VICTORIA TWENTIETH REPORT OF THE ANNUAL REPORT FOR THE

Transcription

1 96869 VCTORA TWENTETH REPORT OF THE HOSPTALS AND CHARTES COMMSSON ANNUAL REPORT FOR THE YEAR ENDED 30TH JUNE, 968 PRESENTED TO BOTH HOUSES OF PARLAMENT PURSUANT TO THE HOSPTALS AND CHARTES ACT 958 (No. 67). Ordered by the Legislative Assembly to be printed, 5th December, 968. [Approrim<Jle Cool of Reporl.Preparatlon, not given. Printing (50 copieh) $,0.] No /68.[80 cents] By Authority. A. C. BROOKS, GOVERNMENT PRNTER, MELBOURNE.

2 The picture illustrates the new centre block at Dandenong and District Hospital. T his block is the first of three to be erected in the hospital's rebuilding programme.

3 CONTENTS GENERAL REPORT.. Page 5 A All A33 APPENDCES REGSTRATONS Subsidized nstitutions and Benevolent Societies Unsubsidized nstitutions and Benevolent Societies.. New, Alterations and Cancellations MANAGEMENT Presidents, Officers and Committee Meeting Dates.. A37 FNANCAL AND STATSTCAL HospitalsComparative nformation A Subsidized nstitutions and Benevolent Societies Maintenance ncome and Expenditure Key to Schedules Summary of ncome and Expenditure Capital ncome and Expenditure Maintenance Fund and Capital Accounts A5 A6 A8 A 5 General Statistics Maintenance ncome and Expenditure Hospitals Hospitals for the Aged Benevolent Homes.. Hostels for the Aged Children's Homes Foundling Homes and Refuges Rescue Homes (Female) Convalescent Homes Blind, Deaf and Dumb nstitutions Medical Dispensaries nstitutes for Maternal and nfant Welfare Philanthropic Organizations Nursing Schools Ambulance Services.. Nursing Societies Ladies' Benevolent Societies Bush Nursing Centres Church Relief Organizations A6 A8 A83 A8 A85 A88 A89 A90 A9 A9 A93 A9 A9 A95 A95 A96 A96 A96

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5 REPORT 30th June, 968. The Honourable the Minister of Health, Melbourne. SR, The Hospitals and Charities Commission has the honour to submit its twentieth Annual Report for the year ended 30th June, 968, including financial and statistical statements for the year, relating to subsidized institutions and benevolent societies on its register. MANTENANCE FNANCE. Gross expenditure of all subsidized institutions and societies was $97,99,055. The public hospital content of this was $80,379,805, towards which Government grants and payments through the Commission amounted to $37,090,7being 6 per cent. of total income. To these grants must be added Commonwealth Government contributions for hospital benefits and pharmaceutical benefits, amounting to 7 per cent. which raised the proportion of Government monies, Commonwealth and State, to more than 63 9 per cent. of income. With the additional income from increased patients' fees, amendment of the Motor Car Act and Government grants, hospitals, in cooperation with the Commission, were able to meet substantially increased costs arising principally from wage and salary movements and, at the same time, arrive at an overall balanced budgetin fact income exceeded expenditure by $58,706. However, hospitals were unable to reduce their indebtedness to banks and to creditors. The accumulated maintenance overdraft and outstanding creditors' accounts amounted to $9,888,303 at the end of the year. The daily average bed cost of public hospitals for the whole of the State was $9.35, an increase of $.3 since last year. The average cost of each outpatient attendance was $5.50 compared with $5. lo in the previous year. n cooperation with hospital and medical organizations, a publicity campaign to stimulate hospital and medical insurance was conducted during the year in the metropolitan area and many major country centres. The campaign is achieving substantial success inasmuch as movement is taking place of persons insured from lower tables to higher tablesthe depth of cover increasing appreciably ; the numbers insured are also showing an increase. At the same time, the Commission has been considering the implications of proposals for compulsory hospital benefits insurance of all the people, and has come to the conclusion that it will not be practicable to conduct a compulsory scheme within Victoria alone. Any such scheme must be considered on a national basis only. The Commission looks forward to giving evidence to the two Commonwealth committees on hospital benefit matters that will open hearings in this State during this year. n the meantime, representations are being made again to the Commonwealth Government to increase hospital benefits allowances, particularly in regard to pensioner patients and to provide additional assistance, capital and maintenance, for elderly people requiring accommodation and care.

