WHO IS FIRST-IN-COMMAND AT NAPIER HOSPITAL?

Hawke's Bay Herald-Tribune, Issue 137, 26 June 1937, Page 6

WHO IS FIRST-IN-COMMAND AT NAPIER HOSPITAL?

Superintendent Or Secretary?

FACTION ON BOARD Past and Present Chairmen Closely Questioned MR REES GIVES HIS SIDE Lengthy examination of the ehainnan, Mr C. Lassen, and of the immediate past chairman, Mr C. Oi Morse, of the Hawke's Bay Hospital Board occupied the Royal Commission at its sitting yesterday. Both Mr Lassen and Mr Morsewere closely examined npon the faction elements on the board and their effect upon the efficient administration of the hospital, and each was asked his opinion on various aspects of hospital administration generally. The cnairman oi tne commission, Mr E. D. Mosley, S.M., expressed his thanks to Mr Morse for the candour -with which he had given. his evidence. The managing secretary of the board, Mr E. T. Bees,' was closely questioned on the allegations made by former niedical superintendents of the hospital who had said that they f ound his authority with the board and his authority over the finances to . be "homiliating" to them in that medical requisitions had first to be ahthorised by him. Dr. J. ' AHan Berry, former medical •uperintendent of the .Napier Hospital, was questioned' at length by Mr. Foden. 1 Mr. Foden; Doyou consider that the managing secretary co-operates fully iu the welfare of the medical side? Witnees: Definitely, no. Do you think that the medical superintendent has had what you could call a fair go? — "I cannot speak for him, but there ha/ve been a lot of delays." Do you know that the managing secretary. tlinks he has the power, or has he aseumed it? — "It certainly put avery body concemed in a very awkward position. The attitude he takes up remains consistent." You did not resign because of any •onftect with him? — "No." Things have been more difficult for your successors ? — ' ' They have had him to contend with. ' ' You would attribute some of the lack mt co-operatxon to the managing secretary having nsurped some authority?-— "I should think so." 'Would you agree that the lack of •ohesion exists from the board downwards? — "Yes; the cleavage on the fcoard is the cause of the whole trouble, which could not have arisen with a strong head." Would you agree that the position •f the clerical staff is sometimes made difficult because of the ebb and flow of poVer on the board? I mean, supposing the secretary suggested that something should be got for Napier; would he be up against the Hastings faction on the board? — "He would be. Be might get the sack." "To Be Frank 7" Mr Bate: To be quite frank, you and the managing secretary "don't liit it too. well? — "I uon't think X would say that." At the board meeting in regard ro certain returns, have you made the l-emark: 1 4 This will be right — JVii Northe has prepared it"? — "Only once I said that." You have" gone out of your way to critieise him? — "No; my critieism ku.been fair." Do you suggest that within the lasi 12 months ho has been obstructive in the welfare oi" the hospital? — "i am not the best witness to ansvver that." You will admit that he has been quite diligeat in the carrying-out of his duties? — "Yes. he has." In your evidence you have been very eritical of him? — " Yes, I have." You spoke of requisitions having to go before the board? — "I was speaking about trivialities such. as the matron might requisition for.'' You don't suggest. that the board 's business is deiayed by these requisi tions? — "Yes, I do. The board has wasted a lot of toime over it." Do not these requisitions have to come before the board to conform with the by-law? — "I have not studied the by-laws in that respect, but from a commonsense point of view that should not be so." Mr Bate: By-laws aro very oftcn not commonsense. The chairman: Quite. But were they mot submltted to the board 's solicitorai Mr Grant: Oh, no. Mr Bate: I might mention*, Sir, that the by-laws ure a speciuieu set out by the Health Department. Mr Grant: And approved by the Crown Solicitor. Mr Foden: And the board adopted them and had them printed in Napier with the wrdng section of the Act giving the authority at the top. Trouble of the Cleavago. Mr Bate: You know that under the by-law the managing secretary controls only his own offices? Witness: There is the trouble of the cleavage, and I found at at times, as superintendent, to be very humiliating. During the last 12 months have not the two main differenees on the board been those arising out of the trouble over the sister of the Shrimpton Ward and your own susponsion? — "Yes." Do you think that the discipline ti: the hospital ioi satisfactory? — "Yes, on the whole 1 think it is fairly good. " And there is no need for it to come before the commission? — "No, I don't think so." flir James Elliott: You say that the operating theatre at the Hastings Hos- , pital is out of all proportion to that at i Napier? '

