Improvement of the medical care of hospital patients

Recommendation 686 (1972)

Author(s):

Parliamentary Assembly

Origin

Assembly debate on 24 October 1972 (17th Sitting) (see Doc. 3157, report of the Committee on Social and Health Questions). Text adopted by the Assembly on 24 October 1972 (17th Sitting).

The Assembly,

1. Believing that the progress achieved in the field of medicine, with its many highly developed specialities, has increased the costs of hospital treatment in such a way that many hospitals have no longer the staff and the technical equipment enabling them to guarantee optimum treatment in all branches of medicine ;

2. Believing that hospitals should be increasingly equipped for out-patient treatment and examination, thus freeing hospital beds and ensuring, through a fuller use of technical resources, that individual hospitals are run on a more economic basis ;

3. Aware that the most urgent problems facing hospitals can be solved only through increased contributions from public funds, particularly in the form of capital investments, whereas running costs should be met, as far as possible, from the day-to-day income of the hospitals themselves ;

4. Conscious of the fact that, despite recent technical progress, the efficiency of the modern hospital still depends to a great extent on a well-trained nursing staff whose great responsibilities should also be reflected in conditions of work and salary ;

5. Insisting that the prime task of every hospital is to improve the health of the human being in the best possible way, regardless of his social and financial status,

6. Recommends that the Committee of Ministers instruct the appropriate expert committees to work out proposals for the improvement of hospital care, having regard to the following guidelines :

a in regions of viable dimensions, there should be established a network of different types of hospital (ranging from minimum, through standard, to maximum equipment), with distinct functions but with machinery for co-operation ;

b in the matter of treatment, arrangements should be made, particularly when new hospitals are built or old ones converted, for each sick room to contain as a rule no more than three beds, and for each specialised department to be limited to 100 beds, in order to ensure optimum treatment and improve contact between the hospital doctor and the physician who treated the patient prior to his admission ;

c the patients' accommodation should depend solely on the gravity of the illness, and all patients should enjoy equal, optimum conditions with regard to admission, treatment, diet and daily routine in hospitals ;

d "day clinics" for the treatment and examination of out-patients should be attached to large hospitals, including those in country areas ;

e older buildings, which become available as new hospitals for acute cases are built, should, as far as possible, be retained as hospitals or nursing homes for long-term treatment and for the old ;

f the social services should co-operate more closely with doctors and hospitals to ensure that, owing to social or family considerations, patients are not kept in hospital longer than medically necessary ;

g the present bottleneck in the nursing profession should be overcome by improving working conditions, guaranteeing appropriate salaries, bringing working hours up to date, modernising accommodation and combining a carefully planned recruitment drive with a system of initial and inservice training consonant with the times ;

h a doctor in charge of a department should ensure that his assistants receive the benefits of individual responsibility and team-work, and in such countries where hospital doctors are allowed to take fees from private patients, such fees should be shared by the medical persons concerned on the basis of services rendered ;

i modern administrative and staffing methods should be introduced in hospitals to check the steady rise in running costs and to prevent the assignment of qualified hospital staff to administrative duties ;

j electronic data processing should be introduced on regional or national lines to provide doctors with the maximum of information on their patients, to facilitate the planning of the hospital system and to promote medical research ; but such information must in no way be made available to any other individual organisation, commercial or otherwise, or government department, which could disclose the identity or provide personal information on the individual patient.