( 7 )
yet the cost per patient is more than double. The reason is that Cuttack has
only about a quarter of the number of patients under treatment at Patna.
It seems to the Committee that any inferences drawn from relative cost
must always be fallacious under such conditions, which, moreover, vary yearly.
A comparison of the proportionate number of patients looked after by each
keeper and servant is less misleading, but even here bare figures must be sup-
plemented by a knowledge of the details of plan, buildings, watch and ward,
and the character of the cases under treatment. Special keepers have some-
times to be engaged for an individual case, and keepers, and especially head
keepers, cannot be extemporised. If they are to fluctuate with every change
of numbers good men cannot be retained. The present proportion of jemadars
varies from 1 to 40 to 1 to 49 male patients, except at Dacca, where it is 1 to 32.
But Dacca has only one jemadar more than Dullunda or Hazaribagh, and
there may be some local reason for retaining him. At Cuttack there is but one
for the whole asylum. He has nearly as many patients as he can manage,
and the addition of a few more would necessitate the appointment of a
second man, when the proportion would rise above that of any other asylum.
Dullunda
Dacca
Patna
Cuttack
Berhampore
Ratios given in
the report.
......
1 to 5.6
1 to 10.68
1 to 5.96
1 to 12.30
Corrected
ratios.
1 to 6.7
1 to 5.6
1 to 5.87
1 to 2.98
1 to 7.62
The ratios of female-keepers to women given in the report are entirely
misleading. The figures given have probably been compiled by a clerk, and
are correct arithmetical deductions from the number of " female-keepers"
shown as such in the return. It is obvious, however, that what is wanted is a
comparative statement of the establishment required for the female lunatics,
and that the name by which the attendants are known is immaterial. Dullunda
has no " female-keepers," but it has a matron and five female sweepers to attend
to its female wards, and should have appeared in the table as having one
female attendant to 6.7 women. The ratios given in the report and the
correct ratios are noted in the margin, and show
that the great apparent differences have no real
existence, except in the case of Cuttack. Here,
however, the daily strength of female lunatics is
only 5.96, and there is only one keeper to look
after them, and one female sweeper.
In the opinion of the Committee, then, no just comparison of the relative
cost for establishment is possible, and each asylum must be judged on its own
merits, measured by its plan and other inherent circumstances. The numerical
strength of the Patna and Berhampore Asylums is practically the same. Dacca
is higher, the increase being chiefly in sweepers and keepers. So is Dullunda ;
but with reference to this, Dr. Payne explains that he has several lunatics who
could replace some of his asylum servants, but that, as they make more in the
workshops than the pay of the servants, Government would lose and not gain
by the transfer. So far as the Committee can judge, the establishment in all
the asylums is moderate, but the compounder at Dullunda might, they think, be
dispensed with.* The door-keepers are really guards, and the Committee are
satisfied that they cannot be dipensed with.
Diet.—The next item in the comparative statements is the average cost of
diet, and it would at first appear that here comparison should be easy, allow-
ance being made for difference of prices. There are, however, many dis-
turbing elements. Not only do prices vary greatly in different places,
but they vary much in the same place in different years, and the vari-
ations affect the asylums in different degrees, the rise in one district being
often much larger than the rise in other districts. The component parts
of the diet scales also differ, and there are important variations in the system
of keeping the diet accounts. It has been already noticed how in one year
oil, vegetables, milk, &c., were not charged for at all in one asylum, the com-
parative cost of diet being reduced in consequence, to the apparent disadvantage
of other asylums which included them; and how in another asylum the calcula-
tion was based on the total number instead of on the average strength of patients
with a similar effect. It appears that some asylums supply dietary articles at
cost price, buying the raw material and preparing it for use without charge, and
supplying vegetables, &c., at less than market rates, while other asylums debit
* He has since been dispensed with.