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HONGKONG LEGISLATIVE COUNCIL
25th October, 1913.
P.C.M.O.
"I have been through the indent for drugs with Mr. Taylor and I think it has been drawn up carefully to meet our requirements. As far as I can see there does not seem to be any chance of our over-stocking nor of being short in any of the more important items." On the 11th August, 1914, shortly be fore his retirement on pension, Dr. Bell
wrote: --
Dear Dr. JOHNSON,
With reference to our conversation this morning I beg to state that I have not discussed your administration out- side the hospital nor have I stated that you have hampered the hospital work by cutting down the issue of the equip ment. I also do not consider that you have so hampered the work."-Yours truly,
(8d.) J. BELL.
Dr. Aubrey states that he can recall no instance of the shortage of a drug of any importance. He remembers that on one occasion & Sister stated that she was short of boracic powder. Dr. Aubrey did not require it. Efficient substitutes were available, and boracic powder could be bought in the Colony.
ber, 1915, and to delay by the Crown Agents in forwarding goods ordered, due to the war. Many of the shortages were not brought to the notice of Dr. Johnson; and in only one instance did Dr. John- Bon decline to allow local purchase, namely, in the case of Sodium Sulphate, which be did not consider necessary, a similar and equally efficacious medicine, namely, Magnesium Sulphate, being stock in good quantity. And it must be remembered that shortages have not made their appearance since Dr. Johnson's coming, but that they have always been of annual occurrence; and properly so, as to indent so fully that every unfore- seen need may be met in advance must I may mention lead to extravagance. that iner Dr. Johnson's arrival the amount of local purchases compares fav- ourably with those of previous years, ad indication that shortages are numerous as in former days.
not so
Dr. Koch. however, makes the point that when an article is not in stock he. or any other medical officer in charge of a case at the hospital, ought to have power to send out to purchase such article m the spot, referring the matter subsequent-
In order to sift the matter to the very bottom I have questioned all those whom I considered competent to form an opin- ion on the matter, namely, Dr. Aubrey, Honorary Consulting Physician, Mr. Digby, Honorary Consulting Surgeon of the Hospital, Dr. Koch, Superintendently to the Principal Civil Medical Oficer; of the Hospital. Mr. Pullen, the Apothe- in accordance with the practice prevail- ing prior to Dr. Johnson's arrival. I cary, and the staff of Sisters.
have asked the opinion of Exputy Sur- geon General Dreamer, and of Lieut. Colonel Crisp on this point, as they, by virtue of their position at the head of the local Naval and Military Medical Services, are best able to advise me on the working of a Government Medical Department. Surgeon-General Dreaper informs me that he has not the power. whien is vested in the Principal Civil Medical Officer, of purchasing anything that he may consider necessary, but that bis requisitions are scrutinised and pass Dr. Koch referred to shortages of varied by the authorities in England. Ne ous drugs and disinfectants occurring subordinate has any authority to order mainly in 1915 and during the present drugs without reference to him. Colone! year, attributing such shortages to reduc- Crisp reports that he must conform his tions in the indent of the autumn of 1913, requistions to a fixed, schedule, which He is of the opinion that most, if not all, schedule, I may state, contains far fewer of the shortages could have been obtained items than those stocked at the Civi As Hongkong is a foreign locally. Each item in the list supplied Hospital. by Dr Koch has been examined in detail station, Colonel Crisp may make such and his report, and that of Dr. Johnson, local purchases outside this schedule an thereon, are open to the perusal of the he may consider necessary, but he must bou. member. These reports show that submic the Hills to the Home Authoritie! the shortages were insignificant in charae- for covering approval. No subordinate ter, that they were due in part to losses has ny authority to order drugs with in the s... Yasaka Maru, sunk in Decem-out asking his prior permission.
Mr. Digby writes: "I have always been completely satisfied with the supply of drugs and stores. The extra instru- ments and apparatus I asked for have always been supplied."
HONGKONG LEGISLATIVE COUNCIL
The Apothecary in the first instance stated that there had been a shortage of various articles. Pressed for details he admitted that the shortage was in respect of articles which Dr. Johnson declined to order, as being in his opinion unneces sary. The articles could have been pur chased in the Colony, had Dr. Johnson thought it desirable to do so. The Apothecary was asked to quote all avail able instances of articles which were short at the Civil Hospital and could not be obtained locally. He named six arti cles in 1913, the only one of importance bring diphtheria serum; but in any event Dr. Bell was responsible in respect of that year. He was unable to name any article in 1914. He named three articles in 1913 for each of which there were com- pletely efficient substitutes.
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of
the 27th July last:- The requisitions for Izal from the Maternity Hospital had been steadily increasing, and I had reason to think that the medical prepara- tion was being used for ordinary sani- tary medical preparation instead the cheaper solution supplied for that purpose. I spoke to Dr. Koch about it, and he told me to limit the supply, as there was only one patient at the time who required it. I therefore stopped the supply of 4 oz. bottles pure Izal, and supplied half gallon bottles of diluted solution, Seven four oz. bottles were supplied between the 1st and 15th April, which is sufficient to produce 30 gallons solution. This evidently did not meet with Sister A's approval, as she wrote back to me asking by what authority I had done this. The matter was reported to Dr. Koch. It was not brought to your notice as I considered it too trivial. I acted on Dr. Koch's instructions."
cases
The Sisters were personally interview- ed by me on the 20th July last. Use of them stated that Dr. Johnson cut down the issues from store to such an extent
Dr. Koch states: The facts are as as to endanger the safety of patients. stated by the Apothecary. I ordered that As an example, she quoted a case of some the diluted solutions should be prepared time previously in which a strong dis- in the diapensary and supplied in what infectant was required, and she asked
ever quantity was requisitioned for. No for Izal. After the Superintendent sign-limit, of course, was placed on this. The ed the order the dispenser sent her a only point was the dilution, which I note to the effect that she could be sup-considered should be made under the plied, not with pure Izal, but only with supervision of the Apothecary and not diluted solution. In another case a left to be done haphazard." On the ques- patient was dying, champagne was re- tion of concentrated mixtures generally, quired, and, as none was in stock, his which arose out of this incident, the friends had to go out and purchase some. Apothecary reports: Similar
Another Sister stated that she had only have occurred in other parts of the bos- one forceps for removing dressings and pital with other stock mixtures, lotions, she required more. This request was etc., each floor having its own particular generally supported. No other instances concentrations. In my opinion this was of the cutting down of issues was quoted, asking for trouble,' as unless the same but it was complained that there were Sisters were always on duty on the same many new rules in connection with stores floor, mistakes were sure to arise, and which had been made by Dr. Johnson. have arisen. As far as possible all mix- In the matter of the forceps Dr. John- tures, lotions, etc., are now of a uniform son is of the opinion that the number strength, and I consider that the dis supplied was adequate, He has, how pensary is the only place in which dilu- ever, at my request issued further pairs. tions should be made, and to issue mix- With regard to the champagne incid-tures in poisonous concentrations is
practice. ent, it is admitted by the Apothecary much too dangerous a that he had instructions from Dr. John- alteration was not carried out without son that champagne in small quantity some trouble." was to be kept in stock. This order was disregarded. The question of the issue of Izal was heard of for the first time by Dr. Johnson when he was asked to report upon the complaint made by the Sister. The Apothecary reported in writing to the Principal Civil Medical Officer ou
The
Finally, I have asked Dr. Johnson for a personal statement, and he informs me that throughout the period of his resid- ence in the Colony he has on no occasion received any written or verbal protest in the matter of the cutting down of stores. In this connection Dr. Koch
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