HOSPITAL COMMISSION.

New Zealand Herald, Volume XLI, Issue 12697, 27 October 1904, Page 6

HOSPITAL COMMISSION.

STATEMENTS BY FORMER PATIENTS. AGAIN COMPLAINED OF. PAYMENT OF FEES. FURTHER SURGICAL EVIDENCE. The sittings of the Royal Commission ap-< pointed to inquire into matters connected with the management of the Auckland Hospital were continued yesterday, the Commissioners being District Judge Ward (chairman), Mr. Richmond Beetham, ex-S.M.,aud Mr. S. *E. McCarthy, S.M. Mr. R. McVeagh appeared on behalf of Dr. J. Hardi© Neil (who has made-a number of charges against the Hospital Board and the senior medical officer), Mr. J. R. Reed (instructed by Messrs. Hesketh and Richmond) appeared for the Hospital and Charitable Aid Board, Dp. Roberton. appeared on behalf of the Auckland division of the British Medical Association, and Dr. Collins (senior medical officer of the hospital) conducted his own case. Dr. MacGregor, Inspector-General of Hospitals, was present on behalf of his Department. DR. GORDON'S EVIDENCE. The first witness was Dr. Gordon, who was for some time attached to the honorary stall' of the Auckland Hospital. He said ho had heard the evidence in the theatre case, and thought that the non-union of the bone should have been discovered within three months. At the end of that time the proper- course to pursue would have been an operation to remove the dead, bone and join the bones. . Mr. McVeagli: Do you approve of the junior residents putting up fractures? — Simple fractures, under the supervision of the senior officer and the honorary stall'. The witness said emergency cases would •include ordinary cute, scalp wounds, and hemorrhage. An urgent case would be one requiring attention within |wo, three, or four hours. Mr. MeVeagh: Do vou consider it proper that such cases as these should be treated by the senior medical officer?— Not major

cases. Within what time would it be possible for honorary surgeons to be at the hospital after being telephoned for?— Between a quarter to three-quarters of an hour. The time occupied in. the preparation of patients for operations would depend upon the nature of the particular case. In a. serious abdominal operation from balf-an-hour to an hour would be necessary. Dr. Gordon, referring to consultations. said many cases hud been brought up for consultation which did not. require it. They should save the time of the visiting honoraries so they could devote more attention to serious cases. Do you approve of the senior medical officer doing post-mortem and surgical work at about the same time?—l don't think it is wise to do so. ,

Do you approve of the medical officer engaging in anthrax culture, and at the same time doing surgical work?—No; I do not. The witness said he ' attended a patient. named William Allen at $ie Auckland Hospital for an ununited fracture. It was a fracture which witness would not approve of juniors putting up. Replying to Dr. Robeitbn, the witness said he was a member of the staff for a year and a-half, finishing up in. April, 1904. His, position was that of honorary visiting surgeon. Did you consider the condition of the hospital satisfactory?— when I went on the staff.. There was a great, deal of suppuration. , ' Dr. Gordon went '' on to say that steps were' taken to suppress the .suppuration -eases. 'A meeting of the honorary staff was called, and a number of resolutions were framed, some of which were not earned out. Personally the witness said he redoubled his own exertions, spoke to the theatre nurse, made bis own preparations, and spoke to the. assistant. Dr. Collins, he said, rarely assisted! him at operations. " Matters" gradually improved in regard to the suppuration cases. THE HONORARY STAFF AND THE

SENIOR MEDICAL OFFICER. Witness did not flunk the rule permitting the senior medical officer to attend meetings of the honorary staff a. good one. His presence at the'meetings was sometimes of advantage—for instance, in cases such as suppurationwhile his presence would be a disadvantage when the duties of the senior medical officer came up for consideration. He should not be regarded as a member of the honorary staff. At the meetings of the staff the medical officer would represent himself, and also, witness presumed, the Board. Dr. Roherton: Ride 37 says that y the senior medical officer is to be the sole medium between the honorary staff and the Board. The Chairman: One would think the Board controlled the post office. Dr. Roherton: There are various interpretations to be put on it. Dr. Gordon said it was so interpreted that all communications between the staff and the Board had to go through Dr. Collins, and all communications to the staff from the Board, he believed, went through the same channel. That was not a good rule, because it asked the honorary staff to communicate through one who should be in a subordinate position. Dr. Collins gave a few anesthetics while witness was on , the staff. The nurses on the surgical side ; should, he thought, be partly trained by the honorary surgeons, because the surgeons had to rely on the nurses to cany out instructions given. On the question of the tenure of the appointment of the honorary staff, Dr. Gordon considered a year too short. If the tenure was longer the doctor could carry on the work better, and with more interest, and it would ensure greater experience. The Costley Wards were not, in his opinion, satisfactory, it being awkward to cany cases for . operation from the main building to the operating theatre in the Costley Wards. The distance of the Costley Wards from the main building entailed more' work,, involving extra nurses and additional expense. A "MONSTROUS" SYSTEM. The Chairman: That system is most monstrous. Carrying the patients up and down the steps, through bad weather and the rest of it, was monstrous. . : Mr. Reed: It is the intention of the Board, When the new operating theatre is completed, to use the Costley wards as surgical wards. Dr. Robfcrton: That is an extremely important admission to make, and I would like the Commission to make a note of it. Dr. Gordon said when he spoke to patients about going to the hospital, he was told by some that they were too poor, but they Mere exceptional cases. In joining the staff he expected to give his services to the poor, and objected to attend to patients who were able to afford to pay for attendance outside the institution. The perscmsi who could afford to pay being in the hospital would keep the poorer patients out.

