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PUBLIC RECORD OFFICE
بليبيا
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Reference :-
885/26
PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE COPYRIGHT PHOTOGRAPH-NOT TO BE REPRODUCED PHOTOGRAPHIC-
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112
23 February, 1920.]
COLONIAL MEDICAL SERVICES COMMITTEE.
DR. Cox, Dr. Macpherson, Dr. van Someren, and Da. GOODLIFFE.
Association trusts that the Committee will report in favour of a considerable development of this Service in every colony. The matrons and sisters should be thoroughly well trained British Nurses, with a salary and prospects of pension which will induce women of that kind to accept service. They should be given plenty of help from native sources.
Staff other than Medical Officers and Nurses. 24. There is reason to believe that in many districts the native staff (other than nursing) for assisting the doctors is insufficient. The need for more ade- quate clerical assistance has frequently been men- tioned to the Association.
Leave.
25. This important question is bound up with the restoration of pre-war personnel. Until the cadre is complete there will be constant dissatisfaction in the service owing to the inability to get leave.
26. The Association has abundant evidence that the opportunities for leave are at present insufficient. Its experience in regard to the Colonial Services in previous years, and the Indian Medical Service during the past year or two, has convinced it that there can be no contentment in any foreign Ser- vice unless there are proper arrangements for local, home, and study leave.
27. The Association feels that there is no need to elaborate this point further, except to emphasise the growing importance which is attached to study leave as a factor in improving the status and efficiency of * service,
Promotion.
28. There is much discontent caused by difficulties as regards promotion, and these seem to the Asso- ciation to be inherent in Service most of the unita of which are so small. The ideal way of getting rid of these difficulties would be by the establishment of one Colonial Medical Service, but the Association realises that this is, at present at any rate, unobtainable.
29. A great deal of relief would be given by adopt- ing the grouping system ruferred to in a later para- graph. Generally speaking, the Association believes there should be more interchange of medical officers wherever possible, and that the records and capa- bilities of individual officers should be brought regu- larly before the Advisory Committee, which might do much in the way of facilitating interchange. and promotion.
30. If the Committee is not convinced of the practicability of the grouping system, the grievances connected with the lack of promotion must be met by more liberal salaries with equitable grading.
31. Incidentally the Association would suggest that the Army System should be adapted to the Medical Service, and that the Annual Confidential Report of the Principal Medical Officer should be sent to the bordinate concerned for his information and initialling.
32. Attention is called to the delay which fre- quently occurs in filling senior posts. As an example, the P.M.O. of Uganda retired in February, 1918, with one year's leave on full pay due to him. During that year the D.P.M.O. did the work of the P.A.0. without extra pay, and an 8.M.O. did the D.P.M.O.'s work. The P.M.O. finally retired in February, 1919, and the post was not filled until July. The Deputy's post was not filled until December, and apparently the vacant 8.M.O.'s post has not yet been filled, though the Governor and the Acting P.M.0. recom- mended a medical officer for the post in April, 1919. (B) PAY, PENSIONS, AND ALLOWANCES.
33. The Association fully recognises the impossi- bility of fixing any scheme which would be appro- priate to every Colonial Medical Service. It is con- vinced that the present payments are inadequate even with the war bonuses that have been granted.
[Continuand
The cost of living has mounted rapidly in practically every part of the world, and the Association is not aware of any place in which the bonus has placed the recipient even approximately in his pre-war position.
34. The Association recommends that the salaries of the Colonial Medical Officers should be revised throughout, and brought into line with those in the Army, Navy, and Indian Medical Services, and would recommend that there should be at least a 50 per cent. increase On pre-war salaries (including
emolumenta).
35. The Association wishes to point out that the granting of bonuses, welcome as they have been, has led in the case of the Colonial Services to a new hardship. The war bonus is not pensionable, and therefore an Officer who retires now and has his pension based on pre-war salary is placed in an almost impossible position.
36. In a later paragraph the Association refers to action it has taken in regard to pensions of men already retired, but it would strongly urge that steps be taken to prevent more persons being added to that aggrieved class. This grievance should be reme- died by an all round increase of salaries as above suggested. If this cannot be brought about imme- diately, war-bonuses should at once be merged into salaries.
