CO
885/26
PUBLIC RECORD OFFICE, LONDON
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COLONIAL MEDICAL SERVICES COMMITTEE.
23 February, 1920.] DR. Cox, Dr. Macpherson, Dr. van Someren, and Dr. Goodliffe.
be desirable in a single Institute?-Well, I see no more difficulty about doing that than having different departments of a University under the same roof.
3457. Have you had many complaints a to the inadequacy of leave from the point of view of dura- tion ?-Duration of the leave; no, I cannot say that I have; it has been more the difficulty of getting it at all than the question of duration.
3458. Would you agree that it is desirable that a man should have study leave at periods of five years up to a certain point?—It would be a very desirable thing.
3459. Do you not think that it is an advantage that men holding Administrative appointments should have that study leave as well; that is, that an Administrative Officer is possibly where he is more closely in touch with professional work?-Well, that in a new point; 1 am not at all sure. I am an Administrative Officer; I was in practice; 1 am not sure it would do me any good to go back to hospital. As regards my particular work, I do not think it would. I do not know how far that analogy would apply to Administrative Officers in the Service. I rather think, when they get up pretty high, they have got their time so fully occupied with things that are merely Administrative that it would be rather a waste of time to go back to their ordinary professional work again.
3460. Do you think there is a feeling in the Service that the confidential reports should be shown to the officers concerned P--I do.
3461. Do you think it is possible that, although very few men have taken the gratuities of £1,000 or £1,200, after a certain number of years, retiring on gratuities, yet that gratuity may have operated to bring them into the Service, that possible gratuity? Yes, I think it does operate that way. I am sure it does as regards the Army and the Navy, and I have no reason to think it dosa not operate in that way in the Colonial Service.
3462. So that the fact that very few have taken it would not be absolute proof that it has had no effect in bringing men into the Rervice? No, I do not think it at all. I would be very glad if someono would put that question to my two friends who are in the Service now, and you would get first-hand evidence.
3463. Do you agree that there is in the West African Medical Staff great esprit de corps?—Yes, I think it is more marked there than in any other part of the Barvice.
3464. And that it would be very desirable to pro- duce that esprit de corps in every unit of the Ser- vice? Very desirable.
3465. Therefore it follows that it would not be wise to take away the name of the West African Medical Service; at any rate, to do anything that would take away their name?-I think at present the West African Medical Staff would feel it was a grievance. I am not at all sure that, in the course of time, an African Medical Service would not be even more attractive than merely a West African; but I do not think the time has arrived when it would be wise to try that experiment.
3466. East and West in Africa are far distant from one another, are they not?-Yes, so I understand. Bir.
3467. There are large areas of Tropical Africa which neither of these Services are connected with, are there not?-At present, no. I suppose the same thing applied in India at one time, but communica- tion will improve. Of course, what we suggest here is the grouping on the Eastern and on the Western side, and we think it quite likely, in the course of time, everybody will see the advantage of having an African Service.
3468. Sir Harry Verney: I do not want to go over old ground if I can help it, but I want to ask a little more in regard to the recruiting in the Ser- vice. Sir James Fowler emphasised the question of examination, you did not give us ย very definite
[Continued.
opinion; do you think the present method of recruit- ing candidato in the right one?-Our difficulty on that has always been the fact of the Service being split up into so many small units. It is difficult to suggest a general examination, a different method of entrance, until something more is done in the way of getting larger units. We believe the larger unit is the thing to be aimed at, and that undoubtedly would affect the method of recruiting,
3469. You think the rather haphazard method of recruiting now is the best they can do under the present circumstances?—Until you get some more grouping, yes.
3470. Arising out of that, there comes the question of age.
We any candidates must be 25 years of age, and over; do you think in that way we lose a number of candidates who could come if they could come the moment that they were qualified?—I think you must undoubtedly lose some,
3471. What is the earliest age at which a man can be qualified? A man can get qualified by 21, but as a matter of fact, not many men are qualified before 22 or 23.
