THE HOSPITAL SYSTEM

Sun (Auckland), Volume I, Issue 162, 29 September 1927, Page 10

THE HOSPITAL SYSTEM

THE chief features of Dr. MaeEachern’s report on the hospital system of New Zealand are his recommendations for the foi'mation of a Dominion Hospital Board, redistribution and reduction of hospital districts, the provision of wards for “paying” patients in public hospitals, and a wider adoption of the honorary medical staff principle. There will be considerable opposition by the district hospital boards to the formation of what would he an over-riding body. The boards are jealous of their local powers, and are already resentful of what they consider too much supervisory interference by the Health Department. The same attitude would apply if any attempt were made to reduce the number of hospital districts in a country where local body activity is intensely parochial. In regard to the proposal that there should he special wards in public hospitals for paying patients, there will assuredly arise the most hitter controversy if any attempt is made to bring it into operation. It has been emphatically stated on the high authority of Dr. MacEachern, who is associate director of the Amei’iean College of Surgeons, that its “paying” wards have been most successful in the United States. ' Under this system not only the poor and the relatively poor are treaded. The rich man, or the man just comfortably situated as to finance, can enter a public hospital and receive all the benefits of its superior equipment, making his own arrangements with his own doctor, who will attend him, as to medical fees. Dr. MacEachern gives the assurance that there is not the slightest difference in the treatment of the rich and the poor under this system, the chief benefit being that a patient can be attended by his own doctor, and can pay him if he can afford to do so. While this sounds a very equitable and desirable arrangement, both in the interest of the patient, who is entitled to receive the best treatment, and of the doctor, who should not be expected to give his services gratuitously to those who can afford to pay for them, there is the human factor to be considered. Can it he expected that the ordinary doctor would give exactly the same service to the piatient who paid him nothing as to the patient who paid him well? Would not that paying patient demand that he is the patient to receive first consideration ? There is much to be said for the doctor’s point of view. Why should he be asked to attend patients well able to pay for his skill and be unable to charge them? Dr. Mac Eachern’s recommendations are those of a recognised world-authority, and are not,to be either adopted or rejected without the weightiest deliberation. Tim report is to be considered hv representatives of the Health Department, the British Medical Association and the Hospital Boai-ds’ Association, who may, with a proper diseei-nment, find in it something that will he worth adoption in the interests of all coneei-ned. If there is anything in the report whieh suggests a more economical system of administration, that, above all, should be given the most careful study.