Medical Supplies

Hawke's Bay Herald-Tribune, Issue 136, 25 June 1937, Page 6

Medical Supplies

SECRETARY HAS THE PURSE-STRINGS Dr. Biggs and the "Hastings Bloc" UNPLEASANT RELATIONS *'A& extraordinary state of affairi" was the description applied hy the Crown Solicitor at the Koyal . CommiBslon investigating Napier Public . Hospital affaixs to the - system under which medical requisitions for the hospital have first to be authorised hy the secretarymanager, when it was revealed to the Oommission hy the medical Euperintendent, Dr. J. J. Poley, yesterday. Further evidence on the same pomt was given by Dr. A. O. B. Biggs, or. Poley's predecessor. After havinz given instances in which he had found the secretaryxnanager's authority with the hoard to he "humiliating," Dr. Biggs passed the co'mment: "Nearly everything the hoard undertook after* the earthquake it - made a rness of." Hereferred to the emharrassment caused him hy the existence on" the hoard of ' what he termed the * 'Hastings bloc," and dated the unplersantness between himself and the hoard from the time at which, when the huilding programme was heing considered after the earthquake, he recommended : that there should he only one hospital for the district and that Ihe Hastings Hospital should he bonfined to urgent cases.^ "Have you had the utmost co-.opera-tion from ihe. managing secretary?" Dr. J. J. .Poley, .medical superintendent, was asked by.Mr Foden. Witness: Yes. There has not heen any active obstruction. Your hesitatipn suggests that you thought that answer out very carefully and you used the term "active obstruction." = ' Would you suggest he had not heen as he should have heen in lorne "things for" the medical sidef — "1 think" he put the screw on, rather. ' «• Tour answer almost suggests a suspieion. The managing secretary does al* ways consider the welf are of . the patients in the carrying out of his duties? .Witness: He is watching the finanees. As .to xepairs to he carried out, can you order them to.be carried out? — "No; it would go to the managing •ecretary." If a laundry pipe goes wrong, who wiuld report it' — "It would not go through me. The person in charge would report it." Anything involving a few shillings in. repaixs would have to go through the managing secretary? — ' f The engin•er himself might decide-it." Did you find any delay in getting your requisitions fulfilled! — "No, onco the hoard approves of it." If an instrument costing, say, £10, has heen broken or has disappeared, and you want it nrgently, what do you do ' 'J fill in a xequisition and it goes to the managing secretary and he sets the maehinery in motion to ohtain it. I want to mahe it clear that he hasn't "bloched me in getting anything. I haven't got the authority . to get anything} he has, and he takes my recom■aendation." ' Have you got authority on your initlative to get s packet of safety pins?— "Strictly speaking, no; it would have to he counter-signed." "Extraordlnary State of AffairsV * The chairman: There appears to be Bo douht ahout it. Mr Poden: It is a most extraordinary •tate of affairs. "3f the managing secretary blocked you from getting anything, what would you. do? " Mr Poden asked Dr. Poley. —-*'1 would see him and discuss it," Dr. Poley answered. Xa-es the managing secretary regard you as the head of the institution?— "He may xegard it as two different in'stitutions. "When he knew the commismoa was coming he might have thought that I was the head." Does he supply you with all the nonprofessional assistance that you need? — "I eould- do with things that I intend to ask for once this is over." Have you ever had reason to complain that you have not had the full eo-operation of each and every memher of the honoraTy staff? — "No; the honoraries have been very good." Do the honoraries have regular hours and days? — "No,"i Do you Tegard the.practice of the honorary doctors coming ahd going at all hours as advisable? — "It is not conyenient for the sisters." Do you have patients for whom you are xesponsihle?— -"Only nurses." Do you flnd the attitude of honoraries towards the nurses as satisfactoryl— "Xes, except that oue is some--fcimes a little impetuous." To what extent do the honoraries have consultations? — "Every iSaturday morning." You are Eatisfied that they euter those consultations in the interests of the patients and of medical science?— "Yes."Gould Do With Four. What residential medical staff have you? — "Three." Is that sufficient? — " We couid do o with four." ilre they efficient? — "Yes, very elhcient." What l.-, the procedure regarding ad.missions?— "Urgi'nt cases at auy tiine. dyy or uight; ordiuary cases hetween two and iour 111 ihe al'teruoou." The iuternul connnuuication aud hell xingiug system is reliable? — "No; a report is coming before the board oi) , Do you get full co-operation from the ,.*iatron? — "Yes.Do.yoq conduct inspection with her? -vtNo;jWe do that independently." gp you .inspect the ward hookBfr~