Witness: Yes, I think so. What is the position with regard to the Hastings Hospital? — The Hastings Hospital as a growing hospital and is becoming a base hospital. We in Napier are taking all the chronic cas&s from Hastings. Mr Bate: There is no accommodation out there for them? Witness: They will have to have more accommodation out there for such cases. That is what the Napier members have been fighting. The operating block at Hastings is as big as that in Napier, and is large enough to cover a 200-bed hospital. Hastings showed the largest increase exeept Lower Hutt in the recent census, while Napier went down. You can't overlook that? — "We in Napier look upon the hospital as our birthright." . Yes, we have heard that before. You pay only one-fifth of the hospital levy. You will admit that the base hospital in Napier has now been re-establishcd? —"Yes, it has." It was only sheer necessity that a uiove was made to have a 50-bed hospital at Hastings? — "No, I don't admit that." •■Sack the Board." You are a sheer protagumst for oue hospital? — "One base hospital." kou say that the Napier Hospital is clotted up with chronic cases and that the Hastings Hospital has more pauents per bed than the Napier Hospital per year? — "1 should say so." Have you any suggesuons .as to the differenees between Napier and Hastings? How could we prevent a conffact between the people of Napier and the people of Hastings? — "Sack the ooard. ' ' Mr Bate: That is worth thinking about. Miss McKennie: Have you thought of an alternative? Witness: Two boards. Mr • Foden: What would be your reaction towards the abolition of hospital "boards? — "I would be au ardent advocate for it." You would not mind being depriveil of your franchise that you exercise as a ratepayer?— "No; other places have done it, mcluding London." . To Mr Lawry, witness said that he .was very proud of the hospital as a training-school. He considered that it was one of the best training schools in New Zealand. Ch'arles Ormond Morse, ex-eliairnian and member of the idawke's Bay Hospital Board, said that it was to " be admitted that there was a cleavage between the Napier group and the Hastings group on the board, but it did not contain anything personal. There was nothing serious about it. Mr. Foden: lt has been serious enough to have a commission. In reply to a question witness said he considered that some of the members did not act in the right way. Mr. Foden : You would suggest that it would »not be in the best interests of the hospital P Witness : I have often told them to get on with the business and forget about other things. You are in iavour of the tiniehonoured custom of majority rule. — "Yes, I am." There was a question about the termihation of the services of a honorary surgeon? — "Yes." ' In the absence of a by-law the wishes of seven as against three should be abided by? — "No, 1 think that any member should have a fair spin." If one of the members of the honorary staff wero a member of the board ltseli, would that mako it difficult to dispose of the question? — "Yes, on accoun't of the lay mind." Un that account you will agree tha.t it is not in the best interests for any oue to hold a dual position? — "1 have brought that up at the Hospitals Conference, and no-one has been game enough to deal with it." You have two members of the board who are honoraries? — "Yes." Board Member and Honorary. it might have been Dr. Vvilson's resignatiou that you might have been .ionsidering?— "Yes, that is so." A member of the board who is an Honorary .would come in close contact with members of the staff? — "Yes." it would piace them in an invidious position? — "That was very possible." in the difficulty that arose here the uoard held an mquiry into the desir■ibility of terminating the services oi ihe honorary " doctor concerned ? — • Yes." • it was the Napier group who voted wgainst the termination uf his services. -"Yes, it was." You thought that you were not the right body to do that? — "Yes. 1 was ngainst the personnel of the committee dq iaymen." Where a body of ten men meet to Uecide whether the services of one of their employees, whoever he might be, be dispensed with, the majority should uecide? — "In ordinary matters 1 /agree. in a drastic measure I could u«»t agree, and I dissociated myseli trora it." If it were the medical superintendent, then what would be your opinion? •"Ib might require the opinions of medical men before such a matter could bo decided." You feel that if an employee's condnct related to the medical side, you a& a lay board are not the , proper I udges ? — ' 'Hight. ' ' Do you think the members should tahe all questions on their merits without being iufluenced by local feeliug?— '"'Yes, l do. Very definitely I rdo." What about the practlce which gtew up of the matron having direet contact with the board? — "Yes, that practice has grown up." Provisions of By-Laws. The chairman. What about the bylaws? Mr Foden: You will agree that that practice is not in conformity with the liV-laws? . Witness: 1 understand that. Do you think that is a wise depar"ture? — "Perhaps it is unwise, but since • 1931 we haye all had to apply our selves away from by-laws Hard-and-I'ast rules went by the board, and matters were allowed to drift that way." You would say that your institution was not rising from the ashes wrth the rapidity of the proverbial Phoenix? — ■"Noj it has been a fcard fifihi."

