HOSPITAL POLICY

Evening Post, Volume CIX, Issue 117, 21 May 1925, Page 4

HOSPITAL POLICY

There can be no doubt that as our hospitals have changed in so far as concerns the class of patients treated, so there must be a change in the staffing arrangements. At one time public hospitals were almost wholly charitable institutions maintained in part by public subscription aud in part from the public funds for the use and benefit of the poor. Now many patients well able to pay. seek treatment. Even if they pay the hospital fees (and all of them do not), they are under no charge for the services of honorary doctors. In fairness to these honorary medical officers, the time has come- to introduce a new system. There are two courses open to the hospitals: (1) To exclude all persons who are able to pay for private attention; (2) to admit all, but to make a charge which will cover the cost of medical attention, including the attention at present given by the honorary staff. The first course would involve hardship upon the general public, and is unlikely to be entertained for a moment. The second opens up a difficult staffing problem, and is far from simple in its effect upon finance. .Many poor people now make an effort to pay; but if the fees were raised to 15s a day they would consider it impossible to discharge the debt in full and would possibly feel that they might as well pay nothing at all Yet if a lower scale of fees were adopted, some patients would escape payment of part of the cost of their treatment and maintenance, i

The staffing problem is equally difficult. The bigger hospitals may decide to carry on the work with full-time staffs only, except for occasional consultations. This is the practice in many of the larger hospitals in other parts of the world, and it is for experts to decide whether our own hospitals are now of a size which would render this method satisfactory as regards both efficiency and economy. The alternative is to arrange payment on a part-time basis. This would involve a less radical departure from the present system, and on that account may well be deemed the better course to adopt as a. first step m reorganisation. No great difficulty should be met with in arranging the rate of payment, in which, of course, consideration would be given to the fact that the hospital provides the accommodation and equipment and relieves the medical attendant of all the worry of collecting fees. The discussion at yesterday's meeting of the Hospital Board revealed a desire to act fairly by the medical profession, and the doctors themselves have proved by their past actions that they are more concerned to do the best that is possible for the sick than to drive a bargain. Because they have been unselfish and selfsacrificing it is now a public duty to see that they are no longer called upon to bear so great a proportion of the cost of free or cheap medical attention. The community, if it desires to be generous, should be so at its own expense, riot at the expense of the doctors.