The responsibility for the professional treatment of patients should, in witness' opinion, fall on the hon. staff, who should J also attend emergency cases when pos- ' sible. It was not desirable that the senior medical officer should perform major operations, but witness thought it would very rare jy occur that an urgent major case would arise requiring the senior officer to perform the operation. Dr. Gordon iavoured the appointment of assistant-sur-geons, which would enable the younger surgeons to gain an experience of the serious part of surgical work before being appointed full surgeons. ° , CROSS-EXAMINATION BY MR REED Questioned,by Mr. Reed, Dr.' Gordon said the u„„ surgeons were r . generally sard tfa« 1 on surgeons were generally available at all times of the day to ™ to the hospital if required. If engaged & they left word where they would be found at stated intervals. It had been the practice

for the senior medical "officer to perform operations when requested to do so by the hon. surgeon for the week. He always understood that if the surgeon for the week was not available, the senior medical officer had a right to do the operation. The Chairman: Under what rule? Mr. Reed pointed out that rule 72 had something applicable to the position. It placed the responsibility on the senior medical officer after the hon. surgeon had been notified. . The Chairman: Was that acquiesced in] by the hon. staff, because it is a direct violation of the rule. I Dr. Gordon: Dr. Collins was a member I of the hon. staff. | Mr. Reed: Yes, that was the position. | Dr. Roberton asked that a note be made? of the admission. §

Mr. Beetham: He can't be a member of the hon. staff unless he has been made one j by the rules. What is the rule? j 'The Chairman: He must obey the orders of the hon. staff. | Mr. Beetham: The rule says he can attend meetings, and that differentiates him from a member of the hon. staff. The Chairman: He is to be under the] control of the hon. staff. He cannot con- j trol himself. " ' - Proceeding with the cross-examination ' of Dr. Gordon, Mr. Reed elicited that some recommendations as to the washing of patients, and aseptic precautions by assistants, which were made by the hou. staff in their endeavour to combat suppuration, were not carried out. He favoured the lion, staff having a representative on the Hospital Board, through whom, or else through the secretary, communications could" be received, either from or to the Board. The management of hospital and charitable aid affairs should be distinct. It would be better to set aside the Costley wards for surgical cases. Mr. Beetham : If these wards were set apart for the purpose would they cope with the cases? Dr. Collins said there were four wards capable of holding 12 beds- each, and four single wards holding one bed each, making a total of 52 beds. In connection with improving the premises, Dr. Gordon said the best thing to do was a difficult question. It would be hardly advisable to add to an old building, while ii" separate buildings were erected it would be best to connect them with corridors. How to discriminate between patients able to pay for outside attendance and those not able to pay was a question also full of difficulties. He thought' it would depend a good deal on the doctor wlio sent the cases in. The production of a doctor's certificate should not be made essential to a. patient's admission to the hospital.

