Poultry buried to treat neurological conditions, deaths uncertified, do-it-yourself child delivery; and a handful of doctors and nurses to cover vast areas of the country.

No this is not the third world but the Highlands and Islands of Scotland in the early 20th century, when the profound rural poverty too often proved fatal.

The new National Insurance Act of 1911 didn't help, because it did not cover crofters. Eventually there was sufficient public concern for a comprehensive inquiry into health care provision in the Highland and Islands to be announced in 1912. It was chaired by Sir John Dewar, Liberal MP for Inverness and son of the founder of Dewar's whisky.

The inquiry's centenary will be marked by a conference in the Highland capital this weekend, because of its remarkable achievement. The committee's report led to the establishment of the publicly funded Highlands and Islands Medical Service (HIMS) which transformed the rural health provision and was a critical forerunner for the NHS – which wasn't to come till 1948.

Even now, the problems of retaining GPs and nurses in some of the most remote communities remain, as recent events on Ardnamurchan have underlined.

Last year the two doctors in the Acharacle Practice announced they were planning to opt out of out of hours cover and have now confirmed they will leave their posts in August, highlighting in particular the demands of working 24/7. Today the chair of the Royal College of General Practitioners Scotland calls for greater support for those in such exposed clinical situations in rural Scotland.

But the problems the Dewar inquiry found were of a different order. There were many areas where there were no doctors at all. So 90% of deaths went uncertified on the Ardnamurchan Peninsula and 81% in Coigach, Wester Ross. In the rest of Scotland it was just 2%.

Dr Miles Mack, a Dingwall GP, is organising the centenary events and says the conference will not only take a look back but also look to the future of health services.

He said: "The findings in the John Dewar report were startling. They uncovered a desperate lack of medical care including women often giving birth without assistance; the report highlighted one case where the mother had to read instructions from a medical textbook, while the husband delivered the baby.

"There was also a reliance on herbal remedies, 'quack medicines of American manufacture' and folk cures. For instance, burying a live black cock at the site of a person's first fit was used to treat epilepsy."

In 1904 the poor law doctor on North Uist, Dr Murdo Mackenzie, had highlighted what it meant for the ordinary people: "The want of sufficient medical attendance and nursing have a most prejudicial effect on the wellbeing of the district. The loss of life, hardship and misery which this implies cannot be calculated."

He told of the conditions his patients lived in: "Houses of practically only one room, with damp walls, damp clay floors, sunless interiors, a vitiated and smoky atmosphere, and the cattle under the same roof with the human inmates..."

The Dewar Committee took evidence from doctors, ministers and local dignitaries by post, as well as visiting the remotest parts of the area.

It found that medical and nursing services were either poor or non-existent in many areas within the crofting counties of Argyll, Caithness, Inverness, Ross-shire, Sutherland, Orkney and Shetland and Highland Perthshire.

Those doctors that were there struggled to make any living in such sparsely populated areas, as one doctor in Lewis stressed: "The extent of non-remuneration can be estimated from the fact that, for the last two years and a half, my partner and myself have travelled in one parish, upwards of 2000 miles on express visits ... without obtaining any payment whatever, not even, in most cases, for the medicines given."

Many didn't stay long. Papa Westray in Orkney had 13 doctors between 1895 and 1914. The committee was warned by some Highland landowners that a state scheme would undermine local charity to help those in need, but chose to ignore such seigneurial counsel.

The Dewar committee report led to the setting up of the HIMS in 1913 with a Treasury grant of £42,000. Doctors would have a basic income but could continue to treat private patients. Fees were set at minimal levels but any who couldn't pay were still treated.

The report recommended doctors be provided with a house, telephone, car or motor boat and locum cover. By 1929 there were 175 nurses, one on St Kilda, and 160 doctors in 150 practices. Stornoway had its first surgeon in 1924, Wick in 1931, Shetland and Orkney by 1934.

GP turnover became less of an issue. In North Uist and Berneray, in stark contrast to Papa Westray, Dr Alex MacLeod came in 1932 and stayed in practice until 1974.

The American nursing pioneer Mary Breckinridge visited Scotland in 1924 and on her return built the Frontier Nursing Service in Kentucky on the HIMS model. She said: "The combination of doctor and nurse is extraordinarily impressive. Many of the doctors say that work in their areas would be impossible without the services of the nurses, and everywhere we are told that co-operation between doctor and nurse leaves nothing to be desired."

But Dr John Gillies, chairman of the Royal College of General Practitioners Scotland, who is a native of North Uist, believes the Dewar centenary is a chance to look again at provision in the Highlands and Islands.

"Sir John Dewar's Commission of 1912 produced a visionary report which transformed medical and nursing care in desperately poor communities in the Highlands.

"The method of his inquiry – listening to the health professionals and lay people in these communities – would now be called a needs assessment.

"In 2012 we face very different health issues: multiple chronic conditions rather than acute infectious diseases, an ageing population with fewer young people and children, over-nutrition and obesity rather than the malnutrition of poverty. The problems associated with alcohol today are not new but loom much larger than a century ago, and illegal drug use is a problem in the most remote locations.

"We have come a long way in providing health care, but recruiting and retaining GPs, as well as nurses and other health professionals in the Highland and Islands, remains a real problem. Part of the solution, I believe, is to make sure that we develop much better support for GPs and others in these exposed clinical situations.

"The centenary of Dewar is an opportunity to look for some fresh thinking, and perhaps a new needs assessment – on this issue by all stakeholders, to make sure that people on these communities have high quality health care for the century ahead."