6 6 CAPTAL EXPENDTURE. On capital works for all institutions, including construction of new buildings, additions, remodelling, and the supply of new equipment and furnishings, the Government contribution amounted to $,0,000. Some details of expenditure are Teaching hospitals (medical school projects) New hospitals Hospital additions, remodelling and miscellaneous works Furnishings and equipment, land and property purchases, vehicles $ 388,0,000,000 7,63,73 78,6 Other expenditure Hospitals for the aged Benevolent homes Ambulance services, children's homes, schools of nursing and miscellaneous institutions 0,70,89 95,793 8,93 75,,0,000 CARE OF THE AGED. The Commission is concerned at the shortage of accommodation for frail or infirm elderly people amounting to more than,500 beds. The cost of meeting this need is such that the Commission cannot at present make a significant impact on the need. Without substantial new money from Commonwealth or State Government sources, the position will worsen. The States continue to press the Commonwealth to contribute towards the costs of providing more accommodation and, if the Commonwealth Government should accede to these requests, the position would be alleviated. WORLD HEALTH ORGANZATON. As a result of the Chairman's appointment for a term as W.H.O. consultant to the Government of the Philippines, the W.H.O. decided to make use of Victoria as a training centre for hospital administrators selected from SouthEast Asia. Mr. Hui Jan Tsai of Taiwan, Republic of China, was selected as the first W.H.O. Fellow to undertake a study course in hospital administration in Australia, and was placed under the supervision of Dr. Lindell and the Commission in February, 968. Before Mr. Tsai completes his course, a second W.H.O. Fellow from the South Pacific Area will be attached to the Commission. The World Health Organization's action is a compliment not only to the Hospitals and Charities Commission, but also to the hospitals and health services of Victoria. AR AMBULANCE. The air ambulance service continued to developflying a total of 397,000 miles, and the desirability of reviewing the facilities, location, service and organization to meet the predictable needs of the future arose. The Commission is considering this and proposes to examine also the possible use of helicopters in the service. Later in 968, a trial use of helicopters will be arranged and an appreciation made. RECRUTMENT OF MEDCAL PRACTTONERS FROM OVERSEAS. The Commission again arranged to recruit medical practitioners from the United Kingdom to take up practices that had become vacant in country townsbringing to the number already obtained for this purpose. By 97, the increased graduations at our medical schools should obviate the necessity for undertaking special recruiting campaigns overseas to fill vacant country medical practices in Victoria.

7 7 Photograph shows the residents at lnala Village relaxing in the courtyard of the new residential block recently completed. This block has a number of selfcontained motel type units. BULDNG PROGRAMME. Many building works, major and minor, were completed ; others are progressing. Progress of Building Construction. Building works were essentially completed at the following institutions during the year. n some cases minor works are continuing. HOSPTALS. METROPOLTAN. Bethlehem (Caulfield) Caritas Christi Hospice (Kew) Royal Children's.. Royal Victorian Eye and Ear Royal Women's New car park New ward block, car park and roadways E.S. and A. Bankextensions New steam generators and associated building works ; toilet accommodationremodelling Conversion of laundry to linen exchange Specia/ General Alfred Altona Austin (Heidelberg) Box Hill.. Dandenong Fairfield.. Preston and N orthcote Theatres 8 and 9minor works ; Commercial Road frontagedevelopment Ward and toiletextensions New lift tower and lift ; new students' teaching block ; new elevated covered ways New emergency power generator New steam generator, piping, plant and associated building works Scholes blocknew bathroom New Xray film storage building

8 8 Royal Melbourne.. Sandringham Southern Memorial (Caulfield) St. Vincent's Fire servicesextensions ; main switchboardreplacement ; staff cafeteriaextensions ; new prosthetic laboratory; main lecture theatrealterations ; new medical clinic New room for Cancer nstitute New theatre wing and ward block Switchboardreplacement ; toilet facilitiesadditions ; balconiesconversion ; Gertrude Healy Wingair conditioning Glenelg (Hamilton) Mildura.. Mooroopna Wangaratta W arrnambool Base Ballarat Geelong General Apollo Bay Bairnsdale Ben all a Camperdown Casterton.. Castlemaine Central Gippsland (Traralgon) Cobram.. Coleraine Echuca nglewood Kerang Kilmore.. Korumburra Kyneton Maffra Mal don Morwell Ouyen Ovens (Beechworth) Port Fairy Robinvale Rochester Seymour Skipton.. South Gippsland (Foster) Southern Peninsula (Rosebud) Swan Hill Terang Warracknabeal Werribee.. Westernport (Kooweerup) West Gippsland (Warragul) William Angliss (Upper Ferntree Gully) Wodonga.. Wonthaggi COUNTRY. New central block Mechanical servicesextensions ; new animal house (pathology department) ; mortuary blockextensions ; workshopextensions ; temporary staff cafeteria ; toilet accommodationextensions ; casualty departmentremodelling Kitchenremodelling and extensions ; new mobile kitchen equipment ; theatre suiteair conditioning New kitchen equipment ; new medical officers' flats Ward 6remodelling; laundry machineryadditions New ward block New casualty department and offices ; laundry, stage extensions ; laundry machineryadditions ; new steam generator ; bulk storealterations Additions and remodelling New offices and outpatients' department General ward areaair conditioning New thermal fire alarm installation Repainting First and second floor wardsalterations New residence for Manager ; airconditioning equipmentreplacement Alterations and additions Services wingremodelling New ward block Patients' toiletsremodelling Kitchenroofing Nurses' quartersrenovations New access road and car park Liftrenovations Midwifery wards, offices and theatresalterations and additions ; new residence for Manager Maternity wardalterations New flat for Matron New residence and surgery ; patients' toiletsadditions Repainting and renovations Alterations and additions Fire serviceextensions Kitchenalterations and additions ; new residence for Manager Mechanical servicesalterations ; repainting, stage ; operating theatre and delivery roomair conditioning New medical consulting clinic New residence for Matron New ward block Water supply and fire servicealterations Engineer's residenceextensions ; fire serviceadditions ; connexion to town sewerage Manager's residenceextensions Ward blockextensions General repairs and repainting, stage ; mechanical servicesextensions Existing liftrenovations ; children's wingremodelling ; laundry equipmentadditions Midwifery wingalterations and additions Kitchenremodelling New residence for Manager ; new boiler house and mechanical services

