HOSPITAL AND CHARITABLE AID ADMINISTRATION.

New Zealand Herald, Volume XXXI, Issue 9559, 10 July 1894, Page 6

HOSPITAL AND CHARITABLE AID ADMINISTRATION.

REPORT OF INQUIRY COMMITTEE. Yesterday afternoon ab the meeting of the Hospital and Charitable' Aid Board, the report of the Inquiry Committee was brought up and read by the chairman (Mr. Garratt). Owing to there not being time to fully discuss the report and its various

recommendations, it was ordered to be placed on the table for fourteen days for perusal by members, and will hereafter be taken into consideration. The committee was set up two months ago, and went into the working of each department, examining the officers separately. The hon. medioal staff have already sent a letter to the Board, calling attention to the facb that subordinate officers had been examined as bo the working of departments without the knowledge and in the absence of the officers who were responsible heads of such departments. . The Enquiry Committee state that they'' have made thorough enquiries into the working of the different departments of. the Hospital and Charitable Aid Board, and submit their report for consideration.

Office.They commence with the office first, and state that the secretary's position is a very unsatisfactory one, and they refer to matters in which they think tho method of carrying on the business of the Board could be improved. The committee then go on to allude to applications for relief received by the Relieving Officer too lace in the day to be dealt with by the committee, orders for rations, the making up and payment of certain accounts, and the indexing of the letter-book. They find that the house steward deals directly with other District Boards, and receives replies without the intermediate aid of the secretary. They also find that no security has been given by the secretary, and that be was never asked to do so, while one of the subordinate officers (the House Steward) gives security to the extent of £250, although he has not a tenth of the money passing through his hands. They believe there is too much overlapping in the work bebween the Hospital and Cosbley Home accounts, they therefore recommend that the secretary of the Board should be the House Steward as well, and live on the the premises, as he, being the chief executive officer, there would nob be bhe constant friction now occurring. The Board should hold its meetings, there, the minutes of the Charitable Aid Committee be taken by the Relieving Officer, and those of the Costley Home Committee by the manager of the institution, these officers being always in attendance at the respective meetings. A considerable saving would thus be effected, as well as the annual saving by the amalgamation of the offices of Secretary and House Steward. As to the Relieving Officer's deparbmenb the Committee think a building might be erected on the Board's property in Victoria Quadrant, one room for the Charitable Aid meetings, and a residence for the Relieving Officer. Relief sheds for the homeless might be erected, bhe said officer to have charge, doing away with the Princes-street Home. In their opinion the rent at present) paid would more than cover the amount of interest on the sum required, while the amalgamation of duties would effect a saving almost sufficient to cover the other expenditure which they recommend the Board to incur.

Hospital Rules. —The Hospital rules they state have been violated or set at) defiance with impunity, and they do nob know who can be held responsible with the present divided authority existing. They acknowledge the valuable services rendered by the honorary staff, but respectfully submit that while in the treatment of cases the Board has no right to interfere, the hon. staff have no jurisdiction as to the management and administration of the Hospital. The secretary being resident at the Hospital would represent the Board, and be batter able to see the rules enforced. The wear and tear of the Hospital would be better looked after, because the present House Steward's position is not clearly defined, and not of sufficient authority. The committee state that goods are purchased without direction or knowledge of those supposed to have charge. This should be stopped, and could not occur if the secretary resided on the premises. They give the numbers of fifteen rules which they state are continually violated.

