THE HOSPITAL AND THE AUCKLAND MEDICAL MEN.

New Zealand Herald, Volume XXVII, Issue 8404, 4 November 1890, Page 3

THE HOSPITAL AND THE AUCKLAND MEDICAL MEN.

TO THE EDITOR.

Sir, —As one of those implicated in a paragraph which appeared in your issue of this morning, in which it is said of certain surgeons of this city that " it is conjectured that, under the new unionism now so rampant, they have been ' called out' by the union," I trust that you will allow me a few words of explanation. Firstly, I think it is a gratuitously offensive remark, and one that I am surprised to see in the news columns of a newspaper. 1 do not belong to any union, medical or other, and consequently have not been "called out." When the present medical superintendent was appointed I spoke at a public meeting in terms of hign commendation of his personal and professional character. When it was determined that the members of the Medical Association should not consult with him in any case, I remonstrated with one of the chief officials of the association, and pointed out that a boycott like that, if it resulted in the Hospital staff being unable by themselves to perform necessary operations (and there are numbers of operations that no man can do single-handed) would bring odium on all the profession. I therefore offered my services, being not unwilling to earn an honest guinea when I could. I relied" on the promise of the chairman of the Hospital Board that consultations would be called for in all cases of major operations. But I found after a time that it was only in extraordidinary cases, and by no means in all cases, of major operations that my assistance was required. This I thought not fair, either to the public or to myself. Then again I found that the medical superintendent and myself differed very widely as to the position and functions of a consultant. My idea was and is, that a consultant is called in to express his opinion, first as to the na-' ture of the diseaseor the extent, etc., of the injury requiring operation, secondly, as to whether an operation is desirable or necessary, and thirdly as to the time when an operation should be performed, and the kind of operation when there is choice of methods. The medical superintendent's idea was that the consultant should be called in, told what operation was to be done, and asked to assist. At the very last operation I assisted in I never was asked to examine the case ; I was told what it was and what operation was to be done. Now 1 am a very poor man and cannot afford to quarrel with my bread and butter, but even a worm will turn, and when it comes to be treated simply as an assistant house surgeon, with no more voice in the diagnosis or choice of an operation than a house surgeon has, well then 1 declined to act any longer. I have no quarrel with the Medical Superintendent; he is a, very courteous gentleman, and is deservedly very popular everywhere. But his notions ana mine differ. I am always very glad to have a consultation in any case of surgical operation ; I see no degradation in it; I have been accustomed to consultations all my life, although occasionally I have had to do urgent capital operations without either consultation or assistance, but I don't like

it. I _ think _ Mr. Collins is making a mistake in taking the entire charge and responsibility of a general hospital of a hundred beds on himself alone. I never knew such a thing done before, and I don't) believe that* there lives on this earth a single man competent to take the sole medical and surgical treatment of the Auckland Hospital. Medicine and surgery are so specialised nowadays that if a man in London were to offer to do such a thing, he would simply be laughed at. It is not worth arguing about. In a town not athird of the population of Auckland, there is a general hospital, to which I was formerly house surgeon. Besides a surgeon dentist, that hospital has now a consulting surgeon, two other surgeons, three physicians, and a house surgeoD. It contains 120 beds, but 20 of these belong to the fever j ward. The house surgeon, in my time, was assisted by two resident pupils. The number of in-patients) annually is about 7SO.

There is another view of the case in which the public are interested. Medicine and surgery must stagnate here, if all the medical practitioners are excluded from hospital practice. In the vast majority of cases it is impossible to treat disease thoroughly or efficaciously in private. One has to do the best one can, but there can neither bo accurate observations, nor thoroughly efficient treatment in any private houses except those of the very wealthy. We hardly ever see any post mortem examinations in private practice. Numbers of cases have to be sent to the Hospital that it would be most interesting and instructive to watch, bub which, even if we attended for nothing, we cannot treat at their own residences. All severe surgical cases, fevers, and many acute diseases occurring in persons who have no relatives in Auckland, must be sent to the Hospital. I am certain that a young man who has not had previous experience can never learn the practical part of his profession here.—l am, &c., R. H. Bakewell, M.D. Hobson-street, November 3.