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PUBLIC RECORD OFFICE, LONDON

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

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22 December, 1919.]

COLONIAL MEDICAL SERVICES COMMITTEE.

Dr. E. I ANGLRY-HUNT, C.M.G.

1378. For a simple extraction?-For extracting a tooth he charged me £4.

1874. Did he give you gas?-He gave me what he called "painless extraction," but I would much rather have had the pain instead of what I got.

1975. He has to be a dentist registered in England? We have the Dental Practitioners' Registration Act in force there, which only permita English qualified dentista to practise. There is a loophole for American dentists; they cannot practise as registered dentists, but they are allowed to practise. The man who is doing the most work out there is an American, a very good man indeed; his income is considerably more than that of the Governor.

As

1878. Dr. Hood: Is the qualification of the Ceylon Medical College quite a good one?-Quite good. everyone recognises, the native is a most marvellous man to work up his knowledge of a subject. They may break down badly over their practical work, but theoretically their standard is exceptionally high. Consequently we try to get all the men we can absorb into the Department and put them in the Government hospitals, under supervision, before we send them out to districts, in order that they may learn their practical work.

1977. Chairman: They do learn it They do. 1878. Dr. Hood: Are the locally qualified men in the Service recognised like they are in the Indian Service --No. The Ceylon Medical Department con- sists of over 90 per cent. of locally recruited men. We have not a great number, but we have provincial surgeons. He may be a locally recruited officer who has worked up from a lower grade of the same De. partment. The Department is divided into first, second and third grades. A locally recruited man can get into the second grade, but he cannot get further until he has the home qualification; he has to come home and get an English qualification.

1979. If the Ceylon qualification is as good as the English qualification, what is the object of that?- I think the qualification policy was that they should work up. We had a school there, and the Governor thought, very wisely, that men trained in England would make good demonstrators In the school our demonstrators and lecturers are fellows of the Royal College, and they give the students every opportunity of going home. Now the Government afford every facility for them to go home and to continue their work.

[Continued.

home and give them free training in the Tropical School.

1381. And salary whilst they are training?-I would not be quite certain about that. I think they do get salary, or half salary—I am not sure whether it is not full salary; I could not say definitely.

1382. Are these officers entitled to go to England?—

No.

1389. They are on different leave ronditions? They are on different leave conditions.

1384. Dr. Hood: They only get local leave?—They only get local leave.

1385. Do you think, from your experience of the Gold Coast, that a similar curriculum might be started on the West Coast of Africa ? Do you think that a College could be established on the West Coast to produce men of the same class P-I do not see where you are to recruit your students from. A large number of our students are the sons of doctors and landed proprietors who have married European wives and speak English fluently.

1386. A good many come home to get an English training-As lawyers and doctors, yes, but I do not think the Gold Coast is sufficiently big for that.

1387. Not in the whole Colony At least, I do not think so.

1898, Chairman: There is a much smaller educated class in West Africa -Yes, much smaller.

1989. Dr. Hood: You do not think these Tamils or Burghers would be of any use on the West Coast ?-- No, I do not think so.

1890, Chairman: You are talking of West Africa? I cannot now speak about West Africa; we have no native medical officers out there, with a few exceptions.

1391. You say there are 50 estate hospitals in Ceylon P-There are 92 hospitals all run by the natives. 1392. And 50 estate hospitals P-Those are hospitals run by the Europeans.

A

1399. Are not these hospitals run for the good of the estates-No; there are one or two instances.

1394. In many instances do they maintain hospital-Yes, I think there are about 800 estates.

1395. In British Guians, where there are sugar estates, every estate is bound to have a hospital?- In Ceylon we make provision for the estate coolie by having estate hospitals to which all the estatea send their coolies.

1396. From miles round P-Yee.

1380. Chairman: The Government pay their pas- sages home The Government pay their passages

1997. Thank you, we are much obliged to you. (The Witness withdrew.)

MR. CECIL CLAMENTI, C.M.G. (Colonial Secretary, British Guiana), called in and examined,

1398. Chairman: You are Colonial Secretary of British Guiana ?—Yes, sir.

1999. You have been there six years? Yes, six

JOATH.

