THE HOSPITAL INQUIRY

Star (Christchurch), Issue 5295, 27 June 1895, Page 2

THE HOSPITAL INQUIRY

THIS DAT.

The Hospital Inquiry was resumed at 10.30 a.m. to-day.

De Jennings, called by Dr MurrayAynsloy, deposed that he was president of the New Zealand Medical Association and of the local branch. Dr Murray-Aynsley was secretary of the New Zealand Medical Association, and of the New Zealand branch of the British Medical Association. He had also been secretary of the local branch of the former for two years and a half, and had been specially requested to act 63 secretary for the Medical Congress. Witness had often eeen him late atmght.and had never seen him anything but sober. Witness was not a member of the hospital staff, and had never applied to be, because he had not liked to have his name associated with the staff as it had been constituted. He would have no objection to be associated with the present staff.

v To Mr Loughrey: Young ladies being trained for nurseß could not become efficient without having attended operations. To Mr Joynt : He meant all kinds of operations and on both sexes. It had been the practice in England for young women to attend all operations— ever since 1873 about. Ward g men were never employed* in England now. His objection to the former staff was on the grounds of its personnel. There had been objectionable elements, which had been eliminated. He was not actuated by professional feeling, or by personal feeling. He would not associate with any man who did not do what was right as a professional man. Thtere' was a certain code of professional morality in the medical profession. Mr Stringer : There is in the legal, too.

Mr Joynt : Of course.

Witness (to Mr Joynt) : He did not know enough of the way in which the hospital staff was appointed to be able to say whether it was a good way or not. He had been in Christchurch for Beven years, and there had been objectionable elements on the staff all the tim 9 until just recently. He thought that the uledical staff should be represented on the Hospital Board in some way or other.

Dr Macgregor, called by Mr Stringer, deposed that He had been Inspector* General of Hospitals since 1886. He bad been in the habit of inspecting the Christchurch Hospital since that date. He had reported from time to time on the nursing staff. He put in the offioe copies of his report. His first report was dated Out. 25, i 1886. In it he stated that he heard no complaints from the patients, and that the food was excellent in quality and well cooked. ' He there found fault with the want of attention to details, and with the nursing. There was a want of authority on the part' of the matron. In 1888 he reported that the defects had been remedied, and that the whole institution was in a satisfactory condition. la 1889 he reported that the nursing system was well organised, and that there was a notable improvement in discipline; that the food w«is abundant, good and well cooked, and other matters generally satisfactory. In 1891 he reported that the nursing etaS was inferior as a whole to that of Auckland, and especially Wellington, and that the House Surgeon should insist on all vacancies being filled with well educated young women capable of profiting by his instruction, and that a nurses' home was wanted. In 1892 he reported that .it would be impossible to put the nursing staff on a satisfactory footing without a nursea' home, and that, when it was obtained, the Board would reorganise the nursing staff. In 1893 he spoke of the nursing system as having long been the weak spot in the hospital. In 1894 he reported that the great drawback to the success of the hospital, the want of a nurses' home, was being removed. At first he was very much struck with the defective discipline of the nursing staff bb a whole. Next year he saw an improvement, and spoke somewhat more hopefully than was warranted. DrDeEenzi was bent on introducing new ideas, and there was a new matron, Miss Steel. On one of his visits, however, Dr De Renzi told him that he despaired of accomplishing this thing, and had given up. Witness saw that it was hopeless to get well educated women as nurses unless they could be properly treated, and this' could not be done until there was a nurses' home. Miss Steel told him that she could not enforce discipline — that the old nursea had so many friends on the Board that they could not be touched, and could not be shifted. Dr De Renzi told him practically the same thing. Witness had Been the modern nurßing ' system introduced into every hospital in the colony except Christchurch, and he hoped to introduce it here now. In regard to the inquiry he had been asked by the^Board to make it. He felt^thatit was not his duty to bell the cat for the Board, to do what the Board ought to have done, but was afraid to do. He had urged the Minister that he (the Minister) ought not to interfere in this matter. It had been said that the Minister was unwilling to interfere, but that was incorrect. The Minister wanted to put things right, but he (witness) told him that he should not allow himself to be dragged in; that it was the Board's duty to inquire into the matter. The public of Chriatchurch had had their minds filled for years with all sorts of rumours | about the hospital, and the matter had < come to a head when things really were ! better than they had been in years gone l by. This agitation was quite absurd and \ foolish, so far as the present condition of , the hospital was concerned. All that had ; been found out by the inquiry was that a ; new kitchen range was wanted, and that : they knew before. The hospital for two : years had been in a satisfactory condition* with the exception of the trouble over the ! nursing staff. He had sent Mrs Neill to report, because he could not come himself, and because he .thought it was mainly a woman's agitation, and that no man could ' get to the bottom of it. After her report he came to Christchurch, and told the j Board plainly that he thought their j conduct was foolish and weak. He had ; mentioned the names of the pereonß who he thought Bhould be dismissed ; and this he had done entirely of his own motion. The firat name was that of Brown, who for years had been the origin and tap-root of all the mischief in the hospital, and who was very popular in Chrietchurch, and

