HOSPITAL PROBLEM

Hokitika Guardian, 29 April 1933, Page 6

HOSPITAL PROBLEM

THE NEW ZEALAND SYSTEM

TREATMENT WITHOUT FEES. SYDNEY, April 15. Strong criticism of the fi'ee use of public hospitals by persons who are able to pay was the main point ip the Syme oration, delivered at the opening of. the Australian College, of Surgeons by Professor F. Gordon Bell professor cf sufgery at the University of Otago: He said that free treatment was a d-e----gredatiou to . those able ,to pay who -sought it. . Professor Bell devoted practically the whole of his oration to hospital problems, which' he said, are so numerous and obvious as to embarrass one in discussing them. They were similar-du Australia and New Zealand, though in New Zealand the problems created.-by the large Australian . cities did; 1 -net. e'-'M- The world of surgeons hath a vital interest in hospital matters as far as surgical efficiency and surgical education were concerned. As for the hospital system, a surgeon had tc ac-., oept things as they were, though they might reasonably hope to exert their influence in tv carefully considered policy which in due course must demand public recognition. No one could question the right and duty .of surgeons to speak on hospital matters. The professor said that in New Zealand public, hospitals were maintained by,rates levied on the taxpayers and by Government contributions. Medical treatment, with two exceptions, was free. There was no great qtiarrel with, the larger hosptals, but there were ex-

travagance and inefficiency in the smaller institutions. The majority were controlled by full-time superintendents, responsible for both administrative and clinical work. They were known a® “one-man hospitals” -and the New Zealand College had directed attention to the pernicious system, -but so far without great success. The evils of the small hospitals were two-fold—the surgical work was deprived of the healthy criticism of an honorary staff and of the benefits of consultation. He. suggested that t!ie great hospitals throughout the country should bo graded. That would show the people that they could expect better treatment in Iho larger hospitals and would inspire the local boards to im prove the grading of their institutions.,,

NEW CONDITIONS. - Public hospitals had departed, from their original function of Using for -the use of indigent sick. The circumstances that the. public hospitals served other sections of the community than the destitute sick deprived them of many of. t heh' advantages fer edu ating the, surgeon. The plain fact • was?.that-, they wero trying to put into the new conditions a system that had achieved magnificent work in the past. The of charitable and free services . from an-honorary staff was right, only under one condition—that it was restricted to the interests of persons who could pay for accommodation, but not. for .surgical:.-..attention. Otherwise - it-—be-came a misguided charity, a- degrCda-:'. ion to those who sought it. In New Zealand persons who paid direct or indirect taxation toward the hospitals had'a claim to admittance. Personally he paid his hospital levy, but: lie could not say that that entitled him to enter a. public hospital. The surgeon was justified in stating tin’s ease without fear of being accused of est. .

EDUCATION OF SURGEONS. A Speaking of the education G f' surgeons, Professor Bell said there was a. danger of breeding a race of surgical practitioners instead of doctors and lowering the standard of surgery. He suggested the establishment of university hospitals and said he would especially like to see one, with about 200 beds, in Sydney. He hoped another generous person would come forward and make such a hospital possible. He also considered that studens should be compelled by law to undertake a fiveyear medical course in surgery after they had completed their six years’’ medical course. A compulsory national 1 insurance scheme against sickliest was also advocated bv the professor. That would do much to relieve the financial position of the hospitals. However efficient Australian and New Zealand hospitals might be in tbe: treatment} of the sick, they compared unfavourably with those of other countries in the matter of ‘research.