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PUBLIC RECORD OFFICE, LONDON

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24 November, 1919.]

COLONIAL MEDICAL SERVICES COMMITTEE.

Mr. T, Hood, O.M.G., M.R.0.8., &c.

568. Of course, there are places there undoubtedly where children could remain for a long time?—I know people who have been to Nairobi and generally Buried one or two children.

569. I think I may any that in this office there is no false idea as to the healthiness of Nairobi.

670. Mr. Fiddian: You would put medical officers of the rank corresponding to that of Deputy Princi- pal Medical Officers, in charge of each of the four Provinces ? Yes.

571. The existing Provincial Medical Officers would have a somewhat different title, and somewhat different duties, I suppose? Yes; I should probably abolish the Provincial Medical Officer.

672. But, you would not abolish the rank?—No, we might retain the rank.

679. You might give them a different name?—Yes. Chairman: After all, in the lower ranks of the West African Medical Staff, the title of senior officer does not convey very much.

574. Mr. Fiddian: The only remedy you have to suggest for the difficulty of promoting good research men or good surgeons, or good chemical men to ad- ministration is to have specialised posts?--I think so.

575. And so far, you rather confine that to staff surgeons To begin with.

576. The staff surgeon is making a great deal in private practice?—That is true.

577. The more he makes, the better I like to hear it. 578. You still think it right to offer a special rate of pay?-Ldo to begin with.

579 Would you keep him at surgery the whole of Ar career?-I” should."

580. How does the dentist come into your arrange. ment; he is not part of the Department at all?-He is under the director.

581. He is not part of the Medical Staff?—No.

582. Do you regard the present arrangement, in that respect, satisfactory? It is very satisfactory sa far as it goes, but they want about five or six dentists for Nigeria.

The Secretary: It has been altered now; there is to be a dentist in Nigeria alone, the Gold Coast alone, and probably in Sierra Leone and Gambia.

589. Mr. Fiddian: But even one dentist for Nigeria is not a very large allowance?-No. Years ago I suggested training the natives; natives to be sent home to be trained as dentista,

584. As fully qualified dentista? Yes, but unfor- tunately the money was not available.

585. Sir James Fowler: To be trained, but not to be qualified?We have a medical practitioners and dentists Ordinance.

588. Mr. Fidian: Which must have a British qualification? There are one or two American, or ons or two others.

587. Practising unofficially? We have had to allow it because we cannot help it.

588. Have you found the effect on the staff, due to the private practice, constituting a grievance on the part of other officers with whom they come into con tact? Oh, undoubtedly it is unfortunate that it creates a lot of jealousy.

[Continued.

689. You do not see any remedy for that?—I do not see any remedy whatever.

590. Sir Harry Verney: Political officers you mean? Of all sorts.

591. Chairman: The medical officer who gets a gɛod post and the others are not doing so well?—Yes."

502. Mr. Fiddian: Would you say that, in order to meet the increased cost of living and so on, medical officers have put up their charges in private practice? -I do not think so.

699. They have not increased the contract charges, for example?—I believe they have, I know that Dr. Grey, at Lagos, who has all the contract work, has,

594. He is

a private practitioner ?—Yes, but I do not know anything else; I have never heard of it. 595. Sir Harry Verney: He is in the Government Service? No, he used to be.

596. Did he get his gratuity?—No,

597 Chairman: That is a personal matter, another man might not do so well? Yes, that is so, he is a very, very able man.

598. Did not Dr. Maples join him P--No, he did not, he is still in the Government Service.

599. Afr. Fiddian: He did join him for a time, then he was invalided from West Africa ?He came, but it was to relieve him for health reasons.

600. Sir James Fowler: Do you not see a certain difference between the Inspector-General of the West African Frontier Force and your Inspector-General as regarda autonomy of the Governor? The Inspector- General of the West African Frontier Force is an officer from the Regular Army, of high rank. He comes with all the prestige of the Regular Army behind him?—Yes.

601. He comes to inspect a service of which one of his subordinates is in "command?—Yes.

602. Mr. Fiddian: Just one question about the Inspector-General again: Surely one Inspector- General, if he inspected West Africa thoroughly, would find his time pretty fully taken up? He would; it would take certainly six months.

603. It takes the Inspector-General of the West African Frontier Force, who visite comparatively few places, only places where there is a military detachment, something like six months; indeed, it takes him more? Yes.

804. October to May?-I do not say any Inspector- General of the Medical Department should go through all the various outlandish stations where transporta are not available. To go to Sokoto, unless you happen to go with the Governor, is an enormous job. 606. By motor? We went by motor-car, and it took a day and a half; they swept the roads, and all the sand was swept off.

608. That is when you went with the Governor ?— Yes; anyone else it takes about a month to go.

607. Chairman: If you had an Inspector-General, do you think an annual visit would be necessary, or bi-annual? Well, I think a bi-annual, if you had an Inspector-General of East and West Africa,

608. One year the East, and one year the West?— One year the East, and ous year the West.

(Adjourned.)

