NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
6
4. The Advisory Committees for Bombay City hospitals consist of
seven members nominated by the Surgeon General, with the Medical
Officer in charge of the hospital as Secretary. In the mofussil the Civil
Surgeon is the Chairman, with six other members of whom at least three
should be Indians and two ladies. One of these six members is nominated
by the District Board and another by the Municipality. The tenure of
members is one year. The Committees are appointed for Government
hospitals at provincial headquarters and district civil hospitals with
accommodation for 50 or more beds. The decisions of the Committee
are acted upon by the Medical Officer and where he has no power to give
effect to them, referred to the Surgeon General with the Government of
Bombay.
5. In the Punjab a committee consisting of non-official visitors, nomi
-
nated by Government, is appointed for various hospitals in Lahore. Of
these at least four are ladies. In the districts for every provincialised
hospital there is a committee consisting of two members nominated by
the Municipal Committee, two members nominated by the Dis
-
trict Board, three members nominated by the Deputy Commis
- s i o n e r o f t h e D i s t r i c t a n d t h e m e m b e r s o f t h e P r o v i n c i a l L e g i s l a t i v e
Council from the district. The Civil Surgeon of the district acts as
President. The tenure of membership is one year.
6. In the Central Provinces and Berar the composition of the Boards
of Management for provincialised hospitals and Dispensary Fund Com
-
mittees for local fund hospitals varies from place to place, but the salient
feature is that they consist of a few ex-officio and a few non-official
members nominated by the Local Government or the Commissioner of
the division concerned.
7. The Managing Committees in Bihar are nominated by Government
for Government hospitals and by local bodies for local fund institutions
subject to the approval of the Commissioner of the division concerned in
the latter case. Usually the District Magistrate, the Civil Surgeon and
the Sadr Sub-Divisional Officer are ex-officio members of each committee.
The Committees in Orissa are formed on the same lines as in Bihar.
8. Advisory Committees in Assam consist of the Deputy Commissioner
of the district as President Civil Surgeon as Vice-President, two mem
-
bers nominated by the Municipal Board, two nominees of the Local Board
and two members nominated by the Deputy Commissioner.
9. The Advisory Committee for the Irwin Hospital, New Delhi, is
nominated by the Chief Commissioner, Delhi, and consists of the Chief
Medical Officer, Delhi, the Civil Surgeon, New Delhi, an Executive
Engineer of the Public Works Department, a representative of the Lady
Hardinge Medical College, two nominees of the Delhi Municipal Com
-
mittee, one nominee of the New Delhi Municipal Committee, the Chief
Health Officer, one lady each nominated by the Delhi and New Delhi
Municipal Committees, one non-official medical practitioner of the Delhi
Province, the Superintendent of Nurses and the Senior Assistant Surgeon
of the Irwin Hospital.
10. The Advisory Committee for the Lady Reading Hospital, Peshawar,
consists of the Inspector General of Civil Hospitals, North-West Frontier
Province, as Chairman, the Civil Surgeon, Peshawar, as Secretary and
three members of the North-West Frontier Province Legislative Assembly
and three nominees of the Municipal Committee, Peshawar, as members.
11. In Sind there are Advisory Committees at the Civil Hospitals,
Hyderabad, Sukkur and Mirpurkhas. The Advisory Committee consists
of the Civil Surgeon. as Chairman and six other members of whom at
least three shall be Indians and two ladies, who shall hold office for a
period of one year. The District Local Board and the Municipality of the
district is entitled to send one representative each to serve on the Co
m - m i t t e e .
12. The general consensus of opinion is that these committees serve
a useful purpose, that they offer useful suggestions for improvement in
the efficiency of the hospital staff and often help in raising donations and
procuring articles or special comfort for the patients.
2. AVERAGE AREA AND POPULATION SERVED BY EACH
HOSPITAL OR DISPENSARY.
Province.
Total number of hospital and
dispensaries
in the
province.
Average area served by each
hospital or
dispensary.
(Sq. miles).
Average popula-tion served by
each
hospital or
dispensary.
1
2
3
4
Madras . . .
1,134
126
41,217
Bombay . . .
429
180
41,940
Bengal . . .
1,449
540
34,585
United Provinces . . .
597
178
81,087
Punjab . . .
896
111
26,318
Central Provinces . . .
343
291
45,212
Bihar . . .
528
131
61,310
Assam . . .
343
160
25,138
Sind . . .
108
429
35,991
Orissa . . .
164
145
32,355
Delhi . . .
24
24
26,510
North-West Frontier Province . . .
114
118
21,272
Baluchistan . . .
