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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 21-January-2011, Vol 124 No 1328

On some principles of hospital management: part 2
Second part of an article by Dr Colquhoun, Dunedin, published in NZMJ 1910;9(36):33–37.
Socialism may be right or may be wrong. Socialistic principles may ultimately prevail in this and other States, but at least let us not drift into this experiment with our eyes shut. If as an individual class we are to be extinguished, let other classes clearly understand that their turn will come quickly, and that the free hospital must be succeeded by free meat, free clothing, free houses and free land. If these definitions are accepted, and if it is recognised that it is the truest economy to care for the sick poor in the most effectual manner possible, then it is clear that the hospital authorities must make provision for a great variety of cases, and that the same accommodation will not do for all.
Excluding mental cases, for which the State makes provision, the local authorities have two great classes of patients to provide for—1st. Those who are acutely ill and who need constant medical and nursing supervision ; 2nd. Chronic and convalescent cases which need care but of a less exacting nature than the first class. There will of course be sub-classification as between male and female cases, children and adults, medical and surgical, infectious and non-infectious cases-but for practical purposes, especially in connection with the cost of the hospital, the first classification is the most important.
The cost of maintaining each patient in 1906 in Dunedin Hospital was 5s. 4¼d. per day, or over 37s. 9d. a week An examination of the wards of the Hospital, made on July 27, 1906, showed that of 121 patients 66 belonged to the acute class and 55 to the second class. If, therefore, there were a secondary hospital established in one of the near suburbs of Dunedin, nearly half of the patients could be transferred to it with advantage to themselves. Their maintenance would be less costly, they would have advantages of more space and more fresh air, and the relief to the Primary of Central Hospital would be enormous.
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