DUNEDIN HOSPITAL.

Otago Daily Times, Issue 13209, 16 February 1905, Page 3

DUNEDIN HOSPITAL.

PROPOSED MEDICAL PAVILION. . THE TRUSTEES ' APPEAR 3'AVOUR able. A-. deputation, consisting of Drs Gordon Macdonald, D. Colquhoiin, F. C. Batchelor, L. 'I'!. Bamett, J. 0. Gloss, and F. W l . B, Fitchett. -'-representing the medical staff ol the Dunedin Hospital, waited tipou the Hospital - Trustees at. their meeting yesterday to urge the erection of a, medical paviJion. Dr Gordon Macdonald, chairman of (lit medical staff, in introducing the'deputation, said that, the si aff considered tiic time ha< now arrived when a movement should be made in building a medical pavilion at the south end of the building. As the quest ion was entirely a medical one, and not-a surgical one, it was not. a question tlml appealed so much to him as to the mediea men, and for that reason lie would eali iqiou Dr Colquhoun to explain matter; from his point of -view. Dr Colquhoun expressed his views in tin following terms:—lll "urging upon you the need of lietter accommodation for ,mcdiqa cases in the Hospital the medical staff i: not raising a new question, hut is contimi ing a movement begun a good many yeare ago, when, with the cordial co-operation of the trustees a.nd the public, great im piovements were effected. But - there remaind and still remains an old building erected fer otlier purposes in which manj patients have still to be treated. You-will . recollect that the staff his always been dissatisfied with this building, and I think you have agreed with us as to its unsiiitobleness. I feel very strongly that out patients cannot be properly treated in these old wards. As much as the surgeon wants asepsis for his cases, we want foi ours fresh air and sunshine, which arc not to ho got under the present conditions. As you know, 'these wards have narrow windows 011 one side and. a blank wall on the other. They never have been good wards, and the older they grow the worse they get. I hope the time lias arrived when we all—trustees and staffwill do our, utmost to procure-new wards, planned and built' in accordance with modern ideas of hospital construction. The present state of matters is the more to be deplored on account of the spccial responsibilities of this Hospital. It is not only a place of refuge for the sick poor of the district, but it is also the only Medical School in the colony, and»in that capacity is yearly imSeasing in importance. It is doubly unfortuuate that our students should see in our housing of medical 'and other eases only what to avoid, and not .what to imitate in practise. The time has v been when we v/ere warned not to insist 011 this aspect of the question. We were told that tho taxpayers would not • consent to pay a penny, on the grounds' that hettei facilities /for teaching students were • needed. I am glad to think that'those days are past, and that both the trustees and taxpayers ; , the Government (which supplies a large share of the expenditure), "and the subscribers, recognise, in the Medical a national institution which it is a privilege to possess,' and tc fester to the utmost of their powers. It ha: been truly said that- the importance of s sound medical education being within the reach of men of moderate means is greaicsl for the poorest class jn a community. The rich man can always get the best medical aid. but if medical education can only be got at a distance and,'at great expense the poor man has to take, what lie can get. 1 think, therefore,, we need not be afraid tc aek the public for money for, now wards among other weighty reasons, for this— thai we ought- to be able to show our'student? the best methods of housing, as well as the be6t methods of treating • and nursing patients. 'Die time has surely , come when this dual function of tho liospital should be openly and fully recognised. It'is at once a hospital and a school of medicine, and I think if the question is; only fully stated you will get such a 'mandate from yotu constituents as will settle the matter "foi ever. It will not. be necessary. to remind anyone that the tie between Dunedin and the Medical School ; is mot an indissoluble one—that other centres would bo only toe ready to grasp the privilege which is ours if we should bo unwilling to , use it. ] belieVo the time" is opportune for. an appeal to the public of this province to .help us by generous giving, so tint we may bo able to get wards which ws shall not bi> ashamed to place our 'patients jii- or. to,- show tc Strangers who visit us. In .concluding, Di

