The Timaru Herald. TUESDAY, JANUARY 19, 1909. HOSPITAL MANAGEMENT.

Timaru Herald, Volume XIIC, Issue 13807, 19 January 1909, Page 4

The Timaru Herald. TUESDAY, JANUARY 19, 1909. HOSPITAL MANAGEMENT.

The amount of strong feeling that has been displayed by the people of AVaimate over the question of the internal management of the local hospital, and the length of time during which it has been manifested, indicates very plainly that there is something wrong somewhere ; but whether'either of the two parties into which the community is divided is wholly upholding the wrong, and the other side wholly combatting it, is quite another question.- It may be that in a judicial view of the matter a disinterested onlooker would commend the attitude of Mr Norton Francis, the Mayor of AVaimate, who when acting as chairman at a meeting for the election of a member of the Board of Trustees last week, said that he "could iiot sco eye to eye with either'party." The questions at issue arc (1) whether all the patients in the AVaimato Hospital shall continue to bo attended as heretofore by one medical officer, - appointed by the Board of Trustees; (2) whether other medical men in the town should also have the right to attend such'" patients as they may send to the hospital; or (3) whether all the medical men in the town should | lie placed on an equal' footing, and take turn about annually in acting as chief medical office] - . The Trustees have decided that the hospital shall continue to be carried on under the first of those alternatives, and by a vote of 228 to 130 a meeting of 358 persons who were given a right to vote in the election of one of the Trustees, endorsed the; decision of that body. Tlie fact that more than one-third if the voters were of a different opinion is an evidence that some reasons can be urged against.it. It is generally • admitted tliat'thc AVaimato Hospital has been very well riianaged for many years by the present medical officer, Dr Barclay; and the former and tlio present Inspector-General of Hospitals have recommended that the existing arrangement should not be disturbed. Looking at the matter from a quite disinterested point of view, we should say that that advice should be acted upon, until some more satisfactory system has been proposed, discussed, uiJ perfected, for replacing the present one. The champion of change, Mr A. Walker, lias mentioned that at other hospitals other systems prevail and have proved satisfactory, and he proposed that the three medical men now in AVaimato should be naid officers of

tho institution. If returned as a Trustee, lie would "support a scheme of tliat kind." This, however, is not sufficient. The scheme ought to bo worked out in every detail, or a tanglo as difficult as that which lias arisen over the " minors' complaint" might be created. In a previous article on hospital management we suggested that the dispute at Waimate had raised the question whether the whole system of hospital management should not bo recast. The history of hospitals generally, and the development of the hospital management in 'New Zealand, support that suggestion. The first hospitals in England were established as a defence to the community against loathsome diseases. In the second stage they became institutions for the mitigation of suffering from illness and injuries of all kinds, in the case of people who could not afford to pay for private medical or surgical treatment; that is to say, they were charitablo institutions, and they were, and in, England still are, supported by subscriptions r of the benevolent. Such being the case, it is evident that tho patients could have 110 right to select the physicians or surgeons to attend them; the managers appointed whom they pleased, and no one thought ol : giving the patients a voice in the matter. It would have been nonsensical to do so, under the circumstances. This system was transplanted into New Zealand, but the necessity for State aid very soon became evident, . and this aid having been given, the subscriptions rapidly fell off and the whole cost was thrown upon' the taxes, local and general. The hospitals were nationalised 011 the side of their finance. 011 the other side, the idea that they are charitable institutions intended for the relief of those who cannot afford to pay for private attendance, has not been changed with the change in tho form of support. That is, not confessedly ; but witli one breath a board will say that its hospital is, at all events primarily, tor the destitute only, and with the next will say that it cannot refuse to receive tho well-to-do 011 condition that they pay for the benefits they receive. It is usual at Home, we believe, to give regular subscribers to hospital funds, tickets of admission which they may give to persons requiring hospital treatment. The only possible adaptation of that system to the circumstances of a hospital in New Zealand would be to give the right of admission to every taxpayer—that is to everybody. This implies a considerable change in the popular conception of the place of the hospital in the social economy, and a still greater change in the official conception, as this is expressed in tlic reports of the Inspectors-General, past and present. We are not quite certain how tlie members of the medical profession would view such an implication ; but we have no doubt that they would be found willing to accept a reformation which would relievo them of the difficulties which frequently crop up under the present half-and-half system, national 011 the one side, and denominational 011 tho other. Beside such a larger reform the present dispute over the management of. tlie AVaimate Hospital seems but f a'■■small luattiir, and a waste of energy.