Revised Laws of Saint Lucia (2021)

Hospitals Regulations – Section 34

(Statutory Instruments 68/1992, 83/1997, 118/2020 and Act 1 of 2015)

Statutory Instrument 68/1992 .. in force 1 October 1992

Amended by S.I. 83/1997 .. in force 22 September 1997

Amended by Act 1 of 2015 .. in force on Order

Amended by S.I. 118/2020 .. in force 20 July 2020

ARRANGEMENT OF REGULATIONS

HOSPITALS REGULATIONS – SECTION 34

Commencement [1 October 1992]

1.   Citation

These Regulations may be cited as the Hospitals Regulations and shall apply with the necessary modifications to any hospital declared by Cabinet to be a hospital for the purposes of the Act. (Amended by Act 1 of 2015)

2.   Interpretation

In these Regulations unless the contest otherwise requires—

“Baron Wing” means the Baron Wing of the Victoria Hospital;

“hospital charges” has the meaning assigned to it in the Act;

“Act” means the Hospitals Act, 1954;

“patient” means a person (not being a maternity case and who is not covered by Medical Insurance) other than a person who—

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   (a)     is in receipt of an income of less than $6,000 per annum;

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   (b)     is a registered pauper;

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   (c)     is a child of a person described in paragraph (a) or (b);

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   (d)     has attained 60 years and is in receipt of an income of less than $6,000 per annum;

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   (e)     is a member of the Nursing Service of the State;

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   (f)     is a police officer, Fire Service or Prison Service of the State; or

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   (g)     a contributor to the national insurance;

“Permanent Secretary” means the Permanent Secretary to the Ministry of Health.

3.   Remission of Hospital charges

Hospital charges may be remitted or reduced by Cabinet on the recommendation of the Permanent Secretary.

4.   List of special drugs

1.  

   (1)   The list of special drugs in respect of which hospital charges shall be made is specified in Schedule 1.

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   (2)   The said list may be amended by Cabinet by adding to or removing therefrom the name of any drug appearing therein.

5.   Persons liable to pay for use of special drugs

Patients in the Baron Wing shall pay the actual cost of special drugs supplied to them, and all other patients shall pay such amount of the actual cost of the special drugs as hereinafter provided.

6.   Charge for laboratory tests and examinations

1.  

   (1)   The lists of tests and examinations which may be conducted at the Government laboratories shall be as specified in Schedule 2.

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   (2)   Subject to the exceptions specified in Schedule 2, and the next paragraph there shall be paid by or on behalf of every patient the charge specified in respect of any service mentioned in that Schedule.

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   (3)   The charge payable in respect of any test or examination not specified in that Schedule shall be the charge specified for the test or examination which in the opinion of the consultant pathologist is most clearly analogous to the test or examination for which no charge has been specifically mentioned.

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   (4)   Where a person is admitted, or receives treatment in a hospital for any injury arising as a result of a vehicular accident, without prejudice to any claim which may arise as a result of such accident, hospital charges shall be payable—

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      (a)     in the case of a passenger, by the insurance company covering the vehicle in which he or she was travelling;

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      (b)     in the case of a pedestrian, by the insurance company covering the vehicle or vehicles which caused the injury.

7.   Mode of payment of charges

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   (1)   All charges payable under these Regulations shall be paid in advance.

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   (2)   Where charges are not paid in advance then—

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      (a)     if charges are not paid within 90 days of the date of the discharge from the hospital of the patient by whom they are payable, there shall be added an amount equal to 6% of such fees;

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      (b)     if the charges are not paid within 9 months of the discharge from the hospital of the patient by whom they are payable, the charges remaining unpaid at that date shall be recovered in accordance with the provisions of the Act;

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      (c)     after the expiration of the period mentioned in regulation 7(b) the Steward (or other responsible officer) shall forward the necessary documents to the Chief Medical Officer and he or she shall on receipt of the documents aforesaid take steps to recover the amount.

8.   Charges for surgical operation, accommodation, treatment and certain services

1.  

   (1)   For the purpose of these Regulations, surgical operations are classified in the manner specified in Schedule 3.

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   (2)   There shall be paid by or on behalf of every patient in respect of accommodation, surgery and other services specified in Schedule 3 the charges specified in relation thereto in that Schedule.

9.   Consultation charges

Subject to any exemption specified in Schedule 2 there shall be paid by or on behalf of every patient in respect of services mentioned in Schedule 4 the charge specified in relation thereto in that Schedule.

10.   Refund of Charges by treasury to specialists

For each procedure, the hospital is entitled to retain 50% of the charge and then the consultant/specialist, junior doctor, anaesthetist, and nurse specialist shall be entitled to receive from the Treasury an allocation divided as follows if the specialist is a consultant who has attended the case in respect of which the charge is made and has had the services of the above persons —

Under no circumstances will one of the above persons collect 2 or more fees for performing one procedure.