Hospital.—They recommended that a charge nurse be appointed for bight duty, instead of a probationer, owing to suffering being accentuated, and more deaths, ab night. The resident medical men and the lady superintendent approve of this suggestion. Separate rooms should be provided for venereal patients—one for each sex, and that their bed and personal clothing be separately washed, packed, and marked, instead of being placed in miscellaneous fashion with thab of other patients, as is customary. This suggestion is also approved by the medical authorities, as also thab a young wardsman be appointed bo specially attend to these patients, and have no other duty in the Hospital. They recommend better ventilation in the D.T. wards, and that a separate ward should be provided for epileptic and paralysed patients, on account of the dirty habits engendered by such complaints. As to the dispensary, they were greatly dissatisfied with its condition. They suggest better security for the custody of the poisons; thab no one should enter the dispensary but those in charge, and that the dispenser, having ib under lock and key, should be held responsible for its good order, which under existing circumstances cannot be done. He should break down all acids, and thus prevent the recurrence of such an accident as befel the house porter a short time ago. They advise that apparatus be obtained for distillation of water, and also a good microscope for use ab the Hospital. Suggestions are also made for altering window openings, so that patients can be wheeled oub of wards to verandahs, and vice versa; and head pulleys for relief of patients and nurses. For the comfort of patients, they make a number of recommendations as to packing of windows and doors, to prevent rattling, suppression of noises in the wards in the mornings, and thab convelescenb patients, nurses, and porters be compelled to wear list slippers, and also for an improvement in the preparation of the chicken broth. It is suggested that a place be built to hang the meat in, as hanging meat in the dairy is detrimental to the milk, and unfair to the milk contractor; also, that a suitable steam tent, a canvas straitjacket, similar to those in asylums, and a seltzogene be procured. They heartily commend Dr. Makgill's action in starting a mortuary record, and strongly urge the Board to see that) it is followed up. The committee think there is a laxity somewhere in regard to the crutches, 70 or 80 pairs are made annually, and those using them take them away with them when convalescent ; and they ' are informed, that during the last seven years only half-a-dozen pairs have been returned. They think that some stops should be taken to secure their return, or payment in lieu thereof. With regard to giving effect to the Board's resolution, re saving of gas, they think that the house steward has carried economy to the verge of parsimony, and thab it was never intended to cause discomfort to patients, the medical staff, or the : nursing • staff. The committee recommend that the engineer should have imposed on him fresh duties and given fresh privileges in consideration thereof. , The Hospital Fire Brigade the Committee describe as "a huge farce." They state they find there are no regular no defined positions in case of fire, no instructions given as to how to enter rooms filled with dense smoke, or as to the rescue of patients in the event of a fire, or as to the saving of life. They recommend that no further expense bo incurred for the maintenance of it. Instead they suggest that a hose-reel and hydrant be placed on each flab. With regard to the condition of the servants,, they state that ib 1 is very discomforting, and should be improved in various ways. The dietary scale should be more liberal. They state that " they are disgusted at the treatment which is meted out to this portion of the Board's employees. After taking tea at five o'clock, everything is locked up from them till seven o'clock next morning. Not even a bit of dry bread or a drink of cold tea can be obtained to assuage thirst or hunger on returning if a night out." They recommend that they should be put on the same footing in this re?pect as the nurses, namely, have brd&d and* butter, or. that anything left from dinusr should be available if they require it.

Costley Home. committee complain that venereal patient! " mingle , with, eat, sit, and sleep among khe o' 1 * r patients," and saggesb that pteventive measures should be takes. The} refer to the manager's relatione with the;patients, and state that some arrangemeifc should be made with' the doctor of tip Home to attend oftener, or if that is fiund impracticable, and the Board is determined to continue the Home 'as' a pise for incurables, they recommend that* resident surgeon be appointed. ; The cohmittee stated that the percentage of accijents to the number of inmates, fractured arms and legs, cub heads, etc., is, in thei' opinion, too large. They consider that it should be the duty of the manager to forward a report in writing of aay uncommon occurrence within two hotiri afterwards. As to the con duct of the Home, thsy state, " they cannot blame tie manager, the blame is du< bo the Board alone for its vacillating policy, and chairmen taking upon themselves to 85b aside decisions of the committee. Tley feel that no material change can be effected until the manager, whoever he may be, (ias full control, with power to deal ' with refractory inmates." They agree wit the suggestion of the manager tiat wicket gates should be erected oi the landings to minimise the dangerof the old people falling downstairs. Th> committee recommend some better arrangements for paralysed and epileptic pitients; and also that prescriptions to be nude up by the manager should be in writing; and kept for reference, and not stated through the telephone. It is suggested that bed screens and a few bed rests be protured. They recommend- the Board to ap|roach the Government with the object oi obtaining easier admission into the Lunitic Asylum for inmates who indicate symobbms of insanity. Holidays.4-The committee recommend that all in ,he employ of the Board be granted a firbnighb's holiday. They say this will present some having two holiday* in one year, vhile others have to do without any— the case of one man five years elapsed between his holidays. Supplementary.—As to the report of the resident sui?eon re the ophthalmic ward, they have n» recommendation to make on its main fetures. Bub as regards the instruments and to prevent a recurrence of such damige and loss to the Board they recommend that an inventory be taken on each fresh appoinbment of a resident surgeon, wlich he should sign, and on termination of his engagement should be ohecked, and after making due allowance for wear and tesr he should be held responsible, for loss or i damage sustained. His last month's cheque should be held over un si! the Board is [ satisfied ; a written release should then begiven to him, signed by the chairman of :he Board. The committee state if this had been done on the appointment <f each resident surgeon, the responsibility of the damage could have been sheeted home.