whom no one else would venture to tackle, t He also included Nureea Medlam, Knight, g and Henry, and was sorry, from \ what he bad since heard, that he j had nob included some others. He ( had attended a meeting of the house ( committee, which he thought at the time ] was a meeting of the Board, and had told \ them what ought to be done, and why. , .He believed that all the members present, < except MrC. M. Gray, were convinced by , hia arguments. He thought that outside \ ' influence injuriously affected the hospital, ' and that there was a constant under- ; ground railway means of communica- ; tion o! information from the hos- \ pital to Drs de Benzie and Stewart, \ who were fomenting the trouble, and doing so knowing that the hospital was better than when they were there. He thought that discipline and order at the hospital were absolutely gone, and that they could not be restored unless those peraona mentioned were got rid of. He, for his part, would ask all the officiate to resign, and would re -appoint those who should remain. He had aeked the Houee Surgeon and matron why they allowed Nurses Medlam and Cameron, both inferior nurses, to remain in charge of co important a ward as No. 6, and they replied that they were afraid to tackle them. He had to interfere to prevent things from going from bad to worse in the institution. Brown was a very clever, capable man, but ignorant and uncouth, and always necessarily offensive to the better educated women whom witness hoped to see as nurses in the hospital $ but he made himself useful to the doctors, did their post mortems and other work for them and saved them trouble, consequently they backed him up, and would say nothing against him. The idea of a man like Brown going about among those young girls and doing his work as he did was , perfectly intolerable. "Witness thought ; that an assistant medical officer was what i was wanted. Aa to the matron, Miss Maude was very efficient, and perfectly equipped, but. she waa too young to deal | with this difficulty. In fact, hardly any ' woman could have done, except perhaps I Mrs Neill. Some of the nurses were older I than she was, and would not pay any heed to her. Brown and Nurse Medlam were the centre of the cabal, and they had 60 much power inside and outside the hospital that if they were touched, a great agitation and public indignation meetings were got up, and authority was paralysed. To Mr Loughrey : The Board had, in a way, attended to his recommendations except as to the nurees ; but it was a poor Board— poor in point of quality and pluck. He considered that the whole system of local government in New Zealand, with the exception perhaps of the municipalities, had broken down. Things would never be better till larger governing bodies were established, and better men put on them, men of business capacity, men who would do their duty without being frightened by an article in a newspaper. In 1889 a very serious statement about the hospital was made to him by Dr De Eenzi, theu house ' surgeon. Witness saw the chairman on the same day, and attended a meeting of the Charitabje Aid Board, at which Messrs Westenra, Martindale, Gross and Frudhoe, members of the Hospital Board were present. Ho told them of the statements, but bo action was taken by the Board. He wrote to Dr De Kenzi from Wellington aeking him to put his statements in writing, but received a lawyer's letter from him to the effect that he was advised not to do so. No further action could, ot oburde, be taken in the matter. The Hospital Board had, to the best of its ability, tried to carry out his recommendations as to the nurses ; but, on an agitation being got up in tho papers, got frightened and ran away. Witness had known for a long time the unsatisfactory state of things in the nursing staff, and how sneering remarks were made about the younger nurses, and how they would not come to the table in consequence of the treatment they received. To Dr Murray-Aynsley : The prerent Houee Surgeon had always been straightforward in hia reports and communications to witness. The House SurKeon had reported the lobs of a number o£ instruments, and had told him that one of them had been returned by Dr Ovenden, who had said it had been given him by Dr De Eenzi. Dr Murray-Aynsley had expressed his opinion that these instruments had been stoien by Dr De Kenzi. The statement made by Dr De Benzi to witness affected certain persons in tan hospital and others. Witness went and saw the Chairman, who excused himself from taking action on the ground of illness. Witness had made a note of the statement, but did not think that he should produce it.

