HOSPITAL PROBLEMS.

Otago Witness, Issue 3757, 16 March 1926, Page 6

HOSPITAL PROBLEMS.

ADDRESS BY DR MACEACHERN.

Dr M. T. MacEachern, the well-known American hospital expert, who is at present visiting Dunedin, on Wednesday delivered a popuL- 1 illustrated lecture in the Trinity Methodist Church Hall. The Rev. V. G. B. King presided over a large attendance of the public. Mr King explained that the meeting was being held under the auspices of the St. John Ambulance and the Bed Cross, international and world-wide societies for the welfare of suffering humanity. As Dr MacEachern was carrying on an international work, be it was most fitting that he should speak under such auspices. Dr MacEache-ru’s aim was to complete and perfect the work begun by these societies. Before Dr MacEachern began his lecture the audience joined in singing verses of the National Anthem and of “ My Country, tis of Thee," in compliment to the visitor. Dr MacEachern began by paying a hearty tribute to the work of the Red Cross and the St. John Ambulance. He invited questions at the close of his lecture, and explained the nature of his present mission to Australia and New Zcahmd. His work at home involved the superintendence of 2400 hospitals with upwards of 600,000 beds. The- •bole movement was based on service dl the patient. He proposed to give them some facts from his experience. We had a good hospital gystem in New Zealand,

but some weaknesses had crept in, and like every other system, it was capable of improvement. The lecture that followed was on the lines of one the lecturer recently delivered here to the medical profession. He touched first on the reception of the patient at the hospital, and the necessity for a sympathetic and kindly welcome. Then followed the questions of accurate diagnosis and effective treatment. The aim was to get through the hospital period as comfortably and in as short a time as possible. Financial considerations were only secondary, and the care of the patient was primary.— (Applause.) With the aid of lantern slides Dr MacEachern expalined the importance of accurate case notes, and of scientific examination before operation, illustrating his points from his wide experience of hospital practice. A number of the slides clearly illustrated the effects of various diseases on the blood, and these and X-ray pictures showed how different diseases can be simply and accurately diagnosed with the necessary apparatus. Further descriptions of hospital work served to emphasise the vital importance of the best equipment and of systematic methods and records. He stressed the value of the staff conference which enabled the medical staff of a large public hospital to pool their experience for the benefit of the patients. This advantage was lost where there was a large number of scattered pnvate hospitals. The lecturer procceedcd to discuss various aspects of hospital organisation, and stressed the point that every member of the staff was contributing in some way or another to the welfare of the patient. He pointed out the detects of the hospital system under which only those patients who are unable to pay are allowed to enjoy the benefits of the special equip-

ment available in the public hospital. The New Zealand system had many great advantages, but it .. us a defect that even if caring for a wealthy patient from abroad who was not a taxpayer our hospitals could not charge him more than a very small sum. Voluntary effort was decreasing in our hospitals. It would be a very grave loss indeed if that decrease were to continue. Voluntary effort in our hospitals was a thing to be fostered and perpetuated'for all time. He thought the Victorian system when worked out in all detail would be the best system he knew anything about. He described the way in which the whole State was linked up to the great central super-hospital, with its costly equipment in Melbourne, and illustrated many attractive types of ward in the outlying districts. H* dealt in conclusion with the organisation and work of his own headquarters in Chicago, and described the work of his hospital inspectors and the system of hospital standardisation and certificates of efficiency. He believed that the hospital that was going to last was the voluntary community hospital subsidised as necessarv by Government and municipal aid, in addition to fees from patients ard earnings from departments. In these hospitals they must have honorary staffs who would give their services gratuitously to the necessitous poor who must have first call on all these institutions. He did not see any objection in the world to the community hospital anywhere, and he would stake his life on its being a success. He had not yet developed faith in Government .control of these institutions, and he had had considerable experience of them. Mr King thanked the trustees of Trinity Church for the use of the hall.

The first question came from a lady who asked about the hours of nursing. Dr MacEachern said t’-ey sought to adhere to eight hours a day with nraetically a day off each week. He d ; d not agree with the questioner that eight hours was too long. In reply to other questions, Dr MacEachern said he thought it was nec-es-sai w for nurses in their training to have to do with all classes of patients, and not only those met in a public hospital There should always be representatives of women’s institutions on a hospital board. Medical students were admitted to the general wards, but to the paying wards only on request. A dietitian should be in every metropolitan and base hospital. ‘'Are you aware,” lie asked, “that your university here has one of the finest household science departments in any country and that you have 50 young women in training there?” He went on to say that in Australia be was asked to i >pl.v dietitians from America, but he said, “Hold on till you see what New Zealand can do for you. You ought to be doing it for yourself.” Now he was going to report to Australia that New Zealand could supply the necessary personnel from the School of Home Science in the next few months. He expressed strong approval of the provision made at the University for giving girls preliminary training for the nursing profession. He condemned the system in New Zealand under which young, unqualified doctors were at times operating in hospitals to the exclusion of Burgeons of 10 and 12 years’ experience. He upheld the Plunket system as a splendid example of voluntary health effort subsidised by Government and municipalities. A discussion regarding the relative merits of Government and voluntary assistance was carried on for a time with keenness.