The evidence discloses that there tias been a division of authority? — "I have noticed that by the Press reports." According to by-laws, the medical superintendent should he the head? — "That is so." The managing-secretary appears to have taken upon himself certain autholities? — "It might appear like that." You will agree that there is some justification for that suggestioni'— "Again i say that there has been a state of fiux, but it might appear that the managing secretary was holding the purse-strings. There must be someoue looking after the financial side." Witness admitted that after requisitions had passed the various channels it was uecessary for the managing secretary to initial all requisitions. He did not consider, however, that this was carried so far that requisitions ior a packet of safety pins or a roll of plaster should be initialled. Mr Foden: You may not be aware of the fact that the system has been so strictly developed. You will admit that a state that requires that to be done is not satisfactory? Witness : No, it is not. Three Captains Not Desirabl*. You will admit it is not desirable to have three captains of a ship? — "No, it would soon be wrecked." if there are to be two, who do you think should be the captain? — "In all things medical it should be the medical superintendent." You will admit that if the Napiei Hospital in the future required a firstclass medical superintendent he would have to be the captain of the ship? — i'Yes, as far as-all the medical side i« concerned." To Mr Grant, witness explained that in the rebuilding of the hospital the board had kept in close contact with the department. The board was alloted £66,500" for rehabilitation purposes. In addition, the board had borrowed recently £17,500. At the ' present time fche board was still faced with having to pay interest on the money and tht repayment of ihe capital money. Witness explained that the whole of the Hastings Hospital had been erected out of bequests definitely ear-marked for the Hastings Hospital. Ihe chairman; How much was the bequest? Witness: £32,000. The chairman ;• That is a very considerable sum.. ... .. Mr Grant: You have had to borrow all the money -for building at Napier? Witness: Yes. , That accounts for. all your building not being completed by now? — "Partly, and because members chauged their minds." Caiiy that a bit further? — "We have plans from the department which 1 fought to get through but which were turned down by seven to three — but not the saine seven to three as we have experienced of late." There was a general feeling that there should not be a. two-storeyed building? — "Yes, that is so." Dr. Biggs's Statement. Would that explain a statement by 'Dr. Biggs yesterday tbat everything the board had done since the eartiiquake had been made a mess of ? — "Well, if Dr. VVilson says that the buildings are a memorial to piy application to the job, L cannot help it if another doctor has a ditferent vieW." Then you do not think the statement correct? — "Hardly." Do you think that if the bone of contention were removed the board could function satisfactorily ? — "I sincerely hope so. Some time ago we had a conference, arranged by Mr Bedford, of us three Napier members, with three of the county and Hastings ' members, to see if we could get rid of all this numbug The stumbling-block was the finding of the committee in regard to the sister, as we felt that she had been harshly deajt with on the facts made availanie.' That was a very worthy effort to stop the trouble.'' Assuming that this matter is put aside, as it will be ' put aSide, do you anticipate any difficulty in getting the board to function ?— No, not at all, they are all reasohab'le men." The chairman : ' What about an election? You could not guarantee what uew members would dor Witness : Of course not. The present members are reasonable men. Mr Grant: The bmlding programme will soon be .completed and thero should not be any further Napier versus Hastings feeling? Witness: Yes, that is so." There will be plenty to do.in running the hospital., $ When the new chairman was appointed you promised to give faim your support? — "Yes." Have you given it?— "Yes, in most things." You will agree that Mr Lassen has done his best and has a good grip of the position? — "He tas been very attentive and has applied himself very diligently to his work:" Knowledge of Hospital Matters. Questioned by the chairman, witness said that he was before the earthquake a briek-manufacturer, builder and company manager. Since then he had been engaged .in reconstruetion work. He had no knowledge of hospital administration work before becoming a member of the board in 1923. He agreed that .it seemed an anachronisfn that men with no knowledge of - the affairs of a hospital should control it, and insisted that a firm line of demarcation should be made ■ between the financial and medical aspects of administration. Sir James Elliott: Has there beeu trouble witb the Napier Hospital for some years> Witness: Internally. Any way you ljke? — "Yes. You will get it in any big hospital." In bigger hospitals you might get a great deal less?— "That is so." After the earthquake did the board accept the expert advice of the Government? — "No; they did not." What right did they have to veto this advice? What right had the Government to allow it? The board has gone ahead in spite of the Government'? — All the plans have to be approved by the department The Government might have taken the view that they did uot like the board's plans but agreed that thert would have to be a hospital; do you agree with such a state of affairs? — "No, I do not." Did the board defy ihe Government

