CO885-(26N14) — Page 164

137

-

Reference :—

Co

885/26

ALLY WITHOUT PERMISSION OF THE |COPYRIGHT PHOTOGRAPH-NOT TO BE REPRODUCED PHOTOGRAPHIC-

PUBLIC RECORD OFFICE, LONDON

32

16 December, 1919.]

COLONIAL MEDICAL SERVICES COMMITTEE.

Dr. A. D. P. Hopars, O.M.G.

1045. You thought it was only for Afrios, and he naturally would be out there?—No; one proposal was, & Director-General, or some local Head of the amal- gamated Services; and another one, with which I agreed, at any rate, was, to have a Director at home, with a Council. I do not know-this is only my own opinion Director at homo, who, I suppose, would have a Council, and the question was, whether an organisation of that kind would take the place of the present, Advisory Committee.

Well, pre sonally, I do not know whether it would, but I think it is an idea very well worth going into.

1046. You said that the present Advisory Com mittee had been, in your opinion, a great deal of use? -You.

1047. Could you specify some directions in which it had been of use? Well, I think they have helped me. I cannot give you any actual specific instance, but I am quite sure that they have helped me on occasions to get things done that might have been waiting for years.

1048. You had the feeling, in fact, that there was someone at the back? That there was someone at the back.

1049. Who took an intelligent interest in these questions? Yes.

1050. You do not think that the Governors, for instance, might have taken a somewhat different view of the thing; the Governors out there might have thought that the Advisory Committee was on- trenching upon their functions? I do not know, but, so far as the Governors had a certain respect for what the Advisory Committee thought, it certainly influenced their decisions.

1051. I think you said you had never found any difficulty about private practice?I do not think I was asked that.

1052. I would ask that. Have you ever found that the question of private practice at a certain number of stations, and not at others, has made any diff- culty? As regards the medical officers?

1059. Yes. Have you ever found, for instance, people indignant that they were not stationed at these places? Well, I have not had that trouble myself.

1054. So far as you are concerned, the private practice business has worked very satisfactorily P The private practice is a very small thing in Uganda. It was just beginning to be a little more noticeable. I should not be at all surprised if difficulties did arise.

1055. Chairman: Are all medical officers there en- titled to private practice? Yes.

1056. Even the Health Officer? No, not the Health Officer; and the Principal Medical Officers never do

any.

1057. The Principal Medical Officer is entitled to consulting private practice only?—I do not think it was laid down what he was entitled to; as Principal Medical Officer he never had time to do anything of the kind.

1058. Mr. Fiddian. Still, you are of opinion that the private practice privilege should continue?—Yes, I think so.

As a matter of fact, there is no private medical man in the Protectorate, so far as I know, except two or three mission doctors, who have quite as much as they can do in their own sphere.

1059. Are there any native medical officers there?

--No.

[Continued.

1060. Any dentists?—Yes, there is one Government dentist.

1081. In Uganda alone?—In Uganda alone. 1062. He is pretty full upP-Yes, full up. 1063. A full-time appointment?—Yes.

1064. I suppose he has private practice?—Yes, he has private practice too.

1065, Sir James Fowler: He travels?—Yes, he travels.

1066. Chairman: What are his official duties that are not private practice? Well, he attends all Government officials, all Government employees, at a fixed scale laid down by the Colonial Office.

1067. Other patients he can charge what he likes to ?Yea.

1068. That is the only difference?—Yes.

1009. Mr. Fiddion: There are some classes of Government officers that he attends free?—He does some work free; all extractions are free; he gets the salary of a medical officer, but he charges for mechanical work at a fixed scale.

1070. There is a fixed scale also for his private practice, is there not?-No, I think not.

1071. Dr. Hood: What is the size of Uganda in square miles? Have you any idea?-101,199.

1072. How many medical stations are there?- About 15; there may be more now more are needed.

1079. How often can the principal medical officer inspect?-Woll, some stations he can only inspect practically once a year.

1074. He can go round the whole lot in one year? Well, I used to do all round once a year, but then there are certain stations that are fairly near, and more important, that you can go to when you require to.

