HOSPITAL MANAGEMENT.

New Zealand Herald, Volume LXVI, Issue 20332, 13 August 1929, Page 9

HOSPITAL MANAGEMENT.

AMERICAN DOCTOR'S VIEWS.

PROBLEM OF CENTRALISATION

Some interesting views on hospital administration were given by Dr. F. If. McMechan, secretary-general of tho International Anaesthesia Research Society, who arrived by the Makura yesterday. Dr. McMechan will make a short tour of New Zealand, and a special visit to the medical school at Dunedin before resuming his journey to Sydney, where he will attend the Australian and New Zealand Medical Congress.

"The problem of centralisation is one that is facing many hospitals all over tho world, and it would not be surprising if you have encountered the same problem in Auckland," Dr. McMechan said. "The test to bo applied to any hospital is whether it is taking care of the largest possible volume of sick people at the lowest cost a day, providing, at the same time, the safest possible service. If one large, central hospital can do that for the community it is a success, but if smaller hospitals, * which can be managed more efficiently, can accomplish the same degree of economy, they would deserve development.

"A great (leal of hospital overhead and deficits arc still due. not to poor or lax administration, but much more to the fact that there is not the mutual understanding between members of the medical profession and hospital administrators as to how advances in medical science can he made to contribute to a decrease in costs. This is a tremendous item. The latest developments in anaesthesia alone are all on the side of economy and the trained medical niinri can immediately Fum up their possibilities. Co-operation between doctors and hospital authorities ". e fundamental to tho successful working of an institution. Another overhead cost in the administration of hospitals was the cost of replacing the vanishing personnel of trained nurses. Nurses started on their careers as girls and were fully trained in hospital work. At the end of three years' training, about 50 per cent, of them left the work, while statistics showed that at tho end of five years. 85 per cent of trained nurses abandoned their careers. "It is manifest that we are Liking girls as nurses at the wrong age, ' Dr. McMechan said. "The solution appears to be the raising of ages in the nursing staff. If we were to engage as nurses women over the ago of 30 who had dependants and were faced with the necessity for establishing themselves in a career we would get about 20 years vice insteail of between three and fi\c. Authorities in the United States were practically agreed that only training hospitals should have full-time medical staffs. For the ordinary hospital a small medical staff assisted by a number of part-time doctors who, in their private practice, could keep abreast of all modem developments, was the most satisfactory. Dr. McMechan, who is recognised as a world authority on anaesthesia, has been a cripple for 20 years. "I do not regret mv infirmity," he said. 'T have been able to do work which I could not have done had my health been normal." After attending the Medical Congress at Sydney, Dr. McMechan will go to Melbourne to present a scroll of recognition to the Melbourne University in appreciation of the work of the late Dr. 15. H. Emblcy, one of the greatest anaesthetists and research workers ever produced by Australia.