HOSPITAL HOSPITALITY.

Auckland Star, Volume LV, Issue 306, 26 December 1924, Page 3

HOSPITAL HOSPITALITY.

PAYING WARDS CONSIDERED. (By A CORRESPONDENT.) Where great public hospitals are supported by vdluntary contributions, and are purely charitable institutions, relying, as they do, upon endowments, legacies, and gifts, there is nevertheless a general understanding that they are for the use of the poor (apart from urgent cases due to accident), but it is necessary for the patient to be recommended "by a medical practitioner or to present a" "letter" of admission. These "letters" arc (or were) issued to subscribers at the rate of one for each guinea subscribed. In this way a householder might hold a number of these for distribution to employees, or give one to any chance caller desiring the use of it. A "charity" patient is always (from the hospital point of view) considered as "clinical material" for Ule medical j students, and must submit to such ■ uncomfortable things as frequently | repeated examinations for the instruc- I tion of the budding doctors, and perhaps j a little mild experimentation. Also (to quote the words of a surgeon of Guy's) they must—as one of hundreds —"take their chance." Where there are "paying wards" attached to a hospital, there are, i generally, very few beds, and those . persons prepared to pay for special recommendation may find themselves at j the bottom of a list of waiting patients j of such length that it may be a matter of months before a vacancy exists. The new arrangement by which junior inexperienced doctors are taken on to the resident, staff, although not parallel ito the system of student attendances I permitted in London, is unsatisfactory to patients, and as payment of extra fees would give them a stronger right to i claim the services of the senior staff ; exclusively, it is to be expected that \ paying wards attached to New Zealand ' hospitals would suggest this condition, j However, it is for the public (who pay ■ for the hospitals) to decide these i matters, and not the members of the i medical profession. To permit the pro- j fession to dictate, the terms upon which ' individual patients should receive mcdi- I cal aid would produce a form of tyranny i worse than that of any known union. I Vet, taking the Auckland Hospital as I .an example, it is customary to demand ! I from each patient a "recommendation" from a medical practitioner, and he is seldom willing to send prospective fees into a public institution. It is this state of affairs which has recently been dis- : cussed by the Commission appointed in the Bryee case at Palmerston North. It has been decided, as a result of this "test case," that public hospitals are free to all, but every patient must be prepared to face at some period before he leaves the hospital an inquiry into his means of earnings in order that all persons able to pay the fees should do so. It is obvious that there every householder is compelled to contribute to the support of the public hospital of bis district he should be. free to use it. and that without the ipse dixit of any private practitioner. The honorary staff. I although nominally unpaid, benefits | greatly in reputation and indirectly in | pocket as a result of the hospital appointments—the anaesthetist perhaps excepted—the proof of this is provided by the manner in which such appointments are sought. Private hospitals are, or should be, the refuge of men and women whose mentality presents them from meeting the publicity of the ward of a general hospital with comfort and benefit. It is, of course, undeniable that the public hospital must always contain better equipment, and to deny the advantages of this to anyone whatsoever for any reason whatsoever, is to deny the purposes of the hospital. I No board should fear to make their hospital attractive. It is no part of their duty to consider the welfare of the needy practitioner as compared with I their duty to the sick public, and if "paying wards'' were to be, in any medical or surgical sense, superior to the general wards, the poor would not be getting what is justly due to them. Probably the day will come -when the great hospitals of this country become mere medical echools and training for medical students, and for reasons best left, unexplained the poor man is held to offer better "clinical material" than his richer brother, and as such material he will knowingly submit his corpus.