Medical and Holberton Institution (CAP. 270 1

CHAPTER 270

THE MEDICAL AND HOLBERTON INSTITUTION
ACT

Arrangement of Sections
Section

I. PRELIMINARY

1. Short title.
2. Interpretation.

11. THE HOLBERTON INSTITUTION

3. Establishment of Holberton Institution.
4. Medical Superintendent of the Institution.
5. Other officers of the Institution.
6. Visitors of the Institution.
7. Audit of book and accounts of the Institution.
8. Rules for the government of the Institution.
9. Object of the hospital.

10. Admission to the hospital.
1 1. Soup kitchen and workhouse.
12. Fiennes Institute.

111. DISTRICT MEDICAL RELIEF

13. Medical districts.
14. Appointment of District Medical Officers.
15. Residence of District Medical Officers.
16. Duties of District Medical Officers.
17. Emoluments of District Medical Officers.
18. Regulations and tariff of fees.

IV. MISCELLANEOUS

19. Medical aid, &c., to residential labourers, etc.
20. Removal to hospital of labourers.
21. Payment by proprietor, &c., for labourers in Hospital.

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2 CAP. 270) Medical and Holberton Institution

22. Recovery of penalties.
23. Recovery of fees and charges.
24. Finance.

SCHEDULE A.
SCHEDULE B.

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Medical and Holberton Institution (CAP. 270 3

MEDICAL AND HOLBERTON INSTITUTION

(19th June, 1899.)

S.I. 3911989.

1. This Act may be cited as the Medical and Holber- Short title.
ton Institution Act.

2. In this Act- Interpretation.

"destitute person" means a person who is not possess-
ed of, and by reason of infancy, old age, perma-
nent bodily injury or incurable disease is unable
to earn, means sufficient for his maintenance;

"District Medical Officer" means a Medical Officer
appointed under section 14;

"Holberton Institution" or "the institution" means the
Holberton Institution as constituted by section 3;

"hospital" means the Holberton Hospital;

"labourer" means and includes handicraftsman,
agricultural labourer, menial servant, boatman and
porter;

"medical district" or "district" means a district con-
stituted by or under section 13;

"Medical Superintendent" or "Superintendent" means
the medical superintendent appointed under sec-
tion 4;

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6 ' proprietor" used with reference to any estate, includes
attorney, agent, manager and other person acting
under the authority of the proprietor or having
charge of the estate;

"rules" means rules in force under section 8;

"visitor" means visitor appointed under section 6.

11. THE HOLBERTON INSTITUTION
Establishment of
Holberton

3. (1) The Holberton Hospital and the Fiennes
Institution. Institute shall, together with the soup kitchen and workhouse,

for the establishment of which this Act provides, form the
Holberton Institution.

(2) The said public institutions together with all lands
and appurtenances thereto belonging, shall be vested in Her
Majesty for the use of the Holberton Institution.

Medical
Superintendent

4. (1 ) It shall be lawful for the Public Service Com-
of the mission to appoint some duly qualified medical practitioner
Institution. to be Medical Superintendent of the Holberton Institution.

(2) The Medical Superintendent shall receive such
salary as may from time to time be provided by Parliament:

Provided that should the Medical Superintendent be
allowed by the Governor-General to enjoy the right of private
practice on his own account the salary to be received by him
shall not exceed such sum as may from time to time be fixed
by the Governor-General. The Governor-General shall decide
whether any Medical Superintendent appointed under this
Act shall be allowed to enjoy private practice, and it shall
be in his power to withhold or withdraw such right at any
time if he shall think fit.

(3) The Medical Superintendent shall reside in the
grounds of the institution and, subject to the provisions of
this Act, and of the rules and to the directions of the
Governor-General, shall have the entire control of the
Institution and be responsible for the proper lodging, clothing,
care, maintenance and relief of the sick and poor inmates
thereof.

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Medical and Holberton Institution (CAP. 270 5

5 . There shall be such other officers and such atten- 2;g;ff54;'
dants and servants as are necessary for the management and
service of the institution, who shall receive such emoluments
as Parliament may determine.

6. (1) It shall be lawful for the Minister to appoint V'sitors of the
~nstitution.

such persons as he may think fit to be visitors of the Holberton
Institution.

(2) The visitors shall hold office during the Minister's
pleasure.

(3) Such visitor as the Minister shall nominate shall be
Chairman of the visitors.

(4) The visitors shall meet at such place as the Chair-
man may from time to time appoint at least once in every
three months for the despatch of business.

