THE OTAGO DAILY TIMES MONDAY, APRIL 12, 1926. THE COMMUNITY HOSPITAL.

Otago Daily Times, Issue 19761, 12 April 1926, Page 8

THE OTAGO DAILY TIMES MONDAY, APRIL 12, 1926. THE COMMUNITY HOSPITAL.

An outstanding feature of Dr MacEachern’s utterances in our midst on hospital problems has been his steady advocacy of the community hospital. He has now specified a list of the advantages claimed for this type of hospital. Public opinion in the Dominion is possibly somewhat conservative as regards proposals that wohld mean the introduction of new features in the hospital system, and no fault need be found with it on that score. But it should be prepared to give every consideration to advice on the subject that comes from an authoritative source. The fact that the principle of the community hospital has the support of the New Zealand branch of the British Medical Association will, of course, not commend it to any section of the community which is perversely inclined to regard the medical practitioner as guided more by self-interest than by any desire to render health and all that is therein implied as cheap a commodity as possible. A sample of the class of objection to which Dr MacEachem’s suggestions are exposed was supplied at the annual conference of the New Zealand Labour Party. Mr T. Brindled the retiring president, said in the course of his address at the opening of the conference : “The monetary standard of life had become so paramount that the New Zealand section of the British Medical Association was making a supreme effort to bring its baneful effects into the realm of public health by the creation of a class line in our. very hospitals, by means of private wards for those who could pay the most, truly a proposition, which should rouse the wroth of all progressive, men and women.” This amounts to a denunciation of the community hospital, a feature of which is the pay-ward system, and it is the more worthy of attention because Dr MacEachern specifically claims for the community hospital that it abolishes class distinctions. Not for the first time have entirely different conclusions been drawn from the same set of circumstances. Mr Brindle, of the Labour Party, and Dr MacEachern, with a wide experience of hospital administration behind him, view the position from different standpoints. Both cannot be entirely in the right. Dr MacEachern’s argument is that the type of hospital we have in the Dominion caters for one class only, tho supposedly necessitous who are not able to pay for medical service, whereas the community hospital would cater for all sections of the people, as there would be one service for all with different accommodation on a graded basis. It cannot very well be said that the hospitals of the Dominion are class institutions, since they are free to all, but Dr MacEachern relies upon a statement made “on good authority” to the effect that 60 or 70 per cent, of the citizens will not enter our public hospitals as at present constituted. It is rather surprising, to say the least of it, to hear that the public hospitals, great institutions as some of them are, are catering for so small a percentage of the population as is suggested. But it is doubtful if any good purpose is served, after all, in examining the claims of the differing types of hospital from a class standpoint. It has been shown that something can be said on either side from that point of view. Differentiation among patients is a feature of the community hospital of which the effect is said to be that it makes the whole scheme a practical success. But the argument that the community hospital would discharge a function which tho existing hospitals do not discharge, in catering for and in attracting all sections of the community, seems to hold its own. • It is reinforced, moreover, by some very practical considerations. Those who use the hospitals at the present time do not, as a whole, provide anything like the cost of their maintenance. The deficiency has to be made good, in large part, by tlio.se, forming the majority of the people, who do not use the public hospital?. It is reasonably claimed that

the burden of hospital maintenance is a charge upon the ratepayers and taxpayers that would be materially lessened by the very substantial increase in the general maintenance revenue which would be assured in the case of the community hospital through the admission of patients who would be prepared to pay for special accommodation and for medical service. Moreover, the argument as to efficiency in the case of the community hospital is a strong one. It is assumed that the introduction of this type of hospital would eventually entail the disappearance of the private hospitals, and it is logically pointed out that the community hospital, with its resources and its comprehensive organisation, would be in a position to provide, from medical and other aspects, a service in the highest degree efficient, superior to anything that could be expected in a private institution, and superior to that obtainable in the public hospitals at present.