74
26 January, 1920.]
COLONIAL MEDICAL SERVICES COMMITTEE.
Lieat. Colonel W. T. PROUT, C.M.G.
2391. But there are Departments at the Colonial Office, and the medical officers serving in those Colonies would correspond with the Department of the Colonial Office; as in West Africa with the West African Department, and the West Indian with the West Indian Department, and so on?--You mean in the Civil Branches; the Executive Branch?
2392. Yes! Well, you will find the same thing happens there. It is not a homogeneous service, and all the junior people, up to a certain point, are recruited locally. The senior ones are moved, and the senior ones in the Medical Service are moved at the present moment, from Colony to Colony, but the mass of them are not.
2393. My conception is of a Service in sections corresponding to the Departments of the Colonial Office It might be possible to make a cortain number of groups.
2394. That is the idea?-Where the people could be interchangeable and would serve under, more or less, the same conditions. But even that would be very difficult, because you have the local authorities, who are very jealous of their power, to deal with.
2395. Chairman: And that has been done in West Africa, bas it not?—Yes, that has been done, but the conditions are all similar.
on
2396. Sir James Fowler: Do you suggest Inspector-General for West Africa?--Yes; well, my idea is to have one big African Medical Service.
2397. Chairman: For tropical Africa ?-For tropical Africa,
2398. Sir James Fowler: I do not know whether you remember this quotation "It should certainly not be his duty to form a sort of High Court for the trial of errant Governors et hoc genus omne.' "P Who is it?
2399. Do you recognise the author of that; that is Sir Hugh Clifford, now Governor of Nigeria? How do you think he would welcome your Inspector- General-That is surely another matter. The question is what is the best for the Service, and for the Colonies, not for the Governor.
2400. How do you think that the Governors of the various colonies concerned in West Africa would welcome the visits of an Inspector-General ?—I cannot presume to answer how they would.
2401. In your memorandum, which led to the Com- mittee of which we are both members, this occurs: "That facilities may be given to them to express through adequate channels the feelings of discontent, should they arise at any time." Do you think the existing channels are adequate-1 warn you that I have your own memorandum here? This one that I have in front of me?
2402, Yes. I think, on the whole, it is fairly adequate, but I think that a general head would probably be closer in touch with the Colonial Office, and would be able to bring matters, where there was any discontent, more directly home.
2403. But is not that precisely what one is contend- ing for?--Well, but we are talking of West Africa just now.
2404. Still, it applies to them all, does it not? If it applies to West Africa, surely it applies to the other branches of the Service?-Well, but then you are up against at once the local administrations who are very jealous of their power in the smaller Colonies.
2405. But he would not interfere with them, surely? That I cannot say. I do not mean the Governora, I mean the local Administration.
2408. Chairman: The elected members of the Legis- lative Council-In the West Indies, for example, they are largely elected members, do you see; that introduces another element altogether.
2407. Sir James Fowler: You say, in your memor- andum, that you would draw exactly the opposite
[Continued.
conclusion, the conclusion being that the existing system affords adequate means for so and so; you would draw exactly the opposite conclusion P—Yes, I do not think it did, and at that time there was no means of getting the thing home except general grousing.
2408. If this would be an advantage to the members of the West African Medical Staff, why should it not be shared in by members of the Staffs serving in other parts of the world?-Because they serve under entirely different conditions.
2409, Certainly; 1 am not suggesting that the Inspector-General, but you were suggesting that a man in that position would be a better channel than the present one?-On the whole, yes, I think he would, 2410. If they had that better channel, why should not the others have a channel equally; why have they not an equal right to a channel of that kind, to express their discontent or feeling at any time?—I suggest a Director-General because there is a more or less homogeneous Service. If you do not have a homo- geneous service, I do not see how you have a Director- General.
2411. It entirely depends, surely, on the duties and functions of the Director-General-Yes, well, we have discussed that in the Advisory Committee many times.
2412. I do not know whether you read my memoran- dum which came out just before yours?-Oh! yes, I have read it.
2413. Do you agree with the duties laid down there?—I shall have to read it again.
2414, I will not press that. I go on to the question of the union of the East and West African Services. What advantages do you see from a union of those two Services Well, it would be very much larger, and it would allow greater interchangeability; you would have a bigger selection; it could be made more attractive. I think the esprit de corps will be greater.
2415. Chairman: You would get more regular pro- motion P-More regular promotion.
2416. Sir James Fowler: Would you have the conditions as regards pay, leave and retirement the same in the two?-It might be necessary not to have them exactly the same, but you could assimilate them by having local allowances.
2417. Chairman: That is as regarda pay?-Yea.
2418. And the same as regards leave?—Yes, there is no reason whatever why leave should be the same everywhere. It is obvious that certain places are unhealthy. The question is as to whether leave should be all equal on the West Coast of Africa.
2419. Under these conditions, would it be a homo- geneous Medical Service?-Oh! quite. I do not see what difference little details would make, any more than it makes any difference that there is a bigger travelling allowance in one Colony than there is in another.
2420. Sir James Fowler: Supposing a man who had been the whole of his time in Nyasaland were appointed to be Director of Medical Service in Nigeria, do you think that would be to the advantage of the Service?I do not think it is very likely.
2421. It is n possibility though; that is what you are contemplating?-Oh! no, the man who is in a small Colony like Nyasaland is very unlikely to jump from that to the other; he would get up gradually; he would probably have had more experience by that
time.
2422. Do you think that any officer whose whole experience had been in East Africa would be regarded favourably if he were appointed head of a Colony in West Africn ?—I think, if it wore one African Medical Service, that would be regarded with equanimity, just as it is at the present moment, if a man who has
26 January, 1920.]
MINUTES OF EVIDENCE.
