The Guardian And Evening Star, with which is incorporated the West Coast Times. FRIDAY, FEBRUARY 7, 1930. THE HOSPITAL SYSTEM.

Hokitika Guardian, 7 February 1930, Page 4

The Guardian And Evening Star, with which is incorporated the West Coast Times. FRIDAY, FEBRUARY 7, 1930. THE HOSPITAL SYSTEM.

It has been decided by the Council of tne New Zealand Branch of tne British Medical Association that, at the- annual conference which is to be held in Christchurch this month, the discussion on hospital policy should be re-opened de novo. lor some years the Branch has been committed to the policy of the adoption by our State hospitals of what is known as the community hospital system. In the circumstances it has been natural to draw the couojusiqn that the medical profession in the Dominion is generally in favour of this proposal. A circular recently addressed to the profession by the Nelson Division of the B.M.A. makes it apparent, however, that among medical {iractijiion.ers themseKves ai diversity of opinion exists on the subject, for the Nelson Division is strongly opposed to the view that the community hospital system could be advantageously introduced in New Zealand. The members of this division, says an exchange, hold that the community hospital system cannot, for a number of reasons, lie grafted on to the existing system under State control. In the first place, it is contended that public opinion is emphatically against the community hospital system.. It may certainly be agreed that there, has been no public demand for the introduction of the system. Probably the most serious objection to it from the point of view of the taxpayer is that the adoption of it would entail a heavy expenditure in the erection of additional hospital wards, The objection ha-s

also been raised that the effect ol the system would be to create class distinctions. This is, no doubt an argument that weighs with the man in the street, who seems to overlook the fact that class distinctions exist under tne present hospital system, and the circumstance that it is only because a large proportion of the sick do not demand admission to the public hospitals that huge expense in the extension of public hospital accommodation is avoided. The view is expressed by the Nelson Division of .the B.M.A. that in regard to hospitals the duty of the State does not extend beyond the necessary provision for infectious diseases and tne indigent sick. But it is not upon tnat basis that the hospital system as it exists in New Zealand has been developed, and it is a reactionary suggestion that its usefulness should thus „e limited. Except in respect of the treatment of infectious diseases such a restriction would place the public hospitals ,on the footing of charitable institutions, with the result tliat a certain stigma might conceivably attach to persons who were admitted to them. In theory, at all events, the hospital policy of the country has been tliat the public hospitals should be available to all sufferers, irrespective of their woi'dly circumstances, who choose to take advantage of them, those who are indigent receiving accommodation a.ud attention free, and others who are able ,to pay part or all of the maintenance charges, doing so according to their means. In practice, however, tiie public hospitals provide accommodation only for patients who cannot be suitably attended to in their homes or who cannot—as a rule—afford to become inmates of private hospitals. It is' undoubtedly the case that on persons' possessed of only moderate incomes the private hospital charges fall somewhat heavily, and if there were pay-wards in the publichospitals at which medical and surgical treatment could be assured at moderate charges patients of this des-. cription would be grateful for the opportunity of using them It is an argument in favour of the community hospital that it would enable this class of patient to enjoy the advantages in the way of the elaborate equipment with which the public institutions are furnished. The attitude of the Health Department towards the idea of the adoption of the community hospital system in New Zealand lias been cautious, but the trend of its opinion, so far as it has been expressed, has been in favour of a change in the existing system in a direction that would cater for patients who would be prepared to pay for treatment in special wards. The Department has apparently taken the view, also, that Hie fees would have to be based on a scale that would prevent any of the cost, either capital or maintenance, from falling on the public funds. That savours, perhaps, of a counsel of perfection. In such circumstances the popularity and success of the pay-ward system might be distinctly doubtful.