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OUR HOSPITALS AND CHARITABLE INSTITUTIONS., Issue 7950, 4 July 1889
OUR HOSPITALS AND CHARITABLE INSTITUTIONS.
OUTDOOR RELIEF. (Fkom Oor Parliamentary Reporter.] WELLINGTON, July 3. Referring to the administration of outdoor relief, and in that connection to the vexed question of Town v. Country, Dr Macgregor (luspectorGencral) points out that the CHIEF DIFFICULTY TO BE GOT OVER in the working of all our charitable institutions is the impossibility of getting the taxpayers of the large towns, where the most lavish charity is dispensed, to take the least trouble to prevent, or even try to hinder, the wholesale pauperisation that is going on, and nothing (he sayß) but the taxgatherer at the door will make the towns organise themselves to stamp out the professional pauper. He gives his experience of England and the United States on this subject, and recommends THE ONTARIO SYSTEM as being the most suitable to the circumstances of this colony. Its principle is to get over the difficulty between the town and country by State payments of 20 cents a
day tor each bona fide hospital case treated; a payment of 7 cents a day for chronic cases unsuitable for hospital patients. To meet the case of small hospitals, where this rate of payment would not be sufficient, a supplementary allowance is made of not more than one-fourth of the revenue from all local sources. For benevolent homes, or refuges for indoor poor, the rate of payment by the State is 5 cents per head per day, with a supplementary aid of 2 cents per day. All other costß of caring for paupers, whether in refuges or hospitals, is borne by the local bodies. With respect to the TICKET SYSTEM OF SECURING SUBSCRIPTIONS, Dr Mangregor says that some definite understanding will have to be arrived at as to whether the hospitals which have adopted this system, which gives subscribers free maintenance and treatment, should be entitled to get a subsidy on the subscriptions, lie urges a stern resistance to this way of throwing as much as possible to the State, with a view of lightening the burdens that everywhere else are locally borne. The notion of disruption and division of our institutions, which had been inaugurated under the temptation of getting borrowing powers, had inadvertently been allowed to proceed so far that now it had culminated in a reduclio ad absurdum, and the multiplication of these institutions had brought us to A STATE OF ADMINISTRATIVE PARALYSIS. He condemns the practice of permitting voluntary subscribers to take part in the election of members of boards, aud suggests that the powers at present given to these subscribers should be withdrawn. PLAIN SPEAKING. Owing to the apathy of the public with regard to the selection, anybody almost was allowed to step in to a position which enabled him to pose as a friend of the
people; and there was grave reason to fear that these positions were in some places coveted merely as a means to ulterior ends. THE MULTIPLICITY OK LOCAL BODIES is jalso condemned as presenting the gravest difficulty in the reform of the government of our hospitals and charitable institutions, for until some consolidating Local Government Bill is passed by Parliament, l)r Macgrcgor thiuks it will bo extremely difficult, if not impossible, to dovise a scheme for their satisfactory government. Taking, for instance, the case of theDuacdin Hospital and the Benevolent Institution at Cavcislmm, Bhall we, ho asks, hand over the Dunedin Hospital, with its medical school, drawing patients from remoto districts as well as from the provinces of Otago and Southland, to the care of the Dunedin City Council? How, then, shall we deal with the questions that must emerge regarding the maintenance of patients from the dozen municipalities, as well as themselves, according to their property, with the certainty that theße governing bodies will refuse to be rated, unlesß they are represented ? And if they are represented will not their sole anxiety be to keep down the taxes ? Now, though just at present this is undoubtedly
THE MOST URGENTLY NEEDED REFORM, yet there is grave cause to apprehend that the taxpayers' representatives will not be the wisest and most discriminating helpers of the deserving poor, who alone will bo left to their care if the Government proposals for the elimination of inveterate paupers and habitual drunkards are successfully carried out. Again, not merely is it to be apprehended that the municipalities will combine against the city, but they will probably fly at each other. The councillors of Roslyn and Mornington, on the hill, being aristocratic and well-to-do districts, will refuse to be equally rated with South Dunedin and St. Kilda and the others on the Flat, whence a much larger proportion of paupers and hospital patients come ; and so on all over the colony. Christchurch and Auckland will stand on their rights against their independent offspring, and Wellington will still be at war with the Wairarapa. CUSTODY OF ORPHANS. With regard to orphans and other dependent children, it had been fully demonstrated that they could not be brought up in refuges and schools attached to them or educated in separate institutions.
THEY MUST BE BOARDED OUT in families, either by the local bodies or the State, though this system had some awkward complications. Concerning his visit of inspection to
THE DUNEDIN HOSPITAL,
Dr Macgregor writes :—"I inspected this hospital on the 30th January, 1889, and I was particularly careful in making inquiries of the patients in all the wards, without any official being present, as to how they were treated by the nurses. Though the fullest opportunity was afforded, I heard not a single complaint. As I have pointed out in former reports, the fact that this hospital was never designed for its present purpose, and the further fact that it is the only one connected with a medical school whose requirements are constantly growing, make it inevitable that the progressive tendencies thus set in operation must make large demands for improved accommodation and appliances, This is the explanation of the agitation that has taken place over the condition of this hospital, and the rapidity with which the agitation answered its purpose of hastening the building of a nurses' home and certain special wards. While it is a subject of congratulation to all, it seoms to me to have been dearly bought by the un-
I justifiably evil reputation which has been fixed on the hospital all over these colonies. Tho evils complained of had all been previously pointed out, so far as they wore real, and steps wore being taken to remedy them. Mr Houghton (the chairman) was already collecting money for this purpose, and tho very day before the storm burst he was in consultation with me on the subject. No one doubts the superiority of trained female nurses over the class of male nurses that have hitherto of necessity been employed in the Dunedin Hospital. Of late years it has become possible to get for this work well - educated ladies, who are very different from the old-fashioned type of hospital nurses; and no doubt it was somewhat trying that the hospital, which in all the essentials of medical and surgical treatment of disease was ahead of all the other hospitals of the colony, Bhould nevertheless be the only one of our large hospitals where the best system of nursing was unattainable. While the spirit of reform is abroad in Dunedin I would suggest that the bare appearance of all the wards would be vastly improved, and the comfort of the patients greatly increased, by replacing the present beds with Rowcliff's beds, which were adopted in the new Edinburgh Hospital, and have been introduced into Seacliff Asylum and the larger hospitals of the colony. A little more expenditure is also required to provide more liberally for bed linen. Every bed should have a pair of clean sheets each week, and I find that this was not the case up to the date of my visit. Except in those evils which the structural deficiencies of the building caused, I affirm that this hospital has been well managed and tho patients well treated."
OUR HOSPITALS AND CHARITABLE INSTITUTIONS., Issue 7950, 4 July 1889
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