PRODUCTION OP CERTIFICATES. Mr. Reed: In your opinion, should the hospital, authorities refuse to admit a patient if it is perfectly clear to them that the person is. capable of paying for attendance outside? — think they should," if the person could obtain proper treatment outside. The Chairman: In a case of urgency? That is the point. .Mr. Reed : I understand that the rule requiring the certificate was made in order to prevent persons capable of paying being admit bed to the hospital. Is that —The rule was made after a. conference of local bodies was held, about a year ago, and I believe it was for that purpose. The Chairman: It is monstrous that £ patient should be sent away to get a certi £.

icute. Mr. Reed: The particular case that has been, referred to was an unfortunate accident. The porter asked the man to go and get a certificate. The Chairman: Well, it is monstrous. Mr. Reed: You mention an exceptional case, where a. person said he was too poor to go to the hospital.—The first thing that struck ijje on. coining to the colony w&c a person saying ho was too poor to go to the hospital. Do you suggest that the hospital should be free?— haven't gone into that question. Do you- know of any cases in which the Board has unduly pressed patients,for payment of fees?— No. r * The Chairman: What do you mean by unduly? ; .'•-'•*" '". ' "-r;..>v .•'■ Mr. Reed: Issuing-a distress warrant or •something of that sort. We admit we have summoned patients for payment. Mr. Reed (to the witness) : Have you any suggestion to make as to whether the fees should or should not he collected, or whether the fees charged are, too highl am not sufficiently conversant with .the subject to say.; . .At Home the hospitSp, : which are supported by voluntary contributions;, make •no charge.'

In order to avoid misconception in regard to Dr. Collins'/ position on" the honorary staff, did the honorary staff look upon it more that it should be for the purpose eft discussing matters with the members?— Yes. : Mr.. Beet-ham: He attended meetings of the staff and entered into the discussions. Mr. Reed: Being a paid officer he could not be a member of the honorary staff. The Chairman : And being under the control of the honorary staff he could not be one of them. DR. COLLINS' CROSS-EXAMINATION. Dr.. Collins: Have yon asked me to do major abdominal operations?— have asked you to do an appendicitis case. Do you approve of the senior medical officer doing major operations?— as a rule: Speaking further, Dr. Gordon said he had objection to the resident staff doing small operations. He bad not known septic cases left to the residents by honorary surgeons because the latter had outside cases, and did not wish to run the risk of contamination. The honorary staff were not regular in attendance at consultations, and tins would, witness presumed, throw a great deal of responsibility on the senior officer. You have heard complaints made as to the classification of cases for consultation?— I don't know what the classification was. Witness said that he would class such operations as those for appendicitis, and gastric ulcers, of from 17 to 20 hours' standing, as emergency operations. In answer to Dr. Collins, he said that it was a fact that there was no other class of operations more liable to cause dissatisfaction than fractures. He thought that the treatment of fractures and dislocations must necessarily be left to the resident staff, especially cases of simple fractures. In reexamination by Mr. McVeagh, witness said that he did not experience the same difficulty in hie private practice in regard to suppuration as in the hospital. The honorary staff did all the serious l operations in witness' time. In respect to the operation performed on Peake in Hie hospital, he said, that it was'proper isiugery not to remove the loose pieces of bone, and it was also proper to wire them to the main bone, as had been done, as otherwise the effect (owing to the greatness of the separation between the two ends) would have been to make the leg so much shorter. Dr. Roberton; Would not the chairman of the honorary staff be a proper means of communication between the staff and the Board?— certainly. EVIDENCE OF A FORMER NURSE. Elizabeth Susannah Rowles, matron of the Northern Wairoa Hospital, and formerly a nurse in the Auckland Hospital, stated that she left the latter hospital last November, "after having been there 19£ years. She remembered the case of Wm, Peake. Dr. Scott's name was at first over

Peake's bed, but it was afterwards turned in by the instructions of Dr. Collins, who said "that all the names had to be turned in. She remembered Peake having hemorrhage from a broken jaw, and also having a abcess in the jaw, which was ascribed to Peake cutting himself whilst shaving. Dr. Bennett said it was due to the broken jaw. Prior to Dr. Collins' time the honorary staff had charge of witness' ward. They did not have the same degree of charge after Dr. Collins was. appointed. There were good results under both systems. She considered that the food was fairly satisfactory on the whole. Sometimes the fish was not very good. The eggs were not very good during the winter. . Witness suggested that something might be substituted for eggs, but the suggestion was not adopted. Dr. ' Collins usually went to the hospital in the mornings between nine and ten and earlier in cases of operations..

By Mr. Reed: The house steward; used to visit the wards at meal times. So far as she knew all complaints regarding the food were attended to. ; By Dr. Collins: She could prepare a patient's leg for operation in half-an-hour. There would he a further preparation necessary on the operating table, occupying from 20 minutes to Salf-an-hotir. In all it would take over an'; hour from the time a patient came in until the operation commenced. Peake's was a very bad case, and the operation was done as quickly as possible on account of the man's" serious condition. Have we not had satisfactory results from fractures whilst I have been at the hospital?— Yes, fairly satisfactory. What time did you first go to the hospital?—ln 1883.

