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greater hardship is imposed on those nurses who are still on duty. I trust the Council will bear
these facts in mind and further that this hospital is always working short-handed and without the
full complement of nurses (58) that the Council some time ago decided was the number required.
Only 51 nurses can be housed at one time. There is therefore a permanent shortage of 7 nurses
and a proportionate overworking of the remaining 51, always supposing it was possible, which it
never has been, to have them all fit and on duty at one and the same time.
I have therefore again to draw your attention to the necessity for more staff accommodation
so that the proper complement of nurses can be engaged.
So far I have referred only to the shortage of nursing staff. Equally well might my statements
in that connection be applied to the case of the medical staff. Only two resident medical
officers as you are aware hold office, a medical superintendent and one assistant. In other words,
although the hospital itself has increased in size, although its scope of work has enormously increased
in extent and importance, and although the admissions have more than trebled in the last 3 years,
the number of medical officers remains the same. No hospital that I can learn of can show such a
record as this, where with only 199 beds, 2,608 patients (be it noted infectious and non-infectious
cases) are admitted, and yet with only two resident medical officers. In order to be sure of this
fact, I have been at some pains to obtain figures from provincial fever hospitals comparable with
this as to the medical staff they employ. In one hospital with 250 beds, I learn that 2,152 cases
were admitted last year and that three medical officers are constantly in residence, whilst a fourth
is engaged in the stress of winter. In another of similar size, 2,132 patients were admitted and here
three medical officers are employed. In a third, in an extra-metropolitan district where the average
admissions for the last 10 years is 1,050, and where 1,732 cases were admitted last year, the local
authority consider that three medical officers are required. In addition to the fact that the admissions
to this hospital are nearly 500 in excess of the first mentioned hospital and nearly 1,000 more than
in the third, there is the fact that in this hospital half of the total number are non-infectious cases.
Now these cases are admitted for urgent treatment and because they are of such a nature that the
treatment cannot be carried out at home. A very different matter as compared with infectious
cases, a verv large proportion of which are of such a nature that they require very little medical
treatment at all. These figures I feel sure the Council will consider convincing and amply justifying
the appointment of another medical officer.
With two medical officers as at present and having regard to the number of urgent cases that
are being admitted it is not possible for them to get adequate relief. In order to accomplish the
work the Council expects them to perform they necessarily must be on duty seven days a week.
Should they be absent for a few hours, they must still keep in touch with the hospital. There is
no break from year end to year end save for annual leave. Were a third medical officer appointed,
reasonable off-duty time could be arranged which could not possibly fail to have a beneficial effect
on their health as well as to favourably affect the exacting work it is their constant duty to perform.
At the present moment there is some rumour of the estimates for the current year being reduced
by 20 per cent. It is to be hoped that this will not deter any member of the Council from approving
of the appointment of an assistant. A reduction to that extent may mean a reduction in the aggregate
admissions for the year, say from 2,600 to 2,000; it may mean that the wards instead of being overfull
as at present will only be fully occupied; it will mean, however, the selected cases (non-infectious)
requiring urgent treatment will only be admitted, the less serious remaining at home; but, it certainly
will not mean any reduction in the amount of medical treatment or of the possibility of closing any
of the wards.
I will now deal with the figures set out in the Statistical tables appended to this report.
The grand total of admissions as will be seen reaches the high figure of 2,608. Of these, 1,113
are of an infectious and 1,495 of a non-infectious character.
It is to be particularly noted that the infectious cases are unusually high, nothing approximating
the figure has ever been reached before. The highest previously was 979 in 1914. In 1919,
the number was 723. There is therefore an increase of just 400 cases in 1920. The actual increase
takes place amongst Scarlet fever and Diphtheria cases, there being an unusual prevalence of these
two diseases in the latter part of the year.
During the war years the incidence of these diseases was providentially low. It was well
recognised, however, that the comparatively empty state of the hospitals during that period would
not continue long, as it is common knowledge that the incidence of Scarlet Fever and of Diphtheria
is subject to quinquennial fluctuations and that a low incidence spread over a number of years is
followed almost invariably by years of increased prevalence. At the present time of writing, Scarlet
Fever, judging by the number of cases in hospital, is as prevalent as it was in mid-winter, though
Diphtheria cases show more definitely the seasonal drop in the incidence that is customary to expect
at this period of the year.
Of the 1,113 infectious cases, 445 suffered from Scarlet Fever. In 1919 there were 238.
,, ,, ,, 605 ,, Diphtheria. „ ,, 431.
,, „ ,, 63* ,, Other Infections. „ ,, 54.†
(* Including 8 Enteric Fever cases).
(† Including 2 Enteric Fever cases).