Accident care slated

Press, 11 April 1979, Page 25

Accident care slated

PA Auckland The standard of accident and emergency care in New Zealand hospitals “is totally unacceptable in 1979,” says Professor John Conte, of the University of California, after a three-week visit to New Zealand. Most doctors would not know the logical sequence of steps needed to treat an emergency patient, and often the most junior doctor on the staff was called in the middle of the night to do an emergency job, he said. “You cannot take care of a patient like that,” Professor Conte said.

No patient would be kept waiting six hours in an accident and emergency department in the United States, he said.

“Patients in the United States want to know what is going on and will demand an explanation or face doctors with a malpractice suit”

New Zealand needed specialised training for doctors and nurses working in accident and emergency departments, the stepchild of hospitals.

He said New Zealand’s ambulance and para-medic training was improving, “but where are the women?” “Libbers” in San Francisco would force an inquiry and demand women be recruited if they had a New Zealand situation.

Professor Conte, speaking at an emergency care seminar in Auckland, had a few words for finan-

cially troubled hospital boards. He could find no internal accounting systems in New Zealand hospitals and noticed doctors running up huge hospital bills by giving. patients unnecessary examinations.

"Junior or insecure doctors do it because they find it difficult to diagnose a patient,” he said. “If a doctor is given a cost sheet and knows how much treatment is costing, he thinks more carefully and makes a better diagnosis. It is a good check on your thinking,” he said.

Price lists of treatment for doctors in wards was part of the answer. “At the end of the month the hospital registrar knows exactly where the money has gone and

costs are accounted for,” Professor Conte said. Dr D. A. Andrews, the medical superintendent of Christchurch Hospital, said he agreed that doctors and nurses working in accident and emergency departments needed better training. “However, here we do not employ with individual responsibility the very junior doctors. There is always supervision from more senior doctors, but as in all specialties there are not enough specialists,” he said. A recent survey of the Christchurch Hospital’s accident and emergency department had shown that the average waiting time before a patient was attended to was 10 minutes, Dr Andrews said.