EXPERIENCES OP FORMER SUPER-

INTENDENTS. Who was the resident medical officer then?— Dr. Mackellar. Dr. Bond afterwards took it.

Did Dr. Bond leave the hospital on account of any unpleasantness?—l do not remember. When he was afterwards an hon. surgeon some charge was brought against him in regard to on operation, and he resigned. Was a charge laid against Dr. Floyd Collins when he was in charge of the hospital? —Yes ; a charge was brought against him by a nurse. As a result he resigned. Was a Royal Coram appointed?—l do not remember, but there was an inquiry. Witness said that after that they got the honorary staff back again, and then Dr. Baldwin was appointed senior medical officer.

Do you know whether Dr. Baldwin left on account of some trouble in regard to his opinion regarding a supposed plague case?— I do not remember.

Did he not have his salary reduced during his term?— believe so.

Is it not; strange that this should be so, ii things were so satisfactory during his term as we have been told?—lt does seem strange. Was there any unpleasantness between members \>f the staff and Dr. Baldwin? Yes ; I suppose so. Was not Dr. Baldwin exceedingly glad to leave the hospital on that account?—l do not know. :

What happened when Dr. Baldwin, left?— Dr. luglis took charge, and Dr. Bedford, as medical adviser to the Board, acted as supervisor.

Was that satisfactory?— Then why was it changed?—l do not know. \ •

AN EX-PATIENT'S STATEMENT.

William Allen was then examined in relation to the charge against Dr. Collins of allowing junior surgeons to attend to him when he was suffering from a broken arm, J and also of failing to attend to him immediately on admission. Witness said he met with an accident through falling amongst some machinery and broke his arm. He went to the hospital, where, after some time, Drs. Horsfall and Bennett put the arm in splints. Some days afterwards it was taken out and reset. He afterwards became an out-patient, and his arm not feeling right he underwent another operation in the hospital by Dr. Gordon. There was then a consultation. He owed the sum of £19 16s 8d for the hospital treatment. His. wages were £2 3s a week, and he had a, delicate wife and child to keep. ] Mr. McVeagh: Have you received any demand for payment? Yes; I have re- ; ceived two letters demanding payment. Mr. McVeagh read the two letters. The first, dated May, 1903, demanded payment, and the second, dated January, 1904, repeated the demand, and stated that if it was not paid legal proceedings would be taken to enforce payment. Did you make any application to the Board for a reduction?— No. ' By Dr. Roberton: Did it occur to you that the members of the Hospital Board were a kindly lot of gentlemen, who would have let you" if you had asked them?—l do not think they would have done so. * A BRICKLAYER'S STATEMENT) ; Edmund Burke, bricklayer, of Seafield View Road, was called in support of the... charge as to the refusal to admit patient? without a doctor's recommendation. He said that at the end of 1903 he went into the hospital suffering from hernia. When he went to the hospital he saw the porter, and told him "he wished to see Dr. Collins. The porter said: "Have you got a doctor's recommendation." He replied: "No." "Well," said the porter, "you can't see no doctor here." Witness, who was very weak, went away,' and. a couple of days afterwards he got a recommendation from Dr. Gordon, and went into the hospital, where Dr. Gordon attended him. On leaving the haspital in February ho was handed a bill for £8 lis. He said he was unable to pay it, and the house steward advised him to see the Board. Witness went to the hospital on the following Monday, and saw Mr. J. R. Walters, a member of the Board, who said he would have to pay the amount. Witness said he was not able to pay it then, but Mr. Walters said: "I see your father's place has been sold, and there ought to oe something coming from that." Witness said he had nothing to do with that. Mr. Walters said: Well, you will have to pay it." Witness had been told by Dr. Gordon that he should do no heavy work for six or nine months, but he went to work earlier, in order to earn money to pay the. account. He paid £4, and then was informed that if he paid another £2 within three months it would bo accepted in full payment. Mr. McVeagh: What was the food like at the hospital? The bread was about the only thing fit to eat. The eggs were absolutely rotten —not merely stale, but perfectly rotten. I had fish with scales on them, and it was not'very fresh either. The Chairman: I suppose you will probably have some evidence from the the contractors as to the food.

, Mr. Reed: We shall lia,ve to call the contractors, I suppose, to explain. The contractor for the supply of fish is one of the largest merchant? here. .-,-'. The Chairman: Ido not know how they can explain how the fish came to be rotten. v Witness said lie was in, No. 3 ward. There were consumptive and cancer patients in the same ward. ' ■ I

Where did the patients have their meals? —All at the same table. One man had a cancer on his lip, and when he was at the table he used to put the spoon into the Bait and into his mouth and then hack into the salt again. , ■

, Did you observe whether Dr. Collins visited the ward regularly?— never saw him there.

