Hospital Control

Dominion, Volume 28, Issue 111, 4 February 1935, Page 11

Hospital Control

Sir, —While on a visit to Sydney I took the opportunity of studying the organisation and layout of most of the large base hospitals under control of the Hospital Commission. I propose to discuss the various types of hospital control or management in the light of the recent changes we have had at the Wellington Public Hospital and the conclusion I came to as the best solution of this much-vexed problem. At some hospitals the chief executive officer was a qualified secretary. The result was that progress was sacrificed for economy and iu one case the medical superintendent's main object was to be appointed to the honorary staff, and consequently his policy was to avoid conflict with the board, the secretary, the matron, and the honorary staff. At another big hospital. the control was in the hands of a medical superintendent, a secretary and a matron, and recently the mediiMl superintendent was outgeneralled by the combination of. the secretary and matron. This sometimes happens in New Zealand. In another base hospital, perhaps the largest of them all, there was a medical superintendent in control, sut the weak point here was that he did not control because the secretary saw to all the correspondence and the medical superintendent only saw what the secretary'sent-him. At present friction is brewing between the new secretary and an executive officer of long service, I have left to the last the best solution I found of this vexed question, and that was at the Royal Alexander Hospital, with 440 beds. The chief executive officer was the medical superintendent, who was assisted by an accountant and. staff. There was no secretary and all correspondence went through the medical superintendent. There was an honorary staff and resident staff, and the whole outlay of -the building was the best to be seen in ipublic hospitals. As a result of a close study of hospital control I am satisfied the upsetting factor in our hospital system lies in the appointment of a secretary, who sometimes bcc'omes' the rallying point around which some rival faction gathers.. fiction develops and the final solution is that someone has to be dismissed or pressed to resign, generally the medical superintendent. Another factor that should be abolished is the honorarium paid to the chairman of the board. The fact of receiving an honorarium makes the Chairman feel that he must be in daily attendance at the hospital— Wellington.