HOSPITAL ORGANISATION

Otago Daily Times, Issue 19748, 26 March 1926, Page 13

HOSPITAL ORGANISATION

NEW REGULATIONS ADOPTED. AX UP-TO-DATE SYSTEM. The Otago Hospital Board at its meeting last evening adopted a set of new regulations governing the control and administration of the Dunedin Hospital. The demand for such new regulations more strictly defining the duties of the superintendent and staff arose out ot what was known as the Robertson case last year, and they nave now been for some time under consideration by the hoard. One of the main features of the new regulations is that the superintendent is recognised as an administrative officer. The teaching functions of the medical staff are recognised, and they are now to he organised into branches, each under a head. The relations between the Hospital Board and the University Council which have frequently been in dispute are now more clearly defined. More powers and responsibilities have been given to the staff than they ever enjoyed under the old by-laws. Dr Falconer’s reports of last June and July to the Hospital Board have formed the' basis on which the new by-laws have been drafted. Under them the medical superintendent is directly responsible through the Hospital Committee to the Otago Hospital Board for the management, discipline, and economical working of the Hospital, and shall he the recognised official head of the institution. In all matters pertaining to hospital administration ho shall directly represent the board, and he shall he responsible to them alone for the proper performance of his duties. The general medical staff of the Hospital consists of physicians and .surgeons who may be appointed by the Hospital Board to serve the Dunedin Hospital in any capacity. It is divided into the following groups:—- , 1. (1) The consulting medical staff, who have served on the visiting medical staff for a period of not less than 10 years. (2) The senior visiting medical staff, who are active practitioners possessing one of the higher qualifications in medicine or surgery. They are responsible to the Hospital Board for the care and control of the patients and to the University for the teaching of tlie medical students. (2) The assistant visiting medical staff, consisting of active probationers who shall be registered as medical practitioners in New Zeaalnd, and within five years of the first appointment shall obtain a higher qualification in medicine or surgery; and (4) the resident medical staff, onsisting of three senior resident medical officers attached to the surgical, medical, and specialist departments, and the house surgeons attached to the several departments for duty. The resident medical staff is to consist of two sections. The senior resident medical staff are practitioners of three years complete hospital service and are responsible to the visiting medical staff for the treatment of the patients and to the medical superintendent in all medicoadministrative matters arising in the performance of the residents’ duties. The medical staff of the hospital is divided into four major clinical divisions — namely, medicine, surgery, gynaecology, and the specialised department of eye. ear. nose and throat. There will also be a laboratory division. At the head of each service is a departmental chief, who will ordinarily be the university professor in charge of that subject. The five heads of services, together with the chairman of the visiting medical staff and the medical superintendent (ex officio) constitute the Staff Executive Committee, which has wide responsibilities in formulating and adopting all necessary rules, regulations, and measures in harmony with the declared policies of the Hospital Board for the government of the general medical staff, the clinical organisation of the hospital, and all the professional and scientific work properly to be carried on therein. One of the most important duties laid down for the Staff Executive Committee is to provide under supervision of the respective chiefs of service, and bv rotation of service on the part of the visiting medical staff, continuous and adequate professional services to all patients in every department of the hospital. The correlation between the Hospital Board and the University Council is in the hand; of a joint Hospital Relations Committee. consisting of an equal number from either body. This committee is charged with the duty of making recommendations in regard to all matters of common interest, particularly in regard to appointments of tlie staff of the hospital Ihe election of a visiting medical staff is to he conducted bv the hoard as follows: (a) A notification of every va-ancy shall be inserted in one or more of the local papers at least four weeks before the dav of the election; (h) applications on a printed form shall he forwarded to the board not less than two weeks before the date of the election : (cl at least seven days before the date of the election, recommendations as to all condidates for staff appointment (including chiefs of services) shall he made to the Otago Hospital Board by the joint Hospital Relations Committee after due consideration of such candidates and after full consultation thereon with the chief of service interested, the dean of the Medical School and , the medical superintendent of the hospital; (d) the election shall take place by ballot at a general meeting of the Hospital Board not later than seven days before office is to be taken. Ordinarily the head of a university' department will be elected chief of the corresponding clinical service. Arising out of the hv-laws. it will be necessary to appoint three resident medical officers at the hospital, preferably single men of not less than three complete years’ hospital experience. This the Hospital Board Iras resolved to do, provided the Otago University will contribute the sum of £SOO annually towards their salaries in consideration of the fact that, these resident officers perform the duties of tutors to the medical students at the hospital. Ar present the council contributes £4OO. The position, as now defined, may be thus summarised. The board, through its executive officer, superintends and medically directs the hospital in the care * of the patient; the university is in educational control of the hospital, the dean of the Medical School being the educational director The medical staff is a combined appointment and conducts the medical treatment and the medical teaching on behalf of the respective governing bodies All that now remains to be done is to submit the regulations to the solicitors for revision, and obtain the approval of (lie Minister in order to bring the regulations into force.