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23 February, 1920.]

COLONIAL MEDICAL SERVICES COMMITTEE.

DR. Cox, Dr. Machherson, Dr. Van Bomerex, and Dr. GooDLIFFE,

3634. Have you ever heard the desire expressed by members of the Colonial Medical Service that there should be some sort of uniform prescribed ?—No, I have never heard it mentioned.

3635, Chairman: Dr. Goodliffe, would you like to make any remarks? You know the Terms of Reference to this Committee; perhaps you would like to say something. You are Dr. John Henry Good. liffe, I think?—(Dr. Goodliffe): Yes, sir.

3636. Uganda Government Medical Service?—Yes, Sir.

3637. How many years have you served in the Colonial Service P-14 years.

3638. In Uganda all the while ?—Yes.

3639. Do you think the Service is contented now? --No, sir.

3640. What are the reasons for its not being con tented? Well, I think the smallness of the salary has been the chief reason for discontent.

3641. Is that since the outbreak of the War; since the increase in the cost of living owing to the War? --Not altogether that, Bir; the initial salary was sufficient, but we find in a small colony, where pro- motion is very slow, that after you get to the maxi- mum there is nothing further. For instance, to give my own case; I went out there in 1905, and I reached the maximum, £500, in 1909.

3642. You were on a scale of £100 to £500?-£400 to £500.

3643. And in how many years did you reach your maximum?--I reached my maximum in 1909. Since 1909 till last year I have had no increase of salary at all, and I consider that after 14 years' service 1 ought to be more valuable than after five years' service.

3644. Your not getting your increase was due to the absence of vacancies, I suppose P-Yes; due to the absence of vacancies for promotion.

3643. Last year did you get promotion?-No, sir, I have not got promotion, but last year the Secretary of State agreed that we should have an increment of salary..

3646. On what grade are you now, then?-I am at £600, and the War Bonus of £95.

3647. Mr.

Fiddian: And duty allowance?--A duty allowance was passed by the Secretary of State, to come into force on the 1st April last, but none of us has received it.

3648. It is a question of the payment being in arrear? When I applied for it out there, they did not seem to realise that it had been approved.

3649. Chairman: The pay is generally considered to be inadequate?- (Dr. Gondlife): Yes.

3650. Promotion is too slow P-Promotion is too slow.

3651. Are there other causes of discontent?-I think the main discontent has really arisen from the War. For instance, I have had to do six years out there without any leave, and my health has broken down in consequence; and a great many others have done far more than 30 months, which is our usual term, and we ought to be recompensed for that.

3652. How old were you when you joined the Ber- vice? Thirty-three, Sir.

3653. At what age do you think it would be best to recruit officers? Well, personally, I am rather against taking a man immediately from college into the Colonial Service. I think he very possibly will gain a good deal of experience in other posts and branches which he will not get in the Colonial Service, And therefore he will be better equipped. For instance, hospital appointments: I think a

man is much better, after he has graduated, to hold hospital appointments, and even in general practice one can learn a great deal in a year or two's general practice one could not learn otherwise. Take, for instance, gynecology: You get very little experience of that in the Colonial Service, and yet you get a few cases. If you have a few years' general practice, where you get a considerable amount of that, you gain experience which you cannot gain either in college or in the Colonial Service.

that

[Continued.

3654. How long after a man passes his examina. tions and gets qualified would you send him out to a colony-It is rather a difficult question. I think 25 is quite early enough, but I do not think one should make a strict rule.

3655. Between 25 and 30 P-Yes, Sir. But there is another great question which comes in there, that at present in our Service there is a premium on going in late, because we cannot get our pension until we are 50. The consequence is, if you go in at 26 you have to do 25 years' service before you can claim your pension, unless you are invalided. In West Africa, I believe, they are allowed to claim their pension after 18 years' service, irrespective of age.

3656. And you would like a similar regulation in East Africa Yes. (Dr. Coa): Yes. We want to preas that very strongly, Sir; it is in our Memo- randum.

