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22 December, 1919.]
COLONIAL MEDICAL SERVICES COMMITTER.
Mr. CECIT. CLEMENTI, Q.M.G.
1446. Sir James Fowler: Reverting to the condi- tions in Hong Kong, where there was, on the one side European Service and on the other side a Chinese Service, were the Chinese Medical Officers efficient from a European point of view, or were they, so to speak, administering Chinese medicine?—They were administering Chinese medicine according to the prac- tice of China.
1447. Because there are many Chinese who are highly qualified!-There are many Chinese doctors qualified by training in Europe; but the Chinese side of the Tung Wa Hospital is served by Chinese doctors who have not had European training.
1448. None of them ?-None of them.
1449. They were wholly Chinese trained ?—Yes; but they were not in the Government Service; they were private practitioners.
1450. In a Government Hospital?—No, the Tung Wa Hospital is not a Government Hospital; it is a hospital maintained entirely by Chinese.
1451. Previous to the war, had the men who had been sent out from home been satisfactory as Medical Officers-Yes, I think so.
1452. As far as you have been able to judge, do you think there have been any opportunities for a Research Institute, or for research in medicine, or the allied sciencies in British Guiana ?-I should think it is an excellent place for research in tropical diseases.
1453. Is there anything of the kind done now?— The international branch of the Rockefeller Institute has made research to some extent in ankylostomiasis; and Dr. Samborn came out during my time for re- search work on pellagra.
1454. Sir Harry Verney: For improving the condi tions of Medical Officers in British Guiana one of the points you mentioned was in regard to pensions; in what way are the pensions dissimilar to those in other colonies, besides the way you mentioned P--The chief difference is the one I mentioned. I think the scale is the same, for each year's service, but there are two scales, the o'der scale was that has been reduced to .
1455. In the case you mentioned, if you yourself, for instance, are here seven months instead of six months, you lose one month from pension? That is so. 1456. The only way to alter that is by the Com- bined Court?-An Ordinance will have to be passed by the Court of Policy: but the Combined Court, in the first instance, will have to be invited to pass a resolution approving of the change.
1467. Do you assume, if that were brought in, they would turn it down?-Very probably; they have in the past.
1458. Is there anything that the Colonial Office or this Committee could do?-A recommendation urging adoption of the model pension law would be valuable
1459. Draw the attention of the Combined Court to it? If it were pointed out to the Combined Court that recruitments for the Medical Service of British Guiana would be prejudicially affected unless the conditions of service in British Guians were at least as favourable as in other Colonies, the elected members might reverse their decision, especially as the Colony is short of Medical Officers to-day.
1460. The Combined Court is rather in favour of local recruitment --They cannot even
get local rearuita now, they are at the end of their tether.
1481. Sir Harry Verney: Supposing it were decided that £500 was necessary to get a good Medical Officer, would that be the best course ?--Yes; the best course would be to inform the Combined Court that qualified doctors cannot be obtained for less.
1462. Supposing it had passed, would it be possible for the Combined Court subsequently to reduce the salary?-Yoo.
1483. During the tenure of a particular Medical Officer --Theoretically the Combined Court could do that.
(Chairman): They have done it in the case of the Governor; not in my case, but in the case of my predecessor.
[Continued,
1464. Sir Harry Verney: Is not that general; any- one who thinks of the conditions in British Guiana knows before he goes P-He could find out by inquiry. 1465. Assuming you had an assimilated Medical Service for the whole of the West Indian Colonies, are there any special conditions that ought to be made in regard to the transfer of an officer from one to another is there any hardship now?—I do not think it would be right to transfer a doctor from Trinidad to Demerara unless he knew something about public health and sanitation.
1466. But, taking the transfers generally from one Colony to another, is there hardship when an Officer is transferred? In your own case, was there a hard- ship when you were transferred from Hong Kong to British Guiana ?-There was the loss of a certain amount of half-pay leave that had accumulated to my credit. Also I had to bear the whole post of the transfer, which was very considerable indeed, seeing that I came from Hong Kong half round the globe to Demerага.
