COMMUNITY HOSPITAL FACILITIES

Dominion, Volume 31, Issue 190, 10 May 1938, Page 15

COMMUNITY HOSPITAL FACILITIES

Provision Urged By Stall

PLAN FOR INTERMEDIATE AND PRIVATE BEDS The case for the establishment of community hospital facilities, based on the definite public demand in B ellington for the provision of private and intermediate beds, was put to the Royal Commission in evidence yesterday by Mr. T. D. M. Stout, M.S., E.R.C.S., representative of the honorary staff at the hospital. "The development of the community type of hospital, especialy the intermediate bed accommodation, arises as he outcome of the natural demand of the outcome to have facilities for better accommodation, privacy and the individual choice of doctor and nurse, for which they are willing and able to pay,” Mr. Stout said. “This demand its simply a reflection of human nature and human needs. A little extra luxury with regard to health, should not be prohibited, but encouraged. Other facilities in the community to indulge in smaller and greater luxuries are freely available and freely utilised, so much so that examples are obvious to everybody. “The demand for the right to have intermediate and private bed accommodation is insistent in all democratic countries. There is, however, a pernicious doctrine held by many people, and often falsely called democratic, that nqbody should be allowed to have any different hospital accommodation or treatment from anybody else in the community. The rights and wishes of the people are not considered at all. Surely in times of sickness and stress, the humble citizen should be allowed to have some latitude in having extra comforts for which he has worked hard and saved. He should be allowed to have the indivdiual attention of his own medical man and a nurse of his choosing, if desired, and also a little extra privacy during his sickness. Individual Efforts. "Im everybody only to be allowed the same housing, the same clothing, and the same food, and are the luxuries to be distributed in an exact equality to everybody in the community, irrespective of then- individual efforts to provide for themselves and save for emergencies?” he asked. “Is the improvident and wasteful citizen to have by right exactly the same amenities as the hard-working, provident and thrifty citizen, and is the latter entirely prohibited from having any little' extra that should be his due, especially during sickness? “The building of the modern hospital has brought about in all democratic countries the change of type from a purely charity hospital to a community hospital, where all classes of the community are catered for. This has been brought about by the natural tendency to reduce the cost of hospital treatment for all by centralisation of patients of all. types, so as to allow full use of the expensive equipment necessary in a modern hospital. It has been brought about by the necessary specialisation of medical treatment and the highly technical nature of certain modern methods of treatment for what may be comparatively uncommon types of disease. “It can be shown that the accommodation for private patients in Wellington is inadequate,” Mr. Stout continued. “There are considerably fewer beds available in private hospitals to-day than there have been for many years past. If this state of affairs is to continue, either fresh hospital accommodation of this type must be provided or else there will be a still further demand on the accommodation in the public hospital. Surely if fresh accommodation, for this reason, must be provided at the public hospital, that provision should be in the nature of private and intermediate beds, so that an extra drain on the finances of the hospital district and the Government may be prevented. Einaucial Aspect. “■lt has been common experience that the provision of private and intermediate bed accommodation is financially successful, not only rendering it possible to meet all the overhead and running charges of that portion of the hospital, but also enabling a satisfactory contribution to be made toward the expense of the rest of the hospital, thus indirectly being of benefit to the poorer patients in the hospital. “Thio is of supreme importance in the present matter at issue in Wellington. It is proposed to erect a very expensive modern hospital with all facilities for this hospital district. Specialised hospital staffing and equipment will be such that every necessary medical and nursing facility will, be available, but at great expense. “Our contention is that if- private and intermediate accommodation is provided in conjunction with the new general hospital, the profit made ou this extra accommodation wilt definitely lessen the financial burden on the whole as well a® providing urgently required facilities for the whole and not a section of the population. . “Another point of importance in the question of cost is that we are convinced that, if private and intermediate bed accommodation were provided nt the Wellington Hospital, a very large number of the patients at present utilising the Wellington Hospital would avail themselves of that accommodation, with an obvious improvement in the finance of the institution. We, as medical men in Wellington, have frequent requests for this special accommodation at the Wellington Hospital, and I believe that the hospital board members have the same experience. The appeal for a private room is a natural human wish, and one which, if possible, should be met if the extra financial burden can be shouldered by the. patient. “We are convinced that the provision of at least 100 intermediate beds at the hospital would be readily availed of by the patients, and it would be found that extra accommodation of the same kind would have to be provided in the future. If this is so. it is obvious how the finance of the hospital would be improved, aud this would make the expensive scheme foreshadowed justifiable from the financial as well as the social point of view. Hospital Staffing. “The evolution of the public hospital has been a gradual one, and, along with the improvement in hospital accommodation, has gone a still more marked improvement in the quality of the medical and nursing staffs. The method of medical staffing has, however, remained on the whole that of the honorary service of the medical profession to those of the community unable to provide adequate finance for their medical attention, especially in serious illness demanding specialised medical and surgical care. “The development of general hospital accommodation has thrown more aud more work of this nature on the medical profession, and has resulted in medical services being given gratuitously, both by the profession and the hospital boards, to largo numbers of patients who are well able to afford to pay for those services, it not entirely, yet in part. This Ims resulted in an unfair imposition on both the profession and the finance of the liospitai boards. The institution of intermediate beds attached to the public hospitals would do something to remove this definite anomaly. The large number of patients who are able and willing to pay the doctor of their choice for their medical attention would thereby be enabled to do so, and by paying full maintenance cost of this part of the hospital would be no expense to the hospital hoard.” Cross-examined by Mr. J. O’Shea, representing the Wellington City Corpora-■ t.ion and oilier contributory local authorities, Mr. Stout, said he I hough! a cheaper building could be adopted. Would it bo satisfactory?—“That is the

point of contention. We discussed the pavilion system and came to the conclusion that the more compact type of hospital would be more economical from the point of view of running it.” Trend of Development. May I take it from you that the trend Is to develop the community hospital rather than Ihe private hospital?—“l think the tendency is to have all types of patient,concentrated round the medical facilities.” . Do you think any .substantial reduction in the scheme could be made if it were submitted to a committee of doctors? "I think the thing is largely an architectural problem rather than a medienl one. In this new block I believe there are facilities for visitors to patients. If you did not allow visiting you might be able to cut down some of the accommodation provided.” Is it in your opinion desirable and necessary specially to eater for visitors in this scheme? —“A certain amount of provision is always necessary. There have not been proper facilities in the past.. From a health point of view, do you think visitors to a hospital should be encouraged or discouraged?—“From a medical point of view we would like to see visitors in the wards less frequently.”'