9 9 The recently completed wing at Werribee District Hospital. The building is designed to match architecturally the original structure. Alexander (Castlemaine) Bendigo.. Cheltenham Green vale Mount Royal (Parkville) Queen Elizabeth (Ballarat).. HOSPTALS FOR THE AGED. New physiotherapy department and covered ways ; staff toiletsadditions ; external toiletsalterations New workshop block ; mechanical servicesextensions ; kitchenreplacement of floor ; Golden Oaks Village, stage New ward block ; nurses' home heatingextensions New laundry, store and mortuary Liftreplacement New day hospital ; laundry equipmentadditions ; new P.A.B.X. telephone system Gippsland (Bairnsdale) nala Village (Salvation Army) (South Black burn) Nazareth House (Ballarat).. Will H. Clay Nursing Home (M urrum been a) Association for the Blind Ballarat Home Carinya (Box Hill) Clifton Waters Village (Bairnsdale) Corowa Court (Mornington) Dimboola Aged Peoples' Home Eventide Homes for the Aged (Stawell) Eventide Lutheran Homes (Hamilton) Fairview Homes for the Aged (Warragul) Judge Book Memorial Village (Eitham) Lotus Lodge Hostel for the Aged (Rosebud) Lyndoch, Warrnambool St. Catherine's Home for the Aged (Wangaratta) Strathdon Elderly People's Centre (Forest Hill) Sunnyside House, Camperdown Woorayl Lodge (Leongatha) BENEVOLENT HOMES. Mechanical servicesalterations New wing for infirm and frail aged ; new apartments and married couples' units Minor alterations ; exterior painting Wardextensions HOSTELS FOR THE AGED. Mechanical servicesextensions Wards, staff quarters and toiletsextensions New cottages New eight flats New buildings ( Allambi ) Hostelextensions New cottages New eight flats ; fire servicesextensions New single unit flats New residential blocks to 5 New flats 6 to 5 ; hostel unit No. ; domestic laundryalterations New hostel New hostel New flats New flat No. 5

10 Ballarat Children's Home.. Ch:ringa (Greensborough).. Gordon Homes (Highett).. Melbourne Family Care Organization (Glen Waverley) Menzies Homes for Children (Frankston) Morning Star Boys' Home (Mornington) Nazareth Boys' House (Sebastpol).. Providence (Bacchus Marsh) St. Anthony's Home for Children (Kew) St. Augustine's Boys' Home (Geelong) St. Joseph's Home for Children (Surrey Hills) St. Vincent's Boys' Home (South Melbourne) St. Vincent de Paul's Children's Home (ncorporating St. Vincent de Paul's Girls' Orphanage) (South Melbourne) 0 CHLDREN'S HOMES. New administration block and roadways New residential unit and instruction block Accommodationrenovations and alterations Administration building and staff flatextensions Shower roomadditions; William Street propertyrenovations New gymnasium, workshop and garage New rumpus room ; minor alterations and additions New family units New space heating Family group home (South Valley Road)<:onversion of dwelling ; family group home (Alphrasia Street)alterations and additions Residence and dormitory No.!alterations nfirm blockalterations New cottage home Mandurah (Brighton) BerryStreet Babies' Home and Hospital (East Melbourne) Bethany Babies' Home (Geelong) Methodist Babies' Home (South Yarra) Presbyterian Babies' Home (Camberwell) St. Gabriel's Babies' Home (Balwyn) St. Joseph's Babies' Home (Broadmeadows) FOUNDLNG HOMES AND REFUGES. New boiler house, laundry and workshop Toddlers wingenclosure of verandah ; repainting Homeremodelling ; Matron's flatadditions New play room Extension and remodelling Administration and staff bedroomsalterations and additions Abbotsford ReEducation Home RESCUE HOMES (FEMALE). Alterations, maintenance and equipment Melbourne Convalescent Home for Women (Clayton) St. Mary's School for the Deaf (Portsea) Villa Madonna Home for the Blind (Prahran) CONY ALESCENT HOMES. New flat for Matron BLND, DEAF AND DUMB NSTTUTONS. Roofrenovations Fire fighting equipmentadditions NSTTUTES FOR MATERNAL AND NFANT WELFARE. Grey Sisters' Mother and Child Care Centre (Canterbury) Australian Jewish Welfare and Relief Society (South Yarra) Christian Service Centre (Box Hill).. Melbourne Jewish Philanthropic Society and the Montefiore Homes for the Aged (South Yarra) Spastic Children's Society of Victoria (Toorak) Melbourne Nursing Aide School (South Yarra) Royal District Nursing Service New office and store ; cottage renovations PHLANTHROPC ORGANZATONS AND SOCETES. New flats (St. Kilda) New home for elderly people New George Kraus wing New centre (Geelong) TRANNG SCHOOLS (NURSNG, &c.). Minor works NURSNG SERVCES AND SOCETES. Essendonnew centre

11 New maternity wing now under construction at St. Georges Hospital, Ke.v, which will provide additional accommodation for 36 patients. The planning is based on the double corridor principle of beds around a central service core. RADOLOGY DEPT. STAR NO. Z \] 0 BED WARD 0 0 STERLfZER t=q STERLE. STORE r PANTRY 3 BED WARD CORRDOR DAY ROOM MAN NURSERY PR EMS. ODD TREATMENT ARO lbed WARD 0 fjifaro BED WARD 0 LAB.OU DELVERY : FRST FLOOR PLAN a o 0' zo... PORCH 30' 0' so LABOUR LA&OUR DEUVERY 0 D N ClD

