READY TO HELP

Timaru Herald, Volume CXLIII, Issue 20667, 4 March 1937, Page 11

READY TO HELP

“NO NIGGER IN THE WOODPILE ” ADDRESS BY SIR LOUIS BARNETT Matters of hospital policy that were of particular concern in ensuring a high standard of efficiency in surgical service to the community—the surgical staffing of the larger hospitals and the grading of hospitals—were discussed by Sir Louis Barnett, of Hampden, president of the Royal Australasian College of Surgeons, in an address to the conference of the New Zealand Hospital Boards’ Association in Tim-, aru yesterday. Sir Louis said that if any delegate was striken with illness or injury necessitating surgical treatment for its relief or care, he would naturally seek to obtain the service of a capable and experienced surgeon. With very few exceptions such surgeons were to be found only amongst those who had had a long course of training under senior colleagues in a busy hospital. The only reliable pathway to true surgical efficiency went through the large and busy hospital, and it should be a broad and well-trodden pathway, wide enough to give passage to an adequate number of suitable practitioners earnestly desirous of preparing themselves for surgical service to the community. /I Necessary Function It was generally recognised, said Sir Louis, that the larger hospitals had a necessary function to perforin in the training of nurses, medical students and house surgeons, but it was not equally recognised that they were essential for the post-graduate education of medical practitioners, particularly the surgeons. In the opinion of the Australasian College of Surgeons it was necessary that a man who

aspired to the status of a fully competent surgeon should continue his hospital training after graduation for at least five years, and the College would not admit him as a Fellow until he had that post-graduate training. In order to provide an adequate number of capable surgeons for the whole community it was imperative that all the larger hospitals—say those with 100 beds and over, there were only about a dozen of them—should have a visiting staff, honorary or stipendiary, said Sir Louis. That method of staffing not only provided the facilities for the proper training of surgeons but in the opinion of the College it made for more efficiency in the treatment of patients. Some large hospitals, notably the one at Hamilton, clung to the closed or one man system of surgical service, and Auckland and Wellington were being urged by a few misguided enthusiasts to follow the example of Hamilton. The course of action would be attended by a disastrous lowering of efficiency in our surgical service and by a humiliating loss of prestige to the hospitals concerned because they would not be recognised as institutions where postgraduate training of a high standard was available. The Royal College of Surgeons of England, for example, would not include them in its list of approved hospitals, and house surgeons of the best type would avoid them. A Successful Change It was pointed out by Sir Louis Barnett that the Southland Hospital 12 months ago changed over from the closed to the visiting staff system, and he had learned on very good authority that the. change had proved suer cessful. The hospital was now running more smoothly, more efficiently and more usefully to the community generally than it was before. The result was particularly gratifying to him because, on behalf of the College, he worked hard in support of the reform. While he freely admitted that to hospital boards there might be certain advantages in the closed system of staffing, with on? man doing the bulk of the surgical work and usually doing it pretty well—some of them doing it really well, all things considered—the hospital was easy to run, and there were no worries with a visiting staff, efficiency could not be maintained in hospitals of the “closed” type, where team work, consultations, post-graduate education and medical research were all more or less difficult or impracticable. He felt sure that with proper organisation of a visiting staff the weak points in the visiting staff scheme, such as they were, could be satisfactorily eliminated. Speaking of the grading of hospitals, classification, standardisation and coordination, Sir Louis said that the College of Surgeons, with a view to bringing about desirable improvements in the surgical service rendered by hospitals, had submitted various recommendations which were worthy of the Boards’ consideration. Medical Men Only Human “We doctors, physicians as well as surgeons, although we have had a long and expensive education, and have passed stiff examinations in order to obtain our diplomas, are only ordinary human beings like yourselves with the same desires and aspirations for our own welfare and that of our families, but also with the ame earnest desire to serve and help our fellow men. Like you we place in the forefront the welfare of the patient and not only the hospital patient but the private patient,” said Sir Louis. Such private-practice benefits as might accrue to selected surgeons of high ability and wide experience by the adoption of the Coileg recommendations, would be benefits well earned and would be helpful and not detrimental to the public welfare. “I assure you there is no 'nigger in the ’voodpile’,” he said. Many people, in-

eluding- to his regret, some hospital board members, thought that doctors banded themselves into unions like the B.M.A. and the R.A.C.S. solely for the advancement of their own interests. That was not so. Both bodies were based on a constitution of community helpfulness, ethical conduct and true philanthrophy. The relationship of a doctor to his patient was something very different from any ordinary business transaction. The medical profession stood alone as the calling, the almost sacred calling, to which was entrusted the safe keeping of the bodily and mental health of the people and God help the people if associations such as the B.M.A. and R.A.C.S. did not exist to maintain and advance the honourable traditions of the profession. The thanks of the conference were expressed to Sir Lc ': Barnett by the president (Mr J. W. Dove).