1407. How do you think that question of the half pay leave can be met?—I think a Colony to which a man is transferred should accept the liability for the half pay leave. The obligation would, of course, be reciprocal between colonies accepting the liability. 1468. The Combined Court might turn that down? -In such an event, yes; if suggested to them they might turn it down,
1409. (Chairman): The Colony in which the officer has earned the leave should be held responsible for the leave? That is more logical, of course.
1470. (Nir Harry Verney): And do you think the passage should be paid?—I think the pausage should certainly be paid.
1471. (Sir James Fowler): Might it not be re- garded as part of his emolumenta in the Bervice, for which the Colony in which he had earned the leave should he held responsible?-The Colony in which he had earned the leave is responsible; but an officer never gets leave unless the exigencies of the Service permit, and therefore the ordinary Government Officer at the end of his service, in the usual course, forfeits considerable amount of half-pay leave; he has not had the chance of getting it, perhaps he could not afford to go on half pay and he is exceed. ingly lucky if he gets the whole of his full pay leave
even.
1472. How much leave had you on proceeding from Hong Kong to DemeraraP-I had none.
1479. (Chairman): And when you left Hong Kong, how much leave were you entitled to?—About a year. 1474. So that year you lost? I lost completely. 1475. (Sir Humphry Rolleston): Bupposing the Service were amalgamated and were one for the West Indies generally, would not the half pay be trans- ferable No; it is not transferable at all, as things stand now.
1476. No; but if the Service were amalgamated?--- No.
1427. (Chairman): It is on your record, is it not; your record of service from one Colony to another would show the leave was due to you?-Quite so, but you cannot get it, unless service exigencies permit.
1478. (Sir Harry Verney): Does not the Governor of the Colony you are going to give you leave?-Not when an officer has just taken up an appointment. There are very much harder cases than mine. Fre- quently an officer loses full pay leave which is due to him. That is distinctly hard: for he is not allowed to accumulate full pay leave beyond three months; you are allowed three months full pay leave within a period of two calendar years, and if at the end of the second calendar year, you have not taken it, you automatically lose one and a half months' full pay leave. The only satisfactory way of remedying this grievance is to allow an officer to commute his half pay leave for half that amount of full pay leave, in his discretion.
1479. (Nir Humphry Rolleston): There ia 2 Medical School in Hong Kong?—Yes.
1480. Is there in the Straits Settlements too?-1 think there is; I believe there is a College of Medi- gine in Singapore.
22 December, 1919.]
MINUTES OF EVIDENCE.
Mr. CECIL CLEMENTI, C.M.G.
think it yet
1481. Chairman: Yes; I do not grants degrees Not recognised.
1482. Not recognised degrees?-No. 1483. Sir Humphry Rolleston: There ic no Medical school in British Guiana; is there a Univer sity of any kind?-No University whatsoever. They train nurses.
all.
1484. At the Hospital?—At the Hospital, that is
1485. The establishment, you said, consisted of a surgeon-general and 30 officers ?-..Yes.
1486. 1 did not quite catch whether within those 30 officers there were included those various native officers? Yes, they are all included; they are Govern- ment Medical Officers.
1487. There is a difference between them, between the Europeans and the Natives?—No. They are taken on at the same scale.
1488. They are exactly on the same grade? Exactly the same conditions as the white men.
1489. But I suppose they are never transferred from British Guisan; they would not be sent to Trinidad, for instance?-No; at least, none have been in my time. I should not think they would be. 1490. That again is a condition, is it not, peculiar to British Guiana, having natives on the same plane as the European Medical Officer? I expect you will find the same thing in the other West Indian Colonies. I can not speak with certainty on the point.
1491. Have the coloured men the same qualification? -They have the same qualification as English doctors. 1492. They have the same degrees? They have the same English degrees.
He
1493. I do not know whether you consider you are a sufficient judge of doctors to say whether the men you have are satisfactory?-I only speak from the point of view of the Surgeon-General. reports to me whether the service of any of his Officers is not satisfactory, and whether a medical officer is, or is not, suitable for promotion in the Service.
1494. Whether white or black ?-I do not think we have had a white Doctor recruited for a considerable time now.
1495. Not for five years, not since the War, I suppose? I cannot call to mind. We tried hard to get doctors from Canada; we tried to get them from the United Kingdom, we tried India, and we tried the United States, and we could not get anyone.