Lieut.-Colonel W. T. PROUT, C.M.G.
been in Nigeria were appointed to the Gold Coast. I do not think there is so very much difference between West and East Africa; there are certain differences, of course.
Chairman: Buch appointments have been made.
2423. Sir James Fowler: Would you consider that it would be safe for this Committee to state that the climatic conditions prevailing in the West and East African Colonies, in regard to the effects upon health, do not differ to such a degree as to render the amalga- mation of the two Services inadvisable? I think I should go as far as that.
2424. Would you admit that, at present, public opinion regards West Africa as more dangerous than East Africa?-Oh yes, public opinion!
2425. Do you not think that might influence re- cruiting ?-I doubt it very much. Besides, I do not quite see why men should not be given the option; you only use the compulsion for interchange as a matter of necessity. I believe that in the Indian Medical Service they are allowed to elect where they will serve, whether they will serve in Bengal or any other place; there is a certain selection allowed to them.
Sir William Leishman: Yes, there is, or was, but the conditions of the Indian Medical Service are being changed.
2426. Sir James Fowler: You recognise that the West African Colonies are under separate Colonial Governments, whereas the East African Colonies are, to some extent, directly under the Colonial Office and the Treasury?--Oh, yes, of course, to some extent, but the administration is much the same, I think.
2427. Chairman: They are all under Governors P- They get subsidies, but I think the administration is much the same.
2428. You do not think there is much difference?-- No,
2429. Sir James Fowler: Supposing the recruiting were for the two Services jointly, that is, a man had to go into either Service as he was directed to, we should lose all those who refuse to go to West Africa? Yes, but, in the end, I should not allow them to refuse; they would have to go where they were told, but I should allow a certain amount of election.
2430. But, if you stated that as a condition, they might not become candidates? That is a matter for them, but I think you would find that candidates would elect to remain.
2431. Chairman: Would you not do na they do now for the Home, Indian, and Colonial Service, allow a candidate to put his name down for one, two ar three-Yes, that is the sort of idea.
2432. And then offer him an appointment?--Yes. my suggestion is that a certain amount of election should be allowed, but in the ultimate result he would have to go where he was told, or decline the appoint- ment.
2433. Sir James Fowler: Could your Inspector- General inspect all the Colonies of East and West Africa, if he were appointed, and you had amalgama- tion ?-He, or an assistant, would have to do it. Of course, it would be a question of length of tour.
2434. We were told, I think, that it would take 12 months to go round the posts in Uganda?--It does not necessarily follow that an Inspecting Officer would visit every post. I do not think he could anywhere in West or East Africa; it would take years to go over them all,
2435. Sir Harry Verney: I want to go through, if I may, your postulates for the homogeneous Colonial Medical Service, I do not see where we have got to. You say, first, a common portal and an equal standard of entrance. Well, we have got that?-Only in West Africa.
2436. Quite, for West Africa. Where does it differ? It differs in Jamaica, for example.
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75
2437. You mean it is recruited locally ?-It is re- cruited locally, and they take men from the States with qualifications which would not be accepted in this country.
2438. But taking those only recruited in the Colonial Office, they have an equal standard of entrance? Yes, they have an English qualification, and they have a common portal, which is the Colonial Office.
2439. That is what you mean? That is what I
mean.
2440. You could have a homogeneous Service for all those appointed by the Colonial Office as regards that first postulate of yours? They comply with that requirement, but those recruited in the Colonies do not.
2441. They comply with the first requirement?- Those appointed by the Colonial Office comply with it, the others do not.
2442, Then, the second one, with similar condi- tions of salary and surroundings?--Yes.
2443. By salary, you think £400 and £300 are similar? No, what I mean by that specially is this, that in a great many Colonies a small retaining fee is paid, £200 to £250, and the main bulk of the man's living is made up of private practice. You cannot compare that with a Service that begins at £400 to £500 and goen up by regular instalments.
2444. But you can compare that with a salary beginning at £400 or £300P-Yes, approximately. 2445. If it is round about that, approximately you could have a homogeneous Service? Yes.
2446. As regards surroundings you consider Nairobi and Lagos are near enough allied?-Yes. Take, for instance, the Falkland Islands, it would not be quite fair to take a man from the Falkland Islands, who had spent a considerable part of his life there, and put him straight away into a senior appoint- ment in West Africa.
2447. Then, your third postulate was, with similar or equivalent conditions of retirement? That now applies sufficiently to those appointed by the Colonial Office?-I am not quite sure about that. You see in some places, as far as my recollection goes (I cannot be quite certain about this), they have to contribute so much towards a pension.
2448. What I am getting at is, it seems to me there is so very little wanting on your three postulates to admit of a homogeneous Colonial Medical Service; is that your view; we are so very near it?-Excuse me, you are taking two sets of men and you are fitting those into one set of men, and leaving out the great mass of the medical men in the Crown Colonies to which these postulates would not apply. Perhaps I can illustrate it. In Jamaica they have
a retaining fee from Government of about £200 to £250 a year; but in addition they have private practice which goes up to £1,000 to £1,200. Well, a great many of these men would not join the Colonial Service because they are perfectly satisfied with the conditions under which they live. They are more or less free; they are able to live comfortably and so on. But occasionally, as they get older, they begin to feel that they would like to give p.private practice and get a bigger salary, so that they would draw a bigger pension for retirement. This actually happened. A medical man asked me if I thought ho could be transferred to the West African Medical Staff. Obviously, he wanted a senior appointment; he had been out there over 20 years or more. I said, Yes, I think you could be transferred, possibly, if you like to begin at the bottom; you quite under- stand the men out there who have borne the heat and burden of the day would object if you were put over them so then he dropped it.
2449. But is it not the case, that (your conditions-- I quite recognise are not fulfilled, when you compare British Guiana with West Africa-but if you take
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