Mr Joynt pressed for the prod action ol the notes. Dr Macgregor said that these were notes of hearsay, and affected persons' - private characters, and he objected to produce them. He disbelieved what Dr De Benzi had eaid when he found he would not put them in writing. The Commissioner said that the mattei could perhaps stand over till after Dr De Benzi had been called again and asked what his statement had beeD, or Mi Joynt could ask Dr Macgregor about the notes in cross-examination. Dr Macgregor, to Mr ' Maude : The preaent matron was a capable person, but wbb rather young for the difficulties of her position. She would be an excellent matron under ordinary circumstances, She waa very attentive to her duties. To the Commissioner : Dr Da Renzi'a resignation was not directly in consequence of his having failed to put things on a proper footing. He • (Dr Macgregor) had noticed that Dr Hacon had stated that when Dr Murray-Aynsley was appointed witness had wished to hold an inquiry, but had been prevented by the Minister. That was incorrect. (The truth waß that in consequence of certain statements then made, witness was preparing to come to Christchurch to hold, an inquiry when he heard that Dr De Benzi had left for England. Therefore, witness did not come down, and that was the reason why that inquiry was not held. Mr Joynt asked Dr Macgregor what was the position of the department in regard to the present inquiry. Dr Macgregor said . he thought that. the inquiry came too late. It should have been held years ago. All he wanted was to have all the facts brought out, so aa to avoid the necessity for another such inquiry in the future. That was the attitude of the department. The Government was qnite impartial on the subject. Mr Joynt said that he had observed Dr Macgregor in constant conversation with Dr Murray-Aynsley and the gentlemen representing 1 the other side, but that the doctor had never come to the gentlemen on his (Mr Joynt's) side of the table. He would like to know if the department waß taking a side in this matter, and endeavouring to show that the officials and the Board were right, and the public wrong. Dr Macgregor Baid that the Department was not trying to do anything of the sort. He could not see whom Mr Joynt was I representing. : In reply to Mr Joynt, Dr Macgregor ' Baid that he thought that Nurse Cameron 1 was in No. 6 in 1886; He had begun in 1891 to speak of the necessity for reorganising the nursing staff, but he saw that the Board could not carry out the necessary reforms for want of means. He had, therefore, refrained from pressing the necessity of the reforms. In 1888 he said that everything was satisfactory. He had not thought it necessary in his reports to the Government to keep harping on the need for reforms. Mr Joynt : But the last harp, in 1888, said that everything was satisfactory. Dr Macgregor : You are disingenuous. Mr Joynt: Ton must not be impertinent, Dr Macgregor. lam as ingenuous aa you, and perhaps more so, and am not here to be insulted by yon. Mr Joynt then asked if Dr Macgregor had ever attributed, in his reports, either inefficiency or insubordination to any member of the nursing staff till his report j of March, 1895. i Dr Macgregor replied that he had not. ! He had been led to see the inmbordiaaticn and' dissension that prevailed by what Miss Steel had told him. He thought

