health
were to be broken with the introduction of the National Health Service
in 1948 and Robert’s appointment as Consultant: Tuberculosis and
Diseases of the Chest, for Stirling and Clackmannan Health Authority
covering a population of 250,000.
Despite popular views,
the creation of the National Health Service, particularly in Scotland,
had a long gestation period. While Labour in government was strongly
centralised, it had to concede a separate Act for Scotland. Aneurin
Bevan, Labour’s Secretary of State for Health, did not wholly accept
the need but the different background of medical experience in Scotland
made such a concession necessary.
Part of the background
was related to geography and population structure, most clearly evident
in the Highlands and Islands. It was impossible in the early years of
the 20th century to give adequate attention to the medical needs of the
population in remote Highland areas on the same basis as that of the
more densely populated areas of the Central belt.
Lloyd George’s National
Health Insurance Scheme applied only to those who had regular income
from work and, therefore, it excluded many in the crofting communities.
To cover this deficiency,
the Dewar Committee was set up in 1912 and came forward with a set of
ambitious proposals for a Highland and Islands Medical Scheme (HIMS)
which, in many ways, anticipated the NHS.
introduction of the Committee’s proposals were frustrated by the
beginning of the First World War and, although the Highland and Islands
(Medical Services) Board was set up in 1913 restrictions on expenditure
during and after the war meant that it was not until the 1930’s that
real progress was made in providing services approaching the
recommendations of the 1912 Report.
In 1936, the Cathcart
Committee made reference to the success of HIMS in its plans for a
national health service for Scotland and it was relatively easy for the
HIMS to merge with the National Health Service in Scotland in 1948.
Such a background of
experience meant that the reception of the National Health Service in
Scotland was considerably different to that of England and Wales. Voting
patterns show this quite clearly. Scottish doctors voted 1,893 to 1,341
in favour of accepting the proposals for the NHS, whereas their English
colleagues voted 12,550 to 10,906 against.
While approval of the
Bills for the NHS had been given by Parliament (for England in December
1946, Scotland May 1947), there had been along period of hard fought
negotiations with the medical profession before the appointed day of
implementation on 5th July, 1948.
On the evening before,
Prime Minister Attlee made a broadcast extolling the virtues of the NHSS
and the delivery of a comprehensive system of social security in four
measures: National Insurance, Industrial Injuries, National Assistance
and the NHS, plus advances in old age pensions and unemployment benefit.
Careful as ever, Attlee
made it plain that, "All social services have to be paid for, in
one way or another from what is produced by the people of Britain. We
cannot create a scheme which gives the nation as a whole more that we
put into it ... Only higher output can give us more of the things we
His Secretary of State
for Health was not so restrained. On the same day, Aneurin Bevan made a
speech at Belle We, Manchester in which he wound up with his assessment
of the Tories. "... What is Toryism but organised spivery?"
Contrasting this Party’s social programme with his own memories of
means-tested benefits of his youth, Bevan averred: "That is why no
amount of cajolery can eradicate from by heart a deep burning hatred of
the Tory Party that inflicted these experiences on me. So far as I am
concerned, they are lower than vermin".
The Tory media captured this phrase with
ill-concealed glee and Churchill’s later reply was to label Bevan as
Minister of Disease.
Thus the National Health Service which every one
seemed to desire was born in controversy and much worse for the public
in an era of shortages and restrictions.
Of course, much of the worry about being unemployed
and sick had been removed but, in medical terms, if there was not
rationing by the purse, there was rationing in terms of time and queues.
It was in this atmosphere that Robert McIntyre began
his work in Stirling and, it is a further example of his capacity to
engage himself in a number of different areas of concern simultaneously
without appearing to neglect anything of major concern, that he was able
to continue and, indeed, expand his political interests.