41
1,327
11,305
Ajmer-Merwara . . .
10
271
56,029
Coorg . . .
11
145
14,848
8
3. EXPENDITURE ON MEDICAL RELIEF.
Province.
Expenditure on Medical Relief
during 1936.
Per Capita.
Per square mile.
1
2
3
Rs. A. P.
Rs. A. P.
Madras . . .
0 2 7
53 2 5
Bombay . . .
0 4 9
65 7 0
Bengal . . .
0 2 1
84 0 0
United Provinces . . .
0 1 0
29 0 4
Punjab . . .
0 5 7
51 12 9
Central Provinces and Berar . . .
0 1 5
13 11 10
Bihar . . .
0 1 3
35 11 8
Assam . . .
0 1 8
14 5 5
Sind . . .
0 4 0
20 15 3
Orissa . . .
0 1 6
23 5 8
Delhi . . .
1 2 5
1,272 0 0
North-West Frontier Province . . .
0 6 3
70 0
0
Baluchistan . . .
0 8 8
4 9 9
Ajmer-Merwara . . .
0 4 11
63
0 10
Coorg . . .
0 11 2
71 9 7
4. RULES REGULATING GRANTS-IN-AID TO HOSPITALS AND
DISPENSARIES.
Madras.—Grants-in-aid are given to private special medical institu
- t i o n s w h i c h a r e i n c h a r g e o f m e d i c a l p r a c t i t i o n e r s r e g i s t e r e d u n d e r t h e
Madras Medical Registration Act VI of 1914, and are classed as
—
1. Maintenance grants.
2. Capitation grants.
3. Building grants.
Maintenance grants are sanctioned by the Surgeon General with the
Government of Madras, annually after he has satisfied himself that the
institution is popular and run on satisfactory lines. Capitation grants are
given to private Leper Asylums and are payable half-yearly subject to
11
S a t i s f i e d t h a t a d e q u a t e a l l o t m e n t s a r e g u a r a n t e e d b y t h e L o c a l B o a r d
under the different heads of expenditure, recurring as well as non recur
- r i n g , f o r t h e e s t a b l i s h m e n t a n d m a i n t e n a n c e o f t h e d i s p e n s a r y .
Bihar and Orissa.—There are no specific rules issued by Government
regarding grants-in-aid. Grants are regulated in accordance with the
needs of the institutions subject to funds being available.
Sind.—The rules regulating grants-in-aid to hospitals and dispensaries
are the same as are in force in the Bombay Presidency.
North-West Frontier Province.—There are no specific rules or orders
regarding grants-in-aid in the Province.
5. FEES CHARGED FROM NON-INDIGENT PATIENTS.
Poor and indigent patients, both indoor and outdoor, are given free
medical and surgical treatment in all provinces in India. They are not
charged any fees, nor are they required to pay for any special treatment or
for drugs not ordinarily available at the hospital. Patients with a monthly
income of less than Rs. 50 in Madras, 30 in Bombay, 150 in the
Punjab, 100 in Delhi and with an annual income of less than Rs. 2,000
in the United Provinces and Central Provinces fall into the category of
those who are exempted from hospital fees.
2. Excepting Bengal, fees are charged from well-to-do patients inall
provinces. As a rule, they are not admitted into the general wards,
excepting in Madras and Bombay where, if so admitted, they have to
pay Re. 0-8-0 to Rs. 2-8-0 and Re. 0-6-0 to Re. 1 per diem respectively.
3. Fees levied from patients for accommodation in special and family
wards vary in accordance with their monthly income. They range from
Rs. 5 to Rs. 10 in Madras, Re. 1 to Rs. 5 in Bombay, Re. 1 from
Indians and Rs. 3 to Rs. 10 from Europeans in the United Provinces,
Rs. 2 to Rs. 10 in the Punjab, Rs. 2-8-0 to Rs. 5 in Delhi, Rs. 3 to
Rs. 14 from Europeans and Rs. 2 to Rs. 3 from Indians in Bihar, and
Re. 0-12-0 to Rs. 6 in the North-West Frontier Province. These fees
generally cover the cost of medicines, dressings, nursing, etc., ordinarily
provided by the hospital, but if procured from outside, they have to be
paid for by the patients. The rates of operation fees, where levied, are
fixed and fluctuate between Rs. 50 to Rs. 250. In Madras and Bombay,
however, the maximum fees are Rs. 350 and Rs. 400 respectively. The
fee for medical attendance in Madras and Bihar is Rs. 5, but the Medical
Officers in Bihar have discretion to reduce or remit the whole amount.
