EARLY DECISION

Evening Post, Volume CXXV, Issue 115, 18 May 1938, Page 6

EARLY DECISION

HOSPITAL INQUIRY

COMMISSION'S DESIRE

POINTS CLARIFIED

A number of points arising from evidence heard by the Hospital Commission were clarified at today's sitting by Dr. A. R. Thorne, superintendent of the Wellington Hospital. It was arranged that counsel should address the Commission on Friday afternoon. The chairman said that he and his colleagues wished to 'dispose of the matter next week, as early as possible.

The personnel of the Commission is as follows: —Mr. A. H. Young, of Christchurch, principal Stipendiary Magistrate, chairman; Mr. D. S. Wylie, C.M.G., C.8.E., of Palmerston North, medical practitioner; Dr. H. HardwickSmith, of Wellington, medical practitioner.

Mr. A. E. Currie is appearing for the Crown, Mr. J. O'Shea (City Solicitor) for the Wellington City Council and other contributory bodies, and Mr. G. R. Powles for the Wellington Hospital Board.

The history of the negotiations be[tween the City Council and the Hospital Board regarding a proposed combined morgue at the hospital was set out in a statement presented by the City Engineer (Mr. K. E. Luke). The statement showed that the last reference to the subject on the council's files was an acknowledgment in 1930 of the council's decision to contribute £500 towards the cost of the work, provided that it was relieved of any future liability in connection with the management and maintenance of the morgue. The board was to place the plan and estimate' before the Minister of Health for his approval and to advise the council whether the raising of a loan had been agreed to.

Witness said he would be prepared to advise the council to enter into the arrangement again. It was very desirable that there should be a more modern combined morgue. Mr. Currie said that the morgue would be on hospital land and the Hospital Board might want to reclaim the whole of the premises. Mr. O'Shea said that the solution would be to obtain some statutory authority. DECENTRALISATION. A policy of decentralisation of hospital services was advocated in evidence, given by Dr. L. G. Austin, of Wellington. He said that he was not a member of the honorary staff of the Wellington Hospital. He considered that the first step in the development of the system should be the building of a hospital in the Hutt Valley, and that a new children's hospital should be built on the Town Belt somewhere near the present site, and a new ear, nose, and throat department be established away from the Wellington Hospital. There was a site in Abel Smith Street which would be suitable for the purpose. About 80 beds would become available if the children's cases were placed elsewhere and new provision for the ear, nose, and throat cases would relieve the congestion in the outpatients' department. He was in favour of building new units for surgical cases off the main corridor at the Wellington Hospital. That would be all that was needed in that respect.

"I have always adopted the attitude that the Hutt Valley has not had a fair spin from the Hospital Board," witness continued. A number of years ago, the board had spent over £300,000 on new buildings at Newtown, but nothing had been done for the Hutt Valley, which nevertheless had to pay a. fair share of hospital charges. A complete hospital in the Hutt Valley would do much to relieve the present congestion at Newtown. From his experience in smaller hospitals, he would say that the work done there was just as good as was performed in the large hospitals. It might be argued that there should be a central hospital for the treatment of special cases, but it would be interesting to know the exact nature of those cases. Probably many of them were sent to the Wellington Hospital by insurance companies or other hospital boards because of the special plant available there, but the essential equipment was not so very expensive and could be provided in the Hutt Valley. A hospital there should not be of the subsidiary type, but should be able to cope with all except the most exceptional cases. The indicated size was from 200 to 250 beds. TREND IN SYDNEY. Witness said that in Sydney thg Hospital Commission was striving to decentralise the hospital services, and he quoted from medical journals to support his view that a Hutt Valley hospital should be established. He also urged that adequate provision should be made for cases suitable for transfer to convalescent homes.