11.   Charges for specific medical reports

The charges specified in Schedule 5 shall subject to the conditions specified therein be charged in respect of the provision of any medical reports or any other services mentioned in that Schedule and subject to any enactment exempting any person from the payment of charges shall be paid or on behalf of every patient in relation thereto in that Schedule.

12.   Restriction on collecting and payment of charges

1.  

   (1)   Charges other than those mentioned in regulation 9, shall not be collected by any specialists or any medical officer appointed to a hospital for his own use for consultation, examination, diagnosis, operations, treatment or for any report supplied or service rendered in respect of any patient attending or admitted to the hospital for the performance and receipt of any such service.

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   (2)   All charges payable in accordance with these Regulations shall be paid in the Treasury or to the Steward or other authorised officer who shall pay the same into the Treasury.

13.   Payments by Baron Wing patients

A patient in the Baron Wing is liable to pay in addition to the hospital charges, mentioned in regulation 8, the fees specified in the Schedules 1, 2 and 4 if applicable to his or her case.

14.   Application of Hospital Rules

Subject to these Regulations, a patient in the Baron Wing shall be subject to the Victoria Hospital Rules in so far as may be applicable.

15.   Exclusive use of nurse

A patient in the Baron Wing who, in addition to the normal nursing attendance provided by the hospital, desires a nurse exclusively for his or her own nursing and attendance, may be permitted to have a nurse approved by the consultant, but the patient shall provide such nurse at his or her own expense.

Schedule 1

Schedule 2

(Amended by S.I. 118/2020)

Schedule 3

PART A

(Regulation 8)

SURGICAL OPERATIONS

PART B
ACCOMMODATION AND TREATMENT AT A SECONDARY/TERTIARY HOSPITAL

PART C
VICTORIA HOSPITAL CASUALTY DEPARTMENT

(Substituted by S.I. 83/1997)

PART D
DENNERY AND SOUFRIERE HOSPITALS

(Inserted by S.I. 83/1997)

PART E
HEALTH CENTRES

(Inserted by S.I. 83/1997)

Schedule 4

Schedule 5

1.     A written medical report by a medical officer on any patient of the Hospital required by any person in respect of a claim arising under the National Finance Act, or for the purposes of determining compensation or damages under any provision of law or for the purposes of life or sickness assurance.

2.     Every application for a report shall be made to the Steward and the fee payable in respect thereof shall be paid to the Steward before the issue of the report.

3.     The fee shall be paid by the Steward to the medical officer who gives the report whether or not such officer is a full-time or part-time officer.

4.     Where a report is required by a government department, no fee is payable.

5.     A report shall not be made except with the written permission of the patient or, in the case of a minor, his or her parent or guardian or, in the case of a deceased person, his or her next of kin first obtained by the person requiring the Service and the permission so obtained shall be delivered to the Steward.

Motor Ambulance Regulations – Section 34

(Statutory Instrument 10/1962)

Statutory Instrument 10/1962 .. in force 20 October 1962

ARRANGEMENT OF REGULATIONS

MOTOR AMBULANCE REGULATIONS – SECTION 34

Commencement [20 October 1962]

1.   Citation

These Regulations may be cited as the Motor Ambulances Regulations

2.   Use of Motor ambulance

A motor ambulance shall be kept at the Victoria Hospital, Castries, or at any other casualty station, and shall be available on instructions issued by a responsible member of the medical or police departments, for the conveyance of sick or injured persons to or from the Victoria Hospital, to or from the mental hospital or to or from any casualty station.

3.   To whom applications made

Applications for the use of an ambulance shall be made to the Steward or charge nurse of the victoria hospital or the casualty station or, at night, to the charge nurse on duty at the Victoria Hospital or casualty station.

4.   By whom applications made

Such applications shall be made by the district medical officer or district nurse when no other suitable and convenient means of conveyance is in his or her opinion available however, in cases of severe accident or urgent illness when the services of the district medical officer are not immediately available, application in such case shall be made by the Police or a responsible resident in the district.

5.   Exemption from charge

A charge shall not be made for the use of an ambulance for conveyance of persons to and from the Victoria Hospital, mental hospital or casualty station who are admitted to the general wards as free patients.

6.   Extent of availability of motor ambulance

An ambulance will be available for use on motorable roads only.

7.   Hiring of ambulance

An ambulance may be let out on hire for the conveyance of patients from one part of the Island to another on the recommendation of a medical officer that other means of conveyance would be prejudicial to the case.

8.   Confirmation of order

A medical officer, district nurse and police officer ordering an ambulance must give his or her name on the telephone to the person receiving the call.

9.   Attendant to accompany ambulance

An attendant shall accompany an ambulance and no unauthorized person shall travel thereon.

10.   Restriction on driving

An ambulance shall at no time be driven at a speed in excess of 20 miles per hour and due regard shall be paid to the request of the patient or attendant to reduce the speed for the comfort of the patient.

