HOSPITAL AND CHARITABLE AID BOARD.

Globe, Volume XX, Issue 1395, 5 August 1878, Page 3

HOSPITAL AND CHARITABLE AID BOARD.

L u mg of the Hospital and Charitable Aid Boaru was held on [Saturday night at tho Hospital. Present —Tho Mayor of Christchurch (in the chair), the Mayor of Sydenham, .and Dr. Turnbull. Tho Mayor of Sydenham informed tho Board that he had received from a very respectable man an offer to adopt two children. 'J he applicant had been to tho Orphanage and had there seen a boy about twelve years old and a little girl about eight whom he was quite willing to adopt as hi 3 own. Ho had promised to see that the children were pro;.erly educated and, in fact, treated ai hiK own. Mr Booth asked if there had been any custom which might act as a Rtiide to tho Board in dealing with such application. Mr March said that children had been thus adopted, and care had always been taken to secure for the children proper treatment. Dr. Turnbull thought the offer a very handsome one.

The Chairman said the only thing that could be done would ho binding tho children as apprentices. The Board had no power to compel anyone to keep such a promise. It was resolved to submit the offer, with all particulars, to tho'Government, with the Board's recommendation for approval. An offer from a farmer to take a lad as an apprentice to farming was read, and it was resolved to invite the writer to visit tho Orphanage and judge for himself as to the suitability of any of the boys. It was also resolved —"That the Colonial Secretary be advised to appoint the chairman of the Board as the person to bind children under the Masters and Apprentices Act, 18(55." Mr March stated that he had visited the Orphanage. Ho submitted to the Board several minor matters of management and received directions upon them. An application for relief from Kaiapoi was read, and left to be dealt with by the Kaiapoi Board. Other applications for relief were road and dealt with.

A letter was read by Dr. Turnbull from a gentletran, asking if arrangements could be made for receiving pupils into the dispensary. It was resolved to request the staff t;> consider the question of taking pupils, also the questio i of providing accommodation for e:ises of scarlet fever and 'Hph'lieria in the Hospital. Some discussion followed as to the necessity of some alteration in the site of the Orphanage, the present site being considered very unsuitable. Dr. Turnbull was strongly in favor of a hulk being appropriated for the boys. Mr March was satisfied that the plnn would be a success. "With regard to the girls they must of necessity be kept on shore, and with them the boys who were too yotmg for the hulk. The report of the mediral staff, on tho matter of the appointment of a house surgeon, wis read as follows : Christchnrch, July "0, 1873. giv,—T hfwo tho honor, by direction of tho Hospital staff, to acknowledge the receipt of your letter dated July 10th, 1878 In that letter yon state 1 hat, owing to the conditioa of Blr Pridgeou's honltk, yon are anxions. to learn what steps have boon taieu to secure a house snrgoon, and whether the stall consider the salary of £2OO sufficient to secure a competent percon ! J The stops we have tiken areTwenty advertii ements in the "Auckland Herald," twenfcj In i no " Wellington Tost," twenty in tho " Dunedin Times." twenty iutho " Jjyttclton Tnnos," and twonty in the PBEBB.

We also commissioned Dr. Powell to advertise in Sydney. We wrote to tho managers of the Dnnedin, Wellington, and Auckland Hospitals, asking—1. What i« the salary of yonr liouse surgeon ?

2. Is he also house steward, that is to say, has he the control over and responsibility of the general as well as the professional department ? 3. What advantages other than salary attach to tho office of house surgeon, such as board, lodging, &0. ? 4. Will yoti kindly send ua copies of your printed rnlcs, regulations, and diet scale ? "Dr. Powell is also to secure similar information from Sydney. This, I think, recounts the steps taken by the staff as asked by yon- We have not, received suitable; applications from New Zealand, and nntil Dr. Powell's return from Sydney I cannot inform you as to his success.

In answer to your question as to whether tho salary is sufficient, I may say that that amount was adopted at a full meeting of the staff, naturally from no desire to undervalue professional services, but after a careful revision of the altered circumstances under which tho new officer would enter upon his duties.

