THE New Zealand Herald AND DAILY SOUTHERN CROSS TUESDAY, APRIL 30, 1929. THE HOSPITAL BOARD.

New Zealand Herald, Volume LXVI, Issue 20242, 30 April 1929, Page 10

THE New Zealand Herald AND DAILY SOUTHERN CROSS TUESDAY, APRIL 30, 1929. THE HOSPITAL BOARD.

Among the many local body elections to be held to-morrow that for the return of a new Hospital Board should not be overlooked whatever the other claims on the voter's interest. The board, charged with the care of the great institution which has grown year by year, responsible for the distribution of charitable aid, performs functions which are of very deep importance to all citizens. This is not the time to consider whether the hospital system existing in New Zealand to-day is the best that could be devised. Such a question has no immediate bearing on the election of the board, which must administer the system as it is, and could not alter it even if it wished. It happens that a starting point for considering the hospital system as Auckland knows it has been furnished by Dr. E. B. Gunson, who is offering himself as a member. Of his personal candidature it can be said that to have, medical men on the board appears at the outset desirable. Its duties are for the most part administrative and financial, but to have the professional knowledge of a medical man at its disposal would surely be an advantage. This being so, it need only be added that Dr. Gunson's professional standing is so high as to leave his suitability for such an office beyond question. In addition, the campaign speech he made last evening showed him to be at grips with some of the main issues which appear in the sphere of hospital politics at the present time. Regarding an infectious diseases hospital, a convalescent home to relieve pressure on the accommodation of the present hospital, a system of clinical records to allow after-treatment to proceed on the lines followed in the wards and the general questions of finance and administration, Dr. Gunson was so sound as to give promise of becoming, if elected, a highly valuable member of the board. Provision for infectious diseases is without doubt the outstanding point in hospital affairs at the moment. The board was challenged on its policy of placing a building for that purpose in the present grounds. Though there was somo degree of hesitation in proceeding, it has persisted in its design, with the rather vague suggestion that the building could be put to other uses if an isolation hospital was provided elsewhere. Within the past few weeks there has been an object lesson showing that the need for ample accommodation for emergency cases, and more complete isolation than would be possible in a building interlocked with the general system, might arise at any time. The influenza patients from the Maui Pomare pointed the moral, and the action of the board showed that it realised the situation. All this leads up to a contention that has been urged on the board before, that there is immediate need to provide for an adequate infectious diseases hospital on some site well away from the present general institution. With the work done properly, there would be removed the danger of cross infection between patients suffering from different communicable diseases, the staff, both nursing and administrative, would cease to be potential carriers through coming too readily in contact with colleagues engaged on duties of a different nature. Once the idea of a branch of hospital work carried on away from the existing block of buildings is accepted, there comes the cue to consider whether a convalescent branch elsewhere is not ripe for attention. Now, there is no possible stage between the ward and the home. Until the patient is fit to return to his own circle, and to be left to the attention he can roceive there—however devoted, it is in nine cases out of ten quite unskilled —he cannot be discharged, or should not be. Yet he might with advantage be removed to another place, where he could receive the care appropriate to a convalescent, leaving the wards free for those requiring definite hospital treatment. The reasons for considering this would not be so pressing if admission had never been denied patients for want of room. It has been and it may be again unless the pressure is capable of relief. The establishment of branch institutions on other sites might seem to carry the threat of new and unnecessary expenditure if it were not for the known situation at the Auckland Hospital. It is no puny institution in the early stages of growth. Already it is larger than any other in New Zealand or Australia. England can show only two greater. Were it likely to stand still in its present dimensions it would be problem enough from its very size. Yet as the population and needs of its district grow, so will the call for more hospital equipment. This development is inevitable. To avoid the administrative problems of a hospital grown to such unwieldy size as to have become top heavy, some process of hiving-off seems unavoidable. The two policy points of an isolation branch, well detached, and a convalescent home offer an excellent beginning. After that the merits of some measure of further decentralisation could be considered. That nothing of the kind has been planned, that on the face of things to continue adding building to building on the present site is the only future contemplated, adds point to a contention by Dr. Gunson that the board is in the; air on questions of

policy. It is no unjust criticism, and it indicates a position that should speedily bo remedied. The board, as has been remarked during the local body elections, occupies a special position in relation to the community. It is elected directly by the people, but it merely estimates its financial needs, leaving to other bodies the duty and odium of collecting the rates. For that reason it seems to be in a semi-detached situation. Actually it is responsible to, and answerable to, the public just as directly as any local authority. That should be remembered, the importance of its functions, the extensive nature of its responsibilities, and the need for a clear, well-planned policy should be kept in view when the voting paper for the hospital board is being marked to-morrow.