HOSPITAL ORGANISATION.

Auckland Star, Volume LVII, Issue 43, 20 February 1926, Page 15

HOSPITAL ORGANISATION.

A POMCY OtJTLITTED. DR. MACEACHERN'S VIEWS. (By Telegraph.—Press Association.) ■ . NELSON, Friday. In an address before the conference jf the British. Medical Association, Dr. Malcolm Maceachern the American mthority on hospital organisation, said .hat while there was a variety of hospi;al policies in existence it was difficult to md one that was entirely perfect. Every country must consider this problem in relation to its own particular conditions md circumstances. The voluntary community hospital, subsidised as necessary from the consolidated revenue of the State and of the municipality over and above earnings consisting of fees from patients ana departments, prevailed in an overwhelming majority at present and 5000 or 6000 institutions were successfully operating under this system. Dr. Maceachern summarised his general views on hospital policy ac follows:— (1) The voluntary community hospital, subsidised as required, by -Government and municipal aid in addition to patients' fees and earnings from departments, is the great recognised hospital of the age. (2) The taxation hospitals, theoretically for the necessitous poor, tend too much to the nationalisation of the hospital which so far in various sporadic attempts in, America and elsewherehave been regarded as failures, allowing too much political interference, routinism, lazy and lax service,-and the retarding of r medical research , , as well as being a tremendous financial burden on the community. (3) Efforts should be made to stimulate more voluntary support of hospitals. This is best carried out through a system of annual and life governors with power to nominate representatives on the board of trustees. „ (4) The public wards of every hospital should be used only for the necessitous '• poor, treated by a voluntary staff. (5) Every hospital should aim at providing services for all clinical types and different grades of accommodation for patients of varying financial status. (6) The system of a tax rate is not as economical and desirable as indenting on the health budget of the municipality and the State the necessary subsidy each year which varies with the fluctuating demands on the institution. (7) The community-type of hospital offers the most economical policy and is less a burden on the taxpayer, raises the proficiency of the medical profession; renders by all means the best scientific service to the people, service tempered by all the qualities necessary to keej the hospital human. The community type of hospital stimulates more com munity interest and pride, resulting ir attracting benefactions or gifts for th< development of departments and par ticularly the carrying on of research which ie so essential to medicine to 1 day.. '" (8) No hospital policy for a countrj such as this can be developed without due consideration of the various dis tricts to lie served, and the establishing of proper relations between the bas< and subsidiary institutions . through i scheme of co-ordination and co-opera tion. - An extension, of hospital servici must be under definite control with pro per allotments of institutions when needed. Dr. Maceachern considers there are fai too many small inefficient hospitals thi world over and that more concentratioi of hospital work in base institutions ii necessary, where the use of sciertifii equipment is provided and where special ists are: available.