11.   Charges for hire of ambulance

The charges for hire of an ambulance shall be as set out in the Schedule to these Regulations.

Schedule

Victoria Hospital Rules – Section 34  Editor's note: These Rules were made under the Hospitals Act, 1954. This Act was repealed and replaced by the Public Hospitals (Management) Act. These Rules are considered to continue in force under section 28(3) of the Interpretation Act.

(Statutory instruments 36/1949, 20/1953, 54/1955 and 37/1964)

Statutory Instrument 36/1949 .. in force 9 July 1949

Amended by S.I. 20/1953 and 54/1955

Amended by S.I. 37/1964 .. in force 24 December 1964

ARRANGEMENT OF RULES

VICTORIA HOSPITAL RULES – SECTION 34

Commencement [9 July 1949]

1.   Citation

These Rules may be cited as the Victoria Hospital Rules.

2.   Staff

The administrative and medical charge of the Victoria Hospital is vested in the Resident Surgeon, subject to these Rules, and he or she shall have the following staff, viz—

A Resident Medical Officer, a Matron, a Steward, and an assistant dispenser, as well as such sisters, nurses, orderlies, wardsmaids and other servants as may be approved by the Governor General, and who shall receive such salaries or wages as the Governor General may authorise.

3.   Obligation by Nurses, etc.

All sisters, nurses, orderlies, wardsmaids, and other servants employed at the Victoria Hospital shall subscribe to the following obligation on their employment permanently:

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   “I have read (or have heard read) the Rules of the Victoria Hospital, and I hereby promise strictly to obey all such Rules, to avoid gossiping about the affairs of the Victoria Hospital or of its inmates, to be careful of its property, to promote as far as I am able its objects, and to endeavour by my own good conduct and demeanour to sustain the dignity of its staff. If anything improper is done in my presence or to my knowledge in the Victoria Hospital, I pledge myself to report it at once to the Resident Surgeon, the Resident Medical Officer, Matron, or the Steward. I agree to give 2 weeks' notice should I wish to give up my situation or training. I acknowledge the right of the Resident Surgeon to impose upon me a fine not exceeding $1.20 (to be deducted from my wages) or, at his or her discretion, subject to the approval of the Chief Medical Officer, to suspend or to discharge me, without any previous notice, for any act of unkindness to patients and inmates, intemperance, breach of the rules, disobedience of orders, neglect of duty, disrespectful conduct to my superior officers or conduct in any way compromising the character of the Victoria Hospital or refusal to serve anywhere in Saint Lucia either in a Government institution or medical district when so instructed by the Resident Surgeon at the instance of the Chief Medical Officer.

4.   Resident Surgeon

1.  

   (1)   The Resident Surgeon shall subject to the approval of the Chief Medical Officer, appoint such nurses, orderlies, wardsmaids and servants as aforesaid, and shall assign to them their particular duties subject to these Rules. He or she shall, subject to any directions he or she may receive from the Chief Medical Officer, be responsible for the proper maintenance of discipline. He or she may also, subject as aforesaid, and with the approval of the Chief Medical Officer, for due cause remove any persons so appointed and replace them by others.

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   (2)   He or she shall reside at the quarters provided for him or her in the Victoria Hospital grounds.

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   (3)   He or she shall be generally responsible for the proper care of the buildings and surrounding grounds, and the furniture, instruments, and other property of all kinds belonging to the Victoria Hospital, and shall keep, or cause to be kept, such books and records as are herein prescribed, or as the Governor General may direct to be kept.

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   (4)   He or she shall go round the Victoria Hospital wards daily every morning before noon, and shall see and direct the treatment of all cases, and initial the bed-card of each patient and he or she shall visit all parts of the Victoria Hospital frequently, and shall by personal observation, satisfy himself or herself as to the proper maintenance of order, discipline and cleanliness, and shall regulate all matters affecting its sanitary condition, reporting when necessary to the Chief Medical Officer.

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   (5)   He or she shall keep such statistical and other notes and tables as may be requisite to enable him or her to prepare the annual report and returns, and he or she shall be responsible for the correct and due rendering of all financial returns, accounts and requisitions.

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   (6)   He or she shall satisfy himself or herself—

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      (a)     that patients receive the diets and extras, if any ordered for them;

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      (b)     that the nurses, orderlies, wardsmaids, and servants adequately discharge their duties;

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      (c)     that the proper wages are paid fortnightly;

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      (d)     that contractors properly fulfil their contracts.

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   (7)   He or she shall examine frequently the water and food supplied to patients and satisfy himself or herself as to their quality and sufficiency, and as to the proper preparation of the food.

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   (8)   He or she shall keep a journal of the principal events which may occur at the Victoria Hospital and shall enter therein such orders as he or she may think necessary for the guidance of the Resident Medical Officer, Matron or Steward, all cases of misconduct on the part of the nurses, orderlies, wardsmaids, servants, or patients and any punishment inflicted by him or her.