12 East Gippsland (Sale) Latrobe Valley District (Morwell) MidMurray District (Swan Hill) NorthEastern Victoria District (Wangaratta) Peninsula (Frankston) Victorian Civil (Melbourne) AMBULANCE SERVCES. Headquarters station and residencerepainting Moe station and residencerenovations Headquarters stationrenovations Wodonganew station and residence Pakenham Eastnew station and residence Ringwood stationsewerage works Contracts mentioned in previous reports which are still progressing. HOSPTALS. Special Mercy Public Melbourne) Royal Women's Maternity (East METROPOLTAN. New midwifery block New main block building, associated services and equipment General Alfred Prince Henry's New Monash University medical school, stage and 3 New clinical school ; new P.A.B.X. telephone system General Latrobe Valley COUNTRY. New hospital at Moe (Newborough) Wesley Court (vanhoe) HOSTELS FOR THE AGED. New flats The architect's perspective drawing shows the additional buildings to be erected at the Ararat and District Hospital. Construction commenced recently on the new administrative building and lift tower. New works commenced during the year and not yet complete. HOSPTALS. Special Queen Victoria Memorial Royal Children's Royal Women's METROPOLTAN. New University building project, stage ; paediatric departmentextensions ; special care wardalterations Children's hostelalterations New staff flats

13 General Alfred Austin (Heidelberg) Box Hill.. Footscray Royal Melbourne.. St. George's St. Vincent's Base Gippsland (Sale) Mildura.. Wangaratta Warrnambool Wimmera (Horsham) General Ararat Bacchus Marsh Cobram.. Corryong Dim boo la Echuca Franks ton Heath cote Heywood Ouyen Robinvale Swan Hill Terang Waranga (Rushworth) Woorayl (Leongatha) Alexander (Castlemaine) Grace McKellar (Geelong) Queen Elizabeth (Ballarat).. New medical store (Monash University medical school) 3 KZ blockadditions ; University buildingdiversion of services ; new doctors' call system ; pathology departmentextensions ; nurses' homerepairs to roof New link buildingmechanical and electrical services New resident medical staff quarters ; new aftercare ward block Medical students' quartersextensions New midwifery block New clinical teaching block COUNTRY. New R.M.O.'s flat Kitchenremodelling New fire alarm system New cafeteria and dining facilities New nurses' reception area New roadways and car park Ward wingtoilet extensions New ambulance entrance and store Repainting Mechanical servicesextensions Existing wardssubdivision XRay and radiology departmentextensions New residence for doctor ; new medical consulting clinic Ward blockextensions New dining/sitting room for geriatric patients New boiler house and mechanical services ; new electrical mains and switchboard New flat for R.M.O. Casualty departmentextensions New home for nurses New medical services wing HOSPTALS FOR THE AGED. Staff cafeteriaalterations New block for senile patients ; physiotherapy departmentadditions ; new hostel flats Ward S. southair conditioning Association for the BlindBrighton Home Will H. Clay Nursing Home (Murrumbeena) Condare Court (Burwood).. Dandenong and District Homes for Aged Dowell Court (vanhoe) Sunnyside House, Camperdown Swan Hill Old Folk's Home BENEVOLENT HOMES. New wing Existing buildingssundry alterations and additions HOSTELS FOR THE AGED. New hostel and flat units New flats 9, ll, and 3 ( Thuruna ) New home New central heating Homeextension project Antonian Children's Home (Richmond) Gordon Homes (Highett).. Kardina Children's Home (Salvation Army) (Geelong) Kilmany Park Farm Home for Boys (Sale) Nazareth Boys' House (Sebastpol).. St. Vincent's Boys' Home (South Melbourne) CHLDREN'S HOMES. Senior girls' sectionalterations Sundry renovations and additions New cottages New residence Connexion to town sewerage Dormitories and class roomsalterations

14 3 New casualty and outpatients department at Frankston Community Hospital under construction. will architecturally match the recently completed midwifery wing. The finished building BerryStreet Babies' Home and Hospital (East Melbourne) Presbyterian Babies' Home (Camberwell) Royal Victorian nstitute for the Blind (Prahran) St. Mary's School for the Deaf (Portsea) Villa Maria Home for the Blind (Prahran) Singleton MedicalWelfare Centre (ncorporated) (Collingwood) Caulfield Elderly Citizens' Association Spastic Children's Society of Victoria (Toorak) FOUNDLNG HOMES AND REFUGES. New fire alarm system Additional sanitary facilities and fitments BLND, DEAF AND DUMB NSTTUTONS. New craft and music rooms Roofrenovations ; repainting 3 High Street, Prahranminor works MEDCAL DSPENSARES. Physiotherapy departmentadditions PHLANTHROPC ORGANZATONS AND SOCETES. New fiats Additions(Pascoe Vale Centre) ; alterations and additions (005 Malvern Road) ; alterations and additions (Chelsea centre) Ballarat and District Nursing Society NURSNG SERVCES AND SOCETES. New headquarters Ballarat and District SouthWestern Victoria (Warrnambool) Victorian Civil (Melbourne) AMBULANCE SERVCES. Daylesfordnew station and residence Terangnew station and residence Broadmeadowsnew station

