The Renewal of Vision in Hospital Administration

reference, for consultation, before decision. The layman and expert, tlie professional and voluntary helper, auxiliary organisations and the Board, create in themselves a diversity of interest which insists on recognition. Competition, it will be urged, is encouraged and efficiency ensured by such a system. But there is another and less pleasant side. A number of dogs fighting for a bone represents something more than competition. Conditions, too, of work, locality and circumstance vary, no doubt, enormously between hospital and hospital. But it may be wondered if the difficulties, as such, are really greater or more insuperable than those of other large organisations ; and whether competition, individuality or anything else can sufficiently compensate for the undeniable loss of dynamic power which such a system entails. The appointment of numerous hospital committees and organisations at first sight might be taken to refute the charge. What, it might be asked, of the Metropolitan Funds, which systematise and control methods of finance ? The British Hospitals Association, with its Regional Committees, or, more recently, as a result of Lord Cave's report, the Voluntary Hospitals Commission ? to mention only a few.