PUBLIC HOSPITALS.

Auckland Star, Volume LVII, Issue 135, 9 June 1926, Page 16

PUBLIC HOSPITALS.

iTo die Editor.)

Sir, —There is an organised agitation to upset our present popular elective system lor public hospital management. .An inspired article wus in your issue ot June 5, on this subject. The argument put forward is, first, that the board is autocratic and a hindrance; secondly, that the present medical and surgical work is the only up-to-date practise in Auckland. Let mc say, as regards the board's power, that to my personal knowledge on one occasion the staff reiused to carry out the careful and deliberate decision of the board. And the board was helpless. The B.M.A. have complete control, practically, for not only are all the staff and- all the private doctors members 8.M.A., the superintendent is a member also! So there is absolutely no appeal against carelessness in treatment or want of skill. And evidently, their fear of the board is a mere bogy. Then, as regards the unique skill of the hospital staff under the present B.M.A. control: Let mc point out that a lay person can form no opinion on this matter. May 1, as a medical man of some experience and qualification, and a non-member of the 8.M.A., enlighten the public as to the real state of affairs? There is one class of case that I can now put up as a proof of want of skill, on the part of the public hospital staff. The one class must do for a sample of the whole, eince it is difficult ,to get evidence about other diseases. Then let us take the case of fractures to decide whether our public hospitals show skill and are up-to-dats. It is quite beyond dispute that when a long bone is broken it should with any luck have joined up solid in eight weeks or so. Why is it that I continually see cases that five months or more after the accident cannot walk without a stick? As far back as 1900, twenty six years ago, a book was written by one of the most eminent surgeons in the world, attached to St. George's Hospital, London. This book pointed out that a Frenchman had proved by practise that all the disability following fractures was due not to the fracture but to the splints. This London surgeon stated that he had also proved this, and gave detailed explanation how to carry out the treatment of fractures so as to prevent this universal disability. My point is a very simple one; that our hospitals in treating fractures by out-of-date methods stiffen up the joints which never had anything tlie matter with them, except that they had been tied up in splints for weeks and months together. That for thirty years it has been known how to prevent all this fearful disability. (X.B. —You will note that this stiffness is often cured by means of massage. But it should never have been allowed to occur, and causes much pain and loss of time.) To show that this treatment has not been forpotten, I may mention that I have two other books of a later date on the same subject, both emphatically bearing out the facts I have related above. T think, sir, it would be well not to take my (perhaps unfortunate?) experience of failures from the hospitals, but to have a consecutive list of fractures admitted for a certain time, and investigate these cases. Or perhaps the public will write and give their experience. If I have proved my point, then we would do well not to give up the only shred of control we have, that is the board, and to refuse to be bluffed into giving the B.M.A. complete control. It would simply mean that the B.M.A/ would have a private hospital of their own, at the public expense. (As you will know, the B.M.A. propose to support the hospitals by voluntary subscriptions, an evil system, so as to do away with democratic control.) —I am, etc., r. S. DUKES. (To tne Editor.) Sir, —I read with interest the statement of "a prominent local doctor" in Saturday's '"Star." I cannot agree with several of his remarks. As to influence being . necessary to get on the present honorary staff, I have enough faith in the Hospital Board to believe that they would not be swayed Jn their election to the staff by any iJfijiroper influence. Knowing the present Honorary staff as I do, I resent the idea that zhey "are afraid to criticise the administration for fear they will be put off." They are all highly qualified surgeons and physicians, and I do not think they would keep silent in the face of maladministration merely to hold their positions On the other hand, I feel sure that the board would give respectful attention to any suggestions from the honorary staff on matters touching their sphere. Ido not think that the patiqnts suffer from any great "mental stress" through being put under the care of the present highly qualified honorary staff. I am a constant visitor to the hospital, and I have not seen any evidence of this. I think that if the hospital were thrown open to the "well over 100 doctors" he mentions, the mental stress on everyone would be very much increased. Your informant stated that "what was wanted was constructive criticism." I think that much of his criticism was destructive. It was calculated to destroy the community's faith in the Hospital Board's judgment and capacity, and the capabilities of the present staff, for botii of which I, for one, have the greatest respect.—l am, etc., A. BLACKSON.