3
115
PUBLIC RECORD OFFICE
Reference :-
C.O.885
7
PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
2
2
As regards 2. The idea of sending our men to Netley was mooted three years ago, when Sir W. Mackinnon was at the head of the Army Medical Department. He proposed a three months' course as being necessary and squaring with the arrange- ments at Netley, but it was considered that there were difficulties in the way of keeping men at Netley for so long a period, the chief difficulty being, that, when a doctor is wanted, he is wanted to go out quickly, or, at any rate, without very long delay. was also urged that, if that difficulty was got over, we had to face the possibility of having no vacancy for some time, and of being saddled with a man for whom we were bound to provide; that, moreover, the expense to the Colony of a three months' course
short. prove would be a considerable item, if the officer's career should
I think, though, that these difficulties might be overcome,
It
In the first place, however, Dr. Manson does not consider Netley to be well suited for our officials. He says that they would not see sufficient variety of tropical diseases, particularly of the diseases of natives, that they would be lost in the crowd of other students and feel themselves aliens and interlopers.
He thinks that the Seamen's Hospital at Greenwich is a much more suitable place. Netley has one great advantage, at present, in being able to accommodate a large num- ber of students, but Dr. Manson says that the Albert Dock Branch of the Seamen's Hos- pital is going to be enlarged, and that if we decide to send our men there for instruction, he thinks that the Committee will be willing to provide accommodation for them in the new building. I do not know whether the Colonies would be required to contribute towards the provision of this additional accommodation, but Dr. Manson would be able to inform us on this point. It is very desirable that an early decision should be arrived at with regard to this matter, as the Committee are anxious to start the ex- tension of the Hospital at once.
If it is decided to make use of the Seamen's Hospital, I would suggest that we shall proceed somewhat on the following lines:
Our tropical Colonies may be roughly divided into the-
(a) West African,
(b) The Eastern,
(c) The West Indian.
The conditions of medical service in each of these groups are different, and it would probably be safer not to attempt to draw up a comprehensive scheme for all three, but to proceed gradually.
Group (a) is that in which reform is most urgently required, and it would be well to concentrate all efforts, at first, in this direction.
I would suggest-
(a) That there should be one Medical Service for our four West African Colonies, the three Foreign Office Protectorates (Niger Coast Protectorate, East Africa Protec- torate, and the British Central Africa Protectorate), and the Royal Niger Company, the rates of pay being assimilated, as far as possible, and the eight services being con- sidered as one for seniority purposes.
(b) That we should form a reserve of doctors who had attended a course of lectures on tropical diseases and had gone through a three months' course of instruction at the Seamen's Hospital; it being understood that they would have first claim to any vacancies which might occur.
With regard to (a) there seems to be little doubt that the East African Protecio- rates are, on the whole, healthier than our possessions in West Africa. During the year 1896, the Foreign Office only appointed one doctor to their East African Pro- tectorates, while we appointed 10 to our four West African Colonies (though it must, of course, be remembered that some of these 10 appointments were new ones and that 10:1 cannot therefore be taken as the ratio of unhealthiness of the two coasts). One advantage, then, of the proposed arrangement will be that officers who are unable to stand the West Coast any longer will have a chance of transfer to the East Coast, and, vice versa, officers who have been on the East Coast will have been acclimatized and probably be better able to stand the West Coast than a man sent direct from this Country, as at present. I believe that Dr. Manson concurs in this view.
Another advantage will be that, by creating a larger service there will be greater certainty in providing posts for the doctors forming the reserve when they have finished their course of instruction at the Seamen's Hospital.
At present the medical appointments in the various Colonies and Protectorates for which Europeans* are eligible, are as follows:-
GAMBIA
1 Colonial Surgeon, £400
SIERRA LEONE
GOLD COAST
LAGOB
NIGER COAST
TECTORATE.
...
1
Assistant Colonial Surgeon, £300.
..
1 Colonial Surgeon, £500 ...
1
I'RO-
EAST AFRICAN PRO-
TECTORATE.
BRITISH CENTRAL
AFRICA.
ROYAL NIGER COM-
PANY.
1
Chief Medical Officer, £800 to £1,000.
2 First
Colonial Surgeons, £500
to £600.
Assistant Colonial Surgeon, £300 to £3.0.
1 Colonial Surgeon,
£600 to £700.
24 Assistant Colonial
Surgeons, £350 to
£500.
Senior
Assistant
Colonial Surgeon,
Grade
Assistant
1 Chief Medical Officer, £800
to £1,000.
I
£400 to £500.
7 Assistant Colonial Surgeons,
£350 to £400.
14
District Medical
Officers, £350 £500.
to
5
Medical Officers,
£300.
1 Principal Medical Officer,
£1,000.
1 Medical Officer, £500
7 Medical Officers, £350 to £450.
1 'rincipal Medical Officer, 4 Medical Officers, £320 £490 (subject to increase). (subject to increase).
This takes no account of the European doctors who are employed on special work of a temporary nature, e.g., in connection with railways, the operations in the interior for securing our territory, etc., but trained doctors should, of course, be appointed in these cases.
There are, therefore, 74 permanent medical appointments in the eight British possessions in Africa.
During the year April 1896-April 1897, about twelve doctors were appointed to permanent posts in these eight possessions, to say nothing of the doctors employed on temporary work. There ought, therefore, to be no difficulty in finding a post for a man who has been trained at the Seamen's Hospital, within a reasonable time after the completion of his course.
With regard to (6), I think that we should adopt a plan somewhat of this kind:- (1) Lists of candidates should be made up twice a year, instead of only once a year as at present. Under the present arrangement the list soon gets exhausted; men find other occupation, and drop off for one reason or another during the year.
(2) Out of the first list, I would take the six best men and tell them that if they will go to the Seamen's Hospital for three or four months, we will give them the allowances granted by the India Office to their men when they send them to Netley, viz., 8s. a day and quarters, or, if quarters are not provided, the usual fuel and light allowances of a I would subaltern, and will guarantee them a post during the course of the year. not send all these men to the Seamen's Hospital at once, but at intervals, sending two at once, two at the end of the first month, and two more at the end of the second month, so that they would not finish their courses of instruction at the same time and there would be less chance of their having to wait about before a vacancy occurred. If there is no actual vacancy for them when they have finished their course, they must put in their time as best they can by taking other work, such as that of locum tenency, &c., but I think that we may safely say that, looking to the requirements of the eight Possessions, they would not have to wait long. On the other hand, a man might be urgently re- quired, and it might be absolutely necessary to send out a man before his course of instruction was complete. In that case, we could only send out the man who had been longest under training, and console ourselves with the thought that a half-trained man is better than one who is not trained at all.
1918
•There are a few other medical appointments filled by natives, and not so well paid.
A 2
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