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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![1 February, 1951.] [Continued. impossible for hospitals to refuse admission to some of those cases, and it is the case today, in very marked contrast with the position before the war, that there are many more such chronic cases which can only be looked after in those beds. 388. Is there a financial side to this? I mean in this way: if in fact a certain per- centage of the occupants of hospital beds are not persons who, if there were other means of dealing with them, would be occupying hospital beds, are not the over- heads both in consultants and otherwise excessive per bed for that reason?—For that type of case, yes. Chairman. 389. Mr. Powell, I am very anxious that we should not go too far on the very ques- tion which has been put to the witness. What I think Doctor Hill has told us is that a fair number of beds in hospitals are occupied by patients who are properly ad- mitted but who for social and not for medical reasons cannot be discharged, and I do not think we can press him any fur- ther on that. There is, however, the other side to it, and that is the pressure on the out-patients’ department which may after all absorb some considerable proportion of the hospital’s means. Can you say some- thing about that being an undue pressure? —The out-patient pressure in many hos- pitals, though curiously enough not throughout the country, since the appointed day has been very great, much greater than before the war. It is undoubtedly a reflec- tion of the pressure in the surgery of the general practitioner. I am not criticising the general practitioner who is making the very best job he can of his difficult posi- tion today, but when he has very heavy pressure in his surgery he is forced to send to the hospital out-patients’ department many cases which he need not do if he had more time to spare, as he had before the war, before the appointed day; and pres- sure hjs become very great on many hospita/ out-patients’ departments. 39% Can you say from your knowledge what proportion of patients coming into the ordinary out-patients’ department of a general hospital ought not really to have gone there at all—fifty per cent. or what? —(Professor Hartfall.) I made a_ rough estimate of the percentage, and I should say twenty to twenty-five per cent. (Dr. Rowland Hill.) 1 should agree with that estimate. I think that would be right. 391. Of the out-patient facilities in the ordinary hospital, between one-fifth and a quarter are devoted to cases which ought not to have gone there. That is your view, and that is a fairly close estimate too?— Yes. Mr. Thomas Reid. 392. Why do they go to the out-patients’ department if there is nothing wrong with them?—(Professor Hartfall.) I do not. say there is nothing wrong with them, but I say they are such minor things that they could be dealt with by the general prac- titioner if he had time to examine them and make a diagnosis 393. You have no remedy for the over- worked general practitioner?—Except to get rid of the certificate signing which he has got to do. That would be the first answer. 394. Are not these certificates necessary? —They may be necessary, but they are not necessary to medicine. Mr. Turton. 395. Is there a home for the chronic sick in or near Leeds?—Yes. 396. Can you tell me what is the cost per patient per bed in that home, as compared with your own hospitals?—-No, I cannot. It is quite an exceptional home. It is in Harrogate in point of fact. Mr. Thomas Reid. 397. It is much less?—Yes. There are certain blocks of wards put aside in the big old municipal hospitals which still take the chronic sick cases, but the cost of running that service must be much less than running an acutely-ill hospital service. Mr. J. Enoch Powell. 398. Arising out of that, Doctor Hill re- referred to the suggestion of the Ministry of Health that 10 per cent. of the beds in general hospitals should be set aside for the chronic sick. If it were found, taking one month with another or one year with another, that a certain proportion of the hospital beds were, under present condi- tions, in any case occupied by persons not requiring full hospital treatment, could not economies be obtained by regarding that proportion of beds as in fact requiring a jlower establishment?—(Dr. Rowland Hill.) The point is that these cases are in the same wards where the acute cases are, and you could not reduce your staff. Chairman. 399. J think that is not a question for the doctor really. I think it is a matter really for the general administration of a hospital. A doctor can answer whether it saves their time, having these half-cured patients, but that is as far as they can go? —One certainly cannot reduce one’s medical staff because some patients in a ward are chronic cases not requiring much treatment. Mr. J. Enoch Powell. 400. It is only if you could put them in a separate ward that you could obtain such economy?—If in a large municipal hospital](https://iiif.wellcomecollection.org/image/b32182478_0079.jp2/full/800%2C/0/default.jpg)
