HOSPITALS COMMISSION

Evening Star, Issue 17647, 28 April 1921, Page 7

HOSPITALS COMMISSION

Third Day.—Thursday. The Hospitals Commission resumed its sitting this morning, Mr Yemen H. Reed, M.P., presiding. DE FERGUSON’S EVIDENCE. Dr Lindo Ferguson, dean of the medical faculty, said the views lie would put before the Commission were the views of the entire teaching staff. With reference to jtho general question of the extant and manner of Government contributions to the various hospital boards for capital expenditure and maintenance, it appeared to him that it would be impossible to treat them all on an equal footing unless tho hospital districts and rating areas were so arranged that tho revenue of the local bodies was fairly proportioned in each ease to the hospital requirements of tho district. The department should define tho standard of accommodation for each area, and insist on the main hospitals being used as base hospitals for the group of districts they drained.

The maintenance of the special departments and equipment of base hospitals must be on a more clahorte scale than that of the smaller hospitals, and, as they served the country districts, it was obviously just that the various local hospitals for which they’ acted as base hospitals should contribute a fair share of tho extra expense that tho special departments and extra equipment and stall involved.

The Dunedin Hospital had an extra claim for special treatment inasmuch as it was the training school for the medical profession, and provided in this way the house surgeons for other hospitals. It was dearly unfair that tho extra expense attaching to this form of national service should fall on the ratepayers _of one hospital district. The separation of the South Otago district had reduced tho revenue of the Otago Hospital Board by some £20,000, and unless this was made up in some way, either by contributions from all tho 'hospitals for which Dunedin was tho base, or (by a direct grant from tho Government for the national work done, there was every prospect of tho board declining to maintain the surplus beds that were always occupied by patients from other districts, who were attracted hero by the reputation of tho school. This would inevitably impair the efficiency of the school, whicti tho Government was pledged to maintain. In reply to questions. Dr Ferguson said that because of tho expense involved two wards were shut down which were required for tho treatment of patients. It was as a matter of economy, in the interests of the ratepayers, that these wards were closed. Personally, he would prefer a direct grant from the Government than any other system. Several ways had been suggested by which payment could bo obtained for the special services hero. It had been suggested that patients sent to a base hospital should pay a higher rate. The South Otago Board had suggested that it would bo prepared to pay a higher rats of maintenance for patients sent to Dunedin Hospital. Whatever happened he thought tho patients ought not to be charged a higher rate than the rate in his own hospital. Tho Dunedin Hospital should be regarded from an entirely different footing from any other base hos pita-1 in tho Dominion. In reply to further questions Dr Ferguson said the Government made a direct grant to tho Medical School, but it was not by any means sufficient. Roughly speaking, there was a deficit of three or four thousand pounds a year, which had to bo borne by the University Council, who complained because this crippled their arts side.

Dr Ferguson further stated that the fact of a medical school being attached to an hospital meant a much closer study of a case. It involved a case being gone into again and again by the teacher, who had to safeguard against any possible mistake. No diagnosis was as sure as that made for teaching purposes. There had, as long as bo had been associated with hospitals, always been considerable abuse of the system bv patients ■who should have been treated outside. At a time when there were no private hospitals there was more excuse for this than was the case at present, and it was a grave question as to whether the Government, through the Hospital Board, should enter info competition with the nursing homes that wore being successfully carried out at present, and were filling a very useful place in the life of the community. If people who were in a position to pay for medical services demanded adinitance to public hospitals it should be clearly understood that they had no claim on the services of the honorary staff, and some scheme of private wards in the public hospitals, to which patients who were not in a position to pay full fees for attendance outside could bo admitted, paying modified fees for treatment to the physician or surgeon in charge, would have much to recommend it. Any step of this .sort in connection with the Dunedin Hospital would involve a building scheme, and he was disposed to think that the site of the hospital would' in time bo all occupied for public hospital purposes, and that the paying ward block would have to bo erected on another site in the neighborhood of the present hospital. Tire special conditions of the Dunedin Hospital in being a notional school made it highly desirable that whatever was done in the other centres, the Government should have direct representation on the board, and as the board and University Council were partners in the school, the council should also have representation, on the board. The board had at present a representative on the council, hut neither the council nor the teaching staff had any representative on the board. At this stage the commission adjourned in order to visit the Karita.no Hospital, the sitting being resumed at 2.15.