The Daily News THURSDAY, AUGUST 28, 1930. CONTROL OF HOSPITALS.

Taranaki Daily News, 28 August 1930, Page 10

The Daily News THURSDAY, AUGUST 28, 1930. CONTROL OF HOSPITALS.

The craze for centralised control still continues, and it would seem that if it is to extend much farther there will be no need for a Legislature—with its deplorable waste of time and money—but that certain experts may be ! entrusted with the control of the various activities of the State, somewhat on the- lines of the Russian Soviets. The Dominion will then be administered by coteries of specialists, possibly self-elected, and all that the people will have to do will be to find the money, leaving the specialists to spend it as they think best. For some time past there have been in evidence certain movements having for their object the elimination of the basic principle of government by the people for the people-—a democratic principle that has made the Dominion what it is to-day; not perfect perhaps, but still a marvel of progressiveness to other and older nations. It is difficult, if not impossible, to please' everybody, and there are, of course, times when changes become desirable as well as dangerous. These changes are in these days mostly preceded by a campaign, in which propaganda is prominent. Take, for instance, the effort lately initiated' by the Education Department to bring about centralisation and bureaucratic control. More important still is the persistent propaganda advocating the control of hospitals being virtually placed in the hands of the New Zealand branch, of the British Medical Association, for that is practically what the recent recommendations made by Dr. . Campbell Begg mean. This distinguished medico has been making a tour of the principal hospitals of the Continent, Britain, America, Canada, and other places, besides attending a medical conference at Madrid. On his return to New Zealand he made the following somewhat astounding pronouncement:

Our hospitals in New Zealand have become purely political. A Minister from the dominant party in power is in general charge and national politics have invaded board elections. Such political propaganda undermines the whole hospital structure and some of 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 away . . Our future development lies in co-operative effort, and the Mayo Clinic has furnished an example. It would be interesting to know exactly what is meant by “co-operative effort.” Possibly those who study carefully the eight recommendations made by Dr. Begg may be able to unearth a solution of this problem. There can, however be no misconception as to his scathing indictment of New Zealand’s present system of hospital control “by methods which have been almost universally abandoned elsewhere.” He asserts that the medical staffs are badly organised, or not organised at all; the appointments are haphazard; there is lack of co-operation and good feeling between the staffs and boards; the organisation of the nursing service is insufficient; too little supervision is given to the work of the junior men by the seniors; there is too much scope for hasty and wrong methods of treatment and neglect of thorough investigation; equipment is bought on ( th.e advice of superintendents instead of by specialists, and chronic eases are mixed up with those “requiring real medical aid and surgical attention.” What the Inspector-General of Hospitals, the superintendents, the medical and nursing staffs and the members of hospital boards will have to say about Dr. Begg’s strictures can roughly be conjectured. More to the point will be their views and the views of the general public as to his recommendations. He would abolish the boards and create a board of four trustees, who would be barred from " engaging in politics; institute a social service committee to attend to charitable aid eases and assess a fair charge for hospital maintenance; and exclude from the hospitals all who can afford to pay for their own treatment, or only admit them at such fees as would leave a protit. for the institution, as well as remuneration for the doctors. Finally—and this is the crux of the whole scheme—medical boards would be sot up, consisting of the heads of the most important departments, appointed as such for their ability and not by reason of seniority. All appointments to the staff would 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.:” On two matters the remarks of Dr. Begg will probably . meet with general approval, namely, the recommendation for. separate provision for chronic and incurable eases, and. _l. ■ -x

..the separation of the ..wards for infectious cases, and the separate appointment of medical staff for such cases. There can be no doubt that Dr. Begg has thrown a bombshell into hospital matters, but so long as New Zealand is a democratic country it is hardly likely to sanction such a scheme of dictatorship as that which he recommends. That there is room for improvement is unquestioned, but the faults now in evidence are such as can be remedied by an active head of the Health Department without resorting to revolutionary methods.