PUBLIC HOSPITALS.

Otago Daily Times, Issue 19759, 9 April 1926, Page 9

PUBLIC HOSPITALS.

THE COMMUNITY SYSTEM. TEN POINTS OF ADVANTAGE OUTLINED BY DR MACEACHERN. (Peb United Press Association.) WELLINGTON, April 8. Dr MacEachern has received numerous inquiries as to the community hospital system and in reply specifies the following 10 points of advantage : (1) The system provides the patient with freedom of choice of accommodation and doctor. (2) It consolidates the community and professional interest in the hospital in a more efficient and economical manner, providing all round advantages to the patient, hospital doctor, nurse, and more particularly the community. (3) It brings the hospital and its workings more intimately into the minds and knowledge of the people, thus fostering finer community pride which is so essential to-day. (4) It abolishes class distinction. The type of hospital as it now exists really caters for one class —the supposedly necessitous or those who are not able to pay for maintenance and doctor’s service or aole to pay public ward maintenance 9s per day, but not doctor’s fee. It is stated on good authority that 60 to 70 per rent, of the citizens in any community will not go into the hospitals of the Dominion a* at present constituted, for if they do they are accepting free services at the expense of the ratepayers and the consolidated revenue, as 9s per day is not much more than half the actual cost of service. Unlike this the community hospital caters for all sections of the community, there being of course one service for all, but different accommodation on a graded basis. (5) The community hospital by virtue of concentration with its organisation and efficiency and the fact that it embraces all doctors in the community, provides a much higher average of professional ability among the medical profession, and this is not only a great advantage to those who are ill in hospital but particularly to those who are under treatment at home or who come to a doctor’s office for treatment. This phase constitutes at least 75 per cent, of the average doctor’s practice. In no better way can the average professional ability in any community be raised than through a community hospital. (6) It lessens the burden of taxpayers and the demand on the consolidated revenue ty—(a) Encouraging those who are able to pay the entire cost of maintenance rather than only 9s, approximately half the cost of maintenance, which burden is now facing placed on the taxpayers and the consolidated revenue. (b) Providing a way by which a nonresident or non-ratepayer can pay his way in hospital rather than be a burden on the taxpayer and the consolidated revenue. (c) Increasing the general maintenance revenue to a very appreciable extent through absorbing a great deal of the overhead or administrative cost, thus lessening the call on the ratepayer and the consolidated revenue. (d) Through gifts and benefactions from grateful patients who have received service themselves or their family. (All this assists the hospital in lessening its financial burden). (7) It provides better facilities and specialists through mere economic concentration of the various hospital services in one great institution. There is less duplication of administration and effort where this type of hospital exists. (8) It affords a nurse in training broader experience and a better rounded-off practical education, as she has ample oppor tunity of contact with a wider range of temperaments and social conditions. (9) It inspires more confidence in health and the practice of medicine, and through its contact with a much larger group of people'can exercise its educational function much better in the prevention of disease and the promotion of health with its personnel, its facilities, and its numerous par ticular characteristics already mentioned It is a more human institution and keeps in the foreground more pre-eminently the great principle of service to the patient This, of course, is due to the greater enthusiasm, interest and competition which is consequent upon a wider range and multiplicity of interests. (10) It stimulates more voluntary effort where the people give freely of their time, energy and money to further its interests. For instance, always associated with this type of hospital will be found large women’s organisations or auxiliaries assisting the institution financially, and through their own personal efforts so that hospitals may have everything that is required to keep it up to a higher degree cf efficiency. Dr MacEachern said he could give a score more reasons for the system, but off-hand he would advance the 10 outlined above.

THE HOSPITAL SYSTEM.

SOME OF ITS DEFICIENCIES. DR MACEAOHERN’S REPORT. (Per United Press ' ssociation.) WELLINGTON. April 8. At the conclusion of Dr M. T. MacEachern’s tour of the Dominion a conference was held here when the distinguished visitor was met hy the principal medical offi cers of the Department of Health, the Ex ecutive of the New Zealand Hospital Boards’ Association and representatives from each branch of the British Medical Association Dr MacEachem submitted a tentative summary of the report, divided into three parts, namely: (1) Commendatory features of the New Zealand hospital system. (2) Deficiencies of the system. (3) Recommendations. The full report will be published later. In the report submitted to the conference Dr MacEachem made a number of very definite recommendations as follows: (1) Restricting the number of hospital districts which, to-day, he stated, were far too many. (2) A more uniform method of staffing hospitals and especially the abolition of the so-called one-man system or dual superintendent, that is, where the medical officer does both clinical work and administrative work to the exclusion of all other doctors in the community. (3) The establishment and development of the community hospital system. (4) The adequate training of full time hospital administrators in the Dominion. (5) The establishment and maintenance of better co-operation between hospital boards, doctors and the community in many places. A few other matters affecting the policy were dealt with and a number of recommendations relating to peneral administration were touched on. These will be discussed more fully later. Dr MacEachem stated to-day that with the full measure of co-operation which should exist between the Health Department, hospital boards, doctors, and the people, with the addition of the communitv hospital idea, the finest progress possible in regard to the hospitals ■ if New Zealand would be assured.