(5) Three visitors shall form a quorum.

(6) It shall be the duty of the visitors to report to the
Minister from time to time on the condition and manage-
ment of the Institution and on all matters which they con-
sider it proper to bring to his notice.

7. The books and accounts of the Institution shall be t,"dd;:zt,b,"~,k:~
audited by the Director of Audit. the Institution.

8. (1) Subject to the provisions of this Act the Cabinet Rules for the
government of

may make rules with regard to all or any of the following the Institution.
matters, that is to say-

(a ) The powers and duties of the officers and
servants of the Institution;

(6 ) The functions of visitors;

(c) The powers and duties of Guardians;

(d) Admissions to and discharges from the
Institution;

( e ) The lodging, clothing, care, maintenance and
relief of the sick and poor inmates of the Institution;

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V) The fees and charges to be paid by persons able
to pay for their treatment in the hospital;

(g) The distribution of food at the soup kitchen and
workhouse;

( h ) The employment of such of the inmates of the
Institution as, in the opinion of the Superintendent, are
able to work without detriment to their health;

(i) The general good order and government of the
Institution and every part thereof;

The application of any sums which may be
provided from time to time by the Legislature for out-
door relief of destitute persons;

(k) The training of persons desiring to qualify as
dispensers, nurses or midwives;

and may attach a penalty which shall not exceed two
hunded and fifty dollars to any breach of any such rule.

(2) All rules made under this section shall be laid before
Parliament after the making thereof.

Object of the
hospital.

9. The object of the hospital shall be to provide
accommodation and medical and surgical aid for sick persons
under the provisions of such rules as may from time to time
be made by Cabinet.

Admission to the
hospital.

10. (1) Every District Medical Officer shall have
authority in each year to give so many recommendations
as may from time to time be fixed by the Cabinet and every
duly qualified medical practitioner shall have authority at
any time to give a recommendation for admission to the
hospital to any person suffering from any disease, sickness
or injury, which, in the opinion of such Medical Officer or
medical practitioner, cannot be properly treated elsewhere:

Provided that no District Medical Officer or medical
practitioner shall give any such recommendation without hav-
ing first personally visited or seen such person and satisfied
himself that such person is a proper subject for admission
to the Hospital:

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Medical and Holberton Institution (CAP. 270 7

Provided also that labourers resident on an estate shall,
except in cases of emergency, only be admitted to the hospital
on the certificate of the medical attendant of the estate:

Provided nevertheless that any District Medical Officer
having in any year exhausted the number of recommenda-
tions by this section authorized to be given by him in such
year may in special cases and on special grounds and subject
to the other provisions in this section contained give additional
recommendations, such special grounds and the nature of
the case to be stated in the recommendations, and to be sub-
ject to the approval of the Medical Superintendent.

(2) Every recommendation shall be, as nearly as
circumstances admit, in the form given in Schedule A or schedule A.
as may be prescribed by the rules to be made under section
8 and shall comprise such particulars as the Medical
Superintendent may require.

(3) Upon receipt of such a recommendation signed by
a District Medical Officer or duly qualified medical practi-
tioner, the Medical Superintendent shall carefully examine
the person who is the subject of the recommendation, and,
if he shall be of opinion that the case is a proper one for
admission to the hospital, either provisionally or otherwise,
he shall admit such person accordingly.

(4) The Superintendent shall have authority to admit
to the hospital, upon such terms as to payment and other
matters as the Cabinet shall determine, any person suffer-
ing from any disease, sickness or injury, who is not entitled
to gratuitous relief under this Act.

1 . Attached to the Institution there may be, if ~ , " , p k ~ ~ ~ ~ and
deemed necessary by the Minister, a soup kitchen and
workhouse, where soup and other food shall be distributed
to destitute persons, and such inmates of the Institution as
are able to work without detriment to their health shall be
employed in accordance with the rules.

12. The Fiennes Institute shall be maintained for the Fiennes Institute.
reception and relief of destitute persons.

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Medical districts. 13. It shall be lawful for the Cabinet to divide Antigua
and Barbuda into medical districts and to abolish and
reconstitute such districts and to alter the boundaries thereof:

Provided that there shall not be more than six such
districts.

intment of
i ! . . i c t Medical

14. It shall be lawful for the Public Service Commis-
Officers. sion to appoint any number not exceeding six duly qualified

medical practitioners, to be District Medical Officers.

