The Thorndon Hospital
For twenty years until his retirement in 1879, Dr Alexander Johnston was Provincial Surgeon in charge of the Colonial Hospital in Thorndon. During the latter part of that time, he received some assistance from, in turn, Drs Reid, Keating and Gillon, who acted as Resident (House) Surgeons.
Until 1876, the Wellington Provincial Government was responsible for hospital administration, but the hospital was chronically under-funded and at times, Dr Johnston did not receive his due salary.
In 1876, after the passing of The Abolition of the Provinces Act, hospital administration passed to General Government, but by 1879 it had become the responsibility of the Wellington City Corporation.
NZ Mail 9 August 1879
" The newly appointed honorary medical staff of the Wellington Hospital, namely the Hon. Dr Grace and Dr Diver as surgeons, and Drs Collins and Kemp as physicians, commenced their duties on August 1, Dr Johnston having retired from the position of surgeon-superintendent. A meeting of the staff was held on Thursday 31 July at the hospital, when the Hon Dr Grace was appointed chairman. The following regulations were passed:-
1) The duties of the house surgeon to be to see patients at the surgery, calling in the physician or surgeon of the week, as their opinion may be required; and
2) To carry out the instructions of the physician or surgeon in their absence.
3) In case of emergency the house surgeon to take immediate action, and report at once to the surgeon of the week.
4) The medical committee to meet on the first Friday of every month at 4.30pm.
5) That the City Council record and limit the length of treatment upon each ticket to six weeks.
6) That the Council be requested to extend to the honorary medical staff the power of recommending patients to the hospital.
7) That a set of books be obtained for the use of the medical board. The newly-appointed staff will do duty week about, a surgeon and physician being appointed for each ward."
Dr Gillon was the house surgeon. The administration of the hospital was the immediate responsibility of the City Council's 'Hospital Committee' chaired by Dr Diver who was also a City Councillor.
Administration of the new Hospital
In preparation for the opening of the new hospital in Newtown, the role of the 'house surgeon', now to be known as the Resident Surgeon, was redefined.
New Zealand Mail, 6 November 1880
"The rules and regulations to be observed in the new hospital have been drawn up by Dr Diver and the Town Clerk, who carefully adopted them from the rules of other hospitals. They have been printed and will be ratified and adopted at the first full Council meeting after the return of those councillors who are now in Melbourne. The new rules are pronounced by those competent to judge to be well calculated to ensure the good government of the hospital, and before being passed they were submitted to the honorary medical staff for revision and amendment. It may be mentioned here that the new warders and nurses appointed consequently upon the late inquiry are reported to be acquitting themselves satisfactorily, and that the general management and efficiency have been greatly improved since the resident surgeon has had full control of the internal government of the hospital, and therefore the evils that have hitherto existed, and which have at intervals culminated in incidents almost amounting to "scandals", which will never recur - and of this, at least, everyone will be heartily glad. "
The "late inquiry" referred to arose out of complaints made by a hospital nurse alleging that the 'Lady Superintendent' (Matron) and steward (Magill) were often drunk, that Dr Gillon swore at her (the nurse), and that a patient had been mistreated. The City Council held the inquiry, the proceedings of which were extensively reported in the 'NZ Mail' during September, 1880. Despite being supported by testimonies from two warders, the nurse's allegations were not upheld by other staff members and several patients. The nurse and the two warders were dismissed. However, the inquiry did highlight a lack of satisfactory internal administration of the Hospital.An extract from a statement made by Dr Gillon at the inquiry, and reported in the NZ Mail, gives a fascinating insight into the operation of the second Thorndon Hospital toward the end of its life.
New Zealand Mail, 4 September 1880
"When I took the position of resident surgeon here, under Dr Johnston, vice Dr Keating (resigned), I found matters in a peculiar condition. There were certain regulations signed by Dr Johnston relative to patients, but the positions of the house surgeon, matron and dispenser were not defined. I refer you to Dr Johnston as to how I performed my duties then.
The patients (in and out) were practically under my solo care, with the advice and help of Dr Johnston as a consultant. The outpatients were entirely under my care, and I saw an average of 20 daily. I also treated several eye cases, as I had studied eye diseases specially. I have often had eight or nine eye out-patients a day, and three or four in cases. No charge, of course, was made. The steward, who also did the dispensing, had charge of all stores and liquors.I had nothing to do with them, and had no supervising power. I merely confined my whole attention to the in and out patients and their treatment, surgical or medical. Dr Johnston initialed all accounts and supervised things generally. He also had to do with the vaccination, with which I never had anything to do.
