 The Highlands and Islands Medical Service was established in the crofting counties on a non-contributory basis in 1913.Though the fund was held centrally, and the obligation to pay into it was a nationally imposed one, access to the scheme was via "Approved Societies", who collected the contributions, paid out for treatment, and provided day-to-day administration.A worker could choose which Approved Society to belong to; this stimulated competition between the societies.