Maternity Hospital System in New Zealand

Kai Tiaki : the journal of the nurses of New Zealand, Volume XVII, Issue 3, 1 July 1924, Page 115

Maternity Hospital System in New Zealand

Drastic Reform Urged

New Zealand's system of private maternity hospitals is subjected to frank criticism m the report of the Royal Commission which sat m Auckland last March to inquire into the conditions of puerperal fever cases at Kelvin Private Hospital. "The system/ states the commission, "is unsatisfactory, mainly because the provision of private maternity hospitals rests entirely upon the usually slender financial resources of the licensees, who, as a rule, are registered midwives, and not often the owners, but merely the lessees of the premises. "It is almost without exception beyond the financial ability of these women to supply the class of building* and equipment which the welfare of the patients and the national importance of the work urgently demand; and as a commercial venture the income generally derived from these hospitals presents no alluring prospect to the capitalist. The result, therefore, is that the majority of these hospitals are private houses converted, as far as the finances of the persons concerned permit, to the important purpose of a hospital. Need for Drastic Reform. ' ' This arrangement, ' ' continues the commission, "can never be quite satisfactory. "While it must be recognised that the system now m operation has been of much service to the community, its defects cannot longer be endured, and a complete and drastic change is called for. "The only solution of the problem which presents itself to the commission is that private maternity hospitals which do not completely comply with the regulations to be formulated as to building, staffing, equipment and so on, should be subjected to a process of gradual extinguishment, and that m their place efficientlyequipped accommodation for maternity cases be provided by the Government or hospital boards, or by both m conjunc-

tion, for all classes of the community — rich, poor, and those of moderate means— the patients being required to pay for tne service rendered m accordance with their financial ability/ A False Sense of Security. The commission contends that the cost of maintenance would be relatively reduced m proportion to the size of the institution, and holds that even if some permanent loss were incurred it would be reasonable to view this as perhaps more justifiable than any loss incurred m otherState enterprises. As matters now stood it had transpired that the Department of Health, because of the great and increasing demand for this class of service, was practically forced into the position of issuing licenses for private maternity hospitals m cases where it was realised that the buildings and equipment were not entirely suitable. The commission therefore points out that the issue and continuance of a license by a Government department induces a natural assumption by the public that the institution concerned is suitable and safe. "If," adds the commission, "many of these institutions are not m fact suitable and safe, then this sense of security is a false one." "Expectant mothers should not be deluded into a sense of security which the assurance of Government inspection induces, when that security does not m fact exist. The position of the staffing of the Auckland District Health Office is absurd. It should be immediately and substantially strengthened and the inspection of private maternity hospitals rendered a real protection to maternity patients, which at present it is not." Revision of Legislation. It was with some astonishment that the commission had learned that the regulations of 1907 dealing with private hospi-

tals were out of print, and that Dr. Hughes had never been supplied with a copy and knew nothing of them. Therefore it was not surprising to learn further that neither the manager of Kelvin Private Hospital nor any of the medical practitioners had heard of these regulations. Many of the regulations were 'sadly m want of reconsideration.

It is recommended that all regulations and departmental requirements, instructions and recommendations pertaining to all private hospitals, be collected, revised, brought up to date, and, together witli the recommendations of the Maternal Mortality Committee of 1921, and the Private Maternity Hospital Committee of 1923, gazetted m the form of regulations.