1498. Because it seems, on the face of it, that the conditions of British Guiana offer no little attraction, if the men have £900?-That is a thing of the past. 1497. The private practice, is that a thing of the past P-There are still several Medical Officers in British Guians who are drawing £900 salary and are getting in addition high fees in their district for private practice, but none of the new-comers will get as much.
1498. None of the new-comers can look forward to £900 a year? The point I was making was, that it is of the utmost importance that we should really have competent Doctors in charge of an Institution, such as the Georgetown Hospital, which is a very big Hospital, and the other public Hospitals, and also the Leper Asylum, which, as the result of a recent inspection, has been found to be in a most deplorable condition. But the attractions, as regards the Medical Service, are all towards the district, and away from the Institutions. Recently we have tried to improve matters by giving any Doctor, who has charge of an Institution, a duty allowance, while he takes charge of the Institution but even so the Dis tricts are more attractive.
1499. In the case of the man who looks after the Georgetown Hospital, I should have thought that would put him in a position, if he was allowed to utilise it, of being a popular consultant?-He is not allowed any private practice. The Surgeon-General
+[Continued.
is allowed consulting practice, but the other Doctors in charge of Institutions are not. I beg your pardon, there is one exception. There is a doctor in Essequibo in charge of the Suddie Hospital, who is also allowed to take practice in the district, and that is because there are so few doctors in Essequibo; we are obliged to allow him to practise.
1500. I should have thought, on the face of it, it would have been less detrimental to a man's official position if he had been allowed to practise in George- town, than in a district?-In Georgetown there are something like 13 private Medical Practitioners. It is rare in the districts to find any private Medical Practitioners.
1501. They are allowed to, because it is an absolute necesity? Because it is an absolute necessity.
1502. I gather, generally, that the conditions of the Medical Service at present are quite unsatisfactory?— I would not say that, and also I think that the Com- bined Court will be quite willing to adopt a scale of salaries which is authoritatively pronounced by the Colonial Office to be the minimum necessary to attract capable men. I think the elected members would do that.
1503. Mr. Fiddian: Going right up to the top ?-- I think going right up to the top, but the senior posts are already filled by doctors of very long service.
1504. Sir Humphry Rolleston: You were adminis- tering the Government before you came home?—Yes.
1605. For how long?-For the last six months. 1606. Afr. Fiddian: Have you Medical Missions among the Indians?-No, no Medical Missions.
1507. Want of local knowledge, in the case of trans- ference between the Straita and Hong Kong, for instance, is an objection to a system of transfer. That would not apply in the case of Medical Officers, I imagine?-Between the Straits and Hong Kong, I daresay it would not matter so much, except that a Doctor who has practised for some time among the Chinese will get their confidence. The position of Hong Kong is very curious. The death rate and the birth rate of Hong Kong give you no idea of the state of health in the Colouy, because when a China- man is ill, he makes straight for his mother country, and similarly, when a woman is about to bear a child, she makes for her native place, as far as she can.
1508. Would that apply to u Chinaman born in Hong Kong?-Every day there are several thousand people travelling between Canton and Hong Kong. That is happening now.
The bulk of the population
in Hong Kong is not born in Hong Kong; they are Chinese coming from China, because the Chinese woman who expects to have a child prefers to go to her native place, and similarly every Chinaman who falls seriously ill tries to get out of Hong Kong.
1509. Chairman: What is the death rate of Hong Kong-I do not know.
1510. Mr. Fiddian: Suppose it were proposed to establish a Director-General or an Inspector-General of Medical Services operating from this country, what sort of attitude would you expect British Guiana to take up towards the appointment? Do you think locally. that the appointment would be popular with the natives, for instance ?--I should rather doubt it. .It might be; I do not think it would. You are sug- gesting that there should be a Director-General of Medical Services who would control the doctors of British Guiana.
1511. Yes I do not think it would do.
1512. You spoke of a duty allowance being made to any doctor who has charge of an institution; is that to compensate him for loss of private practice P--Yes.
1513. Everybody would prefer to have the duty allowance to private practice P-No.
1514. What is the duty allowance in Georgetown Hospital-I think £200.
1615. Chairman: That is what it is now ?-That is what is paid usually.
No comments yet.
Private notes are available after approval.