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5 January, 1920.]

COLONIAL MEDICAL SERVICES COMMITTEE.

DR. G. B. MASON, M.R.C.S., L.R.C.P., D.P.H.

had been, but officially I have only to suggest what is in the memorandum.

1937. Sir Humphry Rolleston: I see you say, in your memorandum, that study leave should be voluntary or compulsory, the Secretary of State requires-Yes.

19ss. Which is desirable; do you think that it should be compulsory that the course should be taken ?—I think it is a great advantage to the people of the Colony that these men should take these qualifications, and I think it should be com- pulsory.

1939. You leave it to the Secretary of State out of politeness?-Quito so; he pays, and he should decide what ought to be done.

1940. Mr. Fiddian: Surely the Colonial Govern. ment pays? He controls it.

1941. But he does not pay at allP-If you leave it the Colonial Government, then the Colonial Government should pay.

to

1942. Sir Humphry Rolleston: Of course, the Secretary of State could only decide on the recom- mendation made by somebody? That is what in usually done, I believe.

1948. The recommendation would be made by the senior Officer?-You; whoever is responsible, either the senior Officer or the Governor.

1944. Mr. Fiddian: You say it would be a good thing if Medical Officers were appointed to a West Indian Medical Service?—Yes.

1945. It would enable a younger man, when he Arst went out, to be put in the worst districts? Yes, if thought advisable to do so.

1948. Who would be responsible for stationing the medical men!It would depend where the vacancies

were.

1947. Supposing a plan of this kind were adopted, and the Secretary of State selected Dr. Jones for appointment to the West Indian Medical Service. You would say the Secretary of State should decide where he should go?-It would all depend on where the vacancy was.

1948. The vacancy, say, would be in Dominica; the Secretary of State would send him to Dominica; but surely the Secretary of State would not decide which district in Dominica he should go to?-No.

1949. What is the difference between that and the existing system; the Secretary of State appoints?— The existing system is, you have Medical Service for the Leeward Islands, a Medical Service for Antigua, another for St. Vincent, and another for St. Lucia. I think it might simplify matters if you put them all into one Service.

1950. I quite see it would simplify matters, but I am trying to get at the practical advantages. That question of station does not seem to me to work out quite on these lines; it does not seem to me that your scheme would make it very different from the existing one. When you first went out, it was left to the Colonial Government?-Tes, and it should be. 1951. So, from that point of view, there is no great advantage in changing the system?--Except from the fact of pensions and the transferring of men from one Colony to another.

1952. That is another aspect of the ease. Do you think all the Colonies could stand an initial salary of £500 year for a Medical Officer?-I could not

bay.

1959. There is a certain number of Medical Officers who are native to the West Indies; they practically never come home to this country?-I do not think so they have to come home to get better qualifi- cation,

1954. But that is after they have been appointed Medical Officers, surely; there is a certain number of coloured Medical Officers P---Coloured Medica Officers get districts after they are qualified.

1955. They do not come here to qualify? Why? 1956. They do not in practice? They must come over here originally to get their qualification.

1957. But after their appointment? Do they

not?

Chairman: Why should they?

1958. Mr. Fiddian: They are domiciled in the West Indies? Surely they have to come over here to get a British qualification.

1989. Chairman: That is before; after they have entered the Service; after they have got their

[Continued.

British qualification, as a matter of fact, they do not often come to England-Perhaps it is that these people do not like the climate.

1980. No, their home is over there?-My home is over there.

1961. But then you are white, and you like com. ing amongst white people?—No, I do not; I would like to get back out there to-morrow if I could. I like the life. I have a good many friends here but, personally, I like the life over there.

1962. Mr. Fiddian: Is there not some danger of coloured medical men undercutting under your scheme by putting up with less salary than a Euro- pean sent from this country?--It all depends on what class of man the Government want out there.

1963. There is a certain number of Woat Indiana? -I am a West Indian.

1964. There is a certain number of black West Indiana with British medical qualifications; they will be content with much less salary if appointed as Government Medical Officers? You

they

mean

could live on less than a white man could live!

Yes, I think so?-Not all of them.

1965. A certain number of them could? If the Government like those sort of people.

1966. There are some poor Governments in the West Indies. A poor Government faced with the alter- native of appointing a man from Europe at £500 year with expensive passages, or appointing a black man from the West Indies at much less salary and no passage? Of course, they will all savo the passage.