over the isolation block? — "No; there were a lot of changes in the plans. The board was guided by the Health Department in the site on which the block was built. 1 was opposed to it and wanted to go back to.the old site." Continuing, witness said that the board could estimate the number of people who might have to go into hospital, especially cin the case of an epidemio. Th* chairman : Epidemie patients would not be taken into the hospital? — Witness.: But the staff would have to be accommodated. Nurses Could Not Be Cot The shortage of accommodation was not the reasori why there were not sufficient nurses during the vulvo-va-ginitis outbreak. Nurses could not be got. The matron had tried all over the Dominion to get nurses. During the last three or four years the hospital had been very difficult to run. The chairman: Do I understand that the faction on the board permeated right through the hospital? ' Witness: I think that would naturally come. * In regaTd to finance, you made application for £83,000? — "Yes, and we received £66,500 for the first essentials." In addition you could make levies on the local bodies and did so? — "Yes." Bo you had a considerable sum in hand to build the nucleus of a hospital?— "Yes, and we built all but the Isolation block with it." Do you think that a hospital board should be made a rating body? — "We have hammered at this thing from all angles .but we came to a dead end, and I'm not going to answer your question." Do you think the system should be changed? — "I think the system should stand. We have had experts from abroad who say that this system is the best one.in the world. If it is changed and we run it by art unions and Irish sweeps we will balloon the thing and will not know where our revenue is counng from." We can say yiat we have the best hospital system in the world, we have the best oducational system in the world and so on; does that not occur to you to be a bar to progress! — "Yes, cxactly. I have argued that to get a good system is to try to get a better one. ' ' JLtmitation of Boards Don't you think that tne limitation of hospital boards would be a good thing?— "I think that the department should exercise greater supervision and control. ' ' Do you think that the system should be nationalised? — "I would first like to know what the plan is before giving an -answer." What do you think of the Govemuient contributing as ruuch as local bodies and having no direct representation? — "They should have it, as a repreBeutative tree from all parochial troubles would tend to check expenditure in unuecessary matters." Would you tell us how the rivalry between Napier and Hastings could be remedied, apart froih abolishing the board? — "It would go iuto thin air and vanish. " ' Do you think that the c'are of the sick should be dependent upon their political colour or the strength of theii parochial feeling?— "That is a hard one. I would like to ask my legal adviser about it." Is that form of electiou likely to give a harmonious or a competent board? — "It seems to average up pretty well. It works out all right." Mr Foden: How have you found Dr. Foley, as superintendent! Witness: As superintendent partlcularly while I was chairman, Dr. Foley has applied lumself to his work in a most enthusiastic way. He was so cnthusiastif, that he was in his gehial way able to sweep the opinions of the board aside to that extent that he tried to hold dowa the job on his own. For some time he has been labouring under diificulties? — "He has had a shortage of house surgeons and has at* Lemptcd too much." "Lot To Measure Up To" The chairman: He has had other difficulties that are not conducive to good administration? Witness: Yes, there is no doubt that ho has a lot to measure up to. - The chaiman: The commission is ccnsideiably boholden to you Mr Morse for your candour. » Cbristian Lassen, chairman of the Hawke'a Bay Hospital Board, stated that when he assumed office things. were running fairly smoothly. The representation before the. election was five from the county, two from Hastings and three from Napier. The board before the last election was about equally divided, as tw0 of the county members lived in the vicinity of Napier. Mr. Foden: When the question of dispensing with Dr. Berry's servioes came the voting was seven to three? Witness-. Seven to two. Dr. Berry did not vote. Mr. Morse said he did not think a body composed of laymen was able to deal with the matter of Dr. Berry's conduct. Do you agree witb that?— "Well, no." And six more did not agree?— "No." However, I take it you will conceive that if that definite cleavage of local politics continues it will not conduce to the smooth running of the hospital? — "There was no bloc voting, each member voted according to his own opinions. Was Mr, Bedford the only member who supported Mr. Morse' s view that you were. only laymen?