FEVER PATIENTS IN DUNEDIN HOSPITAL.

Otago Witness, Issue 2811, 29 January 1908, Page 31

FEVER PATIENTS IN DUNEDIN HOSPITAL.

DR OGSTON AND THE HOSPITAL

TRUSTEES,

APPEAL TO DR VALINTINE.

At Wednesday's meeting of the Dunedin. Hospital Trustees the question of the outbreak of scarlet fever in the children's ward of the institution, and also among the nurses, came up for consideration.

The matter wae introduced in the report of the resident medical officer (Dr A. R. Falconer), which stated that he regretted to notify that scarlet fever had broken out in the children's ward on January 6, and they had at present in the isolation wards 10 cases, of which three of the patients were nurses. He considered the outbreak to be due to the influx of visitors who came into the Hospital during the holidays. As stringent precautions a r > possible had been taken to prevent the spread of the disease. Dr / Colquhoun had charge of the isolation ward and of the cases, and visited them daily. The resident surgeon reported all the cases to be of a mild type, an* so far there had been no complications. He drew the attention of the trustees to a., paragraph in the Otago Daily Times of the 22nd inst. to the effect that the district health officer inferred that the infection of the nurses was due to some carelessness on the part of the Hospital management. Both Dr Colquhoun and the resident surgeon were satisfied that the matron'is selection 'of nurses for duty in the isolation ward was' the best possible in accordance with hospital requirements. Neither of -the nurses in attendance on the patients had become infected with the disease. The Teport further stated that Dr Valintine had paid an official visit of inspection to the institution on the 22nd inst., and wished to inform the Board of Trustees that he considered "the presence of scarlet fever cases to be a menace to the Hospital, and this view, it was pointed out, was in accordance with the resident medical officer's report of June 30, 1907.

During the time thie and some other matters,- were under consideration Dr "Valintine, by invitation, was present

The Chairman said it was rather a pity that the district health officer bad expressed himself as he was reported' to have done to a Times reporter. It was a very serious matter that a medical officer should suggest carelessness on the part of the Hospital management in regard to nurses being laid up wi£h scarlet fever, and such a reflection should only be made when the officer who made it was in possession of all possible information. So far as the admission of fever patients to the Hospital was concerned, the position was this: If a patient presented iiinself at the Hospital for admission they were willing to accept the ease if there was no danger to other patients in the institution, but if the patient was suffering from an v infectious disease, and there was, consequently, danger to the other patients, then they had the right to refuse admission. But another condition had now arisen, and they were in the position that cases had arisen in the Hc6pital itself, and they were told that they must keep the patients, irrespective of whether they were a danger or otherwise to the other patients. He did not say whether the district health officer was right or wrong in taking up thie attitude: all he eaid- was that the trustees and 1 their medical advisers were of opinion that the presence of the ecarlet fever patients was a source of danger, and they accordingly made application to the Hospital Board to take charge of the cases, and to have them removed from the. Hospital. In the case of a patient who was in a house when attacked with the fever ,, he was only removed when the house could not be isolated; but they could not, when it was not possible to isolate such patients, turn them into the street. There was, therefore, a necessity that they must be sent somewhere, and as they could) not be taken into the Hospital another insitution or other means had to be provided for their reception and care. But in the ease of the Hospital fever patients the position was a serious one : there was a danger to the patients and to others if they remained in the institution, as the trustees believed, but they were told by the district health officer that the patients were sufficiently isolated and consequently that there was no necessity for their removal.

Mr Stevenson said Dr Ogstoi did ,not mean that there was sufficient isolation at the Hospital for the patients. What he meant was proßablv that there was no other place to send them to. and the Hospital isolation area, under the circumstances, provided the best isolation available.

Dr Batchelor said he was stronprlv of opinion that the scarlet fever patients should be removed from the Hospital at the earliest possible moment. The paragraph that had appeared in the Times gave him the impression that the district health officer did not intend to take an-" steps to have he patients removed from the Hospital, >'t seemed clear they were only to remain during the presents emergency and until come place was found to accommodate them. If. however, Dr Ogston meant, that the Hospital was to be used always for this cla©3 of natients, then they would have to fieht the question in order to nrevent the establishment of such a precedent. "

The Chairman eaid Dr Ogston had made a distinct chargre, according to the newspaper paragraph, of carelessness on the pa-rt of the Hosnital management, and he quite ac <3iffHnotW stated iiliSL-b "he -was perfectly satisfied that the , means of isolation adopted are sufficient, and believed further steps in the matter to be unnecessary." The HosDital authorities had done all that was -within their power to do. and the only way to get the patients out of thp institution was by an order from the pistrict Health Officer, and the responsibility was on that officer's shoulders.

