"MUST BE FACED"

Evening Post, Volume CVII, Issue 59, 13 March 1929, Page 10

"MUST BE FACED"

HOSPITAL POLICY

THE ADMISSION QUESTION

PEIVATE WARDS SCHEME

(By Telegraph.) (Special to "The Evening Post")

PALMERSTON N., This Day.

Who are entitled to admission to the public hospitals? This question, which has exercised the minds of hospital boards ■ throughout New Zealand for many years, was referred to by both the Minister of Health (the Hon. A. J. Stallworthy), and Mr. Wm. Wallace, the chairman of the Hpsjiital Boards' Conference, to-day. The matter, according to the Minister, was largely, wrapped up with the question of the medical staff.

".There seems," Mr. ..Stallworthy said, "to have beet; a tendency to avoid directly facing these matters. There seems no reason why the- medical profession should not bo adequately paid for;their services. One suggestion i 3 that the honorary staff system should bo'retaincd but that the honorary staff should receive honoraria or parttime payment. One of the objections voiced against the honorary system was that it gives tho members of the honorary staff' an undue ■• advantage over their brother practitioners in that the latter often lose patients after discharge from hospital. Moreover parttime service does not appear to be satisfactory from the employers' point of view. On the other hand, it has been argued that tho "closed" hospital; that is to say, tho,'hospital'with a full-tiino stipendiary staff, is not a good one, and leads to stereotyped and , indifferent, methods. Such argument, however, is not supported by the expert reports after ' inspection 'of tho •dinicaljiido of the hospitals. PRIVATE WARDS. "Moreover, with the 1 tendency to- v •wards v more complete community hospital system access was permitted to the leading medical practitioners to private wards and operating theatres. This would give them an excellent opportunity by example and criticism of (stimulating the stipendiary staff. . "It seems that the community hospital system must come, and that it be accompanied by (1) some system of hospital insurance, which will materially aid finances; (2) by intermediate wards in which, for a reasonable charge and a moderate operating fee, will be accommodated persons /at present utilising the general wards who are; able and willing to pay tho' cost of their treatment. Private wards will . provide facilities at higher rates to tho well-to-do, who at present are often very unfairly denied tho advantages of the institutions, and often cannot procure similar advantages elsewhere. Freedom of choice from the stipendiarystaff or of their own medical practitioners would be a feature of the private patients' portion of ' the institutions. Tho present system which, in some cases not ostensibly and openly, yet actually by some obscure understanding amongst . those concerned, denies admission to the hospitals to many of those who through rates 'and taxes contribute to their upkeep, appears to require facing. The question of admission or otherwisp of any person because of his financial position should be dealt with by the board, and not by the medical staff." • 'CLASS DISTINCTION. " Later in the proceedings, the chairman, Mr. Wallace, referring to tho same ' matter from a different angle, stating that anything that savoured of class distinction would not meet with he approval of tho people of Now Zealand. He:fancied that if theTe were private wards it would mean that the people who entered them would get better attention. Anything lilce that was not wanted in ambulance hospitals. The Minister had , referred to the cases of people in a position to pay for outside treatment being refused 'admission, but, every board-had laid it down that if there were two cases for admission and only one bed, the person who could not afford to +>ay would be given preference, and that, as it should be, tho trend of hospital development had been in the direction of extending to all classes of the community the advantages of well-equipped hospitals. PAYMENT FOR SERVICES. "The 'community' hospital must.be something more than a'vision," he said, "it must be a definite objective, and all the • features of the hospital i policy must be ahared to that end. , Having regard to the present basis of local taxation, we must : adhere to the policy of, requiring persons to pay to their fullest ■ ability for the services received. Ido not. mean that wo .should adopt a harsh policy that would deter patients from seeking necessary treatment, but we should place, ourselves in a position to collect a reasonably adequate charge from those able to p pay. , "In several directions thore is room for an improvement in the legal machinery affecting the collection of debts, and there are' few remits to come be-, fore this conference affecting that aspect. I. ami inclined to believe, however, that substantial relief can be obtained by instituting a ; provident scheme for hospital expenses. We have the example of hospital bed schemes promoted,in the main by friendly socioties. We mu3t frankly admit, however, that, whilst at present they are a source of definite savings to the latepayers,.none'.of these schemes pretends to provide for even half the actual cost of hospital treatment. We want a scheme universally applicable which will return at least tho ordinary charges for the treatment of contributors and their dependants. A remit dealing with the question will come ' beforo the, conference, and it is for ' the conference to at least shape a course 'towards the establishment of a sound contributory scheme."