Hospital Services

Press, Volume LXXXIII, Issue 25086, 18 January 1947, Page 8

Hospital Services

Sir William Fletcher Shaw, the noted British gynaecologist, has spent some months investigating the Dominion’s obstetrical and gynaecological services. His praise for the general standard of medical practice in New Zealand is tempered by some criticism of the system of hospital staffing in general and of the conduct of the obstetrical and gynaecological services in particular. It is to be hoped that the Government, the local authorities controlling hospitals, and the medical profession will give careful attention to the findings of this visitor, who speaks with authority. The public, too, has a close interest in the questions raised. Attention has been drawn once again to the recurring permanent loss of the Dominion’s best brains. We cannot afford this loss of the most brilliant and promising of our medical and surgical graduates any more than, we can afford the loss of our best scholars in other fields. New Zealand cannot offer to the outstanding physician or surgeon the opportunities for training, practice, and research that are readily available in the more populous countries; but it can and must offer them sufficient inducement to return after their post-graduate training. Sir William Shaw found that New Zealand “ did not show that she “ wanted these well-trained men “back. No posts were provided in “ which they could practise what “ they had learned, and they, re“mained abroad, casting ever-long- “ ing eyes at a homeland which “ seemed indifferent to them ”. Only when an adequate number of these trained specialists are working in New Zealand with the facilities that large institutions alone can provide will it be possible to say that the health of New Zealanders is being cared for as it should. Sir William Shaw estimates that 20 or 30 trained obstetricians and gynaecologists could be employed in specialist departments in New Zealand hospitals; he has been able to find only three

hospitals that have such departments. It is one of the weaknesses of the hospital system in New Zealand—and of the over-riding medical side of the social security system—that too little attention is paid to specialist services. These are expensive to provide and to maintain; and neither the Government nor the hospital boards, faced with evermounting demands for hospital space and general medical and surgical treatment, are likely to be happy about heavy expenditure on specialist services. Sir William Shaw has directed attention to one gap in our hospital services. There may be others, but it is comforting to have his assurance that when obstetrical and gynaecological departments are established in a greater number of New Zealand hospitals there will be no lack of trained New Zealanders with oversea experience to staff fhem. There is something to be said for and against the systenj of shortterm appointments of hospital staffs which he deplores. The system has the considerable merit of enabling a large number of doctors to receivethe varied and intensive practice that a hospital appointment alone can give. It is doubtful whether long-term appointments would in themselves result in a greater amount of medical and surgical research, which admittedly is very limited. As in cancer research and tuberculosis,-New Zealand workers collaborate in some internationally organised research fields. There are, perhaps, others that should be shared in the same way. Besides, there are problems which specifically relate to New Zealand conditions, and only work planned and done in New Zealand will solve them. The means—as the provision of money, of staff, and of equipment furnishes them—should not be wanting, and will certainly not l?e withheld if the demand is properly explained and advanced. Public opinion as much needs to be educated and resolved, in this matter, as the opinion of local and national authorities.