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   5. Ex-Madras areas and ex-Bihar and Orissa areas, which now constitute
the Orissa Province, are governed by the rules regarding hospital fees in
force in Madras and Bihar respectively.

   6. In the Central Provinces and Berar the system of charging a fee
of two pice from each new patient, except paupers, attending a hospital
or dispensary had been in force since 1933. The amounts received on
that account in most cases were insignificant and with a few exceptions
there had been an undoubted fall in the out-patients' attendance. It
was thought that if the system were conscientiously worked out it was
bound to lead to a "set-back" to the popularity of scientific medicine and
the Local Government therefore allowed its discontinuance in the year
1936.

   7. In the North-West Frontier Province an innovation of interest has
been the starting of a "paisa" dispensary, where everybody is required
to pay one pice for the day's medicine supplied and the income thus
derived goes towards the running expenses of the dispensary. The
success of this dispensary has led to the opening of similar dispensaries
elsewhere.

   8. A complaint frequently made against the administration of Indian
hospitals is that large number of patients who can really afford to pay
are treated free of charge. The problem is not simple because modern
scientific medicine is costly and although a person may not be indigent
as regards the ordinary necessities of life, he often is in respect to even
minimum requirements when sick. In the absence of an almoner .system
hospital abuse is not easy to detect, but is probably less common than
is frequently suggested. The increasing employment of honorary medical
officers in hospital out-patients' Departments will probably be a useful
corrective, since the final decision as to a patient's eligibility for free
treatment rests largely with the doctor. On the whole the revenue
obtained from the payments of ordinary patients is not large but fees
paid by patients occupying private or paying wards should cover the cost
to Government (or the Hospital Management) and in general do so.

6. BUILDINGS.

   Madras.—Sir Frank Connor in a note on the Madras Medical Depart-
ment writes that the demand for new buildings and extensions to existing
buildings in the Medical Department seems to have been rather neglected
in recent years. Besides progress has been hampered by what Sir Frank
regards as a bad building policy, for the Medical Department is required
to submit to Government detailed plans and estimates before sanction to
the project is accorded. After such plans and estimates have been sub-
mitted the scheme is often not accepted for want of funds or other
reasons. A very appreciable loss in time and money results as some years
may elapse before it is eventually accepted and by that time considerable
revision of the plans becomes necessary. Besides, for the construction
of large hospitals the system of providing money in small yearly grants
is most disadvantageous.