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HONGKONG LEGISLATIVE COUNCIL
20th October, 1913.
P.C.M.O.
"I have been through the indent for drugs with Mr. Taylor and I think it bas been drawn up carefully to meet our requirements. As far as I can see there does not seem to be any chance of our over-stocking nor of being short in any of the more important items." On the 11th August, 1914, shortly be fore his retirement on pension, Dr. Bell wrote:-
Deer Dr. JOHNSON,
With reference to our conversation this morning I beg to state that I have not discussed your administration out- side the hospital nor have I stated that you have hampered the hospital work by cutting down the issue of the equip ment. I also do not consider that you have so hampered the work."-Yours truly,
(Sd.) J. BELL.
ber, 1915, and to delay by the Crown Agents in forwarding goods ordered, duo to the war. Many of the shortages were not brought to the notice of Dr. Johnson; and in only one instance did Dr. John- BOU decline to allow local purchase, namely, in the case of Sodium Sulphate, which he did not consider necessary, a similar and equally efficacious medicine, namely, Magnesium Sulphate, being in stock in good quantity. And it must! remembered that shortages have not made their appearance since Dr. Johnson's coming, but that they have always been of annual occurrence; and properly so, as to indent so fully that every unfore- seen need may be met in advance must I may mention lead to extravagance. that since Dr. Johnson's arrival the amount of local purchases compares fav- ourably with those of previous years, an indication that shortages are not 30 numerous as in former days.
Dr. Koch, however, makes the point that when an article is not in stock be, or any other medical officer in charge of a case at the hospital, ought to have power to send out to purchase such article on the spot, referring the matter subsequent-
In order to sift the matter to the very bottom I have questioned all those whom I considered competent to form an opin- ion on the matter, namely, Dr. Aubrey, Honorary Consulting Physician, Mr. Digby, Honorary Consulting Surgeon of the Hospital, Dr. Koch, Superintendently to the Principal Civil Medical Officer; of the Hospital, Mr. Pullen, the Apothe cary, and the staff of Sisters.
Dr. Aubrey states that he can recall no instance of the shortage of a drug of any importance. He remembers that on one occasion a Sister stated that she was short of boracic powder. Dr. Aubrey did not require it. Efficient substitutes were available, and boracic powder could be bought in the Colony.
Mr. Digby writes:-"I have always been completely satisfied with the supply of drugs and stores. The extra instru ments and apparatus I asked for have always been supplied."
in accordance with the practice prevail- ing prior to Dr. Johnson's arrival. I have asked the opinion of Deputy Sur- geon General Dreaper, and of Lieut.. Colonel Crisp on this point, as they, by virtue of their position at the head of the local Naval and Military Medical Services, are best able to advise me on the working of a Government Medical Department.
Surgeon General Dreaper informe me that he has not the power, whien is vested in the Principal Civil Medical Officer, of purchasing anything that he may consider necessary, but that his requisitions are scrutinised and pass- No subordinate bas any authority to order Colonel drugs without reference to him. Crisp reports that he must conform his requisitions to a fixed schedule, which schedule, I may state, contains far fewer items than those stocked at the Civil Hospital.
Dr. Koch referred to shortages of varied by the authorities in England. ous drugs and disinfectants occurring mainly in 1915 and during the present year, attributing such shortages to reduc- tions in the indent of the autumn of 1913. He is of the opinion that most, if not all, of the shortages could have been obtained locally. Each item in the list supplied! by Dr Koch has been examined in detail and his report, and that of Dr. Johnson, thereon, are open to the perusal of the hon. member. These reports show that the shortages were insignificant in charae-
As Hongkong is a foreign station, Colonel Crisp may make such local purchases outside this schedule au he may consider necessary, but he must submit the bills to the Home Authorities for covering approval. No subordinate
ter, that they were due in part to losses has By authority to order drugs with- in the 8.8. Fasaka Maru, sunk in Decem-out asking his prior permission.
HONGKONG LEGISLATIVE COUNCIL
The Apothecary in the first instance stated that there had been a shortage of various articles. Pressed for details he adunited that the shortage was in respect of articles which Dr. Johnsen declined to order, as being in his opinion unneces sary. The articles could have been pur- chased in the Colony, had Dr. Johnson thought it desirable to do SU. The Apoecary was asked to quote all avail- able instances of articles which were short at the Civil Hospital and could not be obtained locally. He named six arti- cles in 1913, the only one of importance being diphtheria serum; but in any event Dr. Bell was responsible in respect of that year. He was unable to name any article in 1914. He named three articles in 1915 for each of which there were com- pletely efficient substitutes.
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Ching
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the zith July last:-"The requisitions for laal from the Maternity Hospital had been steadily increasing, and I had reason to think that the medical prepara tion was being used for ordinary sani- tary medical preparation instead of the cheaper solution supplied for that purpose. I spoke to Dr. Koch about it, and he told me to limit the supply, as there was only one patient at the time who required it. I therefore stopped the supply of 4 oz. bottles pure Izal, and supplied half gallon bottles of diluted solution. Seven four oz, bottles were applied between the 1st and 15th April, which is sufficient to produce 50 gallons solution. This evidently did not meet with Sister A's approval, as she wrote back to me asking by what authority I had done this. The matter was reported to Dr. Koch. It was not brought to your notice as I considered it too trivial. I acted on Dr. Koch's instructions."
No
Dr. Koch states: The facts are a stated by the Apothecary. I ordered that the diluted solutions should be prepared in the dispensary and supplied in what- ever quantity was requisitioned for. limit, of course, was placed on this. The only point was the dilution, which i considered should be made under the supervision of the Apothecary and not left to be done haphazard.' On the ques- tion of concentrated mixtures generally, which arose out of this incident, the Apothecary reports: Similar have occurred in other parts of the hos pital with other stock mixtures, lotions, etc., each floor having its own particular concentrations. In my opinion this was asking for trouble,' as unless the same Sisters were always on duty on the same floor, mistakes were sure to arise, and have arisen. As far as possible all mix-
cases
The Sisters were personally interview ed by me on the 20th July last. Ons of them stated that Dr. Johnson cut down the issues from store to such an extent as to endanger the safety of patients. As an example, she quoted a case of some time previously in which a strong dis infectant was required, and she naked for Izal. After the Superintendent sign ed the order the dispenser sent her note to the effect that she could be sup- plied, not with pure Izal, but only with a diluted solution. In another case & patient was dying, champagne was re- quired, and, as none was in stock, his friends had to go out and purchase some. Another Sister stated that she had only one forceps for removing dressings and she required more. This request was generally supported. No other instances of the cutting down of issues was quoted, but it was complained that there were many new rules in connection with stores which had been made by Dr. Johnson.
In the matter of the forceps Dr. John-tures, lotions, etc., are now of a uniform son is of the opinion that the number strength, and I consider that the dis- supplied was adequate. He has, how pensary is the only place in which dilu- ever, at my request issued further pairs. tions should be made, and to issue mix- With regard to the champagne incid- tureg in poisonous concentrations__is ent, it is admitted by the Apothecary much too dangerous a practice. The that he had instructions from Dr. John-alteration was not carried out without son that champagne in small quantity some trouble." was to be kept in stock. This order was disregarded. The question of the issue of Izal was heard of for the first time by Dr. Johnson when he was asked to report upon the complaint made by the Sister. The Apothecary reported in writing to the Principal Civil Medical Officer on
Finally, I have asked Dr. Johnson for a personal statement, and he informs me that throughout the period of his resid- ence in the Colony he has on no occasion received any written or verbal protest in the matter of the cutting down of stores. In this connection Dr. Koch