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   (9)   He or she shall record daily, or cause to be written up, the history and treatment of every Victoria Hospital case on a card provided for the purpose which shall be hung up at the bed-head of the patient, and on discharge or death of the patient, he or she shall sign the card and carefully file it for reference in his or her office.

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   (10)   He or she shall keep a register of all operations performed, containing name of patient, date and nature of the operation and name of the operating surgeon.

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   (11)   The Chief Medical Officer may give directions to the Resident Surgeon for the proper performance of his or her duties as set out above.

5.   Resident Medical Officer

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   (1)   The Resident Medical Officer shall be under the general direction of the Resident Surgeon and shall carry out all duties assigned to him or her by the said surgeon.

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   (2)   He or she shall reside on the premises, in the quarters allotted to him or her.

6.   Matron

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   (1)   The Matron shall reside on the premises, in the quarters allotted to her.

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   (2)   She shall be responsible for seeing that all directions of the Resident Surgeon as to the treatment of cases are promptly and effectively carried out.

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   (3)   She shall, subject to the general directions of the Resident Surgeon, also be responsible for—

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      (a)     the superintendence of the Assistant Matron, nurses, wardsmaids, female servants and the patients;

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      (b)     the clean and sanitary condition of the wards;

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      (c)     the proper care of the clothing, bedding and utensils used in the wards, and of the reserve clothing stock and any other articles issued to her from the general store.

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   (4)   She shall keep a register of the clothing, bedding and other articles in her charge.

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   (5)   She shall have special charge of the Maternity Ward in the Victoria Hospital, and shall give instruction and training in midwifery to such student nurses as may be admitted to the Victoria Hospital for a course of training.

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   (6)   She shall interview all female applicants for employment before they are engaged.

7.   Assistant Matron

The Assistant Matron shall be under the general direction of the Matron and shall assist her in all her work.

8.   Nurses' Qualifications

A candidate for the nursing staff shall be over 17 years of age, shall produce a testimonial of proof of good conduct, shall be expected to pass successfully an elementary educational test and an examination of physical fitness.

9.   Student Nurses

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   (1)   A candidate for the nursing staff may be first admitted to the nursing staff as a student nurse for a probationary period of 3 months. If at the termination of this period the candidate has proved himself or herself suitable, she may be allowed to continue his or her training as a student nurse. The course of training for a student nurse shall be a period of 4 years and he or she shall be expected at the termination of this period to pass an examination for the certificate in general nursing.

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   (2)   A student nurse who has successfully completed his or her examination for the certificate in general nursing may elect to remain at the Victoria Hospital for another period of 12 months, or, with the permission of the Chief Medical Officer, for a longer period, for training in midwifery, and at the end of this period, or such longer period as may be approved by the Chief Medical Officer, he or she shall sit the examination for the certificate in midwifery.

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   (3)   A student nurse who is unsuccessful in his or her examination for the certificate in general nursing or who if successful, does not obtain employment as hereinafter mentioned, or who does not elect to remain for further training in midwifery, shall leave the Victoria Hospital at the end of the 4 year period prescribed for the training of a student nurse; unless special permission is granted to him or her by the Chief Medical Officer to remain.

10.   Employment of Nurses

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   (1)   Any nurse who has successfully completed the examination for the certificate in general nursing, and is otherwise suitable shall, if a vacancy exists, be eligible for employment as a staff nurse on the staff of the Victoria Hospital.

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   (2)   A nurse who has successfully completed the examinations for the certificates in general nursing and in midwifery will be eligible for appointment as ward sister, district nurse or senior district nurse.

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   (3)   Any appointment under this rule shall be subject to the conditions prescribed in rule 3 of these Rules.

11.   Certificate in General Nursing

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   (1)   A person desirous of obtaining the Certificate in General Nursing shall be required to pass the necessary examination.

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   (2)   A person shall not offer himself or herself for the said examination unless he or she has had 4 years' training at the Victoria Hospital or at some approved institution in Saint Lucia or elsewhere.

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   (3)   All applications for examination shall be made to the Medical Board and must be accompanied by testimonials of good character from 2 persons of approved standing, one of whom must be the Matron of the Victoria Hospital, if the applicant was trained or has been employed at the Victoria Hospital, and if not, by the senior nursing sister or principal nurse of the institution in which he or she was trained or has been employed.

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   (4)   The examination shall be conducted at the Victoria Hospital and shall consist of written papers in addition to practical and oral tests. Examinations shall be held at such times as the Board may decide.

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   (5)   The examination shall be held under the direction of the Medical Board who shall themselves examine or appoint examiners.

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   (6)   If satisfied by the report of the examiners that the applicant has satisfied them as to proficiency and knowledge of nursing, the Medical Board shall thereupon grant a certificate in the form prescribed in the Medical Registration Act.

