HOSPITAL STAFFING

Manawatu Standard, Volume LIV, Issue 286, 31 October 1934, Page 6

HOSPITAL STAFFING

STIPENDIARY MEDICAL OFFICERS. LUNCH CLUB ADDRESS. Advocating that public hospitals should have a full-time medical staff, with part-time specialists available, Mr H. J. Christiansen, formerly a member of the Wanganui Hospital Board for two terms of office, yesterday addressed the Palmerston North Citizens’ Lunch Club on hospital administration and its developments. He stated that this proposal required no legislative authority for its adoption, could be put into operation immediately, and was more than justified with the success already being achieved in some institutions with this system of staffing. Mr A. G. Roe presided over a good attendance. Without fees, the medical profession gave very valuable and necessary service as honorary surgeons to hospital '• institutions, stated Mr Christiansen, I I but circumstances ■ had changed and : now made this unnecessary. The first ' I community obligation was to provide, ■ hospital treatment for indigent people.! ’ and in this respect the taxpayers had ] been both very tolerant and charitable.il

Hospital administration, however, al-' 1 ways reached the where it must 9 be conducted on a commercial basis. 1 1 Costs of public hospitals had grown, j i but so, too had their capacity to give ‘ service, and the Palmerston North in-,'] stitution was capable of giving the best I j in the land. I' The State’s service to hospital ad- j ministration was of such extent as to; j provide 5.5 hospital beds per 100 of i f population, but only 3.5 of those bedsit were occupied throughout the year, ' f added Mr Christiansen. Direct levies f on local authorities had amounted to t £237,000 in 1916. Last year the total a was £586,000. Government subsidies of e about the same amount were available, ;v and last year public hospital services p in New Zealand cost about £1,750.000. t There were three forms of medical c staffing in New Zealand, the speaker 1 continued. The first was a full-time ' i stipendiary staff with a part-time a specialist staff. Secondly, as at v Palmerston North, there was an p honorary staff selected from doctors r< practising in the district close to the n

Hospital. Thirdly, there was an honorary staff of all doctors in the district, who dealt with particular cases and those they ordered to the Hospital. Mr Christiansen advocated the first method of staffing, from the commercial aspect, after satisfying himself that the medical service would not be impaired. The difference between success and failure in the commercial aspect of a public hospital lay in the amount of tees collected per occupied bed. Wliereever there was a full-time stipendiary staff employed, there.was a better collection of patients’ fees. This increase more than compensated for the additional costs involved. The average col- ! lection of patients’ fees in New Zealand was some £62 per occupied bed. These collections by six hospitals which employed full-time stipendiary medical | staffs were as follow:- —New Plymouth, I £72; Grey, £7l; Hamilton, £55; Timarn, £6l Southland, £7O: and Whangarei, £7O. At Palmerston North I and Wanganui, where there was an honorary medical staff, the collections I of fees per bed were £44 and £46 re-j spectively. Palmerston North and Wanganui, he suggested, did not compare j favourably with those institutions I under a stipendiary medical staff. Though nine fully qualified doctors were employed at the Hamilton Hospital, the costs there were only £145 per occupied hod, compared with Palmerston North’s £143, which was the

lowest figure for New Zealand. Yet the cost to the individual taxpayer in the Hamilton Board’s district was 12s I 4d per heath compared with 16s fid j per head for the Palmerston North Board’s area. The average for Now | Zealand was 17s per head. | There was ample evidence, considered Mr Christiansen, to justify from flic commercial aspect, and with- j out prejudice to efficiency, the change • from a selected honorary staff to a full-time stipendiary medical staff at the Palmerston North institution. The advantages claimed for the change included better control, increased convenience and economy. Under the present system it was necessary to obtain from a medical practitioner a certificate of admission to a public < hospital. Certain patients wore ad- i vised to go to private institutions I and others to State institutions, which ■ were entitled to a better class of sup- i port. Honorary staff's were often well < epaid indirectly for their services, and j nodical superintendents frequently ’

had little more than administrative authority. The speaker was accorded a vote of thanks on the motion of the chairman. Visitors welcomed were Messrs J. J. Bryce (Iviwitea) and L. It. Bryant (Nelson).