MATERNITY SERVICE

Otago Daily Times, Issue 26637, 6 December 1947, Page 6

MATERNITY SERVICE

Hospital Board’s Extension Plans APPROACH TO MINISTER The chairman of the Otago Hospital Board, Dr A. S. Moody, will visit Wellington next week to place before the Minister of Health, Miss Howard, on Wednesday morning a proposal that the Hill Jack Home at Dunedin should be converted into an open maternity hospital. He will also recommend that the work of building a 20-bed maternity hospital at Marinoto should be pushed ahead with the utmost speed. Dr Moody made this announcement to the deputation appointed by the public meeting this week which discussed the problem of maternity hospital accommodation in the city and which waited on the Maternity Services Committee of the Hospital Board yesterday. He recommended that women’s organisations and the public generally should get solidly behind the Hospital Board in its endeavours to meet the present maternity crisis. He said that the Hill Jack Home could be converted to provide 16 beds within six weeks of approval being given to the scheme, and that Marinoto could be operating within six months.

The deputation comprised Mrs W. K. Cameron (president of the Dunedin branch of the National Council of Women), Mrs L. F. Cleghorn (president of the Dunedin branch of the Plunket Society), Sister Kennedy (Quendon Maternity Hospital), Mrs F. N. Davenport (president of Mothers’ Clubs in the city), and Mrs A. K. Ibbotson (representing young mothers). The chairman of the Hospital Board, Dr A. S. Moody, replied to a number of questions put to the board by the deputation. The questions and his replies were:— Could the Otago Hospital Board and the Health Department co-operate in the provision of an accommodation officer who could advise expectant mothers of available accommodation, and make the necessary reservations? —Dr Moody said that the Hospital Board should be capable of running its own affairs, and that given time to prepare such organisation as was necessary, it would be able to provide this service. With the assistance of Dr J. B. Dawson this would be investigated.

close. It is our job to see that they do not close, and it is for this purpose that El Nido has been bought and preparations made to purchase Quendon if necessary. There is, however, a very great shortage of beds in which mothers may be attended by their own doctors, but that is a very different thing from saying that there are no beds.” “ Before the advent of Social Security maternity benefits, medical and hospital, he said, a large proportion of mothers were denied the privilege of being attended by their own doctor by economic circumstances. The removal of the financial barrier to free choice of doctor had increased greatly the demand for open beds. ".Some of us have long recognised the need for more open maternity beds in Dunedin and have advocated their provision over a long period of years. It is only very recently' that we have got much support.” In 1937 the Maternity Committee, of which he was chairman, carried out a survey of the maternity services of the whole Dominion and in respect to Dunedin we said, “In Dunedin, as in some other large centres of population, there is a marked deficiency in intermediate facilities for those women who desire to be attended by the doctor of their choice. The development of such a service is most desirable.” This view was not shared by many who had now become converted to it. Nine years later, having failed to buy Stafford Hospital for use as a maternity home, he had endeavoured to get the board to erect a large open maternity hospital in the city in addition to purchasing El Nido for the purchase of which negotiations were then proceeding.

Regarding maternity hospital buildings, the deputation stated that it was considered a wrong policy to establish emergency hospitals: they should be permanent structures.—Dr Moody said that a hospital could best be run as a business institution, and it would be policy to have a number of extra beds on hand. He had asked Dr F. H. Smirk, professor of medicine at the Medical School, to prepare a report on provisions at the Dunedin Hospital in the event of any future emergency or epidemic. Dr Smirk had stated that he could not provide accommodation in an emergency except at the expense of other urgent cases. Accommodation at present at the Dunedin Hospital was grossly over-taxed because of the occupation of the Miller Ward by maternity cases. Dr Moody added that it would take at least three years to provide a permanent maternity building. Architects had told him that it would take 18 months for the plans and specifications to be approved, and three years to build. “ The Hill Jack Home would make a first-class open maternity hospital. We could get the whole thing going in six weeks if there is no hold-up by the Government or the Health Department in granting the necessary permits, nr Moody continued. “ It is only outside the city area that you can get building going to-day, as there is no structural steel in the country. Replying to the statement by the deputation that women should demand that they be attended in modern “open” hospitals, Dr Moody said that he agreed with this contention. If the deputation and the public supported the Hospital Board in its representations, Hill Jack Home could be working in six weeks. Private Hospitals Needed The deputation contended that it was absolutely necessary to maintain the private hospitals as they existed in Dunedin to-day. Dr Moody said that the present private hospitals were quite inadequate, and it wus to find the staff for them. I would not recommend that a private hospital should be taken over unless the staff was prepared to remain there for least six months,” he added. Discussing the possibility of tno . op floor of the Queen Mary Hospi^ 1 d be iu| used for maternity cases and the beta? nmiects If the worst came to me worst the top floor of Queen Mary could'provide eight to ten beds in an by the deputation that Miller Ward could perhaps be used as well as the ward below with a separate entrance to Frederick stiee, to toing it under the ‘?P en , f and provide 50 maternity beds, Di Moody said that there were no beds to snare in the Dunedin Hospital. The Hospital Board had explored all the avenues of providing maternity beds. Regarding the provision of staff i?r maternity Up* Dr. E'f&rf that it was possible that the statt oi Chalet Hospital might be induced to relieve in maternity cases until the Chalet was ready for occupation. This was a matter for the new proprietors ° f D t r e MoOdy ta said that he was going to Wellington next week to see the Minister of Health and the heads of various departments on the question of maternity hospitals. He would place before them the proposalsio convert Hill Jack Home and Marinoto into maternity hospitals. ..... “ The public must keep solidly behind us in our efforts to get the Government to agree to ln measures, as well as the relaxation some restrictions, within the safety h Architects 5 had told him that 16 beds could quickly be put into Hill Jack Home, as well as a labour room and one or two nurseries. It could be done at very low cost within five weeks of permission being given. A ..meal builder had guaranteed to provide 1J carpenters immediately and the hospital could be made into one pf the best public maternity hospitals in the .Dominion. Painting and plumbing could also be quickly completed and it would provide better facilities than the average private hospital in New Zealand to-day. About 40 trees had to be taken out before work on Marinoto could be started, Dr Moody added, and the area was practically virgin bush. The job would have to be done quickly, and he had asked . the contractors to go ahead and clear the section. The old stone building on the site would be used as a home for the nurses It would cost many thousands to convert this stone building into a hospital conforming to public health requirements. Twenty beds could be provided in about six months at Marinoto, and the board would be getting good value for the expenditure involved. “ The first thing I wish to emphasise is that up till now no mother has been refused a bed. It has been repeated again and again that for every mother who needs a maternity bed one will be provided. As in the past so in the future none will be refused,” declared Dr McMillan. “ We are told of the difficulties if El Nido or Quendon

