HOSPITAL MATTERS

Te Awamutu Courier, Volume 68, Issue 5942, 12 May 1944, Page 4

HOSPITAL MATTERS

Sir,—l can assure Mr Macky that I am entirely with him in a desire tc avoid controversial matters, especially on the eve of an election, and my one hope is that there may be a better . understanding. For that reason, some of the questions asked are not applicable, because of differing circumstances. For instance the bed capacity, etc., of various hospitals would not help here, because in London there are very large hospitals within a two-penny bus ride of a population equal to the entire number of people in this Dominion. What I said in my last letter was that size is not an indication of low cost or efficiency in a hospital. I know of large hospitals that are comparatively low in cost, and quite efficient. I know of small hospitals that are just as satisfactory. What I want to make clear is that size is not the .deciding thing. The method of finance is, as Mr Macky says, very controversial now, and for that reason I will not answer his question except to say that the tendency in England as in New Zealand is to bring the Public Health services directly under the Social Security Plan. I will certainly not criticise our wise forefathers for locating the hospital at Hamilton. I know it to be a very excellent hospital, but I am not satisfied that the 700 bed limit, which Mr Macky says has been fixed, is wise. TJie number of beds should re*gulate according to the density of population, and the need and functions of the hospital.

Where Mr Macky is wrong, and where policy has been wrong, I suggest, is to speak of the Waikato Hospital. It is the Hamilton Hospital for the district, as Mr Macky himself said previously, within an area which naturally makes Hamilton a centre. When the number of beds at Ham-

ilton hospital is in ratio to the needs of that district, the hospital can be well placed, but while the number pi beds is regarded on the needs of the Waikato, well, Sir, what we now have is a continuous waiting list. This condition should make it plain to Mr Macky and to everyone else that the hospital is not in ratio with the population, or the spread of population, and it leaves the unrest about the spread of finance. Can I make it plainer? Size of hospital is not relevant to either cost or efficiency of the .hospital. The relationship between the population density and the availability of the hospital is a factor. Another consideration is that average figures can be quite misleading, for in the nursing of a hospital there is no workable average of patients or treatment or of costs. Fpr instance, Mr Macky would be quite wrong to go into the medical ward, and then into the surgical ward, and say £2OO per bed. To do so would be stupid. It would be just as silly to say an average of two weeks, when actually a patient may be discharged after one week, and the next patient be three weeks or longer. It all comes down to this. The Hamilton hospital can be very excellent for the area of Hamilton, but not for the district of Waikato. If Mr Macky knew the good effect on patients whose relatives and friends can regularly avail themselves of visiting Hours he would, I am sure, agree with me in saying how desirable it is to study hospitals in relation to population density, and so cut down time and distance. Moreover, for the same reason, he would understand, to so place the hospital that out-patient service is possible—for the desire ought to be for hospital treatment rather than hospital admissions. By this I mean people should be able to attend suitable clinics for the practice of preventative treatment, for electric massage, for X-Ray, and similar helps towards correct diagnosis, and thus by these and other means reduce the number of hospital admissions. If that could be done more generally, a very small hospital would be very efficient: would indeed be better than a big hospital in its value to the people.—l am, etc., SISTER.