HOSPITAL AND CHARITABLE AID BOARD.

Timaru Herald, Volume LXIV, Issue 3625, 21 August 1901, Page 4

HOSPITAL AND CHARITABLE AID BOARD.

The monthly meeting of the Hospital and Charitable Aid Board was held yesterday, all the members being present—Messrs J. Talbot (chairman), Moore, Hole, Macintosh, McLaren, Gillingham, Walker, and Dean. The rfrnirman said he was pleased to see a full Board that day, as there was business of special importance to transact. In regard to the financial position, there was to credit £B4B Is Id, payments to be made were £622 14s 6d—£l6s 12s 9d for charitable aid, £2ll 8s lOd for Waimate Hospital, and £245 12s lid for Timaru Hospital. These pavments would leave » credit of £225 6s Vd. The total amount received from patients' payments from June Ist to date was £7l 16s. All but one of the contributing bodies had sent ■in their contributions, and as soon as the remaining one was paid, the Government subsidy would be applied for. He found on looking over the returns and making "a comparison of patients' payments made to the Timaru Hospital and those reeved at other similar institutions, that this Board came out rather badly. No doubt there were explanations for it, but all over the colony he noticed that these payments were 1435 for 1278 patients;in Auckland, they seemed to collect the largest sum from patients' payments. For 1661 patients treated there during the year- , they collected £3322. In Christchurch the amount and proportion were considerably less, as for 1332 patients treated, they collected £779, The amount collected in Timaru compared more favourably with Christchurch, for they collected £206 for 445 patients. In Dunedin the pavments were £1435 for 127 patients; in Oamaru £179 for 154 patients. He presumed that there were reasons why the amounts varied so much in the different districts. There were some very curious points in these returns. In the district of Grey River, the patients' payments were £561. The number treated was 216, and the daily cost was put down at 2s 10£ d, and though so large an amount was collected it only reduced the average cost to 2s 3d, a very peculiar result. ' And in spite of the low average daily cost, the total cost was £2600, as against £2500 at Timaru with 445 patients. Here the average daily cost was 4s 7jd. At Timaru the cost of rations was £641 13s for 445 patients; Grey River's £832 5s 9d for 216; for salaries and wages, Timaru £940; Grey River £BB6. In reply to Colonel Moore, the chairman said the average days stay were Timaru 24.82; Grey River 85.69. The returns were very peculiar. He was pleased to see a* full Board, because the question of the honorary staff must be discussed. It would probably be well to deal with this matter in committee, but in the meantime he could make a few general remarks on the position. The system which had just broken down was one in which the Board appointed two medical man of the town as an honorary visiting staff. They had no obligation to attend, except in cases of consultation, or to render assistance, and the appointment carried no privileges, beyond that they could, make recommendations; but they never -made any. They could, if they chose, see a case right through. This was practically the system that had been worked, and it was entirely satisfactory to those carrying on the hospital. It had now, however, irretreviably broken down. Dr Reid,. in his letter of resignation, referred to the honorary staff having no status. That referred to the condition which prevailed antecedent to the new system, to the system by which the members of the visiting staff had week about with the resident surgeon, all cases that came in being in the charge of the member of the staff whose " week" it was, and he saw those cases through,and purses and resident officer were required to carry on such cases under the visiting officer. That system was in force here for a considerable time. There were frequent objections to it, and so far as the management of the hospital and the resident surgeon were concerned, there was nothing to recommend it except its cheapness. He hoped it would not be necessary to return tfo that system. So far as he could judge there was another system that could be adopted —a system of fees for assistance rendered. This would entail some increase of cost, but it would maintain the inde--. pendence of the hospital, and not interfere with its internal management. This seemed to be the only alternative to giving the honorary staff their "status" in the hospital, which he hoped it would not be necessary to adopt. When they came to deal with the matter in committee he would have something more to say about it. The chairman proceeded to make some remarks on portions of the report of the Inspector-General, dealing with the qualification and registration of nurses. He had no objection to this proposal, as it would probably result in probationers receiving proper training. Here there had been considerable difficulty' in obtaining certificated nurses. ■ -Dr- MacGreger made a general remark which certainly did not apply to Timaru, -a protests against the interference of Boards in the selection of probationers, in the interests, of. personal ■ .friends. But as the cap- did not fit this Board, they need not ' put it- on. (Mr Walker said the statement condemned itself, as a large number of men were less likely to be influencel in favour of an individual than two—the snrgeon and matron.) The chairman continued that the private hospitals ought to be inspected, and their nurses certificated, as well as those of public hospitals. There would be _ some correspondence regarding the question raised by the Board re homes for consumptives, and there was a circular from Christchurch regarding another question this Board had also discussed, homes for incurables. Considerable attention was now being paid to both matters all over the colony, and possibly something would be done.

A little discussion took place on the quotation from Dr McGregor's report relating to the selection of probationers, Mr McLaren urging- that the public did not know whether the cap fitted this Board or not, and they should be informed that it did not. The chairman said that he did not know any of the probationers in the Timaru. hospital, and he believed no other member did. Other members ■laid they knew nothing of the appointments.

A brief discussion also took place on fhe proposal to register nurses, and the need for assuring the public of the qualification of persons who profess to be nurses ■was admitted. It was remarked that the Act, if passed, will probably not be retrospective, but will admit nurses who have practised for a certain time being registered.—Mr McLaren remarked that the nurses when registered would probably insist upon a limitation being put upon the number of probationers employed.