3657. What are your views on study leave? Do you think a man should be compelled to study when he comes home on leave?—Dr. Goodliffe: I think there there are certain courses which he should take up. Of course, the Tropical School of Medicine that goes without saying; that is before we go out~and possibly in venereal disease, and post-graduate courses. Per- sonally I have always put in study each time I have come home, and I think it is a great benefit. I think we might be helped in that direction by possibly extending our leave, if necessary, if the time of the classes does not happen to suit the time of our leave. and possibly certain allowances in the way of extra expense. It is an extra expense for us. I have to come and live up in town to attend these classes.

3658. Does your Government give any assistance to you towards study leave? The Uganda Government?

3659. Yes?-I,think not, Sir.

3660. You have had no assistance yourself? No. Dr. Van Someren: There is an allowance of 5s, a day, plus 2s. 6d. for lodgings.

3661. You have never applied for that?-Dr. Good liffe: I did not know that was from the local Govaru- ment; I thought it was from a home arrangement,

Mr. Fiddian: It has to come from the local Govern- ment itself; the Colonial Office have not any funds.

3662. Chairman: Any other points?—I think tho gratuities allowed on the West Coast should apply to the East Coast; in fact, all the advantages that the West Coast have in the way of allowances should apply to the East Coast. There are gratuities, and there is the fact that they are allowed to retire after 18 years, and that their minimum pension is £365. I may mention that, although I have put in 14 yenṛa' service, I shall probably have to retire from ill-health this year, and my pension will be about £200, which I cannot possibly live on in these times.

3663. Do you think the assimilation of the various Medical Services of East Africa into one Service like the West African Medical Staff would be popular with the Medical Staff in East Africa ?-Personally, I do not think it would in East Africa, because I have spoken to some of the members there, and they appear to think that the small Colonica, such as Uganda, have a good many men who have had more years' seniority than they, and have not reached promotion, and that therefore they will get promotion in East Africa, and they are rather anxious that their senior appointments should go to their own men.

3664. It would be popular with Uganda, and not with East Africa?—That is my impression, from the members 1 have spokeń to, Bir. (Dr. Cor); Might I say, Bir, on that point, that, of course, in putting this up we have taken the whole case into considera- tion? We know there will be these difficulties and anomalies, but we advise the Committee to take this step because of the ultimate good to the Service,

3665. Sir James Fowler: How long leave have yon got now?-Dr. (Hoodliffe: 202 days full leave on full pay, and 202 days on what we call return leave, that is to say, if I go back I got 404 days, if I do not go back I get 202 days. That is after nearly six years,

3666. Supposing the War had not occurred, how many days would you have been entitled to over that

23 February, 1920.]

MINUTES OF EVIDENCE.

DR. Cox, Dr. Macpherson, DR. VAN SOMEREs, and Dr. GooDLIFFE.

period that has been covered by the War?-If I came home after--

3667. In the ordinary way, after an ordinary tour? ---An ordinary tour is 30 months. We get three days for each month's duty there, and three days' return leave if we are going back.

3668. Chairman: Yes, six days; that is one-fifth of your service?—One-sixth, Bir.

3669. Bix days in a month is one fifth?—Yes. 3670. Five years' service, one year's leave; that is what it comes to P-Yes.

3671, Mr. Fiddian; You seem to think that the East Coast medical man should enjoy the same advan- tages as the West Coast medical man?-As regarda gratuities and pension; I do not say at the same scale; the same ratio after the same length of service.

3672. The same ratio? I do not quite know what that means? Well, 1 mean the same proportion. For instance, the West Coast Service have a duty allow- ance in addition to their salary. I suggest we should get it.

3673. The rate of duty allowance that you get is the same as the rest of the East African Service?-We got no duty allowance at all, Sir, until the increased cale was passed last year. We have not got it now.

3674. It is in process of coming. You do not recog nise any difference between West Africa and East Africa From the point of view of health; in East Africa and Uganda, West Const medical men all absolutely refuse to stay. We have had men from West Africa.

3675. Did they give any reason?-From the point of view of health.

3676. Do you happen to know the statistics with regard to health ?—I have seen them worked out. One

set that I saw was greatly in favour of East Africa and Uganda, and the other greatly in favour of the West Coast.

3677, The West Coast for health?-From the point of view of salary; in favour of giving higher pay.

3678. I was thinking of death and invaliding in East Africa generally, as compared with West Africa. Does not that constitute some reason for the difference in pay and allowances?--I think there is no very great difference in the incidence of sickness in the two countries. I think, if you took our worst station, there would not be much between that and the worst station on the West Coast.

