?THE FUTURE OP THE INDIAN MEDICAL SERVICE.
reorganization of the Indian Medical Service appears to be still in contemplation, it may be of some use to re-consider the subject here in regard to the advantages and disadvantages of such a step to the Government of India, the public, and the As the
members of the service. It may be stated in the commencement that the Indian Medical Service is at the present moment contented, and at the same time it will probably be 'admitted that it is the most
disposal of any Government exceedingly well-informed on this
efficient medical service at the An officer,
in the world.
subject,
stated
a
short time ago, that the Indian service obtained procurable. It is clear, therefore,
the very best men that were
reorganization will enable the Government to obtain There are, undoubtedly, some grievances; the worst of these are the great inadequacy of the pensions, and the disappointment young officers experience when entering the service through the system of officiating pay. Part of this disappointment is due to a clause in the memorandum, issued by the India Office at home, on the pay and position of Indian medical officers, giving any one reading the document to infer that full regimental pay is issued to all officers on passing the that
no
better men.
lower standard examination in Hindustani.
We
are
sorry to say
Januaey 1,
THE FUTURE OF THE INDIAN MEDICAL SERVICE.
1878.]
that, though the Secretary of State
matter has been for
India,
any alteration in this official are being misled every day.
brought to the notice of the thought fit to cause paper, and consequently new men he has not
As at present constituted, the Indian Medical Service is a very large body of officers, discharging all the various duties pertaining to the medical profession in India ; but however employed, they are at the disposal of the State in an emergency for military service, and they have all had considerable experience in this particular branch of the profession?a branch in which experience is in the highest degree necessary. Situated as we are in this country, it would be impossible to devise a medical service so thoroughly adapted to our position here as the Indian Medical Service is. The Indian Government is the only Government that possesses a properly organized medical department fit to cope with any emergency. The British service, in the event of an European war, would have to be almost exclusively filled up with medical students, exactly as occurred twenty-three years a ago in the Crimea. The Naval Medical Service is only skeleton.
profession in India are properly be no question. The report abundant bears officer district testimony to this, and in cf every civil emergencies the serviee has always borne a prominent part with conspicuous abijity. Our readers will remember the Minute of the Bengal Government on the famine of 1874-75, and also on the fearful outbreak of cholera after the epidemic of 1876, and during the present famine in Madras already have appeared expressions of opinion from Government, very favourable to the officers engaged there. Again, it must be conceded that the That the civil duties of the
and
efficiently discharged,
there
can
Schools of Medicine in this country in which medical science
taught in English, are a very great success, and reflect the greatest credit on the service. The Government, then, has a large body of medical officers, selected from the very best men available, and the duties performed by them are discharged in a manner satisfactory in the highest degree. It is, therefore, very difficult to see why any change should be considered desirable, but it may not be impossible to trace out is
one
or
two
much the
influences at work, the motive for which is not so
good community. It
of the State
as
of much smaller sections of the
may be stated here that the chief has been discussed is the creation of a Civil Medical
change that Department
recruited for the services of the Local Governments. The first influence that is at work is the
English War-Office. destroyed by reorganization. Time after time have advertisements appeared, notifying fifty acknowledged vacancies,and the War-Office has, it is well known, a maxim that truthfulness is a virtue not applicable to numbers, and each time they have only secured about half even The British Medical
Department
has been
As the greatest obstacle to the British Service obtain-
of these.
