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PUBLIC RECORD OFFICE. LONDON
I BE REPRODUCED PHOTOGRAPHIC- ALLY WITHOUT PERMISSION OF THE
72
26 January, 1920.)
COLONIAL MEDICAL SERVICES COMMITTEE.
Lieut.-Colonel W. T. PRour, C.M.G.
NINTH DAY.
Monday, 26th January, 1920.
PRESENT:
SIR WALTER EGERTONK.C.M.G. (Chairman)
LIEUTENANT-COLONEL
BART., D.8.0. SURGEON REAR-ADMIRAL SIE HUMPHRY D.
ROLLESTON, K.G.B., M.D., F.R.C.P. MAJOR-GENERAL. BIR W. B. LEISHMAN, K.C.M.G., C.B., M.B., F.R.C.P., F.R.S., K.H.P., A.M.S.
SIR HARRY VERNEY,
[Continued,
KINGSTON
LIEUTENANT-COLONEL BIR JAMES
FOWLER, K.C.V.O., C.M.G., M.D., D.8o., F.R.C.P., R.A.M.C. (T.).
Ma. T HOOD, C.M.G., M.R.C.8., L.R.C.P. MR. A. FIDDIAN.
Mr. J. E. W. FLOOD (Secretary).
Lieutenant-Colonel W. T. PROUT, C.M.G., called in and examined.
2343. Chairman: You were formerly Principal Medical Officer in Sierra Leone, I think? Yes, that in right.
2344. And you are now Medical Adviser to the Colonial Office?—Yes.
•
2345. What length of service did you have in West Africa P-Just over 18 years.
2346. You retired, I think, before the various Medical Services of the Colonies were assimilated; before the West African Medical Staff was formed?- I do not think so; I think it was formed just before I left,
2347. Were you an advocate for its formation ?- Yes, very much so.
2348. And you think it has been successful?—Yes, I do, on the whole.
2349. Have you anything that you would like to say about the Government Medical Service; how it could be improved and made more popular?--Do you mean in West Africa, or generally ?
2350. Yes, in West Africa and generally ?-I do not think that the conditions, so far as West Africa is concerned, can be improved to any great extent, except in matters of detail, of course, and remunern- tion, as the question of supply and demand arises, or na the increased coat of living, may require. Apart from that, I think the organisation in West Africa is fairly satisfactory. I should like to add that owing to my having been on Military Service for nearly five years, I have got somewhat out of touch with existing conditions in West Africa. So far as a General Ber- vice is concerned-I am afraid I have not had time to go into all these matters in very great detail-I should lay down, as conditions for any homogeneous Colonial Medical Service, three things: first of all a common portal and an equal standard of entrance; (2) Similar conditions of service that applies not only to salary, but to surroundings and type of people with whom you have to deal and so on; and (3) similar or equivalent conditions of retirement as regards age, pension and so on. If you have got those three to fit in, as they do in the case of the Naval Medical Service, the R.A.M.O., the I.M.B. and the West African Medical Staff, you can get a homogeneous Colonial Medical Service. If you have not, in my opinion it is impossible.
2351. The conditions in the H.A.M.C. and the Indian Medical Service are different, are they not? -Yes, but I think they fulfil those three conditions pretty well. They are different from each other.
2352. They are different from each other, yes?- But they fulfil these three conditions pretty well.
2353. Is it not equally necessary to have differences in the Colonial Medical Service?-Oh yes, it would be quite possible to have differences.
2354. I mean, the salary that would attract a person to go to Ceylon or Hong Kong would not attract him to go to West Africa?-Oh yes, that in an. You could have differences; you do not need to have actually identical scales of salary, of course, but you want them to be more or less equivalent.
2355. Then, as regards the portal, how would you recruit for a Colonial Medical Service P-I think it ought to be recruited, as it is for the Colonial West African and East African Medical Services, through the Colonial Office.
2356. That is, by selection ?-By selection, and eventually, possibly, competition, i.e., by examina- tion. I do not think the time is ripe for that though. 2357. Would you get your recruits immediately they passed their examinations, or later, as they do now I do not think that is a matter of any very great importance really.
2358. Is it not easier to get recruits when they have just qualified? You need not send them out to their work at once? Yes; but I would not lay any very great stress upon that.
2359. What would you fix as a commencing salary, when a man was first sent out to a Colony?-To any Colony ?
2360. Yes; well, say, West Africa; I suppose you would pay more for West Africa than anywhere else? -I think probably, the inducements will have to be increased shortly. On pre-war conditions, 1 think Whether the £400 a year was quite a fair salary.
that will have to be increased or not is a matter upou which I cannot speak. It is a matter that the Colonial Office will have to find out, whether medical men can be got at that rate of pay.
2361. All your experience was in West Africa ?- Oh no; I was in Mauritius for some years prior to that. I have been also in Jamaica for a short time, though not on service. I have also visited Cyprus
26 January, 1920.]
MINUTES OF EVIDENCE.
Lieut.-Colonel W. T. PROUT, C.M.G.
