HOSPITAL MATTERS.

Hawera Star, Volume XLVIII, 17 June 1924, Page 8

HOSPITAL MATTERS.

—? HONORARY MEDICAL STAFF. APPOINTED BY BOARD. For some Lime past tlie question oi' following the practice prevailing in other centres and having on the staffs honorary surgeons, the members of the profession privately practising in the town, has occupied the attention of the Hawera Hospital Board, and the matter has been discussed with all the doctors on more than one occasion. Yesterday, at the end of the ordinary meeting a. deputation consisting of the private practitioners of Hawera conferred with the members and discussed the question with them at length and to such effect that the Board unanimously decided on tlie adotdion of the scheme.

Dr. Buist, speaking first, said that they were present in support of the resolution passed by the medical men of Hawera. that the time wa.m ripe for the institution of a^ visiting medical staff. Firstly, he saTd, their argument was that the hospital had increased so considerably that, in order to keep pace with the times they should be afforded an opportunity of participating in the work, and in view of the needs of the district necessitating a new enlarged and upffo-date hospital, they considered that in order to cope with the work it would be opportune to secured their suggested division of tlie work. He saicl that undoubtedly the scheme l would be beneficial to them because they would have further opportunities of practice by which alone could efficiency be maintained. He said that much practice could naturally be obtained in their private practice, but as a good many patients were obliged to leave them to enter the hospital, he believed it was right that they should not be debarred from continuing to attend patients who probably wished this course, and had perhaps a sentimental- interest in them.

Continuing, Dr. Buist said it had been said there was a lack of co-opera-tion between the medical men of the district and the Hospital Board. It must, however, be remembered that the Board have rarely approached them but that on all occasion when asked the district practitioners have co-op-erated whole-heartedly, and an opportunity now occurred to bridge anv gulf there might- be. He said that they were struck with the enthusiasm displayed in Auckland, both by the V)cal medical men and those from other parts to organise and develop the hospital system and professional work generally. As a result, the Hospital Board, medical staff, Clinical Society and medical men generally have co-operated in a clinical, teaching school which wfll be second to none. Refresher courses have been proved very popular. What has been done in Auckland may in a lesser degree be founded in Hawera by similar co-operation. He said they felt that benefits could accrue to the hospital, which would be reflected on tlie people generally by outside medical men taking part in the work of the hospital and attending patients who wished to have them, and even if the number were increased, a district hospital was always able to cope with the work offering. He added that the institution of a visiting staff would conduce to more efficiency, and would be a result desired by the Minister of Public Health, and by the people generally. It would give the medical men the desired recognition, and would thus be a consummation in the bets interests of all. Dr. McGhie endorsed Dr. Buisfs remarks, and said tha> all over the Dominion there was more interest being taken in the medical profession because of the question now before the public, proposals to that effect having gone forth from every branch of the British Medical Association.

Dr. Young supported the scheme strongly, and believed much good would accrue. The chairman said that the idea, was for all the doctors to be on the honorary staff and to take charge a week in rotation. Dr. Thomson said his views were known on the subject, and he was the first to say he cordially egreed it would be best for hospital and for district, to have co-operation of doctors and hospital. He had no fear that it could be made to work well, but he was doubtful if accommodation could be found for the increased number of patients certain to follow its inception. They were at present working at the absolute maximum, and the nursing staff was hopelessly overtaxed. He had suggested waiting until the new hospital was completed, say in two years, for accommodation even for the present staff taxed the building to its utmost. This was his only objection to the scheme. In reply to Mr Campbell, he said he feared it could not be put on trial only. • . Air Tayler suggested that the Board room could be used, and the chairman and secretary both agreed that at times it could be available. Dr. Buist said in reply to Dr. Thomson that as far as they personally we*r:> concerned, there need be no fear, because they came down to work, not to burden the hospital unduly. Dr. Sinclair said he personally welcomed the scheme, for from the visiting practitioners he could learn a lot, and he thought the nursing staff would be favourable also.

Dr. Young doubted whether the increase in patients, would take place which was suggested, and if it should so happen a waiting list could be arranged and parents come in rotation, except where they were very urgent. He and the other doctors were willing to put up with some inconvenience, although there would be more thrown on the house surgeon. ' The whole question revolved around an increase of cases, and the waiting list would solve the question. Dr. McGhie said that at a former meeting of doctors all were agreeable to go on the honorary staff. Dr. Sinclair said be was prepared to give it a trial. Dr. Buist said the hospital was never too full not to take urgent cases, and operation cases would take precedence.

Dr. McGhie took leave to doubt the prospective increase in cases. The doctors would still have the private hospitals. and there would not be so great an increase make overcrowding. The proportion of acute cases to chronic was very small, and he added that the waiting list was practically in existence now. They had simply to carry out present regulations. Mr Tayler said that during two years no patient had ever been held up in Eitham.

Dr. Yovvn" said there was no risk about a waiting list, and it would be necessary to see if cases were urgent or could wait. It was an unwritten law to- always take in urgent cases. Tlie scheme was not ideal, but similar schemes were in operation in large centres, here and abroad. The waiting list was found nearly always satisfactory.

In reply to Mr Wills, Dr. McGhve said that there would always he private institutions until the community hospital was an established fact. To the secretary, Dr. McGhio said that the honorary staff would be responsible for their own cases, but the surgeon in charge would decide on the treatment, though in all cases they

will endeavour to co-operate. He added that a decision to operate was no arbitrary decision, Put a question ol agreed opinion. The honorary staff would be more closely associated with the medical superintendent and the house surgeon. If a country case came in the surgeon in charge for the week would decide. In Auckland the medical superintendent was responsible only for the organisation of the institution. The chairman said that he assumed if a patient came in any doubt would be solved in consultation by the resident surgeon, and no case/ would be turned down on one man’s opinion. Dr. Thomson agreed, and said his position would be, as it were, a buffer, lie tween the staff and the nurses, and he* would still be in general charge. This was the position in all hospitals where there was a general staff. It, Was agreed that country doctors were too far away -to take part in the scheme. Dr. Young said an honorary surgeon could not refuse a case unless the medical superintendent had been consulted If there was overcrowding, he would require to- know the reason.

The chairman said if the Board found it was not satisfactory they would be justified in terminating the scheme, but this he did not anticipate. In reply to a suggestion by Mr *Fayler that six months’ trial be given, Dr. McGhie said that it would lie better to initiate the scheme and if unsatisfactory terminate it at once. The chairman said that the private medical men had done a lot for the hospital in the way of lectures to nurses and acting for the medical superintendent when away, and in urgent cases. The Board had reason to be thankful to them, and he wished, on behalf of the Board, to express appreciation for this assistance.

After the medical men retired, the Board briefly considered the position. The' chairman said he saw no reason why the scheme should not succeed and all difficulties got over without much trouble. He moved that the Board agree to the appointment of an honorary medical staff consisting of the three private medical practitioners in Hawera. Mr McKay said that if it was not satisfactory the doctors would terminate it themselves. This was seconded by Mr Wills and carried unanimously. The Board then adjourned.