TREATMENT OF PATIENTS

Press, Volume LXXV, Issue 22851, 26 October 1939, Page 14

TREATMENT OF PATIENTS

PROCEDURE IN

HOSPITAL

DOCTOR’S COMPLAINT

TO BOARD

“INTERNES HAVE TOO MUCH SAY”

Complaints that outside doctors were not allowed adequate access to information about the treatment of their patients in the Christchurch Public Hospital, and that the medical internes at the hospital were allowed too much authority in deciding on treatment, were made by Dr. Maude Fere, of New Brighton, ■ to members of the North Canterbury Hospital Board yesterday. Dr. Fere was allowed to address her’ complaints to the open meeting of .the board, and quoted a specific case of the treatment of one of her own patients. The complaints will be investigated by a committee of the board and a report prepared. The specific complaint presented to the board was covered in two letters, copies of which were given to- members by Dr. Fere. Th_ first letter, from the patient concerned, Mr L. Gordon, of New Brighton, stated. “Please ask the Hospital Board ifit is with their knowledge and consent that a patient should be subjected to the treatment that I was in Ward 11 this last month, September 19 to September 24, 1939. I suffer from a dislocation of the back and inflamed spinal cord, due to an accident. My honorary physician ordered a soothing'treatment, but the ward house interne ordered me down for massage and electricity, in spite of the fact that I heard my honorary physician vetoed such treatment. On two different occasions the ward interne tried to get me down for massage and electricity, and when I refused he abused and insulted me before the whole ward. He told ,me that my honorary physician did hot count, and that it was his place to order treatment, and that if I refused he had a good mind to order me out of hospital. "Although I heard my honorary physician order another X-r?y picture Of my back to be taken from the left side a week before I left, this was not done, so my outside doctor asked for me to be sent home to protect me from further abuse.” . . This letter, it was explained, had been sent to Mrs T. Green, a member of the board, who forwarded it to the board’s office. The second letter, written'by Dt. Fere to Mrs Green (and also sent on to the board by Mrs Green), stated, inter alia:— “Will you kindly inform me if the Hospital Board knows or sanctions such treatment of a patient as was accorded to my patient, Mr L. Gordon, 12 Hood. street, New Brighton. Mr Gordon is suffering from inflammation of his spinal cord and a dislocation of the twelfth dorsal vertebrae, the result of an accident. Mr Gordon entered Christchurch Hospital on September 19, under the care of Dr. Baxter, who advised him to come in for observation. He was in Ward 11. Hr. Baxter ordered ultra-violet rays,, i understand, to be applied daily to his back. The interne suggested massage and electricity. This Dr. Baxter refused to have used on Mr Gordon. In spite of this, the interne on two occasions afterwards tried to get Mr Gordon down to Dr. Will for massage and electricity, and when Mr Gordon refused —September 26 —the interne raged and stormed at him before the whole ward. He said that the honorary physician was nothing, and he, the interne, was in charge to give or direct treatment, and he threatened to order Mr Gordon out of hospital. “Some weeks back Mr Gordon was examined by Dr. Will at the request of his insurance company. Dr. Will wrote to the insurance cotnpany, and said he -prescribed massage and electricity to Mr Gordon’s back. The insurance company wrote to Mr Gordon, and informed him that they were willing to paw for the electrical and massage treatment to the back. I, however, veteod this." Doctor Insists It was explained by the chairman of the board. Mr L. B. Evans, that Dr. F£re had been told that because of the short notice the board had of her complaints, and the need for investigation, it would be preferable for her first to meet two members of the hospital committee. But Dr. F6re had claimed that as it was a matter of public ’ concern she would like to oe heard by the whole board. Mr Evans asked if the whole board wished to hear Dr. Fere, and after a short discussion it was decided, on Mr H. H. Denton’s motion, that Dr. Fere b heard, the Medical Superintendent Dr. A.- D. Nelson, being asked to attend. ■ “I must emphasise that I do nor bring this matter up for any personal reasons, but because of its wide public interest and because I consider it ah example of what is going on m the hospital,” Dr. Fere said. It should also draw attention to the fact tnat the board has a remedy in its hands. Dr. F£re then circulated the two letters already .quoted. She said that she had been referred to Dr. Nelson, who hhd stated that he was satisfied with the work of his staff. Member’s Protest As the letters were being handed round. Mr P. Stanley Foster (who had not arrived at the meeting when the question of allowing Dr. Fere a hearing was first raised) protested that the hospital committee ought first to have been asked to consider the complaints, and then the whole board. He thought that the procedure adopted was not usual, particularly in view of the personal nature of the complaints. “This is a concrete example of what undesirable things happen in the hospital,” Dr. Ff§r6 said, after the two letters had been read., “I know that the honorary surgeons are very busy men nowadays, and that a great deal of the work is now being left to the internes, who are mostly newly-qualified medical students. It was a shock to me to learn that the internes consider that the treatment of patients sent in by outside doctors is in their hands and that the honorary doctors do not count in their eyes when it comes to ordering treatment. The remedy lies with the board itself. The board should do what the Government wants, • and do away with honorary surgeons who do not always have the time to devote to the welfare of their patients, and have a paid staff, responsible to the board and the public; I know that fall members must have heard of undesirable happenings going on which,. because of the present system, could not be fully investigated.” “Not Satisfied” Dr. F«§r6 added that she had not been .satisfied with the access to information about the treatment and condition of patients. Dr. Nelson had , refused to allow access to X-ray photographs, and the patient bad had to be sent outside for another X-ray. But it had been obvious to laymen that the dislocation was there. ' “I want to protest against outside doctors not having free access to in- - formation and to knowledge of the treatment received by their patients. It is not a satisfactory state that internes should run this hospital. The remedy- is ..for the: board to take the