1400. Before that, you were in the Hong Kong Colonial Service ?—Yes.

1401. For how many years?-13.

1402. You have seen the Terms of Reference, I think? Yes, Mr. Flood sent them to me.

1403. Taking your Hong Kong service first, when you went there, what was the size of the Medical Service; was it a small service?--It was quite a small service. There was a Principal Civil Medical Officer, and under him were doctors in charge of the hospitals, with assistanta. There were also licentiates of the Chinese College of Medicine. One very curious feature of the Hong Kong Medical Service was an Institution called the Tung Wa Hospital, in which one side was worked according to Chinese ideas of medicine, and the other side according to European medical prac- tice, and each patient was given his choice as to which side he would go to.

1404. And is it not the fact that the percentage of deaths was higher on the European side? Yes. The reason for it is that only in articulo mortia would inost patients allow themselves to be transferred from the Chinese side to the European side.

1405. Were there any statistics kept ?-Yes. There was a considerable excess of deaths on the European side; but, as I was pointing out, the reason was that most Chinamen preferred to be treated in the first instance according to the medical practice of their own country, and that only when it was evident they were likely to die would they try the European treat. ment.

1406. There was a very small European Service?—

1407. About half a dozen ?—Yes.

Yes.

1408. And the rest were Chinese P-We had Licen. tiates of the Hong Kong College of Medicine who were regarded as doctors within the Colony; but they were not considered to be qualified men outside the Colony. 1409. Mr. Fiddian; They are now? The Hong Kong University was trying to put the matter right; whether it did so or not, I cannot say.

1410. Chairman: When was that College of Medi- cine established at Hong Kong ?-Very many years ago, before I went to the Colony; then, at the time when I left the Colony, the College was changed into the Faculty of Medicine of the Hong Kong University. 1411. Considering the condition of the Hong Kong Medical Service, do you think it could be linked up with, say, the Straits Settlements and Ceylon, and made one Service, for promotion, the one to the other? -I doubt whether anything would be gained thereby.

22 December, 1919.]

MINUTES OF EVIDENCE

Mr. CECIL, CLEMENTI, C.M.G.

Probably you know that the cadet services of Hong Kong, the Straits, the Federated Malay States sud Ceylon were linked together; there was, however, very little transfer or promotion of officers from one of these colonies to the others.

1412. Take these Chinese practitioners, if they were offered a transfer to the Straits or Ceylon, would they accept it?-To the Straits, probably, I do nut know about Ceylon.

1413. Because there are the Straite-Yes.

a number of Chinese in

1414. Will you describe the organisation of the British Guiana Medical Service P-It consists of a Surgeon-General and a staff; I cannot remember off- hand the number of it, but I should think 30 Govern- ment Medical Officers.

1415. Recruited from England P-Recruited usually from England. The Officers at the head of the Service are supposed to take charge of medical institutions, i.c., hospitals, asylums, &c., but it is difficult in prac tice to get them to take charge of institutions, because it is much more lucrative to serve in a district. Some

of the doctors in districts earned as much as £900 a year in private practice, which, added to their salary of £900 a year as Government Medical Officers. made £1,800. That is a very attractive income, and it kept them in the districta.

1416. I think there was a big initial salary offered in the British Guiana Medical Service, gradually rising on the incremental system, to £900P-Yes.

1417. That has been done away with?-That has been done away with. A revised scale of salaries has recently been laid down by resolution of the Combined Court and is now in force. But the Government recognised this year that it would be necessary again to revise that scale, because we could not expect to get junior doctors for £300 a year, which had been offered as the initial salary. When I left the Colony, there were five vacancies for Medical Officers, and a despatch had been written to the Colonial Office asking upon what terms those vacancies could be filled. When the reply is given, the Combined Court will be asked to vote the requisite salaries.

1418. You could not fill the vacancies P-No, it was quite impossible.

1419. Have you any coloured Medical Officers?- Yes, we have black doctors, we have an East Indian doctor, we have a Chinese doctor, and we have doctors of mixed race.

