THE HOSPITAL.

Taranaki Daily News, 16 March 1916, Page 6

THE HOSPITAL.

; ACCOMMODATION OVERTAXED. A PATIENT REFUSED. . DR. WALKER'S EXPLANATION. The Taranakl Hospital and Charitable Aid Board met yesterday. Present: Messrs F. C. J. Bellringer (chairman), A. E. Sykes, E. Maxwell, M. J. MacReynolds, J. E. Hill, ,T. Brown, G. V. Tate, D. McDonald and Mrs. Dockrill. The medical superintendent of the hospital (Dr. E. A. Walker) reported a record in hospital returns during the month of February. Seventy patients were admitted, 72 were discharged, two died, leaving 58 in the institution. The highest number in the hospital for one day was 73, which is also a record. The month had again been a very busy one, with a fully-occupied staff. The' main building had been constantly full, and, in addition to the isolation building, the cottage known as "Tariki" had been occupied, and the small room adjoining the women's ward in the main building utilised. At no time had the isolation accommodation been more heavily taxed, and on one occasion the authorities were compelled to admit their inability (o take further eases. This was a matter both of accommodation and of staff provision, and further building resources were absolutely necessary. While on tiie subject of the overcrowding of the hospital the Board dealt with the following resolution o£ the Egmont County Council:—"That the Egmont County Council strongly protests against the action of the New Plymouth Hospital authorities in refusing to receive an urgent case of infantile paralysis into the New Plymouth Hospital"'-' This resolution was the outcome of a report furnished to the Egmont County Council that a child in the district, who was suffering from\ infantile paralysis was refused admission to the hospital, on the ground --hat there was no room for the case in the- institution. In the course of discussion councillors criticised the action of the hospital authorities, which they described as discourteous, and expressed surprise that a patient should he kept out owing to lack of accommodation. Dr. Walker attended the meeting at the request of the chairman. The chairman said the first he knew of the Opunake ease was when he saw the report in the Daily News, and he immediately forwarded the cutting to Dr. Walker for an explanation. . As far as the complaint of discourtesy was concerned, Mr. Bellringer had never known of a single case of discourtesy on the part of the staff ever since lie had been connected with the hospital, and lie was sure the acting-matron had not been discourteous in the case in question. Mr. MacEeynolds said the matter had come up at the meeting of the Egmont County Council through a report having been received from Dr. Ban-on, of Opunake,, to the effect that he had rung up the New Plymouth Hospital to arrange for the ease to be admitted, and the acting-matron had replied that the case ectild not bo taken, as there was no room. The Hawera Hospital authorities were then communicated with, and they took the case. The child had since died. The attitude taken up by the councillors was that while they had never refused a sixpence and had contributed their share of some '£30,000 for hospital buildings, yet when they wanted to send a patient to the hospital they were told there was no room. If there was no room in the New Plymouth Hospital f or Opunake natients, what were they going to,do with cases while they had no district nurse at Opunake? The new hospital buildings had been finished for a considerable time, and yet the authorities <aid they could .find no room , for patients.

ALL BOOM OCCUPIED. Dr. Walker said any impartial person reading the report of the discussion at the Egrnont County Council meeting would pome to the conclusion that a public body had been treated in an arbitrary and discourteous manner by the hospital officials; in fact, the chairman bad said the case was treated with scant courtesy. The position was, said Dr. Walker, that last Friday morning he was engaged on a serious case in the operating theatre, when the telephone next door rang, and v,'a9 answered by .Sister Campbell, the acting - matron. Presently Sister Campbell came back to the theatre and reported that Dr. Barron wanted to send in a case of infantile paralysis, but she had told the doctor that.they could not take the ease as the institution wa3 overcrowded, and there was absolutely no room .for the patient. Sister Campbell asked Dr. Walker for confirmation of her action, and lie gave it, because he was satisfied they could not take the case, as there was 110 room, and also because thev did not have an adequate nursing staff. Continuing, Dr. Walker said the existing infectious diseases Mock consisted of a building of two wards, and a small room for the nurse 011 duty, and Ward A provided accommodation for three patients and Ward B for two patients.- In Ward A. there were now four cases of diphtheria, and in Ward B there were three cases of diphtheria, while three nurses had been turned out of their temporary quarters in "Tariki'' cottage to make room for further cases of diphtheria and a case of laryngitis. In addition, there were two cases of infantile paralysis accommodated in the main building. They were in a small room adjoining the women's ward, and it was absolutely impossible to put move than two eases in this _oom. The women's ward was filled to overcrowding, and there were only two vacancies in the men's ward. The annexe was also occupied. It would therefore be seen that the resources were heavily taxed in regard to. both accommodation and staff, and it had to bo remembered that a great proportion of the nursing staff consisted of juniors. At a time like the present Dr. Walker felt it was his duty to use tlie available accommodation for the greatest benefit of the greatest number,