15 CARE OF THE AGED. During the year the stream of enquiries for placement of infirm patients increased very considerably over previous years. Many of these patients were referred by general practitioners, social agencies, police departments, or Commonwealth Department of Social Services. n practically every instance the patient needed medical and nursing care, and was unable to gain immediate admission to a hospital for the aged. He was not in a position to pay for private hospital care. Admission to private hospitals is not usually a satisfactory solution because few provide services such as diversional therapy and physiotherapy. Consequently the patient's physical condition deteriorates whilst he is awaiting admission to a hospital for the aged or benevolent home. Despite this, nearly 00 patients were assisted with this type of care. When practicable, patients in private hospitals are encouraged to attend day hospitals. More long stay beds are urgently needed. The Commission has under consideration several proposals to provide more accommodation of this nature, despite other demands on the capital funds available. During the year 56 extra beds were provided in the metropolitan area, and in the country. Church homes provided 79 additional infirm beds in the metropolitan area. Although domiciliary care services are very helpful in retaining old people in their own homes as long as possible, there must be much more rapid development of these services in support of increased bed accommodation. For such a programme additional financial assistance from the State and Commonwealth Governments and from the municipalities is needed. The total number of names of persons on waiting lists for special hospitals for the aged and benevolent homes at 30th June, 968, was Metropolitan Country Male Female Married Couples,36,ll 35, 3,37 6 Total,653 people. This total is slightly inflated by duplicate applications. Some patients make applications to more than one home. Most aged people now being admitted to special hospitals are infirm. The Commission's eleventh Geriatric Conference, held at Ormond Hall, was well attended, by an appreciative audience. The new Commission film Search for Security was shown for the first time. t was well received by many communities and depicts all the services that are currently available for the aged. Because of pressure of work it was not possible to inspect hostels for the aged as frequently as desirable. Nevertheless, 30 visits were made. There are now church and voluntary organizations conducting hostels for the aged and registered with the Commission, including four new ones accommodating 5 residents, established during the year Two hundred and six follow up visits were made to patients in private hospitals. n view of the rapidly changing nature of nursing and medical care given to elderly patients, the Commission approved the creation of a postbasic course for trained nurses which is in the planning stage at present. Regional council meetings in the metropolitan area has been well attended, particularly in the southeastern area. The annual Supervisors Course was successfully conducted again at Mayfield Centre. Old peoples organizations are now represented at country hospital regional council meetings when the business on hand relates to work among aged persons. Nursing staff establishments in special hospitals for the aged and benevolent homes at 30th June, 968 Fulltime Parttime Trained nurses (female).. Trained nurses (male).. 5 Registered nursing aides (female) 6 9 Registered nursing aides (male) 7 Student nursing aides (female) 339 Student nursing aides (male) Orderlies 7 Ward helps 75 3 Total,33 08

16 ACCOMMODATON AVALABLE FOR ELDERLY PEOPLE Housing Units. % Male. Female. Total. Turnover.. Hostel and nfirm Accommodation Male. Female. Total. nfirm ncluded. Turver Male. SubTotal. Female. Total. Day Hospital Attendances. Metropolitan. Benevolent Homes Church Organizations ,5 Voluntary Organizations Geriatric Units Day Hospital Attendances Total Metropolitan ,35, Country Benevolent Homes Church Organizations Voluntary Organizations Geriatric UnitsHospital Geriatric UnitsH. & C.C Day Hospital Attendances ,88,6 660,553, ,637,869,506,30 ' 865,07,937, , , ,086, , ,00 3, ,78, ,379 3,379t , Ul Total Country ,007 3 OVERALL TOTAL ,07,705, ,,993 3,7,05 3,06,86 7,93,8 9 3,86 60,35,563 6,567, lo,7o 0,930 6,309 People of pensionable age in Private Hospitals at 30th June, 968 (This included 5 beds in infirm sections of Church institutions registered as private hospitals). *% Turnover is the ratio of total admissions during the year to accommodation available. t ncluding Sheltered Workshops. Total 3,75.7

17 6 New radial block at Grace McKellar HouseGeelong, nearing completion. This building, based on the circular plan, is designed to house the frail aged patients. MEDCAL SERVCES. Resident Medical Officers. A total of 6 students sat for final examinations, and despite the increase, a shortage was evident in country areas. n 968, 50 students will sit for final examinations and, with the enforcement of the rotating residency scheme, a more efficient distribution of the successful candidates will be possible. General Medical Practitioners for Country Areas. Seven general practitioners and one specialist arrived from the United Kingdom to take up their duties. An additional general practitioner is expected to arrive in midoctober. Pathology Advisory Committee. This committee held regular meetings during the year. The Commission S most appreciative of the continued valuable assistance rendered by the Committee. Pathology and Radiology Trainees. One trainee in pathology and one trainee in radiology are expected to finish training in the coming year. These trainees will be accepted for appointment to base hospitals in their specialities. The total number under training in pathology is now seven, and in radiology, four. Pharmacy Students and Trainees. Nineteen pharmacy students and pharmacy trainees carried out their practical training in approved hospital pharmacies throughout Victoria. On the recommendation of the Victorian College of Pharmacy, the Commission granted scholarships for 968 to three first year pharmacy students. The Commission thanks the College for its assistance in recommending applicants for selection. Fellowships for Young Specialists. The Commission approved fellowship grants to eleven young medical specialists at the Alfred (), Royal Melbourne (), Royal Victorian Eye and Ear (), St. Vincent's (), Footscray (), Preston and Northcote (), Queen Victoria () and Prince Henry's (3) Hospitals. These fellowships are of great value to both the hospital concerned and the holders. The Atom in Medicine. The use of the atom is not new in medicine and industry and with the recent increase in the availability of materials produced in atomic reactors their uses have become wider in scope and application.