2362. You would not fix the same commencing salary in Mauritius as in West Africa, would you? Obi no.
2363. What would be sufficient for Mauritius?-L cannot say. The conditions in Mauritius are entirely different from West Africa; you cannot compare them.
2364. We have heard nothing about Mauritius; what are the conditions there?-There is not a service like there is in West Africa. The men are all appointed locally; they are almost all Frenchmen with the exception of the higher appointments; I do not think they are ever made from the Colonial Office. There would be a great outcry if they were. They
have comparatively small salaries, equivalent, I think, to £200 or £300 a year, but then they have large private practices, you see, which vary in different parte of the island. Then they have what may be called semi-private practices, that is, they are paid by the sugar estates to look after the coolie labour, at a rate fixed by Government, just as they are in British Guiana,
2365. Something like British Guiana ?—Yes, but the whole of the appointments are made locally of men qualified in England or qualified in Paris; a groat many qualified in Paris. I am perfectly sure that they would view with the greatest apprehension the idea of anybody outside being dumped down from another Colony. They look upon Mauritius as being a kind of close preserve.
2366. You wrote a memorandum in July, 1914, on the subject of the organisation of the Medical Service in West Africa ?--Yes.
2367. Have your views been modified at all?—No; I think that expresses pretty well my views, I still think that something in the way of a Director-General for the whole staff would be a good thing, or some Inspecting Medical Officer, one or the other.
2368. By a Director-General, do you mean as In- specting Officer?-An Inspector-General, who would not be resident there the whole time, but would co- ordinate the services in the different Colonics. He would visit and inspect them, and hear what the local authorities and the medical staffs had to say.
2369. All the Colonies under the control of the Colonial Office?—We are talking of the West African Medical Staff, to which my memorandum referred in this particular,
2970. Only the West African Medical Staff?—— Yes.
2371. Now, you have touched upon rather a biggor idea, that is, a Director-General for the whole of the Colonial Medical Service, for all the Crown Colouies under the control of the Colonial Office; you think that would be feasible I think it would be ox- tremely difficult owing to the different conditions and the amount of control which the local Governmenta have over their medical officers.
2372. He could hardly be an Inspector-General, because he could not do the travelling in the time? It would be very difficult.
2373. At present there is an Advisory Board at the Colonial Office to advise the Secretary of State. Do
you think a Director-General would be better than an Advisory Board? They would have quite different functions. There is only an Advisory Committee for tropical Africa.
2374. Would you then have an Advisory Board and a Director-General for tropical Africa?—Yes, some- thing of that kind.
2376. The two?--Yes, he would be a member of the Advisory Committee, and sit as a member when at home, and give us the benefit of his visita. It would be a great assistance.
2376. He would be very much away, would he not. if he had the whole of tropical Africa?-You, he
28248
[Continued.
73
would have to be away a good part of the year, certainly. It would be impossible to overtake the whole of the African colonies thoroughly in any one year.
2377. Do you think it would cause any disaffection with the various Governors having a Director-General at home inspecting?--You mean for Africa?
2378. Yes, for Africa?-I do not see why it should. It might conceivably do it, of course, if he was not very tactful, but I do not see why it should.
2379. What duties would you give him; what you have mentioned here?-Well, he would consult with. the Principal Medical Officer; he would inspect hospitals where he found it possible; he would go into the general question of administration; he would get in touch with the members of the staff and hear what they had to say about local conditions and
so on.
2380. Sir James Foiler: You Inid great stress on the word "homogeneous" in connection with the of proposed organisation the Colonial Medical Service? Yes.
2381. Do you think that it is impossible to have a Service that is not homogeneous?—I do not see
ít what advantage would have over present conditions.
2382. Would you agree that those members of the medical profession who are serving under the Colonial Office have an equal right to an organisation with a medical head, as those who are serving in the Army and the Navy?-If it were practicable, but they undertake to serve under different heads, the Governor and administration of a Colony.
2383. Equally a man serving in France during the war was serving under the D.D.M.S. of his Division and also under the Director-General in France, but still there was another head, and he was in London P Yes, but they were all concerned with one thing, the carrying on of the war. It is hardly analogons to the administration of different Colonies with all kinds of different conditions and races, is it?
2384. Apart from the war, every medical officer of the R.A.M.C. has two masters, in a way, has he not? If he is serving in a Division or at a Base, he has the D.D.M.8. of the Division or Base, and above him is the Director-General?-Oh! yes, that is so.
2385. Is not that a fair analogy?-I do not think it is; they are officers of one homogeneous service.
2386. While he is serving in Nigeria, he is under the Head of his Department in Nigeria?—Yes,
2387. Why has he not the right to have, at the head of his Service, at the Colonial Office, a medical man? Well, I have said that I think it could be done. in West Africa, or West and East Africa.
2388. I am speaking of the whole of the Services?-- Because the conditions in the other Colonies are absolutely different from what they are in West Africa.
2389. Such an officer would have to deal with men serving in every Colony, all over the world? I do not see why there should not be someone who would supervise perhaps even that is very difficult, if you think of the different conditions but who yould be a sort of head of all the Medica! Departments.