12.   Steward

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   (1)   The Steward shall, if required, reside on the premises, in any quarters which may be provided and allotted to him or her for the purpose.

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   (2)   He or she shall, under the general direction of the Resident Surgeon, supervise the work of the male staff and be responsible to the Resident Surgeon or in his absence the Matron for the cleanliness and good order of the offices, kitchens, storerooms, latrines, outbuildings, yards, grounds, and surrounding premises generally, and shall inspect the same daily.

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   (3)   He or she shall have charge of the furniture and equipment of the Victoria Hospital, of the drugs and medicines in store, and of all new stocks of every kind and shall issue the same in accordance with the directions of the Resident Surgeon, keeping due account of receipts and issues in suitable approved registers.

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   (4)   He or she shall be responsible for requisitioning and receiving all provisions and all other articles required for the maintenance of the patients, and for their due issue in accordance with these Rules.

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   (5)   In addition to stock registers he or she shall keep the following:

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      (a)     a register of all admissions and discharges in which shall be entered the name of the patient, the date of admission, the religious denomination, residence and occupation, the reason of admission, the name and residence of the nearest relative, and the date of discharge or death;

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      (b)     an account book showing the quantity and cost of articles supplied by contractors or purchased for the Victoria Hospital;

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      (c)     a book showing all sums due from any patient as Victoria Hospital charges;

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      (d)     a cash book of all moneys received and paid.

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   (6)   He or she shall do such dispensary work as the Resident Surgeon, subject to any directions from the Governor General, may consider to be compatible with the due performance by him or her of the duties of Steward, as may require.

13.   Assistant Dispenser

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   (1)   The assistant dispenser shall reside on the premises if required to do so.

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   (2)   He or she shall be responsible under the general directions of the Resident Surgeon for the order and cleanliness of the dispensary, and for the proper dispensing of medicines prescribed by the Resident Surgeon, and shall also render such general assistance in connection with the medical treatment of the patients as the Resident Surgeon may require of him or her.

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   (3)   He or she shall be subordinate to the Steward, and shall assist him or her generally in the performance of his or her duties.

14.   Laboratory Assistants

The laboratory assistants shall attend daily at the laboratory at such hours as may be determined by the Resident Surgeon, but not on Sundays and holidays unless especially required to do so by the Resident Surgeon.

15.   Nurses, Orderlies, Wardsmaids and Servants

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   (1)   Subject to the general control of the Resident Surgeon, the nurses, orderlies, wardsmaids and servants shall be specially under the direction, and shall obey the orders of the Matron and the instructions for their guidance as set out in Schedule 1 to these Rules.

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   (2)   The nurses shall be severally responsible to the Matron for the order and cleanliness of the wards of which they are placed in charge, and for the care of the patients in such wards. they shall have authority over the patients and over any visitor in the wards, and shall report to the Matron any breach of these Rules.

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   (3)   They are forbidden to accept any gratuity from patients or their friends.

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   (4)   The arrangements and hours for day and night duty shall be made and fixed by the Matron as conditions may demand.

16.   Employment of Nurses in Private Cases

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   (1)   In exceptional cases, and with the permission of the Resident Surgeon, nurses may be spared from their ordinary duties at the Victoria Hospital and allowed to nurse in private cases.

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   (2)   The fee chargeable for the services of a nurse shall be $2 a day and he or she shall be provided with suitable free board and lodging.

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   (3)   Application for the services of a nurse should be made to the medical officer in charge of the Victoria Hospital by a medical practitioner who shall be responsible for the fee of $2 a day, which shall be paid to the Director of Finance and Planning at the termination of the nurse's services or weekly or otherwise as the medical officer in charge of the Victoria Hospital may decide, and the medical practitioner shall also see that the nurse is provided with suitable board and lodging, and with sufficient off duty time.

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   (4)   The medical practitioner engaging a nurse shall inform the medical officer in charge of the Victoria Hospital or the Matron of the time the nurse assumes and terminates duty and shall also forward a brief report on the performance of his or her duties.

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   (5)   A record shall be kept by the Matron of the private nursing done by each nurse and of the reports received from the medical practitioner.

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   (6)   Half the fee received shall be paid to the nurse engaged, the other half shall be utilised for the provision of a library, etc., for the nursing staff.

17.   Cooks

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   (1)   Cooks shall attend from 6:00 a.m. to 5:00 p.m.

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   (2)   They shall be responsible to the Steward for the cleanliness of the kitchen and of all cooking utensils and arrangements.

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   (3)   They shall obey the directions of the Steward in all matters relating to the preparation and cooking of diets and nourishment for the patients, and shall not leave in the evening until the kitchen and all utensils in use have been properly cleaned up.

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   (4)   They shall see that wood and coal are kept properly stacked in the place provided for that purpose, and unless otherwise instructed shall see that the kitchen fire is out before leaving.

