17

H.—22a

Mr. McVeagh then questioned witness as to Hospital Rule 72, which read as follows: "He (the Senior Medical Officer) shall be responsible for the treatment of all cases of emergency, and all surgical operations connected therewith, after the visiting surgeon, under whose care the case was admitted, shall have been notified of the urgency of the case, and he shall be authorised to use his discretion as to the advisability of immediate operation prior to the arrival of the honorary surgeon." Mr. McVeagh: What would you call "a case of emergency"? Witness: Cases which should be operated upon without waiting for the arrival of the honorary staff—as, for instance, bleeding cases ttnd casualty work, such as dislocations and fractures. In other words, you would define " emergency cases " as those I equiring instant action to save the patient's life?— Yes, or to prevent after-effects which delay might occasion. How long would it be before the honorary staff could be summoned and arrive at the Hospital?—ln Dr. Baldwin's time it was from a quarter to half an hour, and they were always very keen on getting there. They are all connected with the telephone exchange?— Yes. A certain amount of preparation is necessary in the case of these major abdominal operations?— Yes; the patient has to be put to bed and prepared for the operation, everything has to be got ready, and the friends notified. Speaking generally, what time should the preparation take?— Fully half an hour. In Dr. Baldwin's time emergency abdominal operations were invariably performed by the honorary staff. I can recollect no case in which the patient suffered from delay in the arrival of the honorary staff. Witness, on being examined as to the case of John Donald McLeod, said the latter would- be called to give evidence. Witness saw McLeod last Sunday. Mr. McVeagh: Was his left thigh in a normal condition? Witness: No; it had been fractured, and there was a large thickening of bone on the side of the fracture. His left knee and ankle were also somewhat stiff. The Chairman : Are you able to speak personally as to this case? Witness: I cannot as to what passed in. the Hospital. Dr. Roberton: You have defined "emergency cases" as those in which immediate action is required to save life or prevent any aftereffects which might arise from delays: do you consider that fractures and dislocations should be included in that definition? Witness: I think the resident staff should treat fractures until the arrival of the honorary staff. Dr. E. Roberton, President of the Auckland Division of the New Zealand Branch of the British Medical Association, submitted that the management of the Auckland Hospital has been, and is, unsatisfactory, and has resulted in impaired efficiency and unnecessary expense. 1. This is due in the first place to the constitution of the Board of Management being unsuitable. 2. That the management has shown itself defective in the following respects: — (a.) There has been no consistent and continuous policy in regard to medical management. (b.) There has been a want of proper method in arranging for increased accommodation, leading to unnecessary expense in maintenance. (c.) Proper provision has not been made for the isolation of infectious diseases, including tuberculosis. (d.) The expenses of the Hospital have been unduly increased by the right of admission not being restricted to the sick poor except in cases of emergency. (c.) The stringent system of fee-collecting has borne hardly on the sick poor, and has led to a widespread feeling that the really poor cannot afford to go to the Hospital. (/.) There has been a recurring tendency to the creation of an out-patient department, in spite of rules against it. (g.) The Board has adopted the policy of appointing the honorary visiting staff from year to year only. (h.) The position assigned to the Senior Medical Officer in relation to the honorary visiting staff, and the divided responsibility for the treatment of patients, has been detrimental. (i.) The work of the honorary visiting physician has been hampered and its efficiency impaired by the time of the resident physician being too much occupied by work other than that in connection with medical cases. The Commission then adjourned. When the Commission opened at 10 o'clock on the 19th October Mr. McVeagh drew the attention of the Commission to a set of rules which he said was in force at the Hospital, and which appeared to preclude Hospital employees from making statements concerning the Hospital. The last rule on the subject read as follows: — " Every officer, servant, or employee, therefore, resident in the Hospital, making public or being in any way the means of making public (except through the correct official method as aforesaid stated) information or statements which may be deemed of a prejudicial nature or otherwise connected with the professional or private character of any other officer or employee, or with the entire or part management of the Hospital, or regarding any possible contingencies which may arise in the judicious management of the internal affairs,

3—H. 22a.