In 1845 the new Scottish Poor Law established a funded medical service for the registered poor. By 1852 the Physicians’ Enquiry concluded that medical provision in the Highlands of Scotland was still seriously inadequate. In this talk Dr Patricia Whatley discusses the changing issues relating to the work of the general practitioner in the second half of the nineteenth century in the remote and isolated regions of the Highlands, culminating in 1913 in the establishment of the Highlands and Islands Medical Service.