Mr. RAMEY. It would be a good thing if that attendant was made a career position. Dr. HAWLEY. We have been able to have attendants up-graded in the civil service, not to start with, but to offer them a career as they improve, and more and more approach a male nurse in training. Their grade and pay goes up proportionately and we are quite sure that that not only will give us better patient care but will be an econLabor turn-over is an expensive thing. Mr. RAMEY. Thank you very much. Mr. Ross. Mr. Chairman. Mr. KEARNEY. Mr. Ross. Mr. Ross. General, the initial question, I think, was why are some of the hospitals being closed. Dr. HAWLEY. Yes, sir. Mr. Ross. In that connection, may I ask a couple of questions? Is the personnel problem with respect to the adequate servicing of the present number of beds as serious as it has been intimated here that it is? The reason I ask that question is this: If my memory serves me correctly, the General testified here several weeks ago that in the program of expansion which has taken place that there was a possibility that many of the hsopitals had become overstaffed and in the program of readjustment which would take place, in all probability this condition would be corrected. I say that is if my memory serves me correctly. That was inferred, anyway. Dr. HAWLEY. Yes, sir. Mr. Ross. Now, in addition to that, is the personnel problem the only factor in the closing of these hospitals? Does obsolescence enter into it? Dr. HAWLEY. No; only the personnel. In fact, of those recommended to be closed, there is one more hospital which has been a great problem to staff and keep patients in for at least the past 15 or 20 years, and one in which we would have to spend some $3,000,000 to rehabilitate the plant and when we had spent that, we would still be faced with the same staffing problem. Mr. Ross. Then plant does enter into it? Dr. HAWLEY. That is in one case. But the Administrator has not made any recommendation concerning that operation. Mr. Ross. How many have been closed recently? Dr. HAWLEY. There have been three that have been ordered closed by the Administrator. Mr. Ross. And in one-third of those that were closed, the plant issue did enter into it? Dr. HAWLEY. No; this one has not been directed to be closed yet. It was on a list of six, so in one case out of six, plant was the entire thing. Mr. WHEELER. Will the gentleman yield? Mr. Ross. Yes. Mr. WHEELER. Numerous inquiries have been directed at me, General Hawley, as to why the Finney Hospital at Thomasville, Ga., has been ordered closed, while at the same time there is a new one being built at Tallahassee, Fla., only about 60 or 70 miles from there and a new one at Americus, which has been mentioned, only 90 miles from there? Numerous inquiries, as I say, have been directed to me, asking why that situation existed? Dr. HAWLEY. We have never been able to get enough nurses to go to Finney. We had hoped to operate 500 beds there and have never been able to get a staff for that many, and the hospital, which is a huge plant of 1,000 or 1,500 beds, at the last report had about 250 patients in it. It is a very extravagant operation. The patient-day cost is running anywhere from $14 to $27 a day, according to the number of patients hospitalized during the month. This number fluctuates considerably. Mr. WHEELER. Is there any particular reason why the personnel. refuse to go to Finney? Dr. HAWLEY. Yes; but this is not confined to Finney. We have that difficulty in other hospitals located in the smaller communities. There is a great shortage of nurses in this country. They can choose and pick and do not like to go to smaller places where they do not have recreational facilities for their off-duty time, and it is just impossible to employ them at such places. Mr. WHEELER. Now, there is not very much difference in the size of the town of Thomasville, for instance, and the size of the town Americus. If you cannot get them to go to Thomasville, why do you feel that you can get them to go to Americus, where you are building a new hospital within 90 miles of Finney? Dr. HAWLEY. I would say that that was a program which we fell heir to and which specified a hospital in southwest Georgia. Is not Americus in southwest Georgia? Mr. WHEELER. Yes. Not in my district but I am familiar with that. Dr. HAWLEY. Our limits of action in that case were to locate that hospital, which had already been approved, within the area of