1987. The whole of your scheme will be under- mined by that? Not necessarily; it would all de- pend on the Government. If you start with a mini- mum, that minimum is there; it is a fixed minimum, if you make it £800 or £400, whatever you make it, there is a fred minimum. If I were the Governor of the Colony and there was a man in the place with British qualification, I would not charge the Colony with a passage from England, if the man was suitable.

1968. You would take the black man P-If he were suitable.

1969. If he were willing to take £800, there would be a strong temptation to give itP-I would bave a minimum, and any," Here is a fixed minimum."

1970. If the Colony could not pay that fixed minimum?-Yon would settle what the minimum was. 1971. But you would have to settle the minimum according to what the poorest Colony could pay, and, at present, I think that is only £250?-I think it ought to be more.

1972. That is what the poorest Colony can afford to pay? Can they get the men?

1978. They cannot? Then you are driven to employ men who go to the United States. They come out with a United States qualification, and they practise in Colonies where they say only men of British qualifications can practise, which is contrary to the

law.

1974. I think that is so?--It has been done in the Leeward Islands, I know.

1975. In your Memorandum you say, "A model West Indian Medical Act should be drawn up by the Colonial Office, and sent out to the West Indies with instructions to the Colonies to amend their local Acta, and bring them into line with the model Act a was done with the Quarantine Acts."

Do you remember how the Quarantine Acts were originally remodelled in the West Indies-I have not got the details, but I was told out there that the model was sent from here.

1976. To a certain extent that is true, but it w very misleading. What happened was that an officer specially selected by the Local Government Board went out there; a Quarantine Conference was held at which all the West Indian Colonies were repre- sented, and the model was drawn up there at that Conference by agreement That is the best way to do it.

1977. You think much A Medical Act might be drawn up in the same way?-I think the precedent of the Quarantine Conference should be followed, as you have told me.

1978. How does the Medical Act some into this; the Medical Act zettles who shall be allowed to prac

6 January, 1920.]

MINUTES OF EVIDENCE.

DR. O. B. MASON, M.B.C.S., L.E.C.P., D.P.II.

tise in the Colony-It does a great many other things.

1979. It has nothing direct to do with the Medical Service? It has a great deal to do with the Medical Service. It defines the districts and states the duties of the Medical Officers, and settles the fees in some

CB506.

1980. I have here the Leeward Islands Medical Consolidation Act, 1915P-That has been passed since my time.

1981. It is consolidating Act. That is the Medical Aut of the Leeward Islands to consolidate and amend the laws relating to medical practitioners and the sale of poisons. I have looked through the Act very carefully, and I cannot find anything here? -Have you looked at the Antigua Ordinance and the Dominica Ordinance?

1982. You mentioned the Leeward Islands? Yes. In my time the Leeward Islands Medical Act only consisted of about six lines. That is 1915. Then, there was the Antigua Ordinance, the Dominica Ordinance, and the St. Kitts Ordinance.

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1083. They are rather different? If you looked at them, they state the duties of the Medical Officer, defining the district, settle the fees, and various other things, which, mind you, are quite in cordance; the Colonies and the conditions varied.

1984. You want a West Indian Medical Act to define not only the duties of the Medical Officers, but their districts, and to settle the fees? Not at all.

1985. What are you to do with this model West Indian Act! You send out a skeleton Act in regard to the Medical Service, stating that the pay should be so and so, and the duties are to take charge of the district. You leave them there to arrange for each Colony. They have now different Acts; it is quite different, and if it is possible to bring them into line-I do not know whether it is or whether it is not; I could not tell you-when they get down to it, they will be able to put one against the other, and so you find in many details they agree.

1986. In one of the paragraphs of your Memo- randum, you say the Senior Medical Officer in the Colony should be the Government Adviser in those Islands where there is not a Medical Department with The first responsible Principal Medical Officer. Senior Medical Officer; do you mean the medical man who is senior, so to speak?—Yes.

1987. The oldest practitioner in the Government Service? If he were thought advisable. Sometimes The some of the younger men are better fitted. Governor exercises his selection; he appoints a younger man.

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1988. You do not see any objection to that?—Not in the least; I think it is a very good thing.

1989. You speak of Medical Inspectors appointed for the whole of the West Indies; they would be paid from West Indian funds?—Yes; 1 do not know how they would be paid.

1990. There are several Governments in the West Indies?—I do not see how it is possible to do it.

1991. Certificate of births and deaths should be

Does compulsory.

that affect the Government Medical Service very little?--Yes.