money that is already being collected for the purpose and have a paid staff instead of an honorary staff. I believe the doctors oppose it because they believe that the hospitals are good places for experimental work and for their own self-advertisement. The outside doctors are in a most unsatisfactory position.” _ ' The chairman (Mr L. B. Evans), after Dr. Fere had made her protest, said that his personal view was that an unwarranted attack had been made on the honorary staff and on the board’s own staff. The board was proud of its honorary staff and its medical staff. Members could see for themselves whether the internes were-run-ning the hospital. The board had an able superintendent, whose task it was to see that the hospital was run properly. ■ Everyone, was satisfied, Mr Evans thought, that such was the case. He also thought, that every person entitled to get information about patients ‘ was given it. But many persons ■ without any right for information expected to be supplied with it. Right Procedure There was then some discussion among members whether the board had been right in allowing the proceedings to go before an open board. After Sir Hugh Acland moved that the complaints be referred to the hospital committee of the board, Mr H. A. Bennett suggested that the board had made a mistake in mot hearing the complaints in committee. , Mr Evans interjected that he had done his best. . Mr. Foster protested emphatically about the complaints being heard in open board. Any such attacks on members of the staff, when heard in openmeeting, could not- be,refuted at the same time by the persons attacked. The complaints were personal, and that such a matter should be first heard by the board and made open to the public press was disgraceful. _ . . ' Messrs Denton and T. Nuttall took the view that as the board was a public body any complaints, ought to be heard in public. “Why hear them behind closed doors if there is nothing to fear?” Mr Denton asked. Mr Nuttall said that it could be understood that any defence against the charges would be given adequate publicity. Mrs Green voiced thesame ■ sentiments. . “We have nothing to hide at all, Mr Evans replied; “But other persons are concerned in these charges who have not been heard.” Sir Hugh Acland: We could not deal with.it now. It will take a great deal of investigation. . , .. Mr J. S. Barnett also suggested that it was quite possible that the. wrong procedure had ,been -followed. .Those members- oUthe-boardwho desir ed pub-

licity, he said, could exercise their rights after a discussion in committee, ‘When the board went into open meeting again. '' , . . It was agreed to refer the complaints •to the hospital committee, with instructions to bring ■ down* a • full'- report to the board.