— "1 don't remember Mr. Morse putting it up in tbat way." Mr. Morse's Argument. Can you recollect what arguments Mr. Morse advanced on that oceasion? —"1 think his inain argument was that he could not see that ,Dr. Berry had done such a wro'ng that he should be dismissed." Is it not likely to develop again in connection with other matters of local conflict? — "1 don't think so. This is the first time it occurred sincc the last election." Is it not likely to develop again on such a critical matter as the expenditure of money on the Napier or Hastings hospitals? — "No; the matter was definitely decided long ago." Well, if 'it does develop, will that not be prejudieial to the welfare of the institutiona as • whole? — "I don't} lee

t that it will affect the welfare ot the institu'tions ?" You can assuro the commission that while you are chairman things will run smoothly? — "1 think that what has happened while 1 have been chairman proves it." I take it that in the future your actions will be quite impartial? — "Yes, and so with my co>-members on the county, and I challenge anyone to say that we have not adhered to the decision of 50 beds for Hastings and 150 for Napier." Division of Authority. Sometimes you go up to the hospital and Call upon the matron? — "Yes, I also call on the superintendent and also the secretary." You have seen it suggested from the evidence that there is a division of a uthority between the matron, the medical superintendent and the secretary? — "Yes, I have seen it." Whom do you regard as the captain of the ship? — "The secretary is in charge of the business side and the medical superintendent is captain of the wholp of the medical side." What you call the business side overiups on the medical side? — "No, 1 don't think so." Are you aware that it has been disclosed in evidence that the medical superintendent must receive the sanction oi the managing-secretary for such small requirements as a packet of safety-pins?— "I do not think that is so." That is the trouble — the secretary is to initial all orders. Do you think that he should initial all requisitions ? — "Not of the medical side. 1 don't know that he has refused to sign any." What side would a packet of safetypins be on? — -"The medical side, I should say." I suggest that that is not satisfactory?—^ "No, it would be detrimenta! to the hospital." "That's a Hard Question,' Don't you think that a medical euperinfendent should be in charge oi tiie whole ship ? — ' ' That is a hard question. The medical superintendent nught' not know anything about business.", The chairiudn: There. must be a captain for the whole of the ship. There can be: a captain and a chief engiueer. Mr Foden; And a purser. The chairman: Yes, a puraer as well.. Mr Foden: Mf that is laid down in the by-iaws, you will agree still more with that' schemef Witness: Yes. The jmatron has been sending her reports direct to1 you, or have you stbpped that?- — "Yes, requisitions for what was wanted were addressed to me as chairman of1 the board." Are. you aware that that is wrong?— "Yes, I pomted out that the reporta should be sent to the managing-secre-tary." The chairman: But that is also wrong, according to the by-law, which says that reports should be referred first to the managing-secretary. 5 lt rather appears that might be oue of.the matters ^hat you wili have to tackle? — "I thought that it did go through the medical superintendent, as his typist .does all the matron 's typing work." • What attitude does Mr Bees take at the board meetings? Does he take part in the debates? — "Ho speaks on anything when 1 ask him to, qr he may explain matters when I have asked him to." How do you explain the doublebarrelled definition of managing secretary? — "It increases his status us head of the ship." ' ' Grandiose Title " You would. ugice ^tmu Uiat is no doubt a grandiose titi)? — "Yes, that is so." Don't you think it complicates thuiga when there is doubt as to who .does rhis and who does that? — "I daresay that there would be1 some coniiict." What is Mr ltees's salary? — "£750." Mr Foden;- What is the mediica/ saperintendent-'s? Mr. Grant: £1000 and a free house. Witness; I don't- think it runs to that. • . . Mr W. E. Bate: £925 and a free house. Mr Fo.den: Does - the - managing-secre-tary get free anything? Witness: A car and running expenses. What is the relation of yourself to the nurses . and sisters on the social side?: — ' 'Since I have been chairman 1 have been invited once to tho opening of the hospital tennis courts. Thq matron invited Mrs Lassen' and myself once to.afternoon tea in her rooms, and we returned the compliment by inviting the matron and sisters tor our home. " The chaiirman: . We are compelled to ask the question because . part, of the ( order of reference is whether any' action of any member of the staff has been detrimental to' the nurses in their duty. Witness; I am only too pleased to answer. • •; • Mr Foden: It has been given in evidence that; some of the nurses have been taken out in a car at nights? . Witness: I'have never had any of the nurses in -my car. The only occasrlon when .anything of the kind has occurred has been when I took-the matron. in my car to