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24 November, 1919.]

COLONIAL MEDICAL SERVICES COMMITTEE.

Mr. T. HOOD, C.M.G., M.R.C.S., &c.

appointments in the hospital, they havo very much increased. That is because they could not get the men otherwise.

480. Their paying more takes away recruits from the African Bervice-The junior appointments in the hospital do not extend over more than a year or two, and it should not have made any great differ-

ence.

481. What does a man look to after that; private practice, or hospital appointments? Yes, I think Quite a number of West African men have done hospital appointments; they generally take them more for experience, I think.

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482. Do you approve of gratuities?—No, I do not. You mean the £1,000 gratuity?

183. Yea!--Yes; I do not think that ought to be altered, except that it ought to be made more liberal --not the £1,000, but I think the gratuity ought to come into force earlier.

484. That a man should be able to retire with a gratuity earlier. It is nine years now?-It is nine years now, but I think it would attract a lot of men if the gratuity, or a reduced gratuity, were available, say, after five years.

485. Having caught the man in that way, do you think that many men would take tho gratuity after five years? I think they would; I think a man fights shy of taking a gratuity after nine years.

488. After five years you think he would take it? -I think some men would.

487. Would it not be disadvantageous to the Gov- ernment? To a certain extent it would, but at tho same time I think it would increase the number of recruits

488. Which class of man do you think the more likely to take the gratuity; the good man? I am afraid the good man would, but even then you would fow get a larger percentage of good men for a years.

489. How about leave?-I think the leave is very liberal.

490. Do you think it could be reduced?--I would not like to be the one to suggest it.

491. It would make you unpopular, you mean?— It would, very.

492. But independently of that? I think, on the wholo, the leave is-I am speaking after having had advantage of it-rather too liberal.

493. Do you think that longer tours could be served without any deterioration of service?—I think that the Governors ought to have more power with regard to granting leave. I think some men ought to go on leave, say, after eight months, and, the other hand, some men could do eighteen months without any great hardship.

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494. You would give the man who did eighteen months longer leave?-I think I would give it him proportionately, but I do not think I would give it him at the rate of ten days a month, because I think after four months', leave in England becomes very boring to most people.

495. If a man did only eight months he would be away a great deal, would he not?-He would.

496. There are the passages each way?-I only meant that the Governors, on the recommendation of the medical people, should be able to allow an officer home after eight months, not invalided; some men gel run down, and before a man can be sent home he has to go through all the formalities of being invalided.

497. Is the Medical Service generally contented? --I think they are very contented, except at stations where there is no private practice; that is at the bottom of most of the discontent, bar the war rate.

498. There are a very large number of stations in Nigeria where there is no private practice? That is

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499. And in West Africa generally?-I think so.

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500. The majority of the stations?-Ob, yes, the majority. That is the trouble; the private practice is so badly distributed. I am perfectly certain there is no serious discontent, certainly not in Nigeria.

601. Do you think the type of medical officer who is being recruited at present generally satisfactory? -Yes, I do; I think there is really a great improve-

ment.

502. And is the Staff up to its full numbers?—

No.

503. Why? We cannot get the men.

504. Something has to be done to get more men; or do you think it is only temporary-I think that possibly I see all the hospitals are full of students again it will rectify itself in a few years.

506. Really there are not enough medical men to go round? I am very doubtful whether there are.

506. I have just heard from British Guians that there are a large number of vacancies there. You think the present assimilation of the Medical Ser- vices of the West African Colonies an advantage, do you not?--I think it would tend to Improve the status of the West African medical staff.

507. Under the present arrangements there is a certain assimilation between them, and you think that a great advantage P-Certainly.

508. Do you think it should be carried further?- I think it would improve the status of the West African medical staff if there was a definite head appointed.

509. For the whole of West Africa ?--Yes, and possibly, later on, embodying East Africa.

510. The East and West; you think that is the end to be worked for?-I think so.

611. Would you add anything on to West and East Africa, or keep them separate-I think at the beginning I should keep them separate-I mean keep the African Colonies separate from the West Indian and others.

512. And the Eastern Colonies?-And the Eastern Colonies.

518. In East Africa do you include Zanzibar?—

Yes.

514. Do you think a similar arrangement should be attempted for other Colonies, like the West Indian Colonies and the Eastern Colonies?-I am not able to give an opinion; I have never been near the West Indies,

515. All you can say is, it has been an advantage in West Africa? It certainly has been an advantage, the creation of the West African Medical Staff.

516. It has made the Service more popular? Yes, it has begun to be better known. It is curious how very little known it is, but it is getting better known.

517. What do you think of the idea of a General Colonial Medical Service? I think the idea is right enough, but I am afraid there will be very great. difficulty in finding men to be the heads of it, who will be able to carry out any real amount of work. I think it would be rather too big.

518. If such an officer were appointed, where would you look for him, from the medical officers in England, or a man with tropical experience?-I think there would be a little objection to appointing anyone outside the Colonies, but at the same time I think that would have to be overridden to obtain the service of the best man. It would be such a unique ap- pointment that all considerations with regard to selecting a man from either the Army or the Navy or the Colonies would fall to the ground; the best man should be selected.

519. If you had a Director, would you have him always sitting in the Colonial Office, or would you have him visit the Colonies?- Personally I should favour the appointment of an Inspector-General who would be able to undertake visite the Colonies, rather than a Director-General; but I doubt whether you could get a man to go all over the world.

24 November, 1919.]

MR. T. Hood, C.M.G., M.R.C.B., &c.

