HOSPITAL COMMISSION.

New Zealand Herald, Volume XLI, Issue 12698, 28 October 1904, Page 6

HOSPITAL COMMISSION.

CLOSE OF DR. NEIL'S CASE.

EVIDENCE BY DR. MacGREGOR.

SOME INTERESTING STATE-

MENTS.

CHAIRMAN OF THE BOARD

EXAMINED.

The sittings of the Royal Commission appointed 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.,and Mr. S. E. McCarthy, S.M. Mr. R. McVeagh appeared on behalf of Dr. J. Hardie 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, Dr 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. EVIDENCE OF DR. INGLIS. Dr. Inglis, who had been called the previous day, continued his evidence under cross-examination by Dr. Collins. He considered he was in charge of the hospital when, senior medical officer, but his position was never defined. Dr. Bedford was medical adviser, and attended the Board meetings. At the time witness was recommended to fill the position now occupied by Dr. Collins, he did not think rule 72, relating to emergency work, was in force. Routine work of the hospital had been interfered with by the irregularity of visits of.the staff. He put up fractures while he was in charge, and attended them afterwards under , the hon. staff. The house physician assisted at operations, attended fever patients, and carried out post-mortems,' but the work was so arranged as to minimise any risk of infection. When a bad case came to the hospital, and the two residents were engaged on an operation, one of the residents left the operation, either at once or*at a convenient time.

In reply to Dr. Roberton, witness said the Hospital Board had too many institutions to look after at present they had no medical knowledge, and the members were elected for too short a period. The effect of annual elections of the Board prevented members from taking a proper interest in the work, and also tended to make a continuity of policy impossible. When witness was in charge all the members of the Board did not frequent the hospital sufficiently to gain a thorough knowledge of the working of the institution. Mr. Bruce and Mr. Sitchbiiry, as succes- ' sive chairmen, were often there, and showed a real interest in the institution. ; Mr. Gordon also attended pretty often. The Fees Committee were also often there. There had been a difficulty with two resident surgeons in taking in patients, but he did not think there should be any difficulty with three residents. He objected to persons able to pay for outside treatment being admitted to the hospital, as it took away beds from the sick poor, and was unfair to ratepayers and taxpayers. ! It was also unfair to the honorary staff to ask them to treat patients in the hospital who were in a position to pay. for outside treatment. It was also unfair to the nursing homes. He had frequently heard it stated by patients that they were too poor to go to the hospital. He had told them hi 'some cases that the Board would probably remit the fees, but they had replied that they would not car© to make a request for remission. ! , Were they Scotch ; foik?—Some of them. (Laughter.) ; . Witness, continuing, said that in many .eases patients, after going to the hospital,; had their recovery' retarded by worrying over the fees, and in many cases they left before they were really fit to do so. He thought the tenure of office of the honorary staff should be for a longer term, and he approved of the idea of assistant surgeons. With proper precautions there should be no danger in the physician who attended to ordinary infections cases giving ancesthetics. He did not approve of the senior medical officer being present at all the meetings of the honorary staff. He should be there by invitation. His presence at all meetings tended to restrain discussion, and also placed himself in an invidious position. He did not approve of the senior medical officer, as a subordinate, being the only means of communication between the staff and. the Board. He did not think the senior medical officer should do any operations. Casualty work should be done by the junior residents, under the supervision of the senior medical officer, who should be really a medical superintendent. There were more medical than surgical emergencies, and there was no reason at all why, the senior medical officer should be more of a surgeon than a physician. There was not sufficient accommodation in the hospital for women. He did not approve of such cases as those of consumption being put into the typhoid ward. ' . VARIOUS SUGGESTIONS. Witness stated that the present constitution of the Board, even with medical representation, was not satisfactory. The Board should be'elected for a period of years, with representation of ratepayers, medical profession, and the Government. It should be distinct from charitable aid. Mr. Reed here pointed out that tenders were invited by the Board in 1901 for the erection of a new lift for the hospital, and the price tendered was £1095. It was a question of finance at that time. The witness said he was not in favour of .the senior medical officer doing any operation under the present conditions. His idea was that a resident secretary could look after the administration work, with three resident medical men. Mr. Reed: That is another system. We have tried many systems. Mr. Beetham: That is the system that obtains at the Christohurch Hospital. Dr. Inglis, re-examined by Mr. McVeigh, said when he was in charge admission was never refused unless the hospital was full.