"Yes, on particular occasions." Does the matron pass her monihly report on to you before it goes to the board? — "Yes." Does she report aU matters, such as insubordination? — "Yes.'' , Do you see any of her special reports in sufficient time to enable you to go through it and "ad'vise the board? —"Anything special 1 would see " If an urgent case came in from an outside doctor what-is the proceu ure? — -"In 90 per cent. of these cases the doctor would advise the hospital and a doctor would be ready. In the case of patients being brought in by ambulance, the ambulance people would know." In one case there was a delay? — "The note did not say that the case was urgent and said, 'Flease admit with a rashV' Does the matron consult you about special nurses? — "N.o." If she were changing the sisters in the wards? — "Yes." Do you inspect the food arrangements?— "Yes, usually at meal times." Do you think that it is in the bcs interests of a hospital for a sister to ' be in charge of a ward for a long time? — "I think it is a good thing to change them from time to time. Although some hospitals kept them in the wards for long periods." Theatre Sister 's Hours. How many hours is the theatre siscer on duty or at call? — "Twenty-four ; but it is not as bad as it sounds. The theatre is usually closed in the after- j uo,on and she has time off." i Mr Grant: l take it that you are J the best of friends with the managing secretary ? — "Yes." You work harmoniously ? — "Yes." When it comes to : spending money, i he . .is on your tracks ? — "Yes."You recoghise. that someone must ' hold the purse-stringe ? — "Yes; I don't want it." In regard to the honorary physicians, who is there in Napier that you cpuld i yecommend as an" addition'al ? — "Nearly all the inen in Napier seem to think themselves surgeons." When you spoke of permanent sisters in wards, were you thinking of the sisters themselves or the patients? — "If they stay too long in one place they are apt to become fossilised." What about ; the patients?— "If a sister is efficient she -should - be good wherever she is." What about the children5 s ward? — "The position is different there, as the sister requires special Karitane training." Mr Lawry : I understand that nurses in training are constantly coming and going? Witness: That is so. Some don't like stndying, finding it too hard. Some j find that they don't like nursing. Has the wage anything to do with it? — "The board gave that consideration." i The chairman: That has got to be considered. Mr Poden: I understand that the wages paid here are not as higb as in other hospitals?— "They went up re- | cently £5 on the wages paid in Wellington." Mr Foden: That is for the initia' stages. "Ctood to the Staff" Mr Grant: Do you know that the , Hawke's Bay board revises its salaries i annually? ( Witness: Yes; they are generous to the staff and very good to them. We have heard a lot about the nurses Working long hours. Do you think that that has been the cause of some deep-seated discontent among the staff? — "I think that the more sincere a nurse was the more ' she would be ready to put up with matters until they can be put right." Mr Poden: And be breaking the law? Witness: Nursing is a vocation; it is no't something commereial. The chairman: It is essential that a nurse should have time off for her health 's sake. If she does not take it she should be made to take it. Mr Lawry: In all cases the nurses have told us that the- welfare of the patient came first. They have been very loyal. The chairman: Yes, they have. "I can't explain it, Sir," said witness in xeply to Sir James Elliott after attempting to explain the difference between a secretary and a managing secretary. "We have, the house manager, managing secretary, the matron and the ijiedica] superintendent all gene'rals in this army?" asked Sir James. Witness: Yes, that is so. The managing secretary has to initial all the most trifling things before you can get them? — " Y es. " Wouldn't it be as easy for you to go to the board as for .the secretary manager? — "I think so." If you left the hospital, do you think they could get a suitable man to take over your place under the conditions that you are under? — "I don't think so, I have thought of that. I think that it would be no easy job. I wisli to inake it clear that 1 have no axe to grind." The "Hastings Bloc" Dr. A. 0. B. Biggs, t'ormer medical superintendent ' at the Napier Hospital, said that up to the time of tho earthquake his lot was a happy one but that after that it was not. At first he was in coniplete charge. At that stage wit uess regarded the secretary as below him. Witness said he had pointcd out to the chairman of the board whfcu the secretary was appointed managing secretary that if he (witness) were to be chief executive officer the secielary could not be a secretary: manager. Atter the earthquake and the question of rebuilding the hospital was bemg considered, a proposal arose that there should also be a hospital at Hastings. Witness gave his opinion ikat there should be only one hospital ior the district and that the Hastings iiuspital should be conlined to urgenl mses only. Tlns was the beginuing oi the unpleasantJiess, espeeially trom ihe members of the board who cuuld be tegazded as "the Hastings bloc." A.t a later stage, witness said, he was attacked in open board for haviug exceeded his duties in conferring with an officer of the departinent regarding lmprovements for the Memorial Hospusl. Witness wrote to the DirectorGeneral of Health, who fully approved .qf the action that jvitneaa had, taken,

