Reports for the five years 1st April 1953 to 31st March 1958 / The Cassel Hospital for Functional Nervous Disorders.

  • Cassel Hospital for Functional Nervous Disorders (Richmond, England)
Date:
[1958?]
Catalogue details

Licence: In copyright

Credit: Reports for the five years 1st April 1953 to 31st March 1958 / The Cassel Hospital for Functional Nervous Disorders. Source: Wellcome Collection.

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    freedom to design expenditure within global sums has not been made by the Minister of Health to his sub units; perhaps he, too, would benefit in work morale and financial economies. I am quite convinced that this hospital could offer a better treatment service if it were given freedom to expend the total exchequer monies in its own way than by the present methods laid down for it. The total expenditure in 1957 was the lowest on record since the Health Service began. In 1958 a rise in expenditure was due to the cost of salaries and wages, but all other expenditure was in fact the lowest of any year. I do not anticipate any further change in the hospital design, and the stage has probably been reached when increased salaries and wages of the future will not be offset by economies in other directions. It is always a matter for question whether financial economies are true or only apparent, so I must give it as my opinion that the conditions of treatment actually improved during the period and that this improvement created rather than suffered from many of the economies made. It seems to me however to make nonsense of all the hospital’s efforts that our doctor-time, the one and only essential for psycho¬ therapy is grossly inadequate and uneconomic and fixed by bodies which however august have no proper knowledge of the hospital’s working methods, purposes or needs. A review made in 1954 of the essential medical and the “ non-essential ” hotel costs at the hospital showed the following:— (a) Omitting medical salaries the combined stand¬ ing and running charges were the lowest of neurosis centres in the Region and the second lowest in the country. (b) The cost of medical salaries was the highest in the Region and the highest of all non-teaching neurosis hospitals in the country. (c) Following from the above, the hospital spent a higher proportion of its budget on medical attention and a lower proportion on non-medical overheads than any other neurosis hospital. These findings are unlikely to be different today from 1954 but the hospital overheads are still not justified by a high enough accompaniment of the one and only essential—medical treatment. The sole purpose of patients being in this type of hospital is that they should receive adequate medical treatment. If they do not, all other costs are uneconomic. The expenditure on medical staff being too low for the nature of the work the hospital economy is un¬ balanced. A high medical expenditure would better justify the “ non-essential ” costs. GENERAL ADMINISTRATION The system has continued that the senior hospital executive under the Management Committee should be the Medical Director. This method of administra¬ tion places final responsibility in medical hands, so that all the work of the hospital is subordinated to and co-ordinated with medical requirements, but it requires delegation to administrative executives, who can accept with enthusiasm that their functions are in the long run medically aimed. In this the hospital is fortunate. Miss Mallion, Secretary to the Management Committee has also been my Principal Administrative Officer during the period. With a maintenance staff of 1 electrician- handyman, 1 chauffeur-handyman, 1 stoker-handyman and 3 gardeners, Miss Mallion has carried out the day- to-day maintenance of the fabric of the hospital and 13 staff houses, has provided the essential services of lighting, heating, power, transport and has main¬ tained 11 acres of garden; major works have been carried out by contract. She and her staff have year by year improved the fabric and maintained a proper standard of external decoration. There has been improvement of paths, fences and a re-condition¬ ing of a greenhouse which had not been in use since the war. A neglected corner of the grounds has been cleared and made into lawn. During tree-lopping we were sorry to lose a 500 years old oak tree which had to be felled; a silver birch and a beech tree have been planted in its stead. The following are among the works carried out during the period:— Repair to and renewal of floors and ceiling in various rooms. Repairs to greenhouse. Internal alterations to and enlargement of patients’ washing and ironing room and installation of washing machines. Resurfacing of hospital paths and drives and repairs to fences, gates and dividing walls. Installation of steel shelving and partitioning of maintenance workshop. Installation of extra section to hospital boiler. Installation of fuel-economy stoves in patients’ and staff common rooms. Treatment of dry rot in a staff house. New coping to Lawrence Hall roof. Re-pointing of walls. Repair of lead flashings and soakers. Adaptation of bathroom for children’s treatment room. Providing a cross-over from public road to entrance to hospital furniture store. Front porch of hospital treated for deterioration of fabric.