"NO COHESION."

Auckland Star, Volume LXVIII, Issue 150, 26 June 1937, Page 7

"NO COHESION."

BOARD AND STAFF.

HOSPITAL DISCORD.

NAPIER VERSUS HASTINGS.

DOMINION SYSTEM AT FAULT 7

(By Telegraph.—Own Correspondent.) NAPIER, this day. A searching examination of the administrative methods of the Napier Hospital was made before the Royal Commission yesterday, both in the course of the afternoon sitting and a long night session. The commission also heard from Mr. C. O. Morse, a member ot the New Zealand Hospitals Association, the ex-chairman of the Havvkes Bay Hospital Board, add a man of 14 year-.' experience in hospital affairs, a scries of pointed observations on the Dominion's hospital system, wiiiie, in reference to the Napier Hospital in particular, the day's evidence included advocacy l.y a former medical superintendent. Dr. .1. Allan Berry, that the Hoard of Control should abolished completely. By pressing on yesterday with the hearing of evidence the commission was able to complete its entire investigation with the exception of the testimony of one witness.

A former medical sujierintendent, Dr. J. Allan Berry, agreed that he attributed Mime of the troubl,; which had arisen at the hospital to the fact that the managing secretary had usurped some of the highest authority. Mr. N. Koden (appearing for the Director-General of Health) : Do you think there has been a lack of cohesion? —Yes.

Does it extend from the board down wards? —Yes.

Does the cleavage in the board militate against the successful running of the institution?— Yes. it has the cause of all the trouble. Had there been a good head it would not have

occur red. Describing the medical superintendent's lack of authority witness said that if, for instance, the medical superintendent wanted a splint made the carpenter would have to refer the matter to the managing-secretary. "I have found it very humiliating." witness added. Witness agreed with Mr. Foden that the point on which the hoard had lieen most sharply divided was his own suspension from the honorary staff and the dismissal of the sister who was in charge of the children's ward where the on*break of venereal disease occurred.

Mr. Koden: Any cKivago of the hoard li-s been largely altributald- ;-, vour own status and what was to be done with the sister?-Yes. "Sack the Board." When ask.-d by Sir .lames Elliott, a member of the commission, if he had anv suggestions as to how the differences between the Napier and Hastings elements on the board could lie reconciled witness replied: "Sack the board."' Sir James Elliott: The lot?— Yes the lot. Sir James: That is worth thinking about. Could you do without a board? —Yes. Asked by the chairman. Mr. E. D. Mosley, S.M., if he could think of any alternative, witness suggested the establishment of two separate hospitals, with two separate boards. Mr. Mosley: What about nationalising hospitals?— Sack all boards. Mr. Foden: What would be your reaction, as a ratepayer, regarding the sacking of the board?—l would ardently support it. Would you not object to the loss of franchise?—Xo. London has done it. Mr. Foden: Well, it's worth looking into. The evidence of three sisters attached to the hospital was taken in, camera, after which the commission heard the testimony of Mr. C. O. Morse, chairman of the board until a year ago. Witness said it was an admitted fact that there was a cleavage on the board between Napier and Hastings members.

Mr. Foden: Can you say that members always act quite judicially in arriving at their decisions?—ln some measure I think they don't act in quite the right manner.

Witness agreed that it was an invidious position that a member of the board, who was also a member of the honorary staff, should come in contact with the staff. Such a person, he agreed, would be actuated by conflicting purposes. Recalling the board's inquiry into the outbreak of disease in the Shrimpton Ward, witness said it was the Napier group on the board which voted against the others on the question of terminating the services of the honorary doctor concerned. Witness did not think board members as laymen were competent to judge the position. "Three Captains." Questioned regarding the division of authority in the control of the hospital, witness expressed the opinion that in the interests of the future welfare of the New Zealand hospital system it was necessary that a clear line of demarcation should be drawn to define the medical side, the nursing side, and the administrative side of all activities. "I say that from experience extending over the past fourteen years," he added.

Mr. Foden: You agree it is not desirable to have three captains on one ship?—Xo, the ship would be wrecked all right.

Mr. Morse detailed the financial arrangements made for the reconstruction of the Napier Hospital after the earthquake. To further questioning witness said that a few weeks ago a private meeting had l>een held. It had been attended by the three Napier members of the board and also representatives of the Hastings and of the Hawke's Bay county. At the meeting a basis bad lieen reached for cutting out "a lot of this humbug."

We three from Napier felt the sister from tlie children's ward had been very harshly dealt with. That was the stumbling block. Mr. Morse added.

Witness described the steps taken by the board for the reconstruction of the hospital after the earthquake and said expert advice offered was not accepted. Sir James Elliott: What right had the board to veto the directions given by the Health Department?— What right had the Department to allow its suggestions to be vetoed?

Witness was questioned a« to his views on ihe present system of hospital finances for the Dominion as a whole. "We have hammered at this thing from lots of angles to try and alter the incidence of taxation surrounding hospitals, but we have always come to a dead end," he said.