520. He would have to travel by aeroplane, would he not, to get through his work P-You might get a man who would do, say, the African stationa.

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521. Have you anything else you would like to lay before the Committee --Well, really I have not. think the time has arrived when there should be Homebody at the head of West African Medical Staff to give it a higher status in the profession. At the present time the Advisory Committee is looked upou by the Staff as sort of Head of the Staff, in a way, and I think it would be an advantage to the Medical Staff if there were either a Director or an Inspector General. I should strongly recom. mend an Inspector General,

523. Then he would be out of England for the greater part of the year? For a considerable time. 523. You mean an officer like the Inspector General of the Frontier Force ?-Yes, certainly.

624. What would his functions be when at home in the Colonial Office?-His main functions would be to inspect and to report to the Advisory Com mittoe.

525. The Secretary of State, through the Advisory Committee? Through the Advisory Committee.

520. And then, as regarde appointments, recruiting and so on, would he have any duty?-He might be referred to, but, as far as I can see, the present system of promotion is quite satisfactory.

527. You would have him 24 an officer in the Colonial Office, to advise the Secretary of State on modical matters in connection with the Staff ?—Yes, and to inspect the various Colonies and see how things are going on. Improvement can only be made by men going into the various Colonies and inspecting. 628. There would hardly be enough work for him if he worked West Africa only? Well, I think at the beginning for West Africa; it might be extended Iater to East Africa.

529. Sir James Fowler: With regard to your proposed rearrangement of officers in Nigeria: The Director would continue to be the Director, but he would now direct?—Yes.

530. Should not the next person be his Deputy P

Yes.

591. Should not he be the Deputy-Director-General? -Yes, I made a mistake.

532. Then, would not the next person be the Assistant Director? That is so, yes.

639. Of whom there would be two?—Yes, 534. If they were sway, the senior Medical Officer would replace them.

535. Chairman: Would you have four officers, or three?—I thought three would be sufficient.

636. Sir James Fowler: The Director-General is replaced by his Deputy?—Yes.

537. Then, supposing one of the Assistants goes away; these would be the persons who are now called the Principal Medical Officers?—Yes.

538. You would have the person who was head of each Province?...Yes.

539. He would be the Assistant Director of Medical Services-Not necessarily; I would divide Nigeria into four provinces. It is very convenient to main- tain the three Southern provinces. I should make the whole of the Northern province into one province from a medical point of view.

640. What would you have there?—Well, one would put the senior man. The Director and the Deputy Director and the Assistant Director would not be stationed anywhere, except at headquarters.

511. Yes, I understand that; now, we have got to the provinces-For the Deputy Principal Medical Officer one would have to find another man.

542. Why not Assistant Director of Medical Ser- vices? I have not really gone into it.

543. Do you think that the fact that those titles became so well-known in the War, is against their being used now? I do not think so, for a moment.

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544. When you inspected, what did you inspect; the Hospitals-I inspected the Hospitals, and the station, and the Medical Stores.

545. They knew you were coming, I suppose?— Oh, always

546. Chairman: You cannot avoid that in Nigeria? -No.

547. You might find nobody there unless they had notice; the man might bo at the other end of his district? Yes.

548. Sir James Fowler: Do you think there is any room for a Research Department dealing with re search in bacteriology in a district?-Wall, there is at the present time, but the Director, of course, has more sense than to interfere, The Director of the Institute is a very independent man.

549. Do you think it would be possible to develop the Research Department-Well, I think it is under- staffed at the present time; I do not know whether an assistant has been appointed.

550. Do you think there are opportunities for research in the West African Medical Service?- Enormous opportunities for research.

651. Not only medical, but otherwise?-Certainly. 552. You do agree there are immense opportunities for research in the West African Colonics P---Uh,

enormous.

559. As regards examination: Do you think that a service, to which admission is obtained by exami- nation, stands higher than one where it is obtained by selection ?-Oh, I think so, yes, distinctly.

554. I imagine that most medical men would answer that as you have?—Yes.

855. Do many of the medical officers learn the Hausa language P-Practically every one of them.

556. They do now; it is a very easy language for anyone to acquire? They learn it sufficiently to get on with their patients, otherwise the medical officer is simply a veterinary surgeon, if he does not.

557. Supposing you had an inspector here who went out to these various Colonies, would he not be trench- ing to some extent on the position of the Governor; would it not to some extent affect the autonomy of each Colony?I do not think so. Sir, any more than an Inspector-General of the West African Frontier Forco affects the automony of the Governor.

559. You know that the question of the provision of an Inspector-General was discussed many years ago? -Yos.

569. You would have him inspect East Africa and Woat Africa?-I think so, yes.

560. What would he direct his attention to when he was inspecting? I think he would mainly direct his attention to bringing the less developed colonies up to the level of the more highly developed. For instance, the stations in the northern province of Nigeria, where they are less developed, are very much less developed than they are in the southern. In the South, there has been very much more money ex- ponded, but I think the time has arrived now when mnay stations in the northern provinces ought to be brought up to the level of the stations in the Bouthern.

561. Supposing you had stayed there, you would have made that your work?-Certainly,

662. Would not that be rather the work of the head of the service? Yes. I think if there were an in- spector who went out occasionally and wrote down his views on paper it would carry very much more weight.

563. Have you seen children who have been out there?--Yes.

564. Long? Yes.

565. What is your observation of them? I think it is wicked.

566. You feel very strongly about it? I do, poor timid little anemic things.

567. You have never been in East Africa?—I have never been in East Africs.

PUBLIC RECORD OFFICE, LONDON