Postcode Lottery in Healthcare? Findings from the Scottish National Comprehensive Geriatric Assessment in Secondary Care Audit 2019

Comprehensive Geriatric Assessment (CGA) is provided differently across Scotland. The Scottish Care of Older People (SCoOP) CGA Audit was a national audit conducted in 2019 to assess this variation in acute hospitals. Two versions of audit questionnaires about the provision of CGA were developed (one each for larger hospitals and remote/rural areas) and piloted. The questionnaires were sent to representatives from all hospitals in Scotland using the REDCap (Research Electronic Data Capture) system. The survey asked each service to provide information on CGA service delivery at the ‘front door’. The questionnaire was open for completion between February and July 2019. Of the 28 Scottish hospitals which receive acute admissions, we received information from 26 (92.9% response rate). Reporting sites included seven hospitals from remote and rural locations in the Scottish Highlands and Islands. Significant variations were observed across participating sites for all key aspects studied: dedicated frailty units, routes of admission, staffing, liaison with other services and rehabilitation provision. The 2019 SCoOP CGA audit highlights areas of CGA services that could be improved and variation in specialist CGA service access, structure and staffing at the front door across Scotland. Whether this variation has an impact on the outcomes of older people requires further evaluation.

Queen Victoria’s "Leaves from the Journal of Our Life in the Highlands": Illustrated Print Culture and the Politics of Representation

QueenVictoria published her first Highland memoir in 1867, a sentimental narrativeof royal life dedicated to Prince Albert entitled Leaves from the Journal ofOur Life in the Highlands.  Inresponse to the popularity of this edition, the publisher Smith, Elder and Co.released a lavishly illustrated edition in late 1868 to capitalize on theChristmas gift book market.  It featuredseventy-nine illustrations after works by various artists andphotographers.  When scholars have turnedtheir attention to the Queen’s journal, they have produced rich andsophisticated discussions of gender, monarchy, and celebrity, especially asthey relate to royal domesticity in the Scottish Highlands.  Yet these readings have rarely extended tothe illustrated version of the text. This article will consider the conjunctionof monarchy, the Scottish Highlands, and illustrated print culture in theillustrated Leaves through two different types of images:  steel plate engravings after watercolors bythe artist Carl Haag and wood engravings after watercolor sketches of Highlandgames by the Swedish artist Egron Lundgren. Each positions the male Highlander as a central figure in constructingthe dynamic of royal family life, sovereignty and empire.  Catherine Hall and Sonya Rose have recentlyexplored what it meant for the British to be “at home with the Empire,” asking“Was it possible to be ‘at home’ with an empire and with the effects ofimperial power or was there something dangerous and damaging about such anentanglement?” In the course of this article I will argue that theseillustrations constructed the male Highlander as a site of familiarity withinthe bounds of the nation, while simultaneously signaling his otherness andproximity to the more far-flung reaches of empire.   As a result, Leavesis as much about empire as it is aboutdomesticity, even as it eschews direct references to current events of theperiod that directly threatened both.   

Highlanders and the City: Migration, Segmentation, and the Image of the Highlander in Early Modern London, 1603-c.1750

The study of Scottish migration in the early modern period has experienced extensive growth in recent decades, but has tended to privilege overseas movement over the presence of Scots elsewhere in Britain. This is particularly true of migrants from the Scottish Highlands: much has been written about Highlanders in America or Continental Europe, but almost nothing is known about their experiences in England and Wales, and in particular in London, consistently the major destination of Scots moving southwards. This article seeks to address that gap by exploring the extent and nature of Highland migration to London during the seventeenth and early eighteenth centuries. It begins by surveying the surviving evidence for Highlanders’ presence in the English capital, suggesting that they were most readily to be found in the elite and mercantile sectors, and were comparatively rarer among the ranks of artisans, professionals, or the poor. It is also argued that Highlanders tended not to form a coherent ethnic ‘bloc’, but instead were subsumed within the wider Scottish diaspora. This, however, was paradoxical, because London was during this period developing a strong image of ‘the Highlanders’ as distinctive from ‘the Scot’. The article therefore goes on to explore the origins of Highlander imagery, and concludes that those Highlanders actually resident in London contributed very little to it. Instead, image-makers drew predominantly on pre-existing Scottish stereotypes, travellers’ reports, outlaw tales, and political discourse, for example surrounding Jacobitism. All of this suggests a degree of invisibility around the Highland community in early modern London, and that, the article suggests, underlines the fundamental blurriness of the Highland/Lowland divide within Scotland. It also indicates that a segmented, rather than ethno-cultural model of assimilation might offer the most reliable means of understanding the Scottish diaspora in early modern London.

Lord Loudoun, the Highlands and Imperial Subjecthood in North America

This article provides a comparative analysis of the tenure of John Campbell, fourth earl of Loudoun, as a regional commander in the Scottish Highlands during the Jacobite uprising of 1745–6 and as commander-in-chief of the British forces in North America from January 1756 to December 1757. It challenges historiographical interpretations of Loudoun as an incompetent bully, instead emphasising his attempts to negotiate with local elites in both imperial fringes for the realisation of the state's aims, albeit within the confines of his own understanding of imperial subjecthood. This article argues that Loudoun's experiences of waging war and pacifying the Highlands directly influenced how he approached the challenges he faced in implementing British military strategy in North America. In doing so, it contributes to the growing body of scholarship investigating the role of the army in British imperial policymaking and the direct and indirect influence British army experiences in the Scottish Highlands had on the transatlantic implementation of empire.

“Under ye Lash of ye Law”: The State and the Law in the Post-Culloden Scottish Highlands

In the aftermath of the Jacobite rebellion of 1745, the British state enacted a series of restrictive legal measures designed to pacify the Scottish Highlands and crush the military power of the Gael. With the evolution of scholarly work on the British state, these measures are increasingly seen through the prism of state power, with the Scottish Gàidhealtachd cast as the victim of a fiscal-military system determined to impose obedience on its territory and peoples. In analyzing the implementation and enforcement of the laws passed between 1746 and 1752, this article challenges this narrative. By focusing attention on the legal system—particularly with regards enforcement—this article considers the local reception of the laws and the ideological, legal, and bureaucratic limitations to state authority. Yet it also explores how clan chiefs and traditional elites, who were the primary target of the legislation, quickly turned the laws to their own advantage. This analysis challenges the idea of effective state intervention in the Gàidhealtachd after 1746 and instead brings attention to how parliamentary legislation was mobilized by regional actors to local ends in ways that cast a long shadow over the history of the Scottish Highlands.

Disability as a Problem of Humanity in Scottish Enlightenment Thought

This article makes a case that disability, particularly visual, hearing, and speech impairments, played a significant role in Scottish Enlightenment thought. Focusing on the work of Dugald Stewart, and in particular on his essay ‘Some account of a boy born blind and deaf’, we argue that disability was a deep preoccupation of Scottish Enlightenment thinkers who used it as a test case for various important philosophical questions including those concerning ‘human nature’ and the limits of humanity. The article starts by situating the philosophical debate in the context of lived experiences of, and proximity to, impairment. The second part offers a close reading of Stewart's text ‘Some account’, about James Mitchell, a fourteen-year-old deafblind boy living in the Scottish Highlands. The third part examines how disability operated in relation to other hierarchies of difference that have been demonstrated to have been central to Enlightenment thought, in particular that of race. Overall, the contribution this article makes is to introduce disability as an important, if currently overlooked, category in Scottish Enlightenment thought that needs further investigation.