HOSPITALS.

Waikato Times, Volume 103, Issue 17383, 20 April 1928, Page 2

HOSPITALS.

IMPROVEMENT POLICY.

FREE TREATMENT PROBLEM. Proposals for the improvement of hospitals arid post-graduate surgical training were put forward by Dr. Victor Hurley, of Melbourne, in sketching a suggested policy ori the subpeel for the College .if Surgeons of Australasia at the recent conference of surgeons at Canberra.

Dr. Hurley staled from the outset it must he borne in mind that the objective of the college was that each person in the community who needed surgical service was provided for, and in such a way that the very best of which modern surgery was capable could be obtained readily at a fair and reasonable cost to those able to pay and gratuitously lo those who could not pay. The fact was that there was a steadily increasing drift towards general dependence on free medical treatment, and for this several factors were responsible. From careful investigations carried out by Mr It. J. Love, Victoria Inspector of Charities, it had been estimated that 10 beds per 1000 people wore necessary to meet all the requirements of medical institutions. In this Agure allowance was not made for chronic and incurable patients, and for these an additional .5 per 1000 of the population was necessary, making a total provision for all needs 10.5 per 1000. Solution of Problem.

Dr. Ilurley stated that the following solutions of the problem of providing private and intermediate patients with the same facilities as those obtained by public hospital patients had been recommended : 1. Bv converting public hospitals into community hospitals, or establishing new community hospitals, all classes being treated in the same hospitals. 2. By direct Stale management. 3. National insurance, including hospital benefits. Contributing schemes with hospital benefits. 5. By establishing large intermediate and private hospitals conjointly. Continuing, Dr. Hurley asked how large modern hospitals such as the above might he established in view of the fact that they required a largo capital outlay, beyond the reach of most private individuals. The means were, he said, by church organisations, by friendly societies, and other organisations; by municipalities or groups of municipalities acting in conjunction, by the State, by combinations of private individuals and by combinations of medical practitioners. in regard to country centres, the needs could he most effectively and economically met by extension of the present public hospitals into hospitals receiving all classes of patients, he., community hospitals. Adequate safeguards and a system of inquiry would he necessary to prevent imposition and lo ensure that patients abic to pay for their treatment should do so.

Central Hospitals Board. Dr. Hurley advanced the idea of the establishment by the State of a Central Hospitals Board, with executive powers in each State of the Commonwealth and in New Zealand, to control matters concerning hospitals as well as other organisations and institutions whose work was closely linked up with them. The hoard would decide what hospitals would be necessarj, where they should be built, what special departments should he provided, the minimum standards of efficiency and all other similar matters oven which there was now no contro . Hospitals he said, are established in a haphazard manner, on no definite plan, am i with great waste of money and effort,, duplication, and loss of efficiency. Dr Hurley outlined the establishment of staff funds in public hospitals Tov leaching research and the training of post-graduates. A certain proportion of this additional expenditure he said should he borne by universities and hospitals as part of their du sponsibilities, and they wouid .reee J<e a full and adequate return for th money expended. A very considerable, K not the major, portion of the money needed could, however, be provided, if he principle of staff funds m connection with public hospitals .were adoptCd 'rontinuinc Dr. Hurley said that in th charge’ll ospiLals the ejormoja mmhers of patients were such that ine work was carried out in the most unsatisfactory conditions and the im Movements were to be sought.ini ehnu- _ thnen nnt reallv in need ol spe hospital facilities', equipment, and staff,‘rather than M ever inercasmg sHITs and buildings. Dr Hurley summarised lus recoinmentations for fho council's hospitals lIO m Press** tofthc establishment of central hospital boards having me 1 cal representation and direct representation on State and Dominion commll(2)SThe establishment of aeeommoelation for private and intermediate patients either in conjunction with public hospitals or in private with adequate accommodation cquipmenL . gion of diagnostic and investigational facilities for private nr-iHitioncrs for their private patients. P m The Provision of a contributing srl nine in which all could be included, willi provision l'or. graduated payments ““Tf"" paid“,"noms 1 whiSl svouid riaaiuf contributors who arc - w Shshment of staff funds in K%nSility of improving the efficiency of work and of limiting [he abuse of overcrowded out-patients dC f 7 ) l Tuffiform system of nomenclaturOgOf ffiscasc-rm syslem of hospital records.