SUNNYSIDE HOSPITAL.

Otago Witness, Issue 3112, 5 November 1913, Page 73

SUNNYSIDE HOSPITAL.

COMMISSIONER’S REPORT. COMPLAINTS UNFOUNDED. STAFF EXONERATED. DEFICIENCIES OF THE HOSPITAL. (From Our Own Correspondent.) WELLINGTON, October 31. The report of Mi’ V. G. Day, the commissioner appointed to conduct the Sunnyside inquiry, was laid 011 the table of the House to-day. The report deals in detail with the different complaints made, and the findings generally disprove those complaints. In the matter of the Tribe case, the commissioner holds that Dr Orchard had neither legal nor moral right to give a certificate of death. “In my opinion,” the commissioner adds, “the complaints all arise either from the disorganised state of the minds of the patients or from the ignorance of tlie patients’ friends of the pitiful state which patients get into, not by reason of any ill-treatment or neglect on the part of the hospital authorities, but by reason of their mental ailments.”

The commissioner proceeds:—“l shall now deal with certain complaints mentioned, during the inquiry which arise from the deficencies of the hospital itself, and for which the hospital staff is in no way responsible. I.—Reception ward: On the male side of the hospital there is not, nor has there been for many years past, any ward for the reception of new admissions. Patients on arrival have to be placed in the refractory ward with the worst class of patients in the hospital. This, I submit,' is improper, and should not be allowed, as it cannot tend to improve the condition of a patient, and in many cases must be harmful. The medical officers state that, owing: to the overcrowded state of the hospital, it cannot be avoided at present. I understand, however, that provision is made for the erection of a reception ward in the near future.

ll.—Classification: Owing: to the over-, crowding, it is impossible for the patients to be properly classified, and so receive proper care and attention. For instance, patients whoso mental derangement docs not affect their table manners have to sit at the same table as patients who slobber into their food. The patients cannot be classified according to their various mental derangements. A suggestion was made during the hearing that patients should be in some %vay classified according to their social status, but this is obviously impossible. Something, however, should be done to separate the coarse or foul-mouthed from those of more refined instincts. Lunatic prisoners from time to time are sent to mental hospitals, and I understand no special provision is made for their custody apart from other patients. This is obviously improper, and requires no further comment. A large class of patients are those who ore certified as mental defectives on the ground of senile decay. I am given to understand that in Great Britain the majority of these cases are to bo found not in mental hospitals, but in workhouses; in fact, they are not classed ns lunatics or mental defectives at all. These patients should be placed in a separate institution, as the majority of them only require a limited amount of care and attention, and do not require the services of trained mental nurses to look after them.

-111. — Hospital treatment for sick patients : At Sunnyside there is absolutely no proper hospital accommodation. Tiiero is a ward called the infirmary ward, but this has to be occupied by epileptics, to the exclusion of all others. If a patient falls sick the only place to put him is in one of the single rooms, which I have already commented upon in Mr Tribe’s case. This should not be in an institution such as a mental hospital controlled by the Government of the country. Friends of mental defectives have the right to expect all reasonable care, comfort, and attention for the patient, which would include adequate hospital treatment when necessary. In this connection the medical officers are of opinion that, when a proper infirmary ward is provided where sick can be cared for, it would be better to employ fcmalo nurses to look after the sick. IV. Medical Officers: There are two medical officers in the hospital—Dr Gow (the medical superintendent) and Dr Ramebottorn (the assistant medical officer). Under their charge they have, approximately, 700 patients of both ecxes. On the medical superintendent devolves whoie work of *h e supervision of the hospital and also of t.he farm of 350 acres attached to it. He, therefore, has little time to devote to the medical work, wh : ch almost wholly devolves upon the assistant. Naturally a number of the patients require very little, if any, medical attention. The attention, however, required by the others, and to which they are entitled, appears to me to be too much to ask from one, or even two medical officers. I understand that in a hospital of this size in England the medical staff would consist of the medical superintendent, two assistant medical officers, _ and a pathologist, who would act as relieving medical officer when necessary. The Sunnyside medical staff is at present deficient. Dr _Hav (Inspector-general of Mental Hospitals) stated that an assistant medical officer is being provided. If this is done it will telieve the position to a great extent. V. —Attendants; The rules and instructions laid down for thc_ guidance cf attendants are as near perfection as possible, and they appear in the main to be faithfully obeyed and carried out. At the Sunnyside Mental Hospital there arc 370 male patients, and a staff of 45 attendants, including the head attendant. Of these two are always on night duty, and at the present time two others are on night duty In charge of one case. This leaves 40 available for day duty. Of these 40 25 per cent, are always

on leave, which leaves 30 on duty. According to the evidence the proportion of attendants to patients should be one attendant to every eight or 10 patients. As it is there is only one attendant to every 12 patients, and this proportion is often increased owing to sickness amongst the staff. It is in evidence that the attendants work 13i hours one day and 115 hours the next, and have three half hour periods off during the day for meals. They have 92 days’ leave duringr the year. The number of hours worked by one attendant during the year is 3411, equal to hours each day for 365 days, or allowing meal times off for the actual days worked it coitus to over eight hours for each day of the year, including Sundays. The work of the attendants is not heavy physical work, but during the hours they are on duty they are almost constantly on their feet, and have to be on the alert, watching the patients under their charge. It is admitted that the work is nerve-racking, and probably a greater strain than mere physical work. Only two attendants are on duty during the night in the Sunnyside Mental Hospital. One r , e ' plains in the infirmary ward, where the epileptic patients sleep, and the othef patrols the building once an hour. This patrol takes three-quarters of an hour. For the proper care of the patients there should bo an attendant on duty on each door. 1 he size of the building can be imagined from the fact that it takes the attendant threequarters of an hour to make his round. I am of opinion that the staff is inadequate in numbers and overworked. It cannot, therefore, be possible that patients receive the care and attention they are entitled to. The lack of a reception ward and a hospital ward at the Sunnyside Mental Hospital brought under the notice of the Government as far back as 1904 by the then Inspector-general (Dr Maogregor), and all that had been done since is to build a reception ward on the female side of the hospital and to acquire a site for one on the men’s side. In the meantime, the .number of patients has increased, thus accentuating the overcrowding of nine years ago. The State has assumed the care and control of mental defectives, and it should bo the first duty of the State to provide what 1b necessary for their well-being. In company with those engaged on this inquiry, I spent a most instructive day in inspecting the mental hospital, and especially the rooms and wards mentioned in the evidence. I was greatly impressed with the cleanliness of the huge building and its orderly appearance. Wc went all through the hospital, visiting every part. A number of beds were taken haphazard and stripped. In every case the bedding was clean and sufficient. We saw the patients at dinner, and afterwards partook of a meal taken from the same dishes. There was abundance of food, which was well cooked and nutritious. We saw the new annexe on the female side, and were pleased with its light and cheerful appearance, which was in great contrast with the older parts of the hospital. It shows much thought on the part of the designer. In my opinion the costs incurred by the medical officers should bo paid by the Mental Hospitals Department, and I would recommend that any reasonable costs incurred by other parties be also paid. In conclusion, I think that the result of this inquiry—lengthy and exhaustive as it has been—should allay any fears that may have arisen in the public mind that patients are eub-

jected to ill-treatment in the mental hospital, as it has been fully shown that cause of complaint on the part of patients or their friends arises not from any laches on the part of the medical officers or attendants, but from defects o! the hospital itself.