2390. But you do not feel strongly that there should be such a person ?-I cannot feel that it is practi- cable; that is my difficulty. The ideal, I think, is the right one. I agree with you absolutely. My impres sion is that some years ago I put forward exactly the same thing at a meeting; but when I went into it. I came to the conclusion that it was impracticable. When you take Colonies such as Jamaica, the Falk. land Islands, Fiji, Mauritius, Cyprus, Ceylon, Hong Kong, it is difficult to see how any system can be devised which would allow of anything like the same conditions of service.
K
157
PUBLIC RECORD OFFICE
TPELLI
Reference :-
885/26
PUBLIC RECORD OFFICE, LONDON ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
COPYRIGHT PHOTOGRAPH-NOT TO
the
MINUTES OF EVIDENCE.
Lieut.-Colonel W. T. PROUT, C.M.G.
same commencing
eat Africa, would you P
Bcient for Mauritius?-L
in Mauritius are entirely * you cannot compare
thing about Mauritius, e? There is not a service ica.
The men are all Imost all Frenchmen with appointments; I do not from the Colonial Office. tery if they were. They aries, equivalent, I think, ut then they have large which vary in different they have what may be s, that is, they are paid.
after the coolie labour, ment, just as they are in
itish Guiana? Yes, but eats are made locally of
or qualified in Paris; a ris. I am perfectly sure the greatest apprehension being dumped down from upon Mauritius as being
andum in July, 1914. on on of the Medical Service
en modified at all?-No;
ty well my views. I still
way of a Director-General
e a good thing, or some one or the other.
ral, do you mean an In- ctor-General, who would hole time, but would co- different Colonies. He em, and hear what the edical staffs had to say.
nder the control of the king of the West African ly memorandum referred
frican Medical Staff?—
hed upon rather a bigger 1eral for the whole of the or all the Crown Colonies Colonial Office; you think
think it would be ex-
• different conditions and
ch the local Governmenta
:ers.
an Inspector-General, travelling in the time?--
an Advisory Board at the
⚫ Secretary of State.
Do
i would be better than
would have quite different
1 Advisory Committee for
e an Advisory Board and sical Africa ?-Yes, some-
would be a member of ad ait as a member when benefit of his visite. It
nuch away, would he not, ropical Africa ?--You, he
157
73
[Continued.
would have to be away a good part of the year, certainly. It would be impossible to overtake the whole of the African colonies thoroughly in any one
year.
2377. Do you think it would cause any disaffection with the various Governors having a Director-General
at home inspecting?--You mean for Africa?
2378. Yes, for Africa ?-I do not see why it abould.
It might conceivably do it, of course, if he was not very tactful, but I do not see why it should.
2379. What duties would you give him; what you have mentioned here?-Well, he would consult with the Principal Medical Officer; he would inspect hospitals where he found it possible; he would go into the general question of administration; he would get in touch with the members of the staff and hear what they had to say about local conditions and
so on.
2380. Sir James Fowler: You laid great stress on the word homogeneous " in connection with the proposed organisation of the Colonial Medical Service? Yes.
2381. Do you think that it is impossible to have
a Bervice that is not homogeneous?—I do not ses what
would advantage it
have conditions.
over present
the
2382. Would you agree that those members of the medical profession who are serving under the Colonial Office have an equal right to an organisation with a medical head, as those who are serving in Army and the Navy ? If it were practicable, but they undertake to serve under different heads, the Governor and administration of a Colony.
2383. Equally a man serving in France during the war was serving under the D.D.M.8. of his Division and also under the Director-General in France, but still there was another head, and he was in London? -Yes, but they were all concerned with one thing, the carrying on of the war. It is hardly analogona to the administration of different Colonies with all kinds of different conditions and races, is it?
2384. Apart from the war, every medical officer
of the R.A.M.C. has two masters, in a way, has he
not? If he is serving in a Division or at a Base, he has the D.D.M.S. of the Division or Base, and above him is the Director-General?-Oh yes, that is so.
2385. Is not that a fair analogy ?-I do not think it is; they are officers of one homogeneous service.
2386. While he is serving in Nigeria, he is under the Hoad of bis Department in Nigeria?-Yes.
2387. Why has he not the right to have, at the head of his Service, at the Colonial Office, a medical man? Well, I have said that I think it could be done in West Africa, or West and East Africa.
2388. 1 am speaking of the whole of the Services ?-- Because the conditions in the other Colonies are absolutely different from what they are in West Africa.
2389, Buch an officer would have to deal with men serving in every Colony, all over the world? I do not see why there should not be someone who would supervise perhaps even that is very difficult, if you think of the different conditions-but who would be a sort of head of all the Medical Departments.
2390. But you do not feel strongly that there should
be such a person?-I cannot feel that it is practi- cable; that is my difficulty. The ideal, I think, is the right one. I agree with you absolutely. My impres sion is that some years ago I put forward exactly the same thing at a meeting; but when I went into it. I came to the conclusion that it was impracticable. When you take Colonies such as Jamaica, the Falk- land Islands, Fiji, Mauritius, Cyprus, Ceylon, Hong Kong, it is difficult to see how any system can be devised which would allow of anything like the same conditions of service.
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