Vol. 14, No. 1. SINGAPORE MEDICAL JOURNAL 49 March, 1973. THE PAUPER HOSPITAL IN EARLY SINGAPORE (PART I) (1819-1829) By Y. K. Lee Tan Tock Seng Hospital, Singapore, started The cost of running the hospital for the three its history as a Pauper Hospital. The foundation months from 1st November 1821 to 31st January stone of the first Tan Tock Seng Hospital was laid 1822 was $72.19, as follows: on 25th July 1844. This hospital built at Pearl's Establishment of the Hospital (i.e. Hill was not used until 1847. The hospital was for salaries) at $16 per month - $48.00 many years known as Tan Sing's Hospital, Tock Diet money - - - - 14.00 named after its founder. It was the first hospital Articles furnished for use in the in to Singapore be built with non -Government hospital - 10.19 funds. In the official records, the name "Tock Sing" was changed to "Tock Seng" in the 1850s. $72.19 Tan Tock Seng Hospital was however not the first Pauper Hospital in Singapore. It had a number In the three months from 1st May of predecessors. It is the purpose of this article to 1822 to 31st July 1822, it was record the development of Pauper Hospitals in the $68.30 (S.S.R., L. 8., 1822). Mr. Prendergast was paid first ten years of modern Singapore's history. not any salary for this addi- tional duty of Later articles will trace and describe the events looking after the paupers. leading to the founding of Tan Tock Seng Hospital, In June 1822, the buildings used as Hospitals and its vicissitudes during the first few decades of in the Cantonment became a nuisance and were its history. moved as a result of this Station Order by the Resident and Commandant, A general introduction to the study of the Colonel William Farquhar, issued on 2nd June, 1822 medical history of early Singapore has already (S.S.R., L. 8., 1822): been briefly outlined (Lee, 1973). "The site of the temporary Very soon after the founding of Singapore on buildings in use as Hospitals for 6th February 1819, people from nearby countries the Europeans and Paupers, appearing to the Resident flocked to Singapore to seek their fortunes. Some and Commandant to be objectionable in prospered, but not everyone was lucky enough to as far as these buildings encroach too on succeed in this pioneering outpost, where each much the Parade Ground, and are also contiguous to the man was for himself and the weak went to the wall. Line of Officers' Quarters, as to become a nuisance. Those who fell ill or were injured were left to fend A Com- mittee of which for themselves. These unfortunate people had no Survey of Captain Murray is President, will means of support, and before long the streets of assemble on Monday morning at six o'clock the Singapore were filled with sick and starving beggars for purpose of examining the site of the said buildings and vagrants. They lived and died in the open as and out -houses, and reporting on the there was no where for them to go to for aid, expediency of removing the same financial or medical. further back so as to form a line with the European Barracks and Sepoy Hospital. To alleviate this distressing situation, the Mr. Assistant Surgeon Montgomerie will be Government erected a shed in the Cantonment as pleased to attend the Committee for the purpose a Pauper Hospital, and Sub -assistant Surgeon of affording his professional opinion on such Prendergast was put in charge. The money for points as the Committee may- require informa- running this hospital came from the Licence Fund, tion." which was the revenue received from granting In November, 1822, Sub -assistant Surgeon licences to sell opium and arrack, or for operating Prendergast wrote to the Resident for an allowance gambling dens (S.S.R., L. 7., 1822). for looking after the Pauper Hospital: "... Aware as you must be, Sir, of the many and heavy ex- penses incidental to a person having a family to support, from the exorbitant rate of wages and Thomson Road General Hospital, Singapore. high prices of the necessaries of life in this Settle- Y. K. LEE, Am MD F R.0 P Lond., F.R.C.P. Edin., M.R.A.C.P., LL.B., Senior Physician. ment, I need not point out the obvious inadequacies of my present salary.... " He quoted as a prece- 50 SINGAPORE MEDICAL JOURNAL dent, Sub -assistant Surgeon Palmer who received there was a great risk of having to spend a lot of an allowance for looking after the Pauper Hospital money on the sick and poor of the neighbouring in Penang (S.S.R., L. 9., 1822). countries who flocked to Singapore. He also There is no record of Prendergast having ordered that in the interests of economy the system received an allowance. He was in fact dismissed of dieting patients by the Surgeon should be from the Singapore Medical Service on 20th abolished: January 1823 and returned to India. This came "... means must be devised to raise the ex- about partly as a result of shortage of staff in the pense by some assessment on the Chinese, on General Hospital. An appeal had