THE BRYCE CASE

New Zealand Times, Volume LI, Issue 12015, 18 December 1924, Page 5

THE BRYCE CASE

HOSPITAL TREATMENT REPORT OF THE ROYAL COMMISSION. FINDINGS ANNOUNCED. The report of Mr E. Page, S.M., sitting as a Royal Commission, on the Bryce case at Palmerston North was re. leased for publication yesterday. The inquiry was aoked for by Mr John Joseph Bryce, farmer, of Kiwitea. who wished it treated as a test case, and was so regarded by- the Palmerston North Hospital Board, and by at least a number of members of th© medical profession. The facts were that in the month of May, 1923, a daughter of Mr Bryce had a sever© and recurrent attack of appendicitis, and was confined to bed for a fortnight. She was attended at lior homo by Dr F. Cameron, of Feilding, who advised that an operation for the removal of the appendix be performed, hut recommended a little delay until the attack should become less acute. Mr Bryce informed Dr .Cameron that ha desired the operation to he performed at tho public hospital at Palmerston North. Mr Bryce was well able to afford the cost of the operation, and of the necessary treatment in a private hospital, but no desired tho operation to ho done in tho public hospital for two reasons. THE FINDINGS. “Looking at all the circumstances, 1 think that Dr Barnett, having accepted! the appointment of honorary surgeon, should not have declined to operate on a patient who was duly admitted in accordance with the practice and policy of the hoard, and whom, in tho ordinary course of the hospital system, it fell to his lot to attend.

“This must, however, he eaid: Miss Bryce was sent there primarily to assert or to test the principle which Mr Bryce maintained. Dr Barnett was aware of this, and his refusal to operate was dictated by his desire to vindicate the view held by himself and by other members of the honorary staff on the important question of principle which Mr Bryce’s action had raised. “I am of opinion that tho practive l of tho medical practitioners in the Pal--1 merston North district (including the members of the honorary medical staff), in discriminating, according to the patient’s financial position, between the various patients seeking ' admission, is not a desirable one, and should be -discontinued. If it should be the policy of the board to seek to" discourage tho better r off members of the community from obtaining treatment at the public I hospital, tho duty of taking steps to carry out this policy should be undertaken by the hoard. It is unfair to ! allow it to fall on to th© medical practitioners. SOME RECOMMENDATIONS. “While there does not appear to bo any precise statutory provision compelling a hospital board ,if it has accommodation, to admit a patient who may be able to afford treatment in a private institution, the origin and trend of our legislation does not, in my opinion, contemplate that the benefits ot our public hospitals should he oon- . fined to the poorer classes. It is not the practice of hospital boards generally throughout New Zealand to admit only tho poorer classes of the community, though a few hoards make ; some effort to do so. j “Hospitals are maintained out of local rates, and general taxes, to which all classes of the community contrijfcute. I think that the hospitals should! jbo open to everyone, though, if the accommodation is limited, the poorer patient should have the preference. Adequate fees (including reasonable ' fees: for operations and other special treatment) sufficient to cover tho whole cost, of treatment should be charged to those able to pay. | MATTER OF FEES. | “I yhave the honour to recommend that the fees charged by the hospital boards for the maintenance and treatment" of patients while in hospital be increased to. such sum as will cover the lull cost thereof (including a reasonable charge for operations and other special treatment). “Boards should, retain the power of lemitting the -whole or part of the fees in the case of any patient who is unable to pay. “Evidence on behalf of the New Zealand branch of the British Medical Association was tendered at the hearing. From this it appears tjiat there is unrest amongst members of the medical profession throughout New. Fleaknd at the growing tendency amongst the better-off people to make, use of the public hospitals ,and thus to obtain, without cost to them, the services of the honorary medical staff, j “It is doubtless due to this feeling 'that the case in Palmerston North now funder review has arisen.

“I suggest that hospital hoards and the Department of Health might take into consideration the important quesion of so extending the operations of the public hospitals, as to adequately 6erve all classes of the community. “The trend of hospital administration of the present day is towards centralisativn, the establishment in the main centres of large, well-equippedi hospitals, which can specialise in every branch of modem medicine and surgery, which will he equipped with the most modern scientific appliances, arid in which all classes of the community can be treated. THE HONORARY STAFF.

“There is, I think, a present demand for tho establishment of private rooms and semi-private wards in the main hospitals. “These could bo made use of by patients willing to pay for them. A workable scheme can, I apprehend, gradually he evolved whereby patients may, if they so desire, and are willing to pay therefore, obtain the services cf, and he treated in the public hospitals by their own private practitioner, in lieu of treatment by the regular staff of the hospital. “If honorary medical staffs are to he continued, further provision might he made that for treatment or operation, accorded by them to patients able to pay ; there would be charged to the patient, and paid to the physician «or surgeon a moderate fee in accordance with an agreed scale. “These matters, no _ doubt, raise many difficulties, financial and otherwise, that will require to be overoome, out if a steady and earnest effort is made to cope with them, conditions, such as those which brought about the present inquiry, should gradually disappear.