PRIVATE WARDS

Evening Post, Volume CIX, Issue 148, 26 June 1925, Page 9

PRIVATE WARDS

B.M.A. RECOMMENDATIONS

A PROTEST

DISCUSSED BY HOSPITAL BOARD.

The following letter from the Society of Carpenters and Joiners, dealing with the question of hospital policy and the' proposal to establish private wards or rooms in connection with general hospitals, was read at a meeting of the Wellington Hospital Board:— At the usual meeting of the Wellington Union of the Amalgamated Society of Carpenters and Ooiners, consideration was given to the report of the proceedings of the Wellington Hospital Board, which appeared in the '-' Evening Post " of 21st May. Reference was there made to proposals to establish private wards for paying patients, and also to give free use of the public hospital establishments and organisations to the members of the B.M.A. for their vested interests. We appreciate the services rendered to the public by the medical profession, for which exorbitant charges are made but consider the interests of the general community of more importance; while we agree with the statement of the superintendent of the ■ . Wdllipgton"• Hospital that the open ward system for general treatment is out of date and condemned .by all hospital experts. We_ emphatically protest against the adoption, for the best interests of one section of the community only,.to the private ward system. Let us not be misunderstood. We are in favour of the abolition of the large open wards, and would welcome the establishment of private wards, for all patients, but strongly oppose the proposals submitted by the 8.M.A., and apparently sympathetically received by the members of the Wellington Hospital Board. As ratepayers, and also indirectly as payers of rates, we consider it bur duty to make this protest.—H. Mitchell, secretary. ' - A formal reply from the board -was sent stating that the protest of the society would be considered when the subject was under discussion. AGAINST PROPOSED CHANGE Mr. C. H. Chapman said that no decision had been arrived at by the.Wellington Hospital Board. He hoped that after discussion a considered decision would be arrived at that the policy of the board_ would not be to encourage the establishment of private wards in our hospitals, as was apparently desired by the B.M.A. There seemed to be an attempt, said Mr. Chapman, to stampede the hospitals of the country into the hands of the medical profession. Although he appreciated what the honorary medical officers had done, the board had to be very careful that no association of doctors, however capable, should usurp the duties of the hospital boards.: PROUD OF HOSPITAL SYSTEM The great advantage of our hospital system m New Zealand was this: that, although the ratepayers contributed about half, and the taxpayers the other .half of the hospital expenses, still the people who paid nearly the whole cost elected their representatives-to see that the funds were properly expended. He thought they could be proud of their hospital system, notwithstanding that it had some minor defects. Personally he was proud of the Wellington Hospital.. He thought that their administration' and system of- finance had enabled them to build up an-institution which was a credit to.the whole of New Zealand. It was due to the fact that our hospitals;had attained a high standard that there was a desire on the part of. private practitioners to take advantage of the facilities offered for the treatment of . disease in our hospitals. - If private medical practitioners wanted to send some of their patients to the hospital, let'such patients come to the hospital as other patients did. They should not come to the hospital aul receive different treatment to ordinary patients. The New Zealand branch of the B.M.AJ recently, published, a comprehensive statement, which appeared in the "Evening Post." The first paragraph in the recommendations of the B.M.A. was as follow :_ "Public hospitals should be so constituted as to be available for treatment for every member of the community;" That, said Mr. Chapman, was- the position - to-day... There -was no reason for the establishment of private wards for the occupation of those who could afford to pay large fees. Paragraph 3 of the B.M.A. recommendations was : "As regards paying' patients, the few to be a matter between the patient and his medical adviser." That, ■ said Mr. Chapman, meant differential treatment—that those patients with money were going to get the services of specialists. The board should not give any grounds for the feeling to exist that differential treatment might occur. He thought they should insist that all who came to the hospital, rich or poor, should be treated according to the necessities of their case. That was a sound policy, and should be adopted. "PARTING OF THE WAYS" Mr.- W. Appleton said, .as had al-. ready been remarked at a meeting of the board, "they had come to the parting of the ways." The position was that men with means should not bo barred from coming to our hospitals. « Why should they turn away a man who could afford to pay a big fee? He thought also that they had come to "the parting of the ways" aa regards honorary services. Although Wellington Hospital was well served by their honorary stan^ they could not expect to get the same services as if they paid them. In order to be able to provide -the best equipment, they should be able to charge a decent fee. They should have private wards for those who desired to pay for them—wards where a. private medical man could come in and attend to his own patients. Mr. Appleton said the private ward system existed at the | Lcwisham Hospital, Sydney, and there was no difference in treatment that he i could discover. The board must advance with the times. The time had come when the whole hospital system should be overhauled. The time, had come when they should pay their medical, men. The general hospitals should be the centre of the medical service of the district. He thought the time had come when they should have private wards. . Mr. E. Vino said ho did not agree with the statement which had been made by a member of the B.M.A. in "The Post" that the. honorary system had failed. The .honorary system had stood the test o[~ years. AVhafc they were in danger of was of the hospital administration drifting into the hands of .a strong; and wealthy body. "The boards should be 'careful"that the control of the hospitals should be taken out of the hands of the people. Although private wards might be necessary in the treatment of cerUiin eases— I t;vnn under the present pysaciii— cure . must b\? tukou lliut lhgi-6 should be utf [