The Chairman: When a man is turned away in the fashion described, and told to go and get an order from a medical man, if he goes to a medical man, and was examined as to his fitness for admission, I presume a fee is payable?— is payable, but is not always got. The Chairman: I don't say it is, but is there always a fee to be paid by the patient? —Yes.

Mr. Beotham: With a properly organised honorary staff, with hon. assistants, and if the patients who are able to pay are excluded from the hospital, do you think that a resident surgeon and physician, with the resident secretary, would be able to cany on"the work satisfactory?— They would have on the work satisfactorily They would have surgeon, a physician, and a man to attend special departments. Mr. Beetham : At all events, there should be three men. Should they be young men? —Yes. With the Costley wards away from the main building, with imperfect sanitary arrangements and obsolete lift, what would you recommend to put the building in proper working order, so that all concerned could work to the best advantage?— would be almost impossible to make the present building suitable. It would be the beet plan to convert the Costley wards into surgical wards. r , JL°" ld y °, Sl l gg€st the building of any £XL ° T^ the °P CTati theatre in the centre?-It » quite possible it, would be necessary to do that. Should the residents be resident in the new building?—l think so. THE SENIOR MEDICAL OFFICER'S NEW HOUSE. The Chairman: What about the new house?

Mr. McVeagh said it was nearly completed. It was ■■■ intended for ill© senior medical officer. Dr. Inglis expressed the opinion that the resident secretary and the resident medical staff could live in that budding. There was very small accommodation in the hospital for the resident men. The Chairman: What is the ccst of the now house? ! > "■ '' \ Mr. McVeagh I understand about £16,000. The Chairman: The Board can afford £16,000 for the medical officer, yet they cannot afford £1000 for, a lift to save the lives of patients. Mr. Reed: One of the complaints was that the medical officer lives too far away. The Chairman: He should not live too far away. Mr. McVeagh: Dr. Baldwin lived close byMr. Reed: But there are no houses -to be had there now. ■,

Mr. Reed (after turning to the chairman of the Board) said the private house being erected was costing £1290, and comprised 10 rooms.

Mr. Reed to Dr. Inglis: Of course there is no accommodation in the hospital for a married —Nc.

The Chairman: Well, then, he should not be married. If the junior residents, on applying, were married, they would not be appointed. Dr. Inglis: In Sydney a man when he got married had to resign. The Chairman s Just so. THE PEAKE CASE. Matron Bowles was recalled by Mr. McVeagh in reference to some correspondence concerning the case of William Peake. Dr. Collins had written to her for some information on the subject, and his letter and the reply were read. The witness, in her letter, stated that her memory was not very clear in regard to the details of the case. DR. MCGREGOR'S EVIDENCE. Dr. ■ MacGregor, who was called by Mr. McVeagh, produced the copy of the evidence taken by him at his inquiry at the hospital last month, and his report to the Government on tho subject. Dr. Iloberton said he did not consider it advisable to cross-examine Dr. MacGregor, ho being a Government servant, but Dr. MacGregor expressed his willingness to answer any questions. The Chairman: Probably Dr. MacGregor may offer some opinions. Of course, when we consider our report we shall take his report into careful consideration. In reply to Mr. Reed, Dr. MacGregor said that the Auckland Hospital, in its time, had been a very fine hospital as hospitals went, but it now possessed several defects, owing to the recent advance in i specialisation in medical science. The hospital was not now up-to-date, and to make it so certain new buildings should be erected. This would mean a large expenditure of money. He considered the position in which the new operating theatre had been., placed required that the whole of the block there should be devoted to surgical cases. Every penny that the Board coidd scrape together for '■ years ; to come ought to be devoted to the pulling down of the wooden building (Nos. 8 and 9) and the erection of new wards on the same site; with the present accommodation very little improvement could be made with the exception of the-lift and sanitary improvements, beyond what had been done. Generally the Board,, with tho existing accommodation., were doing as well as could be expected. The back steps were only a survival of some mediaeval, manor house. He had stated this long ago, but he had ho power to compel anything to be done. Mr. Reed: Do you think the old building should be pulled down?—No; it would! be a pity to do that, as for certain classes of cases it could not be beaten' in tho ! world. '-,• ■ ..■'' : ; '. i. :-;■•".■ '~■"' -■■::■]

In reply to a question by Mr. Reed as to the Board being able to afford to effect improvements, Dr. . MacGregor remarked: I have known the Auckland Boajjd to pretend they were poor when they were not. (Laughter). THE BOARD AND PUBLIC OPINION.

