tion of the causes of absenteeism or dropping-out. From experience gained by an earlier trial with tranquilizers it was established beyond doubt that as many as 80% of those treated became addicted again as soon as they returned to their former environments.
113. The success of any form of out-patient treatment naturally depends on the continuous attendance of the addicts. The good ones will be able to lead a normal life while taking methadone, and their progress must be carefully checked. Some may take other drugs, and the reasons must be found. Others will default, and it is even more important to find out why they cannot carry on. In other words, unless the causes for the addicts to give up the treatment are studied and analysed it would be a wasteful exercise to start an out-patient clinic service for them. In the Department's pilot scheme 550 addicts will be studied, in the course of three years, and besides medical and nursing staff, social workers will play an important part in it.
114. In the event that the pilot scheme achieves a certain degree of success, resulting in more and more addicts demanding this form of treatment, the Department will clearly have to consider organizing an out-patients service for them. It will be within the next five years that a positive decision may have to be taken. The question which therefore arises is whether this service can be organized with the facilities and resources available or whether additional provisions will be required. This has financial implications and deserves careful consideration. The following factors are relevant:
(a)
The number of addicts to be treated, which cannot even be guessed at until the pilot scheme is well on the way or nearing completion, when the demand may be assessed.
(b) The proximity of the clinic to the addicts; if a frequent cause of dropping-out from the pilot scheme is the distance they have to travel (although assistance towards travelling expenses will be provided) then as many clinics should be used as possible, but it is not proposed to set up special centres or clinics for the purpose.
(c) The availability of staff; the pilot scheme will show what load each grade of staff has to carry, and it is feared that there may not be enough social workers if a large clinic service is organized.
Logically this service should be installed in the general clinics, especially in those which are going to be renovated, rebuilt or built, for accom-
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modation is not likely to be available in the existing clinics, as these were built without this additional service in mind.
115. It may be concluded that unless the pilot scheme turns out to be a failure the Medical and Health Department will have an active role in dealing with the treatment aspect of drug addicts from now on.
Family Planning
116. Government is proposing to take over family planning from the Family Planning Association in phases commencing from October 1973. It is hoped that the take-over of family planning services at present run by the Family Planning Association in Government clinics/ institutions will be completed in about a year's time. Initially it is intended that the level of activity would be the same as that under the Association. However, as family planning is to be part and parcel of the Maternal and Child Health Service it follows that any future expansion of the M.C.H. Service will mean a parallel expansion in family planning activities. Thus the second stage of provision of a family planning service will mean expansion of such service in conjunction. with the expansion of the M.C.H. Service. The twin problems of space and staff will be taken into account in the planning of these clinics in future.
117. The Committee certainly considers that there is scope for expansion, especially as through it the potential shortfall of 726 maternity beds by 1982 (paragraph 24) could be eliminated.
The Health Services
118. To oversee the development of the health services of the Colony is included in the Committee's general terms of reference. These services comprise seven: tuberculosis, social hygiene, maternal and child health, ophthalmic, industrial health, the health offices and port health. Their role in the prevention of disease is of the first importance. A Medical and Health Department working party is at present review- ing the staff structure and staff requirements of these services, which are understood, in some areas, to be under strength. The Committee pro- poses to enquire more fully into the functioning of these services after the working party's report has been produced and borne fruit. Apart from maintaining existing services there is scope for expansion. For example, the target of the industrial health service is to expand and develop the present service in all directions into a full occupational
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