18.   Orderlies and Servants

1.  

   (1)   Orderlies and servants shall commence work at 6 a.m. and shall not leave the premises until 5 p.m., except on duty or with the prior sanction of the Resident Surgeon or Steward.

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   (2)   They shall obey the orders of their superior officers and shall perform such duties as are assigned to them.

19.   Dispensary Learners

1.  

   (1)   The Resident Surgeon may, with the approval of the Governor General, sanction the attendance at the dispensary of persons (not more than 2 at one time) desirous of learning Pharmacy and qualifying to become certificated dispensers.

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   (2)   Such persons must satisfy the Resident Surgeon before admission as to their intelligence and fitness to become dispensers, and must produce evidence of good character.

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   (3)   The assistant dispenser shall be in charge of the learner-dispensers and shall give them regular instruction in the art of pharmacy.

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   (4)   The learner shall pay into the Treasury a fee of $4.80 on admission, and shall also pay quarterly in advance a sum of $2.40 which, on the certificate of the Resident Surgeon that instruction has been duly given, shall be paid out to the assistant dispenser whose pupil he or she is.

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   (5)   Every learner shall attend and work regularly at the dispensary as required by the Resident Surgeon, and must obey the Victoria Hospital Rules.

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   (6)   The privilege of attending the dispensary as a learner may be withdrawn at any time on account of misconduct or carelessness or at the end of any quarter by the Resident Surgeon.

20.   Admission and Maintenance of Patients

1.  

   (1)   Applicants for admission to the Victoria Hospital shall be seen at the dispensary by the Resident Surgeon between the hours of 9 and 11 a.m. However, in cases of accident or serious illness, urgently requiring attention, the Resident Surgeon shall see and attend to the same at the earliest possible moment.

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   (2)   The Resident Surgeon shall examine and satisfy himself or herself as to the fitness for Victoria Hospital treatment of every case applying for admission.

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   (3)   Only the following cases shall be eligible for admission—

   1.  

      (a)     accident cases, where the injury is serious;

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      (b)     cases requiring surgical treatment;

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      (c)     cases of serious illness, requiring definite Victoria Hospital attention and nursing;

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      (d)     cases of acute or chronic disease likely to be materially benefited by Victoria Hospital treatment.

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   (4)   The following cases shall be treated and maintained in the Victoria Hospital free of charge—

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      (a)     seamen employed on ships in port, on certificate of the harbour master that such is the case (section 13 of Harbour of Castries Act);

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      (b)     persons who are “paupers”;

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      (c)     workers' children under 10 years of age;

   1.  

      (d)     workers over 60 years of age;

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      (e)     women “workers” when admitted to the Maternity Ward;

   1.  

      (f)     members of the nursing staff of Saint Lucia.

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   In this rule “pauper” and “worker” have the meanings respectively assigned to them in the Medical Officers Act.

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   (5)   In the application of rules 20(3) and 20(4) the Resident Surgeon may, except in cases of urgency, decline to admit for free treatment and maintenance any person who does not produce a certificate from a poor relief officer that such person comes under rule 20(4)(b), (c), (d) or (e).

When the Resident Surgeon admits any person with such certificate he or she shall immediately report the admission to the Commissioner of Police for inquiry as to the condition of the person.

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   (6)   A patient shall not be admitted who is suffering from contagious or infectious disease likely to prove dangerous to other patients.

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   (7)   Police officers will be admitted and their maintenance met, as provided by the Police Act.

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   (8)   Distressed seamen and seamen discharged from vessels in port may be admitted on written application to the Resident Surgeon by the Harbour Master or the Consul of the nation to which such seamen belong, at a charge of $0.60 per day. If special accommodation and treatment is desired, special rates will be charged and must be arranged and agreed to at time of admission.

Officers and men of H.M. Forces, and officers and men of the Merchant Navy not provided for in rule 20(8) should pay at the rate herein specified—

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   (9)

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      (a)     Other cases shall be divided into the following 4 classes, and when admitted, shall be charged the rate herein specified:

      Description of Person.		Rate per diem.
      		$	¢
      I.	medical practitioners	1	60
      	ministers of religion	1	60
      II.	managers, storekeepers, etc.	1	28
      III.	overseers, store-clerks, etc.		64
      IV.	artisans, small proprietors		32

   1.  

      (b)     Except in cases of urgency the Resident Surgeon shall not admit any such person without a certificate from a medical practitioner to the effect that he or she considers the case a fit one for admission, and stating the class in which he or she thinks such person should be placed for payment;

   1.  

      (c)     Subject to the approval and the directions of the Chief Medical Officer, surgeons other than the Resident Surgeon may be permitted to perform operations at the Victoria Hospital.

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   (10)   A person shall not be admitted as an indoor patient or remain in Victoria Hospital when he or she can be satisfactorily treated as an outdoor case.

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   (11)   All patients shall conform to the instructions for their guidance as set out in Schedule 2 to these Rules.

