NEW HOSPITAL SYSTEM.

Northern Advocate, 7 May 1920, Page 6

NEW HOSPITAL SYSTEM.

IXCLI-SIVE FEES FOR PAYING PATIEXTS.

("Times" Medical Correspondent.)

The increased cost of living and the lowering of the general standard of health which has followed the war iv so many directions have rendered it increasingly difficult for the man of moderate means to provide first-class medical and surgical attention for himself and family. The position, indeed, is ap' lo become acute when a serious opnation is necessary and when fees amounting in. some instances to hundreds of pounds have to be paid. The difhculty was recognised long ago in America, and that, country has witnessed the development of a great enterprise known as the "Mayo Glinique"—in which surgical, medical, and nursing attendance are given for inclusive fees which can be stated beforehand. The venture has been enormously successful; so much so that Americans coming to this country heard with wonder that no such institution was available in England. That this state of matters is likely to change soon is evident when the record of St. Chad's Hospital at Birmingham is taken into account. This hospital was founded some years ago; it hsi* now proved itself to be a success, a r - an account of it contributed to the British Medical Journal clearly shows. The idea was to'eliminate charity altogether, and work on strictly business principles, keeping the control in the hands of the medical staff so far as possible. A company was formed. It was agreed that the institution should not be advertised in any way —a point of importance in regard to medical ethics —and that no patients should be admitted except on the recommendation of a member of the medical staff, and on ci.-onditions laid clown by the medical committee. TWO CLASSES OF PATIENT. Patients are divided into two classes: those who pay a composition fee, and ordinary patients. The former receive nursing home accommodation and all professional attendance, and constitute 90 per cent, of the. total admissions. The "composition system" is illustrated by the following .samples:—

"CD. suffering from chronic appendicitis is accepted for an inclusive charge of £21. This covers the cost of the operation, tho anaesthetic, and three weeks' stay in the hospital. The anaesthetist receives a direct payment of one guinea from the inclusive fee." "G.H. is admitted wth obscure gastric symptoms and stays in the hospital four weeks for a composition charge of £31 10s. His ease requires full investigation, and may call for a consultation between a physician and surgeon, an X-ray examination, and subsequent operation. The cost is covered by the single inclusive payment."

The medical staff consists of 23 members, each of whom is a consultant and a member of the staff of one of the Birmingham hospitals. A point of great practical value is tho right that each member of the staff possesses "to call upon any other member for assistance in the treatment of a 'composition' patient without fee." The daily average number of in-patients has steadily increased since the opening in 1914.

The system is one which recommends itself to the public. The difficulty about nursing institutions in London and other centres is that medical and surgical attendance is not included in the scale of charges. The "composition" system thus meets a great demand. So long as advertisement is dispensed with and the control kept in medical hands, nothing but good can result from this method.