Health > Intergovernmental conference of Far-Eastern countries on rural hygiene : preparatory papers : report of French Indo-China

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of the people, are often greater than those of the rich provinces)
are reduced to a bare minimum alike of personnel, equipment
and drugs.
There are exceptions. At Laos, the local budget covers all
medical expenditure ; in Annam, it covers expenditure on
personnel, with the exception of the remuneration of rural
sick attendants; and, in Cochin-China, it covers the remuneration
of European medical officers.
To modify this state of affairs would entail considerable
changes in the general plan of the budgets, particularly as regards
the allocation of receipts. It is to be hoped, however, that, after
the inevitable period of trial and error, the ideal solution may
be adopted—to make the provincial and communal budgets
responsible only for expenditure on rural infirmaries, maternity
homes and dispensaries and for the maintenance of patients
in the provincial hospitals ; and to make the local budgets
responsible for all other expenditure, particularly expenditure
on health services, the cost of sera and vaccines, expenditure
on staff, equipment and medicaments for the provincial health
agencies.
The following table shows the allocation of medical and
health expenditure, the proportion it bears to the total of the
budgets, and the per caput outlay.
It will be seen that this table shows only the expenditure
of public bodies concerned with medical treatment and preventive
medicine. The expenditure of private bodies (private, lay or
religious institutions, Red Cross, etc.) could not be ascertained
in the time available. Expenditure on sanitation, water-
supply, and the construction and repair of hospital buildings
is not shown under health expenditure when these various
items are met from the ordinary budgets.
The percentage of health as compared with general expenditure
increased considerably in 1935 as compared with the preceding
years (4.3% in 1933 and 4.8% in 1934), as the cut made was
relatively less heavy in health expenditure than in any other.
It should be noted that the differences in health expenditure
per head of population in the various countries of the Union
correspond to a similar difference in the general wealth of the