37. The pensions would of course increase with the salaries. On this paint the Association would urge that all Colonial medical appointments filled from this country should be pensionable. It is under- stood that there aro still some few non-pensionable posts in the service. The Association is of opinion that all salaried members of a foreign medical ser- vice, on whose time the Government has the first claim, should be entitled to a pension.
38. The question of gratuities should also be placed upon a firm basis. Certain anomalies at present exist which should be got rid of. For example, in Eastern Africa, owing to the decision to postpone the operation of the gratuity principle until (at the earliest) 1921, a medical officer with Service between 12 and 18 years would receive no extra gratuity for the period he has served over 12 years, and has necessarily to serve until (at least) 1921 in order to be in a position to claim any gratuity.
39. The Association would suggest that gratuities be on the following scale: After 9 years' service, £1,000; after 12 years' service, £1,250; and for every year from 12 to 18 years' service, an additional £100 gratuity. (These amounts are stated in pre-war values. They should be increased on same scale as pensions to meet the devaluation of money.)
The pension should be capable of being claimed as a right after 18 years' servico, irrespective of age,
Existing pensions of retired Colonial Medical Officers.
40. The Association has for some time been urging upon the Colonial Office the need for increase of pensions of medical officers who have retired from the Colonial Service, in view of the greatly altered value of money resulting from the war. The Colonial Office replied that the majority of the Colonial Governments had replied to A communication ad-
dressed to them to the effect that they hoped a decision would be arrived at in the near future, but that as the decision would affect all pensioners, medical or otherwise, difficult questions of consider- able complexity were involved in the case of the less opulent coloniem.
41. The Association realises that this is a very wide-reaching and difficult question, but it comes within the purview of the Committee because the popularity of a Service depends largely upon its history. If a Service geta a reputation for behaving shabbily to the men in its service, the best men fight shy of entering it. If, on the contrary, the Service acts equitably or even generously to the men who have served it well, it can depend with confidence on a supply of the right men,
MINUTES OF EVIDENCE.
23 February, 1920.] Du. Cox, Dr. Macpherson, DR. VAN HOMEREN, AND DR. GOODLIPPE.
42. The Association would therefore be glad if the Committee could do anything to hasten the equitable settlement of this question, which is one of the deepest concern to many men who have served the Empire well, aud who have a right to expect it to help them in economic circumstances over which they have no control.
II. QUESTION AS TO ASSIMILATION OF MEDICAL SERVICES OF NEIGHBOURING COLONIES.
43. As previously stated, the Association considers that the ideal would be one general Colonial Medical Service, but as the difficulties seem at present to be insuperable, the Association would strongly recom- mend that there should be a system of grouping of the Services of Colonies working under similar con. ditions. Thus, for example, the East African, Uganda, Nyasaland, Somaliland, and Zanzibar Pro-
3383, (Chairman) What position do you hold ?{Dr. (or) I am the Medical Secretary of the British Medical Association.
3384. We have the Memorandum which your Asso- ciation prepared; I think. perhaps, it is unnecessary to take you right through it; what would you like to add to what is written here, in elaboration? do not think, Sir, there is anything particular that I should like to add. I think we have emphasised the two or three points on which we were able to be quite definito, one of which is, of course, the ever graeu question of salary. That is the point which underlies the whole Memorandum.
3385. Of course, you realise that salaries, as well as several of the other headings that you mention here. have been rendered inadequate by the War?--Yes, Sir.
3386. And the shortness of staff; that is due entiroly to the War, I should say?-Well, it is due partly to the War.
3387. Very largely to the War?-I think there would have been a scarcity of men, irrespective of the War, judging from the information we had before there was discontent.
3388. That is in the rapidly-developing Colonies principally, I suppose?-Mainly, I think, in the West Indies and in East Africa.
