THE New Zealand Herald AND DAILY SOUTHERN CROSS. MONDAY, JULY 26, 1926. PUBLIC HEALTH.

New Zealand Herald, Volume LXIII, Issue 19389, 26 July 1926, Page 8

THE New Zealand Herald AND DAILY SOUTHERN CROSS. MONDAY, JULY 26, 1926. PUBLIC HEALTH.

The official opening of the Wallace Wards was appropriately made by the Minister of Health an occasion for reference to public benefit from hospital service. Too often that benefit is inadequately valued. It is provided, in the main, out of the pockets of the people, through contributions from the Government and levies on local authorities: and there is an inevitable tendency, where routine is followed, to let the keen edge of appreciation get dull. The larger the administrative machinery becomes, the more pronounced is the habit of taking its operations as matters of course. The Minister is happily not content to look at things so. It can be said of Mr. Young that he regards the Health 3 portfolio with admirable earnestness and is bent on increasing the efficiency of the department. His speech yesterday manifested a due regard for the place the public hospital fills in the life of the community and also a commendable eagerness that that place should be larger still. This attitude was evidenced both in the things he cited, as ground for gratification and those that are occasioning him concern. It is an attitude that the people of the Dominion should share with him. This country, for instance, may reasonably pride itself on an exceptionally low mortality among infants of less than a year in age, but there is nevertheless an unduly large death-rate of infants within a week of birth, and that there are more deaths within a month of birth than during the following eleven months is a fact demanding remedial attention. Even more imperative is the need to check maternal mortality.

Mr. Young does well to suggest, in the light of such facts as these, that the public hospitals should play a larger part, in co-operation with the Health Department, in endeavours to prevent the spread of disease. As he points out, the controlling boards have at present two functions, one as administrators of the district hospitals and the as dispensers of aid to the needy poor. His suggestion would add a third function, by the extension of the hospitals' out-paitent work beyond their walls. He would not have the hospital wait until people come to it, but see its service taken out to the people. At fihSt glance, this may seem a radical departure lacking warrant. A close co-operation between the hospitals and the Health Department in a campaign to check the inroads of i disease, however, is highly desirable. It accords with the opinion, everywhere winning way, that the only rational policy in public health is to take preventive as well as curative measures. There is absolute certainty in the contention that, on the score of expense, a great* saving would be effected if disease were fought where it emerges instead of waiting until its ravages fill the hospitals with victims. From the nursing staffs of the hospitals could be furnished a very fine auxiliary force for the Health Department's preventive work. It would mean increasing those staffs, but the proposal resolves itself into a problem of organisation not beyond solution. Such an idea is more closely in keeping with the actual hospital work of the boards than is the dispensing of charitable aid now undertaken by them. In both matters that Mr. Young has instanced—maternal mortality and the high | death-rate among very young infants —this suggestion has promise of good results. The distribution of instructive information might remain as a direct responsibility of the Health Department; the supply of skilled nursing assistance could be undertaken by the hospital authorities. When the details of some such arrangement have consideration a method of advantageous co-operation should be evolved. All concerned should be prepared to give the suggestion a sympathetic hearing. What is said about the enlargement of the board's functions should not be interpreted as favouring an unchecked growth of the hospitals under their control. Indeed, it is part of the anticipated advantage of the projected departure that it will retard 'the demand for curative treatment and therefore cheek the necessity to build larger hospitals. Experience has already shown the tremendous possibilities of preventive means. Their extension may confidently be expected to produce ever greater results, Public hospitals, while still unfortunately necessary, should become less and less places of cure, and more and more bases of preventive campaigns ; and in fulfilling their new function, gradually becoming more characteristic, they should not make demancls for large expenditure on buildings and equipment. The Auckland Hospital presents an example of a rapidly increasing curative institution. The opening of the new block emphasises a growth so great and rapid that it puts an undue tax on administrative control and entails a risk of failure to maintain the level of efficiency. It is true that the hospital district is large and increasingly populous, but this does not necessitate the massing of buildings on one site. A halt should be called to this gigantic concentration. In the Minister's proposal, implying the gradual displacement of curative by preventive measures, there is supplied an impressive reason against adding a single new block to the number now assembled in the midst of this city.