The Scottish Health Ecosystem
and National Park Status
Appendix A
‘Wildlife Species in Scotland and Remote Health Care Policy
What can we debate?’
A personal viewpoint by Dr James Douglas
Corncrakes
Corncrakes are migrant birds which have traditionally rested in the Inner and
Outer Hebrides in summer months. They are ground nesting birds which require
rough cover and have been threatened by modern farming practice to mow
hebridean fields for summer hay. 20 years ago RSPB put in educational and
financial policies to leave protected areas in crofting land which allow corncrake
nesting. They are birds which are now often heard but rarely seen because of
this ecological management. Intervention has worked for them.
Lesson for Remote Health Care
Simple low tech interventions improve habitat. Housing would help in some areas. We could
make remote communities more aware of the needs of their professionals and turn around
falling population numbers relatively quickly.
Hedgehogs
Hedgehogs acquired anthropomorphic status with the literature of Beatrix Potter.
They are non native species to the Western Isle but were introduced by a biology
teacher in the 1960’s.
They have flourished but become a threat to the
distinctive Machair ecosystem by eating the eggs of ground nesting birds.
Hedgehogs hibernate in the winter and become prickly balls when threatened.
Lesson for Remote Health Care
Introducing visiting super specialists to remote communities who are popular with the public
or press may have an unwanted effect on resident nesting professionals.
Red Squirrels or Grey Squirrels?
Red squirrels are native to Scottish Woodlands. Grey squirrels are American
imports which compete for the same territory and food sources are red squirrels.
The grey squirrel is the more successful species and has replaced indigenous red
squirrels in areas south of the Highlands of Scotland.
Grey squirrels entertain children and visitors in the city parks of Glasgow and
Edinburgh. How important is it to protect one species of squirrel over another?
Lesson for Remote Health Care
How different really is a generalist remote doctor or nurse trained in a city and should we
really erect barriers to migration to preserve a cultural icon?
Wallabies in Loch Lomond
Wallabies are native to Australia. In the 1930’s before National Park Status a
land owner introduced Wallabies to an island certain that they would be contained
on the island. They are now seen on the adjacent mainland.
Lesson for Remote Health Care
Importing attractive new professions from other countries e.g. Physician Assistants to remote
communities may leave them feeling isolated in small numbers and desperate to leave.
Introducing a completely new profession into a remote community may cause role confusion
and identity problems with the public.
St Kilda Wren and Mouse
The St Kilda Wren and Mouse are species unique to St Kilda. Their continued
survival depends upon very careful rules enforced on visiting boats to protect
them. All modern visitors want to uphold these rules because they visit St Kilda
to experience its fragile ecosystem.
Lesson for Remote Health Care
Scottish society with an interest in wild lands would be predisposed to support National Park
Status for remote healthcare.
Pesticides
Pesticides are used to preserve cultures of crops, animals or fish.
Their
unintended consequences on other species and ecosystems depend on whether
they are organochlorines, organophosphates or pyrethroids. Their effects are
predictable and their unintended consequences on fragile ecosystems require
legislation and environmental impact assessments to mitigate and control adverse
impacts.
Lessons for Remote Health Care
Professional appraisal is used in large urban systems to control and eradicate ‘professional
weeds’ like a pesticide. It works in large monocultures of similar professional roles but can
rapidly poison a fragile remote health ecosystem. It may be particularly poisonous to
migrating professionals who do locums in remote communities and cause them to give up
such work which sustains the remote ecosystem.
JD/HC/19.08.13