de Montfort, M.

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The Linacre QuarterlyVolume 40 | Number 1 Article 10February 1973The Catholic Hospital in New ZealandM. de MontfortFollow this and additional works at: http://epublications.marquette.edu/lnqRecommended Citationde Montfort, M. (1973) "The Catholic Hospital in New Zealand," The Linacre Quarterly: Vol. 40: No. 1, Article 10.Available at: http://epublications.marquette.edu/lnq/vol40/iss1/10The Catholic Hospital in New Zealand Sister M. de Montfort, R.S.N., R.N. "The dogmas of the quiet past," said Abraham Lincoln, "are inad-equate to the stormy present. We must think anew. We must act anew." In tracing the present and future prospects of the Catholic hospital in New Zealand, one can more clearly see the situation in perspec-tive against the backdrop of the past. Therefore it seems best to start this survey with a brief look at the New Zealand hospital sys-tem as a whole, embracing the emergence of the private hospitals and locating the Catholic hospitals in their due historical place in this development. The earliest record of an institu-tion functioning as a hospital was Sister M. de Montfort , who has been Administrator of the Mater Misericordiae Hospital , Auckland, since 1964, is herself a graduate of the Mater School of Nursing. She holds a postgraduate degree in hos-pital administration and spent a year abroad in 1968, studying ad-ministration of hospitals in Eng-land, Canada and the United States. Sh e has been Vice-President of the New Zealand Nurses' Association and last year was elected President of the New Zealand Hospital Ma-trons' Association . February, 1973 found in Auckland in 1841, when all eligible patients were admitted to the wards regardless of race or status.! The Maori patient was given free treatment, while the European contributed to his own medical care. In 1885, an Act of Parliament placed the administra-tion of New Zealand hospitals un-der the joint responsibility of na-tional and local government, and amendments over the years laid added responsibility on the Minis-ter of Health and his department for ensuring the provision of ade-quate and efficient hospital serv-ices throughout the country. Final-ly in 1938, came a development of far-reaching consequences that still determines the character of 53 hospital care in this country: the introduction of social security leg-islation in which the state assumed the onus for general medical and welfare services. After the private hospitals emerg-ed early in this century, their de-velopment waxed and waned with the economic fluctuations of the country, although granting' of hos-pital state benefits assisted the pri-vate patient to meet a portion of his fees. Recognizing the important part played by private hospitals in the overall provision of hospital beds, the government sanctioned several loan schemes and subsidies to assist them in meeting higher wage and salary costs. Today one in five general hospital beds in New Zealand is provided by pri-vate hospitals. Private Hospitals The rise and fall of private hos-pitals has been influenced also by the political scene. Nevertheless a viable private hospital system is firmly established and publicly ac-cepted in New Zealand. The wait-ing lists for admission to public hospitals have grown, and as a consequence there has been a mushrooming of voluntary health insurance, selling what the private hospital has to offer: choice of surgeon, choice of hospital, and the assurance of admission to hos-pital on demand. One wonders, however, how long the private sec-tor can continue to admit on de-mand, because of the two main problems that confront those who offer this service: finding finances 54 for expansion and for replacement of the obsolete, and coping with the constant escalation in running costs. This is the position in which the Catholic hospital in New Zea-land finds itself today. There are ten such hospitals, representing dif-ferent religious congregations and all situated in major cities. In size they range from 40 to some 200 beds and provide about 20 percent of the private hospital total. In each case, these hospitals are owned and operated by religious commu-nities and offer beds for medical, surgical, geriatric, pediatric, psy-chiatric and maternity patients. One of the most vital matters concerning New Zealand hospitals, both state and private and includ-ing Catholic institutions, is the question of staffing. In this coun-try, staffing is closely bound up with the system of nursing educa-tion. Nursing Traditions The preparation of nurses here was based on the English Nightin-gale tradition, although the schools were placed under the direct con-trol of the hospitals themselves.2 The beginning of this program dates back to 1884, when New Zealand became the first country in the world to register nurses. However, the apprentice type of training persisted, with the stu-dents being employees of the hos-pital, learning as they worked. Improvements in education led to the expansion of the universi-ties, teachers' colleges and techni-Linacre Quarterly cal institutes. It was unfortunate that an opportunity for nursing training to become part of the main-stream of education in the country was lost in 1920. As a result, the system of preparing nurses is out-dated. One of the great deterrents in the progress toward a more en-lightened system of nursing educa-tion has been the tendency of pub-lic hospital boards to maintain schools of nursing mainly to meet the service needs of their hospitals. This is indicated by some signifi-cant figures - for example, those for March, 1970. At that time, in hospitals where student nurses ob-tained clinical experience, students formed over 50 percent of the staff and were engaged in by far the greater burden of total patient care. Nurse leadership in New Zealand is now striving effectively to raise the standards of nursing education and to establish demonstration programs in university and colleges of health sciences with full student status. The first Catholic hospital to open a school of nursing was the Mater Misericordiae Hospital, Auck-land, run by the Sisters of Mercy. It obtained approval for this pur-pose, after intense parliamentary debate, in 1937. Two other such schools were later established but maintained for the training of re-ligious sisters only. The Mater Hos-pital School has a distinguished rec-ord of graduates, both lay and reli-gious, extending to the present day. However, with the imminence of drastic changes in nursing education and the constantly increasing costs of maintenance, including student February , 1973 salaries, it has been decided to withdraw this school in 1973. The Sisters of Mercy do not regard this as a retrograde step. Rather they plan to extend and develop the services they provide, both within the hospital and reaching out to a wider