HOSPITAL AFFAIRS.

Gisborne Times, Volume VIII, Issue 507, 21 August 1902, Page 2

HOSPITAL AFFAIRS.

APPOINTMENT OF SURGEON SU P E KIN TEND EN T.

JOINT LETTER FROM LOCAL MEDICAL PRACTITIONERS. A CHANGE SUGGESTED. ■ At the meeting of the Hospital Trustees last evening, the resignation of Dr. Craig, as medical superintendent of the institution, was received and accepted with regret, and the following joint letter bearing upon the appointment of his successor was received from the local medical practitioners : “ In the opinion of the majority of the medical men practising in Gisborne, it is desirable that a change should be made in the medical arrangements of the Hospital. Wo feel that under tho present order of things we are debarred from Hospital practice, a branch of our work which is highly valued by the profession all the world over. This feeling is our motive in venturing to bring under your notice certain reforms which we consider would bo for the benefit of the institution, of the public at large, and of ourselves. We suggest that in place of one medical superintendent as in the past, a staff should bo appointed, consisting of the four medical men at present in practice in the town. Each member of such a staff should have

tlic privilege of sending patients into the Hospital and-attending them there ; such patients to be considered to be under the charge of the member of the stall who sent them in, and to continue so until their discharge, and no other member of the staff to be entitled to interfere in any way in their treatment unless requested to do so by the man in charge. To meet the case of patients who may be admitted without having been directly sent in by any member of the staff, we suggest that each member should bo on duty for a week at a time, in rotation, and should during that week bo at the call of the Hospital to such cases. For example, should a man break his log in Aberdeen road, and bo carried at once to the Hospital, the doctor who may be on duty for that week should be sent for, and he would attend to the case, and continue to do so until tho man’s discharge, no other member of tho staff, as stated above, being entitled to interfere in any way with the case. We suggest that such a staff should be honorary or otherwise, as the Trustees may deem best. If the staff be honorary, the present honorarium might ho devoted to procuring the services of a House Sur-. geon. Wo consider that there would he no difficulty in obtaining a young surgeon, say one of the graduates of the Otago University, at a salary of from Tl5O to £2OO per annum, with board and lodging. Should such a House Surgeon be appointed, the duties of Medical Superintendent of the Hospital would devolve upon him. Hut should ,tho Trustees not see their way clear to make tho appointment at present, we suggest that one of the staff should ho chosen, either by tho Medical Staff or by the Trustees, to act as Superiotcndent, say for twelve months, when he might be re appointed or another chosen in his place. Such a scheme, or one modified from it, would, we believe, work smoothly and withjut friction. We know that it does so elsewhere. Anyone being admitted to the Hospital would have the services of his own medical man, and if ho so wished, tho combined know-

ledge and skill of the staff would be available. At tho same time the local practitioners would have the advantage of a fair share in the surgical and medical practice which a hospital provides.—We are, gentlemen, your obedient servants, George AV. Cole, J. AV. AA'illiams, AVelby E. Fisher.” The Chairman said the communication

contained two or three suggestions, tho ’main one being tho appointment of a medical staff, consisting of tho fourdoctors mentioned. Mr Dewing: Regarding tho appointment of a House Surgeon, I presumo that the geutloman would not be allowed to practise outside. The Chairman : That is so. Mr Johnston : Such an appointment would moan tho erection of another building and more furnishing. Mr Harding : Tho sum total of tho matter is-that the doctors want to manage the Hospital. Mr Joyce: I would suggest that the several suggestions be dealt with seriatim. The Chairman : You can take them seriatim, if you like. I have gone through the letter carefully, and know what it contains. Tho meeting proceeded to deal with the letter, hut after the first paragraph was read Mr Harding remarked : “In accepting Dr Craig’s resignation, we have dealt with tho question for a period of three months.” Tho Chairman : Dr Craig’s resignation does not take effeet for throe months. The sooner this matter is dealt with, however, the better, If you do not accept the suggestions of the doctors, you will have to call for applications for the position. Mr Kennedy: AA T e have to make provision for the management of the Hospital after three months. It would not be a bad idea to defer consideration of the matter for a month, during which time wo will bo able to communicate with other hospitals throughout the colony, and get information from those having honorary medical staffs. In Napier there is an honorary surgeon and an honorary staff, and the same exists in other places throughout the colony. Next meeting, we shall either have to call for applications for the position or comply with the suggestions of tho doctors. Tho Chairman said that as far as he knew Napier and Timaru were tho only places wboro there was an honorary medical staff. The Board had some time ago considered the question which was now before them. As far as ho could see there were many objectionable features in regard to tho appointment of an honorary medical staff, and ho did not think it would work well in connection with the

