DOMINION HOSPITALS

Ashburton Guardian, Volume 50, Issue 268, 26 August 1930, Page 8

DOMINION HOSPITALS

COMPARISON WITH OVERSEAS. DOCTOR’S CONDEMNATION. (Per Press Association.) WELLINGTON, August 25. Dr. Campbell Begg, surgeon,, was a passenger by the Makura, 'vluch ai rived from San Francisco to-day, after an absence abroad °f six during which time he attended the Medical Conference at jWnd spent the remainder of the time visi ing principal hospitals of the Co tinent Great Britain and America. He investigated, the- working ® over 100 institutions m the Sts *t ’ Canada, Great Britain France G«many, and Spam, and interviewed mersons of aH kinds in any way m terested or concerned in the control ffiStration and da % round of these institutions including j the best known names in the medical W °The conclusion arrived at was that New Zealand can derive little satis faction the present positmn on account of our splendid system or general education and a certain pendent outlook not prevailing polder rvviiTitries The medical and nursing are equal to - countries, and superior to many . but public hospitals, on the other hand., Tareelv on account of a method control now almost universally abandoned elsewhere, compared unfavour ablv with the 'hospitals abroad. The medical staffs were badly or not organised at all. Appointments were haphazard, and there was a lac co-operation and good fflmg between the staffs and Boards of coi + i +Vint existed elsewhere, and as a result the difficulties of handling large bodies of patients effectively , were accentuated or rendered impossible The averaee stay of natients in hospital, both for treatment and diagnosis, was far too long, and the organisation of the nursing service insufficient, was too little supervision.of the work of junior men by the i semor ones too much scop© for hasty and S methods of treatment on the one hand and neglect of thorough investigation on the other. Equipment was bought and additions carried out on the aa vice of superintendents, wheie, 3 specialists in the different Ete were capable of .real direction. Chronic cases were mixed up those requiring real medical and Seal attention, and. the services of the staff were, dissipated mstead of being concentrated on th© effecti medical and surgical part of the hospi tal. Infectious cases were under tl same superintendence as others. The arrangement was atvanapcewi a modern practice, and as a aule tnese cases were deprived of the benefits o the visiting staff All these disabilities were due in a large measure, d not entirely, to our system of Boards, elected every two years. “Purely Political.”

Dr Begg goes on to say that it had Been found that men of requisite standing will rarely submit to the disagreeable experience of such election, that Boards so elected are far too unwieldy; that members will not give themselves up to the study of hospital management, but simply on mem bershin on a board as a first step on the political ladder. They give; tufficient attention to routine matters brought before them, but are hopelesslv incapable of constructive work. ]Sore capable members are swamped by others, and possibly not re-elected if they adopt a policy for the good o the hospitals . which is a_t variance with some political slogan. After instancing examples of capab management in the States, Dr. oS SbT“ our hospitals in New Zealand have become purely political. The Minister from the dominant Party in “wir io in. general eharge and national politics have invaded Boaid elections. Much nolitical propaganda undermines the whole hospital stiuc ture, and some of it had unfortunately found its way to the Statute Book. The present system had run its tun course, and there was urgent need that the reproach in this sphere should be taken away. Dr goes on to make recommendations to effect this. He says our future development lies in tive effort, and the Mayo Clinic has furnished example. The Recommendations.

,Dr. Campbell Begg’s reeommendatl°(l) The immediate repeal of the relevant section of the Hospital Act and the abolition or elected Boaids m the four main centres at least. - (2) The nomination of the Board of Trustees for hospitals by those v/lio find the money;, namely, the city counts and the Prime Minister s Department, representing the consolidated U (3) The restriction in numbers of these Boards to four members, who must be men of standing in the worlfj of finance and of accountancy, and a certain understanding not to engage m politics during their period of office ■which should extend to at least fne years, is lHiporativo. # i 11 (4) A social service committee should be organised by the Board, not on y to look after cases of distress but to assess what is a fair charge for hospital maintenance. , (5) The exclusion from the public hospitals of all those who may fairly hi asked not to be a charge on the public that is, those who are able to pay fees to cover maintenance. If no_ proper private facilities are available, it should be permissable to admit these at a rate which will cover overhead expenses and produce a profit, and attending doctors should also be remunerated. The size of hospitals and the expense of running them would ibe thus roduccd* (6) Separate provisions for chronic and incurable cases, of those wlio go or are sent to hospital merely because it is not convenient to have them looked after at home. . *(7) The separation of mlectious diseases hospitals from general and surgical hospitals. They might be put under the case of the local health oihcer or have a special board nominated for them. Honorary physicians and surgeons should be separately appointed, and medical boards should be organised, consisting of the heads of the more important departments. These heads should be appointed as such and not merely be the senior men. All appointments to the staff should he recommended by this medical Board, and not by outside practitioners or a consulting staff of retired doctors who cannot be in touch with current requirements.