3472. And the average 23?-Before 23, I should say.
3473. Do we, in fact, lose a number of candidates we would get if we made the age 23, instead of 25? -I would only he guessing: I think you must lose HODIC. In the intervals, some of these young fellows who have a feeling of adventure, like most young men, they get away into the world; some get settled down.
3474. Have you any opinion as to whether 25 is too young?--I do not know the reason that made the Colonial Office fix it at 25 before.
3475. Tropical Africa was the main reason?- There, again, my friends who have had some ex- perience of the subject might any whether it has an unfavourable effect-Dr. Van Bomeren and Dr. Goodliffe. (Dr. Goodliffe): It has been held that it is very unwise for anyone to go out to a tropical climate under the age of 25. I cannot say that that has been borne out by my experience; I think it in a personal equation. Some men might go out at 21 without risk; others much older might be quite un- suitable. I think the age has not very much bearing on the question. I have certainly been told, when I was on the West Coast, that it was not wise to lot one go to the West Coast until the constitution was more or less "Bet," and I think now there is less climatic risk.
3476. Do you think we lose a good many by having the age at 25?--I think that quite possibly you may, hut I think you are gaining one advantage by men not going into the Colonial Service immediately they have graduated. viz., they may enlarge their experience by taking hospital appointments, etc., whereas, if they are taken straight from College they have had no general experience at all.
$477. Supposing we took them the moment they were qualified, and gave them some sort of retaining fee till they reached a later age?-Oh, yes, that would be much better.
3478. If finance admitted of it that would be the solution?-Yes, Sir.
3479. Have you anything to add?-(Dr. Vur. Someren): No, I have not.
3480. Then, just one point about your Inspectors. I did not quite understand who would be their head in the Colonial Office. Have you thought of that?
Of course, they will report to the Secretary of State? --(Dr. Cor): Yon
3481. But to whom, in practice, would they report to?--If we had a general service with a Director. General, he would be the man.
3482, I rather gathered you were against the Director-General; you thought it was premature?-
Yes.
3483. But you think it is not premature to have an Inspector?-Yes, I think he ought to report to the Advisory Committee.
MINUTES OF EVIDENCE.
23 February, 1920.] Dr. Cox, Dr. Macpherson, DR. van Someren, and Dr Goodliffk.
3484, You think the Inspectors should report to the Advisory Committee?-Yes, we do.
3485. You would have Inspectors going to all Colonies, not merely Tropical Africa ?-It might be advisable if you could run to a sufficient staff to have a man who would specialise on Africa, another man doing Asia, another man would take the West Indies. It would not be a good thing to have a man whose interests were too widely spread.
3486. And they would report to the Advisory Com nittee-Yes, Sir.
3487. I did not quite follow you when you said part of their time should be spent in trayelling, and part in the Colonial Office. What would they do when in the Colonial Office? They would meet the Ad- visory Committee.
3488, Do you contemplate half their time in the Colonial Office and half travelling? On page 3, paragraph 9, you say they would spend part of their time travelling and part in the Colonial Office. If they report to the Advisory Committee would they not spend perhaps a month or a couple of months here, and be ten months travelling?-I think that is possible; the main part of their work would be the travelling.
3489. Then the only other point. Sir James did not clear up about leave; it is not that leave is insufficient in duration, it is simply a question of shipping? When leave has been given normally we have had no objections to the length of leave.
3490. It is merely a temporary affair, due to lack of shipping owing to the War?-We hope so, but information we have from the West Indies in that even before the War it was very difficult to get leave at all.
3481. Chairman: Was that from the smaller colonies or larger ones?—(Dr. Marpherson) -. British Guiana and Grenada.
3492. A large and a small,
3493. Sir Harry Verney: From 1912 to 1916, even in that period? Yes, before the War.
3494, Because the Governor would not give them leave?--There were very bitter complaints from that quarter.
3485. But there are no complaints from Tropical Africa-No, I think not.
3496. It will probably be cleared up when the shipping becomes normal?—Yes, we realise that there must be difficulty now, and the men in the Service realise that too.