Do you remember a man named Wilson coming in for an operation for appendicitis? ■ —Yes ; one day before the operation he got up to go down town. He was asked where he was going, and he replied that he was going to get the remainder of his money.

Mr. Reed said this would probably be a serious charge, and he objected to hearsay evidence being taken. If Wilson could be produced, of course it would be all right. : Witness said that the man got up to go down town. He returned later on in the day. No further questions were asked on the matter.

Was anything said further between. Mr. Walters and you as to wiping the whole thing off?—l did not ask them to wipe the whole thing off. I said I was not in a position to pay the account. Did he tax you with spending your money on drink?— said I asked him" one day if he would have a drink. When he declined he said I remarked: " Perhaps you think I haven't, enough money to pay," and then I produced some £1 notes.

CONDITION OF THE FOOD, ■ Mr. Reed Did you ever make complaint in the hospital'about' the food?—-No. I found it was the best policy, to be civil. The nurses know perfectly -well that the eggs were rotten.. Mr. Reed: It i;-: quite possible for eggs to be rotten on occasions; the internal part cannot be seen.

Why did not you make a complaint?—l did not want to make a complaint, but to get well as soon as I could,, and get out as soon as I could. '

Did you see Mr. Schofield, the house steward, go round the wards at meal times? —I, never saw him, and he could not have gone round without me seeing him. Did you make any complaint to Mr. Walters about the food when you were speaking to him?—No; I was worrying about the money..

How often do you say the eggs were bad? —Very often. :'''{■■:;■"■ :: : ■ Was anything els© ever substituted?— No. We all eat round the table in the convalescent ward. There was plenty of bread to eat. ~.'■ . Did you ask for any thing else?— When you smelt one of those eggs'you would not be inclined to ask for anything else. ; What did you say to the porter when yon first applied, for admission? said to him I had a note from Dr. McLaughlin, of Rotorua, aid the porter said, "You must get a note from a local doctor." '

The note was and it certified to Burke being unfit for manual labour. The Chairman You say that note was refused? Yes. ' ; The Chairman: Did you show it?—l had ;no time. He said it was no use; I must get a note from a local doctor. PATIENTS FROM OUTSIDE DISTRICTS. Dr. Collins: When did you see Dr. McLaughlin at Rotorua?— or three days before Christmas. How long were you at Rotorua?—Two months. Prior to that I. was at Atiamuri. Why didn't you go to Hamilton? Dr. McLaughlin gave you that note to go there? —No ; it was not for Hamilton Hospital. Do you think Dr. McLaughlin would give you a note for any other than the district hospital?— note was intended to show to my wife, who had a maintenance order against me. The Chairman: Who is the note addressed to?. Dr. Collins: To no one, Your Honor. Dr. Collins: Did you show the porter that note?-— He took my breath away by the manner lie spoke to me. , Did not Dr. McLaughlin mention the Hamilton Hospital to you?—He said I must go to a hospital at once. Did he mention the Hamilton Hospital to you?—He said, "If you like, I'll give you a note for the Hamilton Hospital. ' I remarked that I had friends in 'Auckland,, and he replied that I must go there at once. Is it not the recognised thing in Rotorua that all sick persons go to the Hamilton Hospital?—l don't know. Are you prepared to swear Dr. McLaughlin sent you down to Auckland? Yes ; I'm prepared to swear that. Dr. Collins : Did you walk from the sta-tion-to the hospital'?— went to Hob&onstreet first. The pain made me sick. Did you ask for me at the hospital?—l said.l wanted to see the doctor.

At this stage Dr. Roberton rose to correct the suggestion that Rotorua was in the Hamilton Hospital district. He said Rotorua was no more in that district than in the Auckland Hospital district. Dr. Collins stated it was a recognised thing that Rotorua patients were sent to the Hamilton Hospital,- because it was not right to admit them to the Auckland Hospital unless a guarantee as to payment of fees was received either from the patient or the Board at Hamilton. Only emergency cases were admitted, and in other cases the Hamilton Board had to be and, then permission obtained. The Chairman: Who is that recognised ■by? Dr. Collins: I have received instructions from my Board, because it has been arranged by, the different hospital district boards'that we should not admit patients from their district, and vice versa. These patients are not to be admitted if they can be sent back by rail. The Chairman How has that come about?

