HOSPITAL FEES.

Press, Volume LVII, Issue 17127, 23 April 1921, Page 12

HOSPITAL FEES.

ADMITTANCE OF PRIVATE ' PATIENTS, CBOWN LAW OPPIOEES* OPINIONS With reference to the proposals discussed by witnesses before the Hospitals' Commission for the establishment of accommodation at public hospitals for the treatment of private cases, on the lines of existing private hospitals, in- ; tcresting evidence regarding the legal position was given in Wellington by Mr E. Killick, Secretary of the Department of Health. In th 6 course of his evidence, Mr Killick presented the following, copy of a. question submitted to the Solicitor(iencral in July last and his A reply thereto: — "There is a tendency at the present) on the part of hospital boards to raise the maintenance fees for patients. The North Canterbury Board pioposes to raise their fees to 8s per day, and th« Board to 9s 6d per day..' In "both cases this will come to more than ! the average- day's cost per patient in i hospital. As the law now stands, it I would appear that under the Destitute Persons Act the cost of relief can be recovered by the Board. Under'these circumstances, therefore, is it possible , ioi a Board to incorporate in its. bylaws a scale of fee 3 that may be more than the average cost per occupied- bed i in the hospital, or is an amendment re~ | quired of the Destitute Persons Act 1 enabling thejn to do so. " | The reply was as-' follows: — I "Section 51 of the Destitute Persons*' ; Act, 1910, provides that the cost of maintenance or relief of any person in ; n hospital shall be a debt due to tlhe i Hospital and Charitable Aid Board, and ] may be recovered by action. Then 'subsection (9) of that section states 'that the cost of maintenance or relief of any person shall be deemed to be such 3um 88 is agreed upon between the person so liable and any person by whom, or on whose behalf, the cost is recoverable, ■ or, in default of any such agreement, such sum as is reasonable. The mere incorporation by the Board of a scale of fees in its by-laws would not, :by it'self, enable the Board to recover the amount therein specified. 'The Board Tvould have to show that the patient had agreed to pay in accordance with that scale, or else that in the particular case the fee charged was reasonable.. 'lf, therefore, a Board incorporated ;i.n its by-laws a,' scale of fees which we're , more than the average* cost per occupied bed of the hospital, it could "only recover' according to that scale if 'the patient had agreed to Day the same, or in any other cases if the scale was reasonable. An amendment of the Destitute Persons Act, 1910, does not appear to be required." As regards the question of whether persons able tor pay for private medical attention Should be allowed to use the hospitals at any rate unless they pay the full cost of their maintenance, the fallowing is the position as advised by the Crown Law Oflßce:—

"There is no statutory authority under which a Hospital and Charitable Aid Board can be compelled to grant relief i to a destitute person resident in its! district. Section 60 of the Hospitals and Charitable Institutions Act, 1900, authorised a board to apply any money in its hands for the purpose,", but the power so given is. discretionary. The duties of a Hospital and Charitable Aid Board as to sick.persons are those set out in section 63 of the- Hospitals and Charitable Institutions Act, 1909. From a perusal of that section, it will be seen that 1 uhe Board must provide and maintain such hospitals, and -make such. othe"r provisions as the InspectorGeneral from time to 'time considers requisite in any-part of the hospital district for the purposes specified in paragraphs (ft) and (b). Then, sub-sectio>i 2 declares that it shall be the duty of every Board, in pursuance of any directions given from time to time m 'hat behalf by the Inspector-General, to receive into any hospital or other institution under the control of the Board, so far as adequate accommodation is therein available, any person suffering from., any of the diseases for the relief of which that hospital or institution' is established. It is, therefdre, only the duty of the Board to do . -the things' specified when the Inspector-General requires or Even if so required or directed, sub-section' 4 provides that no action for damages shall lie against a Board at the suit of any person in respect of any failure of that.Bqard to conform to the requirements of the section. The_ procedure to be followed if a Board fails to perform its duty under the section is that set oittiin section 77, which enables .the Minister to withhold subsidy,, or to do at the,-jx-pense of the Board any net wMch the Boary! had failed to do. Unless, therefore, so directed by the Inspector-Gene-ral, a Hospital Board is not bound to admit to any institution under its control any person for treatment who is sick but who.hp ample means to pay for' his treatment nor'is it bound to admit to its institutions any person who refuses to pay the ordinary maintenance fees as fixed pj the bylaws whidh a Board has power to make under .section- 65, but" which are subject to approval by the Minister, and .-nay at any time bo disallowed by the Governor by Order-inrCouncii." There is nothing, therefore, Mr Killick commented,, to compel a Hospital Board to grant hospital relief to any person applying, unless so directed by the Inspector-General, ,and it would seem that, some clear definition of to whom hospitals should be. available should be made.