Contmuing, witness stated that the board, as the result of the conditions imposed, committed a double breach of his contract;- in . that it deprived him of his medical and surgieal practice, and also of any authority except to take responsibility for anything that went .wrong. — , . . "From Bad to Worse." "Things gradually • grew from bad to wojse," declared witness as, he related his endeavours to obtain a proprietary' medicine for a patient who was seriously *ill. Witness said that he put in a requisition and" sent it to the secretary, who refused it. Witness then explained the special purpose for which it was required. Still it was not approved, so witness obtained the medicine himself and, incidentally, the patient made a good recovery. Mr Foden : How did you feel about it ? Witness: I felt it to be very humiliating. You concux with Dr. Foley that it would be hard to get another good man to act under the present circumstanc.es? ' Witness: lt certainiy would. 1 think . it would be impossible. If a man came, he wouldn't stay long. Can you explain the proportion of bhe office staff to the medical staff ?— "There was no proportion at all. The office staff was far too large, and we who. were looking atter the, welfare of the patients were cutting-down to a minimum." What was the position :of the secretary at the board meetings?— "He got up just when he liked and said what be hked." He was like a board member? — "He didn't' have a- vote.'» • - Did he profess to give opinions oii medical , requiremeuts ?— "Nearly always. lt depended upon his views whether a thing was got or not.' He nearly always : got • away with • it." - Didn't you speak up on these matters?—"! did; but no notice Was taken of me." ......... ....... Witness, 'when asked if he had ' any other views . to express that " would assist the, commission, said: , "Nearly , everything the board undertook after, the. earthquake it. made a mess of. The Health Department prepared plans for a new hospitali The board cancelled these and rehuilt it with the assistance of local ' architects. I maintain that if the board did what the department, wanted to it would have a modern hospital instead of something' rambling. if the hoard, had dohe as the dep'artment suggested there would have heen no trouhle over the isolation ward.' ' To Sir James Elliott,' witness expressed the opinion that a member of ti*.- honorary staff ' should not ' be a member of the board. Sir James: .If a member were . unscrupulous ahd that " type of man to do wrong, he would' have an opportunity to do "so and 'be sheltered because he was a member of the board? ' Witness: Being- a mfember of the board, he wduld have soine infhience. Mr Bate:* You'will admit' that there should be -some eontrol over the expenditure ? Witness; Yes; I agree that- the requisitions shohld pass through the oftiee so that they should know what was being purchased, but I strongly object to the requisitions of the medical superintendent - ha ving to be • approved or disapproved- by the secretary. Witness, added that it was. iargely due to the great. loyalty shown by. the matron and the nurses after the earthquake that the hospital was able -to be carried on as.it -had been. At this stage the sitting was adjourned.