Dr. Collins: The district hospital boards have come to the arrangement, Mr. Reed: The arrangement was made because if a patient comes from one district the charge for his treatment has to be paid by the board in the district from which he originally came. The Chairman: When seriously ill a person has a right to be' admitted. Dr. Roberton stated that the Rotorua township was not in any hospital district. Patients from Rotorua went to other districts, and the charge was sent to Rotorua. The Hamilton Board had had trouble with the Rotorua Town Board over the question. Hamilton was nearest to Rotorua, and therefore the most convenient.

Burke pointed out that he belonged to Auckland, and he was in Rotorua only for two mouths working. , The Chairman: The hospital is open to receive patients when they come to the gates.. Mr. Beet-ham considered an up-to-date hospital in a city was far more suitable for serious cases than a country hospital, where the necessary appliances would probably not be at hand. Because a man was poor he should not be prohibited from taking the best chances he could for recovery. Mr. Reed: The other districts won't allow it. They will not pay for the treatment of persons from their districts unless they first give their consent, or it is a case of emergency, which are never refused. '

The Chairman: If a man is seriously ill, it is a case of emergency. To refuse to adirfit a, man who is seriously ill because he belongs to another district is .wrong. Dr. Collins again rose to explain, but the chairman remarked: We will have an opportunity of hearing you later on, doctor.

The witness was questioned as to seeing Dr. Collins in the hospital while he was a patient, and Dr. Collins pointed out to him that he (the doctor) was on leave at that particular time.

Dr. Collins: How long did the cancer patient put the spoon he was using in the salt, and then in his mouth?ln eating eggs lie put the spoon in the salt and then in his mouth.

For how many days did you notice it?— One or two days I noticed him.

Did you make any remark to him? Another patient named Bell threw the salt out. -

A RAILWAY EMPLOYEE'S EX-

PERIENCE.

Victor George Swinbqurhe, railway storeman, living at Remuera, said that about six weeks ago he went to the hospital suffering from the effects of an overdose ..of chlorodyne. He was shown into the waiting-room on arrival, about ten a.m. He waited there for about an hour without any doctor seeing him. He was then shown into No. 7 ward, where he waited until about three o'clock, when Dr. Ferguson came to see him. This was the first time that he saw a doctor. He remembered a patient-named Bob Halifax. Mr. McVeagh: What was his behaviour towards you?—lt was very rough. He put mo into straps, and on one occasion he came and jumped on my cheat. >. Mr. Beetham: What was he supposed to be? believe he was an ex-patient, but at the time I did not know what he was. "Mr. McVeagh: Did you see him doing anything else?— Yes, I saw him injecting morphia into the other patients, and he told me that he also used it upon himself. He asked me if I would take a dose, but /refused. ' Where did he get it from?— From a cupboard near my bed. It was not locked. MORE ABOUT THE FOOD. Mr. McVeagh: What was the food like? It was very poor—in fact,) bad. The meat appeared to have been warmed up. I was only there a- week, and during that time I never had a warm meal. It Avas always hike-warn). What about the soup? was beastly. The porridge was served up in a mug without any sugar. The sugar we bought our'selves. On one occasion, when the food was bad, we had to have a tarpaulin muster to get something for tea. Mr. Beetham: A tarpaulin muster! What is that? < ! Mr. McVeagh: , It, is a subscription amongst the patients. What about the fish?—lt was often overcooked. Mr. Reed: Did you ever see the house steward visiting the wards at meal times? No. - ~■ ."-.■■ Did you complain of the —Yes, I complained to Halifax. He was in charge, and did the cooking, and washing-up. Did not all the convalescent patients help in the same way?— Yes, but not so much as Halifax. Was there not a wardsman named Cook in charge? —Yes, but when he was absent Halifax was "left in charge. Was it known that Halifax was administering morphia to patients?— it was common talk among the patients. Do you suggest that it was done with the knowledge of the officials?—l would

not like to suggest that. I spoke to Halifax about the ill-effects of morphia, but ho said the feeling was glorious. Did you speak to Cook about it?— No. I may say that I left the hospital sooner than I would otherwise have done but for that. I had to go to another doctor after I left the hospital. DR. COLLINS' QUESTIONS. . Dr. Collins: Why were you strapped down shortly after you went to the hospital?— think it was simply because Halifax did not want to be bothered with me. Were you a quiet, unassuming person at that time?— was at that time. ' Were you so all the time? No,-1 was delirious some of the time, when the chlorodyne had taken effect. Why did you take chlorodyne?—l did not take it. I was ill in bed, and it was given*to me in mistake for medivae. 1 did not inquire what it was. I had been suffering from the after effects of influenza. Did you take liquor for it?— No. If two doctors said that you were suffering from delirium tremens/ would you say that they were wrong?— decidedly I would.

