TOO MANY OPERATIONS.

New Zealand Herald, Volume LXIII, Issue 19389, 26 July 1926, Page 10

TOO MANY OPERATIONS.

THE MINISTER'S STATEMENT.

/VIEW OF A MEDICAL MAN. " FAULT OF THE LEGISLATURE." [Br TELEGRAPH.-—OWN CORRESPONDENT. ] WELLINGTON, Saturday. A statement made in Parliament by the Minister of Health, Hon. J, A." Young, suggesting that too many surgical operations were being performed in New Zealand and that some legislative action might have to be taken, has been commented! upon a good- deal both by the public and. the. medical profession. I' Interviewed ,■ to-day on the subject a well-ktiown'. Wellington practitioner said, the only direct evidence to show that too many operations were performed in New Zealand! was the surprisingly lengthy list of operations performed in some of the smaller hospitals. ■ "This," he added, "is thq fault of the Legislature, and shows the curse- of hospitals is politics. When the Hospital Act was passed in 1908 the Government at first assented to expert advice that the number of hospital districts should be restricted to twenty, but ultimately Parliament created more than double this number. Serious major operations, except in casoof emergency, should be performed in a relatively few large base hospitals with X-ray, bacteriological and other deparments, where the question of :the Necessity of operation can be considered by experienced consultants. As out by Dr. MacEachern many of our public hospitals are one-man hospitals, •the doctor not" only, being •,supposed to-be a capable administrator, but capable also of considering the need' for. operation in any case and. operating on any part of the body, the eye, the car, the brain and so on. An Absurd Position. "This is an absurd position for any man to occupy and a menace to the public. The New ' Zealand hospital system should be !altered, as is being done in Victoria, in the direction: of limiting the number of hospital districts, eliminating unnecessary hospitals, classifying hospitals, prohibiting major operations in minor hospitals except in case of urgency, supervising subsidiary hpspiials from the central base Hospitals, etc. ''The British Medical Association has done much to eliminate unnecessary operations and to insist upon pathological reports on organs rfemoved or parts of organs removed at operation so as to check surgical judgment and surgical technique. There is no inspector of hospitals at present in New Zealand to help to supervise hospitals, inquire into surgical methods, and co-ordinate the work off hospitals on approved standards.

"In regard to the closing up of unnecessary hospitals and allowing new hospitals to . be established control should be in. .the hands of a nqn-political board, as in Victoria and elsewhere, because a new hospital may be established anywhere as the result of 'wire-pulling* or political agitation. A hospital to be successful is judged by the public through the number of successful operations performed and a premium is placed on a.'tendency to encourage operations • whichj" if' justified, should b.e per-, formed under proper supervision, " Terrible Responsibility." "No profession is charged with such terrible responsibility as the medical profession, and the most efficient control must come from- within the profession itself. The Medical Council of . Now Zealand exercises under the Supreme Court.penal powers of discipline, but . the body which has most control in upholding high ethical standards in the medical profession is the British Medical Association, just as the Law Society acts for the legal profession. Our law makers, judging by public utterances and the reports of Parliamentary debates, regard the B.M.A. as a trade union, a term applied in a derogatory sense, even by Laoour members. "Too many operations are performed, si no doubt, but to what extent is a matter of conjecture. Also, too few operations are performed. Certain patients whose cases end fatally might be saved by earlier operation and some die for the want of operation through, too much reliance upon medical as opposed to surgical treatment. The Need lor Experience "Doctors should gain experience in surgical procedure by a term of apprenticeship as house surgeons after qualification, and afterward in assisting experienced and competent surgeons. To put a young, inexperienced man in charge of a hospital or'on ft staff .as. honprajry surgeon is to invite unnecessary operations becanse the best surgeon is not the man who has mere manipulative dexterity, but the man who knows when to operate .and when not to., operate. ■ £* i'Are there too many operations ? Are there too many law suits ? A great deal depends on obtaining men of-high ethical principles for responsible professions, and not a great deal can 'be accomplished by legislation." r ,