WESTPORT HOSPITAL COMMITTEE.

Westport Times, Volume III, Issue 409, 21 November 1868, Page 2

WESTPORT HOSPITAL COMMITTEE.

At the meeting of this committee, on To sday evening, the rnem! Pr ' .. il'es, "< ' man), ....... lane, Muuro, Daly, i Mn Xyxee, as one of a sub-com- ■-, pr< uted and read a scries oi law's, ineludingrules for in i I ■ lmendaa•< i ibseriber ; sn i «ai ■ to Ret forth clearly a ■ Leant. It t ■ • •■ ■• ■" nation Bioii o't n e than medically, aud whether tl 3 ca ie shall be treated gratuitously or not. in the latter ease they will arrange che terms of payment ■•with th< patient or his fri td . Ms Mueeo moved, and Me Tsxejj seconded, the; adoption-of the several :■■ ries of -regulations, and they were adopted, with the exception of the following, which was reserved for discussion :— *' The medical officer shall not be required to treat gratuitously at the] osp fcalany casu Ity which does noi ne< I admission, unless the Visiting shall be satisfied that the person to he tre ited is unable to pay ■for medical attendance." The Qhaib: usr explained that the it' the medical officer- found -at fclie tendance, but not deserving admission, he should, attend to it at once. It might happen that the person would be quite capable of paying a fee, and therefore the rule provided that the medical officer should see that persons should bo fit subjects for hospital treatment, while the Visiting Committee should satisfiy themselves as to bis ability to pay ' Me Txlee moved the adoption of the rule. Me Powell seconded the motion. Me Field could hardly see where ■ the line could be drawn. Me Txleb: This is the way to look at it. We do not pretend to treat persons who are not destitute. The primary object of the institution is to aid those who are destitute. Circumstances like these might arise—A man might break Ins arm, or put his shoulder out, and, not being able to find a medical man, might at once go to the hospital. The doctor goes immediately to the hospital; he sees the man requires immediate attendance, and, without making inquiry, he ait ends to him. Then comes" the question, whether the hospital is to pay for this, or the man. If the man has means, the hospital has no right to pay. Me Field : "But if be is once admitted into the hospital does not that fact imply that he is to be attended to? Me Tylee : But he is not regularly admitted. He only goes there of his Own accord. The Chatemast: If ho is a person entitled to expect relief, he has only to go to the Yisiting Committee, and satisfy them. Me Daly : And the patient would require to remain in the hospital till the Yisiting Committee may call. The Chaibmatt-: I think that is contemplated. It is presumed that all the functions of the Yisiting Committee are discharged in the hospital. Me Field : Would it not be an adraisson if he waits there until the Visiting Committee should come ? The Ciiaik'MA]s" : Clearly not. He is not admitted until the Visiting Committee has decided. Me Tylee : It must be remembered that it is a consideration with a medical man, in taking charge of an hospital, what private practice he may have. I ■ ; ik we must regard a little the practice of a doctor. If a man is able to pay, why should be not? If ho is not able, he will be admitted as a patient. Me Field : But supposing a man goes to the hospital, and it is found he can pay, then the medical man might summon him, and the institution would be brought into bad grace. ME I)alt: Taking that view of tho question, I would not consider it right he should be attended to at all at the hospital, feo long as the doctor has a private place. The Chatemak: Quito so, But wheneverkdocibr meets a man, sufferU ( from injury, the first thing is to ' Ito him. It would be hard to •take advantage of him in any way.

