CHANGES NEEDED

Evening Post, Volume CVIII, Issue 147, 18 December 1924, Page 6

CHANGES NEEDED

The report of the Palmerston -North Hospital Commission proves that our present system of hospital government contains anomalies which may shortly result in grave injustice and hardship to doctors and patients. No particular person or board is to blame for these anomalies. They have arisen in the gradual development of the system. But it should be the concern of all to work steadily for their elimination. The test case submitted in Palmerston indicates the difficulties that may arise in the future. At the root of the problem is the fact that honorary staffing cannot continue on the present basis if the hospitals are to be really open to all classes. This may not be an immediate problem in the larger cities where there are well-organised and efficient private hospitals, but in the smaller towns there is often not scope for public and private institutions if both are to be efficient. What- is then to happen? Either the well-to-do patient must enter the private hospital, which is usually not so well equipped as the institution which is supported by public funds, or he must enter the public hospital and benefit by honorary treatment. In the first case the patient suffers, in the second the loss is that of the honarary medical attendant.'

The public is deeply indebted to the doctors who have given honorary service at the public hospitals. Admittedly they have had some small reward in the honour of the appointment, the experience, and the knowledge that they have helped the helpless; but the honorary service they give on so extensive a scale is quite unique in professional annals. It cannot possibly be continued if the public hospitals are to be used by all classes. The tendency of the times and the advance of medical science making for specialisation and expensive equipment is rapidly driving all classes to these hospitals. Why should the richer, people be denied a share in the benefits 1 And how can they have that share without depriving the private practitioners (who constitute the honorary staff) of their living? We do not wish to lay down a hard-and-fast solution of the problem. It is a problem for consideration by the hospital authorities and the medical service ; but it does appear to us that the Palmerston Commissioner has suggested the lines of a possible agreement. If honorary physicians and surgeons are to treat patients well able to pay, it is only jusMhat payment should be made to the medical officer. Full payment of hospital expense is also reasonable.

This does not mean that the well-to-do patient should pay more than his proportionate share of hospital cost; but all patients should pay according to their means. The cost of maintaining the needy must continue to be a burden upon the ratepayers and taxpayers, lighten-, ed, it must not be forgotten, by the work of the honorary staff. It is possible that many difficulties may be encountered in bringing such a •system into '' operation, but if a start is made now, with hospital boards and doctors working together, we have no doubt' that all the' obstacles will be overcome.