Mr. Reed: Should patients be admitted free?—No, execepting those mot able to pay, the hospital being largely for the

poor. . ': Would you propose; to exckide persons from the hospital able to pay for outside assistance?— members of the Board and the medical staff must, not he afraid to do their duty no matter how the press or public may clamour. Do you say the Board has been influenced by the public?— am not prepared to make any such general statement. I won't be caught like ■that.* Caughter.) In vain is the net spread in 'the eight of any bird. (Renewed laughter). CONSTITUTION OP THE BOARD. Mr. Reed: What should be the constitution of the .Board?— Well, we are living in a democratic country of an advanced kind, and in asking me that question you want me to discuss the political and social position of the country, What improvement do ycu suggest?— There would be an improvement if the public exercised a little common sense. For instance, the alteration of the suffrage upon which the members of the Hoard are elected, which has been spoken of and contemplated, to that on which members of Parliament are elected. Would the same result be obtained under the present elective system?— Practically the only result obtained under the existing state of things is confusion. What is your opinion as to the constitution of the Board to secure better results?— I have thought the Government should be represented as finding more than half the money. The Government 5s not at all represented. No locus standi. I do not know if the Government has really even the power to elect a Royal Commission to see how you are getting on. (Laughter.) With Government representation, is the Board likely to be better constituted from a patient's point of view?ls there a papoint of view? It is a figure of speech, and we are now dealing with accurate ex« pressions. None of the doctors have given a clear reason why, a board, with nominated members, would be in a better position to satisfy, patients than an elective board. What is the reason?lf it is a case of patients perpetually demanding things without paying for them— board likely to give them things for nothing out of the pocket of the ratepayer— I admit it certainly would not be so advantageous to the patients. I am afraid I can't get anything more definite than that.—You can try. (Laughter.) I think perhaps it is a little too definite, and not indefinite. I don't wish to " be charged with giving indefinite answers, not even by implication. Would the medical profession having representation on the Board be of advantage?— Judging of the wisdom of the medical profession of Auckland by the representations made by them, I say it would not be good. (Laughter.) You don't agree with the representations made?— Certainly not. Where are the members of the Board to get their guidance from?— They want to listen to me. (Laughter.) But' you are not always on the premises? — am always accessible, and I give straight answers. Has the Board made errors through following the advice of the medical profession? —Certainly. I don't think with a board of Solomons you would have got the medical profession to pursue the path of common sense with regard to the Auckland Hospital, even during the time I have seen it. In reply to Mr. Reed, witness said he thought that the present annual elections 1 of members of the Board were a disadvantage. He would favour a system under which, say, three members would retire every year, as it would ensure continuity of administration except in regard to the secretary, unless the members were reelected. As a consequence they spent most of their term in learning their duties. As to whether the Hospital Board should be distinct from the Charitable Aid Board, was a big question. There was no possibility of curing the hospital evils in the colony, both here and elsewhere, without local government- reform. Supposing, say, nine-tenths of the existing local bodies were abolished, and they had a few large organisations, hospitals, perhaps, would i be placed in,charge of one committee, and I so on. Ho certainly thought that the lady

superintendent should attend to the inspection of the food, and he~had been astonished and staggered to hear her say that she did not do it now. Mr. Reed : Should not the house steward see to that? —Yes, he could go also, but it should certainly be done also by the lady superintendent. You mean they should go together?— Yes, if they were sufficiently good friends. (Laughter.)

STATUS OF THE SENIOR MEDICAL OFFICER.

Mr. Reed: Have you any other suggestions?— think the present relations between the resident and honorary staffs in the Auckland Hospital are preposterous. 1 object to the position either thrust upon or arrogated by the senior medical officer. His contention is that the honorary staff have thrust upon him certain duties which he should not be called upon to perform. It appears to be j arguable on the other side, and it seems with more likelihood of success, tha?t he has arrogated these functions to himself, and that the Board has connived at it, the result being the present mess in which we find ourselves. But, according to the letter sent to the Board in 1901 by the honorary staff, they seem to have acquiesced in that position? Yes, apparently, but what they were thinking of I am unable to understand. You think that in that case the profession wrongly advised the Board?—Ves, not only wrongly,, but, what is worse, stupidly., (Laughter.) What should be the duties of the junior residents?— should undertake the whole work of the institution under the supervision of the honorary staff. Do you think there should be no medical superintendent at all? Dr. MacGregor (with emphasis): No. The hospital is not large enough to justify anything of the land. Mr. Reed: Do you agree with Dr. Inglia that a business man or secretary should be the really responsible man in the hospital?— I do not. because a layman would be absolutely helpless in directing any department. SOME SUGGESTIONS. Mr. Reed : Do you think there should be a senior medical man in charge? Yes, if you have three residents—l cannot myself agree that more than two are neces—and one of them proved capable, you could give him extended powers in regard to supervision. I think he could do with one assistant. Dr. Inglis said it was hard work, but I would like to know exactly what he calls hard work People can make work for themselves, you know. Would you allow the man in charge to perform operations? Yes. "l Could he attend to fractures? word "fractures" is a most dangerous one in the hands of a lawyer when he is trying to trip up a witness, but I am not going to be tripped up. (Laughter.) Could he set fractures? That term also is old-fashioned. He could set some fractures.

