MELBOURNE PLAN

Evening Star, Issue 21628, 25 January 1934, Page 13

MELBOURNE PLAN

COMMUNITY HOSPITAL WORKING WELL i Public 'hospital authorities in Melbourne discussed with informative interest the subject of community hospitals, says the Melbourne ‘Age.’ As compared with the St. David’s wing of the Koval Northern Hospital, London, with its sixty-fiyo beds in intermediate wards, the Jessie M’Pherson section of ■ the Queen Victoria Hospital for Women in. Melbourne has fifty beds for intermediate and private patients; Hamilton Russell House, at the Alfred Hospital, has thirty-nine beds (twentyeight intermediates and eleven private), and St. Vincent’s new hospital will accommodate forty-three purely intermediate patients on the second door. The community hospital idea has been brought into operation in provincial cities. Ballarat, Bendigo, and Geelong have their intermediate wards, and Kildura, that progressive Murray . centre, is going in for this modern .‘development in an even larger way. . A brief tour over Hamilton Russell House disclosed, on the first floor, of the Punt Road wing of the Alfred Hospital, a modern division of that hospital which compares, in its light, ventilation, comfort, and medical facilities, very favourably with the St. David’s Wing of the London Hospital. Signalling lamps, balconies, and a central observatory for the day and night ward sisters have been constructed in modern style. Jt differs from St. David’s Wing, apparently, however, in its system or fees. ■ In London the Hospital fee of £6 6s a week includes maintenance, nursing, prescriptions, dressing, and such services. In Melbourne the maximum scale of maintenance fees laid down by the Charities Board—i.e., £3 3s to £4 14s 6d (from £3 13s 6d in surgical cases) —does not include prescriptions, the patient making his own arrangements with medical men and chemists. The radiologists’ and pathologists’ fees in London are much the same as here. The B.M.A. in Victoria, in conjunction with the Charities Board, determines the intermediate' rate of medical and surgical fees, while the hospital authority fixes special charges, which are much more reasonable than for private cases, in respect of the use of its equipment operating theatre charges, etc. MELBOURNE HOSPITAL. .'The Secretary of the Melbourne Hospital (Mr R, E. Fanning) said the Melbourne Hospital originated in the treatment of the indigent sick, and quite 50 per cent, of its patients paid nothing at all. For some months now, however, a system had been in operation under which the medical superintendent conducted a preliminary examination of every patient, in conjunction with the assessment of the patient’s means by a layman, and this system was working out satisfactorily and without any nervous embarrassment to the sick and afflicted. Therehad been very little imposition throughout this period. During December, however, a man had not only given a wrong name but also false information to gain admission. He was admitted and treated, but when it was discovered that he had a considerable bank balance and quite a lot of money, legal action was taken, and the full cost of his treatment recovered, in addition to a penalty of up to £2O. Mr Fanning strongly advocated some sort of system other than general hospital treatment in the form of clispen- . saries, where minor ailments could he ■ treater 1 expeditiously. The amplified i scheme of “ panels ” under the Na- ; tiqnal Insurance scheme of Great Bri- | tain, where cases of minor disease and <

casualties were only accepted in certain of the hospitals on the recommendation of their panel, was working very efficiently. In Victoria the “ intermediate” patient was not sufficiently catered'for'.'(if that expression could be used in the sense of illness and accident). Intermediate hospitals, mostly run under the auspices of the Victorian churches, were far too few, but extension was gradually taking place, notably in connection with the Presbyterian Hospital and the Homoeopathic Hospital. Unfortunately there was no hope of providing “ community beds ” at the Melbourne Hospital. This institution had not sufficient accommodation for those who could not afford to pay anything, or more than a nominal fee, for maintenance. The medical services, of course, were entirely honorary, but fees were collected on the basis of the previous year’s average “ bed cost,” which last year was computed at £3 Is per week. • THE ALFRED HOSPITAL. The secretary of the Alfred Hospital (Mr J. H. P. Eller) informed the ‘ Age ’ that the intermediate and private wing, Hamilton Russell House, which was opened for patients in May last, was working very well. With accommodation for 39 patients, the wing has been practically full the whole time, the average being 37} beds during the last four or five months. There had been a continuous waiting list. By reason of fixed accommodation for the sexes and by reason also of the nature of the eases seeking admission, the waiting list was inevitable in any wellequipped institution. The community hospital was a separate unit within the. general* hospital. Its nurses, all fully trained, wore different uniforms, and a separate committee governed the community unit’s activities. The accounts were kept under a strict costing system, and the profits were disbursed in accordance with a special regulation under the Hospitals and Charities Act. As funds became available extension of the intermediate hospital would-undoubtedly be made. Its intermediate section will be the first section equipped and opened in the new St. Vincent’s Hospital building, in Victoria parade. The secretary (Mr W. D. Loughlin) said the mother rcctress and the committee responsible were anxious to extend the intermediate provisions in the new building, which, in contrast with the old hospital of 141 beds, would accommodate 300 patients. In addition to the 43 community beds which would be available soon, it was intended, under the original scheme, to provide further such accommodation on land available between Victoria' street and Princess street, but the funds in hand did not allow of the plan being completed. Approximately 25 per cent, of the patients at St. Vincent’s were treated without any charge. No provision was made in the Charities Board ■regulations for the expenditure of profits from the intermediate section on any extension of the accommodation contemplated. In the case of St. Vincent’s Hospital the board had directed that the profits should be applied as follows:—(1) To moot the interest clue on money borrowed for intermediate purposes; (2) to repay moneys borrowed for intermediate purposes; and 1 (3) the balance to be transferred to tho maintenance account of the public hospital. i