HOSPITAL STAFFING.

Otago Witness, Issue 3755, 2 March 1926, Page 11

HOSPITAL STAFFING.

METHODS OF SELECTION. SIR UNDO FERGUSON’S CRITICISM. A controversy which raised some discussion, some of it inclined to be heated, was initiated by Sir Lindo Ferguson’s remarks regarding the staffing of hospitals during the course of an address to the Hospital Boards’ Conference at Marama Hall on Wednesday. In introducing Sir Lindo Fergusou, Mr Wallace said that lie was there with Dr Unwin as representing the British Medical Association to discuss with the conference the question of the staffing of hospitals. Sir Lindo Ferguson said that he had been authorised by the British Medical Association to give the medical practitioners’ views on the staffing of hospitals. The question of representation of public bodies had been brought up before, and it had been assumed that representation and taxation should go together The medical profession held the idea that, hospital boards, because they were olected by the ratepayers, were inclined to aid the ratepayers more than they were the medical practitioners Another view that hospital trustees appeared to hold was that the whole benefit of the institutions was bound up in the welfare of the buildings only. Good buildings were certainly necessary, but good nurses were essential, and the medical staff was the whole hospital. If an earthquake swept away all tne buildings. the medical staff could still carry on its work. Some of the hospital boards did not quite realise that they owed a duty to .the profession, and that they ought to afford greater facilities for post-graduate work He would say that there was no body on earth more incompetent to judge the attainments of a member of the medical profession than the laymen who constituted the hospital boards, and he would suggest that the appointment of the medical staff of a hospital should be left in medical hands He considered that the members of the hospital board owed a duty to the ratepayers, even though the latter did not use the hospital. There were districts in New Zealand where men who had done their best in the service of the country were allowed a small honorarium and the right of private practice, for taking charge of a hospital. He wished to impress on them that it was a bad thing for a medical man to have sole control of a small hospital without proper supervision. In many oases, such a man was forced to undertake work which he was not fit to deal with.

A problem had been brought up by the Minister regarding the free admission of everyone to hospitals. This, Sir Lindo maintained, if carried into practice would do away entirely with honorarystaffs, and they did notr seem to realise that the honorary services given to the hospital by the medical profession would he worth the whole hospital tax paid by the ratepayers in any large town. He personally, and the profession generally, were more than willing to give their services gratuitously to any hospital where necessary, but he did not consider that they should be exploited. Patients should be allowed, when willing to pay the fees., to have their own medical advisers when in hospital. Another important point was that there should be a free exchange of patients between the institutions of the various centres; this was only fair to the patient and the community. Dr Unwin said that, contrary to general belief, the British Medical Association’s first consideration was for the patients and not for the doctors. Neverthe less, he contended that those who were able to pay hospital maintenance should be forced to do so. He stressed the value of community hospitals, where staffs could meet, compare notes, and discuss various problems, and which would act as a base for smaller and subsidiary hospitals. A drawback in the case of smaller hospitals was that they could not afford to maintain specialists, and enthusiastic juniors who were sometimes put in charge of these institutions were not under proper supervision. It was neither to the benefit of the public nor the junior that his work should not be criticised. Dr Unwin pointed out that a community hospital would also provide for the better training of nurses, who would be able to learn the methods of many surgeons, instead of seeing only the work of one doctor day after day.

Mr Wallace, in moving a vote of thanks to Sir Lindo Ferguson and Dr Unwin, said that the speakers, particularly the former, had made a grave indictment against the and hospital boards in general, and that a member of the B.M.A. (Dr Begg) had distinctly stated at the last conference that they were prepared to accept an honorarium. To Sir Lindo Ferguson’s criticism of the constituents of hospital boards he took strong exception. Mr Hornblow (Palmerston North) said that in respect to the Palmerston North Board, appointments of medical practitioners were not made by the board at all. The positions were advertised, and when the appointments were made they came through a board of medical men in the district. Sir Lindo Ferguson expressed regret at having hurt anyone’s feelings, but he knew of cases where experienced surgeons had been turned off staffs of hospitals to make room for friends or relatives of the members of the board. He was extremely glad to know that Palmerston North was so enlightened, and as far as he knew no other board adopted its methods of appointing practitioners. A Member: "Auckland does.” Sir Lindo Ferguson said that lie was glad to hear it. Mr E. 11. Potter (Auckland): "1 think, sir, that you should have found that out before cominfe here to-day. You have made a grave clinrge against the Auckland Board (which is the largest board in New Zealand), amongst others, and I for one resent your criticism.” Cries of "Hear, hear.” At this point the president again moved a vote of thanks to the speakers, which was carried.