Should he be responsible for fractures? —Responsible to whom? To his employers, the Board?— How could he be responsible to the Board for setting fractures. Could he do major operations?— is another out-of-date terra, and I object to it. Persons who have allowed themselves to be tripped into the use of it have placed themselves in a false position. ; Supposing the senior resident was performing an operation, and his only assistant whs administering tiho an aesthetic, who would attend to patients seeking admission? —In such case the duty (should be delegated to soma other capable officer. It only requires a little common sense. It would be a very unusual thing for both doctors to be occupied as you say. I . have performed operations and given the anaesthetics at the same time, with no one to help me except some old woman. " Operation" is a very indefinite term, and seme can easily be post-: poned or interrupted when, there are more important matters to bo attended to. A " DOUBLE-BARRELLED QUESTION,"

Dr. Roberton: Do you think it would be an advantage if the members of the Board had a medical education?— That is a doublebarrelled question. Fire one barrel at a time. (Laughter.) ; \ .':>■ ■'■'- '■ Matters may come before' the Board of a technical nature. Could a Board with no medical knowledge deal with it satisfactorily?—lt would depend on the expounder or the writer of the letter if it were in the form 'of a letter.

Would it not be an advantage if a,member of the Board could explain the medical terms?-— is the other barrel. Are you going to fire it now? (Laughter.). You were formerly a professor of mental science at the Otago University? Yes. Did you find that knowledge of advantage? —Well, yes. Most of the time that I held that position I was in charge of the largest asylum in the colony. lam now the oldest official in connection with asylum work in the colony. . \ You have, I (suppose, found it advisable sometimes, even when dealing with an insane person, to give a straight answer?— Well, Socrates once asked whether a man was justified in. telling a lie. I think a medical man sometimes is in speaking to a patient. , Still you would condemn a medical man who did tell —Yes ; if done unnecessarily. . . Let us return to the point if we can.— you can, you mean. (Laughter.)

Witness, in answer to further questions, said that members of tiro medical profession, did not always make good members of local bodies, but he thought that the chairman of the honorary staff should be in communication with the Board Mr. Reed : You have said that the Board has got into trouble through listening to the medical profession. Have they not also got 'into trouble through not listening? Very likely. THE "SICK POOR." ' Mr. Reed : Do you think hospitals should be restricted to the sick poor?— That is what hospitals are supposed to be for; but in definiug " sick - ' and " poor" there has always been a difficulty. I have seen people driving up to the outdoor department of a hospital in their own buggy and pair. I think that if people say they cannot afford to pay, it should ensure instant admission! into any hospital. Dr. Roberton read a letter sent by the Board to the staff in July, 1901, suggesting the appointment of a senior medical officer, and asking the Board's opinion. The Board, in reply, suggested that the then senior resident should be advanced to that position, with an increase of salary, that he should be assisted by two residents, that he should administer the out-patient department, give primary treatment to cases upon admission, and supervise the administration of anaesthetics.

Replying to a question regarding this letter, Dr. MacGregor said he objected to the position which the senior medical officer had appeared to desire to conquer for himself, either through the supineness or "onnivance of the staff. He had never previously heard or any other rnan in Dr. Collins' position-performing sudh operations as he (Dr. Collins) had been called upon to perform. The staff's advice, if sternly insisted upon, might have obviated the position. The Board had apparently, in its rules, conferred upon the senior medical officer power which he should not have had. CLOSE OP COMPLAINANT'S EVIDENCE. On resuming after the luncheon adjournment, Mr. McVea;*h intimated that he had examined all the witnesses he intended "to call, and then handed in various documents relating to the charges made by Dr. Neil against Dr. Collins and the Board, A BED CHART. Mr. McVeagh stated that he had asked for the bed chart of the patient Victor George Swinbouroe because it had been sugge'std that he was a delirium tremens case, while the patient contended he was suffering from an overdose of chlorodyne. A chart had been produced, but it' was so obvious that it was recently written out that ho objected, and inquired for the original, which he was told had been destroyed. The Chairman: The original been destroyed? Mr. McVeagh: i understand so. Mr. Reed pointed out that the original copies were only kept for a short time. .The

