HOSPITAL POLICY.

Press, Volume LXI, Issue 18412, 19 June 1925, Page 9

HOSPITAL POLICY.

♦ THE NEW PROPOSALS. NORTH CANTERBURY BOARD'S ATTITUDE. The recommendations of tbo New Zealand Branch of the British Medical Association regarding tho new hospital policy of tho Department of Health, which wore- published in yesterday's issue, wero tho subject of 6omo comment' by Mr W r S. Wharton, secretary of tho North Canterbury Hospital and Charifablo Aid Board. Mr "Wharton said the matter -was discussed ',*,fc tho recent conference, he'tfl in Auckland, of tho New Zealand Hospital Boards' Association, and a resolution was arrived at to the effect that tho hospitals should be available to all ■who claimed admission, and that all medical practitioners were concerned with "was whether tho physical condition of the patient was such as to make him a fit subject for hospital treatment ami whether h© would benefit thereby. In arriving at that resolution, Mr "Wharton suid it was fully recognised that the public hospitals wero open to nil classes.of tho community, and that in carrying out tho work of the institutions with an honorary staff a serious . injustice was being done to the medical pro.ession. As set out in B.M.A. recommendations it was suggested that patients should bo divided into three sections —first, thoso who could not afford to pay fees; or only able to pay the bare "hospital maintenance charge; second, thoso patients, who might bo treated in the opeu wards of the hospital, who can pay a fee lor necessary medical or surgical attention, over ancl abovo tho charge for maintenance; and third, thoso patients able to p,ay in full cost of their maintenance and rail charges for tho necessary proles, sional attendance. It was the second and third divisions who would occupy what are known as paying patients' wards. No details had been worked out in connoxion with these proposals, many people expressing strong disapproval of B.nv different treatment being accorded rich and poor; others favoured special accommodation for those who could afford to pay for ifc. With tho North Canterbury Board that aspect had not been giiven serious consideration. It had been in the forefront of the Board's policy for some years to make Erovision for patients well able to pay, ut so far nothing had been done,, nor could anything be done on those lines until the vexed question of tho Nurses' Home had been settled. It was useless to put up accommodation for patients \n the absence of the necessary accommodation for the staff needed to deal with the increased number of patients. "1 anticipate that the Nurses' Home will be gone on with at an early date," Mr Wharton said, in reply to a question on the point. "It has been temporarily held up owing to certain proposals regarding the Board being able to acquire ground on tho wosterri side ofMibe'Hospital : this, it is hoped, will be settler; shortly. Failing that settlement, there is no alternative but to build on what is known as 'the cabbage patch,' and Elan& for a building on that site--have een already prepared." Asked what new buildings would be required (in addition to the new Nurses' Home) if the proposal regarding paying patients' wards was given effect to, Mr Wharton said that it would be necessary to build one big block of hospital buildings, probably four storeys high, arid acepmrnodating not fewer than 10U beds. There was ample space on tluj Hospital grounds for three such blocks, but':it. would be necessary to pull down some of the early built wooden'buildings and the, temporary buildings erected during" the war period. He estimated that a'hospital block of the"> size indicated' would not cost less than £OO.OOO or £60,000. Asked as to tho extent of the demand for private' paying patients' wards, Mr Wharton said that personally, he thought that tbo demand existed. There were many who were contributing to the Hospital funds who wero denied the privilege of utilising tho special services and facilities obtainable at the general, hospital—facilities and services that could not be obtained elsewhere in tfte city. At the general hospital a number of special departlhenlis were available, and all were essential in the successful diagnosis and treatment of disease. Thcro was no question about that, and it was

bein|j: proved - more and more that ~ parents be examined by every mean's, possible in order to'arrive at a satisfaotipry diagnosis. One of the proposals made by tho Director-General, Mr Wharton went on to say, was that ißoards should make arrangement for a partly-paid staff; but it was assumed, in the event) of accommodation for paying patients being •provided, that tho members of the medical profession would be perfectly wiliiiig to act in an honorary capacity as far as poor patients'were concerned if they had tho privilege of receiving fees from those patients willing to pay. There was no doubt that a number of people sought adm'ssion to the hospital and succeeded in doing so, 7 and that those people could well afford to pay for treatment olsewhero; and those pebplb deprived the medical profession . of their legitimate fees. As far as the .county hospitals under the Board's control are concerned," Mr Wharton went bit to say,'"the now system was practically in operation. Any person is entitled to enter these country hospitals and, if unable to pay the ordinary hospital maintenance charges, the doctor attends them as hospital coses without any other fee than tho small annual payment made him by tho Board; other patients are sent in just in the same way that the city doctor sends a patient into a private nursing home, the doctor coir lectin'g his own fee. In many cpuntry centres there is only one medical mail, and no difficulty has been experienced in worßin'g under tho system just outlined. In Ba,ugiora and Leeston, where there is more than one medical man,' the doctors agree amongst themselves to troat poor patients-without chargp, only charging. a fee where the patient is able to pay. In these districts the Board dpos not retain any medical practitioners, the doctor act? ing in an honorary ..capacity and making use bit tho institution as a nursing hpmo for their own patients. Consequently the proposal made by the Department is not' strange to the North Canterbury Board; which'could easily carry out the sabo'system at the gpneral hospital in Chrißtchurch if it had tho accommodation." Mr Wharton's own personal view was that in tho comparatively near future all hospital work would como into the hands of the Board, and that private hospitals .will gradually disappear; especially. so would this be the case in respect of maternity work. As to the recommendation of tho B.M.A. that tho hospital and charitable aid work should bo separated, Mr Wharton saw no reason why a reversion should be made to a system that had been tried already, and was abandoned after mature consideration after tho Act of 1909 was brought into _ force. Hospital work and charitable aid work w'erb interdependent: the charitable institutions' controlled 'by "the Bowd were very frequently the means of clearing'the hospitals to a very great extent. There was nothing conflicting in the two branches of work; in addi? tion administration costs wero reduced, one offico staff being sufficient for both clitesce of wprk. , Tho modern tendency wais to discountonance a multiplicity of local bodies and to favour tho amalgamation of allied activities when pos<ahlo ujider'o&a cQ&tjroili&e authorita. ,