Further questioned, witness expressed the opinion that the present system should stand. "We say we have the best system in the world and experts agree it is a safe system in making provision for the safety of the people."

A Bar to Progress. Sir James Elliott: We can say then that we have the best hospital system, the best education system and the best railway system in the world. Does that not occur to you as a bar to progress! —Ah, exactly. (Laughter.)

Witness said his friends considered the only solution for witness himself was to go over the end of the Napier breakwater.

Sir James Elliott: That would be a pity. (Laughter.)

Asked by Sir James Elliott whether he thought a limitation of the powers of hospital boards would be a good thing, witness expressed the opinion that the Department of Health should exercise more control than at present. Witness would not commit himself to nationalisation of the hospitals without first seeing the specific proposals.

Sir James Elliott: How do you think this rivalry in hospital matters between Hastings and Napier can be got over, apart from abolishing the board?—By abolishing the board the troubles would float into thin air.

Sir James: The animosity between Xapier and Hastings would "vanish ? — Oh, ves.

Do you think the care of the sick should be dependent on boards of which the members are chosen for their political colour or strength of their parochial feeling?— That's a jolly hard one. (Laughter.)

Do you, as a member of the Hospital Boards' Association, think the present system of hospital board elections is satisfactory?— Yes, I think so.

Asked by Mr. Foden to express an opinion on Dr. Foley's capabilities as medical superintendent, witness said Dr. Foley had applied himself most enthusiastically, and had been able to impress the board to suel. an extent that he could hold the fort on his own. Further, Dr. Foley had had a lot of difficulties to contend with.

Evidence was next given bv the chairman of the Hawke's Bay Hospital Board, Mr. Christian Lassen, who was questioned at length regarding alignments existing within the personnel of the hoard. Witness was asked bv Mr. Foden whether, if clear-cut voting" continuedthree Xapier men against seven of Hastings and Hawke's Bay Countv Croup—it would be iu the interests o"f the institution.

Allocation of Authority. Witness: No, but it has onlv arisen in regard to the dismissal of Dr. Berrv and the Shrimpton Ward sister.

Questioned as to the allocation of authority among the board's senior employees. Mr. Lassen said the managing secretary was the superior officer on the business side, and the medical superintendent on the medical side.

Mr. Foden: That seems as if there were two ships and two captains. Witness: It may seem that way. Witness agreed that it was not satistaetory that the medi.al superintendent should have to go to the managing »ccietary for requisitions relating to medical requirements.

Mr Mosk-y remarked to witness- It has been given in evidence that nurses have been taken out in motor cars and otherwise socially entertained. \\ itness: I have never taken nurses or sisters (> „t mmy ear. On one occasion l Have taken the matron from Xapier to Hastings—in the day time. Mr. Foden: I want to ask vou if in your opinion, any member of the honorary staff or of the board should take any member of the nursing staff for motor rules at night, or should become undulv famihar in the shape of calling one girl by her Christian name. Would that be detrimental to control?

Witness: It would, in mv opinion Questioned by Mr. W. E.'Bate (representing the Hawke's Bay Hospital Board), witness said it was very undesirable that members of the honorary staff should also be members of the board. Witness had absolute confidence in Dr. Foley as medical superintendent. Mr. Lassen said he saw no reason why once the present trouble wjm out of tin? Wav the affairs of the board should not «o swimmingly. e

Mr. Mosley: Even if we have to settle it in rather drastic fashion?— Yes.

Witness said he had been very concerned regarding the conditions of the junior nurses, and it was now proposed to raise their wages. The final witness of the evening session was the menacing -secretary. Edward Thomas Rees. Witness outlined his'position and duties and gave details of salaries. Dr. Bigjss. when medical superintendent, had been reduced to £700 a year. Conflict of Testimony. Mr. Foden asked witness if he recognised the medical superintendent as the head of the institution. Witness replied '•Undoubtedly." It was not necessary, he said, for he himself to initial the superintendent's requisitions for internal medical supplies. Mr. Foden: There is a conflict of testimony, Mr. Bees. Witness: I am telling you the truth. Witness was questioned at length regarding specific instances in which delay in ordering requirements had been alleged. He declared he always saw that requisitions by the medical superintendent were carried out immediately. Witness admitted that he did not know the law provided a maximum working week of 50 hours for nurses, although he had now learned it had been on the Statute Book for five years. Witness was not aware that nurses in Napier had been working more than 56 hours. Mr. Foden: So that if the board made itself liable to prosecution over a period of five years, which it seems to have done, you would not take the responsibility, would you?—l would probably get the sack. I suppose. Mr. Foden: I think you are too shrewd to get the sack. (Laughter.) After witness had given further evidence Mr. Mosley remarked: Mr. Rees is an estimable officer, but whether he has carried'out his duties not merely efficiently but with the mead of discretion which is necessary is another matter. Mr. Foden: That's the fault of the system, sir. Mr. Mosley: Well. I have nothing to disclose about that in the meantime.