bhat Nurses Knight and Henry ought to jo because they were beinij influenced by the others, and because None Henry wa» in tympathy with the reactionary party, and wag in communication with the oatBide members of the cabal. Dr Murray- Aynsley and the matron had told him so, and he had also been Raided by Mra Neill's report. When the Greymouth Hospital wanted a matron witness consulted Dr Murray-Ayneley as to a suitable person, and Dr MurrayAynsley said that Nuraea Ewart and M'Eobbie were hie beet nurses, and that Nuraeß Knight and Henry were good nnreea as far aB they went, but were not educated, and had associated themselves with the reactionary party. Witness came to the conclusion that Dr MurrayAjnaley wanted quickly to get rid of them. Witness had long known of. the faot that the old nurses were using their influence against the interests of discipline and againat the introduction of the modern system, but he had not thought it necessary to constantly refer to the matter in his reports to the Minister. The Hospital Board, who were the parties to act, knew quite well what his references to the matter meant. He bad not come to the inquiry mainly to support his report of March 9 last, bub because he thought that if he did not come, the inquiry might end in nothing. It was in September, 1889, that he first made a statement to the Board as to the members of the staff. That was a verbal report, made on the representations of Dr De Eenzi. Witneaa had made notes. of those representations. He thought that Dr De Benzi should bo made to Bay before the Commissioners what he had said, and that he (witness) should not be called on to do so. Mr Joynt submitted that Dr Maogregor should say what the statements were. They had been the" cause of a representation made by ' Dr Macgregor in his official capacity to the members of the Board. The Commissioner said he thenght the question was a proper one. Dr Maogregor said that he did not wish to be the one to repeat statements, perhaps affecting the character of public men, made by Dr De Benzi, who had refused to commit them to writing. After some further discussion the Com* mi Bioner Bftid be could see no reason why the question should not be answered. Mr Joynt asked what Dr Macgregor had said to the Board, founded on Dr De Benzi'e representation. Dr Macgregor said that he told the chairman, Mr W. White, that Dr De Benzi had charged him (Mr White) with improper conduct. Dr De Benzi had said that he could not do anything in regard to the cooking, because certain persons were too intimate with the cook. Dr De ' Benzi said, "When I spoke to Miller about it, Miller said it was no use, because the cook could do as she liked." When Dr De Benzi refused to put the statement in writing witness disbelieved the whole story, and he protested against having been placed in the po3ition of having repeated statements against gentlemen whom he believed to be innocent. Mr Joynt said that Dr Macgregor wbb not placed in any false position. He had been merely asked to put before the Commissioner the statements on which he ha 4 made certain recommendations to the Board, and he had very properly done so. Dr Macgregor (to Mr Joynt) said that be thought that Dr De Benzi should have been dismissed for not having put the complaints in writing. .Witness' statement to the effect that the hospital wa« credit to the city referred tb tho build ! *g«. ' Miss Steel had refused to sign the certificates of Nurses Medlam, Cameron and Knight, whom ehe did rot consider efficient. Dr Murray-Aynsley and Mis Maude, soon after they came, in a momen of weakness, Bigned the certificates. Before witness' wrote the report of March 9, he assured Mr Beeves that there was not the remotest chance of any of the people indioated being dismissed. He had not recommended the dismissal of anybody, and had told Mr Beeves that if the addition gave were provided as an infirmary, % places could be found for them there. Mr Boevoß specially stipulated with witneßß that none of them should be dismissed. • Mr Joynt : Yet you stud tbey must be got rid of at all hazards. Did you not hear every nurse called here say that there had not been anything like a cabal P Dr Macgregor: I did not see anything of the sort. I saw you very artfully getting these young women, who were in a very difficult position, to say that they had not. Very few people know what a cabal really means. < Mr Joynt : I tried to make it clear to them. The Commissioner: Mr Joynt put it in different ways, and certainly explained • what be meant.

Dr M'Gregor : They did Dot understand ' what was meant. They thought that I meant that they, aa nureeß, wore combining against authority. What I meant was that certain nurses were carrying informs* tion to outside persons, and that those persons were working against the authorities of the hospital. To Mr Joynt : The Board was paralysed because there wore two parties pulling against one another. That was a fault of , popular government, a high price we paid for it. He did not believe in autooracy, but in good popular government, and no : man believed in decentralisation more than he did. He had embodied his ideas on the reform of local government as applied to theße institutions in a Bill now before Parliament. He did not think that the presence of medical men on the Board would cure the erila complained of. The Board should 'not be abolished, but ehould be enlarged, and its powers in- : creased, and better men got on it. ' The offices of secretary and treasurer should not be held by one man, because there was no check on him. There were objections to the secretary being house steward, but it was a question of cost. As to having a housekeeper for the hospital, ■ he would be inclined to defer to Mrs Neill'« opinion in favour of house sisters. He did ; not say that there should be no experienced ' nurses, and he would admit thai, in. thig ' transition period, it was Hard on ; individuals, but no nurse Bhould be ]in a position of authority who had not had a thorough and proper training. ■ The old nurses who could not learn should ; not be got rid of, but should be pensioned , off, or found lighter duties. The oentral ; and most important fault in the hospital 1 was the want of reform in the nursing. ! When that reform was accomplished other reforms would be possible. Other defects were the bad division of time at day and night, the night nurses' hours were too long. Then, fires were kept alight in the ward kitchens, where the nurses could receive their friends who were patients, and where such patients went in alone at night. There were two medical men in the hospitals at Auckland and Dnnedin. At Wellington the house-surgeon preferred to have none. Christchurch was the only hospital where there was a wardsman. Brown was now paid for doing very little, but for some reason no doctor in Christchurch oould be got to say a word against him. He had very little to do, and was continually getting into mischief. Wit* ness did not, of his own knowledge, know the cause of Dr De Eenzi's resignation. AFTBBNOON BITTING. Dr M'Gregor (to Mr Caygill) stated that he thought the appointment or the medical staff annually, was too often, but if there was such a Board as they should have, there would be no objection to it. The annual appointment of the staff, under the present order of things, had struck him as objectionable, but he had never mentioned it in his reports. He had long held that the term of office of members of Hospital and Charitable Aid Boards was too short; members were not long enough in office to get experience of the working, and where there was a cabal, that cabal always got its own way. The resident medical officer Bhould be subordinate to the visiting medical staff. As to whether a resident medical officer would be right in altering the prescriptions of the medical staff, it would certainly not be right, Resuming that the medical staff did its duly-— that applied to both before a prescription had been made use of, and afterwards. Exopt in oases of great urgency, the resident surgeon should communicate with the medical Btaff before altering it. All important operations

