A NEW SYSTEM

Evening Post, Volume CV, Issue 123, 25 May 1923, Page 4

A NEW SYSTEM

ADMISSION OF PATIENTS

REPORT OF MEDICAL SUPERINTENDENT

MORE STRICT CONTROL.

„' The Medical Superintendent of..' tjie Wellington Hospital, Dr. D. M- Wilson, at the request -of the board, submitted 'a'report 'cm the- methods of admission pf patients^ to .the- Hospital, at the meet:ing. of the board • yesterday. •,; ■ ■ ' i. After detailing the existing.methods ;6f admissions, Dr.. Wilson said;— '

■; "E c .Cases from other Hospital.'.Districts'.—During'the ' past year . an, endeavoUr has been made to keep a strict 'control over these cases. An urgent case is admitted .at once, but other cases must come through the Medical- Super-intendent-at the regular•■hours. _.' This ■■Hospital, as a base hospital, has de<Vel6p'.ed; special departments which the smaller, district hospitals do'riot possess, and 'thersfore attracts patients from, surrounding districts'.-•-Also a large,centre :always attract* a..,number- .'-of, .'OKJinary cases from the' country/, Since' the 'Wel'lmgton ratepayers. svf rated^ ipp-ihe upkeep of th«:instituti?n,-it is, not .con.'Eid'ered'.fair.ihat,, patients from -othfir. districts should'- be"'admitted indiscriminately without having some guarantee, of payment of fees. Therefore, before such patients are admitted, either they must sign, a. form, guaranteeing payment of fees or produce a guarantee from their hospital board. "To avoid overcrowding, I would suggest: (1) That prominence be given in ; the''Press '■ to the desirability of patients interviewing or writing, to the Medical Superintendent to arrange a, date for admission before coming long distances, closing their homes, or making other arrangements; :(2) that local medical practitioners be circularised asking them to advise their patients to arrange for date ■of .admission; (3) that the linking up of the children's operating theatre with the General Hospital or making a temporary theatre annexe in the present operating" theatre be proceeded with- It would greatly assist also if each honorary surgeon' had a special operating day each week, as admissions could be then regulated accordingly. However, the honorary surgeons consider this impossible. "Regarding Delays in Admissions.^ Except in the recent unfortunate case, I have not received any complaint of unreasonable or avoidable delay in admitting any urgent case. I shall always be glad to investigate any complaint made to me by patients or friends. However, there is at present a weakness in our system of conducting the Hospital which may cause delay in a patient seeing a doctor, but it is the fault of the system and not of any invididuaJ. T refer "to the . fact that we have no 'Casualty'ofEcejv I'have conferred with .the-.honorary .surgeons, and' they have agreed -to my' suggestion, that each ward have, one'day'in the week on which no operations'will'be performed; This will the 'house surgeon; of' that ward tp'.'be free' for' twenty-four "hours of a]J 'theatre''duty.','.".l ;propose ."that each "house surgeon) by - rotation, ;• act daily as:.casualty..offi'per:: It.will-.be his duty toatiend-to'ahy call'at-the front door, Vand-he .must iot: iriove about the Hos:pi£al without' 'advising the front-door ; whe,re -he,- can ."'immediately be found. Another iweajeness-in the Hospital can also te overcome St the same time. At present there is no one available to inspect the cases for surgical dressings in the outpatient department each morning. The nurse in charge . carries out the dressings, and a doctor may not see the case for days. By appointing a casualty officer it can 'be his duty to inspect these cases each morning." . Mr. C. M. Luke remarked that the recent inquiry showed certain weaknesses, and it was because of that fact that Dr. Wilson had : been requested to furnish a report on the general question of admissions. Dr. Wilson Had gone carefully into the matter, and it was to be hoped that. such a delay as had recently occurred would not occur again. The chairman thought the suggestion of the Medical Superintendent to appoint a casualty officer would do away at least with some of the complaints which occasionally arose that patients had to" wait at the main entrance for a considerable time before they received attention. Such delay was no doubt due to the house surgeons carrying out "their duties in the wards. A large number of these cases were not of a serious character, but they should receive attention at tlie earließt possible moment. Mr. 0. H. Chapman agreed that the recent inquiry and the report of the Medical Superintendent showed that there were weaknesses in. the existing system. It was the duty of the Hospital authorities to endeavour to remove those weaknesesß. , The report was referred to the Hospital Committee, for consideration and report.