is the Indian
Service,
imagine with what joy, the Minister-at-War views the reorganization of a service that will practically prevent it being any longer a competitor with his own. Many a hint will he gladly furnish on the science of making a service unpopular, on which subject he is the highest living authority. We all remember the persuasive eloquence of the fox who had lost his tail. Though the Indian Medical Service is almost unanimous against the change, there are, we regret to say, a few men in it who advocate it, and ing therefore, men
so
we can
21
to sacrifice their own
department. But exception who wish to sell their service for their own private advantage. They are in hopes that, if a new service he formed, for their complaisance they will be placed at the head of it, and their brains are, doubtless, already busy manufacturing the imposing titles they intend to recomwho
they
thus
are
are men
willing
almost without
mend should be conferred upon themselves. If the Government opinion of these gentlemen, let it give them to
wishes the honest
highest administrative post in the new personal assistant to a Secretary on eight hundred rupees a month. These astute gentlemen will then, we fancy, leave the scheme of reorganization pretty severely alone. But on the other hand, the Government i3 in duty bound to listen at least with equal attention to the almost unanimous cry of the members of the service. They are in quite as good a position to judge, and they are as a body firmly united against change of this kind. The Indian Medical Service is not an institution that has been built up in a day. At the present time many men are glad to enter the service on account of its good name. It has kept its position in India for a very long time unchanged, and the Government has kept its faith with it. It has a respectability and, what is as important, a stability that understand that the
service will be
no
a
other medical service
ever
had.
To
a
great extent it is living
reputation, and in this way men are obtained for it on terms considerably below their market value. There are many men in India serving on the extremely small unemployed pay of the department, who could obtain much better terms at home. Every year men join, who have excellent prospects in Great Britain and have highly distinguished themselves on the class lists of our colleges, attracted by the good name of the service, its honourable traditions, and above all, by its stability. But change all this, establish a new service, let men once see that the spirit of innovation is supreme, and the service as a service is gone for evei\ It is not possible to secure better men than are now obtained, but it will be easy enough to get very much The reputation of the service once gone?as it will at worse. the very first sign of a change?and we know from the example of on
its
the British Medical Service what will be the result.
A few
will be obtained for the civil
department, who will come out here on speculation to see what they can get, and when they find how matters really are, it will not be long before they take their departure. A few unsuccessful practitioners may be more permanent members, and now and then the sei'vice will be re-enforced with an occasional specimen of that singular class of "experienced surgeons," which, according to advertisements, are carried on ships in company with a cow and a stewardess. But those men who now come out, proud to join a service with so good a name, and who are content to spend their working lives out here for the good of the many millions around them, and who regard the service as a home, they will have gone for men
ever.
It
is,
as
Lord Cardwell and Mr.
this time, much easier to destroy
a
Hardy
know well
enough by
service than to create one.
But if any great advantage could accrue to the State by the destruction of a service, it is undoubtedly right to sacrifice that service for the
good
of the nation.
But this is not the case
in the present instance. The State is as well served under the present regime as it can possibly be under any other, and the
only of
reorganization will be that a very inferior class to that now obtained wiil come out here, as we have
result of a
men
THE INDIAN MEDICAL GAZETTE.
22
said, and finding on closer inspection things not quite so goldentinted as they appeared from afar, will depart; and their report on the land of promise will?we may be sure?not he very conducive to other men to
will, therefore, destroy which,
try
their fortunes.
service
on
The Government
which
it
can
rely,
to
which may may not turn out well, but about from experience of other services after reorganization,
establish one
a
one
cannot
or
help having
the worst
forebodings.
The Government has, at any rate, some basis on which to form an opinion on this subject. There is an Uncovenanted
Medical Service in India; let the Government then contrast the members of this service with those of the Covenanted-
It is clear, then, that as to most points the Government has thing to lose, and nothing to gain, by this change. In regard even to administration it is difficult to see that there every
advantage in this innovation. If the Government of appoints a medical officer of administrative rank to each Local Government, to be its professional adviser and administrative head of the portion of the medical department in the service of that Local Government, every object desired in the
is any India
creation of the
new
service will have been achieved.
Each
local Government will then have its medical service and its own
adviser.
Finally, we would urge Government thoroughly before breaking up a
very
traditions
as
the Indian Medical
to consider the
question good sanctioning any
service
Service,
or
of such
that has worked
so well. organization great change Let it weigh carefully what it may gain, and what it will lose by these changes. If the British service is incapable of
in
an
discharging its own functions in this country, through want of men, let it give up its duties to its Indian sister, which has never yet been found unequal to any calls that have been made on it. We think we have said enough to show how faithfully the service has served, and is serving, the Government and the nation, and that its organization is admirably adapted for the country in which we live, and that for these reasons the Government will do well, in its own interest, to save it from reorganization.
