From the first of Cleese opinions I differ entirely.
With the second I agree to a certain extent because a Medical officer or any other man in good health is able to perform an excessive amount of work for a certain length of time. If the strain be continued however, the individual must break down unless he avoids the pressure by shirking the work imposed upon him.
I would earnestly urge that no Public officer should be called upon to choose between two such alternatives as these, especially when in this case, the latter involves, apart from all other considerations, suffering and even loss of life to the sick in Hospital or failure in justice in medico-legal cases before the Courts.
When I first took charge of the Civil Hospital and all the duties imposed upon the Superintendent, I found the work excessive both absolutely and as compared with that expected from any surgeon in charge of the Hospitals with which I had been acquainted.
The duties, instead of diminishing, have been increased and a longer experience has only tended to confirm me in my view of the matter.
An opinion on this subject has been formed from over seven years' practical experience of the requirements of the Hong Kong Civil Hospital and as my professional qualifications are not inferior to those of Mr. Mackinnon or Dr. O'Brien, it is necessary to look for a reason for the difference of opinion between us.
The reason I believe to be this: that Dr. O'Brien, being in private practice, is directly interested in keeping down the number of private practitioners in Hong Kong. The Hospital staff may at any time leave the public service for private practice. Dr. O'Brien, though desiring to be impartial in his judgement, could hardly be expected to make such a recommendation as would lead to an addition to the number of his possible rivals.
Dr. Mackinnon, when called upon to consider this subject, had only been in Hong Kong four months and that during the winter, the coldest and healthiest season of the year, during which time the Hospital duties are usually lightest and the surgeon likely to be best able to perform them.
Dr. Mackinnon then had to depend to a great extent upon the experience and opinion of his colleague and could hardly fail to receive a certain bias therefrom.
I may add in conclusion that the Colonial Surgeon, although he has usually expressed the same views as Dr. O'Brien on this subject (and presumably for the same reason), yet seventeen months ago recommended the Government to appoint a second qualified medical man for the Civil Hospital.