The Dominion. FRIDAY, JULY 23, 1937. CONTROL OF PUBLIC HOSPITALS

Dominion, Volume 30, Issue 254, 23 July 1937, Page 10

The Dominion. FRIDAY, JULY 23, 1937. CONTROL OF PUBLIC HOSPITALS

As far as the Napier Hospital itself is concerned in the Royal Commission’s severe report the questions of reform an jJ d ETeen action may be left to the administrative authorities, who have -been taught a lesson, and to the Medical Council and the Nurses Registration Board for appropriate action, lhe Commission did its work of investigation without fear or favour. It spared no one where censure was deserved, and sheltered nobody in its revealing comments and recommendations. „. W nti™->llv Thorough investigation and complete candour wcie exceptionally necessary. Hospital service, above everything else, calls foi efficiency and harmonious co-operation, otherwise public confidence willl be shaken. The inquiry has cleared the air in the Hawke s Bay hospital district, and should go far to convince those concerned of the oily of local rivalry and jealousy. Within the Napier Hospital itself there should be a speedy removal of the defects emphasised by the Commission The publicity given to the various shortcomings revealed sZ have a salutar/ influence upon public hospital administrate gCn From a national point of view the report of the Commission breaks some new ground in that it expresses the opinion that there is much to be said for the contention that the hospital system in New Zealand should be in a large measure nationalised, adding that the system “might well be under the control of commissioners responsible as regards broad policy to the Minister, and through him to Parliament.” It would be easy to read more in that than it really conveys. This opinion was expressed in the light of certain condemnatory features of control and service in a hospital which was the subject of a searching inquiry, and to that extent at least could hardly avoid being weighted. In the light of other experiences as much could also be said quite fairly against complete nationalisation of New Zealand’s hospital system. Indeed, the Commission itselt is by no means partial to more political interference, and favours commissioner control with State representation. But once broad policy has been entrusted to the Government and Parliament, irrespective of parties in politics, it is never easy to keep the breadth ot policy within reasonable bounds. ... However, what the Commission had clearly in mind was the need for practical measures of reform in control and methods in order that people would be assured the best possible public hospital service without extravagance or, to speak plainly, any sort of muddle. The question of hospital development and administration is not confined to this country. It has become virtually a universal problem. Every country with a system of general hospitals is discussing the difficulty of keeping pace with the changing times, the increasing demand for medical and hospital treatment, expanding costs, and the advantages and disadvantages of various systems of upkeep and administration. In the United Kingdom, for example, where the hospitals, or infirmaries are largely supported by voluntary contributions (receipts last year totalled £16,496,522, and expenditure £15,043,140), a Royal Commission has for some time past been inquiring into the position of voluntary hospitals. Rate-supported hospitals in the British Isles are almost wholly confined to fever and smallpox institutions, a few ambulance stations, and several homes for sick and. convalescent children both in the country and at the seaside. Administration by expert commissioners and approved trustees generally is considered very good. Indeed, it must necessarily be kept at a high standard in order to deserve generous voluntary support. Loss of. efficiency means loss of revenue, while a good reputation for service brings its reward in appreciative contributions. The public hospital system in the United States, which contains about 50 per cent, of the world’s hospitals, is considered by British and European experts to be the finest in the world. It is entirely controlled by the municipalities in cities and towns, -and by. county authorities in the country. Their budgets come from taxes imposed upon the public. Of course, there are many private and voluntary hospitals as well. New York alone thus provides for over 700,000 patients daily. The whole tendency in America is to develop hospitals away from conditions suggesting disease and death, and wherever possible, from hideous city noises. In this country the factor of noise in vicinity to hospitals demands closer attention. A feature of American hospital development is the provision made in general hospitals to meet the needs of private and semiprivate patients who are able and willing to pay for their own doctors or surgeons’ services and pleasant aids to health. . This .use of. private wards is extending rapidly in Great Britain, and is helping to increase hospital revenue. Indeed, there is so much scope in New Zealand for hospital improvement and development on the best-proved lines of modern healing services, including convalescent homes, that the authorities should study these achievements before seriously contemplating the nationalisation of the whole system and -exposing it to the influence of politics.