Do you remember whether you were violent?— was not violent.

You know that chlorodyne is practically opium, and is it not strange that it should have affected you in the way you say?—l had had a lot of mental trouble at that' time.

Will you swear that you had not taken liquor, and that you did not have delirium tremens?l will swear that I did not have delirium tremens, and that I had not tasted liquor for a considerable time before that. • :

Mr. McVeagh: How long was it before you went to the hospital that you had any drink?—l had a glass about three weeks or a month before I went there. I was in bed for a week before I went to the hospital, and I had no liquor in the house. Mr. McVeagh said that as it had .been suggested ■ that the witness was suffering from delirium tremens, he would, like the bed chart to be produced. Mr. Reed said this would be done.

FURTHER EVIDENCE AS TO DIET.

Mrs. Emma Rose Mooney, of Pitt-street, said she broke her leg on the hospital steps, when leaving the hospital,on a visiting day last November. She was taken to the Costley Wards on the same afternoon, and the kg was set about noon the next day by Dr. Collins. Have you any remarks to make on the' food?—lf I had depended on the hospital food I would have starved. What was the condition of the fish?—-I could smell it before it came into the ward. What of the eggs?— They were boiled hard, like cricket balls. Not fit for patients. > . " y :

What was the state of the cabbage?— You wanted glasses to look at it. It was full of snails. The soup was coloured with

vegetables. How did you get on?— could not eat the food. My friends and children brought me food. How was the porridge?lt was bo lumpy and raw that I refused it, Did you complain?—l told one of the porters'that it was very hard that we had to pay and get food that we could not eat. He replied that he could not help it; he was carrying out his orders. Mr. Reed: Did you complain to the doctors?— did not see any doctors to complain to. ■ Did you complain to the nurses?— No. Did you send the food back?—-I left it. I used to have bread and butter and a cup of tea sometimes.

Why. didn't you complain?— was no good complaining. It was best to keep it to yourself. So long as I could get it from my home I didn't want it from the hospital. -When porridge was brought to me half-cooked and lumpy, I said: "I can't eat it; it is not cooked." * You did speak to the nurse, then?— Yes; but I don't remember her name. /

Dr. Collins: When you broke your leg didn't I examine it?—-Yes. : ,

Did I not have you sent to the ward?—Yes. ;■,-■■;■, ::', -.■■■■:■■ A , &&%$

Were you not prepared for chloroform that night?— don't remember anything; I was in great pain. - - I said I would put up your' leg.—l don't remember../. " . '

Do you remember asking me if I would do your leg, and I said I would?— of the nurses told me Dr. Collins v was coming in the morning, and I asked to have him sent along early.' ':';.-'." You said the cabbage was full of snails, did they have shells on? didn't have my glasses on, doctor. ' ; , :V You would have seen them had you had your glasses?— Certainly I would. J ANOTHER PATIENT'S CASE. Mrs. Elizabeth Harper, Edinburgh-street, Newton, said she was a patient, for 14 days in August,' 1904. She was first in ward) No. 9, and then removed, to No. .4 ward. No. 9 was a fever ward, but witness was suffering from blood poisoning. were two noisy patients in the ward at that time, keeping witness awake all night. The patients were delirious, and one had, to be strapped down. In No. 4 ward -one patient became very bad, and was for two days delirious, causing great excitement in the ward. AH the patients were upset. It'was a delirium tremens- case, and she was taken away. She was continually talking, screaming and singing out, and it took the nurses all their time in looking after her. What was the quality of the food?— The food was very bad. • In what respects?— was that bad that some of the patients could not eat it.- The fish was not good. , The potatoes were bad, and the beef tea was given without salt. The'bread was also very bad. At times I could not eat it at all. The eggs we got at times were. also very bad. . Mr. Reed/: You say the bread was bad?— Yes. '.. "- ; . * ', '

The tea?—lt was more like water. The fish was bad and insipid. There was no salt with, it, -and it had no taste. - Sometimes it was cooked on the one side and not on the other. ■ ■ t

What do I understand? Was it unfit for food?—lt was rank, and not fit to bring to any patient. . Did you make any complaint was the only complaint, in addition to insufficient attendance.by doctors. Did you say anything to anyone?— said I did not like it. I complained to Sister Wood, and she didn't seem to think anything about it. She said the other patients could eat it. •;. " EVIDENCE BY DR. INGLIS. Dr. Inglis, who was next called, said he was a resident of the Auckland Hospital for two years, and for a time was senior medical officer, completing the latter engagement in 1901. While 'there-he did not have cases of suppuration. He wasi on the honorary staff at present as lion, anaesthetist. When there were scarlet fever cases at the hospital under his regime there was no increase in cases of suppuration. In, his opinion, the administrative work of the hospital should be done the first tiling in the morning. When he was in charge he started on the wards at half-past eight. He lived at the hospital at that time. To leave the administrative work till ten or half-past ten o'clock would interfere with the visits of the honoraries, who arrived any time after.nine o'clock.

