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primarily intended to benefit the people of Hong Kong, the findings have worldwide implications.

5. But this emphasis on tuberculosis as a continuing problem should be seen in the proper perspective of its relationship to the other major causes of mortality. Again this year tuberculosis ranks fifth, the first being cancer, followed by heart diseases, pneumonia, and cerebro vascular diseases. In 1972, the death rate from cancer rose to 107.3 per 100,000 of the population from 104.7 in 1971. The com- monest types were cancer of the lung. primary cancer of the liver, nasopharyngeal cancer, and cancer of the stomach.

Disablement and Age

6. The year saw an increase in problems connected with caring for the chronic sick, the disabled, the elderly, and the drug-addicted. The Government announced its intention to provide an allowance without a means test for the severely physically disabled and the elderly aged 75 and over. Although the scheme is to be operated by the Social Welfare Department, the Medical and Health Department will become involved because of the need to assess the severity of the disability.

7. Increasing concern for the welfare of the aged was also reflected in 1972 by the Government's appointment of a widely representative working party to consider the needs of the elderly. The Department took part in these deliberations, and made a useful contribution to the working party's final report. This stressed the point that the elderly should be served in a variety of ways, helped to stand on their own feet, encouraged to feel they were still contributing to the community, and not placed in institutions unless this was absolutely necessary. These recommendations accorded largely with world trends in atti- tudes, both philosophic and practical, towards the problems posed by geriatrics.

Siu Lam Hospital

8. The Siu Lam Hospital for the severely mentally retarded was completed in the last financial year, but opened in 1972. When Sir Kenneth Ping-fan FuNG cut the ribbon on 28th June, he said the Hospital was a manifestation of the Government's view that the time had come for all sections of the community even the most dis- advantaged, to be brought into the fold to enjoy the benefits of an improved economy and general prosperity. Siu Lam was a recom-

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mendation of Dr. L. T. HILLIARD, who had been invited in 1959 to investigate, advise and report to the Government on the problems of mental deficiency in Hong Kong

9. Dr. HILLIARD concluded that mentally subnormal or defective persons should be grouped in three main categories, according to the severity of their handicaps. He proposed that those with a minor- degree of mental retardation should be the responsibility of the Educa- tion Department which would set up special classes for them. The Social Welfare Department should provide institutional care and train- ing for the medium grade, and the Medical and Health Department should undertake the medical and nursing care of the severe grade.

10. Siu Lam Hospital was built with the third recommendation in mind, and its opening implemented in full the main proposals in the Hilliard Report. The Hospital was built with a donation of $5.7 million from the Royal Hong Kong Jockey Club, with accommodation for 200 patients. After the formal opening, patients were accepted in groups of 50 at a time from special wards in the Tung Wah Hospital and the Po Leung Kuk to enable the staff to adjust to the routines required for this type of patient. Most began to thrive as a result of their transfer from urban centres to a country hospital. Siu Lam is now playing a role in the treatment of the severely mentally handi- capped in our midst, and the conscience of a progressive Hong Kong requires that we do no less for them.

Methadone Maintenance

11. The year also saw the start of the Medical and Health Depart- ment's methadone maintenance programme with the first volunteer patients arriving at the Pilot Methadone Study Centre in Eastern Street on 1st December for admission. The programme got off the ground after some deliberation. It has been fully documented as a result of large scale experiments in the United States that the majority of patients on methadone maintenance are able to hold responsible jobs and do manual work, but methadone is itself an addictive drug, and main- tenance implies a permanent responsibility to keep up the supply.

12. The Department's pilot study is to last three years, and will involve 550 patients. It is hoped the programme will throw light on the efficacy of methadone as a medication capable of achieving the pharmacological effect that is intended-namely the elimination of hereoin hunger, heroin-seeking behaviour, and blockade against the

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