CO885-(23-24) — Page 494

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23 PUBLIC RECORD OFFICE, LONDON

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made the

MR. READ: I think that is a point we might settle now, and I would suggest

SIR T. ROBINSON: I think you would get a better choice if you appointment a temporary one.

three years.

CHAIRMAN: I suppose the medical service in Queensland would not be a good guide, because all your salaries are on a higher scale, and that would apply to Australia generally.

SIR T. ROBINSON: Yes.

MR. WICKLIFFE ROSE: On that point I may say the Commission has rather established the method of doing everything by the year. I am elected every year, and every person connected with the Service is elected every year, and yet it never occurs to us; it is more like an indefinite appointment, although, as a matter of fact, we are elected formally every year and our budgets are made for a year. You understand we are not starting this work in any Colony with any If you take a Colony like thought of its closing, I should say, in five years. Grenada, for example, with 66,000 people, we are going to have that population examined microscopically, and to treat those found infected with intestinal para- sites, and to try to do it in an educational way. That cannot be done in a year. They think perhaps it can be It will take a good long period of time to do that. done in five years, but I do not know whether it can or not.

CHAIRMAN: What length of appointment do you make in the Philippines for medical work?

Of course in our MR. WICKLIFFE ROSE: I think I could not answer that. public health service (and many of those men in the Philippines are in the public health service) it is for life.

MR. READ: Would you suggest, Mr. Rose, that these doctors should be appointed from year to year? There might be difficulties in this way; a man would say, “Yes, I would willingly go out for a year," and the danger is that he would go away at the end of the year, and you would have to start again with a new man.

MR. WICKLIFFE ROSE: That point came up in Grenada, and the Governor there seemed to think it would be necessary to have some understanding with those men for a longer period of time, and on the basis of our arrangement with them he would not hesitate to make such an understanding with them assuming the responsibility. Our own men in the States are appointed every year, but as I say, I suppose it never occurs to them that their election does take place.

CHAIRMAN: They are nearer home for one thing; if you asked a man to go out to a distant Colony he would expect a longer service.

MR. WICKLIFFE ROSE: If you would like me to take that up with the Com- mission I will be very glad.

MR. READ: Yes. With us it is a very common thing to appoint men for three years; you have a firm agreement with them to serve for two years and six months, and to get six months' leave at the end of it, making the three years altogether. Of course there is an advantage in that because you have have a hold over the man; if he goes away before his time he forfeits his passage, and has to pay back Of course if you what has been paid for his conveyance to the Colony, and so on. had them simply from year to year, just as the man was beginning to learn his work he might go away, and you would have to start with a new man and start the whole thing over again.

MR. WICKLIFFE ROSE: There is another side to that which would be worth guarding, I think it extremely important that the man at the head of the Service, or the Governor, or the local authorities in each Colony, should find it not difficult I think it is quite as important to be able to to eliminate ineffective material. eliminate ineffective material, when it shows it is ineffective, as it is to get good material to begin with.

MR. READ: Yes, we have provision for that, and under our agreements a man who is not satisfactory can be got rid of.

SIR HENRY MCCALLUM: It is exactly the same as with a railway; the railway hands have engagements for three years with the option of staying for another two; it keeps them out five years any way if necessary.

MR. READ: Yes.

SIR T. ROBINSON: If this campaign is to take a period of five years would it be worth while making the period two-and-a-half years, so that we might get two men with the necessary training, say, with a change in the middle of the time, or would it be better to have a three years' engagement, with the two years additional in case of need?

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SIR HENRY MCCALLUM: I can only speak for my own Colony, and I think the three and two would meet them best there. Mr. Read, with his experience of the office, would know better as to the other Colonies.

DR. SHIPLEY: I think it is extremely speculative to think of any very definite We do not know the condi- period of time in which you can clear the worms out. tions of infection; we do not really know how long the larvæ live in the soil, accurately, at any rate, we do not know how long they might live. I think we had better engage those gentlemen for three years, and if necessary for another three years, and if necessary for another. I think we shall be fighting this disease for years and years and years, just as we have been fighting phthisis.

MR. READ: I should think a firm period of three years would be, on the whole, best, and we have various precedents for that. Nearly all the Sleeping Sickness Commissions have been appointed for definite periods of three years, and that is considered a reasonable period within which you can get reliable information.

SIR T. ROBINSON: You could get a better choice of men every three years with the possibility of their being retained for five?

MR. READ: I think so.

DR. SHIPLEY: I do not think we can forcibly detain them. SIR T. ROBINSON: Some men might elect to stay.

MR. WICKLIFFE ROSE: I think by the Committee selecting men this work might be worth while; this Commission is going into a big bit of work. While it is now confining itself to this one disease, the whole field of preventive medicine is before it, and we do not know what may develop in the future, and the men who go into this service who show first-rate abilities will have larger opportunities open to them.

CHAIRMAN: After this general discussion are we in a position to come to any distinct conclusion on any particular point on which our opinion is desired?

THE SECRETARY: Information is desired as to the adequacy of these estimates which have been prepared.

The

CHAIRMAN: Have you anything else to say about these estimates? question of the work has been discussed, and the amount of remuneration.

MR. WICKLIFFE ROSE: I have stated to the Colonial Office that, as far as the Commission is concerned, if they find it necessary to increase the remuneration in these estimates, they will be free to do so.

SIR HENRY MCCALLUM: You mean for the West Indies only.

MR. WICKLIFFE ROSE: Yes, those budgets were made by people on the basis of the local conditions. Now there are certain local conditions which the Commission would not like to interfere with in any way. You will understand those conditions, but as far as the Commission is concerned we are not at all disposed to tie your hands by these estimates.

DR. SHIPLEY: I suppose, for instance, in Grenada, where they want a young man trained in the School of Tropical Medicine, who is to be a competent bacteri- ologist, they do not really mean a bacteriologist, do they?

MR. WICKLIFFE ROSE: I would imagine what they have in mind is a man who, while doing this thing, would be able to recognize any other tropical things which might present themselves.

PROFESSOR HALDANE: It is a pathologist, I think.

DR. SHIPLEY: It is a pathologist they mean. In one other place it is mentioned, or suggested, that they must be trained either in London or Liverpool, but the greatest authority on ankylostomiasis is at Oxford. I do not think it is necessary really to confine ourselves to the two Schools of London and Liverpool.

PROFESSOR HALDANE: I think they want thoroughly competent men with a good all-round training in pathology. The Army medical men, for instance, would be very good with that sort of training, and, of course, the man at Cambridge, Mr. NuttalÏ. THE SECRETARY: Possibly Dr. Shipley could tell us whether that estimate for equipment is sufficient. Those estimates differ in material particulars as to the cost of equipment.

DR. SHIPLEY: Microscopes are rather high.

PROFESSOR HALDANE: Microscopes are very expensive; you want a very special kind of microscope.

DR. SHIPLEY: You want too much for the microscope.

MR. READ: Mr. Rose told us that you could get very good microscopes in the States for something like £10. After all, you do not want a very perfect instru- ment for this purpose, do you?