NAPIER HOSPITAL BOARD.

Hawke's Bay Herald, Volume XXIX, Issue 9682, 17 May 1894, Page 4

NAPIER HOSPITAL BOARD.

The ordinary monthly meeting of the Napier Hospital Board was held yesterday ia the old Provincial Council Chamber. Present— Mr H. P. Cohen (in the chair), Hon. J. D. Ormond, M.L.C., Messrs S. Carnell, M.H.8., H. William*, G. Faulknor, Douglas M'Lefsn, J. N. Williams, G. H. Swan, H. C. JKobjohna, and G. Kymer. MEDICAL ASSOCIATION. A letter from the members of the Medical Association who recently waited on the Board with regard to the advantages of an honorary medical staff for the hospital was read by the secretary. It set oat that in supplying details at the request of the Board, of a proposed scheme fot a visiting medical staff, they did so on the understanding that all the details pat forward were capable of modification. If the Board adopted the principle of a medical staff It wonld be well to arrange for a conference between the Board and members of the Medical Association, to disenss details What the writers suggested was as follows : — First, that there should be a resident medical officer in charge of the hospital ; secondly, that there sbonld be an honorary visiting staff, ionr in nnmber, chosen by the trustees from the medical men resident in Napier, and to hold office for two years. Other details as to reception of patients, disposal of beds, consnltatiODS, &c, were given, their general tenor being in conformity with the details published in the Herald at the time the deputation waited npon the Board. The Chairman considered that no discussion wonld take place oa the letter at that stage. I Mr Swan : No. Ittr Ormond : What is going to be done with it, then ? The Chairman explained that it wonld be better dealt with at a later stage. The letter was received. REDUCTION OP FEES. Mr Herlihy, of Woodvllle, wrote asking that the fees charged for his bou, who had been in the hospital tor some months, might be reduced. After consideration, it was decided to rednce the charge to £3 per month. . A COMPLAINT. The visiting committee reported that several repairs and alteration specified were needed. The report then went on to deal with a complaint that bad been laid before them, and concerning which they held a special meeting of inquiry ab the hospital. It appeared that a lad named Roderick Mutheson waa adenitted to the hospital suffering trom typhoid fever on the Cth of April, and on the ZOtb of April he died. His mother and other relatives who came in from the conntry to see him were not allowed to do bo, in spite of repeated requests, nntil a few hoars before his death, when he was unconscious. His mother and hia annta came to the hospital from Tongoio, and An each occasion were refnsed admission to the hospital, and it was not nntil pressure was brought to bear by gentlemen in town that the lad's mother was allowed to see him. The visiting committee met at the hospital on the 24th of April to investigate this complaint. Dr. Menziea then expressed regret at the fact that he bad not been informed of the desire of the lad's mother to see her son, as he would have allowed her to do so. Dr. Sweet stated that the lad fretted very muck because he was nob allowed to ace bis mother, and that if be had been allowed to see her it wonld have tended to do him eood rather than harm. Nurse Lees admitted that when application was made to her to allow the lad to be seen by bis relatives she refused to permit the vtiit. She considered that in so doing she was acting in the interests of the lad and of all the other patients in the fever ward. It was the porter who refused to admit the lad's mother when she applied at the hotpital. The committee considered that Norse Lees bad acted with nnnetessary harshness, and had exceeded her duty in not eonsnltiog the surgeonsuperintendent before admission to the lad's mother was refused. They alto recommended that the porter be instructed to the effect that in future no person desiring to see a patient should he refused admission to the hospital nntil after the resident surgeon had been confinlted. At the reqneat of Mr M'Lean the secretary read the rule relating to the admission of visitors. This rnle provided for visitors attending at specified hours on certain days of the week, but went on to state that visitors c&uld be admitted at other times npon application to the resident surgeon. Mr Ormond said he had taken considerable interest in this case. The relations ef the boy came in from the country several times to see him, bat were not allowed to do so. They complained to Mr P. S. M'Leaa about the matter, and be came to the speaker on the snbject, the result being the inquiry by the visiting committee. He (Mr Ormond) thought when he heard of the circumstances that It was a very cruel thing that the poor child should have died without being allowed to see his mother and bis friends, and the report of the visiting committee was now before the Board. He bad learned, however, that it was a fixed