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75
In connection with the admission and treatment of these " other infectious diseases " I would
draw your attention to the great disability under which the hospital labours in consequence of the
want of small ward accommodation. The infectious part of the hospital, as you are aware, consists
of Blocks D, E and H, which, with the exception of the last, are large wards, obviously unsuited for
these " other infectious diseases " which are admitted, so far, in small numbers at a time. H Block,
which consists of one medium ward and three smaller wards, is the only block at all suitable, but for
over six months of the year it is full of Scarlet Fever patients. For that period at least there is no
small ward accommodation, and there is, of course, none in the non-infectious blocks of the hospital.
Should, therefore, one of these " other infectious diseases " break out in hospital, as it frequently
does a day or two after the patient's admission to hospital for an entirely different complaint,
or should a case (of measles, say) be sent in for urgent reasons by the Health Department, the exact
nature of the awkward predicament your medical staff are faced with will readily be appreciated.
Small ward accommodation has to be found and at short notice. Most often this is accomplished by
emptying a small ward and rapidly disinfecting it. To that way out of the difficulty there is grave
objection, for it not only means moving the patients displaced into another ward already full, but it
means a large amount of needless work to an already overworked staff. Even when the hospital was
purely an isolation hospital there was a shortage of small wards, and that is increasingly felt now
that a more varied class of infectious disease is admitted. For the above reasons I am of opinion
small ward accommodation is urgently needed, and that it should be provided here to the extent of at
least 10% of the infectious accommodation.
Coexistent Disease.
Instances where more than one infectious disease was coexistent in the same patient were
admitted as follows Scarlet Fever and Diphtheria, 4 cases; Scarlet Fever and Measles, 1 case.
Wrong Diagnoses.
By reference to Table No. 77 it will be seen that 76 patients were admitted who subsequently
proved to be suffering from some other condition than the infectious ailment for which they were
certified. All these cases proved to be non-infectious; they have, therefore, been included in the
tables dealing with General Diseases in the latter part of this Report.
Non-Infectious Cases.
By reference to Table No. 71 it will be noticed that 980 patients suffering from ailments of a
general character were admitted. The experience already gained suggests that the number of these
cases diminishes during the summer months, as compared with the autumn and winter months. This
is unfortunate, for it is just at the latter periods that the prevalence of infectious disease is at its
greatest. Could it be arranged that these general ailments and infectious diseases were most prevalent
at different seasons it is possible that this hospital would not have been in the dire straits to which
it was put in its endeavour to find accommodation for the patients, but, of course, that is impossible.
Here, 1 would submit, is another reason, in addition to the lack of small ward accommodation already
referred to, why the question of the hospital extension urgently calls for youf consideration. Towards
the end of the year it was possible to accommodate all the patients only by crowding every ward to
an extent that possibly might not be considered wise. It is to be remembered, too, that your hospital
is probably unique in its arrangement, and that since it was made a Municipal Hospital it has done
unique and excellent work, though, it has to be admitted, at the cost of putting a great strain and
responsibility on your hospital staff. When a ward is full and cubic space is diminished it does not
matter whether it is a general or an infectious ward, it is well known that the patients are prone to
catch anything of the nature of infection that may be introduced into the ward. So far no infection
has spread through the wards, and as long as that is so no question as to the efficiency or general
arrangement of the hospital will be raised, but, if it were to do so, the whole record of the hospital
must suffer. I cannot help feeling that it was more by good luck than anything else that the hospital
got through the end of the year without any untoward event happening. It was not to be thought
from what has been said that the arrangement whereby infectious and general ailments are treated in
the same hospital is impracticable. Far from it; it is a perfectly safe and reasonable arrangement,
but only where adequate accommodation is provided and efficient supervision is maintained.
Table No. 71 sets out clearly the number of patients admitted each month, and the number
which died. Tables Nos. 78, 79, 80 and 81 show the diseases from which these patients suffered as well
as the causes of death.
Children.
Amongst children under 5 years and of school age the diseases mentioned are varied in character.
Apart from enlarged tonsils and adenoids, diseases of a septic nature are perhaps the most common,
and these include such ailments as Tonsillitis, Middle Ear Disease, Septic Wounds, Abscesses in various
situations, as well as Impetigo and Rashes of septic origin from Septic Tonsillitis. With regard to
the cases of Enlarged Tonsils and Adenoids admitted for operation, these, almost without exception,
were urgent cases requiring treatment. Taking into consideration the number operated on (115), it
is difficult to see how they could have received the necessary treatment had there been no Municipal