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HOSPITALS AND DISPENSARIES IN THE BENGAL PRESIDENCY. [Part III.
Liability of localities
for the cost of medi-
cal stores.
The increase of the dispensaries in British Burmah shows a vast decrease
upon the amount of the previous year; but the reason is, that in 1872 a sum
approaching a lakh of rupees was granted for buildings in Rangoon.
The Hyderabad expenditure was, unlike the previous year, within the
income, and the receipts from Government were less.
There is a pretty general growing conviction that localities should officially
accept a very much larger share in the support of their dispensaries than is at
present the case; indeed, it is apparent in this, as in many other matters, that
Government can but develop a system to demonstration in the eyes of the
people who must at that point assume its further charge. It does, indeed, seem
but reasonable that Government should be relieved by the localities which
benefit, of the cost of drugs at least, as well as of diet charges and such like.
The views of the Punjab Government are expressed thus:—
In the statement of expenditure given in paragraph 9, it is noted that in most of the
dispensaries in the province a considerable allowance of European medicines is supplied at the
Government expense. His Honor is of opinion that the time has come when the cost of
European medicines may in most cases be fairly charged to the municipal or district committee
in whose jurisdiction the dispensary is situated, and instructions to this effect will be se-
parately issued.
Deputy Surgeon-General J. Tresidder of the Ambala Circle, in his inspection
report, remarks:—
"The point, however, in finance of these institutions to which I give my close attention is
to take care that no demands which ought to be paid by the local or municipal authorities from
local funds are shuffled off to the debit of Government: private subscriptions are not much in
force, and I think the time is fully come when these institutions should be entirely under the
care of the local authorities, and that imperial funds should pay for nothing except, perhaps, the
salaries of the medical subordinates and the charge of their pensions ; everything else, even
instruments and stores and establishment, should be paid for by local authorities from the
general rates of the zilla."
Municipalities incom-
petent to interfere in
administration.
But should the idea of rendering districts so far liable for the expenses of
gratuitous medical relief be carried out, and the justness of the suggestion
cannot be questioned, caution will have to be exercised to guard against loss
of uniformity in working the civil branch of the Medical Department. Because
a district assumes a just financial charge, it is no reason that it should in-
terfere in the administration of matters of which the municipal authorities
must necessarily be ignorant; but it would seem that this caution is not
unnecessary,—take the question of the supply of European medicines for
example. The Government of the North-Western Provinces observes in its
resolution on the report of the Inspector-General of Dispensaries:—
"That the people themselves do not consider the present state of things satisfactory, is
shown by the fact that an increasing number of municipal committees have taken to purchas-
ing supplies of European medicines for the dispensaries in addition to the supplies passed by the
Medical Department."
But to show how utterly incompetent a municipal committee is to form
any judgment in such a matter, the following quotation from the inspection
report of Dr. J. Fullarton Beatson, Deputy Surgeon-General of the Meerut
Circle, will suffice :—
In the matter of European medicines and instruments, there is sufficient liberality, and
many of the latter more recently supplied are of the most approved and most modern styles.
During the year a complaint was advanced by the municipality of Mainpuri direct to
Government, of course, alleging that such things as European medicines were rather grudgingly
sanctioned,—a statement which only ignorance could excuse. I was called upon by Government
to give the matter consideration when passing indents in future. Being disinclined to allow
such a view to remain uncontradicted, I called upon the medical officer to submit a copy of
such of his annual indents for the past and preceding years, and I demonstrated to Govern-
ment how unfounded was the assertion of the municipality, since, on each occasion of
framing the new indent, the column of "remaining in store" contained a handsome proportion
of the supplies given for the year's expenditure.
Dispensaries should
not be used as asy-
lums for paupers.
A very important point in the detail of dispensary management is pro-
minently alluded to in the report of the Central Provinces, when attention is
drawn to the fact that dispensaries are meant to be used as hospitals and not as
asylums for paupers; indeed, the Chief Commissioner lays it down that "in-
door accommodation is afforded for the treatment of cases demanding special
attention and care, and not as an asylum for paupers."