Work of a Modern Hospital

Manawatu Times, Volume 66, Issue 115, 16 May 1941, Page 8

Work of a Modern Hospital

Survey by Board Chairman POSITION IN PALMERSTON NORTH The wide ramifications of the work of a modern hospital were made evident by Mr. J. A. Nash, chairman of the Palmerston North Hospital Board, in a comprehensive survey of hospital affairs at a public meeting last night. At the outset ho reviewed changes that had taken place in tfie hospital system during recent years, pointing out that the old interpretation of a board ’s duties was that it should erect buildings, take people in when theyi ! are sick and discharge them as soon as possible. Outpatient services were] I limited to minimum services given to the indigent section of the community, j In the last 15 years there had been a gradual recognition of the fact that j these principles were unsound, and that | the development of tfie services must, be on a much wider place if boards ! were to cater for tho minimum needs of a modern community. Consequently, progressive steps had been taken along the following lines:—Better classification of patients while under treatment, the erection of separate institutions for incurable or chronically infirm patients, the better grouping of patients within institutions, including the subdivision of wards and the erection of new wards on a subdivided plan; the adoption of sounder methods of preliminary investigations into patients ’ conditions before their admission j to the general hospital; the undertaking of certain types of preventive work, including- very active measures against tuberculosis, with the establishment of free clinics, free chest X-rays and the supervision through the district nurse and the tuberculosis specialist of all known cases of pulmonary tuberculosis. Another special development had been along the lines of recognising that the patient’s home condition and matters affecting the general welfare, had a great bearing, on much sickness. Keeping the Rates Down. “The changes in social legislation in tho last lew years,” Mr. Nash proceeded, “have, of course, resulted in our receiving payments from the Government in lieu of the patient's fees which were formerly charged. The Palmerston North Board had adopted a I policy since the Social Security legislation was introduced of endeavouring to { ensure that, as the Government has now | increased general taxation and is devot- , ing a considerable portion of this taxation to hospital and allied social services, we should prevent any further increase in local taxation for this same purpose. For that reason we have gone very carefully during the last few years and this yefer for the fourth year in succession, we have not made any increases in the hospital rates in this district. In fact, during the past three years, there has each year been a small decrease in the amounts which the board has demanded from the local bodies. I think that this policy will prove itself to bo sound in the long run. I know that some neighbouring boards have made substantial increases in the demands on kical bodies this year. Tako the hospitals both north and south of Palmerston North. According to newspaper reports, the demands have been increased by the sum of £19,000 in one case and £7900 in the other.”

“We have certain building operations in progress at the present time, but these have been planned so that the necessary loan expenditure i. 3 being met over a period of years and the annual burden of rates is a very small one. The Hospital Board at the present time is c-atering for over 250 patients in the Palmerston North Hospital. . 4 4 The Government has decided that it is part of our work to cater for the Army, Navy and Air Force patients, including Territorials, and we frequently nave as many as oO patients of tnese classes under our charge. Then we must expect that many returned soldiers will require treatment, and this has largely miiuenced the board in pushing on with certain parts of its Dui)ding : programme, despite war conditions.” •;/

Mr. Nash referred to the modernisation of-the Awapuni Home and the taking over of the Otaki sanatorium oy tne board and drew attention to the value of the tuoercuiosis clinic service which had been set up in connection with tho latter. This servico was paid for oy the boards of the different districts and had proved a most useful means of sorting out patients for admission to the sanatorium.