iat Colquhoun said it would not bo out of in-' place for him to express.his gratification at ed the donation, made by Mr Hallelistein, which er- had to a certain extent brought this matter lie within the realm of practical politics. They, in' of course, all recognised that nothing could id, he done without money freely supplied, and ml that money for an object of this kind should iv' bb supplied partly by voluntary contribution at and partly by Government. ' ■ • , ad ' Dr Batchelor said ho simply ,wished to )st ' endorse what Dr Colquhoun had. laid before in., the trustees.' Personally he could only say ad for himself and on behalf of the surgeons :0 . ■ that they had found the greatest difference ad in their cases .since they had had better ■o- wards, and could undertake cases they could his- '.never undertake before, with confidence, and so- had bad better results and although there er wa"s inore'immediato cviucr.ce showing from ,at'surgical than from medical cases, ho was lie perfectly certain that' medical cases suffered od just as much from' deficient'jhygienic condi,r v tions. It was to be remembered that .ill l e ; tlieso medical wards there were naturally a .J 'large number of cases, many almost at death's-door, against whom-the scale might .easily be turned through neglect of (lie k], whole science of hygiene. It was perfectly 1 10 • certain, too, that convalescence must, be 3n delayed by insanitary conditions such as ; 3 ; still existed in their own medical wards, and , 5 | i for. that reason he felt that on behalf of j, c . the patients they must urge the .trustees to e( j . the best of their ability in pushing this mailer ( |p on. Another matter he wished to say a a< ) word about, which lie did not think had ,( 6 been brought tefore tho trustees before, and . which ho thought had a very serious aspect. ! This was that the resident staff of the on Hospital were living under most unfavour[o able sanitary conditions. Their rooms were to not suitablo rooms, and, worse than that-, ;e. these rooms had no adequate' means of ventilation except into the .central building, Ijf Which ventilated into rooms oceupicd by n „ patients. An inspection of these rooms could not fail to lead to their condemnation. j, 0 Tho staff, it must bo remembered, lived in )r . tho building somo 20 _ hours out of the 24, and, tho conditions referred to jgl-- being bad, . they could not be in the | ie good health they might otherwise be. ■j a -Looking at tlio results of the past 20 years in respcct to their resident stall', three deaths in the Hospital of young men, over a a comparatively short time, were recorded, i( v 1 apt! there bad,been much illness—very severe if illness, indeed,—doubtless associated with insanitary conditions. In his opinion, either fresh accommodation apart from the Hosto pital should be erected for the staff, or i else the patients should be turned out of the 1( [! central building ant) proper ventilation supplied to the accommodation for the staff, to - and ho was sure they would then enjoy far lis better Health than they had in the past and 31l they would not run the risk' lie believed n . young men serving in tlio\Hospjtal had run t 0 in the past-. There was (mother point he j r would like to say 'a word or two about. ly They must- recognise that the Otago' Medical j c j School was walffng to an entirely new phase as ' of its existence. In the*past it had been ;s simply ajocal or provincial school, but it was now' becoming a colonial national I. institution, and the standard of the medical profession in New Zealand would depend very largely on how the teaching was conducted in the school in which their students es 1 were turned out. He felt himself, us he was | )e sure they all did, that in the Dunedin Hosj r pital there were a great many difficulties— ,j s ' a great.niany things that ccnld be improved badly wanted improving. That, of course, meant increased expenditure, and, realising j that, they had been rather char)' of coming j 1( j to the trustees and pressing new suggestions on them feeling, as they did, that the 0 . trustees had made cno'jnons reforms and done a great deal of good work in improving 1( ] ; the Hospital during tlie past 10 years, for t 0 wonderfully improved it was. Stiii, be at wanted to impress on the trustees the fact K | that perfection was still very far off, and thpy )n wero still a long way behind the times, and , lie did not- think' they were yet quite in o {"' line with modern hospitals. He understood that the annual call on the Charitable Aid Board was shortly to bo made' by the trustees, and as he foresaw that n»ce3sary n _ improvements necessitating increased oxpen'diture must be.made in the Hospital, he :r ■' hoped the trustees, in making their estimate j.' ; would make it a lil:bra! one to meet ihat. 61 j It- mieht appear that, he was indicating a ■ good deal, but ho looked upon it as part of 55 the duty of the staff to come before (lie trustees and indicate what the' Medical n .' School required. It. was absolutely imposm Fible for a layman to have any real knower 4?d?e of. the enormous advances in medicine i and surgery made inathe past few years, m and even members of tlie medical profession sr .did not -always realise ' l.p.w fast advances j went on iu'llie way of niedieal and surgical ■),. , appliances and medical" ami surgical tcaeh>n ' in* in the Old Covinlry. Tt was. he rr,ntt.. sidfired only the duty of'itb'p staff lo come and ask the trustees to "assist them, and idthomrb lie did not propose to go info detail'. he honed.!! ?raat many improvements would he effected during the next few years. Dr Harnett agreed with all that had been said bv tho previous speakers. The trustees, ho was sure, would recognise the absoluio necessity of making cotisider- „ able improvements in connection with the Hospital. AH along Mie trustees had prided themselves oh the fact that their Hospital was up to date,' and he believed they would m now* be driven to face extensive improveir, .. ments, including the erection of a medical pavilion. More accommodation was wanted n f . for things that were bound to come. - For ; example, acting under instruct ions from (lie trustees, he ordered, while he was at r- ; Home, an X rays apparatus of the latest •i- | design, with every requisite for the proper i application of the X rays for (ho purposes lie j of diagnosis and treatment. That would 11, 'require housing in a suilable room. It would id also require the appointment of a skilled be expert, to make the necessary applicalions. le This could not be done by the ordinary in house surgeon, or by the members of the ■ a. medical slaff. He Ihouchl; there would not at. be much difficulty about apptfiniin; any:al one if Ihe trustees desired lo do so, because 111 among other applicants for such a position rs would he a gentleman he met. in London— | Dr Robert. Donnld. —v.