There is only one small room available for second class patients; the number ought to be increased, as frequently patients have to be placed in the first class wards, owing to want of accommodation.
I would suggest that the first-class wards be made more comfortable and private, and that a first or second class should be provided for females. At present there is no accommodation for women able to pay for admission.
The public mortuary ought not to be situated within the precincts of the hospital, neither should Coroner's inquests be held at the hospital. Both are a source of much inconvenience and discomfort to the Staff and patients, and their speedy removal is greatly to be desired. After the typhoon of October last, owing to the accumulation of dead bodies in the mortuary, the smell was most offensive and could be distinctly perceived throughout the hospital.
The present system of sending the bedding, &c., to the Gaol to be washed, is much to be deprecated, as there must always be a certain risk of contagion being conveyed to the inmates of that establishment. A wash house and disinfecting room are urgently required, and a site found for them within the hospital grounds.
Considerable inconvenience is caused by the want of efficient control over the egress from and ingress to the hospital. The servants can go out and in at their pleasure, strangers can enter at any time without being observed, and it is a wonder that none of the stores have been stolen. The remedy for this is to erect a gate and a lodge for the gatekeeper at the entrance from the Queen's Road.
The placing of the quarters of the Staff in the main building is decidedly objectionable; it renders them liable to the extreme annoyance and inconvenience of being disturbed at all hours by delirious patients and those suffering from great pain or by the arrival of some accident. On the other hand, the patients are liable to be disturbed by the occupants of the quarters, as it is impossible to expect that any man in his own rooms is constantly to be remembering that he is practically in a sick room, and that the slightest noise is to be avoided. It would therefore be advisable to erect a separate building within the hospital enclosure for the use of the Staff.
The present Superintendent's quarters would give all the extra wards above alluded to.
The Staff, so far as numbers are concerned, is ample. However, the great number of the men employed as nurses are of a low class and not reliable. This is in some measure due to the manner in which they are entered, but more on account of the nature of the duties and the way in which they are paid. A man on being taken on as nurse draws the same amount of pay as another man who has served in that capacity for ten years. This ought not to be. It is strongly recommended that they should be divided into three classes and that promotion from a lower into a higher grade be made dependent on efficiency, good conduct and length of service. The pay of the third class might remain as at present, viz.: $8 per month, the second to be $9, and the first $10. There can be little doubt but that such a method would in the first instance secure better men, and, what is of more importance, after they have been trained, tend to retain them.
The dry earth closets in use in the lower building seem to answer fairly well; however, the self-acting kind should be substituted for the present ones, as it is difficult to get the patients to make use of the earth in a proper manner. These closets ought to be emptied at least twice in the twenty-four hours. Great care should be taken to prevent the utilising of this fecal matter as a manure seeing it is frequently liable to be infected with the specific germs of disease. It would be advisable either to have it burned or buried at a considerable depth with quick lime.
Tables have been provided for each ward, so that patients are now able to take their meals in comfort. New filters are being provided for each ward as well as for the kitchens. They are designed by Mr. MCCALLUM and are much superior to those ordinarily in use.
The admissions during the year were:-
Police, 198
Board of Trade, 117
Private Paying, 193
Government Servants, 67
Police Cases, 139
Destitutes, 222
Total Admissions, 1,236
This shows an increase of 181, compared with last year, and is the greatest number admitted in any one year during the last decade, except 1878, when the number was 1,289.
Very few Chinese private paying patients sought admission. This may be that they do not yet appreciate western scientific medical treatment, but it is very probable that the fees charged have more to do with it. The lowest charge for a patient of this class is $1 a day which is a considerable sum for an ordinary Chinaman to pay, and very likely acts as an effective preventative to their seeking ad-
There is only one small room available for second class patients; the number ought to be in- creased, as frequently patients have to be placed in the first class wards, owing to want of accommoda- tion.
I would suggest that the first-class wards be made more comfortable and private, and that a first or second class should be provided for females. At present there is no accommodation for women able to pay for admission.
The public mortuary ought not to be situated within the precints of the hospital, neither should Coroner's inquests be held at the hospital. Both are a source of much inconvenience and discomfort to the Staff and patients, and their speedy removal is greatly to be desired. After the typhoon of October last, owing to the accumulation of dead bodies in the mortuary, the smell was most offensive and could be distinctly perceived throughout the hospital.
The present system of sending the bedding, &c., to the Gaol to be washed, is much to be depre- cated, as there must always be a certain risk of contagion being conveyed to the inmates of that esta- blishment. A wash house and disinfecting room are urgently required, and a site found for them within the hospital grounds.
Considerable inconvenience is caused by the want of efficient control over the egress from and ingress to the hospital. The servants can go out and in at their pleasure, strangers can enter at any time without being observed, and it is a wonder that none of the stores have been stolen. The remedy for this is to erect a gate and a lodge for the gatekeeper at the entrance from the Queen's Road.
The placing of the quarters of the Staff in the main building is decidedly objectionable; it renders them liable to the extreme annoyance and inconvenience of being disturbed at all hours by delirious patients and those suffering from great pain or by the arrival of some accident. On the other hand, the patients are liable to be disturbed by the occupants of the quarters, as it is impossible to expect that any man in his own rooms is constantly to be remembering that he is practically in a sick room, and that the slightest noise is to be avoided. It would therefore be advisable to erect a separate building within the hospital enclosure for the use of the Staff.
The present Superintendent's quarters would give all the extra wards above alluded to.
may
The Staff, so far as numbers are concerned, is ample. However, the great number of the men, employed as nurses, are of a low class and not reliable. This is in some measure due to the manner in which they are entered, but more on account of the nature of the duties and the way in which they are paid. A man on being taken on as nurse, draws the same amount of pay as another man who have served in that capacity for ten years. This ought not to be. It is strongly recommended that they should be divided into three classes and that promotion from a lower into a higher grade be made dependent on efficiency, good conduct and length of service. The pay of the third class might remain as at present, viz.: $8 per month, the second to be $9, and the first $10. There can be little doubt. but that such a method would in the first instance secure better men, and, what is of more importance, after they have been trained, tend to retain them.
The dry earth closets in use in the lower building seem to answer fairly well; however, the self- acting kind should be substituted for the present ones, as it is difficult to get the patients to make use of the earth in a proper manner. These closets ought to be emptied, at least twice in the twenty-four Great care should be taken to prevent the utilising of this fecal matter as a manure seeing it is frequently liable to be infected with the specific germs of disease. It would be advisable either to have it burned or buried at a considerable depth with quick lime.
hours.
Tables have been provided for each ward, so that patients are now able to take their meals in comfort. New filters are being provided for each ward as well as for the kitchens. They are designed by Mr. MCCALLUM and are much superior to those ordinarily in use.
The admissions during the year were:-
Police,
Board of Trade,
Private Paying,
Government Servants.....
Police Cases,... Destitutes,
Total Admissions,..
198
117
193
67
139
222
1.236
This shows an increase of 181, compared with last year, and is the greatest number admitted in any one year during the last decade, except 1878, when the number was 1,289.
Very few Chinese private paying patients sought admission. This may be that they do not yet appreciate western scientific medical treatment, but it is very probable that the fees charged have more to do with it. The lowest charge for a patient of this class is $1 a day which is a considerable rum for an ordinary Chinaman to pay, and very likely acts as an effective preventative to their seeking ad-
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