1075. With regard to the languages, the native languages: Are Medical Officers encouraged to acquire a native language, or is it useless P-They aro encouraged in the same way as other officers; there is a language bonus given for so many languages.

1076. It would be no great disadvantage, supposing a man were well acquainted with the native language,

to be transferred to another Colony, would it-Of course, it is always an asset to the Colony he has been in, but I do not think it is of the first importance. I do not think that it ought to interfere with trans- fers; it is not so important as that.

1078a. If a man gets a bonus for acquiring a native language, it seems rather unfair to the Government to transfer him to another Colony, does it not?— Well, it is not a very large bonus, £25, or something like that.

1077. Sir James Fowler: £25

2.

year P-No, just

one single sum. They used to give £50 a year at one time, when it was under the Foreign Office, for certain languages; Swahili and Arabio.

1078. Mr. Fiddian: That £25 is not, peṛhaps, a vory strong inducement to learn a language? It is not a strong inducement.

1079. Chairman: Are communications good between East Africa and Uganda? How long does it take to get from Nairobi to Entebbe ?-Well, by the ordinary boat, as far as I remember, it takes five days to get down, and two to get back. The down-going steamer goes round; the other one coming back goes direct

Bcross.

(The Witness withdrew.)

Captain G. J. KEANE, D.S.O., R.A.M.C., Venereal Specialist, Uganda-called in and examined.

1080. Chairman: You are a member of the Royal Army Medical Corps P-Yes, Sir.

1081. What has been your experience of the Colonial Medical Service?

you been in it?-Since 1908.

How many years have

1089. Where have you served?--In Uganda; then, during the war, I went to German East Africa; I went to the Military again.

1083. From 1908 to 1914 you have been in Uganda? -Yes.

1084. And during the war you have been under the Military in British and German East Africa?-In British and German East Africa,

1085. Up to the outbreak of the war you were venereal specialist, were you not?—Yes, Sir.

1066. What would you say of the Medical Service in Uganda? Were the men contented ?--I did not hear much discontent before the war; during the war there was some discontent.

1087. You think that up to the outbreak of war they were contented? There seemed to be no agree. ment about it; I do not know that there had been any discussion in the Service.

1088. You talked to various men, and so on; what were the things they did not like?-Before the war I do not think I can my I heard of very much dis content.

15 December, 1919.]

MINUTES OF EVIDENCE :

Captain G, J. KEANE, D.8.0., R.A.M.C.

1089. Was there any complaint of rarity of pro- motion, or anything of that kind?—I cannot say; it was not, at any rate, a question; they did not seem to have any community of ideas about that.

1090. During the war, the cost of living went up? -The cost of living went up, and, I suppose, they met a lot of the other fellows and discussed things generally amongst themselves, and they came more. into contact with other Services.

1091, More into contact with doctors from the other Colonies?—Yes.

1092. What other Services?-The R.A.M.C., the Indian Service men and, I think, the West African Service men.

1099. Did you form any opinion as to the way in which the Medical Service might be improved, might be made more attractive?-What occurred to was that in the Service there are very few appoint- ments of any kind.

me

1094. You mean good appointments? There are very few appointments to be had. It is a very young Service. A lot of the men who are there are the first of their type, I suppose, in the country. They have only just begun to make appointments such as Medical Officers of Health; the appointment of a Sanitary Officer is comparatively recent; only a short time ago there was A certain number of Medical Officers and a Principal Medical Officer, and nothing else. It is a very young affair, and in the Service there are very few posts for the men to get. so that if a man wanted to work hard and to get on, there is very little for him, hence there is a tendency among the men to be content with just carrying on. There is very little in the Service itself; it is rather

■ dull Service; it was so, at any rate,

1095. Good work, no opportunity of recognition?— Well, nothing to be had; there are no appointments to get, S.M.O.'s, Senior Sanitary Officers are within. my own time.

1096. That might be improved by amalgamating the Uganda Service with the British East African and other Services, would it not, and having trans- for from the one to the other? Do you think it would be a good thing to make them all one Service? -If the other Services had more appointments. That, to my mind, is the great failure in the Service. 1097. And the other Services too?—I do not know that the other Services are different from Ugauda.

