The Hospital Problem : the Report of a Special Conference of Labour, Hospital, Medical and kindred Societies
1924 1924 1920s 12 pages 6 proposals. The conference had been told that morning by Mr. Bishop Harman that there was ample bed accommodation, but it was evident that it was not enough to have total figures; there must be co-ordination, and the fact remained that for every person occupying a hospital...
| Institution: | MCR - The Modern Records Centre, University of Warwick |
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| Language: | English English |
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London : The Labour Party ; printed at the Office of the British Medical Association
1924
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| Online Access: | http://hdl.handle.net/10796/FF3DC924-3ACD-43ED-80CA-23964652E105 http://hdl.handle.net/10796/19EC95C7-9479-4CE7-8BCD-AF0B813DB743 |
| Summary: | 1924
1924
1920s
12 pages
6 proposals. The conference had been told that morning by Mr. Bishop Harman that there was ample bed accommodation, but it was evident that it was not enough to have total figures; there must be co-ordination, and the fact remained that for every person occupying a hospital bed to-day there were at least two persons waiting the opportunity of occupying that bed. If that was the result of the voluntary system — (" It is not ") — then that system had broken down. How often did medical men visit a case in which they knew that, owing to the home surroundings, the only hope was institutional treatment? Hospital accommodation ought to be available, and it was not. Dr. C. W. Saleeby declared that the hospitals of the future would be built in the country, on much less expensive sites; they would be less expensive constructions, would employ less expensive drugs, and more regard would be paid to the healing conditions of nature, especially costless sunlight. He urged the ladies and gentlemen of the Labour party to stick to their job of securing preventive medicine and to leave the voluntary hospitals alone, and the hospital problem would solve itself in the next generation. Dr. H. B. Morgan said that Lord Knutsford had been expounding nothing but Labour party policy all the time. He would only remind his lordship that the Poor Law hospitals which he had criticized did not represent Labour party policy at all — they represented the Tory party policy of the past. Mrs. E. Barton (Industrial Women's Organizations) denied that those who had complained of the conditions in the voluntary hospitals — the inadequacy, the long waiting, and so forth — were "hysterical charwomen," to use Lord Knutsford's phrase. They were working women who knew what these things meant. Lord Knutsford had asked what the State had done. Maternity and child welfare centres and the school medical service furnished some part of the answer. Mr. Somerville Hastings asked whether Lord Knutsford, who had criticized the efficiency of the State hospital, had any experience of State hospitals in other countries — Switzerland, Austria, or Germany — which were very efficient and the scene of much progressive work. Mr. G. P. Blizard complained that the Labour party's pamphlet had been referred to as though it had a single author; every word in that pamphlet had been scrutinized and revised by a very large committee consisting of many eminent doctors, publicists, and members of Parliament. Lord Knutsford, in a brief reply, referred to the lack of pecuniary help for hospitals which had been forthcoming from friendly societies, although such bodies, on their members' behalf, had reason to be interested in the hospitals. With regard to Continental State hospitals, he would be very sorry to be a patient in one of them; there the patient was regarded as a number, not as an individual at all. THE DOCTORS' VIEW. At the resumption of the conference on April 29th the chair was taken by Mr. G. P. Blizard, Secretary of the Labour Party Public Health Advisory Committee, and "The doctors' view" was introduced by Mr. Bishop Harman, F.R.C.S., Chairman of the Hospitals Committee of the British Medical Association. The paper read by Mr. Harman was as follows: The provision of money must depend upon policy, so policy must be defined. There are at present two bodies which have formulated their views as to the part hospitals should play in the body politic, and state how they think their policies should be brought into effect. The Labour party has published its scheme of hospital policy.1 The British Medical Association has for years been developing its hospital policy. The policy of the Labour party is the scheme of a committee, a body of persons subject to the limitation of a closed chamber, limitations of time and place, which inevitably make its recommendations in some degree at any rate academic. The policy of the British Medical Association is the result of the slow and steady growth of opinion within the medical profession. It is the work of the members of the Association acting through its deliberating bodies, but it has been discussed and voted upon by the members of the Association through the Divisions of the Association, and it has been submitted to the vote of conferences of medical staffs of the hospitals called for that purpose. We claim that the policy of the British Medical Association is based upon the direct experience of men engaged in the practice of medicine in the widest sense, and in particular of those engaged in hospital work. It is a practical policy, not an academic scheme. We claim that the application of the British Medical Association policy to present-day conditions would secure a steady improvement in hospital work and march towards the goal that is the aim of that work. General Principles. This opens at once the inquiries : (1) What