southwest Georgia, and there were several towns in southwest Georgia considered. Mr. WHEELER. You mentioned a nurse shortage. There is another question that has risen in my mind. Dr. HAWLEY. Furthermore, that is only a 200-bed hospital, which is different from trying to staff a 500- or a 1,000-bed hospital. Mr. WHEELER. You mean, the one at Americus will be only 200 beds? Dr. HAWLEY. Yes, 200 or 250. Mr. WHEELER. As regards the nurse shortage, in my district, I recently had from my district the application of two nurses who had just finished the cadet training. They wanted to get jobs with the Veterans Administration. I contacted your division who handles that sort of thing and they said, "We have a long waiting list. We do not know when we could place these nurses.' Dr. HAWLEY. I would like to check that for you, if you would just give me the details that you have. Mr. WHEELER. And I would just like to know that. Either one of these girls, or both, would have been glad to go to Thomasville. In fact, they would rather have gone to Thomasville than some other place. Dr. HAWLEY. Did you take that up with my office? Mr. WHEELER. Yes. Dr. HAWLEY. I will certainly check on that and inform you of the result. Mr. Ross. Will the gentleman yield? Mr. WHEELER. Yes. Mr. Ross. General, can you give us, if you recall, the reasons why the Bureau of the Budget denied the request of the Veterans Administration? Dr. HAWLEY. No, sir, I do not know what the Bureau of the Budget thinks. Mr. Ross. I make that inquiry again to ascertain if possibly they took into consideration that some of our hospitals may be overstaffed at the moment? Dr. HAWLEY. Yes. Mr. Ross. And I again ask the General if, in his program of readjustment, that has been taken care of? Dr. HAWLEY. Yes. I should have answered your other question more fully: The principal reason for the reduction was that for some reason they estimated for the fiscal year 1948 only 62 percent bed occupancy in our existing general medical and surgical hospitals, whereas it is actually running around 90 percent. As one example, their computations on money for rations and medical supplies, which is always computed on a patient-day basis, they used the figure of 38,000,000 patient-days, whereas we will run, if we keep these beds full, we will run considerably over-how much increase was that, do you remember? Dr. PRESS. About 1,500,000 or 2,000,000. Dr. HAWLEY. The money which they estimated would be sufficient for rations would have fallen short some $9,000,000. I think they estimated on a 74-cent-a-day ration which would show that the original thinking on it was some 1,000,000 or 2,000,000 patient days short of what we will probably run. Mr. KEARNEY. Are your beds filled today, General? Dr. HAWLEY. Yes. Those that we have staffed are full. Mr. WHEELER. I have just one other question. I do not mean to make a particular case of this but there is a general policy involved here, I think. For instance, there is very little difference in the size of the two towns of Thomasville, Ga., where there now exists Finney Hospital, and I believe you said there were approximately 1,500 beds there. Dr. HAWLEY. Yes. Mr. WHEELER. You are closing that hospital and going over to Americus, 90 miles away, and building a new hospital which will have 200 beds.. In other words, the question I am asking, is this: Is it purely a matter of getting rid of some beds so that you can better man the 200 beds? DI. HAWLEY. No, so that we can better man other beds that we now have in existence because that hospital in Americus will not be finished before the fiscal year 1950. Mr. WHEELER. When will the one in Thomasville be closed? Mr. Ross. Will the gentleman yield to me again? Mr. WHEELER. Just one other question and then I shall. My interest, of course, is, generally speaking, for the veterans, and, of course, to be able to answer these inquiries that come to me. They keep asking me about this. I have telegrams on my desk now asking me to use my influence to keep that hospital open and when the Legion Posts and the VFW Posts, and so forth, look at this, they see a new hospital being built in Americus, and one being built in Tallahassee, I believe, 60 miles away, and they can not very well understand why you are closing a 1,500 bed hospital in Thomasville, and going over to Americus and building a 200 bed hospital and down to Tallahassee and building another one. It is very difficult for me to