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The Sanitary Department, which under the new scheme will confine its atten- tion to sanitation in the restricted sense of the term, will deal with town cleansing, housing, scavenging, conservancy, the control of certain trades, and the sanitary supervision of places of assembly such as common lodging houses, theatres etc., etc. In most up-to-date cities the head of such an organisation would be the Municipal Engineer in Panama it is the Health Officer. In Hong Kong because of the desire of certain of the Chinese to have a buffer interposed between them and the professional hygienist it is recommended that until public opinion is more educated on matters of Hygiene and Sanitation the post of "Ilead of the Sanitary Department" shall be held by a Cadet Officer who is a Chinese scholar.
There should be attached to the Sanitary Department one or more Health Officers seconded from the Medical and Sanitary Department one of whom should re- present the Director of Medical Health Services on the Sanitary Board.
The Director of Medical and Sanitary Services as the officer responsible to Government for the health of the Colony should as a statutory duty once a year and as often as he may deem it necessary make a tour of inspection and enquire into the workings of the Sanitary Department submitting his reports to Government direct. The D.M.S.S. should be at liberty to communicate direct with the Medical Officer of IIealth on matters of Public Health Interest. The D.M.S.S. should not give direct instructions to any member of the staff of the Sanitary Department.
There should be established a Public Health Advisary Board consisting of Ileads of Departments and prominent non-officials whose duties would be to consider all matters of public health importance and to advise Government on matters of policy. The Chairman should be the Hon. Colonial Secretary and the Vice-Chairman the Director of Medical and Sanitary Services.
In the Federated Malay States such Boards have proved their worth over and over again in evaluating schemes, in promoting harmonious co-operation between de- partments and in stimulating energy,
THE MEDICAL AND HEALTH DEPARTMENT.
In order to avoid confusion in the future the title of Director of Medical and Sanitary Services should be changed to that of Director of Medical and Health Ser- vices.
The Medical and Health Department should have at its head the Director of Medical and Health Services so that the activities of the Department investigative. preventive, and curative, shall be under one administrative head as is the case in all modern health organisations. With one professional head there is:-
(a) Simplicity of control and assurance of proper co-ordination and co-
operation between the branches concerned.
(b) Simplicity of correspondence with consequent clarity and despatch. (c) Promptness of action especially in emergency.
(d) Economy in that there is no duplication of personnel, machinery
or équipment.
The Medical Department should consist of :-
(a) The Headquarters Staff.
(b) The Medical Branch
(c) The Investigation and Research Branch.
(d) The Health Branch.
(e) The Veterinary Branch.
The Headquarters Staff should include :—
The Director of Medical and Health Services. The Deputy Director of Medical and Health Services. A Secretary to the Medical and Health Department.
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The Investigative and Research Branch should include:-
The Government Bacteriologist.
The Asst. Bacteriologist who should be called Pathologist. The Malariologist who should be also Medical Entomologist. The Government Analyst
The Asst. Government Analyst.
The Medical or Curative Branch should include:-
A Chief Medical Officer.
A Senior Surgeon.
A Senior Physician.
A Senior Obstetric Officer.
A Radiologist. An Opthalmologist.
An Anaethetist.
A Dental Surgeon,
7 Medical Officers.
The Health or Preventive Branch should include :-
A Chief Health Officer.
Two Port Health Officers.
Ten District Health Officers.
Three Lady Medical Officers.
A Health Officer for Social Hygiene. A Propaganda Officer.
The Veterinary Branch should include:--
The Government Veterinary Surgeon
The Assistant Government Veterinary Surgeon.
Supernumeraries to the extent of 20% are necessary to allow for sickness and leave vacancies.
In addition to the above there will need be Assistant Investigative Officers. Medical Officers and Health Officers, Sanitary Inspectors, Meat and Food Inspectors, Veterinary Inspectors and Technical Assistants to the staff of the Laboratories
The Country should be divided up into Health Districts of a size convenient for the supervision of a District Health Officer who would be responsible inside his District for --
1. Registration of Births and Deaths.
2. Maternity and Child Welfare and the supervision of Midwives.
3. School Medical Work
4. Propaganda and House Visiting.
5. Work under the Sale of Food and Drugs Ordinance.
6. Work under the Factories and Workshops Ordinance.
7. Work under the Quarantine and Prevention of Diseases Ordinance
including the Disinfection of infected premises.
8. The collection and delivery of dumped bodigs.
9. Anti-mosquito Work
The Health Districts should be as follows:-
1. Victoria East (comprising present Health Districts 1, 1A, 2, 2A, and
Shaukiwan having an estimated population of 100,000.
2. Victoria Central (present Health Districts 3, 4, & 5) with a popula-
tion of 90,000.
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