PUBLIC HOSPITALS

Southland Times, Issue 21855, 4 November 1932, Page 7

PUBLIC HOSPITALS

SURGICAL STAFFING VIEWS OF AUSTRALASIAN COLLEGE LETTER TO MINISTER The following is a copy of a letter from the chairman of the New Zealand section of the Royal Australasian College of Surgeons (Sir Louis Barnett) addressed to the Minister of Health of which a copy was sent to the Southland Hospital Board and the medical superintendent of the Southland Hospital:— “With all courtesy and with all respect for the devoted public service rendered by all hospital boards throughout this Dominion, I beg to bring under your notice the attached resolution which was passed at a meeting of the New Zealand Section of the Royal Australasian College of Surgeons held at Wellington on September 8, 1932, together with some comments thereon. Copies of this resolution together with the comments are being forwarded to the chairmen of . the boards and the medical superintendents of the hospitals at Invercargill, Ashburton, Hamilton and Gisborne, and to the Director General of Health. Trtisting this communication will receive your favourable consideration.” The resolution passed at a general meeting of the New Zealand Section of the Royal Australasian College of Surgeons held at Wellington on September 8, 1932, is as follows: “That in. the opinion of the New Zealand Section of the Royal Australasian College of Surgeons the surgical staffing of so-called ‘closed’ or ‘one-man’ hospitals in certain of the larger cities such as Invercargill, Hamilton, Ashburton, and Gisborne, suffers from serious defects which lessen the efficiency of these institutions as compared with hospitals that have a properly organized visiting staff. The college, therefore, strongly advocates the adoption of the visiting staff system.” Explanatory Comments. The college offers the following explanatory comments in support of the attitude: (1) In the “closed”, or “one-man” hospitals referred to, the medical superintendent has to undertake to the best of his ability the surgical treatment of injuries and diseases in practically every part of the body and of every grade of severity and complexity. In the opinion of the college it is not possible for one man, no matter how capable or hardworking he may be, to handle with true efficiency all these various difficult and complicated cases, placed under his sole charge in a large hospital. The college recognizes that the one-man hospitals can be run conveniently and economically and with satisfaction to the board and to the patients, but the college nevertheless is convinced that the patients, though they may not know it, are not as efficiently treated as they would be in an open hospital where the services of a properly organized visiting staff are available. If a system of grading New Zealand hosiptals according to their efficiency came into force, these institutions without a well organized visiting staff would certainly be classed B grade or lower. (2) In the so-called closed or oneman hospital the medical superintendent gets a large amount of surgical experience which to him is undoubtedly very valuable though not so valuable as it would be, if he had frequent opportunities of seeing at work other surgeons of his town, men possibly of mature judgment and outstanding ability. These other surgeons and the younger men with good aptitude for surgery are debarred from sharing in the advantages a hospital should offer for the acquirement of experience. It can justly be regarded as a truism that the one and only way a young graduate can develop into an efficient surgeon is by a long course of training in a large hospital, at first in a junior capacity, and later as a full surgeon. It is of the utmost importance for the public welfare that there should be an adequate supply of properly trained surgeons, and if hospitals close their doors to a visiting staff the community will surely suffer, as there will not be a sufficiency of truly competent surgeons to attend them. (3) In the so-called closed or oneman hospitals it is impossible to run in an efficient manner the cancer consultation clinics which are proving such a decided success in the main hospitals of the Dominion where there is a visiting staff and proper facilities for team work. The college is aware of the fact that there have been occasions in an open hospital when the visiting staff have not given complete satisfaction to the board, due chiefly to slackness on the part of some members in attending to their duties. Any remissness of this kind and other possible causes for dissatisfaction could be checked ,by the proper organization of the visiting staff and the laying-down of definite rules which the visiting staff must observe. The college in this connection is prepared, if desired, to submit a scheme for the proper organization of the surgical staff of a hospital.