section of the community, to serve the needs of the contempo-rary world. Direct Involvement The longer established Catholic hospitals have not attempted to in-crease their bed-state to any signif-icant degree. The sisters agree that the effectiveness of our apostolate lies in maintaining nursing religious at the bedside. This direct involve-ment with the patient is thought to have been the greatest feature of our hospitals in the past, and it is imperative that it continue in the future if the sisters are to be effec-tive witnesses of Christ's love to the sick. Compared with those overseas, our hospitals are generously staffed by religious sisters, though with the present dearth of vocations, some concern for the future is being felt. However, it is recognized that for both religious and lay trained staff, constant efforts are needed to keep abreast of the tremendously com-plex development of modern nurs-ing skills. In the case where stu-dent nurses are being withdrawn, a department of continuing educa-tion for registered staff is being strengthened, and back-to-nursing courses are being planned for wom-en wishing to return to their for-mer professional roles. Part-time 55 employment is coming to be ac-cepted, and stronger emphasis is being given to orientation programs for hospital aides. What of the range of services our Catholic hospitals offer? Wise-ly they have not tried to compete in this respect with the state sys-tem, where the impressive expen-diture of public finance has fos-tered immense increases in size and in span of specialization . Rath-er they are striving to improve the depth of service within the hospi-tal and stretching out to reach a more extended sector beyond the walls of their institutions by ef-fective involvement in community health services. In general, Catholic hospitals cater for general surgery and medi-cine, with some featuring special-ties in particular areas such as cor-onary care, cardio-thoracic surgery and orthopedics. One hospital op-erates a cobalt unit with a special clinical section for cancer patients; another concentrates on the devel-opment of a paraplegic unit. Yet another specializes in a psychiatric day center and has acceded to the increasing demand by opening a section for longer-stay patients. All Catholic hospitals in the coun-try have departments for geriatrics and terminal care and find in this area an apostolate characteristi-cally Christian and deeply reward-ing. Obstetric Care At the other end of the scale of life is the touching domain of birth. In the development of obstetric 56 services in New Zealand, the trend has always been away from home confinements to hospital care, and the state has established a hospital service available to all women free of cost. Few private obstetric insti-tutions have survived the difficul-ties of modern maintenance. There are a comparatively small number, operated by Christian churches and including several Catholic estab-lishments, one of which specifically offers a haven for unmarried moth-ers. Although the financial burdens are heavy, every effort is being made to maintain these hospitals, in recognition of the need to pro-vide a Christian moral climate in the face of pressures, both overt and subtle, exercised on patients in most other obstetric institutions. In other ways, too, Catholic hos-pitals try to meet the needs of life in the wider community. Although they are not able to provide acci-dent and emergency services, they do accept urgent cases for admis-sion. Several, including the Mater Misericordiae Hospital, run a dis-trict nursing service, with trained staff visiting and caring for the sick. Patients may include those discharged from hospital and re-quiring follow-up service or oth-ers referred by general practition-ers or relatives. There are many facilities available for these nurses should aid of various kinds be re-quired in the patient's home-meals-on-wheels service, for ex-ample, and provision of linen, oxy-gen and all forms of equipment. This is a full-time duty, ranging far over city suburbs, and bringing help and cheer to many in the twi-Li nacre Quarterly light zones of weakness and inca-pacity. What can the Catholic hospital of New Zealand expect to do in the future? Let us hope it will maintain at a high level the facil-ities it now offers, along with the dedicated quality of care that con-stantly wins a recognition it does not seek. It will surely strive for an expanded and more vigorous participation in community health and it will hope to do this, at least in part, by involvement in com-munity health centers. It will cer-tainly also endeavor to increase its effectiveness in those areas where enlightened Christian de-votion is especially needed - in geriatric nursing and in psychiatric care; here the establishment and maintenance of day centers will be a significant contribution to prob-lems with far-reaching ramifica-tions. It is determined to maintain its obstetrical units as a safe refuge for Catholic mothers and to con-tinue to provide and extend family planning services by the method of ovulation detection. Education Prospects In the field of education, although modern trends make it inevitable that schools of nursing can no long-er be the effective province of the Catholic hospital in this country, our religious sisters will continue to prepare for teaching roles. A representation of religious could February, 1973 well be employed as tutors in fu-ture colleges of health sciences un-der the Department of Education. There is the hope, too, that our larger Catholic institutions, whose standards are recognizably high and whose range of services is con-siderable, may participate in the provision of clinical teaching for nursing and medical students. Un-doubtedly there will be growth in in-service education programs for trained staff and hospital aides, in-cluding training of Pacific Island religious to serve in their own na-tional areas of apostolate. In these ways, and in others that may yet be hidden, the Catholic hospital in New Zealand will seek to foster health and social condi-tions in keeping with the inalien-able dignity of the human person and the integrity of family life. For the sick, its aim is inspired by the word and example of Christ and expressed in the words of the physician: "Sometimes to cure, often to relieve, always to console." REFERENCES: I. "A Review of Hospital and Related Services in New Zealand." Department of Health, Government Printer. Wellington, 1969. 2. "An Improved System of Nursing Education in New Zealand." Report of Dr. Helen Carpenter, World Health Organi-zation Consultant. Department of Health, Government Printer. Wellington, 1971. 3. The Public Health Report of the De-partment of Health. Government Printer. Wellington, March 31,1971. 57 

The Catholic Hospital in New Zealand

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