1420. Are they qualified medical practitioners?--- Yes.

1421. Do you know whether that is the case in the other West Indian Colonies?-That I could not say for certain.

1422. Do you think that the West Indian Colonies and British Guiana could be made all one Medical Service? I do not think it would be advantageous to British Guiana if that were done, because doctors in British Guiana, particular doctors in the districts, are required very nearly always to be cognisant of public health conditions in the Colony, and training in sanitation is likely to be even more necessary in the future.

1423. But if similar requirements were demanded in other West Indian Colonies ?-The local conditions are so very different in the other West Indian Colonies. The only inhabited part of Demerara is the coast line, which is some five feet below sea level, with wet savannahs lying to the south of it. Unless a doctor can advise coastal estates as to drainage and other measures requisite to minimise the pest of mosquitoes and as to matters of sewage disposal and pure water supply, his services are not as valuable as they might

be.

1424. With you, have Medical Officers to learn any native language?-No.

1425. The only native language there, I think, is Indian P-There are, of course, the aboriginal Indian languages; but the aborigines are not looked after by any doctor at present.

1426. How many are there P-About 20,000 abori- gines.

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[Continued.

1427. Scattered over 90,000 square miles? That is it. Apart from the aborigines, about half the adult male population is East Indian.

1428. And doctors are not required to learn any Indian language ?-No, but there is at least one East Indian doctor, or perhaps two.

1429. Are the Medical Officers generally contented; is the Service contented P-Very discontented at pre- sent, because of the increase in the cost of living. I saw a Report went home recently hy the Salaries Com- mission from British Guiana. It says that the cost of living in British Guiana has increased in conse quence of the war by about 125 per cent. Salaries, of course, have not increased; and the tendency before the war was to reduce the scale of pay of Government Medical Officers.

1430. Before the war do you think they were con- tented?-Before the war, there were no complaints from them.

1491. What alteration would you suggest to make the Service contented; simply an improvement in pay? -Housing is very important. In the districta doctors ought to be properly housed. Then, I think certainly pensions should be similar in British Guiana to those in the other West Indian Colonies.

1432. In the other West Indian Colonies?-I think Trinidad, for instance, has adopted a model pension law sent out by the Colonial Office.

1433. You think the pension conditions in British fuiana should be made similar to those in other Crown Colonies-Quite so.

1434. And leave; are leave conditions in British Guiana satisfactory-You do not get leave, that is the trouble. In my period of service it was extremely difficult for anybody to get leave.

1435. Is that owing to the war, or simply the normal condition?-Well, the Medical Service has been extremely short-handed.

difficulty of recruitment, which, I suppose, is due to 1436. A good deal owing to the war?-Owing to the

the war.

But leave and pension in British Guiana are bound up in this way, that an Officer who has more than six months half-pay leave due to him cannot take that leave without losing pension in respect of any period exceeding six months which he takes, and that works out as a distinct hardship, when you remember that several Officers have two or more years half-pay leave to their credit.

1497. Is that a condition peculiar, do you know, to British Guiana P-I think so.

1438. Was it instituted at the instance of the Secre- tary of State?-No.

1439. Locally?—Yes.

1440. Do you consider the type of Medical Officer you have been getting recently satisfactory?—Not recently, no.

1441. You do not consider the conditions of service in British Guiana could he usefully assimilated to ether West Indian Colonies, allowing a transfer to Pach other P-I think that conditions of pay, leave and pension should be assimilated, but whether Demerara would be benefited by promotion of a doctor from (say) Trinidad to British Guiana is, I think, very doubtful, because the conditions of life are very dis- similar in the two colonies.

1442. One condition of such a transfer would be tu effect a steady flow of promotion, the larger the Service the more regular the promotion would be. Have you any Medical Schools for training Medical Officers in British Guiana ?-None.

1443. Do you think it would be a good thing to have one there, or one in the West Indies to which students could be sent?--Yes, I think one in the West Indies would be extremely valuable.

1444. Where would you place it? That is a ques- tion I have not thought about.

1445. You think such a proposal would meet with favour in the Colony; do you think there is my Colony that would be likely to contribute its share of the cost? I think the proposal would probably be received with favour in British Guiana and that the Combined Court might contribute towards the cost.

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