[January 1, 1878.
reorganization of the Indian Medical Service appears to be still in contemplation, it may be of some use to re-consider the subject here in regard to the advantages and disadvantages of such a step to the Government of India, the public, and the As the
members of the service. It may be stated in the commencement that the Indian Medical Service is at the present moment contented, and at the same time it will probably be 'admitted that it is the most
disposal of any Government exceedingly well-informed on this
efficient medical service at the An officer,
in the world.
subject,
stated
a
short time ago, that the Indian service obtained procurable. It is clear, therefore,
the very best men that were
reorganization will enable the Government to obtain There are, undoubtedly, some grievances; the worst of these are the great inadequacy of the pensions, and the disappointment young officers experience when entering the service through the system of officiating pay. Part of this disappointment is due to a clause in the memorandum, issued by the India Office at home, on the pay and position of Indian medical officers, giving any one reading the document to infer that full regimental pay is issued to all officers on passing the that
no
better men.
lower standard examination in Hindustani.
We
are
sorry to say
Januaey 1,
THE FUTURE OF THE INDIAN MEDICAL SERVICE.
1878.]
that, though the Secretary of State
matter has been for
India,
any alteration in this official are being misled every day.
brought to the notice of the thought fit to cause paper, and consequently new men he has not
As at present constituted, the Indian Medical Service is a very large body of officers, discharging all the various duties pertaining to the medical profession in India ; but however employed, they are at the disposal of the State in an emergency for military service, and they have all had considerable experience in this particular branch of the profession?a branch in which experience is in the highest degree necessary. Situated as we are in this country, it would be impossible to devise a medical service so thoroughly adapted to our position here as the Indian Medical Service is. The Indian Government is the only Government that possesses a properly organized medical department fit to cope with any emergency. The British service, in the event of an European war, would have to be almost exclusively filled up with medical students, exactly as occurred twenty-three years a ago in the Crimea. The Naval Medical Service is only skeleton.
profession in India are properly be no question. The report abundant bears officer district testimony to this, and in cf every civil emergencies the serviee has always borne a prominent part with conspicuous abijity. Our readers will remember the Minute of the Bengal Government on the famine of 1874-75, and also on the fearful outbreak of cholera after the epidemic of 1876, and during the present famine in Madras already have appeared expressions of opinion from Government, very favourable to the officers engaged there. Again, it must be conceded that the That the civil duties of the
and
efficiently discharged,
there
can
Schools of Medicine in this country in which medical science
taught in English, are a very great success, and reflect the greatest credit on the service. The Government, then, has a large body of medical officers, selected from the very best men available, and the duties performed by them are discharged in a manner satisfactory in the highest degree. It is, therefore, very difficult to see why any change should be considered desirable, but it may not be impossible to trace out is
one
or
two
much the
influences at work, the motive for which is not so
good community. It
of the State
as
of much smaller sections of the
may be stated here that the chief has been discussed is the creation of a Civil Medical
change that Department
recruited for the services of the Local Governments. The first influence that is at work is the
English War-Office. destroyed by reorganization. Time after time have advertisements appeared, notifying fifty acknowledged vacancies,and the War-Office has, it is well known, a maxim that truthfulness is a virtue not applicable to numbers, and each time they have only secured about half even The British Medical
Department
has been
As the greatest obstacle to the British Service obtain-
of these.
is the Indian
Service,
imagine with what joy, the Minister-at-War views the reorganization of a service that will practically prevent it being any longer a competitor with his own. Many a hint will he gladly furnish on the science of making a service unpopular, on which subject he is the highest living authority. We all remember the persuasive eloquence of the fox who had lost his tail. Though the Indian Medical Service is almost unanimous against the change, there are, we regret to say, a few men in it who advocate it, and ing therefore, men
so
we can
21
to sacrifice their own
department. But exception who wish to sell their service for their own private advantage. They are in hopes that, if a new service he formed, for their complaisance they will be placed at the head of it, and their brains are, doubtless, already busy manufacturing the imposing titles they intend to recomwho
they
thus
are
are men
willing
almost without
mend should be conferred upon themselves. If the Government opinion of these gentlemen, let it give them to
wishes the honest
highest administrative post in the new personal assistant to a Secretary on eight hundred rupees a month. These astute gentlemen will then, we fancy, leave the scheme of reorganization pretty severely alone. But on the other hand, the Government i3 in duty bound to listen at least with equal attention to the almost unanimous cry of the members of the service. They are in quite as good a position to judge, and they are as a body firmly united against change of this kind. The Indian Medical Service is not an institution that has been built up in a day. At the present time many men are glad to enter the service on account of its good name. It has kept its position in India for a very long time unchanged, and the Government has kept its faith with it. It has a respectability and, what is as important, a stability that understand that the
service will be
no
a
other medical service
ever
had.
