CONFERENCE WITH B.M.A.

New Zealand Times, Volume LIII, Issue 12434, 30 April 1926, Page 8

CONFERENCE WITH B.M.A.

PAYMENT FOR SERVICES COMMUNITY HOSPITALS DISCUSSED HONORARY MEDICAL STAFF An important report affecting the future administration of the service in the Wellington Hospital was brought before the board at its meeting yesterday. it was brought up in the form of minutes of the adjourned meeting with representatives of the B.M.A. and members of the board in round table conference with the hospital administration, honorary staff, etc. Those present were: Messrs C. M. Luke (chairman), W. Appleton, F. Bennett, D. Campbell, F. Castle, C. H. Chapman, J. H. Helliwell, Rev. Lochore, C. B. Robinson, Mrs Fraser,. Mrs McVicar, the medicnl superintendent, Dr. McDonald Wilson, Drs. T. D. M. Stout, Marchant, Begg, Cattell, Ewen, and Lynch. The matters for consideration were the payment for services now rendered by the honorary staff, and the question of paying wards being established. The chairman Btated that the conference might desire to hold over the establishment of l private wards, as there was no scope for them at present, but when the present buildings were finished room could be made available. There was also the question

of payment for services hitherto rendered by the honorary staff. There were a few medical men wedded to the present system. He quoted Sir Lindo Ferguson, who stated that as soon as hospitals pnid for services of honorary staffs he would “cut the painter.” They and the community too were indebted to members of the honorary staff for the efficiency of our hospitals to-day; it had been due and possibly owing to the honorary staff that they were able to have the equipment and-effi-ciency in our institutions for free services given. Dr. Stout stated that the professional men were willing to continue their services in future as in the past, and were ever ready to give their services to indigent members of the community without monetary reward, and stated that they wished to give their services, and were perfectly willing to do so for a . further period of one year. OWN MEDICAL MEN Mr Appleton asked if it was ft -sible for the trying-out of the idea of allowing patients in public hospitals to have the services of their medical men while in the institution. He would like to see it given a try-out before private wards were established. It was stated that there would he no objection from the medical men if a workable scheme were established. Dr. Marchant, chairman of the local branch of the 8.M.A., stated that after conferring with Dr. MacEachern he was satisfied that paying patients would have a certain amount of privacy, hut otherwise they would have the same equipments, nursing, food, etc. They would have their medical practitioners attend them. * Mr Chapman asked whether they could provide a better name than community hospitals, and he asked the doctors present to define “indigent patients.” He suggested that if the policy were changed the hospital would have to be called “General and Private Hospital.” Services of medical men could not be over-rated, nor could the experience gained by the honorary staff bo over-rated. COMMUNITY HOSPITALS Dr. Stout stated that New Zealand hospitals at present were not community hospitals, because members of the class who are able and willing to ps y, but who cannot afford large fees ill private hospitals, refused to go into a public hospital, and objected to free treatment. This class was debarred from general hospitals. He reiterated that services were given freely without any remuneration to indigent people who were not able to pay for medical services. The experience of medical men concerned was vnluable, hut members of the honorary staff were not giving their services merely for the experience gained. Dr. Wilson remarked that with the extension of hospitals he would recommend doing away with large wards, and would suggest group buildings or groups of small wards. The chairman stated that quite a number of small hospitals received paying patients. The Rev. Lochore raised the question of group hospitals being most expensive. Dr. Wilson stated that the reverse proved to he the case in America where the future tendency was for small wards.

Dr. Begg stated that Mr Appleton’s idea was the solution of the difficulty that people did not like coming into public hospitals. If the patients had to pay the extra cost there would he nothing for the doctors. If innumerable doctors were coming in at all hours of the day they would have to increase the number of nurses. The remuneration of doctors would not be worth while considering. It was an excellent idea to have separate wards, but he would suggest screen wards. Mr Bennett asked why the medical

men were so very keen on community hospitals. Dr. Marchant stated that it was felt that those people who could not afford private hospital fees would be willing to come into the general hospital and pay for treatment if accommodation was provided for them. The Rev. Lochore stated that a very large number of people only came into the hospital as a last resort. There was the abhorrence of public hospitals throughout all classes. Mr Bennett considered it was impossible now, owing to the immense expense, to give consideration to the question of establishing community hospitals, and community hospitals would, in his opinion, lead to class distinction. Dr. Corkill suggested the Alexandra Home for an analogy as working their hospital on a community scheme, and it was working harmoniously. The introduction of the community system had helped their finances. Mr Luke pointed out that they would not take in paying patients and exclude the poorer class. Mr Appleton stated that medical men-should bring down the proposition in concrete form. Mr Castle said the onus was on the board to bring down poncrete proposals. It was agreed to close the conference, the medical profession agreeing to bring down their in 1 writing.

With reference to the honorary staff, intimation was given that the board ask the honorary consulting staff as a committee or as a whole to assist >n regard to the appointment of honorary staff, and that the matter of paying wards be held in abeyance until communication is received from the B.M.A. Members of the consultant staff may appoint representatives to confer with the board in regard to the election of members of tfie honorary staff.

When the report had been read, Mr Bakewell asked if the board . would have an opportunity of discussing the proposals, and going into the whole matter ?

The chairman thought they should wait until they had the proposals from the 8.M.A., which he thought would be received in tbe course of a week or two.

The Rev. H. Van St aver en thought the board should wait until the hospital buildings were completed before considering anything in the way of a community hospital. The report was received,

MINISTER REPLIES TO B.M.A. NOMINATED SYSTEM CONDEMNED RIGHTS OF PEOPLE TO BE MAINTAINED. Per Press Association. BLENHEIM, April 29. Speaking at the opening of the new nurses’ home in connection with the "Wairau Hospital, the Minister for Health, the Hon. J. A. Young, in reply to the B.M.A. in reference to Doctor Maceacbern’s report, said: “\Ve have recently had in this country a gentleman from America who was invited here by the British Medical Association. He has reported to the 8.M.A., which seems very angry with me because I didn’t throw iny arms around his neck and accept without question everything he had to say.” The Minister stated that he wished to say that neither he nor his Department was above accepting anything in Dr Maceachern’s report which would be helpful or beneficial to the Dominion. If it would better the health of the people it would he treated with consideration and acted upon, but when anyone attempted to dictate to him or put pressure on him. or work propaganda to uniietmino the powers of hospital hoards, the Department, or the people ire would he up in arms and wotild take a stand against the whole medical profession. He recognised that doctors performed an important function. Their job was not to govern the community, hut to help it in sickness. "Whilst the profession kept to that job it would have no greater friend than he, but when it failed to observe that rule he would be up against it. When it < arno to a matter of political control of business, as they called it, the Government of the people by their elected representatives in Parliament would have its say in the matter. The B.M.A. suggested that elected members of hospital boards were not suitable to carry on the work they were doing. If that were so the "community had a remedy and could bring about a change at any time. * NO SOUL TO CONDEMN . “If we had a nominated system it would be neither a soul 15 condemn nor bodv to kick out.” . .The Minister then read Dr Watt’sletter, which has already been published and continued, “I’m told ly medical men in Wellington that it is very unfair for me to read the letter from Dr Watt, but I think ice must trust our own men rather than strangers who come here to tei! us how to run our own business. You can Ims assured that while the community is controlling the hospitals of 1 lie country it has a check lon the expenditure, hut with nominated nersoi-.s in charge or having a controlling influence in any way they would not I'e concerned about finance. They will get what they want whether you can pay or not. so I want the people io be behind and support me in maintaining the rights of n free people to ■govern their own institutions.”