FOR URGENT RELIEF. Dr. Thome said it should be emphasised that the block which the architect, Mr. Haughton, had suggested should be built at once was proposed as a separate work giving urgent relief and that it should be.finished as a separate contract while the rest of the work was proceeding. Witness said, he also wished to state that the hours worked by the senior nurses and sisters were about 50, not 60, as had been reported. The figure of 730 beds given in the annual report of the Health Department was the number actually in the wards at the hospital. The number which should have been in the wards was considerably less. CHILDREN'S HOSPITAL. I In regard to the nurses' home extension, witness said that it had been felt that public opinion would be very much opposed to interfering with the children's hospital, and on that ground a proposal that in the erection of the new wing allowance should be made for the demolition of,, the children's hospital had been set aside. As time went on, however, it had become evident that there was a good deal of opposition to the children's hospital remaining as such. Even at present the nurses' home made the outlook of the children's hospital not very pleasant, and if the new wing was erected it would throw a shadow over the building for at least part of the year. The question, then, was whether the Commission, or at least the Hospital Board, should consider making a further alteration in the siting of the new nurses' home wing. It was desirable that the nurses' home should be connected directly with the main hospital to give protection to the nurses in wet weather. The children would go ultimately into some part of the proposed main hospital block.

Witness pointed out that a special Act would be needed to permit of the Macarthy Home at Belmont being used as a general convalescent home. The Victorian bush nursing hospitals that had been mentioned were suitable only for country districts where ordinary medical and nursing facilities were lacking. They were simply a convenient kind of private hospital and were not suitable for suburban requirements. It was misleading to suggest that a hospital with proper services in the Hutt Valley could be built at from £200 to £250 a bed. Anything

considered for the Hutt Valley would have to be on substantial lines. PROVISION FOR HUTT VALLEY. The Hospital Board had stated on numerous occasions that a hospital would be provided in the Hutt Valley and that the whole question was one of the opportune time, the best size, and where to put the institution, continued witness. Any suggestion that there had been antagonism to the proposal by the board was not warranted. Mr. O'Shea: I am not suggesting that. Replying to Dr. Wylie, witness said that no extra precaution against fire risk had been taken in the building proposals for the Newtown site except with regard to the width of the staircases and the required by the fire underwriters. They had been consulted by the architects on the subject. Dr. Wylie said the fire risk had always been an argument in favour of the pavilion type of hospital. Witness replied that in the present hospital there was a fire risk with the upstairs wards with wooden floors. ALLOWANCE FOR EXTRAS. Replying to the chairman, witness said that, in addition to the estimate of £750,000 for the full scheme, from £23,000 to £50,000 had been allowed for extras such as a mortuary and replacement of his residence. No allowance had been made for a temporary dining-room for the nurses. It would cost a little more to erect the new main block piecemeal and there was also a possibility of getting different' contractors. He did not think there would be much disturbance of patients. It was always possible that labour costs would come down and allow of better contracts being made. After examining the plan of the new main block Mr. O'Shea remarked that many experts held it to be wrong to have staircases near lift wells on the ground that the lift wells acted as funnels in the event of fire. Witness said that the arrangements of lifts and staircases had been made after i consultation between the fire authorities and the architects. He could not say whether the lay-out had been considered by the City Engineer's staff. Mr. O'Shea: I think the late Mr. Morton, when he was City Engineer, was never satisfied with the decisions of the fire underwriters, but always stipulated with public buildings that he should examine these things himself. It was arranged that, if necessary, the architect's estimate' of the cost of a wooden hospital for the Hutt Valley should be put in without the necessity for a formal sitting.

Further evidence is being heard this afternoon.

CENTRALISATION OF

HOSPITALS

The general committee or the Wellington branch of the New Zealand Defence League has instructed its secretary to write to the Wellington Hospital Commission stating that the committee is against the centralisation of hospital services in the heart of the city and favours decentralisation. The members of the committee at •this week's meeting urged that in the event of a national crisis it was desirable that the hospital facilities should be distributed so as to minimise the risk of complete dislocation from enemy aircraft, earthquakes, and seridus epidemics.