MATERNITY BEDS REASONS FOR SHORTAGE

Otago Daily Times, Issue 26176, 12 June 1946, Page 4

MATERNITY BEDS

REASONS FOR SHORTAGE

SURVEY OF WHOLE POSITION A REASSURING STATEMENT A comprehensive survey of the reasons for the shortage of hospital accommodation, with particular reference to maternity beds, was given yesterday in an interview with a representative of the Daily Times by Dr J. B. Dawson, professor of obstetrics at the University of Otago. Dr Dawson considered that, although there were immediate problems demanding a solution the whole position was reassuring.

“ During the past few weeks, as the result of several utterances,” Dr Dawson said, “ them has been created a state of 1 alarm about the maternity services in New Zealand. There are certainly problems needing solution at the moment, but an all-over survey of the situation is actually reassuring. The index which we have of the progress of maternity welfare in the Dominion is, of course, maternity mortality—the number of women who lose their lives in child birth.

11 It has been stated recently that this does not reflect the illness and invalidity which may follow child birth. This is not true, because it is obviously a logical fact that if the care of mothers is such that it materially reduces the number of deaths, it must, of course, also reduce the amount of disability. Indeed, the high average of fitness and well-being found when examining maternity patients six weeks after the birth of their children is a constant gratification to the staff of the Queen Mary Hospital. The maternity mortality 15 years ago was twice what it is to-day, that is to say, the young woman to-day faces half the risk which was faced by her elder sister. New Zealand to-day occupies the proud position of having the lowest maternity mortality rate in the world.” Factors in Improvement

That, of course, was a matter for congratulation, Dr Dawson continued, and the credit for it had to be given, first to the work of the Health Department in supervising the maternity hospitals in the Dominion, and it was only fair in that connection to mention the name of Dr T. L. Paget, who had recently resigned from the position of Director of Maternity Hospitals; secondly, to the fact that there was in New Zealand a body of well-trained midwives, whose assistance to the medical profession deserved recognition; and thirdly, to the vastly improved training of medical students. It would be invidious to attempt to apportion the credit.

“In the last 15 years,” he said, “the training of medical students in maternity work has been greatly improved and especially since 1938, ' when the establishment of the Queen Mary Hospital afforded opportunities for students actually to live in the hospital in daily contact with the work. It is fair to say to-day that training in obstetrics of the New Zealand student of medicine is equal to that of all medical schools in the Empire and superior to that of most. “There is, however, need in New Zealand for opportunities for young practitioners to gain further experience in maternity work. This is very noticeable at the moment, owing to the absence of many of them for years on active service, and it is to meet this need that a post-graduate school of obstetrics is being established in Auckland. Towards this end, considerable progress has been made, perhaps slowly, but the nucleus of this school has been established at Cornwall Park Hospital, where it will be progressively expanded to meet the needs of both post-graduate education and of the women of Auckland. It has been a very general custom of New Zealand graduates to seek further experience overseas, and it would be unwise to discourage this because the isolation of New -Zealand requires the infusion of the knowledge obtained in the larger centres of medical education, but there is a need for opportunities for post-graduate study for many who are unable to seek it in other countries.

Training in Obstetrics

“ Since 1938,” Dr Dawson said, " the Queen Mary Hospital in Dunedin has provided opportunities for residential experience to young practitioners acting as house surgeons, and by the end of this year 22 young men will have received such additional training in obstetrics. “This is the bright side of the situation, but what is causing a good deal of anxiety is the shortage of hospital beds, not only for obstetrical cases but for all others. This shortage is due to many factors. In the first place, the demand for such accommodation is increasing because of the sharp rise in the birth rate. Some of this, in turn, is due to the obvious fact that when tens of thousands of men are suddenly brought back from war service there naturally follows a great enhancement of the birth rate. This can be regarded as a deferred national dividend of young New Zealanders, whose births would normally have been distributed over the war period. It is probable that the birth rate will remain higher than it was 15 years ago, because there is little doubt that the social security benefits and the family allowance will encourage it.

“The next difficulty is that, owing to the great shortage of labour, both of trained nurses and domestic help, together with markedly increased costs of running and maintenance, small maternity hospitals have become unprofitable and extremely laborious to conduct. For this reason many of the proprietresses who are growing older are giving up, and, again owing to the preoccupation of war service, there are few younger women to take their place. Another minor factor is that the attraction of industrial employment is diverting young female nursing labour away from the profession.

Domestic Labour

“ The shortage of domestic labour has made it quite impossible for women to be delivered or, indeed, for anyone to be ill in their own homes, thus throwing a greater load on the hospitals. “The shortage of hospital accommodation.” Dr Dawson continued, “ is due to several factors. The first is that during the depression period a considerable lag in hospital construction took place. This had to be overtaken, a task of great difficulty during the war years, when constructional material and labour were being fully used for war purposes. The increased demand for hospital services has added to this difficulty, and it will be some years before an even very active hospital expansion scheme will meet all requirements.

“The position in Dunedin with regard to maternity beds may be summarised thus: A survey made last vear showed that the addition of 10 to 15 beds to the available private and public obstetric accommodation would meet requirements. With some difficulty eight of these have been added to the resources of ‘ Queen Mary,’ and plans are being pushed forward for extensions which will double the accommodation of the Hospital.

“In Christchurch a new St. Helens Hospital is in the course of construction. In Auckland the nosition is critical because of the number of private hospitals that are closing, and the rapid growth of the population in the metropolitan area has affected the position But there is every prospect that by the end of this year 60 obstetrical beds will be available in Cornwall Park Hospital. Load on Nursing Staffs

“ It would be idle to deny,” Dr Dawson went on, “ that for the next few years it will be a problem to find the required accommodation for obstetrical cases, but the problem will probably be surmounted reasonably well. It should be borne in mind, however, that the increased demand for hospital ser-

vices imposes a great load of work on the nursing staffs, and every consideration should be extended by the public for any minor inconveniences it may experience. “The problem of hospital expansion is not, perhaps, fully understood. It is impossible to conjure a hospital out of the ground. The construction of large blocks of buildings takes time, and even when they are completed they cannot be used without nursing staffs And you cannot have nurses without finding accommodation for them Therefore, when a new hospital block is provided it must be preceded or immediately followed by extensions to the nurses’ home, which takes time and a great deal of money. “There is, however,” he concluded,

“every hope that the lag in hospital construction which occurred in the depression years and continued, perforce, during the wai\ will be gradually overtaken.”