CONTROL OF HOSPITAL.

New Zealand Herald, Volume LXVIII, Issue 20982, 19 September 1931, Page 12

CONTROL OF HOSPITAL.

FAR-REACHING PROPOSALS. WELLINGTON INVESTIGATION REVISED COMMITTEE SYSTEM. REDUCING CHAIRMAN'S POWERS. Tho main feature of the report of the special investigation committee of the Wellington Hospital Board upon the administration arid control of the institution is the division of the whole of the work under three heads —the surgical division, the medical division and the pathological division. For each of these divisions a chief has to be appointed who will have general supervision of each division. Under the surgical division there are to be nine departments; in the medical division theve will be nine departments and in the division of pathology four departments, including a new department —records and research. One is the abolition of the children's surgical department and the distribution of the cases according to their surgical nature. Each department has its own head. A medical committeo is recommended consisting of eight members, so specified as to represent the whole of the medical and surgical work and their subdivisions. The chairman of this committee is the responsible adviser in regard to all technical matters pertaining to the medical woi k. In order to initiate this organisation a medical appointments council is to be set up, which council shall cease to function as soon as the new organisation is in being. Permanent Medical Council. Its place will then be taken by a permanent medical council consisting of the chairman of the board and the chairman of the house committee, a member of the consulting staff and the chairman of the medical committee. The function of this council is to recommend to the Hospital Board, through the house committee, in regard to the appointments of all medical officers, senior members of the nursing staff, masseuses and dental surgeons. It is considered that by means of this organisation a firm grip will be kept on the most detailed work of every department, and the board will be kept in touch with the clinical activity of the hospital through the house committee, whose chairman will have the closest relation to the chairman of the medical committee. Dr. Malcolm T. MacEachern, a recognised world authority on hospital organisation, has approved of the departmental arrangements recommended. A chief feature of the recommendations is the abolition of the general committee of the Hospital Board and the formation of a general purposes committee of not more than eight members, which will deal with all matters concerning the business transactions of the board, with a special sub-comrnittee dealing with endowments and buildings. General Superintendent. A new feature recommended is the formation of a house committee to keep in the closest touch with the medical committee, and, through it, with the clinical work of the hospital. An important new sub-committee of the house committee is suggested, namely, the nursing and training committee, whoso functions will be to supervise all matters connected with the work of the training of nurses and the relation of the training school to the nursing profession as a whole. The most vital alteration, one which embodies a completely new departure for New Zealand hospitals, is the appointment of a general superintendent, with full powers to represent the board. The committeo contends that the powers granted to the medical superintendent are insufficient and out of all proportion to the high salary paid; whereas the chairman of the board, as in most hospitals in New Zealand, acts in fact as a managing director. The appointment of two assistant-superintendents is recommended. 0110 for administration and the other for medical purposes. Discussion of the report indicated that many points will become controversial, although there was general approval of the committee's intentions. One of the recommendations which will arouse interest outside Wellington is that which proposes to make the general superintendent's authority paramount and to end the system under which the chairman of the board is constantly exercising authority. In the Melting Pot. Mr. C. M. Luke said the report had certain characteristics of a heresy hunt and there was more than a hint in several speeches that officers of the board, "disgruntled" over the salary cut, had used tho inquiry as an opportunity for expressing complaints. The meaning behind some of tho comments is not obvious to one who has no knowledge of the board's "atmosphere, but, one would gather that some members would object to the committee of tho whole being deprived of any of its functions. That there is considerable purposo in the investigation committee's mind is made clear by the statement of its chairman, Dr. Begg, that the whole question of hospital organisation is in the melting pot, and that tho whole conduct of the hospital was in a state of chaos. Regarding tlio suggested reduction in tho number of board members, he thought that, four would bo enough if tho work were properly delegated. The present position was that a great deal of the managerial work was carried out by tho chairman of the board, whereas that should bo done by a general superintendent. "Rather Cumbersome Board." Commenting editorially upon tho report tho Evening Post states:—"There has been a public feeling for some time that our hospital system, though admirable in many ways, is not well controlled by a rather cumbersome board. It is not alleged that there are great abuses; but it. is feared that extravagance and waste of effort are possible where responsibility is spread as it is. . . Briefly, the committee seeks to abolish a system under which everybody's business is nobody's business, and to introduce a plan by which definite duties will be assigned to all committees and officers. "Wo hope that the board will deal constructively with tho report. It should not- be viewed as an indictment of past administration, to be resisted so that, past officers and boards may claim that their work has been vindicated. There is no need to blame anybody for weaknesses in the system. Bather it should be considered that such weaknesses have developed through ail attempt to maintain control of an institution which has outgrown methods which wero good enough for a much smaller hospital."