XN000022-1986-10-15 — Page 40

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WEDNESDAY, OCTOBER 15, 1986

HE SAID THE ESTABLISHMENT OF A HOSPITAL AUTHORITY COULD COST A VERY LARGE SUM OF MONEY, AND BEFORE A DECISION TO GO AHEAD WAS TAKEN, IT WAS NEEDED TO CONSIDER VERY CAREFULLY WHETHER THIS WAS THE BEST COURSE OF ACTION, OR WHETHER SOME OTHER MEANS OF IMPROVING THE SERVICE WOULD BE MORE COST-EFFECTIVE.

APART FROM THE MAJOR RECOMMENDATION ON A HOSPITAL AUTHORITY, HE ADDED, THE REPORT CONTAINED A LARGE NUMBER OF MORE SPECIFIC PRACTICAL PROPOSALS FOR IMPROVING THE HOSPITAL SYSTEM, IN SUCH AREAS AS INTERNAL HOSPITAL ORGANISATION, REDUCING OVERCROWDING, THE WORKING ENVIRONMENT AND COST CONTROL.

IN GENERAL THESE WERE LESS CONTROVRSI AL, MR CHAMBERS SAID, ADDING THAT IN FACT SOME OF THE RECOMMENDATIONS WERE ALREADY BEING IMPLEMENTED IN SOME HOSPITALS, AND MANY OF THEM COULD BE IMPLEMENTED WITHOUT WAITING FOR A DÉCISION ON THE SETTING UP OF A HOSPITAL AUTHORITY.

ONE SUCH PROPOSAL WAS THAT A CHARGE SHOULD BE MADE FOR ATTENDANCE AT ACCIDENT AND EMERGENCY DEPARTMENTS, IN ORDER TO DETER ABUSE OF THESE SERVICES, HE SAID.

WHILE PROFESSIONAL BODIES IN GENERAL DID NOT OBJECT TO THIS, OTHERS, INCLUDING DISTRICT BOARDS AND COMMUNITY GROUPS, HAVE POINTED OUT THAT SUCH CHARGES WERE NOT LIKELY TO BE EFFECTIVE IN DETERRING INAPPROPRIATE USE OF SUCH SERVICES IF THERE WAS ANY ABUSE, THIS WAS DUE TO THE LACK OF ADEQUATE OUT-PATIENT CLINIC FACILITIES, PARTICULARLY IN THE LATE EVENING.

+THIS IS SOMETHING WE SHALL NEED TO LOOK AT AGAIN VERY CAREFULLY, HE SAID.

MR CHAMBERS SAID SOME MEMBERS SUPPORTED THE RECOMMENDATION OF PROVIDING THE SO-CALLED +B-CLASS+ BEDS TO CATER FOR THE NEEDS OF THE MIDDLE INCOME GROUP,

+SEVERAL MEMBERS CAUTIONED, HOWEVER, THAT THE PROVISION OF HIGHER CLASS ACCOMMODATION OF THIS KIND MUST NOT BE AT THE EXPENSE OF PROVISION FOR GENERAL WARDS.+

SUBJECT TO THIS RESERVATION, MR CHAMBERS SAID, THIS RECOMMENDATION HAD GENERAL SUPPORT AND ONE SUBVENTED HOSPITAL HAD ALREADY TOLD HIM OF ITS WILLINGNESS TO SERVE AS A VENUE FOR A PILOT PROJECT AS RECOMMENDED BY CONSULTANTS.

HE SAID THE PROPOSAL TO ALLOW CONSULTANTS WORKING IN PUBLIC HOSPITALS TO HAVE LIMITED RIGHTS OF PRIVATE PRACTICE HAD AROUSED A GOOD DEAL OF OPPOSITION.

FEARS HAD BEEN EXPRESSED IN VARIOUS QUARTERS AND BY SEVERAL MEMBERS THAT THIS ARRANGEMENT COULD LEAD TO DISCRIMINATORY TREATMENT OF PATIENTS AND OTHER ABUSES.

/MR CHAMBERS

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