Administration report of the Director of Health Services / [Ceylon].

  • Ceylon. Department of Health.
Date:
[1957]
Catalogue details

Licence: Public Domain Mark

Credit: Administration report of the Director of Health Services / [Ceylon]. Source: Wellcome Collection.

    7/322 (page 7)
    Whatever improvements the country hopes to attain in its hospitals they cannot rise above the competence of the individuals who participate in the service to maintain proper physician-patient-hospital relations. This competence leaves much to be desired in the opinion of the average person who has been a patient in Ceylon’s hospitals. The reason for this is that it has not been possible to inculcate in the medical education of today that the practice of medicine is an art and a professional service as well as a science and a way to make a living. There is also a tendency, particularly true of the specialists, to rely too much upon the tools and tests and not enough upon intelligence and reason for the making of a quick diagnosis to meet a situation in an emer¬ gency. When working under conditions of inadequate staffing and equip¬ ment this attitude has been to the detriment of something being done to the patient expeditiously. There are also instances where due to present day methods of medical education the medical men become so impressed with their importance or attainment as to become highly critical to mar the good relations that should exist in the great family of medicine that runs a hospital. Time and again Medical Officers have brought to the notice of the Department the enormous amount of non-technical work that devolves on them in their day to day management of hospitals. In the light of this in the administration of the larger hospitals the Hospital Secretary has now become an indispensable officer. In order to attract its fair share of recruits to the Hospital Secretaries’ Service and to provide a satisfactory career, proposals for a reform of its salary scale and the grading structure were placed before the Treasury during the year. Since the beginning there has been a series of complaints by the Hospital Committee of the Colombo Group of Hospitals that the measure of its independence and of its power of action has been restricted. The Committee that functioned in 1957, as was expected of it, undertook a complete review of the establishment of the entire group with a view to seeing whether better use cannot be made of the available resources in the group of hospi¬ tals. This was very necessary as the services rendered by technical personnel are by far the most difficult in medical treatment considerably out-stripping material requirements. The Committee has felt that this review is worth its while as evident from some of the recommendations it made to the Hon’ble Minister. Apart from those with well recognized preventible diseases, their number being 20.9 per cent, of the total that occupied hospital beds in 1957 as against 21.2 per cent, in the previous year, the returns of diseases treated as in-patients focus attention on four major disease groups. They are, malignant neoplasms, diabetes melitus, cardio-vascular diseases, rheumatic disease and asthma. These diseases offer a particular problem on account of obscure aetiology, insidious onset and multifarious symptoms. Since the aetiology is largely obscure primary prevention is not a practical pro¬ position as in most of the infectious diseases. Yet there is much that can be done in these diseases by preventive health measures based mainly on secondary prevention. This implies early detection and diagnosis followed by prompt treatment and hehabilitation. We have to go a long way before most of our doctors and nurses, geared to diagnosis and therapy alone, are made to recognize that on either side of the care of the acute ill there is preventive medicine and rehabilitative medicine. In this com¬ bination of the three concepts of medicine lies the ambit of the future physician and the hospital. There are welcome signs of social responsibility that the needs of the elderly are becoming recognized and provision is being made to a varying extent to meet the diversity of problems which arises in association with old age. A high proportion of beds in hospitals are occupied by old people.