HOSPITAL REQUIREMENTS

Evening Star, Issue 17324, 12 April 1920, Page 3

HOSPITAL REQUIREMENTS

♦ ' . I'• FOE, SOUTHERN OTAGO. \ THE DEPARTMENT OF HEALTH ! SPEAKS PLAINLY. \ Tho following is the text of the report I that has been forwarded to the Minister : of Health by Drs Frengley (Deputy In-spector-General of Hospitals) and Wylie 1 (Inspector of Hospitals), who were ap« \ pointed to inquire into the hospital needs i of South Otago : In accordance with instructions received : from the Acting Chief Health Officer, we i visited the South Otago district (Couii- : tie* of Bruce and Ciutha) on February i 24 in order to inquire into the hospital i and other medical requirements of the dis- : trict. We visited the* following places: t —Milton, Balclutha, Owaka, and l\ai- : tangata, and met at each place the medical men concerned and certain representatives ot local bodies. The visit wa« made with the chairman of the Otago Hospital Board, the chairman of the Finance Committee, the medical ' superintendent, and the secretary of the Otago Hospital Board. The counties visited contained (according to the 1916 Census figures), the following populations: Bruce County 4,763 Milton Borough 1',317 Kaitangata Borough ' l'6Sl Ciutha County 6,901 Balclutha Borough 1,409 Clinton town district 413 There are four medical men in the district. No hospitals administered by a board exist in this district, save tlia 'cottage hospital at Kaitangata, which is administered by the Otago Hospital Board, fhc districts concerned are devoted mainly to agriculture and general farming, and the population is tolerably evenly distributed throughout this area. The main railway line from Dimediu to luvorcargill runs through the district, and the main towns in the district are on the railway line and distant' from each other as folio we : Milton is 35 miles from Dunedin. Balclutha is 18 miles from Milton. Clinton is 20 miles from Balclutha. In considering the hospital and other medical needs of the counties .concerned, it is obvious that the medical men practising in the district \vhi> are and have been in daily touch with the medical reof the district are the people best qualified to give evidence, and it is therefore their evidence which we shall chiefly use. The evidence forthcoming from other sources was the outcome of a very evident friction between the counties concerned and the Otago Hospital Board, and as we are concerned more with facts than expressions of opinion, we desire to leave this evidence alone. The essential points of medical evidence obtained ware as follow : (1) From Dr Sutherland, of Milton : (a! Few cases in his district arose requiring treatment for acu.e surgical conditions. Ib) Not enough qualified maternity nurses were available. (c) Could not mention any cases of lives having been lost through being moved to Dunedin ; but considered that many had been jeopardised. Had not had cases refused" admission. (2) From Dr Stenhouse, of Balclutha), who has been 17 years in the district: (a) Considered that a local hospital was necessary, and considered its sizo should be from 20-30 beds. _ (b) Stated that there were an insuffi- ■ cient number of registered maternitv nurses in the" district, and further said that the growing difficulty of obtain ing domestic help was a very serious handicap to expectant mothers." Said that the maternity private hospital at present in existence will shortly cease to be sufficient fur the requirements of the district. (d) Was not aware of any case having died as the result of the journev to the Dunedin Hospital. (e) Had never had cases refused by ■the Dunedin Hospital authorities. (f) Had never had difficulty in procuring an ambulance from Dunedin. (3) From Dr Brown, of Balclutha: (a) Had only been in practice at Balclutha for a few months. (d) Agreed with Dr Stenhouse regard- ' ing necessity for a hospital. _(c) Knew of one case (an acute appendicitis) which he considered died as the result of being transported to Dunedin. (4) Dr Stenhouse, of Owaka: (a) Had been 10 years at'Owaka. (b) Had one private maternity hospital at Owaka, with accommodation for four cases. (c) There were not enough qualified maternity nurses in the district. (d) This district was a diffi.ult one, as the roads in winter were very bad. thus making communication difficult and slow. Manv sawmills existed in the district, and they provided a good number of accidents to attend to. These accident cases often took a long time to reach Owaka, owing to the bad roads, and it was then often necessary to send them to Dunedin. (e) Did not know of any case which had died 0,3 the result of* being transported to Dunedin. (f) Had never had cases refused admission to the Dunedin Hospital. (g- Consider that the needs of his district would be met by the provision of a small hospital providing accommodation for four maternity cases, two isolation cases., and a small number of beds for urgent medical and surgical cases. (hj) Stressed the difficulty women had at the times of their confinements in securing -needed domestic help. ii) Knew of no evidence pointing to either neglect by or maladministration by the Dunedin Hospital Board regarding .his district. (5) Dr Cairns, of Kaitangata, considered that a maternity wing to the hospital would be of great advantage. Apart from the evidence of medical men, one piece of important evidence was given by the Mayor (Mr Simson) at Balclutha, who pointed out that the existence of the freezing works in the neighborhood, employing 150 men, meant the occurrence of accidents, and mentioned several cases which suffered through transport to Dunedin. In addition the following figuros relating to admissions to the Dunedin Hospital from the Bruce and Ciutha Counties have been supplied by the medical super- I intendent of the Dunedin Hospital. Thay i cover a -period of 12 months, and are as follow : BRUCE COUNTY. Acute surgical ca«ea . 24 Acute medical cases 15 Chronic surgical cases 53 Chronio medical cases ... ... 15 CLUTHA COUNTY. Acute surgical cases „. ~, 30 Acute meclical cases 8 Chronic surgical cases 46 Chronic medical cases 16 Having travelled through the district by car, and having heard tho opinions of the various medical men in the district, we are of opinion that the medical requirements of the South Otago district should be met in the following way -. (1) By the establishment of a small hospital at Balclutha—say of 24 beds which would give 10 beds for men, 10 for women, and four beds for infectious diseases. In adcijtion a maternity block of six beds should be established. (2)_ By the establishment of a cottage hospital at Owaka to provide for — (a-) Four maternity bads, (b) Six ordinary beds—four for men and two for women—and (c) Two infectious beds in a separate- block. (3) The existing ward at the Kaitangata Hospital should be subdivided into two, and made available thus both for men and women. In addition a maternity block should be erected to provide accommodation for four to six cases. (4)_lt is not recommended that special hospital provision be made at either Milton or Oltton, as the institutions at Dunedin and Balclutha will serve for _ both these .wgall towns,