3389. Did you have complaints of shortage of staff in the West Indies before the War?-Inability to get leave, I suppose, mainly due to shortage of stuff. There is another point I think I ought to emphasise. and that is the great importance we attach to giving extended powers and an extended reference, to the present Advisory Committee, which we understand at present only deals with Tropical Africa. Our infor mation
that that Committee has ia
been satisfactory, ne regarde the work it has done, that members of the Service who feel themselves outside its purview at present are very anxious to come inside its purview; and we believe that the work of a Committee of that kind might be very beneficial indeed in improving the Service, and in getting rid of these minor points of discontent.
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3390. You mention that, in your opinion, you think that there ought to be more frequent visits by senior administrative and medical officers to out-stations in the Colonies?-Yes; we have had a fair number of letters, and also interviews with men who think that they are left too much on their own; they would like more intercourse with men of superior standing to themselves; they feel that it would be helpful in their work, and would enable whoever it was who did that visiting to compare circumstances in a way which could not but be beneficial to the whole Service.
3391. You say they wish to be judged by experience of their work, rather than by their written report? Yes, that is so.
3392. Then you recommend the appointment of Medical Inspectors from England to go out and travel round the Colonies?—Yes, Sir.
3393. And to report to the Colonial Office P-That ia so.
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113
[Continued.
tectorate with any adjacent territories ultimately absorbed would obviously form a suitable group.
The Association would point to the good example of what has been done in West Africa as a vindica- tion of this suggestion.
The advantages of such grouping are great, particularly as bearing on leave and promotion. Such a group would be large enough for the creation of an esprit de corps, which cannot exist in very small services.
44. The Association would advise a considerable extension of this grouping scheme; for example, there might be a West Indian Group, a Mediter- ranean Group, a West African Group, an Eset African Group, an East Asian Group; and Group of the minor colonies.
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45. The Association attaches a good deal of im- portance to this suggestion. which it hopes will receive the earnest consideration of the Committee.
3394. And to advise the Colonial Office on questions affecting the Colonial Service, I suppose?-Yes, Sir. A good many of the men would like to feel there was a Central Court of Appeal, so to speak, a Medical Court of Appeal. I do not know how far the Reference to this Committee would enable them to act in that capacity, but I have often heard men say that some of the things which they regard aa injustices ought to be capable of being brought up to some medical body at home, who would understand. and who would really act in an impartial way.
3395. Those travelling Inspectors could hardly visit more than once a year any particular place?— No, I do not suppose they could."
3396. They could hardly judge as well as the Senior Medical and Administrative Officers on the spot, who would be able to have a much more intimate know. ledge of the different Medical Officers' work?--Yes, I think that is true, but they would be able to compare much better than the men on the spot the conditions in one part of East Africa and another part or between East Africa and West Afrion.
3397. Between one Colony and another?-Between one Colony and another, yes.
3398. But hardly as regards the ability of each par- ticular Medical Officer, or his work?-I am not so sure about even that. A fresh man coming in very often would be able to size a man up, perhaps even better. At any rate, he would have an independent judgment, which we think would be very useful.
3399. They could only see each man once as against frequent intimate experience of his work by the local men? Yes. We do not place so much reliance upon the value of the Inspector, from the point of view of judging the individual, as we do upon comparing the conditions in the different Colonies.
3400. You say "the full nature of the contract made by entrants into the Service is often not "understood by them. Many members of the Service "are discontented because they now realise that the **pensions attainable are not what they thought they **would be when they entered, or because the oppor "tunities for private practice are less than they
"
expected." I was under the impression that the Colonial Office were very careful to explain the con- ditions. Have you any concrete instances to give u where people have been misled?-1 would not say misled. Sir, but I think it is a fact that in quite a number of those instances men have no written Con- tract. I agree that men are often very careless.
3401, No; they do not have a written contract?-- They do in the Army and the Navy, and I think it is a very good safeguard.
3402. They do not in the Civil Service; the Colonial Civil Service, the Administrative Services. 3403. (Sir Harry Verney) Do they have a contract In the Army?-Oh! yes, in the Army.
3404. And in the Navy?-Yes, in the Navy. I saw large numbers of them during the war.
The con- ditions are laid out and the man signs it.
3405. (Mr. Fiddian) Elaborate and detailed con. ditions? Well, it gives the main points. I would
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