14
6 6 . T h e i n s t a n c e s w h e r e t h e r e i s a n i n c r e a s e t e n d t o i m p r e s s
Government with the competence and popularity of the Medical
Officers in charge. One cause of the falling off at Surat is said to be
the improved sanitation of the town, though the increased popularity
of the Paruck Dispensary no doubt has more to do with it, and this,
together with the fact that no operations were performed during the
year, confirms the belief that the management has been unsatis
- f a c t o r y . T h e B r o a c h H o s p i t a l w a s i n c h a r g e o f t h r e e o f f i c e r s , a n d
to the failing health of one of them the decreased efficiency of the
hospital is attributable. The explanation of the Aden figures
appears to be that 2,770 in 1871-72 includes both in-door and out
- d o o r p a t i e n t s . I f t h i s b e s o , t h e r e i s a n e t d e c r e a s e o f 6 0 4 p a t i e n t s .
The falling off at the Sassoon Hospital appears due to the introduc
-tion of the payment system. There is no explanation of the diminu
- t i o n i n t h e n u m b e r s o f i n - p a t i e n t s a t S a t a r a o r K a l a d g i . T h a t a t
Ahmedabad seems to be due to the payment system. The Sadra
Hospital is dismissed by the Deputy Surgeon General with the
remark that it is a "small affair which may be passed over without
comment." The falling off at Shikarpur is also insufficiently ac
- c o u n t e d f o r .
6 7 . G o v e r n m e n t a r e o f o p i n i o n t h a t s o m e d e f i n i t e o r d e r s a r e n o w
required regarding the payment system at Civil Hospitals and Go
- v e r n m e n t D i s p e n s a r i e s . I t i s v e r y d i f f i c u l t t o l a y d o w n a p r e c i s e
distinction between the persons who should pay and who should be
allowed medicines gratis, while to leave it to the Medical Officer's
discretion would be attended with obvious difficulties. Too great
strictness in enforcing payment at first undoubtedly has the bad
effect of frightening away the indigent as well as the rich. For the
present, therefore, the existing system of giving medicines gratis to
all classes may be continued; but where there are grant-in-aid dis
- p e n s a r i e s i n w h i c h t h e C o m m i t t e e s e n f o r c e p a y m e n t f r o m a n y p e r s o n s ,
the same rules as may be adopted by the Committees should also be
carried into effect by the Civil Surgeons at the same stations. Where
also there are chemists' shops, the Civil Surgeons should give only
advice and prescriptions to such Natives as sowkars, wakeels, and
the like, whose ability to pay is beyond a doubt, great care being
taken not to enforce this rule except in cases where the applicants
are thoroughly well able to pay for it. As regards in-patients, the
Surgeon General has already been instructed that food must be
supplied by the relatives, except in special or indigent cases. In
- p a t i e n t s m a y , h o w e v e r , h a v e m e d i c i n e g r a t i s . G o v e r n m e n t w i l l n o w
address the other Governments and administrations, with a view to
learning what system of payment, if any, is in force in other pro
- v i n c e s ; a n d w h e n t h e r e p l i e s h a v e b e e n r e c e i v e d , t h e y w i l l b e i n a
better position to decide on what further should be done.
DISPENSARIES.
68. Fi ft een di spensari es have been opened duri ng t he year.
The total number in existence apart from Civil Hospitals, was 108, of
which one only was self-supporting, viz., that endowed by the late