THE DESERVING POOR.

Dominion, Volume 6, Issue 1859, 19 September 1913, Page 5

THE DESERVING POOR.

HOSPITAL TREATMENT.

WORK OF HONORARY STAFF.

MEDICAL & LAY VIEWS.

The report brought down at last monthly meeting of the Wellington Hospital and Charitable Aid Board, 011 the matter of tho Out-patients' Department of the Wellington Public Hospital, was the subject of a letter read at yesterday's meeting, which had been received from the local branch of tho British Medical Association. The letter was as follows:—

"The Wellington Division, by the courtesy of your board, has'considered tho proposed scheme in relation to the Out-patient Department of the Wellington Hospital submitted by the Superintendent of Charitable Aid, and begs to thank your board for what is clearly an honest and determined attempt to correct the recognised abuses of the outpatient system. In the first place, we approvo of inquiry being carefully made into tho financial circumstances of applicants for out-patient treatment by tho accrcditcd officers of tho Charitable Aid Committee. Wo also wish to stress tho fact that the Wellington Hospital is primarily intended for the use of the deserving poor, and not for people in good circumstances.

"Wo wish to point out that it is not strictly a fact, as stated by the Charif> able Aid Superintendent, that there is no medical aid available, for Class 11, between free treatment and what is to them a prohibitive price, because tho friendly societies and lodges provide medical benefits for this intermediate class,- and aro largely'taken advantage of; and, furthermore, doctors are, and always have been willing to treat poor people at reduced rates by mutual arrangement between the doctors and patients concerned.

"We cannot recognise the Public Hospital entering into competition for any fees for medical services with the medical profession, and if such a condition is to arise, tne question of the relationship of the honorary staff to the Hospital Board will need to bo reconsidered.

"We have adopted the method of showing'in detail our views on the roport of the Charitable Aid Superintendent by setting out in the margin of this report alterations which we think will tend to the successful working of the scheme. It will be noted that wo refuse to recognise any lower fee than 55., and aa this scheme deals with outpatients, which pre-supposes ability to attend at tho out-patient department, wo exclude altogether visiting at the patients' own homes. "We are not at present traversing the whole report of the Superintendent of Charitable Aid, as our desire is to make our comments brief and practical, but we may bo permitted to point out that tho referonce in tho report to tho class of medical practitioner in the largo towns of tho Old Country, who charge extraordinarily low fees, only demonstrates a practice that is reprehensible, and which in the interests or tho public and of tho poor should not be copied here, bcoause the class of practice referred to is degrading to tho practitioner and generally harmful to the patient,, and an aggravation of the evils which it seeks to avoid. 1

. "Sighed, on behalf of tho Wellington Division of the British Medical Association, by 11. E. Gibbs (President), A. M. Tolhurst (Secretary)." The board referred the letter to its Policy Committee.

"Under tho Association's Thumb." The matter received further attention at a later, stage of tho meeting, when, in accordance with previous' notice, Mr. F. T, Mooro moved: —"That Mr. '[Vuehridge, superintendent of the Ohiro Homo, be asked to suggest a comprehensive scheme for the economical administration of all institutions under the board's control, with details of alterations necessary in tho management and staffing of each _ department to secure economical efficiency." He said that tho cost of tho Wellington Hospital was too great for tho work it was doing. Tho fault lay with the British Medical' Association. In thenletter, the members of tho association had said that they might have to consider their connection with' the Hospital. He thought that it would be bette-r for the Hospital if it had a purely stipendiary staff. Tho outside practitioners had abused their powers, and would continue to do so. Patients were kopt in the hospital after they should do discharged, simply because it was the pleasure of the association's members. They should get right away from the private practitioners, and run 'the hospital as a business concern. ' The Medical Association's control and interests were against tho pockets of tho people who had to find the money for tliie institution. Why should they bo bled for £50,000 a year when 75 per oant. of the oases treated were venereal, tuberculous, and alcoholic—cases which should he treated ill tihe homes of tho patients? The Hospital should bo managed by a business man, who would see that no waste occurred, a.s it had occurred in tho past. It was not fair to place the' responsibility. ( for such details on the medical superintendent. He was propared to go bo far ,as to contend that tho members of the stipendiary staff should not bo members 9f tho Medical Association. The Hospital was not roally under control of tho board, but was under tho thumb of the association, which ran it as extravagantly as possible. . . Dr. Wallace Mackenzie said) that he had great _ pleasure in seconding the motion, on behalf of tho British Medical Association. (Laughter,) He know it to be quite true that the Hospital was not benefiting the community in proportion to the cost of its maintenance. Many patients were admitted who could well afford to pay for treatment at home. Many of the contentions of the mover be could not agreo with, but it was due to the community that a report should bo prepared by a business man. If they had a stipendiary staff, it would destroy the usefulness of the Hospital as a training ground for young doctors. He believed that tho proposal was the beginning of a big scheme of a State medical service.

Work of Honorary Staff. Tho I!ev. H. Van Staveren opposed the motion. The honorary mcdical staff had done a. veiy great deal of good work for the Hospital, and lie was very much surprised tliat such an attack had been ir.ado on them. The Hospital had always been under control of the board. Mr. J. W. M'Ewan contended that Mr. Moore had not Riven them a scrap of proof that the report ho asked for was necessary. Mr. H. Baldwin said that a comprehensive report on tho Hospital was already in course of preparation by a committee of tho board, and lio hoped that nothing would be done until it was presented. Mr. Mooro had been wrong in his statement as to tho porcentago of certain diseases treated at the Hospital. , Mr. F. Castle said that tho Wellington Hospital would compare favourably with any other similar institution. Tho Rev. J. K. Elliott said that Mr. Mooro had made an unworthy attack 011 the medical profession. Stats Medical Service Mr. D. M'Liiien predicted that the day would come when tho whole medical servicc would be a State concern, and would bo freed from all connection with commercialism. Mrj B, R, .Gar^enw-j

port was necessary. They had for years been promised reports which thoy never received. Dr. Platts-Mills, on behalf of tho honorary staff, contradioted somo of tho statements of Mr. Moore. She said that patients could not be kept in the hospital after tho medical superintendent thought that tho case was one for discharge. If tho board really wished to economiso in tho matter of food, they should import a woman dietetist. Tile statement that there wero drones in the Hospital was not borne out by facts. The nurses worked very hard indeed, and were always at their posts. Mr. D. Robertson said that some changes might bo made on the business side, but thoy should hot meddlo with the doctors.

Mr. Moore decided to withdraw his motion, and to await tho report already in preparation.