“NOT ORGANISED”

Taranaki Daily News, 26 August 1930, Page 11

“NOT ORGANISED”

CRITICISM OF HOSPITALS EFFECT OF PRESENT SYSTEM' ‘abolish elected boards DOCTOR’S FRANK REPROACH • r t ’ • f By Telegraph.—Press Association. Wellington, Aug. 25. New Zealand hospitals were criticised by Dr. Campbell Begg, who returned by the Makura from San Francisco today after an absence abroad of six months, during which he attended a medical conference at Madrid and spent the remainder of his time visiting the principal hospitals of the Continent, Great Britain and America. lie investigated the working of over 100 institutions in the United States, Canada, Great Britain, .France,..,.Germany and Spain, and interviewed 1 persons of all kijid& .ln' any way interested or bonefet'ned in the. control .and ad/ninistration of these institutions, including many of the best known names in the medical world. The conclusion he arrived at was that New Zealand can derive no little satisfaction from the present position on accoimt of its splendid system of gen- - oral education and a certain independent outlook not prevailing in the older countries. Its medical and nursing professions were equal to those of most countries and’’superior'fo ‘many. , New ■Zealand’s public ■ hospitals, on the other hand, largely on' account of the method of control now 1 almost universally abandoned s elsewhere, compared «• unfavourably with .hospitals abroad. The medical staffs were badly organised or not organised at all. The appointments were haphazard .and there was 1 a- lack - of co-operation-'and ’'goodffeeliiig? between the staffs and boards of control that existed elsewhere, and sis a-.Fesult the-handling of large bodies of patients effectively was made more difficult or rendered impossible. - The average stay of patients in hospitals, both for treatment and diagnosis, was far too long, and the organisa-tion’-of- the nursing service insufficient. There was too little supervision of ’work of the junior men by the senior ones and too much scope for hasty and wrong methods of treatment on one hand’and neglect of thorough investigation on the other. Equipment was bought and additions made on the advice of superintendents where only specialists ip the different departments'were capable of real dife<?- : . tiOn. ‘‘ ' ■ ©ERVItIES OF ' STAFF DISSIPATED. Chronic .cases were. mixed, up with thope requiring real medical and surgical attention and the services of the staff dissipated instead' of being con; centrated on effective,, medical and sur-. gical . parts, of the. hospital. Infectious eas.es were -.under.’ .same superintendenpe- 4 as. the others? ...The '.arrangements - we.rc,'.aii ( yariance, w.itb all modern practice, and as a rule these cases were deprived of the benefits of the t visiting, staff. , . AB the.se disabilities were due in a laj-ge measure,,, if not entirely, to rhe system of boards elected every two. years. Dr. Begg said it had been found that men of a requisite standing would rarely submit to the disagreeable experience of such an election. Boards so elected were far too unwieldy, and members would not give themselves up to the . study of hospital management, but simply looked, on membership on the board as a first step on the political ladder. They gave sufficient attention to routine matters brought bor. fore-them, but were, hopelessly incapable of " constructive work. The more • capable members.were swamped.by others and possibly not. re-elected if they adopted a policy for the good of the hospitals which was at variance with some political slogan. After instancing an example of capable management in the United States, Dr.-Begg added: “Our hospitals in New Zealand have become purely political. A .Minister from .the dominant . party in power-is in general charge and na-. tional politics-have invaded .board, phe: tions. ; Such political propaganda,. un-;. ' dermines-the whole hospital, structure and some.iOf it has unfortunately found its way to the Statute Book. The present system’has run its full course, and - there is an. urgent need that our reproach in this sphere should be taken a.way.” Dr. Begg made recommendations to effect this. “Our future development • lies in co-operative effort, and the Mayo Clinic has furnished an example. . CHANGES RECOMMENDED. - Dr. Campbell Begg’s recommendations were: — (1) The immediate repeal of the relevant section of the Hospital Act- and the abolition of elected boards in the four main centres at least. (2) The nomination of a board of trustees' for hospitals by those who find the money, namely the city councils and the Prime Minister’s Department representing the Consolidated Fund: ' (3) Restriction in the number of these boards to four members, who must be men of standing in the wo rid *” of finance or accountancy? Certain undertakings not to engage in polities during their period of office, which should extend to at least live years, is imperative. (4) A social service committee to be organised by the board, not only to look after cases of distress,’but to assess what is fair to charge for hospital maintenance. (5) The exclusion from public hospitals of all those who may fairly be asked not to be a charge on the public; ' that is, those who are able to pay fees to cover their maintenance. If no proper private facilities are available ?t should b‘e permissible to adm.t ther-c at a rate which will cover overload expenses and produce a profit, and the attending doctors should also be remunerated. The size of hospitals and the expense of running them would be thus reduced. (6) Separate provision for the chronic and incurable Cases of those' who : go, gt are sent, to hospital merely because it is not convenient to have them lookedafter at home. - (7) The separation of the infections diseases hospital from the general and surgical hospitals? They might be put ■under l the care -of the local> health officer, ; or ; -have a special board ’ nominated fof them. Honorary physicians and Biw* - - .., ’

geons should be separately appointed. (8) Medical boa rite should be organised consisting of tho heads of the most important departments. These heads should be appointed as such, and not merely be the senior men. All appointments- to the staff should be recommended by this medical board and not by outside practitioners or a consulting staff of retired doctors, who cannot be in touch with current requirements.