THE TIMARU HOSPITAL.

Timaru Herald, Volume XCIII, Issue 14350, 16 November 1910, Page 2

THE TIMARU HOSPITAL.

| AND ITS MANAGEMENT. REPLY TO THE INSPECTORGENERAL. SOME SEVERE STRICTURES. In Ills annual report on the Hospitals of tlie Dominion, ur V aluitine, inspector cieuerai, malies some comparisons wnicu are not pitusmg to tlie ouuui uaunnoury 1 io--p. Lai iioara because tiicy are uaiuji'j unjusun-eu, and consequently uncalled lor. lius beiiiy so, tne cniurman (.Air i!'. 11. CiiUingiiunv uueei.veiy repneu to ta*> iifejjocioi'General at tlie meecuig of tiie x>uai'd y-ea to relay. Me quo Lea passages fiOiu the luspoctor-Ueneral's report anu commented upon eacji in cum us lotion's : " Tlie increase o£ £'0,177 in patients 7 payments* is satisfactory; but we may reasonably look lor a cons.derable increase under this item which now oniy amounts to about one-seventh of tlie total expenditure." Receipts amounting to one-seventli of tlie total expenditure from Hospital patients appears to be rather a creditabis amount, that is if all Boards work on tin? same basis as this. It must bo reuiem be rod that a very large proportion of our patients are old age pensioners, charitable, aid recipients, inmates of tho benevolent institution and destitute persons generally. _ " Some Boards liave done cjood v/ork in tin's respect; but some are"still r< ry slack, and some .officials worse than slack."

•It seems a pity that this, statement could not be made directly to the Boards who show a failing in this direction, otherwise a general statement like this will be applied very -often to Boards and officials who are above reproach.

Surgery and Dispensary.—"For fear of offending the local chemist." If such a condition does exist in any district, surely the Inspector-General conld pir-lc out the places and deal with them without throwing abroad an asperation of such a general character. He must necessarily give a good deal of ull'enco to non-oifeiiders, which will not lead to improved conditions. Capital Expenditure.—"A very considerable increasa in this item may ho coiilidciitly looked for if our hospitals aro to he efficiently found and equipped, etc." ■ Th:s matter is now entirely in the In-spector-General's own hands, as the new Act gives liim practically absolute power in the way of building. "On the whole these homes (old people's homes) are very well managed, etc."

Yet in view of (his statement, the Tn-speetor-Geiieral wishes Boards to replace married c-ouplcs, who Jinve brought these homos up to their present efficiency, by a trained nurse, who shall have sole charge. Probably the Inspector's experience of institutions other than the Timaru one has not been satisfactory. He has certainly not had cause to complain of the management of the Timaru Old Men's Home. He ends lus report 011 these homes with the general statement tiiat ir. seine homes "there is unnecessary wui 1 .--' if not someiiitiii; worse in me management"—an ass-t.'tion which any ixaioiniblo person uouiu expect to l)o iimuo direct to tne buciy implicated, initcu 1 oi being tiirowii broadcast to settle on all or any of tiie institutions.

j'i-c I'irst Election.—Xlie Inspector cs[:ieoseL; regret at tlie little interest tiiKen iii tlic election 01 members to the Lkiuixla. ills DepLiinieut have only .{jot themselves to bljme if they iuid u dearth of suitable mcii as candidates. The new Aet so restricts the i unctions of the elected body that it is not every man who cares to render iree services to a Board which has, at every turn, to consult the Inspector-General of (Hospitals, and obtain his permission before entering into any new work or expenditure. Fever Hospital, Dunedin.—From the report there arc unly three fever hospitals iu the colony—Dunedin, Christcliurcli, and Timaru. Tiniaru fever hospital has certainly justified its existence, and appears to be more used than the Dunedin fever hospital, if the instance commented «n by Dr ~alin-' tint! can be taken as a criterion.

Hospital Patients' Payments: Tiniarn Hospital.—Tlie Inspector General thinks the amount 'collected for tlio year far too small for an hospital the siw of this. Hp refers to several other hospitals in the same terms. It is interesting to know that the amount collected ,in Tiniaru is greater than that collected in any previous yea.r, and l I think that the Board, who are in a. position to judge of the circumstances and requirements of the hospital patients of the district, are quite satisfied villi the position. It must always he remembered that the Tiniani Hospital caters principally for those, patients who are destituto or with small means. Furl her, that no i>rivntc patients at an increased fee are received.

" YVaiimito Hospital: Patients' I'aympjsis, £158.—1 imagine the Oonimitti?o of tilo AVriininhe Hospital will itself be prepared to deal with T)r Valititinp's condemnatory remarks on the amount rollortod. Tito domestic staff of ten which" received rather tiring treatment in the previous report of I)r Valintino's, will lie found, on examining the statistics. to be a, very fair average for a H(isp : tnl of its size, and T do not tl-ink-the place can be said to be over staffed.

