The Daily News. WEDNESDAY, JULY 12, 1911. HOSPITALS AND THE SICK.

Taranaki Daily News, Volume LIV, Issue 15, 12 July 1911, Page 4

The Daily News. WEDNESDAY, JULY 12, 1911. HOSPITALS AND THE SICK.

A public hospital is, par excellence, the place to go to when one ia ill. It is the place where science and not emotionalism counts; where the whole; concern of the staff is to fight-disease,'and to defeat death. It is, or should be, the sick person's haven, the budding medico's school, the eminent physician's mast alluring attraction, and the patient's greatest hope of health salvation. We publish a letter in this issue over the pen-name of "Humanity," setting out what may be considered a brood public view of the place a public hospital should, occupy, and raising some points that merit move than passing notice. Our correspondent quotQS from the report of the recent Hospital Conference in Wellington, showing that the Wellington Hospital authorities discriminate as to who shall tun! who shall' not enter the institution, those able to pay for outside medical treatment not being eligible for admission. This custom was strongly condemned—and 1 properly, too, in our opinion—by other delegates, notably by Mr. P. C. Bellringer, the chairman of the Tamnald Board, who pointed out that hospitals were supported by rates, and each member of the community should be treated in them. They might have added that besides rates the general taxpayer contributes to the support of the hospitals through the State heavily subsidising local rates. The right of the public to admittance to the public hospitals cannot be emphasised too much in these days when a section of medical practitioners seek by every means in their power to encourage the idea, that the public hospital exists for the accommodation and care of the indigent and not for the person who can afford to pay privately for his or her nursing and medical attention. Dr. Valintine. we notice, said that hospitals, in the first place, were established for i those people who were not in a position to pay. but pointed out that a hospital could not refuse to admit, if there were ropm, patients who were in a position to pay for outside assistance. That may have been the case in the Old Country, where hospitals are dependent upon charitable contributions for their support, but it was not the intention of the sapient and humanitarian men who framed our hospital 1 system. Their idea was that anyone, of high or low estate, should have the right of entry to the hospitals, and that the cost should be borne, not out of charity, but out of the public funds and rates, and that no one should be under an obligation to the medical profession for the treatment he received there, any more than he should be to the solicitor who rendered professional aid, to the butcher who supplied him with meat or to the baker who supplied him with bread, so long as he paid. Hospital treatment is. after all, a commercial transaction. The man is sick, "and lie wants hospital attention, and he expects to pay, and does so (unless lie is at poverty point). What he contributes in rates or through the consolidated revenue i-s but payment in part, a form of insurance. Without that paymnnt public hospitals, so completely equipped and so efficiently staffed as they are to-day throughout the Dominion, would be impossible, excepting that the fees were increased to a point that would be (|iiite out of the question. A number of hospitals do not pay their medical officers salaries commensurate with the services rendered, and probably this is the reason why some doctors feel that the community is under an obligation to them for attending to hospital work, that the hospital is but for the indigent, and that the man or woman who can afford to pay should be wheeled into the nearest private hospital the doctor may be interested in. This is a condition of things that, should not be allowed to exist, particularly in places where the hospitals can well afford to maintain a resident surgeon. It is an advantage, we admit, to have, as we have in New Plymouth, the services of several highly skilled doctors available for hospital work, but if their services are given out of a sense of charity to the town. well, it is an advantage too dearly purchased. Arrangements between board and doe-tor should be on a business basis, and no other basis should lie tolerated by a self-respecting Board. Tf a superintendent or assistant thinks his services are. worth more than he is receiving he should say so, and it would be for the board to consider the matter. For either to regard the public hospital as a sort of charitable institution and to feel that he is conferring a favor on the inmates by attending them is intolerable. Far better would it be for a board to increase the charges and rates and obtain the exclusive services of a doctor. W'th; a resident doctor, there would be no incentive or reason for the diverting of patients from, the public hospital to private hospitals, a practice in some towns

that is rapidly becoming a public scandal. Apart from the principle involved, there is, as a general thing, little comparison between the efficiency of private hospitals and the efficiency of public hospitals. Few private hospitals have the conveniences, the highly efficient nursing, and the up-to-date means for fighting disease as the main public hospitals. Then there is the matter of charges. Those on connection with public hospitals are extremely reasonable; in some cases, they are too low. Private hospital charges, on the other hand, are very heavy. Firstly, there are the nursing fees, then the chemists' charges, and, lastly, the doctors' fees. In a serious case, they make a crushing total. Our correspondent raises an important point when he states, in regard to the local hospital, that the "money which has .been expended in building and supplying proper appliances to the hospital, end the large expenditure which takes place in connection with it, tannot be well spent if a much larger number of patients cannot be treated there." If it can be shown that the low average at the public hospitals is due to the immunity from sickness in the district, it is a matter for congratulaton; but, if on the contrary, it oan be proved that as many cases a.re treated at local private hospitals as at the public hospital, and that "very many serious eases are constantly being treated in private hospitals and private nursing homes" (as our correspondent states), "owing to the notion that it is very difficult for anyone other than a pauper to obtain admission to the hospital," it is high time, and very necessary, for the Board to enquire into the position and take steps to put things on a proper footing, whatever extra cost is entailed. The "pauper" notion must be killed, and killed flfl quickly as possible. That effectually done, things will right themselves. Our correspondent believes that the time has arrived when a maternit.v ward (in a separate building adjacent to the general hospital) should be provided. We agree. In a district such as this, it is surprising no effort has yet been made to provide what is an absolutely necessary institution. The big centres have their public maternity hospitals, and the necessity for them is, relatively, just as great here as there, if not more so, for the district is wide and difficult, and the. handicaps great and many in cases of maternity. The Board propose spending a good deal of money shortly on building a new hospital, and there is no reason why n maternity hospital should not form part of the general scheme. The question of appointing a resident medical officer would then have to be faced. The whole subject is a very important one, and we would like to sec it discussed from every angle.