In the Punjab this fee varies from Re. 0-8-0 to Rs. 8 according to the
status of the Medical Officer attending.
4. In the case of persons employed in factories, mines, quarries, tea
estates and railways in Madras, Bombay and Sind, if admitted asin
-patients at the instance of their employers, a charge of as. 8 is levied
from the employers, but if they attend Government hospitals of their own
accord they are treated as members of the general public for purposes
of hospital charges.
5. Ex-Madras areas and ex-Bihar and Orissa areas, which now constitute
the Orissa Province, are governed by the rules regarding hospital fees in
force in Madras and Bihar respectively.
6. In the Central Provinces and Berar the system of charging a fee
of two pice from each new patient, except paupers, attending a hospital
or dispensary had been in force since 1933. The amounts received on
that account in most cases were insignificant and with a few exceptions
there had been an undoubted fall in the out-patients' attendance. It
was thought that if the system were conscientiously worked out it was
bound to lead to a "set-back" to the popularity of scientific medicine and
the Local Government therefore allowed its discontinuance in the year
1936.
7. In the North-West Frontier Province an innovation of interest has
been the starting of a "paisa" dispensary, where everybody is required
to pay one pice for the day's medicine supplied and the income thus
derived goes towards the running expenses of the dispensary. The
success of this dispensary has led to the opening of similar dispensaries
elsewhere.
8. A complaint frequently made against the administration of Indian
hospitals is that large number of patients who can really afford to pay
are treated free of charge. The problem is not simple because modern
scientific medicine is costly and although a person may not be indigent
as regards the ordinary necessities of life, he often is in respect to even
minimum requirements when sick. In the absence of an almoner .system
hospital abuse is not easy to detect, but is probably less common than
is frequently suggested. The increasing employment of honorary medical
officers in hospital out-patients' Departments will probably be a useful
corrective, since the final decision as to a patient's eligibility for free
treatment rests largely with the doctor. On the whole the revenue
obtained from the payments of ordinary patients is not large but fees
paid by patients occupying private or paying wards should cover the cost
to Government (or the Hospital Management) and in general do so.
6. BUILDINGS.
Madras .—Sir Frank Connor in a note on the Madras Medical Depart-
ment writes that the demand for new buildings and extensions to existing
buildings in the Medical Department seems to have been rather neglected
in recent years. Besides progress has been hampered by what Sir Frank
regards as a bad building policy, for the Medical Department is required
to submit to Government detailed plans and estimates before sanction to
the project is accorded. After such plans and estimates have been sub
- m i t t e d t h e s c h e m e i s o f t e n n o t a c c e p t e d f o r w a n t o f f u n d s o r o t h e r
reasons. A very appreciable loss in time and money results as some years
may elapse before it is eventually accepted and by that time considerable
revision of the plans becomes necessary. Besides, for the construction
of large hospitals the system of providing money in small yearly grants
is most disadvantageous.
13
The most important work under construction in Madras was the
remodelling of the Government General Hospital at Madras. H. R. H.
the Prince of Wales Hospital for Children, as an adjunct to the Govern
- m e n t V i c t o r i a C a s t e a n d G o s h a H o s p i t a l , M a d r a s , w a s c o m p l e t e d a n d
opened during the year. The construction of the new hospitals at Madura
and Cocanada was nearing completion by the end of 1936. A new out
- p a t i e n t d e p a r t m e n t h a s b e e n a d d e d t o t h e G o v e r n m e n t V i c t o r i a C a s t e
and Gosha Hospital, Madras and a Venereal out-patient block to the
Government Rayapuram Hospital, Madras.
Bombay .—During the year 1936 no major works pertaining to Govern
- m e n t h o s p i t a l s o r d i s p e n s a r i e s w e r e u n d e r t a k e n i n t h e B o m b a y P r e s i d e n c y .
Minor works representing additions and alterations to hospital buildings
costing about Rs. 53,000 were carried out at the several hospitals.
Bengal .—In Bengal an up-to-date and well equipped block, named Sir
John Anderson Casualty Block, has been added to the Medical College
Hospitals, Calcutta, at a cost of Rs. 2,84,030. It has accommodation for
40 beds and 4 cabins and is likely to remove the congestion in the Medical
College Hospitals. Among the other important new works carried out
mention may be made of the new out-patients department and menial
quarters added to the Mayo Hospital, the new maternity hospital building
in the Belgachia Medical College Hospitals and the extension of the out-
- p a t i e n t s d e p a r t m e n t i n t h e S h a m b h u n a t h P a n d i t H o s p i t a l , B h o w a n i p o r e .
