Honorary Medical Staff

Sun (Auckland), Volume II, Issue 587, 13 February 1929, Page 8

Honorary Medical Staff

Will System be Superseded ?

IT was hinted by members of the Auckland Hospital Board last evening that the time is close at hand when the honorary medical staff at the hospital will have to be abolished and payment made for medical services throughout the institution. This process, it is recognised, is a gradual one and would have to commence with the appointment of several highly paid men. under whom the remainder of the staff* would be moulded.

JT has frequently been claimed as unfair that qualified doctors should give their services free of cost in a hospital system wherein the rich share with the poor the advantages of low-priced treatment. Even before Dr. MacEachern, the Ameri-

can investigating medical expert, visited the Dominion and made his sweeping recommendations for changed administration, there had been suggestions that doctors who attended hospitals should be paid for their attendance.

None to this day has challenged the justice of the claim, but the manner of

administration has been mingled with so many compromise proposals that a big question of general policy would have to be determined before the payment of honorary surgeons could be assured. The honorary medical practitioner is a product of the now obsolete voluntary hospital system—a system under which the hospitals were dependant upon voluntary effort and services, and upon donations and subscriptions wrung from charitably-disposed people, and supplemented by State grants of various amounts. In the hour of need, he was a valuable asset to a growing community service. In the hour of comparative prosperity, it is feared he is liable to be overlooked.

It i§ not inferred that the hospitals’ purse in New Zealand is bursting with surplus money; on the contrary, its carefully-conserved funds are expended with a fine discrimination for general needs. It is clear, however, that many people who are using the public hospitals are receiving the

benefits of the services of honorary, staff's free, while they could —and in: many cases would —pay handsomely ■ for them. I The Director-General of Health, Dr.. T. H. A. Valintine, has expressed the | opinion definitely that the time has j come for the abolition of the honorary staff, and that, as hospitals are open; to all. it is not right to expect the; services of the medical profession in an honorary capacity. EARLY START URGED Mr. M. J. Savage, a member of the j Hospital Board, urged last evening, that steps should be taken almost ini- j mediately to start the evolutionary movement toward a purely stipendiary staff. The general health of the people comprised the nation’s greatest asset, he said, and it was worth the engagement of the nation’s most highly-qualified men to ensure its preservation. It was agreed by Mr. Savage that a stipendiary staff could not be appointed immediately, but he favoured the appointment of three, or even j four, doctors of the highest degrees procurable to lay the foundation of the j new system. These men -would have | under them the remaining doctors at! the hospital, and by a steady process the paid staff would be increased until the medical personnel was wholly stipendiary. Closely associated w r ith the settlement of this problem, yet in a department of its own, is that of private wards in hospitals, upon which the hospital authorities are by no means agreed. The Hospital Boards’ Association wisely left the decision upon this to the individual boards, but the British Medical Association favours private wards and the treatment of private patients for separate fees. Patients in these wards would then have the choice of their own doctor — either an outside man or a member of the resident staff. QUID PRO QUO FOR DOCTORS Public hospitals, the doctors claimed, should be open to all members of the community, and in small institutions the medical and surgical work should go to the practitioners in the district, who would also attend their paying patients in private w T ards. It is probable that no immediate call will be made for private wards here, for their establishment would be opposed strenuously by many influences in a democratic community. Hospital boards throughout New Zealand, however, are preparing to face the question of purely stipendiary staffs, and in some cases—Hamilton is an instance—this already has been done. The general principle is partly approved by the Health Department itself, whose opinion -was expressed in a recent report: “The honorary system is suitable only for hospitals treating only pauper patients, and it could not be expected that the medical profession should give its services free unless some quid pro quo in the form of a voice in hospital policy and administration were given it.”