HOSPITAL FINANCE.

Dominion, Volume 6, Issue 1720, 10 April 1913, Page 3

HOSPITAL FINANCE.

THE YEAR'S LEVIES.

COST OF THE ADMINISTRATION. "PAYING THE PIPER." A special meeting of the Wellington Hospital and Charitable Aid Board was held yesterday Uo receive tho annual statement showing the apportionment or tho contributing local authorities and 110 amount of subsidy ; to bo claimed thereon in\respect of such expenditure, and also a statement of estimated expenditure on account of capital and other expenditure. There were present; Messrs. J. Trevor (chairman), J. Godber. H. Baldwin, J. E.' Ktzgeraldj B. If. Gardener, A. IT. Hindmarsh; L. Jl'Kenzie, H, Freeman, J, \V. Jl'Ewen, D. M'Laren, 0. JJash, Jliss Richmond, and the Rev, W. A. Evans. 1 A General Review. ,Tho following review of tho financial statement was read by the secretary, as coming srom tho chairman:— "The balance brought forward oil April 1, 1912, was .£3313 19s. 2d„ and the balance on March 31, 1913, was.£llo 7s. fid- It was hoped by tho ex-treasurer, when framing tho estimates for last year, that there would be a balance of n similar amount, so as to enable tho board fc) have ia hand sufficient funds to pay the outstanding accounts at tho close of tho year. . "The total receipts tor the year of the general account amounted to >£45,G61 18s. 3d., which does not include the balance in hand of 19s. 2d. This is an increase of eE&lal 13s. 'