HOSPITAL BOARD.

Evening Star, Issue 15293, 19 September 1913, Page 10

HOSPITAL BOARD.

The fortnightly meeting of the Hospital and Charitable Aid Board was held last evening, and attended by Mr J. H. Walker (chairman), Mrs Ferguson, Mrs Jackson, Messrs C./N. Scurr, S. S. Myers, F. G. Gumming,- H. M. Driver, R. Templeton, and Dr Marshall Macdonald. V

Mrs Clara Christensen wrote resigning her membership of the Ladies’ Benevolent Advisory Committee.—Received with regret- :

The Hospital Saturday Association wrote asking the board to enlist the support and assistance of the various committees attached to the cottage hospitals in country districts for the association’s work.—The Chairman stated that the Port Chalmers Committee had already approved of the suggestion, and he, had no doubt that the .others would willingly do so. —Treatment of Consumption.— Accompanying the sanatorium report, the Secretary read a very lengthy minute prepared by the chairman, tracing the whole history of the circumstances leading up to the present proposal to extend the Pleasant Valley Sanatorium. This minute included the medical superintendent’s report of June, 1912, on insufficiency of accommodation at the sanatorium, his later outline of plans for the control of tuberculosis, the proposals of the Otago branch of the British Medical Association, which supported the sanatorium system, and records of various conferences. The minute was prepared as a reply to criticisms made by Dr W. M. Macdonald,

Air Templeton, in moving the adoption of the minute and the Sanatorium Committee’s report, said that it was a matter of regret that Dr Macdonald should have brought up his objection at the eleventh hour. He had had ample opportunity of doing so before. So far as he (the speaker) remembered, it was the first time be had ever suggested anything against the enlargement of the sanatorium. At the same time the doctor did not suggest any other remedy than the present one for the cure of consumption. He said that he believed they were on the eve of a great discovery. It was to be hoped that it Would come soon, but it might not come for the next 20 years. In that case, what was to be done with the patients in the meantime? Their sanatorium was full at the present time, and there was nothing else for it* but to enlarge the institution. Probably there was a diversity of opinion among members of the medical profession in respect to, the treatment of consumption, but they knew, as members of the board, that the majority of their medical men were in favor of sanatoria.

Mr Myers seconded. The members of the board were there to provide some means_ to eradicate the disease of consumption, and they were told by authorities at Homo that a farm colony was the correct thing. He also agreed that Dr Macdonald should have brought up his objection before now.

Dr Macdonald said that a reply had been made to his remarks at the last meetlnS, ' n a lengthy minute which nobody could digest on hearing it read for the first time. It was dated September 10, and he thought it should. have been circulated among members before that night’s meeting. It had only been put in his bands at the last minute. This proposal to spend £12,000 was contained in a report, the mover of which said there was nothing in it calling for explanation. The lengthy minute in which reply had been made to him bore the date September 10, and he thought it might well have been circulated in committee, and not put into his hand at the last' minute. However, he was quite prepared to reply to it at once. The minute seemed to distribute the responsibility for spending the £12,000 over a large number of people, but whether it was successful or not would be seen later.The. chief thing that emerged from the report was that they were prepared to adopt the Edinburgh system, but in one very important instance they proposed to depart fiom it. Dr Philip referred to his system not .as a sanatorium system, but as a dispensary system, for the dispensary, with the object of hunting out early cases, was the chief part of it. He maintained that there was no use educating people in the treatment of tuberculosis unless they saw that the education had some result. The only excuse for extending the sanatorium treatment would be either that it diminished the incidence of the disease, or that it was curing cases. But their report said that the incidence had gone up 100 per cent., and as for curing of cases, he said that had not been proved yea. The system was still on its trial. The secondary hospital had been advocated by every authority quoted in their report, but nothing had been done yet. There was not sufficient accommodation at-the sanatorium, because 65 per cent, of - the cases treated there were in advanced stages. He made a calculation, showing that fresh' cases occurred in the Dominion at the rate of a little over 500 annually, and, allowing four months’ treatment to each case, this would necessitate a total of only about 180 beds in the four centres taken together. He argued, therefore, that the present sanatorium accommodation would be quite sufficient even if they took in patients from Ashburton to Bluff. The asylum for chronic consumptives should not be at Palmerston, but near Dunedin. He held strongly that they ought to go ahead with the secondary hospital and release the sanatorium and the open-air wards at the Dunedin Hospital for the purposes for which they were originally intended. The Chairman explained that the minute clearly stated that so far as the members of the board were concerned they had acted entirely, on the advice: of the medical practitioners' of this district. They had not considered the question of erecting a sanatorium on their own. It was erected on the advice of the medical experts. It was simply on the advice of the 1 responsible officers of the Government that they were acting in the matter. They had asked them for a plan of the buildings, and they were placing it before them. The board had committed themselves to no expenditure. If the board were not prepared to do their duty in the matter of the segregation of consumptives the public would take a stand and demand that something be done. At present the board had en° tered .into an arrangement with other hoards to take the consumptives in their districts into their own institution. That institution was quite full. If they were not going to extend the shelters they would have to make prevision in some other way. No provision could be made’in the Hospital, nor at present- at the secondary hospital. If the Medical' Association said it was not waste to extend the'sanatorium, then the onus was of! the board, arid the board’would know wliat to do in the matter.. The motion to adopt the report and minute was carried. Sir Templeton subsequently gave notice of the following motion :—“ That in view of the opinion expressed by a medical member of the board, the Otago branch of the British Medical Association be asked if it has any further recommendations to make in connection with the extension of the Pleasant Valley Sanatorium.” The Chairman, in the course of his remarks, read the following extract from a letter by the Inspector-General, and dated December 18, 1911: Chronic Consumptives.—ln further reference to the decision of your board to extend the accommodation at the Plea- - sant Valley Sanatorium for the reception of patients with consumption in its various stages, I am of opinion that, contrary to what I have hitherto expressed, it will not be necessary for your board to acquire any more land for the purpose. In company with the chairman of the Sanatorium Committee and the board’s architect and secretary, I visited the sanatorium on 29th November. The ridge above the sanatorium lends itself very well for the gradual erection of a sanatorium on modern lines. It has an excellent aspect, and is admirably suited for the administrative and other build ings necessary. In the meantime, it has been well planted, so that ultimately the ridge in question will be sheltered from the southerly winds. The curable cases could, be accommodated on the western slopes of the ridge, and the chronic cases on the eastern, in the neighborhood of the present shelters ; in fact, that portion of the section now , uscd for the patients is admirably

adapted for the chronic cases, as it is well cut off from the view of that part of the section that should ultimately be used for patients ib less advanced stages of tho disease. I have asked the board’s architect to draw up a rough sketch to show tho gradual development of a sanatorium on the above lines, so that any buildings that have to ho erected could be in conformity therewith, and thus justify their being of a more permanent character than has hitherto been the case. In this plan the sites for the medical superintendent’s house, the nurses’ quarters, etc., will also be considered. In the meantime I would suggest that the existing shelters be utilised to their full. _No physician can say definitely what is a curable and what an incurahk case of consumption—this is the opinion _ of practitioners who have made a special study of the disease—and such being the case it would be as well to keep the shelters occupied, and to rely on a wise discrimination on the part of your medical superintendent as to the distribution of the patients. Towards .the first cost of these buildings you might again consider the advisabfiity of approaching other boards who now send their patients to Pleasant Valley.