explain to them why that is taking place. That is the reason I am asking the question. Mr. Ross. General, have they opened any new hospitals since January? Dr. HAWLEY. January 1 of this year? Mr. Ross. Yes. Dr. PRESS. Yes; there were some hospitals opened after January. Dr. HAWLEY. I would like to correct the record. My information at the moment is that four actually have started receiving patients since the 1st of January, although they may have been opened and staffed prior to that time. Mr. Ross. Opened and staffed prior to that time? Dr. HAWLEY. That is right. Opened and partially staffed prior to that time. Mr. Ross. What was the personnel load in January? As I remember, I think it has been testified that it is now 61,521. Dr. HAWLEY. That is right, sir. The figures for January is approximately 55,700 full-time medical personnel. Mr. Ross. I am still trying to find out if the General feels that under his program of readjustment, some of these hospitals can be reduced in their staff and still operate efficiently? Dr. HAWLEY. Some of them will have to be reduced in their staff, but there are only a few. As an over-all picture, I do not think we will have to readjust very much between branches. I can give you an example. It is already in our estimates for next year, and that is that Branch 4, which includes the States of Maryland, Virginia, North Carolina, West Virginia, and the District of Columbia, will have to reduce staffs, whereas there are other branches which are understaffed. The over-all picture of the branches is that we think they are understaffed. Mr. RANKIN. Will the gentleman yield? Mr. Ross. I yield. Mr. RANKIN. General Hawley, I think we ought to have this proposition cleared up. Is this general hospital, the Finney General Hospital at Thomasville, Ga., which is being closed, a temporary hospital? Dr. HAWLEY. Yes, sir. Mr. RANKIN. It is not a regular veterans' hospital? Dr. HAWLEY. Yes, sir. Mr. RANKIN. That fact has not been brought out. Mr. WHEELER. Will the gentleman yield? Mr. RANKIN. Yes. Mr. WHEELER. If the beds and facilities are available there, why should it be a temporary one and why should it not be permanent, instead of building others in the same area? Mr. TEAGUE. Is it fireproof, General? Dr. HAWLEY. No; it is a wooden hospital. It is one that is strictly temporary. Mr. PRICE. A temporary Army hospital, built during the war? Dr. HAWLEY. Yes. Mr. ALLEN. Let me say again that some of these temporary hospitals are not fit for veterans' hospitals and ought not to be taken over and made permanent hospitals because it would result in having to rebuild the whole establishment. I do not know anything about this in particular but I think the fact ought to be brought out that this is a temporary frame hospital that was thrown up during the war and is not a permanent veterans' hospital. Mr. MITCHELL. Will the gentleman yield, please? General Hawley, is the construction of this hospital the same construction as the one at Clinton, Iowa-the Schick Hospital? Dr. HAWLEY. No; it is all frame. Mr. MITCHELL. I think you referred to the Schick Hospital as a temporary hospital, too. Dr. HAWLEY. It is semipermanent. Mr. MITCHELL. Semipermanent? Dr. HAWLEY. I think that is the official War Department classification. Mr. MITCHELL. That is a long way from semipermanent, if you ask me. That is about as permanent as this building. Mr. CROW. Will the gentleman yield? Mr. RANKIN. General, I remember we had one of these frame buildings in California 20 years ago, and there was a terrific amount of uneasiness for fear that fire would sweep it and burn up the veterans, and my recollection is that they did away with it, or rebuilt it, out of permanent materials. Now, it is probably cheaper-I do not know the facts in this casebut it is probably cheaper to go ahead and build the veterans' hospital-cheaper in the long run to build a veterans' hospital at Americus-than it would be to maintain this temporary, inefficient firetrap, we will call it, at Thomasville, that was constructed for temporary use by the Army. Mr. WHEELER. General, how many beds do you propose to have in the hospital at Tallahassee? Do you remember oflhand? Dr. HAWLEY, 200. Mr. WHEELER. 200 beds at Tallahassee and 200 at Americus? Mr. WHEELER. That will be tuberculosis. The one at Tallahassee will be more or less the same type as the one at Thomasville? Dr. HAWLEY. It will be for general medicine and surgery. 64872-47-3 |