Mr. McVeagh: From your experience of hospital administration, do you think a hospital could be well looked after when the senior medical officer lived away from the institution, and came to the hospital about ten o'clock, leaving about four or five or six o'clock?—l don't think that would answer.

Mr. Beetham : Should he live at the hospital?At any rate, close to it. Dr. Inglis considered the production of certificates acted very well, but in a case of emergency should not be insisted upon. He had admitted patients without certificates. Mr. ; Beetham: You never allowed the porter to deal with cases?— The witness did not think it a good practice to put delirium tremens cases in the same ward as typhoid fever cases, as they would irritate the latter. When in charge he had carried out his duties in regard to giving lectures to nurses, and in addition to the lectures gave clinical demonstrations in the wards. The proper training of the nurses was important to the administrator, as well as important from the point of view, of the public. ■'■■■ • EMERGENCY OPERATIONS.

Mr. McVeagh : Who did the major operations during your time?—-The honorary staff. ■ ■ ] ■ ■'■' : ■■'l'. , "-\.r:h:

Did the senior medical officer do any serious abdominal operations?— don't think so. I did one while I was there. Do you approve of the system of the senior medical officer doing these operations? —No, I don't. , Had you ever any difficulty in getting surgeons in cases?— Any difficulty in getting them to attend consultations?— " 1' think we always had a quorum. In. what classes of cases hare consultations been called lately?— Consultations have been, called in oases where they were unnecessary, with the result that members of the hon. staff have got rather tired of it, and won't attend because it takes up a lot of time. '"•■>..'.-.

Were you present at a meeting of the hon. staff just prior to Dr. Neil's suspension?— Yes. ' Was there some discussion about emergency operations?— Yes. , Was Dr. Collins present?— Yes. What was the trend of the discussion? —On the subject of emergency work generally.". ; - '■ " Did Dr. Collins make any observation? He objected to the rule relating to emergency work being altered. The proposal under consideration was that the hon. staff should be called oh to perform major emergency operations. I understood Dr. Collins objected. Was a statement made as to the Board changing the rule?— Dr. Collins said it could not be changed without affecting the status under which he was appointed. 1 further understood him to say that it would mean his resignation if it was altered. *•■'>."?■ ' It has been suggested that Dr. Collins was overworked, and had all these things, thrust on him?— can't say. '. • .- Dr. Inglis said when he was in charge he always produced the consultation book, and had it signed at each consultation. Lately the book was -written up-and signed some time after the consultations had been held. Since the inquiry held at-'the hospital by Dr. MacGregor, he had been asked to sign the book to a consultation held before the inquiry. It was far better to sign the booJi at the time of the consultation. ; ADMINISTRATIVE MATTERS. "Mr. Reed: Do you approve of the method adopted in some of the English hospitals, of having a highly-paid manager, without any medical training, to act as administrator?—l think that would work better. . *•■.-'.: . v '/'ln one of the leading London, hospital^ \they have a non-medical manager at £1000 fk year, who was; formerly manager of a soap-works. What do you think of such an arrangement?—lt would all depend on, what the duties were. '.. ''-■'. Do you think the honorary staff could i-manage the hospital wiih the assistance of juniors.' — a secretary at the hospital and two, or possibly three, juniors would do. . . ;', : ( ' . Continuing, witness said that in his time he did most of the administrative work. The medical adviser did not interfere much. He understood that; the ar- ■ rangement was satisfactory. He did not ! know of any particular complaints as ;to | there being no one on. the premises with | sufficient experience to '■■' perform major j operations, but on returning from a holi- : day be found that the system had fallen | into disrepute.; On being questioned as to | the honorary staff's recommendations (as I embodied in Dr. Pentreath's letter), witness said he thought the staff were coerced into that position. If the Board said practically that the senior medical officer must be on the staff, of course, they would carry it through. With regard to delirium tremens and consumptive cases, he always tried to' isolate them., but it: was difficult to do this in entirety, especially in regard to female patients, owing to the. lack of accommodation- The septicaemia cases were usually kept separate. The Commission then adjourned till ten o'clock this ..morning. ;