HOSPITAL SYSTEM

Otago Daily Times, Issue 23002, 3 October 1936, Page 14

HOSPITAL SYSTEM

TRENDS OVERSEAS

Important recent developments overseas in public health and hospital administration were discussed recently by Sir James Barrett, the noted Melbourne eye and ear specialist, who passed through Auckland by the Aorangi on his way back to Australia after retiring from the position of president of the British Medical Association at the 104th annual meeting in England. The outstanding movement in the hospital sphere, said Sir James, was the development in America of a system similar to that adopted by the Victorian Bush Nursing Association, of which he is honorary secretary. The fundamental fact had been recognised that some form of hospital insurance was essential, since the average man could not pay full hospital and medical fees. It had been realised that this applied to the middle classes as well as poorer people whose hospital fees would be dealt with by charitable organisations. The system developed was not connected with charity People paid an annual sum 36s or more, and in return were guaranteed hospital service if necessary for a specified period during the year, and made their own arrangements for the attendance of their own medical practitioner. The scheme had grown to such proportions that 270,000 beds were maintained in this way in America. Sir James was very impressed by the way in which the introduction of a health insurance system was being tackled in British Columbia, and considered the methods being adopted could be watched with advantage by other countries contemplating such a step. The medical profession was urging that the scheme should be nonpolitical, and that there should be no cash payments to the sick person. He should be provided with proper medical attention but his lack of employment should be dealt with under a separate unemployment scheme, and certification for this should be by a medical officer not in practice, on whom pressure could not be brought to bear The most objectionable part of the system in other countries had been found to be that cash payments were made to a patient on the cor tificate of a medical practitioner. Commenting on British hospitals, Sir James said there was a growing feeling that the system must be modified. It was generally held that the general practitioner, who was the backbone of the profession, must be associated in some way with hospitals, so that when his case went into one he did not lose sight of it altogether It had become plain that the two greatest svstems, the voluntary hospitals, which had been the glory of English medicine, in which the staffs were honorary, and the hospitals maintained by county councils with paid staffs, could not run alongside each other indefinitely without modification. While in England Sir James inducted Sir Farquhar Buzzard, physician in ordinary to the King and regius professor of medicine at Oxford. as his successor as president of the British Medical Association. Sir James is chancellor of the University of Melbourne, and he attended the congress of the universities of the Empire and the centenary celebrations of the University of London.