is the aim of hospital work? (2) What principles should guide us in our choice of a line of advance towards that aim? All are agreed that the aim of hospital work is to relieve pain, cure disease, and secure a healthy, virile nation. The principles that should guide us in working towards that end are in debate. One side asserts that it can only be secured by the State acting through its statutory authorities; another side points out that the surest, though perhaps slower, road is through the progressive action of the individuals within the nation. It may seem at first glance that these two roads are one and the same. But the means that would be employed by the two sides show that there is a wide difference between the two conceptions. The differences in hospital establishments on the continent of Europe and in Great Britain and the United States of America are so wide that they seem to point to more than mere expediency. They appear to arise from primary differences of outlook upon life and organization. Continental hospitals are for the most part owned, financed, and controlled by the State acting directly or through its subsidiary authorities; voluntary hospitals are almost non-existent. In Great Britain and in the United States the hospitals that bulk most in the public eye are the voluntary hospitals. In both the latter countries there are many State hospitals; indeed, the State hospitals far outnumber the voluntary bodies. Yet most citizens of these two countries think in terms of voluntary institutions. The voluntary principle has taken deep root in the fibres of the nation. That is a fact to be reckoned with in considering hospital policy. The two conceptions of hospital policy now under discussion are typical of these two views of hospital work — the Continental and the Anglo-Saxon. The policy of the Labour party is conceived in State action by ownership, finance, and control from the centre. The policy of the British Medical Association is conceived as the development of existing practice in which — whilst there is State action in fields in which the State can best be employed — there is local, independent, and voluntary action in that part which comes closest to the daily life of the people. The policy of the Labour party is in this respect revolutionary; the policy of the British Medical Association is evolutionary. The policy of the Labour party has found little support amongst doctors, for we are so saturated with the triumph of evolution in physical and mental development, both in the individual and the race, that revolutionary methods have no charms for us. The Labour Policy. The policy of the Labour party is embodied in the following thirteen propositions : 1. The Labour party, recognizing the importance of health to the individual and national well-being, considers that all hospitals, both general and special, together with allied institutions, should be so organized under one authority as to form the foundation of a complete hospital system for the nation with sufficient accommodation to deal with all cases requiring institutional treatment. 2. It would establish treatment centres in outlying districts, local or cottage hospitals in the smaller towns, one or more county hospitals conveniently situated in each public health area, and national hospitals in London and Edinburgh and other university towns. 3. It would organize intimate co-operation between all the hospitals in each public health area and also between them and the nearest national hospital. It would make arrangements for easy and rapid transference of patients from one hospital to another according to the nature and requirements of the case. 4. It would organize intimate co-operation between the medical staffs of the various hospitals, and also between them and general practitioners, making the participation of the latter an essential feature of the hospital scheme. 5. It would provide the Health Authority with sufficient beds under their own control to deal with all patients for whom they have already undertaken the responsibility. (Patients suffering from tuberculosis or venereal diseases, children from the school clinics, mothers and infants from the maternity and child-welfare centres, and adults from the National Health Insurance Schemes.) 6. It would introduce the necessary legislation for the transference of the Poor Law Institutions from the Guardians of the Poor to the Local Health Authorities, thus placing at their disposal many beds now vacant. It would remodel these infirmaries, where necessary, equipping and conducting them in every way on the lines of the best existing general hospitals. 7. It would give voluntary hospitals the option of being taken over by the Health Authorities entirely, or of receiving grants from public funds conditional on efficiency. The Local Health Authority should be represented on the Boards of Management, and, though remaining on an entirely voluntary basis, such hospitals should work in co-operation with the public hospital. 8. It would relieve pressure on hospital beds in the cities and towns by acquiring convalescent homes in the country, into which should be admitted cases of threatened breakdown and patients no longer requiring hospital treatment, but not sufficiently recovered to return home. 9. It would establish free dental clinics connected with all hospitals, believing that supervision and treatment of the teeth are essential to health. 10. It would also arrange a scheme for visiting nurses and home helps in connexion with the hospital system, and lays special stress on the importance of the skilled supervision and after-care of patients who have recovered or partially recovered from an illness. 1 The Labour Movement and the Hospital Crisis.
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