1992. How-In some of the Colonies there is no registration of births.

1999. How is that?-E do not know.

1994. You do not think there would be any diff- culty in introducing a compulsory system?-I do not think so.

1995. Chairman: How far might a man have to go to register a birth?-He would go to the nearest post office, I suppose. I do not quite know. They have a Registrar of Births for each district.

1996. They have got it for Dominica?—I think they have.

1997. What Colony has not got registration of births?--I do not know; I am not sure about Dominica at all: I do not remember about Dominica; I do not know whether they have or whether they have not in Dominica; I thought that they had.

1998. You cannot specify any Colony where they have not got it?--Registration of births?

1999. Yes, or deaths?-No. I cannot specify. 2000. Sir James Fowler: I think you mentioned that you had been offered appointments, but they were not attractive to you? That is so.

2001. Could you tell us what they were? Well, I was asked if I would go to British Guiana as Assistant

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[Continued.

Medical Officer at £800 a year. I think I have got the letter here; or would I go to Dominica?

2002. Sir Harry Verney: When were you offered British Guiana? A few months ago. I asked what vacancies they had. They said, "There are these things; British Guiana; would you like to be con- sidered for them-British Guiana and Dominica?" So I said, I did not wish to be considered for them.

2003. Mr. Fiddian: British Guiana was £300, ris- ing to £500, was it not? I think so, yes; something like that, but I had to go as Assistant to a Hospital, and the Dominica one was in an outlying district. which I know very well. I had an experience in Dominica that I did not want to repeat.

2004. Sir James Fowler: These are all the appoint- ments you have been offered? These are all, I think, recently. After I resigned, I asked for an appoint- ment. Thoy said, will you go back to St. Vincent. They asked me to go to St. Vincent; they wanted me to go to a Leeward District; I said I could not inke that on. (Lefter handed in.) I sent in a state- ment of the salary I received whilst I was in the West Indies, but I do not suppose that is of any importance. That is when I asked for Antigua, as I knew Antigua; that is the salary I had whilst I was in the Weat Indies. (Paper handed in.)

2006. Your salary averaged about £350 P....... No. What you see there: £500 the first one, then tha £300 one.

"I

2008. Dr. Hood: You never had an appointment ut £500 a year?—No; it was made up with private practice. I think it was £250 Government pay, then there were some places where I had private practice.

2007. Bir Humphry Rolleston: You said: ared enough to do three months at the London School of Tropical Medicine and take the certifiente." You had not to pay for the course? I did not pay the fees for the course, but I had to live in London, and I had to support the wife, too, and I had to đó Drums to get the money to do it.

2008. Sir James Fowler: How long would it take a Medical Inspector to visit the whole of the West Indies. where inspection was desirable or necessary ?...-- It would all depend how long he was going to devote to euch Island. Some Islands are bigger than others. 2009. Assuming that he inspected efficiently, could you give a suggestion as to how long it would take; would it take a year?-A good year, I should think

2010. More than a year?—I think he should be able to do it in a year, or less.

2011. Possibly less than a year?. He might be able to do it in nine months. It would all depend how long he stayed in each Colony, and what he wanted to investigate, or what he was asked to investigate.

2012. Have you soon any opportunities for research in the islands, to which you have been attached, which might be utilised; research in medicine and the allied sciences? The only possibility for research is at the hospitals; in the districts you have no oppor- tunities of doing so.

2019. Are the hospitals well equipped?- Well, so far as I could see, I thought they wore.

2014. Have they got clinical laboratories attached to them? No; all of them have not. St. Vincent has not.

2015. Are the operating rooms up-to-date, so to speak? - From what I recollect of them, the operating roons were quite suitable for the Colony; they would not be like the operating rooms over here.

2016. Is there much surgical work there? Not very much, except accidents; that is usually done at the hospitala.

2017. Have all the Medical Officers microscopes?— They have not; they cannot afford to buy them."

2018. They are not supplied with microscopes by the Government? The Government supplies one for the hospital. If a man wants anything done with microscopic work, he goes up to the hospital and has it done there, or gets the man in charge of the micro scope to do it there.

2019. There in an allowance for drugs. How does the Medical Officer obtain the drugs he requires? What I used to do was to order them from the drug people over hero.

2020. And then, in what you call your practice, you had to supply all the drugs?--Yes, I used to send over here for them.

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