The salary received by tho Into house surgeon was £3OO a-year, but it is believed this was given in mistake. The original salary was £2OO, but after years of service by the late Mr Parkerson, jun., it was raised to £250, and then to £3OO a-year. It might prove awkward if each honso surgeon were to commence at the long-service salary of bis predecessor, bnt in addition to these reasons for the lower salary, the responsibility and work to be clone were diminished by at leist one-half. After Mr. Bnrrell T'arkerson died a house steward was appointed, with control over tho servants, charge of stores, and of tho buildings and grounds. Unfortunately, the office of house steward was given to one whose work as an officer or th« Geueral Government absorbed the greater part of his time, and the efficiency and economy hoped for from the appointment of house steward were feebly realised, but unquestionably it relieved the house surgeon from a multiplicity of harassing duties, and therefore seemed to entail a salary smaller than when the work of tho two offices, honse steward and house surgeon, were combined iu one officer. I may hero mention the salaries of the two arc estimated at £SOO a year. The staff look at the wholo matter in this light. It is customary in small hospiHls to give the house surgeon tho entire control. The stuff consider that tins Hospital has mssedont of tho class of "small hospitals," and requires quite a different stylo of management. The expenditure is £BOOO a year. The number of officers, nurses, and servants, not including visiting staif (3G) thirty-six. Tho number of beds (130) one hnndrcd and thirty. The number of visitors and general communications with the public daily are very numerous. The buildings, including wards, kitchens, washing house, laundry, &c., arc extensive, and the pleasure grounds enclose six acres. Unquestionably the management of so large a department demands that it should be immediately settled upon fixed principles. The members of the staff address themselves to tho solution of the question. We would indicate as a chief item to be held in view, that every inducement should bo afforded towards making the chief officer of tho institution hold tho office permanently. To derive tho greatest good from the high expenditure, wo place groat importance upon the prolonged residence of the managing officer, so that a continuous scheme of progressive improvement may bo evolved. Wo are of c;>inion that tho time has arrived when this large department should bo placed under tho care of an experienced layman, and that the professional element, whether the visiting staff or the house surgeon, should take a subordinate position, or rather have no place in tho business management of tho Hospital. We have s:iid that absence of change in tho officer administering the department i 3 essential, and we are of opinion that this "permanence" will not be attained so long as wo rely upon comparatively young surgeons—inexperienced in any form of business—as our chief officer, The question seems in many minds to turn upon whether the house surgeon should get £3OO or £2OO a year, but with ns the actnal amount is of little moment, becanse neither salary will purchase that business experience and permaueuce in office which wo deem of vital importance in tho management, of this large concern. On the contrary, whether the amount be two or three hundred, the office as in the past will still in the futnre be made simply a halting ground, until a good field for medical practice turns up. We therefore urge upon the Board to recognise fully the house steward as chief officer of the establishment, responsible to them for the efficient and economical working of all tho departments. Ho should be responsible for the fulfilment of all contracts ; for the care taken in the distribution of fond to the patients; for cleanliness tnroughout the buildings, and for all sanitary arrangements; he should hire and discharge all nurses and servants, and be held responsible for the regular observance by all tho officers, nurses, and servants, from the house surgeon downwards, of tho rules and regulations; all communications with the Board or public should pass through the office of the steward. It will be seen that tho aim is to entrust the government of the Hospital to the lay offieer, called a house steward, and necessarily to confine the work of the house surgeon to tho medical and surgical care of the patients. The house surgeon should be a fully qualified practitioner, competent to cope with cases of emergency, or severe accident, until tho arrival of one of the visiting staff; to see that the wishes of tho visiting staff are carefully carried out by dispenser and nurses, and to take daily the entire attendance upon the out-patients. By thus confluing the attention of the house snrgeon strictly to professional details, it is expected that much benefit will accrue to the patients ; that the well-defined responsibility will be established, which is so requisite in tho management of all large in:-titutions ; and that tho governing officer will ho-d the appointment for lengths of period which will conduce largely to progressive improvement in all the departments of the Hospitals. The staff is of opinion that the cause of delay in securing a house surgeon is the non-arrival of any immigrant vessels, and not the amount of salary offered. The staff of course leave the matter of sa'ary entirely with the Board. Accompanying this paper are the replies received to-day from Auckland, Wellington, and Dnnedia. They will be found to confirm the views put forward by the staff. I have the honor to be, sir, Yonr obedient servant, James S. Tuenbutl, Chairman of the Hospital Staff. The Chairman of the Hospital and Charitable Aid Board, Christchnrch. ! etters were read from Dr. Fhilson, of A tickla d, Dr. Johnston, of Wellington, and Mr A. Burns, secretary of the Dunedin Hospital Committee, conveying full information ns to the management of the hospitals in those cities. l)r.° Turnbull said that in reference to_ remarks made by Mr J. E. Brown ho wished it to be understood that tho staff wanted no more than they had in the past, so far as regarded the qualifications of the hou.:C surgeon. What they wanted was a permanency. He might say that the Hospital had been placed at a great disadvantage in consequence of the frequent changes in the office of surgeon. There was a month between the death of Dr. Parkerson and Dr. Guthrie's appointment. Dr Guthrie had held the office only seven months, Dr. Robinson nine months, Dr. Hayes five months, then there wa3 an interval of five months, Dr Collins held the appointment for eleven months, and now there is another interval. The medical staff had devoted many meetings to tho consideration and drawing up of regulations which would no doubt have been found to work satisfactorily but for tho numerous changes. The diet scale also had occupied much time. When the present Board was appointed it had been proposed that the administrative power should not be taken from the staff, but they Lad at once given up all their power He might state that Dr. Powell had received three applications in Sydney, but not one was from an eligible par.-mn. Gn the motion of Mr Booth, it was resolved to withdraw for the present thß advertisement for a honse surgeon. The consideration of the rep - rt of the medical staff was held over till the r.csl meeting.

Mr Pridgeon reported the number of admissions during the past week. Considerable discussion took place as to tho inhumane conduct of some people who hid sent to the hospital servants suffering from fever. The following resolution was carried : —"That as a general imprcsion' prevails that an order from a medical man is sufficient to secure admission to the Hospital, tho acting house surgeon's attention be drawn to rule 90 of the regulations, which st ites that ' patients will be admitted by tho house surgeon, subject to approval of the physician or surgeon of the week.' " Af'.cr transacting a considerable amount of business of a routine character, the Board adjourned shortly after ton o'clock.