18 7 t is playing an expanding role in the treatments and diagnosis of numerous complaints with much success. Radiation from radio active isotopes is injected into a patient at the Royal Melbourne Hospital. The radiation enables vital body structures to be outlined with the aid of a magnascanner. This machine produces an impression of the area being investigated and from this impression faults and defects can be ascertained. Above :The magnascanner is set and the radioactive isotope is injected into the patient being investigated. Below :The impression of the patient's skull is printed out in various colours for examination. Air Ambulance Service. The emergency air ambulance service has now been absorbed into the daily routine atr ambulance service mentioned elsewhere in this Report. Handicapped Persons Coordinating Committee. This committee met regularly each month and made recommendations on problems presented to it by the Commission. 089/68.

19 8 The committee advises the Commission on problems peculiar to handicapped children and young adults, and recommends to the Commission ways and means to resolve these. n addition, the committee recommends means of coordinating the activities of all agencies concerned in this problem to avoid unnecessary duplication. t will establish and maintain a register of handicapped children under the age of years. Hospital Bed nformation Bureau. The Hospital Bed nformation Bureau, which opened on st September, 966, at the Victorian Civil Ambulance Service Control Centre, has functioned very successfully. Many appreciative letters and comments have been received from medical practitioners. The Bureau received 865 calls from medical practitioners and assisted in placing 70 public patients in the nine metropolitan hospitals involved during the year to 30th June, 968. Radiology Advisory Committee. This committee held regular meetings, at twomonthly intervals during the year. The Commission is most appreciative of the valuable assistance rendered by this committee in its advice to the Commission on the many and complex problems presented to it. State Disaster Plan. The Commission has taken an active part in exercises involving the Medical Division of the State Disaster Plan. ts Medical Officer was actively engaged in the bush fire disaster procedures in August of this year, and will participate in a further exercise envisaged in September next year. Further equipment for the mobile operating theatre has been provided and is held in store at St. Vincent's Hospital. HOSPTAL SERVCESRATONALZATON. Cardiology and Cardiac Surgery. The recommendations of this committee regarding open heart surgery'' are under consideration. Neurology and Neurosurgery. The final report was received on 3st May, 968. three meetings being held during this year. The committee had met nineteen times, The report has not yet been circulated. t is comprehensive, and is at present being studied by the Commission. Rehabilitation and Accident Services, including Orthopaedics. The committee met ten times. Significant information has been collated and pertinent subcommittee reports compiled. The aim is to complete the report within a few months. Management and Treatment of Renal Failure. The initial meeting was held on 3th March, 968. The committee met four times. Longterm requirements, including the number of centres required for renal units, are under consideration. MEDCAL, SURGCAL AND GENERAL EQUPMENT. Extensions and major remodelling were completed during the year at many institutions. Among the new areas equipped were the following : Alfred Hospital East block Royal Women's Hospital New main block (equipping in progress) Dandenong and District Hospital New block Bairnsdale District Hospital Administrative section.fairfield Hospital.. McLorinan block Southern Memorial Hospital Society New ward, operating theatres, central (Caulfield) sterilizing departments, &c. Cheltenham Home and Hospital for Two new ward blocks the Aged Southern Peninsula Hospital (Rosebud) New wards Werribee District Hospital.. New wards The Queen Elizabeth Home Day hospital, new ward and medical services Ballarat and District Base Hospital New casualty, central sterilizing and theatres Ballarat Children's Home Administrative section Lotus Lodge Hostel for the Aged Four residential units (Rosebud)

20 * OUYEN * HOPETOUN * NHLL * e WARRACKNABEAL * HORSHAM * ST. ARNAUD * STAWELL SHEPPARTON * * BENDGO Victorian Air Ambulance Service HSTORY OF SERVCE: n 965 the emergency air ambulance was expanded to give service to any sick or injured patient from beyond 00 miles of Melbourne. Last year over,00 patients were transported. CORRYONG * TYPCAL DALY FUGHT CHART BLACK: AFTERNOON FUGHT CODE: BASE HOSPTALS e COUNTRY HOSPTALS * AERODROMES * HAMLTON * BARNSDALE * ORBOST * MORWELL lo.. P. ft_ Q 'ill _,, e LAUNCESTON

21 9 Although equipping of new and remodelled areas is expensive, the bulk of the expenditure on equipment is spent on replacing worn out or obsolete items, or buying sophisticated medical equipment of an improved or not previously available type. Equipment is playing an increasingly important part in accurate diagnosis. To keep up with modem trends in such specialities as radiology, pathology, nuclear medicine and cardiology, it is necessary to invest large amounts of money annually in new equipment. Care of the patient has become more dependent on diagnostic and control investigations and the work (and the equipment) in the departments has increased considerably in recent years. The trend will continue. ndeed some experts estimate the work load will double every five years. Funds were allocated for the whole range of hospital equipment. Special attention was paid to anaesthetic and resuscitation equipment, ward furniture, floor coverings, sterilizing equipment, operating theatre equipment and the fields of nuclear medicine, pathology, cardiology and radiology. Significant new developments included the use of oscilloscopes for continuous monitoring of patients with cardiac conditions. This is confined at present to larger hospitals, but the future may see the use extended to all hospitals. Cost, the need for trained staff and more reliable equipment will, for the immediate future, limit its use. Ultrasonics are being tried in widely separated fieldsfor use in cleaning babies bottles and as an aid to diagnosing brain conditions. The Commission continued to provide financial assistance to aged peoples homes to purchase furniture in homes and hostels financed by the Commonwealth Government for building purposes through the Aged Persons Homes Act. Ventilatory tests on the respiratory function of a baby are carried out at the Royal Children's Hospital by means of an infant spirometer. This instrument is invaluable in the investigation of many babies who develop respiratory difficulty.. Advisory Committees. The Xray Advisory Committee, the Cardiac Equipment Advisory Committee, and the Pathology Advisory Committee all met on a number of occasions and gave the Commission valuable help in creating policy in these specialized fields. Dr. R. R. Clark, Consulting Anaesthetist, and Dr. J. Andrews, Consulting Specialist in Nuclear Medicine, readily assisted during the year. The Commission thanks them for their assistance. This use of specialized help becomes increasingly important as new equipment and techniques are developed.

