16 OCTOBER 1880, Page 13


(To VIE EDITOR OF iIIB " SIISCTATOR.-] SIR,--I beg your permission, as a hospital physician, to point out to you what seems to me to be an entirely erroneous assump- tion as to the relations of the Medical Staff' of Guy's Hospital and the body of Governors, which pervades your article on the existing dispute. You talk of the Governors having been elected to control the medical staff, and there can be little doubt that it is this view of their functions which has animated that body, and very decidedly their representative the Treasurer, and which has much to do with the lamentable quarrel which has now reached a climax. As a matter of fact, at Guy's, as at all the leading Metropolitan Hospitals, the Medical Staff is formed

of eminent members of the profession, who give their services gratuitously, as do the Governors, to the charity with which they are connected. Such remuneration as they receive is derived from the fees of the medical school, which is often, but not necessarily, connected with the hospital, and is generally not under the control of the Governors. When, there- fore, the Governors act to these gentlemen as if they were subordinate officials under their control, friction is, sooner or later, sure to arise. When, as at my own hospital, the senior members of the Staff have seats and votes at the Governing Board, perfect harmony exists, as ought to be the case between gentlemen, each in their own sphere, having the interests of a great public charity at heart. When questions of vital moment are under discussion, such as the regulation of the nursing, the free interchange of opinion between those who have to do with the regulation of the hospital and those who are responsible for its medical work, results in arrangements which are satisfactory to all. Can it be doubted that the present difficulty had its origin in the fact that the Treasurer committed the absurd error of introducing a radical change in the system of nursing, without the slightest consultation with the Medical Staff P Had he asked the advice of these gentle- men, probably they would have been very willing to give him every assistance in inaugurating reforms, which were certainly well meant, and the necessity for which I do not question. As it is, his course of action has driven the Staff to a display of temper which is seriously damaging their cause, and which may result in the rain of an ancient and splendid charity. The plain truth is, that the method of government in the Royal Hospitals is radically bad. An autocratic treasurer, if he be an able man, may doubtless carry on the work well ; when, by chance, he is the reverse, a catastrophe such as that at Guy's occurs, which would be impossible under a better system of management. Should the present crisis result in the alteration of a system of government which is antiquated, and altogether opposed to the spirit of the times, even these deplorable dissen- sions may end in good.—I am, Sir, &c., F. R. C. P.