IN OWN HOMES?

Auckland Star, Volume LXVIII, Issue 40, 17 February 1937, Page 16

IN OWN HOMES?

TENDING THE SICK.

NEW SERVICE SUGGESTED.

HOSPITAL CONGESTION.

The institution of an extended dis;>ensin:r nureing and medical service by the Auckland Hospital, with the treatment of a number of case* in the homes of the patient', was urjred by Dr. J. W. Craven, medical superintendent, in a special report placed before the Auckland Hospital Board yesterday afternoon. This and other suggestions for radical changes were made with the object of relieving the congestion at present being experienced at the hospital. The board, after a brief consideration, referred the report to a sub-committee consisting of the Rev. W. C. Wood, Dr. J. P. Hastings, Mrs. M. M. Dreaver, Messrs. G. T. Parvin and W. A. Bishop. Dr. Craven set out that again recently the hospital had been filled to capacity and that he had found it necessary to cancel all booked cages in order to allow of accommodation being available for urgent Certain of the wards had been grossly overcrowded. He eaid that Ward 16, which normally accommodated li> cases, to-day had 21 in it, with the result that patients were unable to get the full benefit of nursing service and it was difficult to keep the ward clean. One of the difficulties lay in the fact that many cases were of. necessity admitted that could well be nursed at home, providing proper facilities were available. Caeee were sometimes admitted merely because there was no one to look after the patient at home. Again many cases that no longer required active treatment had to be kept in the hospital because there was a lack of Transport facilities in taking the patient backwards and forwards between the home and the hospital for the simple treatment required. Reflection on Social Work? "This appears to me to be somewhat of a reflection on the eocial work of Auckland," eaid Dr. Craven. "It simply means that until transport facilities can be provided for these people who are unable to afford daily return taxi fares the hospital rnuet continue to be overcrowded, with the result that cases that should be in hospital will be kept waiting and no beds can be kept in reserve for any sudden emergency.

"Further, if the Auckland Hospital is to take its proper place in the teaching of final year medical students (as it should, seeing it is the largest hospital in the Dominion), then facilities should 1-e provided for these students to see the home conditions' of their patients and treat them there and so get to understand their difficulties more fully. It is essential that they should have the best possible training under supervision if they are eventually to be our best general practitioner^

"Therefore, I take the liberty of urging the board'to consider seriously the provision of an adequate dispensary medical and nnreirig service, at the *ame time making an appeal to sociallyminded citizens to provide transport for certain selected cases." Enlarging on the question, Dr. Craven pointed out that a large number of people sought medicaf assistance' at' tie hospital dispensary because they were unable to pay for general' practitioner service. In addition there were many who received "G.P." service free, or were sent to the , hospital because the dispensary medical officer traa not always available. Many of .these could be seen and nursed in their owjn homes. An average taken between July and October, 1936, showed that 908 cases attended monthly at the dispensary, and that 30 were attended monthly in their homes. Only medical cases were so visited. All minor surgery was done at the hospital.

He suggested that an•»ordinary general practitioner service be instituted in connection with the dispensary, so as to conform with the board's policy in catering for the interests of the poor. More Help Wanted. "In the first place the medical service is not sufficient," he said. "It is impossible for one man, without assistance, to attend to anything from 780 to 960 cases a month at the dispensary, involving up to 1962 attendances and up to 42 visits to the homes, "over a widely scattered area. Secondly, there is no associated nursing service. It is recommended that the dispensary service as a whole could be enlarged with advantage by having two dispensary doctors, one to be at the dispensary, wherever it mav be located, from, aay, 9 a.m. to 5 pjn", and the other located at the hospital to attend to cases in their own homes and to be available for emergency calls. Only urgent Sunday work would be done. A regular change over would be carried out every; four weeks.

"To begin with, the dispensary nurse should be attached to the present Home Patients Nursing Service at the hospital, and as the service grows, the required additional nurses would be added. It is to be remembered that the present nursing service began with one nurse, and torday three nureea are fully occupied in this-work. The nurse would do her work under the orders'of the doctor eon-1 cerned.

"The benefits that would accrue would be that the poor of Auckland would receive a better medical (service than they now have; certain beds to-day occupied at the hospital. by .patients who ehonld sot be there would be vacated, and sixth year medical etu-J dents would receive an adequate and proper training in general practitioner work, tinder supervision. This latter reason, while being perhaps the least important of all e* far ae the board is concerned, is nevertheless a very important one, in view of the position the Auckland Hospital holds to-day, and will continue to hold in the future.

"To safeguard the intereete of the ratepayers and the board, only cases which have the authority of the relieving officer would be attended, except in cases of emergency, where, after the first attendance, it would be necessary for the waatfas* of the patient confined to bed to obtain the necessary ticket' on the we*mni«idation of the medical officer." their congratulations to on his report and the snjrneed ef eee h a i>ot a«ord medical fees. Mrs M. M Dream referred to tl.e 500-odd'patient* who attended the Dock Street Mu££ every Thursday night seeking medical attention.

"They are all practical ideas," said Mr. Wallace.