“Some members of the Board were not in complete agreement with me and asked for the opinion of the staff of the hospital. Had the staff executive, of which Dr G. Fitzgerald was a member, not opposed my contention that we should proceed with the erection of an open hospital, then I am sure that one would have been completed almost 12 months ago. Building conditions were not as acute then as they are now, and we could have built quickly outside the brick area. As it was, some members of the board were influenced by the staff’s expression of opinion and I was not able to get my board to agree to proceed in opposition to the staff’s considered opinion. It took quite a while to convert the staff and some members of the board to my way of thinking, and those who to-day are urging the public to put pressure on the board should remember first, that as’the chairman has said the board will move as rapidly as is humanly possible, and, secondly, that it was the opposition of the staff two years ago to what is now advocated that persuaded a majority of the board not to act then.

“We want to get the maternity patients out of Miller Ward not because it is not a good ward. It is as good as Hill Jack can be made. It is as. good as most private hospitals, but is urgently needed for other purposes ”

v Building Lag Dr Dawson explained that the present position had been brought about largely owing to the depression and the war, when no building was carried out. They had to deal with a building lag of from 10 to 12 years, and this was overlooked by people who had criticised hospital boards. A suggestion had been put forward at the public meeting that an accommodation officer should be appointed in- order to assist expectant mothers, but he thought this could be done by the patient’s doctor. Dealing with the objections made to the erection of temporary buildings for hospital purposes, Dr Dawson said he could not see any objection to the construction of buildings in polite. “ What are we going to do with the nurses? ” Dr Dawson asked, dealing with a suggestion that the top floor of the Queen Mary Hospital could be used for maternity cases. It would be costly to make the necessary alterations, and he thought it would be much better to keep El Nido going. If they lost the 13 beds at El Nido he did not know how they could be replaced, especially with the Public Hospital so badly overtaxed. “ The question is,” continued Dr Dawson, “ where are we going to find the accommodation? It is certain that it cannot come out of the Public Hospital or out ( of the Queen Mary Hospital. It is imperative, then, that we should keep El Nido going.” There was the alterantive that El Nido could be used for convalescent purposes, but, personally, he thought that, this was undesirable. There was a slight risk in moving patients after a few days, and if they developed a disability the Hospital Board would be blamed. On the other hand, a convalescent depot could be staffed much more easily than a hospital.

Dr Dawson added that the proposal to erect a 20-bed hospital at Marinoto would not replace the beds that had been lost as the result of the closing down of private hospitals. The Queen Mary Hospital was to be enlarged to provide for another 20 beds. He added that the proposal made by Dr Moody in connection with Hill Jack had not been taken into consideration by him when making his report, and Hill’ Jack might compensate for the loss of El Nido. The auestion, however, was whether a staff could be obtained. Dr Moody: We intend getting a staff. Dr Moody said that El Nido must be carried on bv the Hospital Board. The board was advertising for a staff. “If El Nido closes,” he said, “ the crisis will be on us in a month.” Question of Staff “The crux of the matter is staffing.” commented Dr N. H. North. / He thought that one of the reasons why private hospitals could not be kept going was that the staff had to be paid higher than award wages or they would not remain. He expressed the opinion that it was advisable to keep Quendon going. Dr J. Fulton commented that the board was acting in a very energetic manner in order to meet the position. He hoped the board would receive the help of various women’s organisations in obtaining staff. Mrs N. Ross pointed out that one reason why private hospitals had to close down was that they had actually received less social security payments from their patients than public institutions.

Sister Kennedy said that this had been brought about by the fact that patients had to be sent away early in order to make room for others.