3497. Do you think study leave should be at full pay, half pay, or no pay?-I think when a man is on study leave he is on duty; he ought to be on full pay. Along with that, you would need some measures taken to see that he really was studying and doing the work that he was being paid for.
3498. Sir Humphry Rolleston: You paid a very high compliment to the Advisory Committee. Is it not that they do a good deal of good by being the means by which men can mention grievances or dif- ficulties? Yes. We have evidence from the men on the West African Medical Staff that they have a very high opinion of the service the Advisory Committee has been to them.
3499. I should rather put it to you that that func- tion of the Advisory Committee is very much the function of the Medical Director-General? Yes.
3500. Instead of having a number of men you would have one?-Yes,
3501. Supposing there Was Medical Director- General who carried out the functions of the Ad- visory Committee in looking after the interests of the Medical Officers, do you think he ought to be a man who has had Colonial experience, or do you think he ought to be a man who is of very consider- able distinction in the profession at home P-I think he ought to be a man who has earned his promotion from the Service itself. There are men of distinction in the Service; it ought to be possible to get men from the Service.
3502. You mention that the British Medical Asso- ciation has soon, with some regret, that men with
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West
American qualifications are going to
the
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Indies. Have you any record of that kind before the War, when
very
had considerable shortage occurred?-1 am not sure when that grievance dated. (Dr. Macpherson): It has been latterly.
3503. Bince the War, but has there been any before the War? I could not say. (Dr. Cox): During tho War.
3504. I was wondering whether it was not a War emergency P-It may have been, but the information we have is that the States are handy to get to, and among some of the natives of these islands there is likely to be a tendency, if it is not stopped, for them to go and take the American degree instead of taking British degrees.
3505. Can you give a statement as to what the Medical degrees are? They are good degrees; there has been some selection about them; so far as my information goes, only certain degrees have been recognised.
3506. Is that the first grade only that has been recognised?—I am not very sure about that, Sir.
3507. That leads to the question as to why you regret it. The first idea would be that they get some inferior medical dugree, and so you get an inferior man? No, but at present there is no reciprocity. If we cannot send people to America, why should they send people into our Colonisa ? We would have no objection to # Canadian degree. Canadians have reciprocity with us, so have the Australians, but when it comes to America, we have no reciprocity, and we do not seem any nearer to getting it.
3508. Sir James Fowler: As a War emergency ?-- No, there was no reciprocity between us and "America. An American practitioner coming over here is an unqualified practitioner.
3509. Chairman: Have you any cases of the ap- pointment of a man with American qualifications before the War?-No, Sir.
3510. It is only a War emergency?-We do not want it to go on if we can help it; we do not think it is a thing to be encouraged. We could imagine, for example, a Service which was not willing to pro- duce the money to get men from England, having Americans because they are cheaper; we do not want to encourage that.
3511, Sir Humphry Rolleston: That was merely a War emergency?-Yea, which we do not wish to he continued if it can be avoided.
3512. I think they were rather in a difficulty to get the work carried out?—Yes.
3513. With regard to the important point raised about private practice, would it be your feeling. from what you have heard, that private practice should be rather put aside as being only exceptionally available P-That would depend upon the extent to which it was possible to have independent practi. tioners to practise in the area. If there is plenty of scope for men to set up in private practice, then I think the less the Colonial Medical Service take private practice, the better; but if, as happens in many of these places, there is no such room, it seems a great pity to deprive the public of the service of these officers, and to deprive the officers of their opportunity of adding to their remuneration.
3514. That is not quite what I meant; that private practice should not be put in any way in the fore front of the inducements to the men to enter the Service?--No.
3515. Your suggestion is that men have somehow got into their heads that private practice is likely to be on the same scale as it was in the East Indies, and they are very disappointed to find that they are making £100 or perhaps £200 a year? That has not been entirely their own fault; I think they have been tacitly led to think on entering that there was rather a good thing to be made in private practice, and most of them say there is not.
3516. Chairman: That in nut peculiar to the Medical Service, I fancy; I know an instance of a lawyer going out to an appomitment; his predecessor made a very large income from private practice, but
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