Doctor Urges Reform in Hospital Staffing

Sun (Auckland), Volume II, Issue 342, 1 May 1928, Page 14

Doctor Urges Reform in Hospital Staffing

COMMUNITY SYSTEM TRAINING OF SURGEONS

(Special to l 1 HE SUN) HASTINGS. To-day

Honorary surgeons and community hospitals are needed for the most efficient treatment of the sick in New Zealand. This is the opinion of Dr. H. M. Wilson.

Dr. Wilson, in an interview in the "Tribune,” strongly supports the resolutions passed by the Australasian College of burgeons at Canberra. A surgeon of recognised skill, Dr. Wilson wants the post-graduate medico to be able to enter his operating-room to learn by experience and to be able to do the work that he and other experienced surgeons have gained by actual practice. He recently toured England, the Continent and America to make a complete study of the hospital systems of other countries, and lie came back convinced that drastic changes wore necessary in New Zealand. “The future medical efficiency of New Zealand depends a great deal upon what the public does in these matters,” said Dr. Wilson. “First of all, they want to get out of their minds that the College of Surgeons and the profession in Australasia are acting on selfish lines; for they realise that the primary object of all medicine is the getting well of the patient, and that the man at the top—the doctor — must be the prime factor. If he is inefficient, or is disgruntled at the way in which the public is treating him, friction leads to inefficiency. Everybody is human, the doctor included. “Complete efficiency in surgery can only be achieved by the surgeons working in the hospitals, serving their probation as young men there, helping their seniors and gradually acquiring that experience and skill for when their time comes.

“This can only be done if the public decides to throw the hospitals open to them. I can recount two very good men who would have gone into a certain town, but there were no hospital facilities for them there, and that town was deprived of their services. In all countries now, post-graduate training is looked upon as essential. In Victoria, they pay professors from England and America quite large sums of money to come to lecture to them. These sums are refunded from the fees paid by the doctors attending the post-graduate courses. This postgraduate work can only be carried out with hospital co-operation. “Education must not run wild. It must not interfere with the careful and efficient looking after of our patients. Therefore, it is essential that each district should choose the very best men in that district to serve on the hospital staff. Personally, I don’t think that these men ought to be paid, because, if they are, there will be a liability to limit their numbers, which in my judgment would be a mistake. “The college thinks that all names of candidates for appointments should be submitted in the first instance to a Medical Advisory Board. Say in this country we had Sir Louis Barnett, Sir Lindo Fergusson, Sir Donald McGavin, Drs. Carrick Robertson and D. S. Wylie appointed as Advisory Board to help the lay board in any appointments they might make.

“Speaking now of community hospitals, it may be said that these are the ideal aimed at by the college and profession in Australasia. A community hospital should comprise a hospital such as exists in most of the large towns of New Zealand to-day, with the addition of a building somewhat adjacent, but quite distinct, where anyone can get a private room, either alone, or with others, and have his own doctor in attendance, be he a medical or a surgical case. Such patients will have to pay according to the room, just as anyone has to pay, say, for a cabin on a steamer. But the building will be accessible to the hospital, so that the laboratories, X-ray and other modern diagnostic equip - ment are available. IN OTHER COUNTRIES

“I have seen the community hospital system at work in the most democratic countries of the world—Canada, the U.S.A., and Australia, where the church hospitals have their free wards, cheap ones and dear ones. I saw and talked to many of the patients, rich and poor, and never heard anyone remark unhappily on the conditions. In these democratic countries the people know, and we medical men know, that this cry of democracy is pure bunkum. “When a person is ill, there is only one consideration for the medical and nursing professions, and that is to get him well; and be he the dirtiest or most miserable person, if he is more ill than Ivs neighbour he will always receive more attention. In all countries I have seen this, and one can assure the public that it is an in controvertible fact. QUESTION OF FINANCE

“Now, turn to the. next objection raised —that in the U.S. hospitals the patients are asked what their financial position is and are graded accordingly. “Personally, I contend that that should be done more than it is, and I say that because I know that on many occasions my patients have demurred or refused to go back to hospital because they owed the board money. In many of these cases I am certain that an inquiry, by a sympathetic, speciallychosen official, would have shown their inability to pay, and in these cases the fees would have been omitted. “I feel,” concluded the doctor, “that the prime need in New Zealand to-day is that the public should settle the staffing question. We have the buildings*. We have the men. We have the money. With wisdom, compromise, realisation of the ambitions cf the patient and the doctor, we can have the finest medical system in the world. We ought to build on our present system, not destroy it. If I were an independent man, I would realise that. I could serve my country no better than by going round and explaining this to the public. I would like to see our hospital board invite Sir Louis Barnett, who will be acting as president of the College of Surgeons of Australasia, to discuss with them openly the question of hospital efficiency; and not in committee, but so that he could speak through the board and the Press to the public. Sir Louis is a New Zealander, has been an eminent teacher in the medical school here, and has had a long and honourable career as a doctor. He is very fair, has retired from all active practice, and is only concerned now with giving to the public of this country an efficient medical service.”