TUBERCULOSIS

Hokitika Guardian, 1 November 1929, Page 3

TUBERCULOSIS

CONFEiIENC'E OF HOSPITAL

BOARDS

GROUP SCHEME FAVOURED

CHRISTCHURCH, October 31

By a unanimous vole ;i conference •»f Hospital Hoards in tin- Soiiilt Island, north of the Raka.ia river, failed b> discuss tile North Canterbury Hospital Board’s scheme to combat tuberculosis, expressed itself wholeheartedly in favour of the proposals yesterday morning. The deb'-oitcs present were : North Canterbury Hospital Board: Messrs I!. .1. Otley. R. B. Kraus, A. T. Smith, and W. Anderson. Wairau Hospital Board: Messrs f). MiOalluni, C. Nees, A. Gavin, and G. Mitchell. Bailer: Mr W. (>. Smith. Nelson: The Hon. Mr Mclntyre. Grey: Mr J. Hannan. Hokitika: Mr G. Davidson. I nnngahna: Mr Ji B. Anld. Mr Otley presided, and on behalf of the North Canterbury Board welcomed the delegates to Christchurch,

and' expressed the' hope • that their deliberations would end a Handing trouble of many years. It "was felt that they in the South Island had been doing their share, but they felt that there was no use m one wart" of the Dominion dealing with the disease unless it was dealt with by the whole country. Now they had .’cached a stage when they Were nearer having something done than 'ever before. They wanted to help the smaller Boards as much as possible. He added that a meeting was being called in the North ‘lsland, and he had hopes that they would come to an understanding regarding tuberculosis, so that every district would be represented in some Sanatorium. It was hoped to establish institutions where patients could go to he examined by T.B. officers. . The dispensary in Canterbury had done an enormous amount of good in that direction, and he felt that there would be a big chance of clearing and. reducing the disease, while the expense would.be. a great. deal less. Dr Blackmore, before lie left, had said that in 20 or 30 years tuberculosis should be a thing of the past. Already it had been reduced very considerably in the past few years, and if the problem was attended to properly they would reduce it even further. “I believe the proposition will be quite easy for you,” Mr Otley continued, “and it will not be unjust to our Board.”

The chairman asked whether it was the wish of the conference to go into committee or ; to discnss. the matter in open Board. 1 , Air F.- W. 0.. Smith • (Nelson) moved that the discussion be held in open Board, as the matter was of material interest to the community. • The motion was carried ly'THE SCHEME. The secretary of the Board (Mr W. S. Wharton) read the ; scheme, which was as follows.— “The formation of the complete group of all the Hospital Boards in +he South- Island—north of the Itakaia river—for the purpose of dealing with tuberculosis will 'comprise the following Boards: —

“The needs of that portion, of the Hard—smith of Rakaia—are already •’''"lt with : by the Waipiata- group of Hospital Boards, which has been .in '"■is'euce for some years, and the Otago Board, which, although not addicted with the, Waipiata group; has complete institutional equipment for 'dialing with the disease. “The North Canterburyßoard, in the past, has made two attempts to bring about am amalgamation of Boards for dealing with tuberculosis —the first in. 11)14, which resulted in ■vi agreement with the' Westland, (Irey and Wairau Boards, whereby it was agreed that they should pay the capital cost of erection of necessary shelters: the North Canterbury Board agreeding to provide maintenance end treatment at actual cost. This did not cover any charge for capital expenditure on the administration buildings. This arrangement is still in force. An effort was made at a Infer date to extend the privilege to other Boards, but without result. <, ‘Tho conference of Boards associated with North Canterbury now lias to consider the most satisfactory means of combination. It is possible to group, as did the Boards under the Waipiata agreement, accepting financed involvement for all capital cxoenditurc in proportion to the populations or rateable values of the various Boards comprising the group. This moans the vesting of the land and institutions at present being used hv the North Canterbury Board in a separate organisation, with a separate Board of Management and Executive staff. This would probably mean placing a finameial burden for capital purposes on the Boards, other than North Canterbury, that they would not be desirous of accepting. “A Committee of the North .Canterbury Board has had the matter unde,r consideration!, and submits the following:—

“That the land and buildings at nr. r vont Momging to North Canterbury shall remain vested in that Board.

“That the patients from each district. shall he accepted for treatment and maintenance. “That the contracting Board shall reimburse the North Canterbury Board the actual cost of such maintenance and treatment, and also pay interest at a rate to be determined on (he capital value of the land and institutions in proportion to the number of patients or occupied beds per annum.

“A separate Manigeihent Committee be set up to which the other Builds may :p <)int representatives in due proportion. “Any new capital expenditure determined to be necessary shall he undertaken by. North Canterbury, and interest charged as previously indicated.

“The contracting Boards -shall cuter into an agreement for not less than ten years, after which period any Board or Boards may withdraw or may renew the-agreement for such period as may he determined. “Whatever agreement is entered into, the conference has to determine the means to be adopted in the selection of patients and whether advanced ca--.cs are to be admitted to the Institutions.

