24249
RBB
405
HONG
KON
ANNUAL
DEPARTMENTAL
REPORTS
NG
1959-60
RBB 40S
PRICE: $9.00
THE ROYAL SOCIETY
for the Promotion
OF HEALTH LIBRARY
DIRECTOR OF MEDICAL
AND HEALTH SERVICES
22501293169
:
HỒNG KONG
ANNUAL DEPARTMENTAL REPORT
BY THE
DIRECTOR OF MEDICAL
AND HEALTH SERVICES
FOR THE
FINANCIAL YEAR 1959 - 60
PRINTED AND PUBLISHED BY W. F. C. JENNER, GOVERNMENT PRINTER AT THE GOVERNMENT PRESss. Java Road, Hong KoNG
EXCHANGE RATES
When dollars are quoted in this Report, they are, unless otherwise stated, Hong Kong dollars. The official rate for conversion to pound sterling is HK$16=£1 (HK$1=1s. 3d.). The official rate for conversion to U.S. dollars is HK$5.714=US$1 (based on £1=US$2.80).
WELLCOM
1.:UTE
Coll.
Cail
No.
I.
CONTENTS
THE COLONY'S HEALTH Service
Introduction
Events of Importance during the year 1959-60 . Administration of the Medical and Health Services
Staff
Finance
Legislation
Professional Registers.
Work of the Statutory Councils and Boards
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Paragraphs
7
-
6
17
18
19
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27
28 32
33
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34 35
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36 - 54
JI.
PUBLIC HEALTH
General Comments
Vital Statistics
HI.
WORK OF THE HEALTH DIVISION
Hygiene and Sanitation
Urban Areas
Rural Areas
Epidemiology
Port Health
Tuberculosis
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Malaria Bureau
Social Hygiene
District Midwifery Services.
Maternal and Child Health.
School Health
Industrial Health.
Health Education
i
55
56 - 61
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+
62 - 67
68 - 69
70 - 100
101 112
113 - 181
182 - 200
201 - 217
218 - 226
227 - 235
236 - 242
243 - 247
·
■
248 - 250
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IV. THE WORK OF THE MEDICAL DIVISION
Hospitals
Government Assisted Hospitals
Out-patient Services
Specialist Services
Radiology
Radio-diagnosis
Radiotherapy
Medical Physics
Ophthalmology
Dental Service
Government Institute of Pathology
Forensic Pathology
Government Chemist's Laboratory
The Pharmaceutical Service
The Almoner Service.
Physiotherapy
Occupational Therapy
Medical Examination Board
Blood Banks
Hospital Administration and Supply
Staff Welfare
U.N.I.C.E.F. Projects.
Auxiliary Medical Service.
V. TRAINING PROGRAMME
Doctors
Dentistry
Nurses
Midwives
H
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ii
Paragraphs
251 - 308
309 - 331
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332 - 338
L
339
340
341 342
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343 - 345
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346 - 349
L
4
350 - 352
353 - 361
362 - 373
374 375
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·
376 - 381
382 - 384
385 - 394
395 - 401
402 - 411
L
412
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416
417 419
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420
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422
423
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424
r
I
425 - 431
432 434
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435 - 437
438 441
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442 - 443
Paragraphs
V. TRAINING PROGRAMME Contd.
Health Visitors.
Radiographers
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Laboratory Technicians
Other Forms of Department Training
P
Attendance at Conferences and Meetings includ- ing those sponsored by the World Health Organization
Courses of Study including World Health Organ-
ization Fellowship
·
444 - 445
446
447
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448
449 - 450
451
Visitors
VI. BUILDING PROGRAMME
VII. PUBLICATION
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ACKNOWLEDGMENT
VIII.
ACCOUNTS
Samaritan Fund
Nurses Rewards and Fines Fund
IX.
MAPS
X.
APPENDICES
452
453
454
455
+
Statistical information in this report
refers to the calendar year 1959
1. THE COLONY'S HEALTH SERVICE
INTRODUCTION
THE Colony of Hong Kong occupies a land area of 3981 square miles. The estimated mid-year population in 1959 was 2,857,000 of which approximately 86% is concentrated in the urban areas of Kowloon and Hong Kong Island. This distribution of a population of 2,457,000 within 21 square miles of the urban areas gives rise to an average density of 117,000 persons to the square mile. It is a young population and although the age structure will not be known accurately until after the 1961 census, there is good reason to believe that one third is aged 15 years or under, that there are some 460,000 children of pre-school age and that there is a predominance of males amongst the young adults.
2. At the end of a decade and during World Refugee Year it is appropriate to review the demands on the medical and health services and the progress made towards meeting these demands. Despite shortage of land, housing and domestic water supplies an increase of population of some 1,000,000 due to the influx of refugees has been accepted. These refugees have not been segregated as such but have become part of the community and the medical and health services of Government and other agencies have been operated on a basis of serving the medical need of the individual without query as to origin.
