MEDICAL OFFICERS OF THE HOSPITAL FOR MENTAL DISEASES REGULATIONS

SUBSIDIARY LEGISLATION 94.11

MEDICAL OFFICERS OF THE HOSPITAL FOR

MENTAL DISEASES REGULATIONS

9th July, 1965

LEGAL NOTICE 36 of 1965.

The title of these Regulations is Medical Officers of the

Hospital for Mental Diseases Regulations.

PART I

I. RESIDENT PHYSICIAN SUPERINTENDENT

The Resident Physician Superintendent (hereinafter

referred to as "the Superintendent") shall be entrusted with the

general administration and control of the hospital, and shall have in

addition the direction of the care and treatment of a number of

patients. The Superintendent shall see that all members of the staff

of the hospital perform their duties strictly in accordance with these

Regulations and shall bring without delay all instances of neglect

or disobedience of orders to the notice of the Chief Government

Medical Officer. The Superintendent shall be responsible for the

correctness of supplies of all kinds, the regular working of all

branches of the service, the cleanliness and good order of the

premises, the maintenance of discipline and the due observance on

the part of all officers and employees of the regulations and of all

instructions given by the authorities, and shall report any deviation

therefrom to the Chief Government Medical Officer.

The Superintendent shall correspond with the Chief

Government Medical Officer (or his representative) on all matters

of management, discipline, supplies and alterations and repairs in

the hospital. He is the channel of communication between the

hospital and the Chief Government Medical Officer, and all

correspondence, requisitions and matters connected thereto shall be

transmitted by him.

The Superintendent shall reside in the quarters provided

for him in the hospital.

The Superintendent shall give advice in his speciality to

the Government, to the Chief Government Medical Officer or to

any other Government Medical Officer, with regard to any matter

which these officers have to deal with in their official capacity.

The Superintendent shall examine every newly admitted

patient under his care and shall see that his instructions as to

classification, diet, nursing and treatment of all such patients are

properly carried out and entered by the medical officers concerned

in the relative registers or case sheets.

The Superintendent shall be responsible for every entry in

the professional registers of the hospital and shall take care that all

admissions, discharges and deaths be duly recorded, and that the

prescription books, medical visits book, case sheets, diet books and

all other records are regularly kept.

When any violent or sudden death or absence without leave

of any patient under his care occurs the Superintendent shall see

that the medical officer on duty has acted in accordance with

regulation 40, and shall submit a detailed report of the case and of

any investigations to the Chief Government Medical Officer.

The Superintendent shall cause lists to be prepared of all

patients under his care who are suicidal or subject to any disease or

habit requiring particular attention; such lists are to be delivered to

the nurses in each ward for their guidance and are to be corrected

from time to time with every change.

The Superintendent shall pay surprise visits to the wards

whenever he deems it proper both during the day and during the

night. The night visits shall be entered in the officers’ night

inspection book.

The Superintendent shall inspect or cause to be inspected

by a medical officer and by the store officers all the provisions

supplied to the hospital, and shall ascertain that the food is properly

cooked and distributed, and that the patients receive the diet that

has been prescribed for them. Whenever the Superintendent is

unable to attend personally the inspection of provisions, he shall

delegate another medical officer to act in his stead.

The Superintendent shall submit to the Chief Government

Medical Officer statistical returns and financial reports, and such

other reports regarding the patients and the administration of the

hospital as may from time to time be required by that officer. As

soon as possible after the end of each calendar year he shall

transmit to the Chief Government Medical Officer a report on the

professional and administrative work carried out in the hospital

during the year.

All prison cases and cases of persons found insane and sent

to hospital by order of the criminal courts shall be under the direct

care and treatment of the Superintendent.

II. RESIDENT DEPUTY PHYSICIAN SUPERINTENDENT

The resident deputy physician Superintendent shall

exercise such duties, powers and functions as may be delegated and

assigned to him by the Superintendent.

When the Superintendent is absent his deputy shall act in

his stead and shall have the powers and functions assigned to the

Superintendent.

The resident deputy physician Superintendent shall reside

in the quarters provided for him in the hospital.

The provisions of these Regulations relative to

psychiatrists in so far as applicable shall apply to the resident

deputy physician Superintendent.

III. THE PSYCHIATRISTS

Psychiatrists will be directly responsible for the care and

treatment of a number of patients under the overall administrative

supervision of the Superintendent. The psychiatrists shall have full

clinical control and responsibility for patients under their care.

They shall take full personal responsibility for the investigation

and/or treatment of patients without supervision.

Psychiatrists shall examine every newly admitted patient

under their care and shall see that their instructions as to

classification, diet, nursing and treatment of all patients are

properly carried out and entered by the medical officers concerned

in the relative registers or case sheets.

When any violent or sudden death or absence without leave

of any patient under their care occurs the psychiatrists shall see that

the medical officer on duty has taken action as in regulation 40 of

these Regulations. The detailed report of the case and of any

investigations shall be submitted to the Chief Government Medical

Officer through the Superintendent.

The psychiatrists shall cause a list to be prepared of all

patients who are suicidal or subject to any disease or habit

requiring particular attention; such lists are to be delivered to the

nurses in each ward for their guidance, and are to be corrected from

time to time with every change.