tho Hastings Hospital. That is the only occasion any ' of them have been • in.my , car. Question of Familiarity. In y'our opinion, if any hiember of the mediical staff, whether honorary or otherwise,' or any member of the board should take any member of the nursmg staff out for motor rides at xnght or should become unduly familiar by ealing each other of them Christian .names, would that bo detrimental to the control of the nurses t — "Yes, it would." Mr . Foden: I agree with you. Mr Bate: What is your view as to a member of the honorary staff having a seat on the Hospital Board; do you tbdnk that it is desirable? Witness: Speaking of our experience» of late, I say definitely no, although" Dr. Wilson has not given tlie slightest trouble and has been a help. Iti reply to a question, witness agreed that nothing sho.uld bo put in tho way of the medical superintondent's obtaining what he wanted. He would have t'a/ith in the medical superintendent tliat he would in no way Overstep Ihe iuark. ' When'ho went on to the board in 1932, witness added, the plans for the Napier Hospital wore completed. Ex-cept-fdr the resignation of Dr. Berry and tha trouble witb ,th« .ward sirter, I

there had not been any tTouble. T'ho Hastings members and those of the county had co-operated an the welfare of the hospital. Considerable help had been . accorded by Mr Morse. Uf the Kelly Bequest £5000 had been called up; the remainder of the expenditure had been as the resuit of general donations made to the Hastings Hospital. Tho board still had £27,000 of the Kelly Bequest to expend on the Hastings Hospital. Witness considered that after the diificulties now to be settied by the commission there would be no reason why the affairs of the board should not carry on very smoothly. "Even if We Are Drastic?" The chairman: Even if we have to settie it in a rather drastic fashion, Mr Lassen? Witness (iaughing) : Yes. Mr Bate: Some mention was made regarding the secretary going to Hastings to pay wages. Did not a cierk in the employ of the board some time ago get snanghaied and lost a lot of money ? Withess : Ihe money was lost in some way and the board wanted to take every care in the future. Mr H.. Dowling (lor Dr. J. A. Berry) ; You did not endeavour to prevent Dr. Berry from making a full statement at the board nieetrng? Witness: i certainly did. He wanted to disclose in ' open board matters wiiich had been taken in committee auu the comments of the department on them. " The chairman; You appreciated the ract when you gave that' decision, tha„ British fair piay deiuands that a man has a right to defend himself? Witness: Yes; biit Dr. Berry wanted to divnlge iniormation that was taken in committee, and 1, would not allow that. "•» .Mr Dowling : - You- know a number ot the sisters?. - - - - Witness: 1 know them by name. You know sonie of -them pefsona,lly? — "Yes." : - . . Have you been in. ^he N.urses' Home frequently ?— ' 'Not • unless I have. .been accompamed by the matron or the foreman oi' workS." , , Have you had ;.afternqon tea- there? — "les,- once, with the, matron and sisters." • The chairman: 1 can beat..you; 1 have had afternpon, tea, twice' there. Social Side for Trainees. , Mr Dowling ; You are concerned with the social side' of the' trainees ?:" Witness: Yes'.""'" ' \V ould it ' not " be adyisable. ' to put on a roow where they could nieetr their irienUs ? — •" Yes,' it would be nice;" ' Don't you 'thinik that it is warranted?— "i could' 'not Say that it" ; was warranted." . . Do you remember that in' this' smoking incident soiiie of" the "sisters were ratiier mcensed at .the notice in the fiome?— "1 "doh't think they were" incensed at. the notice." 1 believe they were incensed because of the fact tliat' the notice was signed by you and hot by 'the matron? — "1 was called into the liatter after there had been. two fires, to co-bperate. lt was thought that lqore notice* would be tiiken of a notice signed by me than oue signed by the. matron;" Sir J ahies Elliott : ' Db 1 understand you to say that any possibility of 'any iriction between Napier and 'Hastings on hospital questions could be scttled? Witness: Yes, 1 say that cpnfidently. How can you say that?^ — "lt was definitely decided that Napier should have 150 beds and 50 beds at Hastings. 1 have not seen the Hastings Hospital, but 1 understand that- you have an elaborate operating theatre? — "1 would not say that. We have an outr patients' departmeut. We have as inany outpatients in Hastings as in Napier." '. The chairman:' What about the next" election ? Witness :' 1 might go. We might all go. . . . ! : Sir James Elliott: You are'a delightful optimist? . . ' . : Witness: 1 am putting the position to you quite , fairly. . You. haye 50 becls there. There . is no saying ,how inahy, beds might be there in five yearsK— "That is so." Department's Wishes. ' I understand" that' the department did not want a . hospital at Hastings at ali?_«rl.q1e" departmental officer-' did not, but the , Mmister. gave his sanctiOU." , , . . ! Where do you think that ihe m'ain hospital should be? — At Napier." And what about the '* other members ? — ' 'I can definitely • say -for. : my co-members on the cqimty that they are definitely of the opinion that the -main hospital should be at Napibr.?? . . •: In - perpetuity?