To
a
great extent it is living
reputation, and in this way men are obtained for it on terms considerably below their market value. There are many men in India serving on the extremely small unemployed pay of the department, who could obtain much better terms at home. Every year men join, who have excellent prospects in Great Britain and have highly distinguished themselves on the class lists of our colleges, attracted by the good name of the service, its honourable traditions, and above all, by its stability. But change all this, establish a new service, let men once see that the spirit of innovation is supreme, and the service as a service is gone for evei\ It is not possible to secure better men than are now obtained, but it will be easy enough to get very much The reputation of the service once gone?as it will at worse. the very first sign of a change?and we know from the example of on
its
the British Medical Service what will be the result.
A few
will be obtained for the civil
department, who will come out here on speculation to see what they can get, and when they find how matters really are, it will not be long before they take their departure. A few unsuccessful practitioners may be more permanent members, and now and then the sei'vice will be re-enforced with an occasional specimen of that singular class of "experienced surgeons," which, according to advertisements, are carried on ships in company with a cow and a stewardess. But those men who now come out, proud to join a service with so good a name, and who are content to spend their working lives out here for the good of the many millions around them, and who regard the service as a home, they will have gone for men
ever.
It
is,
as
Lord Cardwell and Mr.
this time, much easier to destroy
a
Hardy
know well
enough by
service than to create one.
But if any great advantage could accrue to the State by the destruction of a service, it is undoubtedly right to sacrifice that service for the
good
of the nation.
But this is not the case
in the present instance. The State is as well served under the present regime as it can possibly be under any other, and the
only of
reorganization will be that a very inferior class to that now obtained wiil come out here, as we have
result of a
men
THE INDIAN MEDICAL GAZETTE.
22
said, and finding on closer inspection things not quite so goldentinted as they appeared from afar, will depart; and their report on the land of promise will?we may be sure?not he very conducive to other men to
will, therefore, destroy which,
try
their fortunes.
service
on
The Government
which
it
can
rely,
to
which may may not turn out well, but about from experience of other services after reorganization,
establish one
a
one
cannot
or
help having
the worst
forebodings.
The Government has, at any rate, some basis on which to form an opinion on this subject. There is an Uncovenanted
Medical Service in India; let the Government then contrast the members of this service with those of the Covenanted-
It is clear, then, that as to most points the Government has thing to lose, and nothing to gain, by this change. In regard even to administration it is difficult to see that there every
advantage in this innovation. If the Government of appoints a medical officer of administrative rank to each Local Government, to be its professional adviser and administrative head of the portion of the medical department in the service of that Local Government, every object desired in the
is any India
creation of the
new
service will have been achieved.
Each
local Government will then have its medical service and its own
adviser.
Finally, we would urge Government thoroughly before breaking up a
very
traditions
as
the Indian Medical
to consider the
question good sanctioning any
service
Service,
or
of such
that has worked
so well. organization great change Let it weigh carefully what it may gain, and what it will lose by these changes. If the British service is incapable of
in
an
discharging its own functions in this country, through want of men, let it give up its duties to its Indian sister, which has never yet been found unequal to any calls that have been made on it. We think we have said enough to show how faithfully the service has served, and is serving, the Government and the nation, and that its organization is admirably adapted for the country in which we live, and that for these reasons the Government will do well, in its own interest, to save it from reorganization.
[January 1, 1878.
