Second report from the Select Committee of the House of Lords on Metropolitan Hospitals, &c. : together with the Proceedings of the Committee, minutes of evidence, and appendix / Ordered, by the House of Commons, to be printed, 5 August 1891.
- House of Lords
- Date:
- 1891
Licence: Public Domain Mark
Credit: Second report from the Select Committee of the House of Lords on Metropolitan Hospitals, &c. : together with the Proceedings of the Committee, minutes of evidence, and appendix / Ordered, by the House of Commons, to be printed, 5 August 1891. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
28/956 (page 10)
![26 January 1891.] Mr. Lushington. [ Continued. Earl Cathcart—continued, class surgeon, and pay his fees, then the senior surgeon of the week at Guy’s will come in and perform the operation for nothing. 9930. And you think there is no danger of these paying patients running away with the attention that ought to be devoted to the poorer patients?—Certainly not. They are kept in a separate ward by themselves ; they have a separate staff, a separate cook, and a sister in charge, and so on. Then, also, we have in the general wards what we call guinea beds, and the patients who occupy those beds are treated in precisely the same way as if they were free patients. 9931. And you think there is no tendency that those guinea patients should run away with the attention that ought to be devoted to the poorer patients?—No, it is rather the other way ; we generally find these guinea patients’ beds filled up with free patients. 9932. Do you find the guinea patients dis- contented, and more apt to complain than the poorer patients ?—No, I do not think so. 9933. The guinea does not really defray the expense of the patient?—No, hut it covers a certain amount. 9934. Did the idea ever occur to you of a co- operation for the supply of drugs to the different hospitals ; 1 believe that some such system exists in Paris; did you ever hear of it?—No, 1 can- not say that I did. 9935. Would any such system be likely to work well, in your judgment ?—I am afraid it would not work well. 9936. My opinion does not quite agree with yours on one point; my experience teaches me that if I were in your position I should, myself, go and see the bread and meat that comes in, and certainly I should make the steward go and see it ?—I can only say about the bread, that I eat it every day myself; with regard to the meat, I could not promise to see it every day ; it arrives early in the morning. 9937. In your {position, I think I should get up sometimes even early in the morning to be there when it came ; but 1 should certainly make the steward go to see it. My experience tells me that such supervision is of the greatest advan- tage in the Army. When I was adjutant of a regiment, my colonel used to come every morning to see the meat, and it was attended with the greatest advantage. Do you know that there are complaints in the London hospitals about the supply of meat?—Yes, I do. 9938. That the meat is of inferior quality ?— Yes ; I have heard that stated. 9939- Have you got a college club in con- nection with your college ?—Yes. 9940. And it works well?—-Yes, very well. 9941. Is it on the same principle as the club in the London Hospital ?— I am not acquainted with the club in the London Hospital ; but ours works very well. 9942. Now, with regard to the power of dis- missal of a nurse which is confided to the matron ; that malron is brought into contact with that nurse, and there might be a case where the matron might lose her temper ; in a case of that sort, would it not be desirable that there should be somebody who was not brought into contact Earl Cathcart—continued, with the nurse who might adjudicate upon the case with an even mind?—It might be so ; but, at the same time, I feel that our matron is a very just woman, and I think she would be very sorry that her temper should lead her to do any in- justice to another woman; she would rather lean the other way. 9943. But still, from an abstract point of view, leaving your own matron out of the question, you would admit that it would be better, where people are brought into contact, and there might be temper, that there should be some person of an even mind to adjudicate ?—In the abstract, I do not deny that. Earl of Arran. 9944. I think you said that, if there were any changes necessary in the nurses, they first came before the taking-in committee ?—Yes. 9945. And then were referred to the court of committees ?—Yes. 9946. If a long period elapsed between the meeting of the taking-in committee and the court of committees, how would any changes which were necessary to be made be dealt with?—I should deal with them myself, if 1 thought it advisable, and mention it to the taking-in com- mittee ; if orders should issue at once, I have issued them. 9947. If your funds allowed it, would you easily fill up the 100 beds which you now say are vacant for want of funds ?— I should think there would be no doubt about that. 9948. There is a greater need for accommoda- tion than there is accommodation existing ?—It is so ; we have constantly to send patients out of the hospital, besides sending them away occa- sionally when we should have been glad to have kept them in until their convalescence became well assured. 9949. If patients apply for admission and you cannot admit them, what becomes of them? — We send them to St. Thomas’s very often. 9950. What would be the proportion of guinea patients to non-paying patients ?—Something very small. We have altogether 17 or 18 wards, and I think somewhere about 20 beds of guinea patients. Earl Cathcart. 9951. Is there an absolute limit to the. guinea patients? — There is an absolute limit. Earl of Arran. 9952. Is it a percentage ; can you only take so many, or would that depend upon the number of free patients in at the time ?—N o, it is a fixed limit. 9953. What is the limit?—It rather depends upon the size of the ward. We will say that in this ward we may keep four beds, in that ward two, and so on. 9954. I understand that there are about 500 beds altogether; how many of those 500 could you say are for paying patients. What is the limit of paying patients?—I think 19 to 20. 9955. Altogether ? —Yes, not more. Lord Zouclie of Haryngworth. 9956. 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