3. The impact on all services has been of staggering proportions and heavy public expenditure on water supplies, housing, communications and social services has been met from the Colony's own resources. Shortage of trained medical, nursing and health staff has so far been the most important factor limiting the expansion of the medical services. As a result, the building and staffing of clinics and hospitals has not been able to keep pace with the rapidly increasing demands for western medicine. Thus more and more work has fallen on already over- burdened institutions. Nevertheless by applying modern methods of prevention and cure the results as measured by the vital statistics of the past ten years, have been encouraging. However there can be no complacency in the face of the enormity of the task ahead and the necessity for an increasing tempo of development if the needs of a population increasing by approximately 3% per annum are to be met.
even according to standards imposed by local resources rather than those considered desirable in the modern industrial state.
4. During the past five years emphasis has been on the development of training facilities for the greatly increased numbers of doctors and nurses needed to staff the very large programme of clinic and hospita! development in hand. The building of such new clinics or hospital accommodation that has been undertaken during this period has had to be geared to the annual output of trained staff available each year and has thus necessarily been limited.
5. The pressure on existing institutions has to a certain extent been met by holding evening clinic sessions, by accelerating, as far as possible within the limits of safety, the turnover of patients in hospital and by developing measures for the prevention of disease that can be applied under local conditions.
6. Such results as have been achieved during the past ten years are outlined in more detail in the relevant sections of this report. The salient features have been a considerable reduction in infantile mortality rates, the absence of the formidable epidemic diseases during the past seven years, the cessation of malaria transmission in the urban areas, the elimination of rabies and the progressive reduction of the tuber- culosis mortality rate from 208 per 100,000 in 1951 to 76.2 per 100,000 in 1959.
EVENTS OF IMPORTANCE DURING THE YEAR 1959/60
7. The Society of Apothecaries in London again held examinations for the L.M.S.S.A. in Hong Kong. Of the 118 candidates who entered for the examinations, 106 sat the examinations. Of these 39 passed in all subjects and 45 passed in one or more subjects. Prior to the written examinations a 3 months refresher course was conducted by University and Government clinicians at the Queen Mary Hospital.
8. There are now 82 refugee doctors who have obtained the L.M.S.S.A. as a result of the facilities which, with the approval of the General Medical Council of the United Kingdom, have been so generously accorded by the Society. A third and last L.M.S.S.A. examination will be held in Hong Kong towards the end of 1960.
9. Work continued on the drafting of legislation for the registration and licensing of medical clinics operating in the Colony.
2
Salaries Commission
10. The Commission completed its work during the year and those recommendations which were accepted by Government became effective in January 1960. The consolidation of the former high cost of living and expatriation allowances into the basic salary, 90% of which is now pensionable, has considerably improved career prospects. More promotion posts have enhanced the opportunities for the accelerated promotion of well qualified and able officers in the junior ranks of the service. Women Medical Officers who have completed their probationary service and who are members of the permanent and pensionable establishment are now receiving pay equal to that of their male counter- parts.
Drug Addiction
II. The publication in November 1959 of a White Paper on the Problem of Narcotic Drugs in Hong Kong focussed attention on the widespread use of addicting narcotic drugs, particularly heroin. The treatment and rehabilitation of drug addicts amongst convicted prisoners. has been placed on a sound basis at H.M. Prison Tai Lam where 700 prisoners can be accommodated. There is however a demand for accommodation for the treatment of addicts on a voluntary basis and the details of a pilot scheme, within the new Castle Peak Hospital of 1,000 beds for mental patients, have been worked out. A ward block of 120 beds will be set aside for this purpose and addicts coming forward as voluntary patients will be expected to surrender their liberty for a period of six months. During this time treatment and training will be given which is designed to build up the individuals physically and psychologically for rehabilitation and re-absorption into the community. Full social and medical records will be obtained with a view to assessing the local circumstances giving rise to addiction and the measures best fitted to prevent it. A vital necessity in any such rehabilitation pro- gramme is the cutting off of sources of supply and thus of temptation. To this end a vigorous drive against traffickers is being maintained by the police and preventive services, with considerable success.
12. The secondment of a trained Psychiatrist to the Prison Medical Service has enabled some preliminary investigation into the causes of drug addiction amongst prisoners to be started.
Dental Council
13. The statutory regulation of the practice of dentistry in Hong Kong dates from the promulgation of the Dentistry Ordinance No. 16
1
of 1914. Since that time successive Dental Boards have maintained a Register and acted as the examining and disciplinary bodies. During 1957 work started on the drafting of a new Dentists Registration Ordinance which was designed to bring the legislation up to date and more in line with the Medical Registration Ordinance. The Dentists Registration Ordinance 1959 replaces the Dental Board by a Dental Council and the new Council met for the first time on the 7th October, 1959. The new Council will continue to function as an examining body.
14. A tribute is paid to the work of successive Boards over the past 45 years which has culminated in a project approved in principle by the University of Hong Kong and the Government to establish a University Dental School. Arrangements for the pre-clinical training of dental students have been made in conjunction with the development of pre-clinical facilities in the Faculty of Medicine, due to become effective during 1962. Meantime the planning of a Dental Hospital has started with site investigations and the drafting of schedules of accommodation,
Mental Deficiency