Consideration should be given to the tact that the 'J'imaru iiospitai wards are very mucli spread out, that there is a. steam laundry attached, consumptive shelters in the grounds, and that the nurses oi the Jrio&oital uro iio,t asked to do the ordinary domestic work so bitturly complained of in Connection with the present trouble at the Duiiedin Hospital. Cost of Provisions.—There is no outstanding item which could be said to be out of proportion to the size of the institution. As a matter of fact the figures are if anything bedow the average of institutions of similar siao.

Drugs, Dressings, etc. —Our total expenditure is considerably below t/he average.

Dr Valintine mentions ill particular tiie Palmerslou Hospital as being very efficioutly and economically managed, so that it would be pretty safe to cornpure the Timaru Hospital with it; yet when jv'o go through the analysis of expenditure, it appears that the total cost of maintenance and administration per occupied bed per annum at Palmerston North is £92 10s I'd, and at Tiinani £Bl 9s 9d, which in view of Dr Valintino's remarks that the patients at Timaru have not .suffered from the economy., can oniy be taken as highly satisfetory, although the Inspector-General does not tliink it is necessary to call attention to the efficiency or economical management of.the Timaru Hospital. Further, Timaru Hospital keeps a resident medical officer, Palmerston does' not. This in itself is a bi;i item. On administration Palmerston North expended £7 2s per cent. Timaru £3 Gs. Timaru furtiier treated 1-105 outpatients, an expensive item which Palmerston does not handle at all.

Southland Hospital is also referred to by the Inspector-General as being economically managed; but it spent £3O more for provisions., £75 mere on the surgery and dispensary, £330 more on the domestic establishment, £'2u2» more in the salaries and wages, and £l7O more in general maintenance, other items practically in this proportion, yet they have one bed less than the Timarn Hospital. When the whole matter is washed up, we spent £SOO less than Southland in maintenance, yet we are not told that the Timarn Hospital is efficiently or economically managed. Considering the somewhat scathing remarks Dr. Valintine previously made on our cost, of provisions and food generally, I think it hardly fair, that in view of his own figures showing a capable administration in Timarn, ho should quietly ignore the fact when publishing a statement which circulates from one end of the colony to the other, and in which he finds it necessary to make pointed allusions to efficiently and economically-managed institutions. As a whole the Inspector-General's report will be found to be of much interest to anyone interested ill liosjiital and' charitable aid matters. The statistics supplied are most interesting, although the varying conditions prevailing: in the different centres make it impossible to draw definite conclusions from statistics as to the management and efficiency, yet a very fair idea may ho gamed. Mr Giilingham. emphasised the fact that the Inspector-General seemed to think tho Board should persecute people in order that the receipts from patients' payments might be high. That was not the purpose of a public hospital. It was primarily lor people who could not afford to pay, and the South Canterbury Board had never made a practice of pushing patients to an unreasonable extent for payment. All caro was taken to collect from those who could pay, and further than this, the Board would not he justified in going. A hospital should not be looked upon as a money-making institution. During the past four or five years tho Board had written off £IOOO in patients' fees, and it was far better to do that than to squeeze those people, who could not afford to pay, into a tight corner by robbing them of their last penny. Mr Maslin said the figures of tho Inspector-General would not stand analysing, and he was most inconsistent. For instance lie praised Palmerston North Hospital find decried the management of Tiniaru Hospital from a financial view* point-, vet his own figures showed that the'average cost per occupied bed at Palmerston was £<3, while at Tiniaru it was only £67. And a similar comparison could be made with New Plymouth. If, as the Inspector said, thore was extravagance at Tiniaru there must be reckless extravagance at Palmerston and -\rw Plymouth.

I r I ho. Chnirmnn said the figures ooidd 1)0 taken iu iiftydifferent ways, and they would tell against the InspectorGeneral every time. His criticism was most unfair unci inconsistent. Mr Butler said the Inspector must do something to justify his position and that was probably why he road© these reckless and unjustifiable assertions. Mi* Francis thought tliey should give the Inspector-General a chance to exolam the positio.M h* ]i;h 1 taken ut>, before condemning liim. There Was possibly some explanation. The Chairman and Mr Maslin said there could be 110 justification for throwing out such suggestive insinuations as tlic Inspector-Geineral had thrown out. The Board was composed of men who were giving their services free, and no one had a right to cast such aspersions on them. If 110 Inspector-General knew of anything wrong it was his duty to say so straight out. He said that one secretary had ".a, deal to exulaiu " that another had '-a good deal to explain" in not collecting more fees from patients. What did that mean? |); t l It mean that they had collai-ed the money, and should be in gaol? That was no way for a public official to talk nnci ho resented it very strongly. Again the Inspector said there was blame m another direction, "if not something worse. Tliey wero v&rv nasty v, ords, and should not be aJJcwccL Xi&t the Inspector-General write and make a definite charge if he could, instead - J . i n '?Y ,,Ln » out thes « base and vmjustifiable insinuations.

Mr Maslin and Mr Butler sttoke to similar and other members concurred, Mr Butler remarking that the Department did not practice what it preached.