-lio was well known lie: to of Ihe trustees, and who was lie ' thoroughly well versed in this particular al branch. Dr Donald would be in Dunedin is in the course of a month or six weeks, u- . Then Ihe out-patient department wanted is considerably enlarging. Only one room >n ■ could now be used for casualty cases, and li- often, there ,was confusion in dealing with e- I the eases, ipefore long provision would ig- : have lo be made, for enlarging, tlie otitiy'\ patient consulting rooms, which ought lo ill he entirely separate from the ordinary in casually room. He. could go on instancing ik other directions in which accommodation it- ought to be provided. No up-to-date hospiiir ' tal he_ saw at- Home was content now with in ': one. theatre in jvhicb to operate on clean m and dirty cases "alike. Provision nhcukl be or made for flip septic eases, otherwise they ro had difficulties which wero we'.t-nigh insuI'i- perable in keeping tho operating theatre ;e thoroughly clean for the proper treatment ib of clean eases. Sometimes they got eases :n from which the stench would "make some le people almost lose their balanced It was as ■ not fair to operate in such cases in the — • same place in which clean cases wero s, operated on.. The old theatre had been th ; made into an isolation department, conio i trary to the wishes of the staff, 'and it je j seemed to him that, sooner or later, pron-! vision would have to bo made for a theatre ly ; —not an elaborate theatre—where operations ie ~ in septic eases could lie undertaken, al'! Dr Closs emphasised all that the prety | vious speakers had said. The time had is ! come when efforts should be made to extend Id i tho Hospital. There was no question that er it was not the right thing to have medical at and surgical cases treated in the same ward. m and he would be very triad to see them in' separated. Tho Dental School was about Id to lie established. It would inevitably come, to and' accommodation would be required for er if the proposed pavilion wero erected re it might give sufficient room for nearly all >•9 that would be. required there. Every effort id should be made to get money for the purp- pose of erecting a new medical pavilion so li- as to relieve the congestion in other parts ie of the building. in 'Dr Gordon Macdonald said tliaf. being-a to . surgeon, the question was one that did not as ' affect bini personally, hut ho sympathised a 1 with tho position. He would like to add 10 to what , had already been said that _ const sumption was a-.deadly di-ea». and said to he be more or. less -infectious. Yet eorisu'mpal t-ive cases were now put into the surgical be ward, together with typhoid fever, pneu--10 monia, and other infectious cases. The I raising of the necessary money, ho was sure, to cou'.d be accomplished quite readily. He Is, believed the medical profession .would be at willing to appoint a committee which would its 1 work in conjunct-ion with . representatives bo of the trustees and of the general public to lg organise a scheme by which Mr Domos »n would be made to disgorge as much money ye as was required. One member of tbe prois fession, ho believed, bad guaranteed that id lie would get- £1000, and, if £5000 could be >d raised-from other sources, they could then nr go to " King Dick," and with another or ■. £4000 or £5000 from that quarter the thing id • would be done. ■ id The Chairman said he was sure they wero le all pretty .well of one mind in the matter, jo If tlie money. could be raised a medical rs ward ought to be provided; it was the first I work to which the trustees should , sot tliemal selves. He would like to correct- an imU5 pressiotf that- might pro abroad in conscile quence of Dr -Batchelor's remarks. The :d oublic might think from what the Doctor to ; had'stated'thai; the main building'was. full Jr of patients, whereas" thore were compara-

lively few patients in it. As to tho question | of funds, lie thought it'might be well-to call a public 'meeting 'to- talcfe the: matter into consideration, when the'position could be laid before tlie people and'thoroughly discussed. Mr Tapper asked Dr Burnett, respecting the X rays,; if there, was anything very difficult in, working the apparatus, or in learning the-way-to work it. ', Dr Barnett replied that the work was both didioult and dangerous—dangerous, to the patient- and to the. manipulator. In the course of ; 'his travels lie. came across numbers of men in charge of:X ray departments. ,Somo of them .were miuus a'finger owing to a sort: of cancerous disease having developed. .Many of them had exzema and eruptions over their hands,. and sometimes the patients were buret through the unskilful ase of the rays. Mr .Sinclair thought that something more should-be done thaii' merely- to talk the matter over. He thought'a committee of tin trustees-should-meet the medical staff, ascertain the probable cost of the-proposed pavilion,. and if possible r devise a way of raising the necessary money. Tht Chairman remarked that it would cost £10,000 to put up the proposed building. At this stage the deputation asked leave to retire, and Dr Macdonald thanked the trustees for the courteous .'reception extended to'them.. The matter was not further discussed by the trustees. '