The proposal to rebuild the Lady Dufferin Victoria Hospital, Calcutta,
made rapid progress during the year 1936. The King George V Silver
Jubilee Committee gave a gift of Rs. 4,71,000 while further amounts
were promised by the District Boards of Bengal. With the donations
already received, the construction of the main hospital building is
in progress.
In the mofussil in Bengal additions of flew wards were made to some
of the existing hospitals and many new dispensaries were opened.
United Provinces .—Due to financial stringency no major works could
be undertaken in the United Provinces of Agra and Oudh. Certain works
of a petty nature were carried out during 1936 from the lump allotment
of Rs.12,000. The Ursula Memorial Hospital, Cawnpore, was built at a
cost of Rs. 3 lakhs, donated for the purpose by Messrs. Horsman Brothers
of Cawnpore. A building for an X-Ray installation has been constructed-
in the compound of the Colvin Hospital, Allahæbad.
Punjab.—The financial depression continued to stand in the way of
new developments in the Punjab. Several schemes remained in abeyance
for want of funds. The important events of the year 1936 were as follows:—
(i) Opening of the R. B. Amar Nath Tuberculosis Institute in the
Mayo Hospital, Lahore.
(ii) Establishment of the Lady Emerson Chatarbhuj Maternity
Home at Amritsar.
(iii) Construction of the Gujjar Mal Tuberculosis Hospital at
Amritsar.
14
(iv) Provision of a new dispensary block at Mukerian in the
Hoshiarpur district.
(v) Construction of the Teka Devi Health and ante-clinic centre in
association with the Lady Willingdon Hospital, Lahore.
(vi) Construction of a new hospital at Phalia by the Red Cross
Society, Punjab Branch.
Bihar.—As a result of the devasting earthquake of 1934, several
hospitals in Bihar were almost completely destroyed. Among these were
the Bettiah Raj Hospital, the Purnea District Hospital, the Motihari.
District Hospital, the Darbhanga District Hospital, the Sitamarhi Sub
-divisional Hospital and the Madhubani Subdivisional Hospital. Complete
reconstruction has been necessary in the case of the six above named
hospitals. At Bettiah a new hospital building has been completed at
a c o s t o f R s . 6 l a k h s ; e v e r y e f f o r t h a s b e e n m a d e t o m a k e i t o n e o f t h e
best designed and best equipped hospitals in India and the Bettiah
Hospital for Women has also been enlarged. The plans and estimates for
the rebuilding of the Purnea and Motihari District Hospitals were ready
in 1937, though building operations had by then been started in the case
of the former only. The new Darbhanga Hospital was expected to be
ready for occupation by March 1938, and it has cost Rs. 7½ lakhs to build
it. The Madhubani Subdivisional Hospital has been rebuilt, while the
Sitamarhi hospital was still under construction in 1937. A new District
Hospital has been built at Hazaribagh to replace the older one. In
addition to these, several small District Board dispensaries that had been
destroyed by the earthquake of 1934 have been or are being reconstructed.
Besides, there has been general progress throughout the province and
hospital buildings are being improved every year.
Central Provinces and Berar.—In the Central Provinces and Berar
modern up-to-date hospital for women was built at Khamgaon at a cost of
Rs. 1½ lakhs in 1936. In 1937 schemes were ready for the building of a
modern hospital in connection with the Countess of Dufferin's Hospital Fund
Scheme at Amraoti at a cost of about Rs. 2 lakhs and the Lady Elgin
Hospital for Women and Children at Jubbulpore at a cost of about over
Rs. 2 lakhs.
Assam.—The largest major work carried out in 1936 in Assam was
the construction of a new hospital and a dispensary building at Sadiya
at an estimated cost of Rs. 77,548 with staff quarters. A mater
-nity and gynæcological ward attached to the Dibrugarh Civil
Hospital has been constructed at an approximate cost of Rs. 26,800. One
of the important construction works executed in 1936 was the enlarge
-ment of the anatomy department in the Berry-White Medical School,
Dibrugarh.
Orissa.—In. Orissa a children's ward with four beds and a Nursing
Home with accommodation for three patients were added to the Cuttack
General Hospital. Septic, tuberculosis and female wards were added to
the Sadr Hospital, Balasore. In the same district new dispensary build
-ings were put up at Soro, Jellasore and Ballipal.
15
Sind.—No major works were undertaken in Sind during the year 1936.
Due to the generosity of private individuals the accommodation at the-
Mirpurkhas Civil Hospital was increased in 1937 by the construction of a.
separate building for out-patients and offices and a ward for tubercular
patients.