The problem presented by the South Otago district is an interesting one, especially m view of what we regard as the only sound policy to pursue so far as hospital accommodation is concerned, and that 13 the estaolishment and development of certain large hospitals in the Dominion as base hospitals, to which all the small hospitals in their district should be attached. In these days of specialisation and "team work.", which all are agreed are essential to the attainment of the highest degree of professional efficiency, ana therefore to the provision of the most skilled and efficient service for the people of the districts concerned, it J* mamiestly impossible for a country like New Zealand to have more than a fewi srueh hospitals; and therefore the tendency for hospital districts to split up and oecor«e smaller must be vigorouslv combated in the interests of economy, efficient administration, and efficient professional service. The district concerned us too small to have its own base hospital for many years to come, and must rely on the Dunedin Hospital for the following and specialised services: (1) X-ray, both radioscopic and radio-therape-Jtic. Even ordinary X-rav work cannot bo efficiently done exceot by a , man who is devoting his whole"time to [ it, and who therefore becomes not only an expert operator, but an export interpreter. The growing importance of an X-ray department as an aid to the diagnosis of chronic respiratory and digestive disorders and from a therapeutic standpoint—e.g., in the treatment of malignant disease both before and after operation—render it essential that the services of a first-rate X-ray department shall be available for all cases requiring the carrying out of. major operative procedures of an elective character. _ (2) Clinical Laboratorv.—The provision of a clinical laboratorv ie. not onlv ■necessary for the carrying" out of ordinary bacteriological and pathological work, but is becoming more and more necessary for the elucidation and early diagnosis of many chronic diseases which in the past have drifted into a definitely incurable condition before receiving consideration. (3) Physio-therapeutic Department.— The varieties of treatment grouped together under the name " physio-therapy " comprise the following: —Message, electro-therapy, hydro-therapv, re-educa-tion of muscles, gymnastic" treatment, radiant heat in all forms. Their usefulness in the treatment of all kinds of surgical and medical disabilities has been conclusively demonstrated during the war from which we have emerged, and they are more important to-day than ever, espoeiallv in the treatment of injuries. The proper use of a physiotherapeutic department should ha' the means of lessening the degree and the duration of the disabilities which too often to-day follow upon the infliction of not only severe injuries, hut often minor ones. (4) The services of skilled physicians and surgeons who are devoting their whole energies to their respective specialties. The importance of being able to secure the services of such men is not ralised enough by many sections of the public. The special developments of medical and surgical work cannot be established in South Otago for many years to come, and until such a time arrives there is no doubt in our minds that the hospitals which it is recommended should be established in Otago ought to remain under the general administration of the Otago Hospital Board.