OPEN HOSPITAL SYSTEM.

Auckland Star, Volume LVII, Issue 138, 12 June 1926, Page 11

OPEN HOSPITAL SYSTEM.

DOCTOR REPLIES TO CRITICS. "FOR THE PUBLIC GOOD." THE VANCOUVER EXAMPLE. An answer to two critics of the open hospital system, advocated last week by a local doctor, is given by that gentleman in the interview below. The critics ventilated their objections through the columns of the "Star" on Wednesday. One was Dr. Dukes and the other, Mr. A. Blackson. "I would like to make it clear," said the doctor, "that the new system as advocated by mc, would not do away with the Hospital Board. The board would still be elected and would have complete control of the administration of the hospital, the only difference being that, instead of the board saying who the doctor should be to look after the patient, the patient would have free choice of any medical man in the city. Quarrel is With "System." "I am not condemning the Hospital Board. My quarrel is really with the present system. It is only human nature —and I understand it pretty well —that the members of any board, not necessarily that in charge" of the hospital, will, when two men of approximately equal qualifications apply for a position, appoint the man who is best known to the members. I know myself that, under similar circumstances, I would give preference to my friends: its no use disguising it. •"I would not condemn the honorary staff if. under the present circumstances. they did not oppose the board when they felt inclined to do so in matters over which they might be at variance. In any case, it would look almost like tempting Providence to do so. However, there is no doubt that there are two or three members of the present honorary staff whom no board would be audacious enough to displace. I have it on good authority that in the election of one of the present doctors on the staff, influence was used to prevent his being appointed. To-day. that man is an ornament to the profession and of international repute. One naturally thinks what the result would be had the alleged influence used against him been successful. May not other cases arise in which equally jrood men would be prevented from beinsr elected. "Palisade of Fractures." Rejrardinsr the two critics, the doctor said: "Dr. Dukes has written in criticism of the open system. He has so himself with a palisade of fractured limbs that his line of vision has been obstructed. T cannot agree with him in his criticism resarding the results of fracture treatment at the hospital. He has missed the point that, under the new system, he would be free to attend his own fracture cases. Then he could wave what macric wand ho wished in the matter treating fractures. "Mr. Blackson writes in a strain =o pathetic as to bring tears to the eyes of the innocent. Unfortunately, in these days, there are few innocents. I have not questioned the fact that the present honorary staff is composed of highly qualified surgeons .and physicians. What I do contend, is that it is impossible for a man to keep up-to-date unless he has access to a large hospital. The 100-odd doctors of Auckland are allowed to attend their own patients in private practice. There they are under no supervision. In a public hospital their results would be watched critically. I contend that if they are not considered well enough qualified to attend their patients in public hospitals, they should not be allowed to practice on the public m private. An Example. "I presume that if Mr. Blackson de- j veloped a severe abdominal pain; he j would be willing to pay one or two guineas for a consultation and call in one of the present honorary staff of the hospital. There are many people, however, who' could not afford to pay one or two guineas. They would be obliged to call in a half-guinea doctor. Through not being able to attend a large hospital, this doctor may have become, through no fault of his own. I somewhat rusty as to the possible causes of severe abdominal pain Some of these cases, if not diagnosed within six hours of onset of symptoms, are j almost invariably fatal. Mr. Ulackson j would he on safe ground calling in it man who is constantly seeing such case*. The other people may not bo j quite so fortunate. It is quite pos- j sible that in their cases, by the time; the diagnosis is made, the patient mn-'--he a more fit subject for the next world than for the operatine table. Surgeons are constantly complaining that cancer cases are sent into the public hospital too late. If the general practitioner could attend a public hospital, thereby keeping himself in touch with the latest medical and surgical thought, much suffering would be spared the public. "The complexities of modern diagnosis and treatment are so great that the sooner the open hospital system is adopted, the better for the public «ood. I have it. on the authority of a late member of the Vancouver General Hospital that the open hospital system works smoothly and has been a* treat advance on the old system. His statement fits in with my own nlvservations when I visited that » hospital." '