ADMINISTRATION OF HOSPITALS

Press, Volume LXXIV, Issue 22345, 8 March 1938, Page 14

ADMINISTRATION OF HOSPITALS

CONTROL BY DOCTORS

AUTHORITY

URGED

VIEWS OF AUSTRALIAN

fTHE PRESS Special Service!

AUCKLAND, March 7

"If you installed delicate engineering plant you would not have a baker to run it. We believe that nobody knows more about a hospital than a doctor. For that reason we have eliminated layman control of our hospitals," stated Dr. A. B. Lilley,* general superintendent of the Royal Prince Albert Hospital, Sydney, who was a through passenger by the Mariposa from Sydney. Dr. Lilley has been sent on a world tour to study hospital administration and construction to guide his board in the spending of £350,000 in the near future.

Dr. Lilley said that the Sydney authorities believed strongly in the administration of hospitals by medical men. How, he asked, could a layman, with a problem to solve in the laboratory, argue with a doctor about what particular plant was needed? A layman could live and learn, but the doctor was presumed to have the requisite knowledge. It had been tried and proved in Sydney that administrative control by medical men was highly successful. "We had experience of layman control," he said. "We changed over, and then we had dual control, with a layman in charge of the business side and a doctor in charge of the medical side. The result was chaotic.

"The doctors in charge of hospitals give up their clinical work and become administrators purely, and exercise supervisory control over the wards. This system has proved itself in both America and in England. There are many students who pass through the medical schools who have adequate business ability to control a hospital. Why not make use of their bent? I understand that as yet New Zealand has not decided that layman control or dual control is inferior." I Intermediate Hospitals Dr. Lilley said that there was no doubt that the system of having intermediate hospitals as part of the general hospital plan had been a pronounced success in the United States, Canada, and England, and in certain parts of New South Wales. In New South Wales no one who could afford to pay for treatment in private hospitals was admitted to public hospitals, but to meet the need of a large section who could not afford private hospital fees., intermediate sections were introduced at the public hospitals. He commended them to New Zealanders. The fees ranged from £3 13s 6d a week in a four-bed ward and £4 14s 6d in a two-bed ward, and single bed wards for private patients ranged between £6 6s and £lO 10s a week. Dr. Lilley expressed astonishment that with all the examples which New Zealand had of the success of this system in other parts of the world the Dominion hospitals had not introduced the intermediate hospital. Private patients were expected to pay the fee. but intermediate patients paid only half of this fee.