MEDICINE FOR THE SAKE OF THE PATIENT

New Zealand Listener, Volume 3, Issue 74, 22 November 1940, Page 18

MEDICINE FOR THE SAKE OF THE PATIENT

MEDICINE AND HEALTH IN NEW ZEALAND. By Douglas Robb. Published by the Author, and Printed by Whitcombe and Tombs. 8/6.

(Reviewed by |

LAYMAN

reviews of this book will be by medical men, perhaps in journals read almost solely by members of the profession; and I think I’m fairly sound in saying that the majority of them won’t give the book too good a reception. Mr. Robb needn’t worry about this, however. Any intelligent layman who has ever required the services of a doctor or a hospital (and that should indicate a tremendous number of us) will be on his side; for the very good reason that Mr. Robb’s vital concern is so obviously on behalf of the public that is in need of these services. The impulse behind the book is essentially a humane one, and it is as a layman who is impressed by the value of such an impulse that I am writing this review. What, then, does Mr. Robb say about our medical services, and what improvements does he suggest? | CAN’T help feeling that most First let me emphasise that there is no question about Mr. Robb’s being in a position to speak with authority. His academic record is a scholarly one, he has travelled far in search of experience, and his record in Auckland as a consulting surgeon is quite distinguished. Hence (just to give an example) when he says that it took 50 years for the injeetion treatment of piles to reach the citizens of Auckland — well, no one can blame those citizens if they suddenly take it into their heads to sit up and ask, Why? It is impossible to give an adequate summary of all the matters discussed in the book-so many important ones are touched on-but it is mainly the hospital system that receives attention. "Only when I see a continuous stream of distinguished medical visitors coming to New Zealand from all parts of the world, to learn our knowledge and our ways, will I agree that our hospital system is the finest in the world-as public men afe in the habit -of asserting," Mr. Robb says, and itis a sound observation, surely, And he proceeds to give a highly interesting sketch of the public hospital system in New Zealand, and how it has been developed; and suggests matters that will certainly require to be discussed and decided if there is to be further development consonant with the rapidly growing needs of the community.

The questions suggested are: whether hospitals should be developed as fullyequipped community hospitals. whether de-centralised and special hospitals are required: whether hospital districts should be reduced: what sort of control is necessary: whether (and this is most important) the University, through its Faculty of Medicine or otherwise, should have a voice in the conduct of base hospitals, particularly in those where medicine is taught: whether hospitals should officially be centres for research. No one, I imagine, would deny that these are all vital questions. And I should say that no member of any existing Hospital Board can afford to remain unaware of the fertilising points that are made on page after page. He mightn’t agree, naturally, but not to be aware of what has occurred to Mr. Robb’s highly energetic and imaginative mind would be little short of disastrous, particularly if a long and forward-looking view of further development is envisaged. It is, indeed, this imaginative quality about the book (in addition to its humane quality) that makes it such attractive reading for the layman. Mr. Robb has the capacity of being able to place himself in the patient’s position; and he demonstrates that he’s aware of most points that at some time or other occur to all patients. Not, of course, that he’s solely concerned with the patient: he’s concerned with the dignity of the profession to which he belongs, and he’s proud of its contribution to scientific medical progress. There are, I admit, a number of additional points I should like to have seen dealt with. For example, it would surely be of great advantage to patients in public hospitals if the cumbersome system of dragging screens from one bed to another were abolished. A system of rods and curtains, making it possible for each bed, at appropriate times, to be enclosed in a sort of cubicle, would be much more satisfactory from all points of view. Qne obvious advantage would be that inside his cubicle a patient who was unable to sleep could have his light on at night and read, without being a source of annoyance to other patients -provided, of course, this would be no disadvantage to him from the medical point of view. I don’t want to suggest for one moment, however, that Mr. Robb is unaware of a point such as this, and for all I know the rod and curtain system may have already been adopted in some hospitals, The point I want to make is that you feel Mr. Robb has great reserves of knowledge about these matters. He has merely selected a few points for the purpose of his book; and as I've tried to emphasise, that purpose is to put forward suggestions of immense significance to the people of the country. It is to be hoped that the book will be widely read, both inside the profession and out. Everybody is concerned,