■ Daly: It will not look well on it, aud it will compromise! i ; Lout to put him in audi a posi-1 ' ■ . ": 3 : It would look much if fcho doctor were to say, i; I . to you here ; you must i ito my place." Mr Mi rao : I am afraid the rule I contemplates an extreme contingency ait likely often to occur. I would ■-■:.• with tSie principle, but, as it is than bi : ■ " :e on the institution, we should di men le with it. Mr Harris also thought that cases might be met without any rule on tin subject. The whole case lay with tin Visiti ig Committee. The 'Chairman thought also that a rule was scarcely necessary, as the doctor could inform the patient thai he must satisfy the Visiting Committee. Mr Daly had no objection to the doctor attending such eases, and being paid for, but he objected to it b;j:.Tig- done under the cover of the hospital. Mr Tyler : In such a case, a man who is able to pay may remain in the Hospital. The proposed rule was then put to the meeting, aud was negatived. Mr MuMno proposed another addi tion to the rules, to this effect : " Subscribers recommending cases for medical advice as out-door patients will be required to certify that the applicant is unable to pay for medical attendance. Such recommendations to bo presented at the Hospital, on Tuesi days and Fridays, at 10 a.m., for i medical advice only,.and the medical o icer shall not be required to give I medicines gratuitously." He had lately laid before the Committee a motion that medicines should be given gratuitously, but, however liberally the Committee might desire to act, the full execution of their liberal intentions, was, for a time at least, impracticable. He thoroughly sympathised with the desire to provide medicines, as well as advice, especially in the case of women and children, but it was impossible to provide for everything. The Chairman-; And it ought to be remembered that out-door patients are not yet recognised as part of the Hos- . pital arrangements. Mr Kakkis reminded the Committee that, lately, they had been at very great expense iu buildings and furniture. Mr Daly was of opinion that the Hospital could not be hurt. The giving of medicine might prevent some patients from coming into the Hospital at all. What might be lost in one way might be gained in another. The Chairman - suggested that Mr Daly should propose an amendment, expressing his wish on the subject. Mr Daly proposed to add" to the motion the words—"But incases of destitution, the Visiting Committee may provide medicine as well as medical attendance." Mr M'Farla> t e seconded the amendment ; and the motion, so amended, was agreed to. Forms of requisition for the admission of patients, to be signed by subscribers, were also approved of. ADAMS'S CASE. Mr Tyler, as one of the Visiting Committee, said that, after the appearance in the Westport Time's of a letter signed by Alfred Adams on a subject as to which there had been many exaggerated reports, they thought they were justified in taking some action in the-matter. Having seen the letter, although they found it contained nothing like the statements which had otherwise been made, they thought it desirable to take notice of it, and wrote to Dr Thorpe, ealliug his attention to the letter as an embodiment of certain remarks calculated to seriously injure the Hospital, aud asking for a full report of the case. At the same time they addressed a letter to Mr Poole, the Hospital Steward. From Dr Thorpe they had received the following reply : Sib, —In reply to your letter, requesting me to furnish the Visiting Committee with a full report of Adams's case, I proceed to state the facts, so far as they are known tome. On the afternoon of the Oth ultimo a man came to my rooms, stating that his mate had injv.red bis shoulder,' and had gone down to the Hospital. He said that the accident had occurred on the previous evening, and that I should have been sent for at once, had not the creek been flooded. They had just walked down from the Caledonian Terrace, passing my door. _ I told the man that. I would follow him directly, and did so. On my way I happened to meet Mr O'Conor, who asked mo if I had heard of the case. I replied that I had, and was then on my way to the Hospital, where I learned the man was. On arriving there I found the man Alfred Adams. I believe he or his mate had a card, but I did not look at it. I regarded the case as an " emergency case," and at once proceeded to examine tha