chart of thin particular patient ted been, destroyed along with others. , Mr. McVeagh (continuing) said he objected, because it was stated in the chart that the patient was suffering from delirium tremens. In the discharge-book the case was stated to be one of chlorodyne-poison-ing, so a chart to that effect was insisted on and granted. In justice to Swinbourne, he had the chart produced. AN INDISPOSED WITNESS. Mr. McVeagh stated that Dr. Williams, of Avondale, who was too ill to attend the Court, desired to give evidence to the Commission. The doctor had for 16 years been in charge of the Thames Hospital, and could give valuable information in regard to hospital management. The Chairman intimated that the Commission would like something more definite as to what information Dr. Williams could supply before consenting to spend a day in going to his house. Mr. McVeagh stated that the doctor had also been on the honorary staff of the Auckland Hospital for two years. ■ Dr. Roberton said he did not know in what direction, the evidence of Dr. Williams would be, but recommended that it should be obtained. He was prepared to say the evidence of a man of the skill of Dr. Williams would be accepted by the Medical Association as of great value. The Committion decided to take the evidence of Dr. Williams at his residence on Saturday. CHARGES BY THE MEDICAL ASSOCIATION. Dr. Roberton then proceeded with the allegations brought forward by the Medical Association against the management of hospital affairs by the Hospital Board. He pointed out that ' the allegations were quite distinct from the charges made by Dr. Neil, and he would like to have been able to bring his evidence in a systematic way, instead of being required to examine witnesses in the order called by counsel for Dr. Neil.

THE CHAIRMAN OF THE BOARD.

The first witness called was Mr. George Joseph Garland, who said he had been a member of the Board for four years, and represented the Manukau County. This was his second term of chairmanship. Previously he had been chairman of road boards, a member of school committees, and licensing committees, acting as chairman of the latter on one or two occasions. He had no actual experience of hospital administration prior to being appointed on the Auckland Board, but had visited the large institutions .if New South Wales. The Manukau County was a portion of the Aucklaud Hospital district, and he was elected by the local bodies, numbering 29 or 30. The election was held annually. Dr. Roberton: Who notified you of your election?l saw it in the Auckland papers. Not officially?— was a returning officer elected.

Mr. Garland said candidates were elected by the local bodies, who had one vote each, excepting one borough council, which had four votes. His election had been annual for four years, and it had been contested. The interest the districts had in hospital affairs was that underlying the broad principle of democracy, viz., where there was taxation there must be representation. The local bodies were not the only contributors. The expenses of the hospital annually were £12,000, roughly, of which sum the Government contributed half, and the local ratepayers the other half. SERVICES OF HONORARY STAFF. Dr. Roberton: Do the hon. staff contribute towards the maintenance of the hospital?—

Are their services not of monetary value? —I don't think so. If the staff was Tinreasonable in their recpiests they would cost the Board money.

Witness went on to say that if there was no hon. staff the work they were doing would be carried out by the Board retaining medical men at a cost of £600 to £700 more than was now being paid. Two more medical officials, a junior and a senior, would be required, and witness thought they could do all the work at present being done by the hon. staff. They possibly might not do it as well. It would depend on the cases coming in as to the cost of consultations, which would require to be done outside. An hon. staff would save £700, or even double that, if they were not unreasonable in their requests, but witness would not admit without consideration that the staff contributed that amount to the hospital maintenance. .If they did it would be right, on the broad principle of democracy, that they should have representation on the Board.

