Report of the sub-committee appointed to consider the means by which the abuses of the Out-Patient Department of General Hospitals may best be remedied / [A. Meadows and others.

Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Report of the sub-committee appointed to consider the means by which the abuses of the Out-Patient Department of General Hospitals may best be remedied / [A. Meadows and others. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    in almost every dwelling. He must also write out in full his prescription, so that it may be clearly understood. The Sub- committee are therefore of opinion that the teaching power of the out-patient department would be very largely increased if students of three years’ standing were required to attend for six months as assistants at a Provident or Poor Law Dis- pensary, and they think that some provision might be made by which serious and interesting cases admitted to these in- stitutions shall through their instrumentality be transferred to the hospital for special treatment and clinical illustration. By such an arrangement the consulting staff of hospitals would at all times be able to secure the attendance at the hospital of a series of cases illustrating special diseases, and by this means also carry out and test special modes of treatment, whilst, as in Edinburgh, the affiliation of such dispensaries to hospitals would always secure the prompt admission of acute diseases, and of cases requiring the peculiar resources of the hospital. It is believed that an ample field of useful and interesting observation would always be secured to the out-patient staff, without the possibility of abuse, and they therefore think that the out-patient department ought to be recognised for purposes of special clinical teaching in the same way as the in-patient department is already. It will be seen that the Sub-committee propose that the admission of out-patients to general hospitals shall, as a rule, be made through the Provident and Poor Law Dispensaries, and it is believed that the proposal would confer the greatest advantage on the sick poor, who would thus be secured the best professional advice whenever it was really needed. But as it is obvious that such an important change could not be carried out at once, and that there will always remain a certain number of patients who require prompt assistance for accidents, injuries, and sudden attacks of disease,your Sub-committee are of opinion that the duty of instituting inquiries into the social position and resources of all patients not admitted as proposed should be confided to the secretary or other lay officer of the hospital. Without desiring to lay down for the guidance of this officer any absolute condition of admission to the hospital, the Sub-com- mittee recommend that such an officer should be authorised to require particulars as to the income, occupation, and rent paid by the applicant; and also a certificate from the agent of the Sub- committee for organising charity, if such exists, or, in default, from a governor of the hospital, a clergyman or medical man residing in the neighbourhood. This certificate ought to state that the applicant cannot afford to pay for medical advice ; and it should further be required that no subscriber to a hospital