THE HOSPITALS.

Press, Volume LXVIII, Issue 20491, 9 March 1932, Page 13

THE HOSPITALS.

JUNCTIONS OF PROPOSED BOARD. A REPLY TO CRITICS. (mcum wbittzn roa the pkess.) [By R. Cabi'iibia LSegg.] 1 1 The Mggestion of the formation of a Btud of Hoapitals in the remit of the ' Wellington Hospital Board, has been jpptMd oh various grounds, some of a ptfr wtnwi and some that require dote investigation. Jfco main objective in the general recommendations is the formation of independent hospital administptiont sufficiently conversant with nediea) and hospital matters to be able to control their areas and the various hospitals included therein to the best advantage. The extent of the areas guarantees that .each Board will be able to have the advice of a strong aedieal committee to yoMe it in its functions from the purfl/j technical asppct. but be itxong enough and have sufficient knowledge, to ensure that it is. . «t ttsduly influenced on policy mat- , either by its medical "committee or | ftf its medical officers. ; Us best safeguard against that " a&al control, that spectre which ■ MM'to plague a few Board members k»'ja4 tiere, is strength and know- [ Ufcl ea the part of the real adminisf and that the electors surely [ hna right to demand in their chosen njmtststives. If they do not feel &auehci eapable of administration i tittMt being unduly influenced by the joince of their medical superintend<afenul officers the only remedy apJHOfb be their own resignation or the Mtftnent of the hospitals without Mm at all Spending Money Wisely. lit qntem aims at decentralisation. Wilt large part of the finance used I? tbf. Boards is derived from the Conafitted Fund it is the duty of sonic •aba! authority to see that this money & Heat to the best advantage, <md i t ■itf'iave power to prevent any partiolw Wttnl acting in a way which is JUjaikial to tlie other Boards and the at * whole. This central authorBy* at present the Minister for Health, «dUs executive department, the De'jWfaest of Health. The Ministry of however, not a permanent l»d the incumbent of it may have ttfajjfaojar knowledge of hospitals i>r jNfiSiP natters. In addition he has of Mental Diseases and portfolios from time to time. The "®soH3eneral of Health administers W Department with various divistasd big attention and that of JHjMf is divided between hospitals, dental nursing, child etc. -There are various Boards SgM with the Department to assist notably the Nurses RegisBoard and the Board of Health, jfiwution of a Board* of Hospiao new departure, but •Hl4' riißn|y strengthen the hands of Btent in its administration of i of hospitals, just as the lealth docs in the division Pgiene. Hospital qulstions enough to warrant a group tative men devoting their bought to the subject as I {ministration of the Hosnld remain in the hands »f >epartment exactly as at utment's Powers. ingenuous of Board nieraas some have said that 0 be governed from Welthey know the Act they ie Department of Health •overs at present, some, of vested in the Directorin the Minister for Health or through Order-iu-Couii-owers are mentioned in ons of the Act. They in regulations in regard to ' hospitals cannot be built onsent of the Department, iry ones cannot bo closed I ta standard of staff in revere is controlled by the ral under Section 37, and lit the name of any senior Department for comment ppointment is made. Tho fsl under Section 77 derequisite provision to be sick in a given hospital ®®t only can the Minister withhold subsidy from a • e Director-General himself loriaed by the Governornncil to do at the cost of it is considered the aould have done under the neglected to do. to the formation of the pUals have been raised, on : W The formation of a _(2) the composition augbe Wellington Hospital be proposed powers and the Board.

Keply to Objections. The objections made under the head of No. 1 have been: — (a) It is taking away the rights of the people's representatives. This has already been answered. (b) It would involve further machinery of Government. The suggested Board would, however, have no executive functions and would work through the Health Department, of which it would be a component part. (c) It would be expensive. The expense would, however, amount to little more than travelling expenses of those members who lived outside Wellington. As, after the system was " being, it would not be necessary for the Board to meet more -than four to six times a year the expenses would be at most a few hundreds. The composition of the Board. This matter is, of course, one for discussion. The suggested Board includes, however, representatives from the contributing j r ,». ai-ss cannoTbe altogether eliminated m spite ?he recent protest of a Wanganui Board member who is reported to have ■a fW he noticed there were two representatives of the British Medical Association and that would be d = as far as the country was con levied As.a matter of fact, only one BM A representative was suggested, Sfto £ B»«; ber eoneei-ed it may tu „ llo „ ea The poire" of ;!!ir?l»,,c" w li i«»»e <■' I"!'" 1 "- in accordance wi ..... This see nis tion and trans P° rt • any flexibility a necessary * J imp le matt° the system. i istra tion, and one ter of liospital v ided for at WIU /» 8 n the Department of Health's present as the vey In thw> ag experience s U^ ere any party may f 1 has a grievance, it might be feel he has a g right of appeal advisable to give the ngn* r?

on similar lines to the appeal against the decision of the Board of Health. To sec that unnecessary hospitals are eliminated.—lt is certainly somebody's duty to see that this is done. As to who is to decide whether a given hospital is unnecessary or not, it is presumed that the Board of Hospitals would not act without taking the opinion of all concerned on the matter. Again the right of appeal might be given. At present no Hospital Board can close unnecessary institutions without the consent of the Minister for Health. To lay down standards in regard to staffing and equipping of each type of hospital.—This clause has been much misunderstood and has been interpreted as meaning that the Board would override a Hospital Board's decisions in regard to appointments. Of course, it merely implies that certain minimum standards of qualification would be required in applicants for certain positions. Even at present the Board cannot appoint a man as surgeon unless he is a registered practitioner. It is advisable, however, that still further limitations in regard to the amount of experience and qualification be laid down as is done in the by-laws of some of the Boards already. This is necessary to protect patients.. Standardisation in regard to qualifications does not restrict any Board's choice in respect to individual applicants. These are the only contentious clauses. The other functions suggested follow the present Act or are of a purely advisory nature. Dr. MacEachern, in his report, advised that such a Board was the "missing link " in the New Zealand hospital system, and from the point of View of administration this position would be difficult to combat.