should bo done by the visiting staff. As to the proportion of operations that would properly fall to the resident burgeon, he would draw the line according to major or minor operations, and drawing that line would depend on natural good feeling and good sens?. In the absence of good feeling, it was possible that a Houbo Surgeon might appropriate too large a proportion of the operatioi-8 to himself. During the year in wliich he bad known of what he called a cabal in the hoapital, he had not aaid anything about it to those persons whom he nov^, named ac concerned in it. It was not hie business to do bo, but to report to the Government. He had mentioned it to tieir superior officers. He had commended the lighting, heating and ventilation of tho new wards some years aso bs bt-ing a model, bat now there were better wards in other parts of the colony. He did not agree with the honorary medical at«ffa condemnation of wards 1 and 2, on thu ground of their being satura'ed with disease germs. It waa a question of finance. If those medical gentlemen who bad wished to pull those watd* down had had to pay the piper themselves, they would not have been co earnest about it. If the department had refused a request for him to come down and inspect those wards, the refusal would come nominally from the Minister, but really from himself. To Mr Hunt : If an acoident case were brought for admission the medical officer should examine it. Patients should not be discharged without reference to the visiting staff. The abuse of outside reliei at hospitals in this colony was very great, and the. cause of tfoio rested mainly with the Boards. It was right tor the matron to administer nnsejth; tics in emergencies. To Dr Murray- Ay nsley : As to the housesurgeon altering prescriptions, he would be warranted in altering one if the member of the medicai staff had not come up for a • long time, und if it were found that a drug Was not having the effect intended, or if, when a patient was doing well on a medicjne, it was charged to one on which lie did not do co well. In those esses he would alter the prescription, and inform the member of the staff. It was a matter of give and take. , To Mr Stringer : Wards 1 and 2, which were recommended to be pulled down, were now being used. He urged the Board veiy strongly indeed to take action in regard to Dr De Benzi's statement, but no action waa taken, and witness washed hia hands of the whole business. He could not understand either Dr De Benzi or the Board. Dr De Benzi continued at the hospital (or a long time after. To the Commissioner : At Home the members of the honorary medical staff of hospitals were taken on and kept fora number of years. Mr Joynt asked that Dr MurrayAynaley should be recalled to stato what had been the statement which he had made to Dr Hocon, to which the latter had referred in his evidence.

The Commissioner said that he had thought that Mr Stringer, a3 representing the Department, would have elicited what the statement wua.

Mr Stringer said that he knew tbe motive of the statement, which did not refer to the matter of the present inquiry, but which might launch it into quite a* diffeient direction altogether. He (Mr. Stringer) had 1 no objection to the statement being made, but as it involved a serious charge against another man the parties concerned should be present. Dr Mnrruy-Aynsley aaid that he had no objection to make the statement, bathe thought tjhat the parties concerned should beprese'rit. ' ' ' •

: The Commissioner said that he did not know who the parties were. Mr Stringer said that he would undertake to let the personß concerned know. The Commissioner said that the statement should be postponed till the persons concerned were present. He -would like to say that he was not there to inquire into particular charges against individuals, bat into the question of hospital management. He could only take statements about charges against individuals in so far as they affected that question.