— "Yesl' ^ . . . , • The chariman: • But political; eonsiderations enter into the question, do they not? Witness : . Definitely, yes. . To Miss McKennie, witness said that he understood. that" the advantage of having Hastings as . ari adjurict training ,school would enable the board to have a larger permanerit 'staff. . ' ' Miss McKennie:' At present- you are working at capacity? Witness: Yes. - ' . How do you propose to house : the extra nurses preparatory to . starting the schemo iri Hastings? — "I understand that the matron has ' already starfed arrangements." . But that is accommodation qqly for tho extra nurses to ensure.a weekly day off. What about- thc extra prelimiiiary nurses? — "Then Hastings will have to wait until .that is carried out." Bir James Elliott: We are told that you have not accommodation for • the nurses for the isolation block? Witness: At present, no, we haven't; but we are considering it now; with Dr. Shore, ' •• • Secretary 's Evidence. Edward Thomas Bees, managing secretary, explained that all the lay services came under his control— everything except the medical and nursing sides of the hospital. About 50 employees were under his direct control. Witness received a salary of £750, and tho assistant-secretary, Mr. Northe, received £500. ITe admitted that ho had a comploto staff, all of whom wero neeessar}' in tho working o£ the office. Mr. Foden: When Dr. Biggs's salary was cut as low as £700, what were you getting? • • '■ Witness: About '£540. And what you say goes in connection with all those departments? — "Yes." So that you ' h'ave control of the lauudry in which the medical aide ia

concerned? — "Not that I know of. They deliver the laundry dirty and it goes to them clean." Do you recognise the medical superintendent as the official head of the institution. — "Yes, undoubtedly. " Oh, we've heard differently. What do you base that on — the letter of the by-laws? — "Yes, on instructions from the department." If he wants a packet of safety-pins, what musL he do as far as you are concerned? — "Nothing." Don't you have to initial all requisitions.— "No." Don't they have to go through you? . through the house manager. All requisitions from the medical superintendent come to me after haying been through the house manager or the dispenser." \ Conflict of Testhnony Thef e 's a' conflict of testimony, Mr ^ees- "I'm telling the truth. " sign the requisitions? — Not internal requisitions between office and office." The chairman: Dr. Biggs wanted to purchase some patent medicine. Mr Fodens Are you aware that you have not got medical supplies when asked? Witness: Yes; the matter of that medicine I took up with the dispenser to see if he could make it up. You always see that the requisitions from the medical side are carried out? — * * Absolutely. Immediately. ' ' Splendid. And you give full co-op-eration on the- non-medical sidef— "Most decidedly." , If the ambulance requires equipment, do you attend to it quickly? — "Yes." These matters are done immediateJy? — "Yes, as far as possible. These things can't be got out of the air. Due inqniry has to be made."' Has your present ambulance got a certificate of fitness? — "No; it is not likely to." That is a flne thing?—" Wc have a new one beirig built which will be one of tho' finest in New Zealand, and it will be ready in about a month. We also have a new ambulance at Hastings." Then everything that goes outside the hospital precincts ln the matter of requisitions, you sign for? — "Yes." Everything? — " Well, practically everything."- C A "Super-cptimist" That does. not seem to comply with this by-law • 38. It doesn.'t say that you have to sign all these things and namper ,the . medical superintendent?— "I comply with all the . by-laws relating to the managing secretary." xou are a super-optimist? — ' ' Thank you.'? "... la there any. monetary lirnitl— "Not J for a drug" requisition, which may run to £40 or £50.?' The chairnum quoted by-law No. 34, to which witness replied that it was hardly appiicable to this institution. . Mr Foden: You don't suggest that seriouBly?"- • Witness: It would not be practicable, as these supplies are wanted immediately and our finance committee xneets only once monthly. , >■ What arrangemeute do you make to see that the superintendent or the matron have sufficient clerical assistance in their duties? — "They are given the clerical assistancs they want." When any decisions are being com municated to the matron, are they sent through the medical superintendent? — "No." You are well-versed concerning legislatiou relating to institutiona such^as yqure?— "I try to be versed," Did you knqw that under the • 1932 Act the hours for nursing work wero l'imited to 56 a week? — "No." Did you know - of any one of tho Hospital Board staff that did? — "No; that is the first I've seen of i't." "Think I Would Get the Sack." If the board made ltself liable for a prosecution over five years, would you be' liable? — "I think I would get the sack." I thinls • that you' are too shrewd to get the sack?