PUBLIC DEMAND

Evening Post, Volume CXXV, Issue 107, 9 May 1938, Page 10

PUBLIC DEMAND

COMMUNITY HOSPITALS Dr. T. D. M. Stout said that as a representative of the honorary staff of the Wellington Hospital, he was in agreement with the evidence submitted by Dr. Luke with regard to the present condition of hospital accommodation at the Wellington Hospital, and with the ideas submitted by him to improve hospital facilities in the district. In dealing with the question of modern hospital provision of the community hospital type, it was desirable to give a short history of the development of public hospitals in the past, said Dr. Stout. Originally, public hospitals were provided mainly by voluntary subscriptions for the treatment of the poorer people in the community who were unable to afford ordinary hospital attention. Today these institutions had grown up to be large and well-equipped hospitals with highly-specialised medical and nursing staffs, and providing facilities for treatment sometimes unable to be obtained elsewhere.As the cost of specialised equipment increased, and medical treatment became even more diversified, it would become gradually more difficult for the smaller hospitals to provide some of those special facilities. Cases were referred to the Wellington Hospital from the whole of the middle district of New Zealand, going as far as Gisborne and New Plymouth to the north, and Blenheim, Nelson, and the West Coast in the south. Many of those cases were of the private and intermediate type of patient, the facilities for the special treatment of which were only obtainable at the General Hospital in many cases, and they were debarred from getting the special accommodation they desired and from the satisfaction of paying adequately for the medical treatment they received. A NATURAL DEVELOPMENT. Centralisation of special services was inevitable. The development of the community type of hospital, especially the intermediate bed accommodation, arose as the outcome of the natural demand of the people to have facilities for better accommodation, privacy, and the individual choice of doctor and nurse, for which they were willing and able to pay. This demand is simply a reflection of human nature and human needs. The demand for the right to have intermediate and private bed accommodation was insistent in all democratic countries. "The building of the modern hospital has brought about in all democratic countries the change of type from a purely charity hospital to a community hospital, where all classes of the community are catered for," Dr. Stout continued. This has been brought about by the natural tendency to reduce the cost of hospital treatment for all by centralisation of patients of all types, so as to allow full use of the expensive equipment necessary in a modern hospital. It has been brought about by the necessary specialisation of medical treatment and the highly technical nature of certain modern methods of treatment for what may be comparatively uncommon types of disease. The provision by the community of multiplicity of expensive appliances such as radium and deep X-ray plants, in different buildings in one centre of population, is obviously uneconomic, and one cannot conceive of a competent hospital administration not making provision against sue'# waste. "If a hospital administration is only to make provision to one type of hospital accommodation, and thereby not satisfy the legitimate needs of the community as a whole, then there should be given to those whose legitimate needs are not met some definite compensation. If, also, the provision of intermediate and private accommodation can be made, not at a great loss, as happens in the general hospital, but actually at a profit, as can be shown by examples all over the world, surely there can be no reason against that provision." FINANCIAL ASPECT. , It could be shown that the accommodation for private patients in Wellington was inadequate. It had been the common experience that the provision of private and intermediate bed accommodation was financially successful, not only rendering it possible to meet all the overhead and running charges of that portion of the hospital, but also enabling a satisfactory contribution to be made towards the expense of the rest of the hospital, thus indirectly being of benefit to the poorer patients in the hospital. "This is of supreme importance in the present matter at issue in Wellington," said Dr. Stout. "It is proposed to erect a very expensive modern hospital with all facilities for this hospital district. Specialised hospital staffing and equipment will be such that every necessary medical and nursing facility will be available, but at great expense. Our contention is that if private and intermediate accommodation is provided in conjunction with the new general hospital, the profit made on this extra accommodation will definitely lessen the financial burden on the whole as well as providing urgently. required facilities for the whole and not a section of the population. "Another point of importance in the question of cost is that we are convinced that, if private and intermediate bed accommodation were provided at the Wellington Hospital, a very large number of the patients at present utilising the Wellington Hospital would avail themselves of that accommodation, with an obvious improvement in the finance of the institution. We, as medical men in Wellington, have frequent requests for this special accommodation at the Wellington Hospital, and I believe that the Hospital Board members have the same experience. The appeal for a private room is a natural human wish, and one which, if possible, should be met if the extra financial burden can be shouldered by the patient." The provision suggested would tend