22 AMBULANCE SERVCES. The Commission made grants of $999,8 to ambulance services Capital 0 Building works Furnishings and equipment Vehicles } 0,8 Maintenance.. 759,000 Maintenance grants included $65, towards the cost of transport of pensioners and indigent persons. Branch Stations. During the year new branch station buildings were completed at Pakenham and Wodonga. Buildings at present under construction are Broadmeadows, Daylesford and Terang. A voluntary branch of Goulburn Valley Ambulance Service was established at Yea. There are now 07 ambulance stations in Victoria. Statistical Table. Headquarters Branches with fulltime officers Branches with voluntary staffs.. Vehicles Staff Subscribers Patients carried Mileage travelled ,75 08,7,39,79 $ ,6 73,75,88,7 Commission officers made fifteen visits to services for administrative inspections, assistance and advice during the year. Eleven officers attended civil defence courses held at Mount Macedon. Two tone warning horns were approved at Victorian Civil Ambulance Service, and circulatory resuscitation equipment with supplies of serum albumin were issued to the regional services. Transport fees were increased to help meet rising operating costs. The Commission thanks the Victorian Ambulance Services Association and the Victorian Ambulance Superintendents' Association for their assistance during the year. Training Courses. The Ambulance Officers Training Advisory Committee met on three occasions and advised the Commission on a number of ambulance training matters. The committee was strengthened by the addition of the Reverend James Martin, B.A. (Melb.), the Chaplain of Geelong College and a science master, who has had considerable experience in ambulance leadership. The Country Hospitals Association agreed that some practical ambulance instruction should be given in country hospitals. Training is proceeding in the maintenance of intravenous therapy instituted at the roadside by a doctor using the kit provided by Australian Red Cross Society. The need for a training course leading to Superintendent's qualification is recognized and proposals are being investigated. The need for new ambulance officers to attend their first course shortly after appointment is recognized and steps are being taken to meet this need. The appointment of eight cadets in January, 968 raised the total in training to twenty. n all, fourteen courses at the various officer levels were held. Of 75 students, only eleven failed to pass their examinations. Two hundred and fiftyeight students are continuing their correspondence and assignments leading to examination. Eight clinical year medical students underwent a threeday course in December, before taking up vacation jobs with various regional ambulance services. One hundred and five Victorian members of the Mt. Buller Branch of NorthEastern Victoria District Ambulance Service, who are also members of the Ski Rescue Service, attended a first aid course obtaining either the St. John Ambulance Association Certificate or the Alpine Certificate for Ski Rescue.

23 Training weekends for voluntary members of regional ambulance services were held at Bright, Manangatang and Horsham. Able assistance was given by senior members of Ski Rescue Service and Latrobe Valley District Ambulance Service. Committee on Ambulance Design. Sir Laurence Hartnett, the Chairman, has given inspired leadership to a group of doctors, automotive engineers and senior ambulance officers who have worked to define the design and specifications of a sound ambulance at a reasonable cost. A detailed survey was made of the uses to which ambulances are put throughout Victoria. This information, together with ideas from all available sources, is the basis of a specification from which a prototype is being built. Whilst it recognizes the probable need for modification and further development, the committee hopes that the result of its work will be a vehicle of reasonable economy more suited to the need than those at present in use. Air Ambulance Service. The Air Ambulance has continued to bring patients smoothly and quickly to Melbourne. Three hundred and ninetyseven thousand miles were flown to transport,30 patients on prearranged flights. Ninetythree special flights were mounted for medical emergencies, although the number of emergency cases exceeds this as more than 50 were included in the routine flights. The cost of patient transport was cents per mile which compares favourably with the cost of road ambulance transport. ADMNSTRATON. There were fourteen managerial changes in institutions during the year. Commission officers made administrative inspections, including special assistance to newlyappointed managers, and 75 finance inspections. Courses in communications were held in regional centres for managers, medical superintendents and matrons. BURSARES. (Other than Nursing.) Twentyfive bursaries to the value of $5,536 were awarded to students undertaking the course of training for registration as dietitians, and seven to the value of $3,0 to medical social work students studying for the Diploma of Social Studies at the University of Melbourne. REGONAL. The regional plan has been in operation for the past years, during which period many services have been instituted. These have been appreciated considerably by participants. Where they have had to be curtailed through lack of personnel, they have been missed very much. Regular meetings were held during the year, at which a number of excellent speakers were present. This is a very good method of disseminating information to country hospitals and proved of interest and assistance, especially to the smaller hospital. n belonging to a region, the small hospital feels it has a part to play in the hospital field. Most of the base hospitals realize they are regional hospitals and render assistance to the district hospitals as and when required. Managers, matrons, engineers, caterers and doctors meet regularly in different regions. Medical specialists are visiting regional hospitals to teach and to see patients in consultation with local doctors. Some of the larger country hospitals have resident medical officers attached on a rotating basis with a teaching hospital ; this is proving very worthwhile. More interest is being taken in the young doctor and he, in turn, is discovering interesting work in the country. Many are likely to settle in the country as a result of this move. The central linen and regional engineering services are operating successfully and are proving their value throughout the country. Decentralization is being discussed in some regions, and this could be the means of building up additional services in time to come. During the year, some courses in communication were conducted at regional centres, and the Commission is examining a proposal to conduct more education courses regionally. The Commission is watching the regional scheme in New South Wales for help in its own developments. At present, New South Wales development rests on decentralization of some staff rather than devolution.