8 December, 1919.]

MINUTES OF EVIDENCE.

MR. A. CoOKE.

THIRD DAY

8th December, 1919.

PERSENT:

SIR WALTER EGERTON, K.C.M.G. (Chairman).

Lieutenant-Colonel S HARRY VERNEY,

Bart., D.8.0.

Surgeon Rear-Admiral Sıx HUMPHRY D. ROLLESTON, K.C.B., M.D., F.R.C.P.

[Continued.

19

Lieutenant-Colonel SIR JAMES KINGSTON FOWLER, K.C.V.O., C.M.G., M.D., D.Sc., F.R.C.P., R.A.M.C, (T.), MR. T: HOOD, C.M.G., M.R.C.S., L.R.C.P. Ma. A. FIDDIAN.

MR. J. E. W. FLOOD (Secretary).

Mr. A. Cours (Assistant Private Secretary to the Secretary of State for the Colonies), called in and

examined.

609, Chairman: You are Assistant Private Secre tary to the Secretary of State?—Yes, sir.

610. Your evidence is chiefly required in regard to the candidates that are offering for the Colonial

Medical Service P-Yes.

611. Are as many coming forward as are needed to All appointments now F-No, air; it is very difficult indeed to fill appointments now,

812. Can you give any reasons for that? Well, I think that the reason chiefly is that the salaries are inadequate, the salaries attached to medical appoint- meats generally.

613. Less than medical men can get latterly out of the Service?—Yes.

614. How long has this difficulty existed in getting sufficient officers?-At least since I have hold the appointment of Assistant Private Secretary, and that datos from the beginning of April.

615. There is a general scarcity, is there not; it is difficult to get medical men for any appointments? -It is difficult to get them in anything like sufficient numbers for some appointments, and impossible to get them at all for others. There is an unusual number of medical vacancies, of course chiefly due

to the war.

616. And the scarcity of medical men has a good deal to do with the war, has it not?-I should supposs

BO.

617. Other than the question of pay and allowances, are there any reasons why candidates do not like taking Colonial medical appointments? Do they tell you any reason? There is possibly the circumstance that I think a great many more officers are married now than used to be, and, of course, a number of them, besides finding the salary inadequate, being married men in some cases, are unwilling to take their wives out with them.

818. To what Colonies does that disinclination chiefly apply West Africa principally, I think, also to East Africa to some extent; the West Indies, also British Guiana and Fiji. People have been reluctant to take their families, chiefly owing to the difficulty of getting away from Fiji when they get there.

819. Does that inadequacy of pay apply to all the Colonies, or only to a certain group? I think it applies to all of them, to some of them more strongly than others.

620. Which now? The West Indies chiefly.

621. And British Guiana P-British Guiana, yes. I think there is no appointment in the West Indies in which an officer has an initial salary of more than £350 a year,

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622. In British Guiana?-In British Guiana it is £300, in British Honduras it is £350; the majority of appointments in the Leewards carry a salary of £250 only.

823. Have you formed any opinion as to how much it would be necessary to increase salaries to get candidates F-I put an absolute minimum of £400.

624. Auy Colony?-Any Colony, yes. That is, a white candidate of anything like a good class.

625. Do you include the Mediterranean Colonies- Gibraltar, Malta and Cyprus-in that?—I should do, but I have not had occasion to fill any vacancy in the Mediterranean, except one at Gibraltar, which is still vacant.

626. You cannot even filla Gibraltar vacancy P- Yes, we have been filling that vacancy. The salary offered is £480.

627. You think it is the initial salary being too low, not so much the future prospects in the Colony; or are the future prospects not sufficiently attractive? That is another point. In the smaller Colonies or groups of Colonies I think it is the lack of prospect as much, perhaps, as the inadequacy of the initial salary. In the small Colonies it often happens that there is no post to which an officer can hope to rise, except that, perhaps, of Principal Medical Officer of his group, carrying any higher salary than the one be starts at.

628. And there is no prospect of transfer to another Colony? There is a prospect. We always tell candi- dates that after a certain number of years of satis factory service they will be eligible for promotion and transfer as well, but of course that is rather in- definite.

629. Do candidates ask about private practice? Yes, they do generally.

630. Are you able to give them any general in- formation P-I am able to tell them whether they are permitted to engage in it or not.

691. But not what the practice is likely to be worth P-In some cases we can tell them roughly; *we can tell them that it is not estimated to be worth very much, or sometimes we can tell them that there is practically none at all. In a few cases, chiefly the West Indies, the Governor has usually given us on estimate in figures, about £400 a year, for instance, for medical officer in the Leeward Islands. That is, in some cases, not in every case,

682. On the question of leave, are there any com- plaints about that?-No, I have not had any com- plaints about that. Candidates are usually very well Batisfied with the leave conditions; in the medical staff they are usually agreeably surprised to find they get leave as often as they do.

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