HOSPITAL CONSTRUCTION

Southland Times, Issue 19102, 21 November 1923, Page 6

HOSPITAL CONSTRUCTION

LESSONS FROM AMERICA. INTERESTING REPORT BY NEW ZEALAND DOCTOR. Dr. D. MacDonald Wilson, formerly of Invercargill, has presented some exceptionally valuable information to the Wellington Hospital Board in regard to different aspects of the American hospital system. The following facts are the results of impressions gathered by him during his recent tour about the latest and most desirable methods of hospital construction: — SOME RECOMMENDATIONS. The report contains the following recommendations to the Wellington Hospital Board, but which are of interest generally in respect to hospital building:— First, I wish to emphasise that if the people of Wellington desire a modern up-to-date hospital, providing accommodation and means for the best treatment of the sick, they must be prepared to pay for it. Treatment to-day is so specialised, and such expensive equipment required, that only large sums of money can possibly build a hospital. Also this specialisation of equipment is becoming more and more advanced every day, and the cost of treatment will necessarily increase. While we have considered £lOOO per bed a huge price to pay in America £2OOO-£3OOO is not considered unreasonable in building a hospital. However, the more I have seen of hospitals the more I am convinced fine buildings alone can never make a real hospital. Ample accommodation and provision of necessary equipment is .essential, but also there must be a properly organised numerically sufficient staff. Since the cost of a modern hospital is so great, it is necessary to see that all money is spent in the right direction. Ample and the best accommodation for patients and all necessary departments and equipments must be provided, but care must be taken that money is not spent on luxurious fittings and fixtures just because they are the fashion. My recommendations naturally fall into several headings: ARCHITECTURAL. I have already discussed how other countries have different conditions, problems, and climate, and hence in building we must build to suit ourselves, always with minds open to copy, adopt, or modify suggestions from them. While one style of hospital has certain advantages over another, yet in all my tour, after visiting 1 some of the most recent hospitals I have yet to see the “perfect hospital.” However, there are certain rules which have established themselves everywhere, and we should ‘endeavour to follow them. I have given much thought to the question of the proposed administrative block, and I can see nothing fundamental in itj that is not essential. I may have some minor alterations to suggest. I see as we are situated that any site but the proposed one could be utilised. As I see the future extensions of the hospital, this site will be more central than to-day it appears. HOSPITAL CONSTRUCTION. On the question of hospital construction, i Dr. Wilson said:— Personally. I am strongly of opinion that for New Zealand without climate and conditions the pavilion type is the most desirable for a general hospital. It allows of most light, air, and sun, to large wards, provides for future expansion and gives patients best accommodation. Where heating to us is comparatively not a big problem the extra expense is not great, and other services can be centralised to give satisfaction. In America to-day the cost of maintaining hospitals is vastly higher than in New Zealand. In spite of nearness to manufacturers and necessities, the average coat to build varies from 10,000 to 15,000 dollars per bed. Some hospitals have even cost 20,000 dollars per bed. Hospitals generally, are constructed more lavishly. Beautiful marble halls and waiting rooms, wards and rooms finished with expensive materials, and equipment are seen all over the country. On the other hand, just as excellent surgical and medical work is being done in more modest buildings, provided there is tha equipment and a well organised staff. ALL TO LEARN. Dr. Wilson said that a department in which we had all to learn from America was the kitchen. It is here that all special diets are prepared—diets for cases suffering from diabetes, renal disease, heart disease, obesity, malnutrition, and anaemia. The percentage of special diets to ordinary diets is very small, and therefore this room does not require to be anything like the size of the main kitchen. Blackboards set in the walla are essential for noting daily orders. STRIKING FACTS. Regarding other staff appointments, a dietitian is an absolute necessity and should be appointed as soon as possible. The appointment of an instructress to the nursea should also be considered. There was one very striking fact about hospitals in America. Those supported by rates were generally not those hospitals leading in medical investigation. It is difficult I know to set public money aside for research, but the effect in America is only too striking. Where hospitals have beeni privately endowed, there abundant provision Is made for research and training the young graduates in investigating disease.