Residence of
District Medical

15. Every District Medical Officer shall be liable to
Officers. be assigned to or transferred to or from any district or districts

and shall reside at such place as the Minister may from time
to time approve.

Duties of District 16. (1) The duties of every district Medical Officer
Medical Officers.

shall be as follows-

(a ) To afford, when requisite, gratuitous medical
and surgical aid and to furnish, without charge, all
necessary medicines to all children of labourers under
ten years of age and to all labourers above sixty years
of age within his district;

(6) To give such notices, perform such vaccinations,
make such inspections, deliver such certificates, and,
generally, do such acts and things as the laws relating
to vaccination may require of him;

(6) To afford within his district, when requisite,
gratuitous medical and surgical aid and to furnish,
without charge, all necessary medicines to every destitute
person and to every destitute woman who may be in
travail ;

(d) To afford to labourers not entitled to gratuitous
services under this Act medical and surgical aid and
medicines at the rates set forth in the tariff of fees framed
by the Cabinet as hereinafter provided;

(e) In all cases of sudden illness within his district
to attend and afford and furnish all necessary medical
and surgical aid and medicines without in any such case
demanding prepayment for the same:

-*;

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%

Provided that nothing herein contained shall be con-
strued as debarring any medical practitioner from
subsequently demanding and recovering reasonable com-
pensation for such attendance, aid and medicines;

Cf) Gratuitously to afford medical and surgical relief
and supply medicines to such Inspectors of the Police
Force as were appointed before the passing of this Act,
to the non-commissioned officers and to the privates of
the Force stationed within his district, and, at the re-
quest of the officer in charge of any police station within
his district, to afford such relief as aforesaid and supply
medicines to persons confined therein;

Cg) To attend all inquests held within his district
when required so to do by the coroner, to make all
necessary examinations and reports in connection
therewith and to give evidence thereat;

(h ) To inspect at least once in every quarter every
village and hamlet within his district and for that purpose
to enter any house, building or premises within the
district; and to inquire into and report upon the sanitary

:a condition of his district and every part thereof in accord-

5 ance with such instructions as he may from time to time
@ receive from the Minister;
B

(9 To enter into and inspect any place where
articles of human food or spirituous or fermented liquors
are sold or kept for sale and examine the same, and,
if it shall appear to him that such articles or liquors are
intended to be used as food or drink for man and to
be unfit for such use, to cause the same to be seized
and carried before a Magistrate, who may order the
same to be destroyed or otherwise disposed of, and the
person to whom the same may belong, or in whose
possession they may be found, on summary conviction,
to pay a penalty not exceeding two hundred and fifty
dollars:

Provided that, if, in the opinion of the District
Medical Officer, any article is putrid, or in a state of
decomposition, or so manifestly unsound as to be a
nuisance, he may forthwith order the same to be seized
and destroyed by any police or other constable;

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(J) To keep a dispensary in such part of his district
as the Governor-General may appoint;

Schedule B.

(k) To furnish the Chief Medical Officer for the
Minister's information with a monthly return of the cases
coming under medical or surgical treatment in his
district, which return shall be in the form set forth in
Schedule B; and

(I) In general to do such acts and things as may
be required of him by any law.

(2) Where in a case of sudden illness, or in a case of
an illness becoming suddenly and seriously aggravated, the
District Medical Officer for the district wherein any such
case occurs is by reason of absence or illness unable to attend
to such case, it shall be the duty of any other District Medical
Officer, upon request made, and notwithstanding that such
case does not occur within his district, to attend and afford
and furnish all necessary medical and surgical aid and
medicines without in any such case demanding prepayment
for the same.

(3) Nothing in this section shall be deemed to debar
any medical practitioner from subsequently demanding and
recovering reasonable compensation for such attendance, aid
and medicines.

Emoluments of 17. District Medical Officers shall receive such salary
District Medical
Officers. as may from time to time be provided by Parliament.

Regulations and
tariff of fees.

18. (1) The Cabinet may make such regulations, con-
sistent with the provisions of this Act, as may be necessary
for the direction and guidance of the District Medical Officers
and frame a tariff of fees which shall be payable in respect
of professional services rendered and medicines supplied by
them to labourers not entitled to their gratuitous services
under this Act.

(2) All regulations and tariffs under the authority of this
section shall be laid before Parliament after the making
thereof.