3679. Possibly; but taking the average. You cannot really regulate the pay of the Service from its worst station, can you ?-No.

3680. Dr. Hood: You say it is a matter of discon tent that men on the West Coast are allowed to retire after 18 years' service?-No; I say it is a matter of discontent that men on the East Coast are not allowed to retire after 18 years service.

3681. You do not think it will lesson the discontent in Uganda when they know that in West Africa they are not to be allowed to retire until they are 50P- I cannot imagine that the men in Uganda would be so small-minded as that.

3682, Chairman: Dr. Van Someren, do you wish to say anything?-Dr. Van Someren: I think Dr. Good- liffe has covered most of the points; but I certainly would like to emphasise the point that the East African Medical Service would like to see the 18 year rule brought in on our side.

3683. To be allowed to retire after 18 years' service, with a pension?—Yes.

3684. You are a Senior Medical Officer in the Uganda Protectorate?-Yes, Sir.

3685. How long service have you had there?-I went out with Dr. Goodliffe, in 1905,

3686. What is your present salary P-I am on the new scale of £700,

3687. Fixed salary?-Fixed salary, with a War Bonus attached to that of £90,

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[Continued.

3688. And duty allowance?-I have not got any of the duty allowance yet, Sir.

3689. You know it has been granted, but you have not got it yet?-No.

3690. Mr. Fiddian: Do you suggest that at the Colonial Office you did not understand the prospects of private practice P-Dr. Goudliffe: In Ugauda there is absolutely no private practice at all, except at two stations.

3681. What were you given to understand at the Colonial Office?-Simply that there was private practice.

3682. That wna all?—And that you were allowed to do what private practice you could, provided it did not interfere with your Government work.

3693. Did you understand the prospects of private practice when you went out?—(Dr. Van Someren): I went out for sleeping sickness work.

3694. Is there any private practice?—Might I just any one thing in regard to what Dr. Cox was saying about leave? The point is not so much the long leave as the local leave. We are supposed, under the Regulations, to get about 14 days a year. Well, medical men practically never get that. There is never anyone to relieve us.

3695. (Chairman): There is nobody to do your work P-No.

3696. So you cannot get the leave?-You cannot get the leave.

3697. I am afraid I suffered like that in my early service? In the administration they have generally junior men attached to senior men; I had no junior medical officer under me.

3698. Was that before the War, too!--Yes, Sir. 3699. Of course, since the War, you have been much shorter still of officers ?—Yes.

3700. (Mr. Fiddian): Do you suggest that there is a junior man always with the senior man?—No, I do not suggest that.

men

com-

3701. Giving senior appointments to paratively junior for leave, long periods of leave?— Yea. Men in that position could not get local leave? —No, not under present circumstances at all.

3702. (Sir James Fowler): Do you think there are opportunities for research work P-(Dr. Goodliffe): In Uganda ?

3703. Yes? Very great.

3704. But they necessarily have not been utilised during the WarP-(Dr. Van Someren): No; I do not think there has been anything done during the War. 3705. But there are great opportunities for research there? Well, there are opportunities, but facilities.

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3706. (Sir Humphry Rolleston): Did you make any facilities yourself; did you manage to ?-As regards smallpox; I worked on smallpox chiefly. I do not know what work one could have made. I was collect- ing statistics; that is about all I could do. There has been no means of getting good lymph.

3707. That was on your own initiative, was it?- Yes.

3708. What I wanted to get at was, how far a man could, on his own initiative, start research ?-I do not think he could do very much at all, bocause the equipment of the hospital is not complete. For in. stance, I wanted to ascertain the malarial carriers in my district, but I could not get a dissecting iniero- scope. The only microscope I had was my own, which was unsuitable for the purpose.

3709. (Sir James Fowler): Are the officers in the Uganda Service provided with microscopes at the Government expense P-In some stations they are, Sir.

3710. Are those efficient microscopes P-Those that I have had were efficient.

3711. Have you got a 1/12th ?--Yes, (Chairman): Thank you.

(The Witness withdrew.)

(Adjourned till Monday next, 1st March, 1920, at 3 p.m.)

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