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The Grand Total of qualified Medical Men employed by the Government Medi- cal Service and the Municipal Services for investigation, prevention and cure, is as follows:
→
Europeans.
Asiatics.
Total.
A B C D E
A B C D E
Government
4
3 11 25
6 = 49
4 16 48
= 68
117
Municipality
1
6
-
=
4
11
Totals
A
-
B
=
56
72
128
Administration.
Investigative.
Prevention.
D = Cure.
Ε
=
Reserve.
The European qualified Preventive Staff provided for the Straits Settlements which has a population equal to that of Hong Kong numbers altogether 17 or one for every 60,000 persons. The Asiatic qualified Medical Staff for preventive work— 20 or 1 for every 50,000 and altogether the qualified Preventive Staff is in propor- tion of 1 to 27,000.
I-PUBLIC HEALTH ORGANISATION IN THE
DUTCH EAST INDIES.
The Dutch Indies Medical Service which has a personnel of some 200 and which deals with a population of fifty million of which 130,000 are Europeans, is controlled by one head The Director of Medical and Sanitary Services. Officers may be seconded to work with lay authorities but in no case are they seconded to work under lay authorities and thus be separated from the control of the Director.
All Officers of the Service are responsible to the Director, all have to report to him or to his inspectors, and all are subject to inspection by the individual heads or inspectors.
Until a few years ago Preventive Medicine was considered to be a branch of Curative Medicine and the Physician included the Health Officer. Under the present scheme there is a separation of the two systems, the place of honour being given to the preventive side. It is the intention of Government to concentrate on preven- tion, and leave the curative side to local action providing three quarters of the cost of the erection of hospitals and paying a proportion of the upkeep. The local hos- pitals are subject to inspection by the District Health Officer and should there be any shortcomings these have to be made right.
Now the only curative establishments staffed by Government are :—
(a) The large teaching hospitals at Batavia and Soerabaya.
(b) The Lunatic Asylums
(c) The Leper Asylums.
(d) The Sanatoria for Tuberculosis.
(e) The Hospitals in connection with quarantine.
The Professors at all the teaching institutions are Government employees and they are under the Director of Medical and Sanitary Services.
In the Municipalities the Head of the Sanitary Service is a member of the Government Medical Service who has been detailed for duty with the Municipality. He is responsible to the Municipality and to the D.M.S.S. and his district and his work are subject to inspection by the Divisional Inspector of the Medical Service.
In the rural districts the District Health Officer has his own duties and his own staff. It is the duty of the Civil Servant to give him all assistance that may be neces sary but it is in no way the duty of the Civil Servant to direct his activities. He has to co-operate with the Civil Servant as far as is possible but he is responsible to the D.M.S.S. that his duties are properly carried out and he is subject to inspection by the Divisional Inspector.
Everything works in a true spirit of co-operation and there is efficiency with- out friction.
In every hospital and in every Municipality the Medical Officer and the Health Officer is assisted by a thoroughly competent lay secretary who deals with the busi- ness side of the question including the finances leaving the professional man to con- centrate on the work he has been specially trained for.
Those who have enquired into the Dutch system and have seen it working are satisfied that it is highly efficient.
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