Eleventh report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee E and appendices, session 1950-1951: regional hospital boards and hospital management committees.
- Great Britain. Parliament. House of Commons. Select Committee on Estimates
- Date:
- [1951]
Licence: Public Domain Mark
Credit: Eleventh report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee E and appendices, session 1950-1951: regional hospital boards and hospital management committees. Source: Wellcome Collection.
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![25 January, 1951.] [Continued. as have come to the notice of the British Medical Association, it might help us at a later stage?—(Professor Hartfall.) 1 can quote one example. If I wanta splint for a patient at one hospital the request has to go through the supplies department of that hospital to the supplies department of the other hospital. I cannot get a splint for a patient inside three weeks ; it took two or three days before. I suggest that is an example of waste, and the patient is also occupying a bed. Chairman. 260. | wanted to ask some questions on this matter of the grouping of hospitals, and i think that really comes most conveniently now. On the subject of grouping, first of all I think the general tenor of the memo- randum is to suggest that the present group- ing is not satisfactory. I am not certain that you go to the length of objecting to large scale grouping on principle. Could you say something on that subject?—(Dr. Rowland Hill.) We feel it is an aspect of the Service which would repay a careful enquiry. We think some of the groupings are bad. We even think that in some parts of the country the principle of grouping at all is bad and unnecessary. There is no doubt that in various parts of the country hospitals widely separate from one another with no natural connections have been grouped together under a common com- mittee management, and we have had evidence of waste, delays and inefficiency for that reason. One example was quoted here of the long time which certain repair jobs have taken because they have to be dealt with at the centre of the group twenty- five miles away. We think the principle of grouping hospitals, as well as their teaching application, in various parts of the country should be really sympathetically enquired into. 261. Could that be done without any very serious disturbance of the Service from your could be done without any disturbance to our work. 262. Would you state any principles which you think should be applied in con- sidering re-grouping?—-Yes. Dealing with a typical district hospital, if that district hospital appears to be self-contained and the sole hospital to do the work in the area it serves, if the drainage area around that hospital is all natural into that single hospital and it is a hospital of some size, it might well be better that that hospital should be independently managed on its own and not artificially grouped with some hospital and district with which it has no natural connection a good many miles away. It might be better, in other words, to have more management committees in the country rather than to have the principle of marrying hospitals together where there is no natural reason for them being married together. 263. That would lead to some duplication of administrative staffs, would it not?— Yes, but that might well be sma!] in each case, with less headquarters staff. The curious position which can be seen in many hospital groupings to-day is this. You take two big hospitals five miles apart, and you decide to put them under one manage- ment committee. That management com- mittee needs headquarter offices for its operation, and a group secretary. In many groups throughout the country that group secretary is in his office, and is no longer the secretary of either of the hospitals. 264. He is a mere bureaucrat ?—The Minister in one of his original circulars referred to the fact that the group secretary might with advantage be the secretary of one of the hospitals, but in practice in many parts of the country it has proved impossible and the group secretary is a centrally placed bureaucrat. One feels that if that grouping was split and each hospital acted alone, you could do without the group secretary, group headquarters, group staff and all its expenditure. 265. I am rather leading you off the boundary from what is in order, but I think it is necessary to clear up the matter. - I suppose you do have substantially less grouping in the rural _ districts. The question I wanted to put to you was this: how would that affect the doctor’s ability to find a suitable bed for a patient?— (Professor Hartfall.) 1 do not think it would be affected at all. The number of beds would not be affected. The occupancy of the beds would not be affected, and the same opportunities for admission or other- wise would exist whether there was a joint hospital arrangement or an individual one. Before the Act came into force hospitals frequently did utilise one another’s services in this way without there being any joint management machinery to direct it. In the old days local authority hospitals had a statutory obligation to take patients, which, as far as I know, does not exist to-day. The arrangement was one which worked perfectly. If there was a bed available and a bed was needed it was found. As a matter of fact it was found very often through the hospital bed bureau, which was a voluntary organisation set up by local voluntary fund collecting agencies. Our argument really comes down to this: if you consider the set-up now the regional hospital board with all its officers is some- thing which has been brought into existence and it is working, shall I put it this way, without necessarily increasing in any way the number of beds or the number of patients and so on. It is a new organisa- tion, and the staff is, I was going to say, additional.](https://iiif.wellcomecollection.org/image/b32182478_0065.jp2/full/800%2C/0/default.jpg)
