HOSPITAL POLICY.

New Zealand Herald, Volume LXVI, Issue 20242, 30 April 1929, Page 13

HOSPITAL POLICY.

AUCKLAND INSTITUTION,

CRITICISM BY DR. GUNSON.

MEDICAL MAN ON BOARD URGED.

Believing that (lio administration of tho general hospital, as directed by the Auckland Hospital Board, falls short of that degree of efficiency that should obtain, Dr. E. B. Gunson explained to a large city audience las! evening the main reason prompting him to seek election to tho board at to-morrow's poll. " I appear before you as a candidate from the conviction that the presence of at least one medical man on the board i 3 essential to its economic administration," ho said. "I am not standing on my own initiative. Ido not pretend that any high sense of civic duty has prompted me to think this out for myself. On the contrary, some of my medical colleagues pointed out to me the desirability of a medical man being on tho board, and suggested that 1 for various reasons, would be a suitable man to offer my services, mainly because I was not a member of the honorary staff."

Dissociating his criticisms of the board from personal considerations, Dr. Gunson claimed that failures of administration, such as he would indicate, were bound to arise where a hospital board was composed entirely of laymen. Dr. Gunson considered Auckland had been very fortunate in having men of high standing and undoubted integrity on the board. He paid a particular tribute to Mr. W. Wallace, who had been chairman for nine years, a record of public service of which Mr. Wallace might well bo proud. Tho speaker made the further explanation that he was standing in an entirely independent capacity. The British Medical Association would not wish him to sta7id in any other capacity, and, if elected, he would be entirely free to exercise, to the best of his ability, his judgment on matters that arose. " Amazing Waste ol Space." The Auckland Hospital had grown from small beginnings into a very large institution. its situation was ideal, and citizens owed a debt of gratitude to Sir George Grey for his vision in that regard. But one aspect that had forcibly impressed tho speaker was the amazing waste of space in the hospital grounds. Buildings had been dotted down here and there regardless of their relation to each other, and tho institution had seemingly grown up like the proverbial lopsy. Dr. Gunson at a later stage suggested that the architects of Auckland would willingly co-operate with the board in planning for future needs on more uniform and economic lines, and to that end he suggested the offering of a small prize by the board for a comprehensive design for future treatment.

Discussing the various divisions of hospital work. Dr. Cunson dealt first with the pathological department, which, he said, was run at a high state of efficiency, for which the director and the board deserved every credit. Next discussing the X-ray department, the speaker said the facilities for radium treatment of cancer were far from satisfactory owing to the lack of an adequate supply of radium. The board was some years ago in process of acquiring a supply of radium, but the effort was abandoned, largely as the result of unfortunate advice from a visiting medical man. There was not a home in the city but was touched, directly or indirectly, by the cancer scourge, and tho position regarding tho supply of radium should be immediately remedied. Treatment of Cancer.

That question could not be dissociated from consideration of llio hospital's attitude toward the newly-formed Committee of Cancer Research. In considering how to dispose of its funds, I lie committee had to determine whether a concentrated effort should be made. A suggestion had been made that a central fund would be better. However, Mr. Wallace, chairman of the board, and Dr. C. E. Maguire, medical superintendent, contended a proportion of the fund could usefully be spent in Auckland, ana Dr. Cunson said ho agreed with those gentlemen in their insistence upon the Auckland Hospital's ability to deal with its own cases. Ho had no doubt that when the appeal for funds was made clearly to the public thero would bo generous support. The opinion that the clinical records department, a vital part of a progressive hospital service, must lie considerably strengthened was expressed by the candidate. The records at present were totally inadequate. Some plan should be adopted by which medical men in charge of patients after their return home could be informed of the treatment given in hospital. Without that information the doctors were "in the dark," and the patients lost much of the benefit that otherwise would bo derived. Maui Pomare Incident.

A short account of hospital expenditure had recently been published, continued the sneaker. The board anticipated an increase of about £BOOO in maintenance charges in the coming year, but no indication of detailed expenditure had ever been placed before the public. It was highly desirable that the public should know exactly what the various departments were costing. The board might bo exercising the strictest economy and be operating upon a well-thought-out plan. "There has recently been such a glaring example of the board's lack of policy and inefliciency, however, that I seri-

ously doubfc the quality of its internal organisation," said Dr. Gunson. _ He referred to the recent outbreak of influenza on the Maui Pomare. _ln a -wellordered institution the machinery would havo been available to enable the medical superintendent immediately to arrange for the correct disposal of these patients, involved in an epidemic which came within the board's sphere of jurisdiction. _ As it was, they were allowed to remain in want of adequate medical and nursing care for several days in such a manner as to constitute a serious menace to the whole community. The board was committed to the building of an infectious diseases block in the present hospital grounds. That Dr. Gunson strongly opposed. With perfect isolation there was no fear of infection from a building in that situation, but perfect isolation was impossible in conjunction with conditions which would always obtain in general hospital work. All that was required at the general hospital was an adequate isolation block. Ihe infectious diseases block must bo placed on a site apart from the main hospital buildings. To suggest, as had been done, that the contemplated block could lie utilised later for general medical cases was futile. The building would be unsuitable in plan and placed so far from the central activities of the hospital as always to make it an economic failure. A further objection he held on purely civic grounds was that the board was not entitled to despoil the beautiful slope of hill which at present set off the hospital. "It would be an atrocity the board should not bo allowed to perpetrate," declared Dr. Gunson. Convalescent Home Suggested.

The board should plan a comprehensive scheme to meet the community's growing needs. The speaker advocated the planning of an infectious diseases hospital elsewhere, and a modern isolation structure in the vicinity of the present buildings. He made the further suggestion that s.erious consideration should be given to a proposal to erect a convalescent home in a suburban location. If accommodation were thus given for, say, 150 or 200 patients, the present average length of stay in the hospital would be enormously lessened, and in that way there would bo" sufficient beds at the general hospital for immediate needs, A vote of thanks .and confidence was proposed by Mr. C. It. Lord, and seconded by Mr. Eliot Davis, who said Dr. Gunson had spoken so clearly and so much to tho point that be hoped the candidate would consider later following the footsteps of his brother, Sir James Gunson, in other spheres of municipal work. The motion was unanimously carried. Professor F. P. Worley presided.