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   (12)   All sums due by a patient shall be paid either to the Steward or the Director of Finance and Planning upon the day of the patient's discharge. However, where the stay of the patient in Victoria Hospital has been prolonged, the Resident Surgeon may recommend by minute to the Governor General such reduction of the charge as, having regard to any circumstances within his knowledge, he or she may consider it right to do.

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   (13)   A surgical operation shall not be performed without the full consent of the patient (if over age) or without the consent of the parents or guardians or those responsible in the case of patients under age or where the patient is incapable of signifying his or her assent.

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   (14)   The co-operation of a medical practitioner is to be obtained whenever possible by the Resident Surgeon for the giving of anaesthetics.

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   (15)   Patients may receive visitors without a special permission on the day and at the time fixed hereunder—

   General Wards:	12.30 p.m.—1.00 p.m.		daily
   	5.00 p.m.—6.00 p.m.
   	except on Wednesday and Sunday which will be at
   	2.00 p.m.—4.00 p.m.
   Baron Wing:	11.30 a.m.—12.00 noon
   	4.00 p.m.—7.00 p.m.

The medical superintendent and the surgeon specialist shall nevertheless have full discretionary power in the matter of permitting or disallowing visitors to any patient.

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   (16)   In urgent circumstances a patient may be allowed to receive visitors on any day and at such times as may be permitted by the medical superintendent or the surgeon specialist.

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   (17)   Visitors shall refrain from making a noise or behaving in such a manner as to disturb the order and quiet of the institution. the nurse in charge shall report to the Matron or the Steward any breach of this rule, and any offending visitor is liable to be peremptorily ejected from the premises.

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   (18)   Ministers of religion may, at any convenient time, visit patients of their denominations in the wards (subject, however to the power of the Resident Surgeon to withhold sanction for such visit on medical grounds, if he or she thinks proper), if they inform the Matron or other person in charge, of their purpose.

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   (19)   The diet scale for patients shall be as set out in Schedule 3 to these Rules.

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   (20)   A copy of the diet scale shall be hung up in each ward.

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   (21)   Meals shall be served at the hours stated in such Scale.

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   (22)   On the death of a patient the Steward shall, by telephone to the police or otherwise, forward a message to the nearest relative of the deceased living in the island, for which purpose the name and residence of such relative will be ascertained and recorded on the admission of the patient.

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   (23)   The relatives and friends of a deceased patient of any class shall be permitted to provide a coffin, remove the body, and do all things necessary for interment.

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   (24)   An autopsy shall not be performed against the wish of the nearest relative unless ordered by the coroner.

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   (Amended by S.I. 37/1964)

21.   Visiting Committee

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   (1)   There shall be a Visiting Committee appointed annually by the Governor General in the month of December, and consisting of one person as chairperson, nominated by the Governor General, and such other persons as the Governor General may nominate. The Visiting Committee shall remain in existence until another is appointed.

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   (2)   2 members of the Visiting Committee besides the chairperson shall be a quorum. However, in the absence of the duly appointed chairperson if 3 of 4 members are present they may elect one of their members to act as chairperson.

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   (3)   It shall be the duty of the Visiting Committee to meet at the Victoria Hospital on the first Wednesday in each quarter, or whenever otherwise specially summoned by the chairperson so to do, and all the meetings shall be recorded in a book kept specially for the purpose.

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   (4)   The Visiting Committee shall at the quarterly meetings inspect the wards and premises of the Victoria Hospital, and record the result of such inspection, and shall bring to the notice of the Governor General any matter as to which they think, as a result of such inspection, that it is desirable he or she should be informed.

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   (5)   The Visiting Committee may depute at each quarterly meeting one of their number to be the “Visitor” until the next quarterly meeting.

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   (6)   The “Visitor” may visit and inspect the Victoria Hospital wards at any time after midday, first notifying his or her presence to the Resident Surgeon, or in his or her absence to the Resident Medical Officer, Matron or Steward, However, any report to the Governor General on the result of such a visit must be made through the Visiting Committee.

22.   General

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   (1)   An officer or servant shall not be permitted to bring into the Victoria Hospital any fire, matches, pipes, tobacco, wines, fermented liquors, articles of diet, or other unauthorised articles for the use of patients or inmates.

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   (2)   Livestock shall not be kept on the premises of the Victoria Hospital save with the special permission of the Resident Surgeon.

Schedule 1

INSTRUCTIONS FOR NURSES

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   i.     The day nurses shall commence their duties daily at 6.30 a.m. precisely and shall not go off duty until relieved at 6.30 p.m., or such earlier or later hour as may be specified by the Resident Surgeon or Matron in any particular case; they shall first attend to those patients who may be unable to leave their beds, and shall then clean up the wards thoroughly.

