K.—^-Aa

44

But was there any compulsion in the matter? —There is considerable compulsion implied by an authoritative body sending a bill to the patient. But is that understood to amount to compulsion?—l do not know the inner working ol the matter at all. Do you know that a large amount of hospital fees—several thousands 01 pounds a year—are written ott?—l have seen statistics to the effect that a large amount is written oft, but 1 do not know how much. 1 understaiiu that one of the first things that happens to a patieut on going to the Hospital is a visit from the Uouse steward, to mid out what his financial position is. Have you ever heard or any person being turned away on account of not beiug able to pay the tees?—ino, l have not; but tnose who can pay the 4s. Bd. a day are more welcome. Air. Keed: is it not the practice lor modem hospitals to be built ail on one fiat?— Where wouiu you get the land fromf Hospitals are still built several stories high. The structural state oi the Hospital prevents the present lift being made available lor use, Ho you know that plans were prepared some time ago lor a new lift?—l did not know it, but 1 am glad to hear it. The Chairman: How long has the present practice of carrying patients upstairs existed?—l rhink: it has always oeen the case. 1 do not know how long the fift has not been working. Mr. Heed said the lilt was too narrow lor the conveyance of patients. in the course of further examination, Dr. Lewis said that the custom of putting delirium-tremens cases in the wards in the basement was not at ail modern, and a separate ward should be buift. ihe Hospital Board should certainly taKe such cases in. There should always be a means of dealing temporarily and separately with the consumptive cases, which were not fit to take to a sanatorium or tor outdoor treatment. Such cases should be dealt with separately at the Hospital, and he believed there were several spare small wards in the basement which would be suitable. At any rate, they were suitable tor malignant complaints. ihe witness said provision should be made for incurable cancer cases, and the cases wnich were not broken down could be treated in the general surgical ward. For the latter cases it was not necessary to erect a separate building, but the incurable cases, in which there was a lot ot discharge, should be sent somewhere else—he thought the Costley Home was the right institution, ihe Hospital should receive ail cases until proved to be incurable. Diphtheria should -be treated in an isolated hospital, in his opinion there was no great danger in treating the diphtheria cases in the buildings on the Hospital grounds, so long as the staff took reasonaufe precautions. There was no necessity tor a separate staff, ihe question of the treatment oi semi-funatics wa<> rather a difficult one. The profession did not desire to commit to an asylum a man who was onty on the borderland of lunacy, and it was those kind of cases that had to be provided for. They had to be treated somewhere, white it was seen whether or not they developed insanity. The Chairman: ihe Hospital should be the last place to send them to. if their friends or relatives could not take care of them they shoutd not be put amougst the typhoid cases at the Hospital. Dr. Lewis: Oh, certainly not in the typhoid wards. The doctor went on to say that there should be accommodation for such cases before committal to an asylum. More room could be made at the Hospital were the patients who were well able to pay excluded from the institution. The patients were reduced last year by the Hospital authorities, but the witness was not aware of the mode of discrimination brought into effect. In reference to patients having to get a medical practitioner's certificate, the witness did not think such a rule was required. He did not favour the abolition of the honorary stall and the introduction of the system of a paid staff. It had been tried once, he said, when the honorary staff resigned in a body but it was not a success. a a , Reed: - As to tne erection of the new operating-theatre, he did not know it it was for general surgical cases, or for the Costlev Home inmates, because the theatre was 200 yards from the main building. Mr. Beetham: Is the theatre to be used for inmates of the Costlev Home, or for surgical cases generally ?—ln the latter case the patients and d car "cd at least 130 yards to the theatre through rain Dr. Lewis: I think it is quite wrong. Mr - Beetham: It is useless to erect such an expensive building for the Costley Home inmates alone. & In reply to Dr. Collins, Dr. Lewis said he saw no reason why a patient should not produce a doctor's certificate on admission but there was no necessity for it. ' ii, Br *~o ol' i ns: An ? J "ght in saying that before the production of the certificate was brought into force medical practitioners in town found that when his account with a patient was getting large the think" W rtra ight to the Hospital to avoid expense?—No, I don't . P<>es not it encourage patients to leave their own doctor and go to the Hospital to avoid expense?-Certainly not. People don't go to the Hospital for pleasure It didn't make the slightest difference. tb Q A, T ji ll^, anybody should be admitted as soon as they come to r^d^t r pl7y!irn ded *" & " CMe ' is »« and by the Without a recommendation?— Certainly, if it is a lit case.