The psychiatrists’ responsibility for their patients applies

to them all continuously. This applies to in-patients and out-

patients, to urgent and non-urgent cases alike though the extent of

this responsibility may vary in accordance with the classification of

the patient (in-patient or out-patient) and circumstances of the case

(urgent and non-urgent). Psychiatrists shall be on call at any time to

give advice on their patients whenever this is needed. They will

assume functions relating to admissions, discharge, leave of

absence and dealings with relatives and curators of all patients

under their care. Privileges and general amenities within the

hospital are, however, subject to prior arrangements with the

Superintendent in accordance with the facilities available.

Day to day attention may be delegated to resident or other

medical officers but the psychiatrists’ overall and personal

responsibility for their patient continues, notwithstanding

delegation.

The psychiatrists shall immediately make out a written

report to the Superintendent about any misconduct of nurses or

other employees towards patients under their care.

All official communications with the exception of those

referring purely to the clinical and therapeutic conditions of

patients must be made through the Superintendent.

Any research carried out in hospital must have the prior

approval of the Chief Government Medical Officer. A record of any

research undertaken in connection with a particular patient or

patients shall be entered at the time on the patient’s clinical record.

All drugs used for research purposes shall be kept in the hospital

pharmacy under the care of the apothecary.

IV. RESIDENT AND OTHER MEDICAL OFFICERS

The resident and other medical officers shall perform such

medical and administrative duties as the Superintendent may

prescribe, subject to the approval of the Chief Government Medical

Officer. They shall be responsible for the mental and physical

treatment of patients allotted to their care under the guidance of the

Superintendent or the psychiatrist.

The resident and other medical officers shall be entrusted

with the medical registers of patients, the case sheets and the diet

books and any other professional registers of the hospital as the

Superintendent may direct.

The resident medical officers shall reside in the quarters

provided for them at the hospital.

Each one of the medical officers shall pay surprise visits to

the wards at night at least once a month or more frequently if the

Superintendent so directs. The results of these visits shall be

entered in the officers’ night inspection book, which shall be

forwarded for the inspection of the Chief Government Medical

Officer every quarter, or more often, as required.

All new admissions into the hospital must be attended to by

the medical officer on duty without delay. The medical officer on

duty shall examine the admission papers and see that they are in

order. Immediately on admission the medical officer on duty shall

examine the patient for any signs of injury or physical illness and

make a special note of the presence or absence of such injury or

illness.

As soon as possible after admission and in any case within

twenty-four hours of admission, the medical officer is to draw up -

(a) a complete and detailed report on the physical and

psychological condition of the patient on the official

case sheet;

(b) a history of the case as obtained in an interview with

the relatives or friends of the patient.

Subsequently, entries describing the course and progress of

the case and recording the medical and other treatment, with the

results, shall be made on the clinical record as follows: during the

first month after admission, twice in every week and more often

when necessary; afterwards, in recent cases, once at least in every

month; in other cases, notes shall be made as frequently as

necessary but at least three times a year, and one of these notes

shall contain the result of a complete physical examination. All

entries in the clinical record must be signed by the medical officer

making them.

Medical officers shall not absent themselves from the

hospital whilst on duty without the consent of the Superintendent.

Apart from the usual medical visits in the wards as

prescribed by the Superintendent, medical officers shall hold

private follow-up sessions with patients selected by the

Superintendent and/or psychiatrists recording the result of these

sessions on the relative case sheets.

One of the medical officers shall be in charge of the

dispensary, surgical dressing rooms and surgical appliances, and

shall see that proper inventories are kept by the assistant

apothecary. He shall be responsible for the supply of all drugs and

medicines prepared or issued by the assistant apothecary and shall

be accountable for the medicines and other things connected

thereto and under his charge.

The following shall be the periods of duty of resident or

other medical officers

Winter

8.30 a.m. to 12.00 noon

2.00 p.m. to 4.00 p.m.

Summer

8.00 a.m. to 1.00 p.m.

Day and night duty from 8.00 a.m. to 8.00 a.m. of the following

day. The above periods shall be allotted to the medical officers in

turn according to a roster prepared by the Superintendent and

subject to the approval of the Chief Government Medical Officer.

The ordinary ward visits by the medical officers shall take

place from 9.00 a.m. to noon and from 2.00 p.m. to 4.00 p.m. in

winter, or from 3.00 p.m. to 5.00 p.m. in summer. The medical

officers shall supervise the conduct of nurses and others dealing

with patients and immediately report any misconduct, through the

psychiatrist in charge of the patient, to the Superintendent.

Any medical officer, even when off duty, may be called to

the hospital at any time during the day or night if his attendance is

required by the Superintendent or in the latter’s absence, by the

medical officer on duty.

The attendance registers of medical officers shall be kept

by the Superintendent and shall be forwarded for inspection by the

Chief Government Medical Officer at the end of each quarter.

When any violent or sudden and unexpected death or

absence without leave of any patient occurs, medical officers shall

notify the Superintendent or the psychiatrist in charge of the case,

the relatives of the patient and the Police. Medical officers shall

submit a detailed report of the case and of their investigations

thereon to the Superintendent or psychiatrist for transmission to the

Chief Government Medical Officer through the Superintendent.

GENERAL

Unless otherwise provided for in these Regulations, no

information concerning patients or hospital shall be given by

Medical officers to any unauthorised person or to the press unless

permission is obtained from the Chief Government Medical

Officer.