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8. The Sanitary Board contained officials and non-officials. The Sanitary Department was composed entirely of Government servants. The former had no authority over the latter. This organisation which was completely independent of the Medical Department included within its sphere of action registration of births and deaths under a clerical staff, control of infectious diseases under a medical staff, food control including supervision of slaughter houses and markets under a veterinary staff, and sanitation and disposal of the dead under a staff of sanitary inspectors.
9. The Chinese Secretariat dealt with restaurants, boarding and lodging houses, factories and workshops, Chinese hospitals and dispensaries. The Police dealt with hawkers of foodstuffs and food stalls. The Education Department dealt with school hygiene. The Public Works Department dealt with buildings, crown lands, water works, sewerage and drainage. The District Officers dealt with hygiene and sanitation in the New Territories.
10. There were voluntary health organisations such as (a) the four Chinese hospitals connected with the Tung Wah Charity which dealt with general diseases and infectious diseases under both Chinese and Western methods; (b) the eight Chinese Public Dispensaries each under its own committee; and (c) the St. John Ambulance Association and Brigade.
11. The Medical Department's sphere of activities included action with regard to Government Hospitals, sea quarantine, vaccination, bacteriological matters, and matters connected with chemical analysis. Health Officers were seconded to the Sanitary Department to work under the Head of the Sanitary Department, a Medical Officer was seconded to the Chinese Secretariat for work in connection with the Chinese Hospitals and Chinese Dispensaries and a Medical Officer was seconded to the Education Department for work in connection with school hygiene.
Reorganisation.
12. The fundamental faults in the existing system were (a) that responsibility was divided among a number of independent lay authorities, (b) that co-ordination and co-operation were to a great extent lacking, (c) that the Director of Medical and Sanitary Services, though responsible to Government for the health of the Colony, had practically no authority outside Government hospitals and Government laboratories.
13. The solution of the problem of reorganisation of the Medical and Sanitary Services appeared to be to place all Government public health activities other than acavenging, conservancy and public works, under one medical direction as obtained in municipalities such as Glasgow, Toronto, Shanghai, and Singapore, and appoint as director the officer holding the title of Director of Medical and Sanitary Services. A scheme on these lines was contained in the report I submitted to Government in 1930.
14. In 1932 the scheme was referred to the Sanitary Board. The Board expressed approval of the main outlines but recommended that the Sanitary Board be enlarged to function as a Public Health Board.
15.
In February, 1933, the Attorney General and the Director of Medical and Sanitary Services were instructed to draft legislation to replace the Public Health and Buildings Ordinance of 1903 proceedings on the assumption that-
(a) the Sanitary Board would be replaced by an Urban Council.
(b) the Chairman of the Council would be a cadet officer and the Vice-
Chairman the Director of Medical and Sanitary Services.
(c) the scope of activities of the Council would be greater than that of the
Sanitary Board.
(d) while the clerical staff of the Sanitary Department would remain under the direct control of the Chairman, the technical staff sanitary inspectors would be grouped under the Health Officers, who in turn would be under the general direction of the Director of Medical and Sanitary Services.
I
ment.
16.
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At the end of September the draft legislation was submitted to Govern- It included (a) an Urban Council bill, (b) a Public Health (Sanitation) bill, (c) a Public Health (Quarantine and Prevention of Disease) bill, (d) a Public Health (Food) bill, (e) an Adulterated Food and Drugs bill, and (f) a Buildings bill.
17. In 1934 a Committee under the chairmanship of the Secretary for Chinese Affairs, Mr. N. L. Smith, was appointed to report on the draft legislation. As a result of the committee's report certain changes were made in the legislation.
18. In 1935 the bills were passed by the Legislative Council and became law. It was decreed that the new laws should come into force on January 1st, 1936, and on that date they came into force.
19. Under the new scheme the Medical Department and the Sanitary Department were brought into close relationship by the Director of Medical and Sanitary Services becoming Vice-Chairman of the Urban Council and having general direction over the activities of the Urban Health Officers and the Veterinary Surgeons under whom were grouped the Sanitary Inspectors of the Sanitary Department. The Director of Medical, and Sanitary Services was declared the official adviser to the Council on all matters pertaining to the public health including matters both of medical and sanitary interest.
20. Under the scheme
(a) The Medical Department is responsible for
(1) registration of births and deaths.
(2) quarantine and the prevention of infectious diseases.
(3) vaccination.
(4) venereal diseases clinics.
(5) leprosy work.
(6) maternity and child welfare, supervision of midwives.
(7) school clinics in co-operation with the Education Department.
(8) prison medical service in co-operation with Prison Department.
(9) Government hospitals and dispensaries.
(10) inspection of Chinese hospitals and dispensaries. (11) treatment of Government servants.
(12) the activities of the malaria bureau.
(13) the activities of the Bacteriological Institute. (14) the conduct of the Government mortuaries.
(15) medico legal and police medical work.
(16) the examination of candidates for air pilots. (17) anti-gas and first aid centres in case of emergency. (18) chemical analyses at the Government Laboratory. (19) Radiology and Physio Therapy.
(b) The Urban Council and the Sanitary Department are responsible for-
(1) work under the Public Health (Sanitation) Ordinance which deals with nuisances, house sanitation, street sanitation, public latrines, the collection and disposal of night soil, the collection and disposal of refuse, the control of wells and pools, the sanitary maintenance of eating houses, factories, workshops, and places of public instruction, recreation and assembly, public baths and wash houses, stables and animal houses, mosquito breeding, cemeteries and the disposal of the dead,
(2) work under the Public Health (Food) Ordinance which deals with slaughter houses, markets, dairies and milk shops, food factories, food shops, eating houses and restaurants.
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