Sessional_Paper_1902 — Page 168

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that of the "Health Officer of the Port," but I wish to point out that. I at Medical Officer of Health for the Colony" and, that it is certainly misleading to describe my office in any other terms. My jurisdiction is, by Ordinance, co-extensive with that of the Sanitary Board, and comprises the island of Hongkong, which has an area of 29 square miles, and the whole of Kowloon this side of the first range of hills, covering a further area of 18 square miles.

The population of this territory of 47 square miles is now considerably over 300,000, and the plans of every new building to be erectel, and of every alteration to an existing building, within this area passes through my hands, and has to be approved by me as being in accordance with the sanitary laws of the Colony, while the whole of the buildings comprised therein are visited by the sanitary staff under iny direction.

(2.) There also appears to be some confusion as to the actual relationship at pre- sent existing between the Medical Officers of Health and the Medical Department. As Dr. ATKINSON explained, the Medical Officers of Health are appointed in England to the Medical Department of the Colony, but on the understanding that on arrival they will be seconded for service under the Sanitary Board.

To make this clear I have put in the form of appointment (Appendix IX) and I think I need hardly explain to members of this Committee that, after being so seconded, we owe no allegiance to the Principal Civil Medical Officer and do not receive instructions from him. It is of course always open to His Excellency the Governor to transfer either myself or the Assistant Medical Officer of Health back to the Medical Department, when we would of course come under the authority of the Principal Civil Medical Officer and would cease to hold service under the Sanitary Board, but it is hardly to be supposed that such a course would ever be adopted, as sanitary work is now essentially a speciality and sanitarians cannot be made interchangeable with hospital surgeons and physicians.

As an illustration of the entire separation of the Medical Officers of Health from the Medical Department 1 may remind you that for about fourteen months previous to Dr. ATKINSON's return from leave, Dr. BELL was acting as Principal Civil Medical Officer and yet he is nearly twelve months junior to myself in the Medical Department. Had the Medical Officer of Health been subordinate to the Principal Civil Medical Officer, it would have been impossible to place Dr. BELL in that position.

(3.) Dr. ATKINSON suggests that the Sanitary Department should be made a sub- department of the Medical Department. In my opinion this would be a most impos- sible arrangement. To begin with, it would involve the entire abolition of the Sanitary Board, for no man can be asked to serve two masters-if the Principal Civil Medical Officer is to be my chief, the Sanitary Board must cease to be so, and they would then have no executive staff to carry out their wishes. The present Sanitary Board fulfils, I consider, a most valuable purpose by enabling the public to know something of what is being done in regard to the sanitary welfare of the Colony-were there no Sanitary Board there would be no public discussions, the whole policy of the Department would be decided departmentally, and I think it is generally recognized that as such very large interests are so frequently involved in sanitary questions the fullest publicity is essen- tial.

Moreover I do not consider that any one man can be at the same time an expert physician, an expert surgeon, and an expert sanitarian, using this latter term to cover the multifarious duties which are now performed by a Medical Officer of Health. I may perhaps be excused for mentioning that I have been a qualified member of the medical profession for almost exactly sixteen years and that I have devoted the past eleven years exclusively to sanitary work and administration-having been the Medical Officer of Health to an English Borough before I came to this Colony. I lay no claims to being an expert surgeon, but I think I am justified in claiming a more thorough know-