24 Side The results of patients' tests are printed out on the teletype by the computer for transcription. Below The computer is set ready to its memory bank a collection from the analytical instruments. record into of readings. :. =. : :

25 3 COMPUTER COMMTTEE. During 967 the Commission's Computer Committee extended its activities. t appointed a medical officer for development of medical information systems. An admission /discharge recording system was commenced and preliminary design has been completed. A project to link a small special purpose computer to the autoanalysers of the clinical laboratory in biochemistry was commenced in 967. A computer was delivered early in 968 and production began on a limited basis in June. Work is continuing in conjuction with the Alfred Hospital and Royal Melbourne Hospital to produce the final system which should become fully operational during the next twelve months. Additional development of computer based administrative procedures will be made immediately. Computer nstallation in Hospital Laboratory Departments. Biochemical investigations play an increasingly important role in the diagnosis, care and treatment of patients in our hospitals. The ever increasing demand for diagnostic procedures, which in the case of a patient receiving a renal transplant may involve as many as 3,000 tests, necessitates automation of certain procedures and lends itself to the application of computers. The introduction of computers to this field improves accuracy and speeds up reporting of results. A digital PDP 8/S computer was installed at the Alfred Hospital and is the forerunner of similar installations in other major hospitals. Research into further application of computers in the hospital field is being undertaken by computer committee study groups. Eventually, computers will record collected specimens, their quality and quantity, and will print and transcribe results. NURSNG. The last Commission Report said that nursing is going through a period of growth and change. A nursing journal recently stated that with the change has come a slowly changing selfimage for the nurse, from the handmaiden role to that of the professional colleague of the physicians ; from the mute ' angel of mercy ', eyes cast down or heavenwards, to the more articulate questioning professionally orientated individual. Nurses appreciate more the need for postbasic and postgradute education, and more nurses are interested in undertaking these courses. The Commission approved thirty Florence Nightingale Scholarships at the College of Nursing, Australia, for 968 Diploma in Nursing Administration Diploma in Nursing Education Hospital Nursing and Ward Management Diploma Operating Theatre Nursing and Management Diploma and will make an extra two scholarships available for 969 to enable two students to undertake the new course to be conducted next yearntensive Care and Ward Management. Students undertaking this course will do their practical work at the intensive care unit at St. Vincent's Hospital. With the introduction of new educational requirements for general nurse training, nursing bursaries were approved only for those students who intended to undertake a matriculation year of study. Nursing bursaries have always been made available to students who are eligible to commence nurse training. When proficiency was the minimum educational requirement, bursaries were given for intermediate, leaving and matriculation years ; when intermediate was the minimum requirement, bursaries were awarded for leaving and matriculation years. Now the minimum requirement is four specified subjects at leaving standard, bursaries will be awarded for 969 to undertake matriculation only. The Commission awarded 80 bursaries to assist students to remain at school in 968, 9 of these being second bursaries. Of the 80 awarded, only 636 students finally accepted them. Since the inception of this scheme, 8,8 students have received payment for either one or two bursaries. One thousand and fiftynine did not commence nurse training99 of them being released on medical grounds ;,35 have completed their contracts, but very many of the,7 girls who made refunds completed their training but did not complete a staff nurse year that was required when their bursaries were awarded. Two thousand one hundred and eighteen bursary holders are in training or have made arrangements to commence training

26 The picture shows the interior (nurses station) of the new 60 bed wing completed at Caritas Christi HospiceKew, in January, 968. The planning of this wing is based on the circular plan first used in the design of Sandringham and District Memorial Hospital. Recruitment. A recent publication Schoolgirls nterest in Nursing as a Career has highlighted some ideas and recommendations that our two recruitment officers had already put into operation. A survey sought to determine at what age and in which form schoolgirls developed an interest in nursing. We have found that the visits to primary schools to talk to senior girls prepare the girls for an interest in nursing, and this is followed up later when they are at high school. The following is a summary of the work of the recruitment officers : Number of schools visited..,075,, schoolgirls addressed 8,680, times films shown 97, Careers Days /Nights and Exhibitions attended 6 When visiting schools, the recruitment officers do not advise girls to go to a certain hospital, but it is interesting to note that even at that stage, most girls who are interested in nursing have already developed an interest in a particular hospital. Nursing Establishments. More work has been undertaken regarding this, including a comparison of nursing staff in Victoria and New South Wales. Officers visited hospitals of the category and areas of those where the recent survey was undertaken. Staffing establishments and average bed occupancies were discussed with officers of the Hospitals Commission of New South Wales and comparisons made. t was difficult to make true comparisons because of the absence of a common and precise measuring stick, but the interchange of information and ideas was valuable. The Commission approved the appointment to hospital staffs of an additional 38 fulltime and 3 parttime nurses for new services and increased use of existing services during the year. One of the recurring problems besetting public hospitals in the country is the difficulty in obtaining an adequate cover for midwifery patients. There is a shortage of double certificated nurses willing to work in the country. The shortage has been met from the Commission's relieving staff. Relieving matrons again provided an excellent service which was much appreciated.