ENGLISH HOSPITALS

Hokitika Guardian, 2 July 1932, Page 2

ENGLISH HOSPITALS

REVIEW of problems. LONDON DOCTOR’S COMMENTS. 1:1 WELLINGTON, June 29. English hosptal systems were briefly described yesterday morning by the chief medical officer of the London County Council, Sir' Frederick Mcnzies,'; who arrived at Wellington by the Manama from Sydney. He expressed the opinion that patients remained in hospital too long, both from an economic point of view and for their own benefit. Sir Frederick also spoke of the extravagance in hospital buildings, and considered lhat elaborate buildings were unnecessary. Sir Frederick, who is making an Empire tour, intends to visit various parts of the Dominion. He will eail from Auckland for Vancouver on July '25, . and travel across. the Dominion' of Canada on his return • home. Be is accompanied by his son, - who has recently completed his education at Rugby. Sir Frederick i,s a member of the council of the National Association 1 for the / Prevention of Tuber- . cuiosis and has represented Great Britain at various medical congresses. He is the author of papers oil medical subjects, including tuberculosis 4ml tilaternal' and child welfare.

In the course -of ah interview, Sir Frederick made it clear that he had no desir© to criticise the hospital system of New Zealand for the Dominion h d experts of its own better qualified to do that. It was, he eaid, -difficult to institute -a, comparison between the hospital systems of England and other lands, / since the English methods were I peculiar to the., t country. There were three systems operating in London, inI eluding -th e public hospital' system and the voluntary hospital system. For a population of 4,500,0C0 there were 100,000 beds. NEITHER RICH NOR POOR. i “The great difficulty is to provide satisfactorily- : for the big group ,• 'of peop'e who are. neither 'rich nor poor,” continued Sir Frederick. “There is a legal. obligation on the part :of the London -County Council to give treatment for even the- most’destitute.. The/e ’ people are provided for . in hospitals possessing a high standard of equip-/ ment. There* is -also, legal power to •recover payment from . such patients : as ar,e, able to pay for. treatment. If' people are able to pay; say, £4, they must do 1 so, and so on down the scale iavea to ./a -f ew /shillings. : There /'is ': also a legal obligation, ,7oh the'■ part of relatives -to pay; for relatives. The annual cost-, of the 83,000 beds i n the public- hospitals is about £3,C00,0C0, Which, is borne by the ratepayers Of London find supplemented by . bldck gfaphs, Jrom,, the, Gover jinien t / the p aythen t of such grants Usually extending oter a period of years.” y, V -V , The voluntary hospitals, he continued, were » great feature of the 'British system. The post-war, experience of these institutions - was that they were found to be costing, 140 per cent, more per. bed per annum. thlat in prig-war day s . Subscriptions were increased, but could not come up to the increased : cost. .Things came to a head in 1920. The Government made a grant of £500,000 and moneys were made available from the National War Fund, the Red Cross, the King jEdwaird Hospita-l Fund and other sources. These moneys gave them a breathing space, but other ways -and .means had to be devised. SYSTEMS OF PAYMENT.

The system of payment by patients was introduced,- but it proved unpopular. The public mind had to be educated to it. An almoners’ department was then established. Suitable . persons underwent a two ■ ■years’ course of .training so as to be able to,investigate the true circumstances of each patient. Th e duties of the. almoners did not end there, for they Had to deal with matters affecting patients’ convalescence. Gradually, however, payment by results became an established practice.

Another scheme was . known as the contributions scheme, and under it contributors paid small sums of a few pence weekly, .which were collected ’ under arrangement between emp’oyers and the hospitals. Private nursing homes in London were too expensive for people of ordinary means. Attempts were now being made to establish large hospitals, run by businessmen as business propositions, and such undertakings would probably do a lot to kill thei private homes. "At present,” 'Sir Frederick continued, “there is too much uneconomic use of hospitals. Patients remain in them too long from the 'economic point of view and too long for their pwn beindfWj. Hospitals ishouid be used to the end of the necessary point onlv. Aftod' that patients ought to be provided for by other institutions. In London' there lias been established a system of auxiliary hospitals, or convf lesof’t hospitals, to which patient 1 * are removed as soon cs they av e , rble to be moved. The turnover of hospitals is in consequence doubled, and if the cost of a hospital is between four and fiv e ' guineas a week it should be possible to provide auxiliary treatment for half that amount.” EXTRAVAGANCE IN BUILDINGS Sir Frederick concluded by stating he had always been impressed with the extravagance in lli e matter of hospital buildings. For that lie thought the philanthropic' magnates. of America were largely to blame. They set; the pace and others followed. Elaborate hospital build'ngs were unnecessary, especially. when it was remembered that with the rapid * progress of medical science what would be termed ' a

“She building’’ to-day would years hence probably be described "ad wrong. 1 ’ If flumey were available it should be, used in the Provision of the very best in the way of staff arid equipment,