HOSPITAL TREATMENT

Rotorua Morning Post, Volume 2, Issue 476, 9 March 1933, Page 3

HOSPITAL TREATMENT

question of fees CLASSIFICATION OF PATIENTS DISCUSSED BY B.M.A. ABILITY TO PAY. In a circular to its members, the executive of the British Medical Association in New Zealand comments on proposals that public hospitals should cater for those able to pay for private ' treatment. It states that these cases should not be admitted to hospital till such time as proper provision is made for their treatment, and arrangements carried out that the medical practitioners should be adequately paid for the same. The executive feels that medicial men cannot indefinitely develop a hospital seiwice which depends on the philanthropy of the profession unless some definite principles are agreed upon with regard to What members of the community are to be eiititled to this service. Patients who are not indigent, but who are able to pay smaller fees, it is held, should he treated either by the adoption of a part-time arrangernent or under a mutually-agreed upon scale of fees. The executive feels that with regard to this class the adoption of a comprehensive insurance scheme against hospital and medical expenses should solve most of the difficulties encountered by both the hospital boa'rds and the association. The institution of an insurance scheme, it is stated, would automatically and satisfactorily limit the h'onorary attendance on patients to those truly indigent. It appears to the executive that there are certain cardinal points of hospital policy which affeets the profession which it must agree upon and emphasise. There are points which. deal with administrative problems wihich are not in themselves of cardinal importance to the profession, though of great importance to the country at large. The points it considers of especial importance to the profession are as follow: — (1) Hospitals should be "open" in character wherever this is possible. All hospitals of .50 beds and over should be staffed in this manner. It should be the aim of the hospital authorities to have as many local practitioners on the staff of the hospital as is compatible with the satisfactory working of the institution, pr'ovided the qualifications of the practitioners are satisfactory in every way. (2) The small hospitals could with advantage he open to all the practititioners in the district, who should have the right to attend their own patients therein, j (3) Medical staff appointments j should be made by the hospital boards, ' guided by^the adviee of a special medical consultative body or, in the case of the small hospital districts, by the advice of the Director-Gcneral of Honltb

(4) That such special consultative body comprise the consultant staff, if any, of the hospitals, and in other cases the senior members of the medical profession in the district, selected by the Hospital Board, with the approval of the Director-General. (5) The tenure of medical appointments to be three years, subject to re-election if satisfactory service is given. (6) The age limit for active service to be 60 years. (7) Satisfactory provision to he made for junior staff appointments, to ensui'e proper training and,' facilities to the younger men. (8) The organisation of the medical staff so as to ensure satisfactory team work, 'and review of the work of the staff, at regular meetings. (9) Co-operation between the medical staff and the hospital board by means of a liaison committee. (10) Medical superintendents in the lar.ger hospitals should confine their duties to administration. In the smaller hospitals part-time sup'erintendents Who might also undertalce clinical work could he appointed. (11) Patients to he classified by employing properly-trained almoners for admission to hospitals according to their ability to pay for treatment, as follows: — • (a.) Indigent — these to be treated by the medical staff in an honorary capacity, and (b) Those able to pay for private treatment.