In time, after some four or five months, the honorary staff began their duties, still there were no defined rules as to each officer's respective position. I was merely led to understand that the members of the honorary staff were to have alternate admission weeks for in patients, and had certain wards allotted to them.These instructions have been carried out. I then appealed to the Council for a set of regulations, defining my position and those of my subordinates. The Hospital Committee met frequently at the Hospital and went over the accounts, I believe, with the steward. I did not attend, as it was ruled that it was the steward's work, and not mine. I was now in a very trying position for a young man. The patients had got to consider me as "the doctor", and were slow to recognise the advantages of the attendance of the honorary staff. Often, a member of the honorary staff could not, from pressure of work or otherwise, attend the Hospital regularly, and as, perhaps, the patient needed changes in his prescriptions during the doctor's absence, I frequently altered the medicines to suit the patient's case, for they were apt to grumble and say they were being neglected if I did not. I found, however, that this did not please the honorary staff. In fact, the change in my position was so sudden that I had not perhaps properly realised it. About this time then, after my return from Nelson, I began to see where the hitch was, and have since endeavoured, as far as lay in my power, to act more in accordance with what I conceived to be the wish of the honorary staff. How far I have succeeded, I leave to the honorary staff to decide. Of course, it takes time to produce any thorough change like this. I did not come into the Hospital, like most house surgeons, with my position and duties marked out for me. There was absolutely no guiding line. Everything has had to be formed by a gradual method of progression.Another great difficulty in the way of making a well-ordered institution, was the absence of any rules relating to the house staff. My predecessor, Dr Keating, was very friendly with the matron and Magill, I believe, and they often dined together. When I came, I saw the position of affairs, and with all due consideration for both Magill and Miss Sutherland, determined on taking up a different position.I may say that Magill has given me great satisfaction in the discharge of his duties, and so has Miss Sutherland, and, for that matter, so have all the warders and nurses, with one exception. I have kept myself aloof as much as was possible, but all this time I really did not know who was master. I had the patients certainly, but my power extended no further. I never saw the accounts, and had nothing to do with the administration of liquor or food. I repeatedly mentioned this to the Council, and asked for rules &c.No attention was paid to my request, however. In May, I, as a last resort, wrote out a set of rules, and sent them to the Council for ratification. The honorary staff objected to this proceeding, and the Council referred them back to the honorary staff. Some weeks afterwards, I was informed by the secretary that they would consider and draw up rules when it was decided who were to govern the Hospital. Still my rules were not ratified.I posted them up, however, in the wardsmen's room, but as everyone knew of the correspondence about it, and that they were not ratified, much attention was not paid to them; the subordinates evidently looked to the honorary staff, instead of first to me. Both Magill and the matron were older than me, and had been longer in the institution, and naturally would not be pleased at any alteration in their positions as regards myself. Again there is only one room for surgery, consulting room, out-patients' dispensary, and in-dispensary, doctors' board room, and store room for liquors. The whole day there was a constant rush of some one or other to the surgery on business.Till lately the fences around the hospital ground have been broken down, so that any patient that liked could roam about wherever he pleased. There was no lodge-gate, and no porter; in fact nothing approaching to order in the whole building. The Hospital, instead of being a hospital proper, was and is what the Lancet calls a "workhouse infirmary”. It is a hybrid institution, with no laws whatsoever, and I have never received proper authority to deal with it. I want, and must have, if things are to be conducted well, complete authority, in the absence of the honorary staff, in all things. Since I came to the Hospital I have increased the out-patient's department (to which it has been said I pay to much attention) from some 14 or 15 patients,
to as many as 45 or 50 a-day, and these I see within the space of two or three hours. There is no regular visiting hour for the staff, they come whenever it suits their convenience. With regard to beds, bedding, night nursing, food, &c, &c, in the Hospital, I have, with the matron, asked for these things, but the Council would not accede them, as they said the Hospital was too expensive already. Grant me power to organise the Hospital and rules, and I will undertake to put the whole thing in smart working order within a reasonable period of time.
The Hospital is far more comfortable now than it was 12 months ago, and the patients are, I consider, better fed than most Hospital patients. They get considerably more than those in English Hospitals. The diet and wine cards should certainly have dates appended to each ordering, to serve as a check on the storekeeper."
At the time of the opening of the hospital in Newtown, the medical staff comprised Dr Gillon, the resident Surgeon Superintendent, who was the only salaried medical officer, plus two honorary surgeons, the Hon. Dr M S Grace and Dr H W Diver and two honorary physicians, Dr W E Collins and Dr W G Kemp.