Some remarks were also made on the subject of "matrons" being certificated nurses. The chairman was of opinion that it was not though it might be desirable, as organising and not nursiiig skill was required in a matron. In reply to questions, Dr Logan said there were two certificated nurses and sir probationers now in the hospital. He •was satisfied with the staff if all were available, but four of the nurses had been sick and two were still unwell. Besides this, he had had to open the fever ward for a scarlet fever patient, and this took one of the nurses. These deductions made a great difference in a small staff. With regard to probationers, there should be some agreement provided, that would prevent them from leaving after being three months in the institution, acquiring some knowledge at the expense of a good deal of trouble to the staff, and then leaving and setting up as nurses. Colonel Moore raised the question of the X-ray apparatus, which had been previously reported to be incomplete.—Dr Logan said the " coil" is not strong enough—the fault with all the apparatus in the colony, but it was nevertheless very useful —It was agreed that the chairman should make some further inquiry about it.

The return of patients for July showed that there were 26 under treatment at the beginning of the month, and 32—20 males and 12 females —were admitted during the month, making a total of 58 treated. There were 31 discharged-«-20 cured, 7 relieved, 3 as incurable, and 1 by death, leaving 19 males acd 8 females in the hospital. Nine males and an equal

number of female out-patients were treated during the month. Mr Macintosh had how worked out some results from the Inspector-General s •report, regarding the amount of patients payments c oil ed, and read some of the average amounts collected on the number of patients treated —Timaru (the lowest average in returns mentioned by the chairman), 9s 2£dj Christchurch, lis 7£d; Napier, 12s 4d; Invercargill, 15s 2d; Waikato, 16s 8d; Ashburton, £1; New Plymouth, £2 7s; Grey Eiver, £2 10s Id; Cromwell (the smallest attendance), £2 8s Hd Mr McLaren expressed much dissatisfaction at the small amount collected nythis district, and on the motion of Mr Macintosh a committee consisting of the chairman, Mr McLaren and the mover was set up to consider and make a recommendation to the Board on the subject. Correspandence was then taken : Mr W. Healey wrote drawing attention to his sanitary slop-pail and commode, a~ sample being sent.—Dr Logan said the pail might be a very good thing, but it was not needed at the hospital. , Replies were read from the Christchurch City Council and Hospital Board, the Ashburton Hospital Committee and Borough Council, the Oamaru, Palmerston North and Napier Hospital Trustees and Borough Councils, the Dunedin. and Wellington Hospital Boards, approving of the Boards circular advocating the establishment of sanatoria for consumptives. The Oamaru Hospital Trustees, however, thought it unnecessary to do anything, as the Government were taking it up. The chief medical officer, Dr Iklason, wrote that the Blatter was under the consideration .of the Government, and the Hon. W. C. Walker, •Minister in charge of hospitals, wrote that he would take the matter of the circular into consideration, and let the Board know as soon as possible what the Government proposed to do.—lt was approved that the chairman should send a summary of the replies of other bodies to the Government. The Waikato Hospital and Charitable Aid Board sent a printed circular pointing out the need for amendment of the law in regard to fixing the liability as between two Boards, in the case of indigent persons shifting from one district to another, and obtaining hospital treatment or charitable aid.—As the circular is a long one, and contains much debateable matter, it was agreed that the chairman and secretary should consider and report upon it at next meeting. Mr W. M. Miller, secretary to a conference of local bodies of North Canterbury recently held, to take united action to show th 6 Government the necessity of the State providing accommodation for chronic and incurable cases,' which are not suitable either for general hospitals or homes for the aged needy forwarded the resolutions passed by the conference in favour of the Government erecting central homes for such cases. Moved by Messrs Moore and Hole, and carried: —"That this Board strongly approves of the course taken by the conference of local bodies in North Canterbury in urging upon the Government the absolute necessity of providing for the accommodation of .chronic and incurable cases which are not suitable subjects for treatment in- general hospitals, nor for admission in homes for the needy, and that fTii<; Board recommends also that accommodation for imbeciles, who are not fit subjects for admission to asylums nor to hospitals or homes, should be included in the scheme." A few charitable aid cases were considered and ordered upon. A deserted wife at Geraldine with three children asked for an increase of her cash allowance of 25s a week.—lt was resolved to discontinue the money order and grant 30s a week in rations. A Waimate case was left in Mr Dean's hands.

An application from Orari for care of four young children of a widower unable to maintain or look after them, was referred to the chairman and secretary, who are trying to find homes for them. Mr Macintosh brought np a complaint made to him by members of a coroner's jury at the inquest on the late Mrs Krenzel, found dead in her chair; that the body was laid by the police on the floor, and covered with a bit of scrim, though there was a bed and bedding in the place; and that the -undertaker put the body in' the coffin just as it was, unwashed and unkempt, and took it away to the cemetery. If the Board took any responsibility in these cases,. they should at least see that things were done decently. People were crying "Shame" at them for the way the funeral was carried ou.t

The secretary explained that the deceased was not in receipt of charitable aid, and, acting npon the instructions of the Board, all he did, when the police telephoned to him about the funeral, was to refer them to the Board's contractor for funerals. He had never heard of any such complaint before. A discussion took place cm the question of the Board's liability in such-cases,-and it was decided to inquire what the practice of- other Charitable;-Aid .Boards is. .

. Accounts were passed for payments, and the Board ; then. adjourned for lunch, .to resume afterwards in committee on the honorary staff quest-ion. ■ »- As a result of an hour's deliberation, it was resolved—" That the resignation of the medical staff be accepted, and that Dr R. B. Hogg be appointed honorary consulting physician and surgeon, in recognition of his long services to the hospital." It was further resolved—" Thai the resident surgeon be empowered to obtain any outside assistance he may require at a fee of one guinea."