rnle of the hospital not- to allow visitors to tba fever ward, and the doctors said that it would be dangerous to admit visitors, dangerous both to the patient visited and to obbera in the ward. That left) a very great responsibility upon the person in charge. The whole question seemed to him to resolve itself into one of authority, and that for any other person except the one in fall charge of the hospital to assume the right to refuse admission was wrong. In fatnre no visitor to a patient dangerously ill sbonld be refused admission until after application bad been made to the resident surgeon. It was only fair to state that the head nurse had by circamstances had forced npon her the doing of things which she should not do at all, and this resulted from the lack of management at the hospital daily becoming more apparent. In this case Nnrse Lees was carrying ont an order ot the hospital that never should have devolved upon her. Mr H. Williams agreed with ali Mr Ormond had said except with relation to Nurse Lees. Supposing the circumstances bad led to her assuming duties not within her sphere, that was no reason why she sbonld not consult the doctor when, as ia a case like this, it was her duty to do bo. The doctor did not take so much notice of things as he might do, bat that did not lelieve the head nuree from the duty of consulting him. Seeing that In this case there were so many applications to see the lad before he died, she wag decidedly blameable in taking upon herselt to refuse admission instead of asking the doctor. Mr Faulknor said it appeared to him as if |the hospital bad for a long time cot been under the cho'»s of the doctor, but of the bead nurse. The thing was wrong. The visiting committee's report was adopted. INCREASED ACCOMMODATION. Plans by Mr li. Lnmb for a building to provide accommodation for the nurses were laid npon the table and considered. They showed an elevation in keeping with the main building, and providing all the accommodation needed, On the motion of Mr Ormond, seconded by Mr J. N. Willlms, the chairman and the visiting committee were nppolnted to confer with Mr Limb as to detail* of the plan, and to call for tenders far the erection of the building, returnable at tho next meeting of the Board. VOTES OF THANKS. The Chairman stated that he had received from the City Band £16 Oa 2d, the net result of the sacred concert they gave In the Botanical Girdeos, and £7 7a 7d, the proceeds of the collection when the City Bind gave a sacred concert at Hastings. A cordial vote of thanks to the bind for their valuable assistance was passed A vote of thanks was also pissed to Mr T. Whitelaw for the gift of a parcel of tasty calendars for the use of the staff. AN INSURANCE QUESTION. Messrs E. and W. Lyndon, as agents for the Manchester Fire Insurance Company, wrote asking that the Board, instead of giving the whole of their insurance to one office, shonld divide it among the offices (doing business In the town. Ab the hospital was a public instiptloa the reqneO wai » jaet one,

The Chairman, in reply to n question, said that at present the buildings were insured for £10.000 in the Norwich Union. Mr Swan did nut see any reason for altering the arrangement unless tli3 hospital wcie tfoiug to benefit by it pecuniarily. The fuct that the risk wim held in ooe ollice simplified matters for the Board, and the olliee thnt hid the risk divided it amone the other oilices. Mr Cornell thought that the Board should patronise .-. i:i>lonial office. Mr Willirtnw cfin'idered that to dividu the iHSuriituv noiild bo more equitable than tlm i>:i m lit iiitangemt-nt, and moved thut tin 1 . ft-!;il f-nin nf £ 10,000 be divided into live n*k-; us £2000 eich and given to five separate olliooa. The motion was seconded by Mr Camel). Mr Swan explained that at the death of tho late Mr Mahon, when the hospital books were found in a bad stati>, Mr Banner, the agent tor the Norwich Uuion, spent a long time in auditing nnd otherwise putting righti the books. For that he was paid £25, which ho gave back to the hospital as a douation, on the stipulation that be should have the preference at current rates for the insurance. Under the circumstances ho did not think iD right to break through that arrangement unless it could be shown that to do so would result in profit) to the hospital. Of course, if the proposed alteration would save money be wonld not oppose it" Mr H. Williams thought it would have been better tn have paid Mr Banner and to have kept the Board nnbonnd. Mr M'Lean referred to the improved fire extinction service at the hospital and suggested that in consequecca of that, carried out eince the arrangement referred to was made, the companies might give better terras. The Chairmin did not think they would get any reduction of premium. There was a tariff scale that all the offices charged. Mr Swan moved as an amendment] that the insurance remain as at present. The amendment was not seconded, and the motion upon being pat was carried on the