MEDICAL “EXPERTS’” PART IN HOSPITAL AFFAIRS CRITICISED

Otago Daily Times, Issue 27091, 27 May 1949, Page 4

MEDICAL “EXPERTS’” PART IN HOSPITAL AFFAIRS CRITICISED

A charge that many of the faults in present-day hospital services could be traced to the advice that had been given by medical “ experts ” in the past was made at a meeting of the Otago Hospital Board last night by the chairman, Dr A. S. Moody. The chairman was-taken somewhat to task afterwards by members of the board, but he emphasised that the opinions were his own and not necessarily those of the board.

“The question of hospital control is much in the news to-day, and I think it desirable to emphasise that the present failure—or breakdownin hospital services cannot be entirely laid to the blame of the ‘ lay ’ hospital boards in New Zealand,” Dr Moody said. Take< the case of the Otago Hospital Board. Up to the time of the present board, the control to a great extent had been given to the Otago Medical School and the hospital staff, and can they not see that as individual doctors they may be excellent, but as business men they are frequently failures? “ The present shortage of beds, which is almost a calamity, would have precipitated an impossible situation if the advice of the expert medical staff had been followed in erecting the theatre block in preference to the new Wakari scheme. The Health Department told the board, in as plain language as possible that it (the department) did not approve of the theatre block, but did approve of the major scheme, which would overcome our bed shortage. The erection of the theatre block would have taken four years, and would have meant the loss of 25 beds, and this would have come at a time when the poliomyelitis epidemic was with us lately. “The appointment of medical staff is intimately bound up with the Otago Medical School and the University of ( Otago,” the chairman continued. “ ( Here, again, up to the time,this new board was elected, the appointments made mainly by recommendation from the two bodies—the Medical School and the University of Otago. Have all those appointments been a success? What assistance did the two bodies concerned give the Otago Hospital Board to keep the services of our director of tuberculosis? I told the Vice-Chancellor of the University of Otago five months ago that if the position of tuberculosis director was not made more attractive we would lose Dr Brian Thompson. The same reasoning will apply sooner or later to Mr Murray Falconer. Did the experts help the board to solve its problems concerning anaesthetics, or did it. help in any way to get an increase in salary and improved conditions so as to make several medical positions attractive enough to keep other good full-time men in Dunedin? “I. personally, feel,” Dr Moody said “that the chances of getting medical men with business ability to run hospital commissions is so small that the public should realise that when the Prime Minister, Mr Fraser, said, ‘ God forbid that the time should come when the public hospitals should pass from the control of the public,’ he really knew what was for the good of the people. "Most of the troubles associated with our hospital have arisen through previous boards taking the advice of the medical 'staff—the experts. They must now admit that they are mainly responsible for many of the troubles associatedwith shortages of beds and other administrative problems. “There should not be any friction between the University of Otago and the Otago Hospital Board.” he said. ‘'There would be none at all if all real'sed that the board’s one desire is that the institution is to be run for and in the interests of the public. “ The question of shortages of maternity beds is also one which does not concern the board alone. It is a problem that the medical staff could help a great deal to solve, as it is a problem which may become conten-

l tious whether Miller Ward is to become an open ward. The women of Otago have been promised attendance by their own doctors, and they cannot get that service because we are approximately 20 beds short of the required number of private maternity beds. ’ Problem of Aged “ Interference with the board’s plans to go ahead with Marinoto maternity hospital plans is the cause of this shortage. In regard to the aged and infirm, these must be divided into three groups: (1) The almost totally disabled; (2) those who are able to do something for themselves and are ambulant; (3) the old people who can look after themselves if they have somewhere to live. “It is the latter class, I take it, for whom Mr Semple is out to do something.” the chairman went. on,',.“but the main hospital problem is associated with classes one and two who occupy hospital beds and keep the younger generation from getting urgent medi-' cal attention. I notice that Miss Howard mentions that the Health Department is introducing a new type of decoration—pastel shaaes, etc. The idea is taken from the pamphlet on the treatment of the aged written by Dr Cossens, of Orsett Lodge, London. It represents probably all that New Zealand will get from thq visit of two or more Health Department experts, to England. The most satisfactory, cheapest, and best way to solve New Zealand problems on the treatment of the aged and infirm would be to ask Dr Cossens to come to New Zealand to advise the Health Department on the best methods of utilising the facilities which are available. He is the recognised authority, and I think he would probably come out if asked. The problem is acute,” he concluded, “and demands immediate use of what facilities are available.” Dr John Fulton asked the chairman who he meant by “experts.” Dr Moody: Sir Charles Hercus and company and the medical staff at the Hospital. Dr Fulton said he was doubtful whether the board should subscribe to Dr Moody’s statement. Dr Moody: I am saying what I think. It is not a statement from the board. He was disturbed about the chairman’s reference to doctors being failures as business men' Dr Fulton said. That statement should be modified. Defending his statements, the chairman cited a temporary theatre block at the Dunedin Public Hospital—there was a bill for £2500 to make the block fit for use. “ That block was approved by the medical staff,” Dr Moody added. ■ Dr N. H. North: I would say that members of the profession, on the whole, are not good business men. Dr Fulton: Do you include Dr Moody in that statement? Dr North (with a smile): I am talking about doctors as a whole. Dr Fulton: May we please go into committee?The chairman said that the board was in open meeting. It was stated that the temporary operating theatre cost £3968 14s 3d, and now it was proposed to make it fit for use bv the expenditure uf £2500 The board’s architect. Mr N Y. A Waips. said he did not think a permit would be granted for the alterations to the theatre. Originally the plans for the block were altered by the Department of Health and later approved. It was decided to find out whether the theatre could be used if it was ventilated and whether staff could beobtained to operate it.