Hospital. Mr Warren had given the communication careful consideration, having previously seen a draft of the letter. He feared that if the suggestions were given effect to each doctor would send his poor patients to the hospital, and the institution would soon bo crowded. They would have to provide forty additional beds before the year was over. The doctors suggested the appointment of a house surgeon, but they did not say whether they would be prepared to give their services gratuitously. He considered the appointment of a house surgeon would mean £350 per year to the Board, so doubt in the future they would require to appoint a house surgeon, but then they should endeavor to get the best they could possibly obtain, and not one f-ash from his studies as was suggested. He had thought matter over carefully without any outside pressure, and he did not see how they gould improve upon the present system. yjr Kennedy said that as there was j three months to spare, there was really no necessity to come to a final decision that evenin'’. The matter had been brought up, and it afforded food for reflection. There was a good deal in what the doctors said, and he did dot think the Trustees would be unwise in allowing the matter to stand over. He opposed the application on the ground that the doctors would inundate the Hospital with patients, and he was not absolutely certain that it would work as harmoniously as suggested. Pie would like every member to think the matter over, and would therefore like to see the subject adjourned for discussion until the nest meeting, when they would all be in a better position to deal with it. The Chairman had thought the matter over carefully, and was prepared to come to a decision that evening. Mr Jo3’ce predicted that to make a change as suggested by the doctors would cause a lot of friction. Be was also of opinion that that it would lead to the overcrowding of the institution. Trouble would also arise when one doctor was called away, and another was expected to look after his ease, Hitherto the Hospital had been worked very harmoniously, and he was opposed to make a change in the manner suggested. The expenditure would enormously increase, and the nurses iu the .Hospital would be at the beck and coll of four or five doctors. He did not see why members should hesitate in coming to a decision that evening. Mr Tuohy agreed with Mr Kennedy as to the matter beiDg allowed to stand over

(or a month, but ut the same time if a motion were put to the meeting inviting ■ applications for the position he would support it, as he did not think they could improve upon the present system. Mr Harding referred to the fact that there had never been any trouble in the hospital in regard to the Medical Superintendent, and he did not think they could improve upon that form of management. If it were suggested that they should obtain a first-class resident surgeon then he might have entertained it, but be could not see how they "ould otherwise improve matters. He strongly objected to the proposal to bring a young surgeon along and allow him to practise on the patients in the Hospital. 11c did not believe in a medical staff, for what was everybody s business was nobody's business. They must- have somebody at the holm, and ho would vote that they have the same management as hitherto. Mr Hewing said that members appeared to be unanimous in regard to the matter, and he saw no objection in allowing the matter to stand over. There would be still plenty of time to call for applications. Mr Kennedy proposed “ That further consideration of the matter be adjourned until next meeting, and in the meantime the secretary be authorised to make enquiries from hospitals in the colony where similar management exists as to the satisfaction given by snch administration.” Mr Tuohy seconded the resolution, which, after further discussion, was carried by five to three, the Chairman, and Messrs Harding and Joyce voting against it.

Mr Harding said that he did not wish to hurry the thing on, but he would like to move another resolution. He considered that delaying the matter only meant prolonging the evil day, and seeing that there was a full meeting, he thought that they should decide US to Calling applications for the position. The Chairman said that he could not accept another resolution as it would practically be a contravention of the one already adopted. Mr Harding did not press the matter, and the discussion was adjourned until next meeting.