injury, which I found to be a dislocation of the shoulder-joint. .[ reduced tl ! without any delay, and ti I the "an he wus all right. 1 . i him somei r •■■ tions as to keeping the joint i ■; I. . quiet, not intendin ; to Keep him in • '• pital, as I did not a ider quired it. Me conmlaincd of uo injuries but the oiie I had set to . ! and was fit and frco to go. ... , however; seemed to expect, or.vvish, to remain, and some rejjaavk was I J believe by him, as'to the noise of hotels; As I did not feel justified in takii man in, simply as a matter of accomniolation, unless on payment of the maintenance money, I took- bis mate out oi' he room, and enquired whathis(Ad p ■ircumstances wore. I was told that he was iu a claim, from wbicb he ceiving £6 to £7 a week. Whilst outside 1 saw that the weather was threatening, and that the men could not reach bpriie before dark. I returned to the ward and told Adams that under these circumstance:: he could remain in the Hospital if lie liked, on condition that he paid the sum iixed upon by the Committee as maintehance money, us I understood ho was in a position to do so. He agreed to dp so. To the best of iny recollection, the amount was neither enquired nor n '. but, if it were, £2 a-week was meal ion V, The man needed and received no'further treatment; but, the weather continuing bad, remained until the fourth or fi th day, when it cleared up. On my morning visit of that day, I advised Adams to take advantage of the fine weather to return home. He said thai ho had intended doing so. On my leaving the building, Ire asked mo if he could go without paying the moiiey before leaving, as ho had not it with him. I said I would take his word to send it down. This he promised, (I think on the following Monday). lie asked what the amount was. I told him that it was for the present fixed at £3 a-weelc, and I supposed that, for part of a week it would be at the rate of 10s a day or £2 ; but that he could speak to any of tho Visiting Committee on that point. I then, believing that I had been often unfairly called upon to act as Hospital surgeon, in cases where men were able to pay as private patients, (their cases not being such as to necessitate their treatment within the Hospital.) and that this was apaie i i point, spoke to Adams on the subject generally—ho appearing to be a sensible and intelligent man. I mentioned the rules and objects of such an institution, as I understood them; and the classes and eases for which tliey were designed. I told him that I did so only with a view to these things being more generally known than they appeared to be. He replied to tho effect that he had not known these, but had been under the impression that any bearer of a " ticket " could claim admission or treatment. He asked what nry fee was in such cases as his ovrn. I replied that had he come to my rooms as a private patient, with such an injury, my fee would have been five guineas or £5 (I forget which), but that as I had already attended him as an Hospital patient I did not require any fee from him, nor did I speak to him with that object, and all it was necessary for him to do was to send down the maintenance money, for which I held myself responsible. I remember that Adams then expressed his intention of sending down £5, professing his wish to make me some acknowledgment, and that I replied that if he did, I should pay in £2 as maintenance money, but, I said, I wish you distinctly to understand that I do not ask you for any fee. This conversation took place outside the building, and after I had discharged tho man. I have not received any money, nor have I heard from Adams since. I need scarcely say that had the promised money been sent it would have gone into the Hospital box, or that, as it was not, I bold myself liable for the maintenancemoney. These, Sir, arc the facts of the caseas known to me, and I have, I believe, given the very words. To sum up, Alfred Adams, being in a position topayfor medical attendauce,came to the Westport Hospital instead. He brought no recommendation, nor was his name on the subscribers' list. He had a card, which I believe to have been a receipt for a subscription from Mr J. F-raithwaite, but I did not examine it, not recognising such a document as of itself entitling the bearer to Hospital relief. I attended the man as an "emergency case," and at once remedied the injury regarding that as a sufficient recommendation. He could have left directly, had he so chosen, without being called upon to pay one farthing. The question of his means was not mooted until that of his remaining in the Hospital was. It was simply an accommodation matter. He agreed to pay tho maintenance money for the accommodation. I made, myself liable for his maintenance money by trusting to his word instead of having his promise to send it in writing. I asked him for no fee—what was said in reference to a fee,-I have exactly stated previously. I named £2 off-hand, as his maintenance money for four days, leaving it open to abatement if he chose to apply to the Visiting Committee. My chief regret in connection with this case is that I did not dismiss the man at once, after reducing the dislocation. That I gave him the option of remaining, was owing simply to motives of kindness, and to my belief that the charity would not thereby suffer loss. In concluding this statement, I would respectfully suggest to the Visiting Committee, as bearing upon, and perhaps originating, this case : —lst, the misconception which is so general, as to the nature and objects of this institution—the classes it is intended to benefit, and the mode of