“Am*, agreement entered into shall he as from April Ist, 1930. “The cost of • maintenance in tlm ’various institutions for the year ended'March 31st, 1929, was:— . £ s. d. .Middle Sanatorium—Fc- ' males, per occupied bed 138 711 Upper Sanatorium—Males per occupied bed ...... 156 12 11 Coronation Hospital—per occupied hod ... 142 8 / “At the present time additional accommodation, for about thirty-six beds, is being made to the Coronation Hospital for ‘advanced’ cases, and some addition will have to he made to the accommodation in the Nurses’ Home, and in the commirativoly near future, it will probablv be found necessary to extend nr re-build the administration block in connexion with the Upper Sanatorium. These additions will make a slight difference so far •as the capital cost is concerned, but it will not affect ti e cost of. maintaining patients to any appreciableextent.” ■ DELEGATES’ VIEWS.

The Hon. Mr McTntyre (Buller) moved that , the North Canterbury Board’s, scheme, be adooted. It would, he said, give even - Board the nscht to have patients sent to the sanatoria at a .reasonable cost. Mr F. W. O. Smith seconded the motion, saying that it was very satisfactory to know that the North Canterbury- Board was offering to assist those who were not able to help themselves. The smaller Boards could not afford a large capital expenditure, and they would find it exceptionally hard, on account of the recent earthquake damage, to raise money from the ratepayers at the present time. ‘The secretary, of the North Canto l - bury Board (Mr. W. ,S. Wharton) said that the interest on the capital, cost would probably . amount to £lB per year for, each occupied bed. Jn supporting the scheme, Mr C. Xees asked if the examination of patients bv T.B. officers could he extended. “That is our present anxiety,” he said. “Will ' the. . officers he able to pay visits to the district'?’ “That would have to he done.” Mr Otley said. “Our officers would 'visit vour districts periodically.” Mr Nees mentioned the reluctance of some patients to undergo examination, but the chairman said that they' would soon get over that; D SPENSARY ESSENTIAL

The importance of a dispensary was referred to by Dr I. C. Mcintyre. superintendent of the tuberculosis institutions, who said that the dispensary Was, really an out-patients’ department, similar to the out-patients’ department of. a general hospital, except that it was necessary for a patient to go there with a doctor’s note. He hoped under the new scheme to take in advanced cases just as well as early cases. In order to get hold of cases they must look for them, and the dispensary was the central unit of the whole scheme. “Tuberculosis is a disease that is never cured,” Dr Alacintvre said. “The germ is in the body, and although they may arrest the disease they can never cure it in the 'ense of killing the germs, which are ‘walled in.’ It depends on the patient himself whether he comes hack after discharge.” He added that it would be necessary to have a- nurse who was trained in tuberculosis work to go into the homes of patients and advise the relatives and friends, and explain what measures should be taken to prevent infection of other people. He did not think it would cost much for a dispensary scheme. All that was necessary for me smaller Boards was to make use of the out-patients’ department and have a part-time nurse. AH the medical officers would need was a room or . two rooms Jn the hospital where they could see patients. The dispensary scheme was, however, the central unit. GFNEiR AL SATISFACTION AH- AlcCallum (Wairau) added his quota of praise to the Canterbury Board for what- it had done. Tn a small way they had had practical results from patients who had gone into Cashmere, and they- were very proud to be linked up with the scheme. Mr ATaeintyre had cleared up a good mnnv difficulties in their minds. He asked if local -Ifoards would have sufficient status to decide on sending in a patient who required treatment for incipient stones. The chairman said that the patient would in all rases receive first oons’deration, no' matter where he came from. Air A. Gavin (Wairau) expressed the view that under the scheme they would make a tremendous advance.

He asked if the committee set up would have the power to make in ■regard to further capital {expenditure. “Yes, that is so,” said the chairman. “North Canterbury is finding the. capital so you are thoroughly protected.” , Mr L. B. Evans said that the position was that the Canterbury Board was selling its services to the other Boards. Air A. T. Smith said that, lie felt a. separate T.B. Committee should be set up.

■Mr J. B. Aukl (Inangahua) expressed satisfaction at the North Canteiv bury. Board’s, efforts. The Board had, he'said, led the- way in New Zealand! He was satisfied that the dispensary would be the means of stamping out miners’ phthisis which had caused him-' deeds of deaths in their district. Al.tnough he was not prepared to.commit'his Board to support; the scheme,, he would do his best to persuade them of its advantages. “At present we have got, more accommodation- than we are using,” said the chairman, “and that the accommodation in Coronation lias, been increased by 32 beds.’’ Air J,. W. Hannan (Grey) said that was thoroughly satisfied with the scheme, and would support its adoption. The chairman explained that the North Canterbury Board would find all capital expenditure, and the other Boards would pay their share of the interest. In answer to a question, Dr Macintvro •••aid that very few- patients refused to enter the Sanatorium once n tv.rv| i -■;] | officer had had a talk with them, and he did not think the other Boards would experience difficulty. The best way of getting the patients to understand the advisability of. entering was by getting the local medical, men . interested. To his mind it was far better if the patient had tuberculosis to tel! him so, whether he came into the Sanatorium or not. The motion, was carried unanimously. Before the meeting dispersed Dr Macin.tyre mentioned that Dr Blackmore. during bis term in Christchurch, had reduced the death rdte of the town from the highest in'New Zealand to the lowest. " The visiting delegates paid a visit to the tuberculosis institutions, in the afternoon.

District. Population. Rateable value. North Canterbury 165.145 X/ 68,504,208 Nelson 27-305 7,237,505 Wairnu and Pi.et.oh 16,'805 9,754.256 Crev ... 14,830 1,612,726 Duller 10,320 1,584,577 Westland 7,670 1,141,511 Innngahau 3,530 500,667 245,106 90,335,540