HOSPITAL ECONOMIES

New Zealand Herald, Volume LXIX, Issue 21263, 17 August 1932, Page 10

HOSPITAL ECONOMIES

PROPOSALS BY BOARD

ELIMINATION OF 100 BEDS

REDUCING STAY OF PATIENTS

MATTER FOR SUPERINTENDENT

| The desirability of reducing the stay of patients in hospital and the elimination of 100 beds are among the suggested measures of economy which are under consideration by the Auckland Hospital Board. Various reports have been considered since the board's original estimates for the year 1932-33 were returned by the Health Department for reconsideration. The Finance Committee submitted economy recommendations and the new medical superintendent, Dr. J. W. Craven, furnished reports on these economies. Neithei the committee's recommendations nor the medical superintendent's reports have been included in the agenda papers provided for the press at recent meetings. A special meeting of the board was held on August 2 to consider economy recommendations, but the press was informed that the matter would be dealt with in committee. However, the minutes of this special meeting, confirmed at the meeting of the board yesterday, make no reference to the business having been transacted in committee. Moreover, the minutes of the special meeting were not attached to the agenda paper supplied to tho press. Suggested Economies The economy recommendations of the Finance Committee were first considered by the board at an earlier special meeting on July 5. The committee recommended that the residence of the junior medical officers should bo closed and that an annual residential allowance of £65 should be made to each officer concerned; that expenditure in tho hospital gardens bo reduced from £ISOO to £IOOO annually and that expenditure in the engineering department be similarly reduced; that a reduced day's stay of patients and the elimination of 100 beds be aimed at, with the removal of all verandah beds where possible and the eventual closing, indefinitely of tho wooden wards, Nos. 11 and 12; that the lady superintendent should report on the advisability and practicability of sisters and other trained nufses living out and on the limiting in future of the number of probationer nurses; that she should be informed of the proposal to close 100 beds, so that immediate action could be taken to reduce tho nursing and domestic staffs; that the isolation bluck, which had not as yet been occupied, should be opened for the accommodation of 40 chronic cases from other wards and administered as a separate unit on the lines of the infirmary: and that the medical superintendent should be instructed to introduce a "rotary" system of admission of patients, allocating beds in order of applications as vacancies occurred, but giving priority to urgent cases. Discussion by BoSrd Consideration of the recommendations was deferred in order that a report might be obtained from the medical superintendent. The matters were discussed at the special meeting held on August 2, from which the press was excluded. The recommendation that the residence of tho junior medical officers should be closed and a residential allowance substituted was not supported by the medical superintendent, who stated that, by virtuo of their duties and the fact that they had no fixed hours, it was desirable for these officers to be resident in the hospital. It was decided to defer the matter for three months, when it could be reviewed.

With regard to the reduction of expenditure on the hospital garden, the medical superintendent supported the committee's recommendation, which was adopted. However, Dr. Craven held ttoat expenditure in the engineering department was a different matter and recommended the board to exercise extreme caution in corning to any hasty decision t.o reduce the engineering department below what might be called the safely line. The board decided to congratulate the engineer on his successful efforts to economise in his department, but emphasised the necessity of further reduction in costs without sacrifice of efficiency. Reduced Stay in Hospital

Tho medical superintendent reported at length on the committee's recommendation to aim at a reduced day's stay of patients and tho elimination of 100 beds. The honorary staff, ho said, was being urged to reduce the stay of patients in hospital as far as was consistent with safety. It had to be realised that many patients were kept in hospital for reasons other than those requiring true hospital treatment. Relatives of patients were frequently reluctant to take charge of them for reasons other than nursing; therfc was an absence of beds at the Epsom Infirmary and Epsom shelters for male chronic cases and tuberculosis cases respectively; and many patients lived so far away from the hospital that they were unable to make daily visits for special treatment. Another point was that many patients objected to being discharged from hospital until they were fully recovered and able to took after themselves completely. In this connection, the medical superintendent asked for a definite ruling that the discharge of patients should bo entirely a matter for himself in consultation with the member of the honorary staff concerned. Every care would bo taken in this respect. The board had arranged for two nurses to be available for visiting discharged patients in their homes and the home nursing sorvico might be extended to cover a wider area, including the North Shorn Private Treatment "There aro patients in the hospital who contend that on discharge they have no money to-pay for lodgings and no home to which they can go," Dr. Craven's report continued. "These- patients, while not requiring any active hospital treatment, are fi till occupying beds at a gross cost of 14s 2d a day. Perhaps their cost of maintenance could be transferred to another account when they are certified as fit for discharge. The other alternative is to discharge them from the institution and leave it to sonic other organisation to arrange for their assistance. The time is ripe for religious and other bodies to combine for the purpose of helping discharged hospital patients." The hospital was primarily designed for the treatment of medical and surgical cases which could not be treated at home, the medical superintendent added. Its services should bo available only for those who were unable to afford private treatment. Rates did not cover the cost of the institution and patients who could afford private treatment should not embnrass the accommodation of the hospital by their presence. This would reduce tho number of people receiving treatment as inpatients. It was decided to authorise the medical superintendent, in consultation with the honorary physician or surgeon, to decido when a patient was to be discharged. An amendment, moved by Mr. M. J. Savage, providing that no patent requiring continuous medical or surgical attention should be discharged without authority from the board, was lost. • The remaining points in the committee's recommendations'and the medical superintendent's report will be considered at a further special meeting on August 30.