Mr Stevenson: Dr Osrston agrees that it is not desirable \to have ecarlet fever patient* in the Hospital. The Chairman : Then, if that is so. wp should sret come information of what steps have been taken to get some other place to take them to. Have all possible steps been taken to get some other place? Has any inquiry been made to get Quarantine Island ?

Mr Mill : It has not been applied for in the proper quarter. Mr Stevenson: We have tried to get it Dr Valintine said he was. perfectly

satisfied, from investigations "he Tiad made, that the Hospital staff had done_ everything- that was possible to safeguard the patients, and he agreed that the scarlet fe\er patients should be removed from the institution at the earliest possible moment. The local health department was doing all that was possible at the present time to secure a suitable place to remove the patients to. To remove the patients to priv-ate hospitals would be a greater danger to tHe, community than to allow them to remain where they were; but it was imperative that some place should be found where they could beT temporarily | provided foi\, Dr Falconer, in continuing ' the nuises in attendance on the patients after they were attacked, had done the best possible thing under the circumstances. It would ds obviously wrong to put off nurses wlio had already been exposed to infection for the purpose of putting on others. The Hospital Trustees and the Hospital staff could do no more than they had done. The isolation in the Hospital area- was not so complete that it was desirable to have fever patients isolated there. Mr Stevenson (epeakinf as chairman of the Hospital Board) said that body was willine to do all that it possibly could to assist in the matter, and was prepared to erect tente on. the infectious diseases hospital site. Dr Valintine stated, in reply to a question from Dr Batchelor, that he considered scarlet fever cases could be safely treated in a tent provided flooring was put down and a trench cut around -(for drainage.

On the motion of Mr Stevenson it was resolved to refer the whole question 6f scarlet fever patients to the House Committee and Dr Batchelor, with power to act.

A -SOLUTION OF THE DIFFICULTY. Thanks principally to the energy and - promptness of the chairman of the Hospital Board (Mr M. Stevenson) and those associated with him on the boartl, a. highly satisfactory solution of the position in regard to the scarlet fever patients \in the Hospital has been arrived at, and on Saturday the 10 patients, with nurses and attendants, were boused under canvas near the infectious diseases hospital site at Pelichet Bay. On, Thursday morning Mr ' Stevenson, with Dr Batchelor (representing j the Hospital Board), conferred with Dr I Valintine and Dr Ogston (representing the j Health Department) on the- matter of 1 removal of patients from the isolation ! area at the Hospital. Previous to the eon- ! ference Dr Valintine and Mr Stevenson Tiad personally inspected- the infectious diseases hospital site at Pelichet Bay. and the conclusion then oome to was that the available land on the site outside the area required for the erection of the hospital was too limited to permit of tents being erected ac a temporary means of housing I the patients. The conference of local bodies on Thursday followed, at which it was resolved to endeavour to obtain more landj and with this object Mr Stevenson immediately waited on Colonel Smyth, of the Defence Department, and requested permission to use a portion of the shootingrange land adjoining the board's land for the jmrpose of erecting tents. Colonel | Smyth met Mr Stevenson in a very friendly manner, and at once not only agreed to grant the use of the land asked for, but i despatched Adjutant Hickey with him to mark off an area that would be outside the range of fire at the -butts. Colonel Smyth was then asked if he could supt>!y tents for the purpose of accommodating the patients, and this request also was complied with, the only proviso being that after the tents were done with the board, if required, should purchase them from the Defence Department. Everything being thus satisfactorily arranged, Mr Stevenson at once took over the personal supervision of clearing the site of bush and of having the tents erected for the reception of the patients, and in this work Colonel Smyth came to the board's assistance in granting the services of -a number of his men who were familiar with fixing up encampments. The tents secured are two large marquees, each capable of accommodating 10/ persons each, and three bell tents for the accommodation of nurses, night porter, coot, etc. The practical work began at 4- p.m. on Thursday afternoon, and the area was so far cleared and ditched round that yesterday evening everything was almost in readiness for all requirements. One tent, the large marquee for' the use of patients, has been floored, and all the necessary sanitary arrangements provided for. The other tents in process of completion, and everything is expected to be in readiness to-day for the removal of the patients to their new quarters. Arrangements have been made, with the Hospifel Burgeon and matron for a matron to be in cnarge at what may be termed the " fever encampment," and the requisite nursing staff has also been secured. Water for the encampment -will be obtained from the corporation supply at Logan's Point. Dr Valintine and also the chairman of the Hospital Coard (Mr Stevenson) express their "best thanks to the Defence Department for its assitance in the hour of emergency, and both gentlemen sneak in highest terms of the assistance given by Lieut. -colonel Smyth and Lieutenant Hickey, and also of Sergeant-major Meade and men of the Permanent Artillery who erected the tents. Dr Valintine also desires to express appreciation of the energy and promptness displayed by Mr Steveneon in dealing with a difficult situation.