PRESENT DEFECTS

New Zealand Herald, Volume LXXIII, Issue 22353, 26 February 1936, Page 14

PRESENT DEFECTS

"CANNOT CAKRY ON" TIME FOR A DECISION EFFICIENCY HAMPERED That the Auckland Hospital is overcrowded and cannot carry on as at present, and that the time has arrived for a decision to ho made, was stated in the report of the staff committee presented at the special meeting of the board last night. The alternative was said to bo the commencing of a modern hospital on the present site, scrapping the old buildings as beds become available, or the building of a new hospital in the suburbs first and, when pressure is relieved, a commencement with modernisation of the old site. A summary of the problem, taken from the superintendent's report, was quoted by the committee as follows: — Overcrowding of the wards and shortage of beds; lack of space in departments in which the work lias greatly increased since the present space was allotted; faulty co-ordination of departments, leading to difficulty of consultation, increased internal transport and delay in discharge of pationts; continued use of condemned and unsuitable buildings; advisability of clearing verandah beds; no provision for immediate emergency or future growth; and no available space to which pationts can be transferred when repairs and maintenance have to be done in wards. Reorganisation Essential " These," stated the report, " are the outstanding 'defects of the hospital which interfere with its efficient functioning along the present lines. But the committee feels that, even if they did not exist, the present hospital wotild still leave much to be desired, and the committee considers it essential that a complete reorganisation should be planned and proceeded with forthwith." While stating that the site was the best possible, the report added that many of the wards were old-fashioned wooden structures which had * more than once been condemned. They were bad from all points of view, being unsafe from fire, unsuited to nursing requirements, and badly placed in the grounds. During the growth of the hospital po building had been scrapped. However unsuited, it had been "tinkered into a makeshift for some purposo and made to do." The position was that a good sito had been spoiled by ill-considered buildings, and good buildings deteriorated by similar alterations, with the result that the present hospital could not be modernised, and so reach maximum efficiency, without radical scrapping and rebuilding. Care of Out-patients Continuing to deal with the present state of the hospital, the report said that no properly-organised out-patients' department, as known in metropolitan hospitals overseas, was establisned at the Auckland Hospital, but follow-up clinics dealt with certain groups, A very large number of patients was seen, and in most cases no adequate accommodation existed. The X-ray department was overdue for enlargement, and its present position in the grounds and its congestion were real factors in prolonging the patient's stay in hospital. The resident staff of the hospital lived too far from their work, the report added. This meant delay in attending urgent ward work. Students were becoming more a feature of the hospital. The formation of a clinical school had been mooted, and in any replanning space should be considered. Full development of team work at the hospital had been attempted without success. Consultation work was somewhat haphazard, and this largely arose from the scattered nature of the wards. Administration also called for much reorganisation of space. REMEDIES SUGGESTED FULL USE OF PRESENT SITE QUESTION OF AUXILIARIES Discussing remedies for the present hospital situation, the report submitted to the board last night stated that the committee was not in favour of first building a suburban hospital, and then, as pressure was relieved at the present hospital, commencing with remodelling there. The grounds for this decision were:— That no site was available having anything like the natural advantages of the present site; that full use should first be made of this site before any further general hospital was started; that, given proper buildings. properly equipped and subdivided, tnere was no reason why the present site could not be used up to, say, 1000 beds —800 active, 200 recovery (Wallace Wards); that this number would suffice for a considerable time (with auxiliaries), and that it should not be exceeded; that a new hospital be then built, the site to be governed by the then obvious trend of population. The report stated: "A new block may bo essential, and soon; but the committee feels strongly that it should be no isolated structure, but the first instalment of a complete new hospital." The erection of new auxiliaries to n large extent was a policy question, but no complete planning of the ideal general hospital could be undertaken until this policy was decided. It would depend on the presence or absence of auxiliaries how long it would be before a new hospital must be started. The committee favoured the establishment of an intermediate hospital. The main points of an intermediate hospital were that it was open to all classes of patient prepared to pay the full fee for maintenance, accommodation being at a graduated price, usually from £3 13s 6d to £6 Cs. After enumerating the benefits of recovery homes, the report states that the Wallace Wards would serve admirably as a recovery home without upsetting the general plan for the more active divisions of tho hospital. This would bo preferablo to any attempt to weld tho Wallace Wards into any new scheme, or, worse still, building a new hospital in relation to the Wallace Wards. The report added that suitable convalescent home accommodation would appreciably relieve the hospital beds, and that additional infirmary beds were required. On the question of a chest hospital, the committee considered that the infirmary site was entirely suitable For tho purpose. It agreed with Dr. McDowell that there was no reason why the chest hospital should take precedence over other hospital alterations, and that with the altered arrangements at the present sanatoria there was not any extreme urgency in the matter. It was felt, however, that tho proposal should proceed as soon as the more urgent features of the general hospital had been attended to. The relief afforded by tho chest hospital would not amount to more than about 35 to 40 beds.