PAYING PATIENTS

Dominion, Volume 14, Issue 245, 11 July 1921, Page 6

PAYING PATIENTS

TREATMENT IN PUBLIC HOSPITALS COMMISSION RECOMMENDS SPECIAL WARDS An important section of the report of the Hospitals Commission relates to the treatment m public hospitals of persons who can afford to pay medical and attendance fees. The commission lecoinuiends that greater efforts should be made by hospital boards to collect fees from patients who are able to pay. It suggests u. uniform fee for maintenance of 9s. per day, with half rates for children, and projxises that a portion of the Government subsidy should bo withheld from boards that fail to lake proper steps to collect tho fees. The commission proceeds to recommend tho establishment of paying or private wards in connection with the public hospitals. A good example of the system is to bo found in the general hospital at Toronto. The private hospital attached to this general hospital is a building of several stories erected en tho hospital site, but separate from tho main block. It has its own operating theatre and separate nursing staff. Patients are accommodated in small wards containing a limited number of beds, which can be curtained off ata desired to securo privacy. The proximity of tho main hospital blook, with laboratories, X-ray and special departments, ensures that each patient shall have the benefit of the latest advances in diagnosis and treatment. The scale of fees for board and residence, with nursing attendance, is in proportion to the accommodation required. The fees for professional attendance aro a matter of arrangement between ‘lie patient and tho attending physician and surgeon. Similar arrangements are made in tho United States and Great Britain. Witnesses before the commission pointed out that the New Zealand public hospitals -.vero (regarded iia .institutions, since honorary staffs served at the various hospitals, and well-to-do people obtained the services of tho honorary medical officers without payment, urging as their reason that the public hospital was better served from a medical point of view than the private hospital. "From tho evidence your commission believes it is correct that the public hospitals of to-day are better equipped and. etaffiod than private states tho report. “Dr. John Guthrie, of Christchurch, stated! that private hospitals were of such a small nature that proper and desirable plant was not obtainable, nor was a projn-r staff from a medical point of view obtainable. A surgical crisis might ai'isa in a private hospital at any time, and the only sheet anchor that tho patient has to rely upon is .the telephone and the ability of those who aro in charge of the homo to get the doctor's services at once. Dr. Guthrie suggested .that the hospital -boards should take over the entire responsibility for the care </f tho sick by establishing private paying wards attached to public hospitals.

“Your commission considers that witn tho increasing necessity for institutional treatment and tho advantaiges of efficient hospital organisation, those who can pay for hospital services should be placed in a position where, by doing so, they can avail themselves of the facilities afforded in our public institutions. In order to meet the objection made by some people on the score of differential treatment, Dr. Guthrie advocated that, private wards should bo kept quite separate from tho general hospital, though possibly under the same roof, but should be under the one control of tho board, the medical superintendent pnd fthc matron. To the assertion that the doctors would give more attention to the paying patients than to those in the general hospital, Dr. Guthrie answers that the same position exists to-day, when doctors are attending patients both in private hospitals and tho genoral hospital, and no charge has been brought against them of devoting their time to the patients in private institutions to the detriment of thoso in the public institutions. "Other witnesses expressed the ojiinion that tho establishment of private wards, attended by private practitioners, would have tho effect of adding to the efficiency of the work in the public hospitals. It was pointed out that by concentrating .the practice of the consulting staff at the hospitals, the medical men would have more time to devote to the patients in the general wards ~' ! Q opportunities for comparison and criticism of methods would help to raise tho general standard of efficiency. In most of the larger hospitals preferencw is very properly given to the patient® who are unable to go to private nursing homes, but there arises the injustice that ratepayers who contribute to the cost of the hospitals are unable to make any use of tho superior facilities which these afford, even though they are prepared to pay the full cost, not only of maintenance and nursing, but also of their treatment. “Your commission considers that the provision of private wards would remedy this grievance, and at tho same time afford a source of some profit, which should be devoted to the improvement of the general hospital. The necessity for private maternity wards being connected with public liospital:; under the Ixiards also impressed your commission, and it is felt that this want should receive immediate attention. "Your commission recommends tho cs.tablishment of paying or private wards in connection with public hospitals wherever the conditions are favourable, that such wards I>e under the control of the medical superintendents, but that patients chose their own medical attendance, and make their own arrangements as to his fees.”