been made to whose account, it (the Pauper Hospital) is Sir Stamford Raffles for funds to increase the principally incurred. The expediency of such an establishment of the General Hospital (S.S.R., establishment may be doubted in a place like L. 6., 1822). This was sanctioned, but Raffles this, where there is no indigenous population. decided that in the interest of economy and to The effect must naturally be to bring upon us balance the budget, the Pauper Hospital should be all the sick and invalids of the neighbouring discontinued and Prendergast dismissed (S.S.R., islands. The patients are now fed at a fixed A. 31., 1823). rate by the Medical Officer in charge, which as the Surgeon far exceeds the The local authorities in Singapore managed to reported by Senior rates allowed on similar cases at Penang. A convince Raffles that the Pauper Hospital should regular contract should be substituted on the not be abolished, but could not prevail on him to lowest terms procurable." retain Prendergast. In May 1823, it cost only $20.30 to maintain the hospital (Establishment $16 The Authorities at Singapore tried to carry -and Diet $4.30) (S.S.R., L. 20., 1823). out the instructions but failed with regard to voluntary contributions by the Chinese com- The Pauper Hospital was moved again from munity. On 24th August 1827, a very drastic step its site in December 1825, "the ground being was taken by Mr. J. Prince, the Resident Council- required to build a part of the new Sepoy Lines lor. He issued the following instructions to the upon, owing to the late augmentation to the Troops Surgeon: serving at the Settlement, and without which this could not have been effected." This was the second "I take this opportunity to acquaint you that Pauper Hospital, and the third one was partly it is my intention not to admit any more patients built with materials salvaged from it. "The old into the Pauper Hospital until the Chinese building was in a state of considerable decay, and Community establish the means of covering its would shortly have required extensive repairs. The expense, and consequently that the present available materials have been however brought to patients are to be discharged as early as possible account in the new building" (S.S.R., M. 12., consistent with humanity" (S.S.R., N. 2., 1826). 1827). Since money matters seemed to be all-important And in October 1827, he recommended to the be made in the to the Government authorities, a brief mention of Governor that reductions should the financial aspect of the hospital administration establishment of the Pauper Hospital. The Gover- would not be out of place. The Surgeon in charge nor however was of the opinion that the "Pauper of the hospital was given a fixed allowance to Hospital should be struck off" (S.S.R., N. 3., employ subordinate non -medical staff for the 1827). This was also the view of the Senior Surgeon establish- hospital. In this instance, it was $16 a month. The after a tour of inspection of the medical Surgeon also supplied the patients with food, ments at Singapore. This was his official report to clothing and medicines at a fixed rate, and sub- the Governor (S.S.R., A. 51., 1828): mitted his bill to the Government at the end of "Pauper and Chinese Hospital each month. The rate was 20 cents per man per This is a large attap boarded shed close to the day in 1826 (S.S.R., A. 28., 1826). Singapore Infirmary. Supplied also with a few In June 1827, the Medical authorities submitted cots. They have discontinued to receive addi- through the Resident Councillor at Singapore to tional sick and four Chinese only now remain the Governor a proposal that more funds should in that Institution. be allotted to the Pauper Hospital as the ad- missions had increased. Return of the Establishment Attached J. Caswell Assistant Surgeon. The reply which is quoted below was by no means encouraging (S.S.R., V. 2., 1827). The J. Powell Assistant Apothecary (employed, Governor suggested that the Chinese should here occasionally). contribute towards supporting their poor, and that Mittre Dresser. MARCH, 1973 51 ... observing that the numbers both in the the purpose of providing funds for the support of Singapore Infirmary and in the Pauper Hospital their old and infirm, and it continued for a long are extremely limited, that the objects of both period under the direction of the principal persons establishments are precisely the same, but that of that nation, but in consequence of neglect and they are maintained at the expense of two houses mismanagement, Government was obliged in the and a double establishment of servants, I there- year 1803 to assume the collective management of fore beg leave to recommend to the favourable the tax as well as the charge of the Asylum for the consideration of His Excellency the Honourable poor, and the farm has ever since composed a part the Governor in Council that the Pauper Hos- of the public revenue" (S.S.R., B.