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   ii.     They shall carry out all orders given to them by the Matron. They shall administer the medicines and stimulants prescribed by the Resident Surgeon and see that the nourishment ordered is regularly distributed and taken. They shall be kind and attentive in the discharge of their duties. They shall report immediately to the Resident Surgeon or to the Resident Medical Officer, or to the Matron, or in their absence to the Steward, on observing any change for the worse in the state of any patient.

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   iii.     They shall see that the wards are kept clean and that silence and order are preserved in them, and they shall report to the Resident Surgeon or Resident Medical Officer, or Matron, any irregularities that may take place in their respective wards.

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   iv.     They shall prepare every evening a list of patients who are to take medicine and extra nourishment during the night and shall deliver the list at 6.30 p.m. to the Night Nurses to whom they shall supply all information relative to those patients who may require especially strict attendance during the night. When about to deliver over charge to the Night Nurses, they shall see that the medicines and nourishment directed to be given during the night are prepared and are in the possession of such nurses.

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   v.     When a patient has been admitted to Victoria Hospital, he or she shall be received by the nurse of the ward, whose duty it is to see that he or she be bathed in warm or cold water as may be ordered.

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   vi.     They shall take charge of the clothing brought in by patients, secure the same in a safe place, and shall enter particulars thereof in a book to be provided for the purpose. They shall be held responsible for the loss of any patient's clothing which may have been delivered into their custody.

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   vii.     They shall have charge of all books or papers provided for the patients. They shall not permit any books or papers to be taken into the wards unless permission be previously granted by the Resident Surgeon or the Resident Medical Officer.

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   viii.     They shall report without delay to the Steward the name of any patient who may express a desire to see a minister of his or her denomination in order that such minister may be immediately sent for, as far as possible.

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   ix.     They shall see that all plates, pans, forks, spoons, etc., are removed immediately after the patients have finished their meals, and that they are cleaned and duly returned to their proper places.

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   x.     They shall be held responsible for the loss of any articles placed under their care.

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   xi.     The night nurses shall commence their duties at 6.30 p.m., daily, and shall not go off duty until relieved at 6.30 a.m., or such earlier or later hour as the Resident Surgeon or Matron may in any particular case specify.

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   xii.     They shall take care to receive a list from the day nurses of such patients as require particular attention and administer their medicines, nourishment and stimulants, according to the directions they receive. They shall take care that they receive from the Day Nurses all medicines, nourishment and stimulants so required, and shall pay attention to the patients generally but more particularly to those whose names are on the list of special cases handed to them.

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   xiii.     They shall report in the morning to the Matron any changes they may have noticed in the patients during the night.

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   xiv.     The temperature of any patient named in the Ward Book shall be taken at 8 a.m. and 5 p.m. (or any other hours that may be ordered) and shall continue to be so taken until the Resident Surgeon directs otherwise.

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   xv.     The Nursing Staff shall be granted leave in accordance with General Orders and is liable to be recalled at any time deemed necessary by the Resident Surgeon.

Schedule 2

INSTRUCTIONS FOR PATIENTS

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   i.     The patients must conduct themselves with civility towards each other as well as towards the officers, nurses, and servants, and abusive or improper language, loud talking or disobedience of orders shall be strictly forbidden.

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   ii.     A patient shall not be allowed to smoke within the wards of the Victoria Hospital, but, with the sanction of the Resident Surgeon, patients may be permitted to smoke during such time and in such part of the premises as may be appointed for that purpose.

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   iii.     At 6:00p.m., the patients shall go to their wards and at 7:00p.m., they shall retire for the night, and between the hours of 6 and 7 p.m., and during the night no talking or walking from one ward to another shall be permitted.

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   iv.     The night nurses shall report in the morning to the Resident Surgeon or Matron any breach of the above rule.

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   v.     At 6:00a.m. convalescent patients must rise from their beds and leave the wards unless otherwise directed by the Resident Surgeon, and on no account shall they lounge about the ward whilst the servants are cleaning them.

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   vi.     Patients shall not enter the kitchen, dispensary, storerooms, officers' quarters, or any other ward than that assigned for their use.

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   vii.     Patients (other than seamen) maintained free of charge, shall make themselves useful, as far as practicable, in making up their beds, sweeping and cleaning the wards, rendering assistance to other patients or employing their time in needle-work and other useful occupation for the benefit of the Victoria Hospital.

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   viii.     Any patient behaving in a refractory or improper manner may be expelled by the Resident Surgeon, who shall make a note on the patient's bed-card stating the offence; but no patient shall be expelled whose health is such that life may be endangered by such expulsion.

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   ix.     Every patient shall be most careful in the use of the latrines, and shall strictly obey the instructions respecting them; and any misuse or injury to them will subject the offender to expulsion from the Victoria Hospital.

Schedule 3

DIET SCALE FOR PATIENTS AT VICTORIA HOSPITAL

DIET SCALE FOR CONVALESCENT PATIENTS AT VICTORIA HOSPITAL