voices. A SALARY QUESTION. Nurse Childs, odd of the recent additions to the permanent nursing staff, wrote asking for an increase to her salnry of £35 a year. She urged that the duties were very onerous, particularly with regard to night work, and ehe thought that the request was a just one. The Chairman said that he had told tbe applicant she was not likely to get any increase, bat that if she did not care to take that as an answer she could write to the Board. The result was the letter that had been read. Nurses on night: duty got £1 a month extra, which had apparently been overlooked by the writer. It was decided that the Board could make no increase. HONORARY MEDICAL STAFF. The Chairman stated that at the meeting of the Board in committee last month it was decided to send a circular to the various hospitals in tbe colony asking for information as to how they were worked by honorary staff* or by resident surgeons, &c. Circulars were Bent ont to 16 hospitals, and answers had been received from eight. Mr Swan thought that the question raised should be dealt with at a special meeting, called to deal with that and to further consider the article recently published by the Herald on the question of the treatment of alleged diphtheria cases In the general ward of tbe hospital. Mr H. Williams took a similar view. Mr M'Lean pointed out that these continued adjournments were not fair to the conntry members. Why could not tbe letters and the whole subject be discussed there and then ? Mr Ormond was of opinion that the letters should be read at) once. The secretary read the letters. The Christchnrch authorities wrote that the hospital there was worked by a visiting staff. There were two visiting surgeons, two physicians, and an ophthalmic surgeon. Details of the mode of arranging duties were given, and it was stated that in all cases of major operations there were consnltations by the full staff. The Wellington authorities wrote that the hospital there was conducted by an honorary staff, and that the system worked very well. The members of the staff were elected by the Board at Intervals of two years. The secretary of tbe Waikato hospital wrote to the effect that an the district was a scattered ope they did not have an honorary visiting staff. Auckland wrote to the effect that the secretary was away on leave, A book of bye'laws was forwarded, however (four, other hospitals sent their bye-laws), and from this it appeared that the Auckland hospital was also conducted by an honorary visiting staff elected by the Board. The Thames hospital authorities wrote stating that the hospital used to be at one time conducted by an honorary staff, but that for the past seven or eight years the trustees found that with a capable resident surgeon there was no necessity for a visiting staff. When the necessity arose the outside practitioners were called in to consult. Possibly the system only worked well there becanse tbe district was a small one, and that In a larger place with more patients it would be to the manifest advantage of the latter that there should be a larger staff. The trustees allowed oattide medical men to visit the hospital when they pleased, believing that such a course was in the Interests ot tbe pnblie. The Hokltika hospital authorities stated that they had a resident surgeon, bat that the other two medical men praciising ontside the hospital were cilled in to consul!). The letter from the Oamarn Hospital Board set ont that the hospital there was run by a medical man who was non - resident, and who gave part of his time for £150 a year. Ho was elected annually. At one time the question of a veiling ttaff was discussed, and it was decided that this would not work unless they could keep a resident surgeon, and as the place wag too small for that the proposal could not Ie adopted. All the medical men in the place were honorary officers of the hospital. Mr Swan proposed that a special meetIng of the Board be held on Wednesday next, at the hospital, at 2.30 o'clock, to discuss the question of the appointment of an honorary visiting staff, and to further consider the article pnblished in the Hebald on the Recond of May, on the question of diphtheria. Mr Ormond t Vvhy should tbe meeting be at the hospital ? Mr H. Williams said that additional facts had come to the knowledge of the trustees with regard to the question of diphtheria, and it was thonghti advisable to get further evidence on the point before coming to a conclusion. As that involved continuing the inqnlry at the hospital it wonld he convenient to meet there. He seconded Mr Swau's motion. The motion was carried. MISCELLANEOUS. A discussion aro-e on the qaeitlon of the accounts, and oa the mixion of Mr Swan, seconded by J. N. Williams, it was decided that in future all accountsshoizld be certified to hy the visiting committee before being laid before the Hoar d. Vouchers to the amount of £323 2a 5d less £53 83 GJ received from patients were passed for payment, and the Board idjourned.