— "I don't know abo.ut it " ' • * : ' ' • - Do you see that all the laundry is managed in such a way that there is no delay in regard tto the supply of house linen? — trYes, I do it. personally." You see that" fresh vegetables are supplied regularly?: — "Yes, 1 can give the; numbers of ounces per. head." Asked by Mr.- Foden if he knew two sections of .the by-laws, . uamed, by their respective . numbers, . witness sighed heavily. "Would you ask a clergyman to repeat the-fifteenth verse of Isaiah?" he asked. Mr., Foden : Certainly. 1 would I You do see. thqt the house manager carrjes out his duties? Witness: Yes. You don't see if he earrieB out bylaws 278 , and 279 ?— "No." Do you look' after the control of waste?— "Tbat is the work of the nouse manager." - Who drew up some foriris of receipt for the X-ray rooiri?— r"I did." . And -you didn^'t tell the medical superintendent about it? — "No, it was a new form." Drawn up by you ? — "lt was a great improvement on the previous system."' I think that that comes under the medical superintendent?— "I think that it is under the radiologist. He is in charge >. of the forms and customs in that • department. I don't think that the medical superintendent kuows what forms to use." "Ordinary intolligenco." What do you know about it? You have no experience of the medical side of -the hospital? — "1 have ordinary intelligence." ' And you. did not tell the radiologist about it? — "lt'was an improvement on the previoug .system, which was a rather crude method of keeping the entries of loans in the hook." •And it was you who decided that it was crude? — "Yes." At thi3 stage Mr. Grant quoted the specimen regulations and by-laws adopted by the Health Department and in which it was stated that the manag-ing-secretary was answerable to the chairman of the Hospital Board and that the medical superintendent was the senior officer. Witness continued to say that, following the earthquake, he had received two reductions in salary that had put his salary bacfe almost to the level where it had stood ten years previously. He did not consider that the statement by Dr, Biggs thqt the clerical staff in

the managmg-secretary's office was too large compared with that of th'e medical superintendent was correct. Mr. Grant: You were not allowed to give the explanation about this bottla of proprietary medicine ? Mr. Foden: Who prevented him? Mr. Gfant : You did. Mr. Foden: I must object to that. .1 did not stop him. The chairman: You couldn't. Mr. Grant (to witness) : Did. you stop this medicine from being obtained? Witness: No. I went down to sea if the dispenser could make it up. What would it have cost in town? — > "5/6 for four ounces." What would the dispenser mahe it up for?— "About fourpence." Have you adopted a policy of vetorng anything the medical superintendent has requisitioned ? — "Never 1" Ha$ Hot Caused Delays. Who looks after the stock? — "Tho house manager. The dispenser looks after the dispensary. Both theso officers replenish. supplieB when they become low." H.ave you ever been responsible for delays in getting requisitions by the medical superintendent? — "Not that I know of. Inquiries have sometimes tu be made. id you have anything to do 'with these by-laws? — "I think they were probably framed by the Crown Law Office." Upon this answer, Mr .Foden asked if witness actually knew if the by-laws had anything to do with the Crown. Law^Office. As witness attempted some explanation, Mr. Foden continued to repeat his question until he received an answer in the negative. The chairman: Such things are not done Mr. Bees. The Crown Law Office is a very much under-staffed office wfiich deals with. things more important than that. . Mr. Foden: Did yo'u have anything to do with these by-laws? Witness: No. The board adopted them withotit referring them to their solicitors ? — "Yes," . • They adopted these specimen by-laws without Beeing jf they were applicabl® to this district? — "Yes, they were®" "I think you should recommend tho board to refer them to the board's solicitor. I am sure that Mr. Grant will see the iinportance of it," - commented Mr. Foden; To Bir James Elliott witness said: "I did not hanker- after the pasition'of managing-secretary. It might be » coined jvord." "Complicated Position." Sir James:. There is another vrord coined, perhaps in the fires of afflictiou, and that- is "hous© manager." I tako it that he is the steward? Witness : Yes. The board may be respprisible fcr putting you in a complicated position? — "It is a complicated position. I have done my best and I would bs willing to become a plqin secretary., There has not been any friction that I know of." Take the instance of the doctor who is worried oVer a serious case and wants a certain medicine which fie believes will relieve tlie patient ; you deiayed getting it in order to see if the dispenser could make it with a limited f ormula ?— "That is so." Mr. Foden : The intention of the Act is to make the secretary a secretary and nothing more. It does not suggest that he should trespass. on the work of other officers. The chairman: Mr. Rees is an estimable officer, but whether ho has carried out hjs duties not only efficiently but with that mead cf discretion tbat ia necessary is another matter. Mr. Foden; That is the fault qf the system. The chairmajr: We are not going to make any disclosures about that in.tho meantime.