North-West Frontier Province.—In the North-West Frontier Province,
a ward named as the "Brierley Memorial Tuberculosis Ward" with
accommodation for 30 beds for tubercular patients has been added to
the Lady Reading Hospital, Peshawar, at a cost of Rs. 23,286. To the
Mansehra Civil Hospital was added a 16 bedded ward, the cost of which
was borne by the local District Board.
Delhi.—In the Delhi Province a start was made with building the
Irwin Hospital in 1934, the foundation stone of which was laid by Lord
Irwin in 1930. The responsibility for this hospital was undertaken by
the Government of India, which had recognised for some years that it
was necessary to build a modern general hospital for Old and New Delhi.
The construction work of this hospital was completed in April 1936 at a
cost of Rs. 2,361,390 on buildings and Rs. 2½ lakhs on equipment for the
hospital. This hospital has accommodation for 320 patients, including
20 family wards and 10 special wards. The administration block and the
operation theatres in the Irwin Hospital are air-conditioned.
A new ward has been added recently to the Silver Jubilee Tuberculosis
Hospital, Delhi. An additional private cottage ward has also been built
in this hospital.
The Delhi Municipal Committee decided to construct two new ward
blocks, an administrative block and staff quarters during the financial year
1937-38 in the Isolation Hospital, Kingsway.
Lala Sri Ram of Delhi has donated Rs. 1 lakh for the construction of a
Maternity Hospital which is being built in the Minto Road Area of New
Delhi. The buildings will provide good accommodation for 40 maternity
beds, labour rooms, theatre, etc., and the necessary staff quarters. The
equipment will be supplied by the Delhi Municipal Committee, who will
be responsible for running the hospital.
Baluchistan. —The construction of a new dispensary with residential
quarters for the staff at Killa-Saifulla in Baluchistan was sanctioned
during the year 1936 at a cost of Rs. 23,700.
Owing to the damage caused by the earthquake of 1935 several import
-
ant works need to be taken in hand at an early date, viz., the construc
-
tion of the Civil Hospitals at Quetta and Chaman, a new hospital build-
ing for Usta, a Civil Dispensary at Sinjawi and office of the Civil Surgeon,
Bort Sandeman and Loralai.
Coorg.—At the Civil Hospital, Virajpet, an extension to the
out-patients department was carried out and a small labour room cons
-
tructed out of charity funds. Additional accommodation was secured at
the Headquarters Hospital at Marcara by building a glass facade to one of
the general ward verandahs.
16
Ajmer-Merwara .—A new out-patients department capable of dealing
with 500 out-patients, with accommodation for veneral diseases, tuber
-culosis, ophthalmology and anti-rabic departments, has recently been
added to the Victoria Hospital, Ajmer.
7. NURSING HOMES.
Few private Nursing Homes exist in India except in Calcutta, Madras
and Bombay. In the last named, where there is a large and increasing
demand for hospital maternity accommodation for all classes of people,
the number of small, often badly equipped and indifferently managed
homes calls for some form of supervision. The Provincial Medical
Department has recommended legislation on the lines of the Nursing
Homes Registration Act of Great Britain, which provides for registration
and inspection.
8. X-RAY AND RADIUM FACILITIES.
Adequate facilities for Radium treatment do not exist in India, for
while no such facilities exist in the United Provinces, Central Provinces,
North-West Frontier Province, Baluchistan and Coorg, the following table
indicates the limited extent to which they exist in the other provinces.
Madras . . . Barnard Institute, Madras . . .
1½ grammes.
Vizagapatam . . .
100 milligrames.
Bombay . . . J. J. Hospital, Bombay . . .
The radium used is
not the property of
Government but of
the Honorary Sur
-
geons who give the
treatment.
St. Georges Hospital, Bombay . . .
Bengal . . .
Medical College Hospital, Calcutta .
296.21 mgms.
Presidency General Hospital, Calcutta . Radium elements,
tubes and needles.
Carmichael Medical College Hospital, Bel-
g a c h i a .
170 mgms.
Chittaranjan Seva Sadan . . .
100 mgms.
Punjab . . . Lady Willingdon Hospital, Lahore .
447.64 mgms.
Mayo Hospital, Lahore . . .
71 mgms.
Memorial Hospital, Ludhiana . . .
210 mgms.
Bihar . . .
Radium Institute, Patna . . .
1,560 mgms.
Assam . . . Welsh Mission Hospital, Shillong . . .
400 mgms.
Orissa . . . General Hospital, Cuttack . . .
20 mgms.
Delhi . . . The Lady Hardinge Medical College, New
Delhi . . . 255.33 mgms.