ONE-MAN CONTROL.

Press, Volume LXII, Issue 18671, 21 April 1926, Page 8

ONE-MAN CONTROL.

PAYING WARDS IMPRACTICABLE. DUNEDIN DOCTOR'S OPINION. (special to 'THB PUSS "1 DUNEDIN, April 20. Asked for his opinion on Dr. MacEachern's report, a senior member of the honorary medical staff of the Dunedin Hospital said: "I quite agree with what Dr. MacEachern says about hospitals controlled by one man. No hospital should be controlled by one man, however good he is, because there are so many departments. There should be visiting honorary medical staffs in all public hospitals. • As to the constitution of hospital boards, I think the present system works very well. It suit* the conditions under which the hospitals are governed and on the whole hospital boards disoharge their funotion with fairness and with ability. I do not think there is any necessity to alter the constitution to any large extent. Paying Wards. "With regard to.the question of paying wards in public hospitals, I would say that however good that system has proved in Canada, I do not think it would be a wise thing to introduce it in New Zealand; where conditions are totally different. The first point is that from the patient's point of view it would be a very expensive system. A paying patient under Dr. MacEachern's system would have to contribute not only £6 or more to oover the cost of his own maintenance, but, according to Dr MacEachern, would be expected to pay the deficit on the patients in the public wards to make it a paying concern all round. Secondly he would have to pay for his medical attendance, and thirdly he would have to pay for his nursing attendance, because it would be a wrong thing to have one set of nuxses attending both the public and the paying patiento, since the paying patient would expect a great deal more attention from the nurses. The result would be that the nurses' attention would be devoted chiefly to the paying patients at Ihe expense of the necessitous ones. The only remedy then, in order to avoid this, would bo to have private nurses attending to paying patients in just the same way as doctors attend to them, moaning a further £4 4s weekly to the paying patient. He would have to pay, too, for his drugs, X-ray Slates, laboratory tests, and in the end e would be lucky if he got off at £2O a week. I do not think that even well-to-do people, who at present occupy our private hospitals, would be willing to face this expenditure. Hospital Hates. "Then, again, it must be remembered that here people have got used to being rated for the cost of their hospitals and that the charge is equitably distributed over the population. If you institute the voluntary system the first result would be-that a great number of people would be glad to be relieved of the hospital rate and would not feel it in any way incumbent on them to make a voluntary contribution to the hospital, which was going to take in wealthy paying patients. In Canada there is a much larger wealthy class of people than in New Zealand, where, further, the public debt per capita is so enormous and is so pereistently increasing. This does not augur well for voluntary support of private patients, as well as non-pay-ing ones. The scheme of getting the money by rates has proved satisfactory in the past and so long as the requests are reasonable ; there is no difficulty in getting what is required. In any case this can always be supplemented by voluntary contribution if the people desire it." Referring to the statement that medical patients should not be left chiefly in the hands of resident officers with limited experience in this particular field, the speaker said that that had never applied to the Dunedin Hospital, though there were hospitals to which it might have applied. NO INCREASE IN RATES. TARANAKI BOARD'S DECISION. (press association telegram.) NEW PLYMOUTH, April'2o. The Taranaki Hospital Board decid!ed to-day not to increase the levy on contributing local bodies, but to leave the rate as it was last year, namely, 2s 4d in every £IOO on the capital value. Proposals were made that the levy be increased by twopence in every £IOO and alternatively by one penny in every £IOO, but these were not adopted. To compensate for the non-increase in the revenue due to this decision, the Board decided to raise the fees paid by the patients of the hospital from 9s 6d to 10s a day, and to charge amounts varying from £2 2s to £lO 10s for operations performed in the hospitd, a practice which has not been in vogue up to the present. The operation of tne fees will be according to scale to be fixed after consultation with the Medical Superintendent. The Taranaki Board, which led the Dominion in increasing hospital fees to nine shillings, is also the first to increase them to ten shillings.