War Emergency bituation. In regard to the war emergency situation, tne Government had decided that the wnoie of tho treatment to be afforded in hospitals and temporary hospitals under any war emergency situation was to be provided for by the Hospital Boards in the same way as their ordinary services were provided to-day. Having this end in view, a detailed system had been prepared for tho Hospital reception of casualty or such other cases which, might anso from enemy action. The whole of tho. cost of converting buildings and preparing hospitals would ue borne oy the -Hospital Hoards, whicn migfit, ox course, get some special Government assistance, but so far they had neard nothing official in this matter. They understood that they would be paid the usual 6s per day for patients maintained in emergency hospitals, but it would be realised tnat, when they had to consider the estaoiishment of large temporary hospitals and prepare plans and equipment accordingly, a tremendous responsibility in this matter was thrown on the individual boards. For emergency work, the area from New Plymouth to Wellington city and to the East Cape, including Gisoprne, had been placed under the control oi one hospital officer, and the administration of this work was centred in Palmerston North, the managing-secretary (Mr. A. J. Fhillipps) Doing tfie hospital officer for the whole area. The special activities of the staff here, on account

of the war emergency, were very considerable, and for this reason it was not possible to allow members of the staff tto take up Homo Guard or Women’s War Service Auxiliary duties. Tho hospital organisation was an integral part of home defence organisation, and those who joined the emergency hospital service, either as nursing aids and did their 60-hour course in ttie public hospital, or those who were selected for any Other posts in accord with the emergency hospital system, could rest assured that they were playing as important a part in home cieiento and war service organisation as any other oraneh of home defence service. During the year the matron (Miss Banks) had provided 60 hours’ training as emergency aids to no less than 60 young women, and she hoped to double the number by the end of the present hospital year.

Growth of the Hospital. “The nursing staff of the hospital,” Mr. Nash continued, “consists of 17 sisters, 20 staff nurses, and 108 nurses in training, making a total of 145, and more will be required when the present buildings now in course of construction are completed. We endeavour to keep the numoer of nurses so that we have twq nurses for every three patients, but we are not able to reach this position. We anticipate that by the end of the year we will have a nursing staff of 175, catering for about 300 patients. We have 10 district nurses, made up as follow: Two each at Palmerston North and Feilding and one each at Levin, Foxton, Shannon and Otaki, one relieving and one part time, so that every care and attention is given to people living a long way from the hospital. The car mileage covered last year by the nurses totalled 59,461 miles.

With, the rapid growth of the hospital it is interesting to note that, apart from the provision made at Awapuhi since 1929, we have only added the Hornblow Ward of 25 beds. During the same period the bed rate has risen from 201 to 234. This is very satisfactory and in a great measure has been brought about by the medical superintendent through the introduction of the out-patient clinic and the introduction of an almoner. Had it not been for this new system, we should have had to add to the hospital a great i deal more accommodation. In 1937 the average days ’ stay was 24.6 and for j 1940 it was reduced to 19.67. I men- J tiou these facts to show the care that i is being exercised in keeping down expenditure at the institution. I think * am justified in saying that we have oue ‘ of the best if not the best district nurae service in New Zealand, and

these women are doing a very fine work. “Another instance of the increase in work at the hospital is in the X-ray department. In 1938-39, 4201 patients were X-rayed, and with war work add-: ed for 1940, the number had risen to 1 9002. In the massage department in! 1939-40 treatments numbered j while last year this had increased to I 20,454. “The total indebtedness of the hospital is £90,600, but the new buildings in course of erection and to be erected will add another £91,000 by way of loan. They consist of the following, ! namely, Centennial block, morgue, kitchen block addition, new out-patient I block, engine room and boilers, ambu- ) lance station, tutorial block and mater- ' nity home additions. I want to assure | you that these additions are urgently ■ I required and long overdue. We have t no desire to increase the liabilities of ' local bodies and have held these mati ( ters up for some time. For the past " | three years we have been told by the 4 ! department that we must erect a new 3 five-storey block to replace a portion ’ j of the original part of the hospital and : ! which has been condemned for the past ’ 1 14 years. However, we are doing our r ; best to avoid this expenditure which I would mean at least £100,000.” | j Mr. Nash concluded by paying a [tribute to the work of the board’s . I executive officers, saying it was a ‘ pleasure to work with such capable , officers. 3 On the motion of Mr. F. L. Cubitt, j who was in the chair, Mr. Nash was > accorded the thanks of the meeting. j