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Medical and Holberton Institution (CAP. 270 11

IV. MISCELLANEOUS

19. (1) It shall be the duty of every ~ r o ~ r i e t o r of any EZ.;~;: aid,
estate having not less than fifty acres in cultivation to retain ,,,ide,tid
the services of a duly qualified medical practitioner to afford labourers, etc.
medical and surgical aid and medicines free of charge to-

(i) residential labourers;

(ii) the children of any such residential labourers,
who are under the age of twelve years and are
resident on the estate; and

(iii) aged and infirm persons who are resident and
who have previously been employed on such
estate.

(2) The proprietor of any such estate who shall fail to
retain the services of a duly qualified medical practitioner
for such purpose shall be guilty of an offence, and shall on
summary conviction thereof be liable to a fine not exceeding
two hundred and fifty dollars for every month during which
he shall so fail.

(3) It shall be the duty of every Magistrate to make
a return for the information of the Minister once in every
six months of all such estates within his district with the name
of the medical attendant retained by the proprietor of each
estate.

(4) In this section "residential labourer" means any
person who, with the consent of the proprietor of an estate,
enters into the sole or joint occupation of a house or part
of a house on and belonging to such estate for the purpose
of serving as a labourer on the estate.

20. It shall be the duty of the proprietor or the per- Removal to hospital of
son in charge of any estate, having not less than fifty acres labourers.
in cultivation, to remove to the hospital at his own expense
any labourer resident on such estate whose removal from
his place of residence may be ordered by the medical attend-
ant of the estate. For such removal, use may be made, at
a rate or charge to be fixed by the Minister, of the govern-
ment ambulance, when available, and any proprietor or
person in charge of such estate, who shall refuse or neglect
to convey or cause to be conveyed to the hospital any such

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12 CAP. 270) Medical and Holberton Institution

labourer within a reasonable time of the order for removal
being made, shall be liable on summary conviction to a
penalty not exceeding two hundred and fifty dollars.

Payment by
proprietor, &c., 2 1. The proprietor or person in charge of any estate,
for -- labourers in h a v i n ~ not less than fifty acres in cultivation, shall pay to
Hospital. the superintendent the s&m of fifteen cents per diem To; the

maintenance and treatment in hospital of any labourer
resident on such estate who may be removed to the hospital
as provided in the preceding subsection, or who may be
admitted to the hospital by the Superintendent under any
of the provisions of this Act, and such amount shall be deemed
to be a debt due from the proprietor or person in charge
of the estate and his executors to the Superintendent or his
deputy for the time being, and shall be recoverable by civil
proceedings under the provisions of the Magistrate's Code

Cap. 255. of Procedure Act:
Provided that the liability of a proprietor or person in

charge of an estate for such maintenance and treatment at
hospital shall not continue for a longer period than thirty
days after the admission to hospital of such labourer.

Recovery of
penalties.

22. All fines and penalties imposed by this Act or the
rules shall be recoverable summarily on the complaint of the
Medical Superintendent of the Holberton Institution under
the provisions of the Magistrate's Code of Procedure Act.

Recovery of fees
and charges.

23. All hospital fees and charges and all monies due
to the Institution respectively under this Act, or the rules,
are hereby declared to be a civil debt recoverable summarily
in accordance with the Magistrate's Code of Procedure Act
by the Medical Superintendent in his official name or by
the House Steward in his official name.

Finance. 24. The expenses of the upkeep of the Holberton
Institution and of the maintenance and support of the inmates
thereof, and the salaries, allowances and wages of all officers
and servants appointed under this Act shall be defrayed from
the general revenue of Antigua and Barbuda.

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Medical and Holberton Institution (CAP. 270 13

SCHEDULE A (S. lO(2) )

1, the undersigned duly qualified
practitioner,* hereby certify that on the
day of
I personally examined (name) of (address) (condition t ); that I then
found the said to be suffering from

; that, in my opinion, such
cannot be properly treated elsewhere than in the hospital, and
the said is a proper subject for gratuitous
admission to the hospital; and that the subjoined particulars are
to the best of my knowledge and belief true and correct; and I
hereby recommend that the said
be admitted to the hospital.

Dated at this day of

(Signature and qualification)

*If the person proposed for admission is an estate labourer, add "and medical atten-
dant of [ ] estate".

t If the person proposed for admission is an estate labourer, give the name of
the estate.

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SCHEDULE B ( s . 16(1)(k)

Return of the cases attended by the Medical Officer of District
during the month of

Date of
attend-

ance

Disease,
or cause

of
treat-
ment

If sent
to

hospital
or not

Names of
parents

of
children

Age Names of
persons
attended

8
5
2

Result
Remarks