Unwieldy Hospitals

Sun (Auckland), Volume III, Issue 765, 11 September 1929, Page 8

Unwieldy Hospitals

Model Limits Exceeded

Ip the statements made the other day bt r Sir James Barrett, the eminent Australian surgeon, are to be accepted by New Zealand as a true indication of modern hospital development. substantial adjustments in policy will require to be effected in the four New Zealand centres. The suggested efficiency standard of TOO beds is already exceeded by the larger hospitals in the Dominion.

A significant announcement made by Sir James Barrett at Auckland on Monday while on his way home to Sydney from the medical conference at Honolulu was that large hospitals were a mistake and that 400 beds were found by experience to be the closest approach to complete administrative efficiency. The coldness in character of large institutions and the tendency for patients to lose their personal identity and become merely “casts,” are two of the specific reasons for suggesting this restriction of bed accommodation, while the delay in transfer from one part of the hospital to another was also advanced as a cause of lost efficiency. To Auckland, where the declared object of the hospital authorities is a maximum of 1,000 beds in one institution, the statements of Sir James Barrett are of particular moment, but other centres of the Dominion also will find an intimate interest in them when the whole position of hospital accommodation in New Zealand and abroad is examined. At present the Auckland Hospital has accommodation for 700 patients, or nearly three beds for every 1,000 persons of its population. Just on 516 of these beds are occupied all the time, although for many months the wards have been well filled, and at times overcrowded. It is now proposed to erect an infectious diseases block next door and increase the accommodation by 200 beds. The three other centres, Wellington, Christchurch and Dunedin, are similarly exceeding the quota established by Sir James Barrett as the ideal hospital. Wellington, a growing hospital with an annually increasing demand upon its facilities, possesses 584 beds, or one for every 4.2 of its people. Of this number just on 530 are occupied on an average throughout the year.

North Canterbury hospital district is even further than Auckland from this basis of administrative efficiency, for there are 753 beds in the hospital there, 442.4 of which are permanently occupied. In Dunedin, where practically the same basis of beds per capita is maintained, there is accommodation for 463 patients, the nearest approach in the centres to the ideal set by Sir James

Barrett. A fraction over 353 of these are permanently occupied. The Waikato Hospital, which is in the centre of a rapidly expanding community, is approaching the mark where it must consider its position if a convenient standard is to be set. There are now 315 beds, of which 211 on the average are occupied throughout the year. An analysis of the position abroad reveals that New Zealand is not alone in overstepping the efficiency mark of hospital administration, although it is seen conversely that in proportion to the population there is less call upon the voluntary hospitals in Great Britain than upon the public institutions in this country.

Guy’s Hospital. London, for example, one of the best known in the Empire, accommodates 647 beds —fewer than Auckland, and fewer also than Christchurch. In the whole of Great Britain there are aproximately 950 voluntary hospitals, with 63,000 beds. There are 3.19 beds a thousand of population in London, 1.15 a head in England and Wales apart from the metropolis, 1.45 in Scotland and 1.35 in Ireland.

With few exceptions the main hospitals in Australia are closer to the convenient 400-bed institution than in most countries, though even there one or two of them display a tendency to outgrow their controlling authorities. The principal Government hospital of Sydney is at Little Bay. where there are beds for about 720 patients. The Sydney Hospital itself has a staff of 69 medical men and only 415 beds; the Royal Prince Alfred has a medical staff of 90 and 584 beds, and the Lewisham takes in 292 patients. The Melbourne Hospital has a register of 358 beds, and the next largest in the State of Victoria, the Alfred Hospital, has 340 beds. Queensland’s largest metropolitan institution has room for 361 patients, South Australia has at least one with beds for 580, and Tasmania has two, each taking 225 people. In the light of comparison, as well as in consideration of the distinguished surgeon’s comments, New Zealand appears to be working well ahead of itself in providing unwieldy hospitals, which, apart from detracting from present efficiency, are likely to give further trouble in the future. —L.J.C.