differentiation in the treatment of patients in our hospitals. The Rev. J. A. Lochore expressed the opinion that in view of the exteasion of the activities of hospital boards and of the Health Department, we were moving to a State medical service. He had held the,view for many years that that was the direction in which they should tnove ; Already there was medical inspection of schools. As they were moving towards a State medical service, it seemed to. him that every section of the people must be catered for. If there was a section of the community which was prepared to pay high fees for services, why not give them an - opportunity to pay such fees? He maintained that they should not allow the control of the hospital system to go out of their own hands. "On that, hi would be very insistent. He recognised that the B.M.A. had done its best. TURNING BACK HANDS OF-THE CLOCK • Rev. Dr. J. K. Elliott cordially supported what Mr. Appleton had said. As had been stated, they had come to "the parting of the ways." It was quite evident that we could not carry on a colossal institution like our hospital system \in the way we had been doing. The amour t of money we were getting from tlie patients was only a small proportion of the revenue we ought to receive. At pnssent, the balance had to be borne by the taxpayers. He was very surprised that there should be any discussion on the matter, in view of the resolutions arrived at by the Hospital Boards' Association and the . policy" outlined by the Health Department. In the face of all that, Mr. Chapman now wanted to turn back the hands of the clock. The chairman (Mr. F. iCastle) pointed out that the board had not yet come to any decision on the matter. Therefore it was not fair to say that the recommendations of the B.M.A. had been sympathetically treated by the board. No vote of the board, had been taken on the proposals. There were many matters that required careful consideration before the board could come to a vote. The Wellington Hospital Board would hot be dominated by the Hospital Boards' Association or by any other organisation. Mr. Castle said he must confess that he thought the private ward system must come ;• but he did not altogether agree with the basis laid down by the B.M.A. They might agree that private wards were likely to come in the future—and he believed they would come—but he did not think they should be restricted to- patients who paid their fees. These were matters which the board should discuss with the Medical Association, and the Finance and Policy Committee had been instructed to arrange for such "a conference. It seemed to him that the B.M ; A. did not want to dominate the administration of the boards—in fact, they wanted to retain the boards—but they wanted to dominate' the medical and surgical side. He could not support that attitude. .In the large hospitals they required a large stipendiary staff. It appeared as if there -would be a conflict of interests with .the Medical Assodatura on that point. The board would ■have to look at the matter from tha public point of view. He thought they all agreed that the hospitals should be open to all—even Mr. Chapman agreed with 1 that. Mr. Castle said he*, thought they could all agree to have a differential basis without having differential treatment. He moved :J'That the board notes the protest of the" Carpenters and Joiners' Society, and approves of the reply sent." ' Mr. C. H. Chapman said h« had no desire to sneer at the B.M.A. or at any 'members of it. He knew a number of them, and had the greatest admiration for • their work. The motion was agreed to.