1098. You think there should be more well paid, senior appointments P-Yes, more things to work for, to make a man keen.

1099. Have the Medical Officers opportunities for studying out in the Colony? Well, they had time, at first there were few microscopes, but as time went on they got more, but I think they had the time.

1100. Were they encouraged to study?-Well, it did not seem to matter if you did not study, it I

may Bay RO.

1101. There is no advantage?-There was little advantage in studying,

1102. When they come home on leave, do you think they should be encouraged to study ?—I think so, Sir.

1103. To keep their knowledge up-to-dato?-Cer tainly.

1104. What inducement would you offer?--I think the post-graduate course for men. They should be offered the opportunity to go and take post-graduate courses, and then, if you improve the Service, if you make a greater future in the Service than exists at present, the men who do well in those courses examination, or by report, ought to have better chances of getting promotion.

at

1105. What inducement would you give them to study? I mean, would you pay their fees, or grant them extra leave, or give them a bonus on passing? -I think I should follow the procedure of 1.M.8. and the Naval Service, where they actually pay for their courses of instruction, and give then extra leave to do their post-graduate courses.

1106. Sir James Fowler: Do you think, speaking

26248

[Continued.

33

generally, a Medical Service to which admission is obtained by examination stands higher in the estima- tion of the profession than one to which admission is obtained by selection, or do you think there is nothing in it-It is a very difficult question, Sir. I think that probably some value does attach to examination for entrance, especially if there is an excess of candidates, but, on the other hand, it is not a question of whether there is an examination or not that induces men to join. I do not think they look at it from that point of view: they look at the Ser- vice, see what they can become, how soon they can etire, what is the pension scheme, and so on, more, I think, than at the entrance conditions.

1107, t'hairman: What the initial salary is, too? ....Yes, Sir.

1108. Sir James Foiler: Speaking generally, do you think that in the Colony it is better to have the Sanitary Service and the Medical Service separate or conjoint? For administrative purposes, do you mean?

1109. For the greater efficiency of sanitation would you have a separate Sanitary Service?-Separated off, as they are at present.

1110. With the Chief Medical Officer the Head of both Services or not?-Yes, under the present organ isation you have. Otherwise, no.

1111. NoP-If they were to be controlled inside the Colony the only way would be under the Principal Medical Officer. If later on you get a Sanitary Organisation for the whole of East Africa and Uganda and German East Africa then I think they might be separate, but as long as the Colony carries on its own Sanitary Service it should be under the Principal Medical Officer.

1112. Do you think that there is any scope for a separate research department or Service in East Africa? Yes, I do, Sir.

1113. You think there are considerable possibilities if there was such a Service?!-Yes, because it is an exceptional field. Uganda certainly is an exceptional field. Sleeping sickness, blackwater fever, malaria, relapsing fever, syphilis, beri-beri, and other tropical diseases. The opportunity is rather unique, I think,

for research.

1114. Do you think there is any scope for a special Bacteriological Service, that is, men who would be Heads of Laboratories? Yes. A special Service for research.

1115. A Bacteriological Service would lead up to the Research Service, that is what I have in mind? --Yes.

1116. Some men, of course, would be good for the bacteriological work and others for the research, do you agree with that?-I think if you open a Research Laboratory like you do here, like the Lister Insti- tute, you draw at once a large number of bacterio- logists, and from there you could send out bacterio logists to districts again.

1117. Supposing there were such & Research Service, would you limit it to research in medicine and the allied sciences, or would you have economic re search attached to it?—I think it would be largely a question of what money you got. It would be s very big thing to run an ordinary research alone, but if there is money available for the economic work it might, of course, be cheaper to include the economic work in the general research than to separktë them. I think it is likely it could include both.

1118. Chairman: The economic part; it might pre- vent over-lapping? Yes, they might include economic research in the general research.

1119. Sir James Fowler: Economic research might lead to economy ?—Yes.

1120, Sir Harry Verney: Would you, from your knowledge, recommend B first-rate doctor to enter the Colonial Medical Service?—I would, because I' think it will improve.

1121. When I came here you had a Principal Medical Officer and A Deputy Principal Medical Officer but no other appointment. The tendency is there is no reward being offered in any way!If you

B

剖

T