Dr. Roberton questioned the witness as to the law relating to the appointment of representatives to the Board, and the chairman remonstrated, remarking: You may give us credit for having some knowledge of it. I must confess we are intelligent, and quite willing to listen, though. LOSS OF TIME. The witness said the Board managed the hospital and Cost-ley Home, and the general business pertaining to these institutions. In arranging finances the Board had been hampered through pressure 'brought to bear through the press. Tho non-payment of contributions up to date by local bodies had been inconvenient, resulting in the Board being short of funds at times. A board should ■ always • have its finances in a sound state. In giving particulars of the time members of the Board ordinarily devoted to their duties, Mr. Garland said members would give up a full day a week, and a chairman three days a week. Dr. Roberton: Are there many members of the community who could afford thattime?—l suppose there are. Are many prepared to do it?— don't know. 1 won't be prepared to do it after this year. (Laughter.) Witness said he could not say if members of the Board had had previous experience of hospital administration, but ho did not think the members of the present Beard had had a medical education, which would be an advantage. He did not remember if necessary improvements at the hospital or a change of policy had been deferred on account of the election of a new Board approaching. DR. COLLINS' APPOINTMENT. Dr. Roberton: What led up to the appointment of Dr. Collins to the hospital? Was it a public agitation against the hospital being "run by two boys?"— .said the Board had to acknowledge this, and communicated with the hon. staff, asking their advice on the matter. A reply was received, partly affirming the appointment of a senior medical officer, at a salary of £500 a year. Witness subsequently admitted that the hon. staff favoured the appointment of three medical tten, and that he regarded the alternative suggested by the hon. staff, that Dr. Inglis be promoted to superintendent, with an increased salary, as an affirmative reply. As the staff would terminate their appointments in nine months from that time, the Board did not give much consideration to the recommendation of the staff. A letter was written to the staff in reply, and Dr. Pentreath (secretary of the staff at that time) wrote about four months later. Prior to Dr. Collins' appointment the Board had it strongly impressed on them that the man appointed should have had some experience in surgical work, and the members of the Board had that in their mind in making the appointment they did. They realised it was- necessary to have a man able to assume responsibility for operations in the absence of the hon. surgeons. Probably the best and legitimate course to adopt would be to take the advice of the hon. staff, but he further admitted (hat the advice given by the staff in regard to the appointment of Br. Inglis was disregarded. The letter written by Dr. Pentreath, as secretary of the honorary staff, remitting recommendations, was referred to by Dr. Roberton. Mr. Garland stated that Dr. Collins attended Board meetings, but did not vote.

Did you intend that lie should vote at the meetings of the honorary staff V— did not look at it in that way. The rule regarding the senior medical officer being the medium <>f communication tweeu the honorary staff and the Board had, the witness eaid, been honoured more in> the breach than the observance. He

did not distinctly remember a recent case in which he objected to' a communication because it did not go through the senior medical officer. Witness said the senior medical officer was made responsible for the giving of anaesthetics, because there were some deaths under chloroform, but the responsibility had been removed since' the appointment of an. Hon. anaesthetist. Dr. Roberton: Are rules 56 and 75 compatible? One says the (senior officer shall assise at operations, and the other that he may delegate the administration of anaesthetics, but shall be responsible to the Board in case of doubt as to proper administration Yes, I think so. Is it fair to put such duties on the senior officer—assisting at operations and making him responsible for the giving of anaesthetics, which he could not control?—lt does not seem fair.

What was the object of the Board in wishing the senior officer to attend meetings of the staff?—l don't know. What effect it had I cannot tell, not being present. ' Are you. in favour of continuing the rule? —I cannot tell. I will tell in a month's time. .''"..;

" Mr. Garland said the senior medical officer was often consulted in hospital work. Personally, he had not consulted him in the appointment of the honorary staff, but hebelieved they consulted in regard to the appointment of Dr. Neil to the honorary staff. Dr. Roberton: Do you think it wise to consult on such a matter? — course, I do.

Does it net put a, dangerous power in the hands of the senior officer?— don't think so, if you trust him. ' Had the medical side any consideration when the Board was determined to appoint a man of ripe surgical experience as superintendent?—l thought a man who was a good surgeon would also have good qualifications as -a medical man. I know eminent surgeons who are good medical men. Will you name one?I will, if I'm pressed

Dr. Roberton : May I press the question, Your Honor? * Witness: I'm not afraid to mention it. Dr. Roberton: I won't press it. Your Honor. - -

Continuing, the witness said the senior medical officer was consulted sometimes in regard to finances, but he was not allowed to reply to a deputation from the honorary staff, which waited on the Board in March, 1903, in regard to the Board's finances. Some technical questions .arose, and the senior medical officer was asked to explain, them. Witness himself replied to the deputation. Dr. Roberton.: Has the senior officer kept all the hospital rules? • Witness: You and I are not able to keep the ten commandments, so I don't know how you expect the senior officer to keep 47 of them'. '.•••.';' The Chairman : You are. not paid for keeping the ten commandments.' (Laughter.)' At this juncture the Commission adjourned till ten o'clock this morning.