THE INCREASE OF PATIENTS. Br. Walker then went on to show how the number of patients using the hospital had increased in recent years. In July, 1911, the acting medical superintendent reported that the accommodatior and staff was taxed to its fullest capacity, and the number of- patients then in the hospital was 45. In December, 1912, it was again reported that the t hospital was overtaxed, and the number of patients was 43. The same con-

diton existed in July, 101.1,. when the number was ".7, and' vet in Dee. 191.1, the number T.as 72; in .laiiuarv. IDifl, it was 7i>, and in February last the number was 70. From this it could be :-eon that the hospital was regarded as o\ererowded with 45 patients, and now the number was in the seventies, showing that the hospital was being worked to its utmost capacity. Dr. Walker emphasised the strain that was now being placed on the stall', and he assured the Board that lack of accommodation was the sole reason for which tliey would refuse admission to a patient. If the case in question had been admitted to the hospital under these circumstances the hospital authorities would have added to their responsibility for the care of the child, and he was satisfied the patient could be treated just as well at Opunake as anywhere else. It was now recognised that physicians and surgeons could do little to* relievo the established disease. The disease called for careful treatment at a later period to restore all possible power 'to affected muscles, and prevent deformity. Tn other words, it the case had been in Opunake, New Plymouth, London or Xew York the result would have been the same. Xo hospital treatment could better th'e condition of the case. People seemed to think that if the case had received hospital treatment the consequences could have been prevented, but' he did not agree with this.

Dr. Walker said he had communicated with Dr. Barron, who had said that this was the first occasion on which a case from him had not at once been admitted, and he added that he had always received every courtesy from the hospital authorities.' Dr. Walker considered that this statement of Dr. Barron's was an adequate reply to tlie criticism that scant courtesy ' was accorded .in this ease. In 1!)13 there were 75 admissions from this district, in 1014 there were Gf) admissions, and in 1915 04 admissions. STAFF NOT TO BLAME.

Mr. Macßeynolds said it was clear that the medical superintendent and Die staff was not to blame, but the Board was at fault in not providing the necessary accommodation.

_ The chairman said the requirements at present were abnormal as far s.s isolation eases were concerned, and it was evident that every ease could not be taken,

Mr. Maxwell said it seemed to liim that there was no case to support the suggestion of discourtesy on the part of the staff. He had never met anyone who did not have praise for tim New Plymouth Hospital. It seemed quite clear that the patient could not lie received, and if there was 110 room the hospital authorities would have acted wrongly to have taken in the patient. The staff was free from blame, and the only question was one of the Board being negligent in failing to provide adequate accommodation. An institution would not be justified in providing for abnormal conditions, and would do its duty in providing reasonable accommodation. An important point was that the question of cost had to lie considered, for if it were not the members would soon he out oi ofliee, for the ratepayer would not tolerate it. T)r. Leatliam, Mr. Wylie and Dr. Walker had from time to time called the Board's attention to the overcrowding, and the result was that the Hoard embarked 011 a very heavy expenditure to provide a new hospital. 111 normal times the now hospital would have been ready long ago, hut the work had been hampered, and there were very considerable delays. But for this the institution would have been ready long ago. TJut could anyone say the Board was to blame? He could honestly say that the Board had done its duty and had done everything possible 10 provide the new building as expeditiously as possible. The Board had not been neglectful in any respect. If the Board could have done so they would have had tlie new hospital ready for occupation to-day. The scheme wsw launched at an opportune time, but the strained financial position had led to great delay in considering ihc plans and the question of finance. .Mr. Maxwell was quite satisfied that in the case ill question there had been absolutely no discourtesy on the part of the staff, and though it was regrettable u ease had been refused, he was convinced the authorities would not have heel justified in taking the case in view of the overcrowded condition of the hospital.

Tn answer to Mr. MacEeynolds, the chairman said there was a wrong impression that the building was lying idle, while as a matter of fact the building was not finished yet, and was certainly not ready for occupation. NEW NURSES' HOME WANTED. Dr. Walker said to erect, a big isolation block would be to cast a reflection on public health methods, while a small block might reproduce the present position. He suggested, however, that while the question was a difficult one something should be done in. the direction of providing an isolation block, which would accommodate from twentyfive to thirty patients. The Board had provided a new hospital, but ,'iad vet to face further accommodation problems The Nurses' Home was greatly overtaxed, . and the present building was very much too small to provide qoartei's fo; all the nurses. Three n;r, scs wore accommodated in "Tariki"cottage, but they came home one night to find their belongings outside, as the cottage had been commandeered for patients. Some nurses were living away from the instituiion, while others were accommodated ,'n oik of the wards of the new hospital. Tlu Board would have to face stiff financial problems to provide all lii; essential accommodation.

Mr. Brown said lie was quite satisfied with the explanation of the modioli superintendent. Tlie hospital wa* only supposed to accommodate about 40 patients, Imt last month there ;vei:e 0.-tr 70 patients there. The chairman: It was originally built to take 28 patients, and it has not been added to since then.

Continuing. Mr. Tirown said this was not the only hospital board that was confronted with the same problem. To provide a big isolation block would be a waste of money, for, as Dr. Walker had pointed out, it would be frequently vacant for long periods, and it might also be found too small to meet abnormal conditions. It was decided that the chairman

should draft a letter to the' Kgmont County Council explaining the position at the hospital, on the lines of the medical superintendent's statement,