. r its benefits; and,secondly, .■' üblicly correcting this incoptiob, (if indeed I am right in ' • .: that to be one which regards ital as a club, rather b the tiekets oi' ■ i to non-members). i have niyseli fcri lain the matter, on several o '■■■ . buj a.; I find my ,3 have ceased to do s , in he hope, Sir, that your committee vrould lake action in the matter and by ; l ~ dc idihg the "ticket question," protect both the institution and myself from imposition, unci your committee from a recurrence of similar annoyance to the And. from Mr Toole they had received the following letter : '" tEM■" :, — 'u obedience to your circular requiring me to furnish you with tho facts within my knowledge bearing upon Alfred Adams's ca.se, in reply, I beg to state that on the 9th of October Adams came to the Hospital and demanded admittance, handing mo a card '• beli ugi ig to a subse»ibep." I told him, in accordance with th' 6 Hospital regulations, ho should have brought a letter from a subscriber, which would have to i he counter-signed by a member of the Vi itiug Committee, and handed to the medical officer, who would send mean ■■ •to admit him. I immediately took 1 Uim into the Hospital, and his friend went and got the "order as directed by me. Dr. Thorpe promptly attended, and reset the dislocated shoulder, bandaged him up, and told him to remain perfectly quiet, or ho might put out the shoulder a second time. Adams was discharged on the 13th of October, and, on leaving, he thanked me, and to my surprise apologised for not being in a position to remunerate me for my attention. I told him distinctly that as a rule I never accepted money from patients, and that ho had given mc no trouble. He then said he had a small wages claim, and that when ho would be in funds he would contribute to the Hospital ; such are tho plain truthful facts. In addition, I have no hesitation or mental reservation in distinctly stating that Adams never directly, or otherwise, mentioned that lie was to give Dr Thorpe any remuneration cither within the Hospital or when leaving. It was necessary that they should come to some resolution upon the knowledge obtained by these letters and other inquiries. There was a good deal of misunderstanding on the matter, raid a resolution might prevent the recurrence of similar cases, to the injury of the institution. Mr MtnntO thought it was evidently a case in which some statement had been made by Adams to a very indignant correspondent of the Times. The party signing himself " Subscriber " was to be blamed for any noise in the matter. Ee thought it unnecessary to take any notice of an anonymous letter, but he might Bay that he considered that it was not supported on any side. He thought it would be as well to express some opinion as to the conduct of Dr. Thorpe in the case. He thought the two parties were at cross purposes. It would appear that Adams considered he was free to the accommodation of the Hospital on a ticket which was not his own; and the Doctor found that, i except for the flooded slate of the creek, he would have had a private patient. A hasty explanation had taken place, and a general misunderiug was the result. Mr Tsxeh, after a desultory conversation on the subject, read, as the report of the sub-committee, +he following : " That this committee is of opinion that the case of Adams does not warrant the commotion which has been made about it, and that the Doctor was right in not recognising the production of a ticket as a title to admission; and that he reduced the dislocation at once without making inquiries as to Adams's means ; and that after discovering he had means, and there being no necessity for Adams remaining in the Hospital, asked him for maintenance money at the rate of £3 per week, and did not ask for any professional fee." Mr M ; Eahlane : That expresses my opinion. Mr Mtjseo : And mine. I perfectly agree with the report. Mr Powele proposed the adoption of the report. Mr Fiei/d seconded the motion, and it was agreed to. THE NEW HOSPITAL. Mr Haesis reported that the amount of the contract for the erection of the new hospital had been paid, and he submitted accounts for "extras," which he recommended should be paid, subject to the report of the Inspector. Mr Mronto reported that tho bedsteads for the new hospital had been received, and, through the kindness of Mr Field, had been obtained at a very moderate price. Including all charges, they cost only £1 8s Od each. Mr Harris reported the necessity of an assistant to Mr Poole, as Hospital Steward, and tho Visiting Committee were empowered to engage a person in that capacityIt was agreed that Mr E. C. Eeid should be appointed a member of the

Committee, and that Dr Giles should be empowered to act in concert with the Visiting Committee in all matters —the Visiting Committee for the mouth being Messrs Powell, Eield, and Harris. The meeting was then adjourned.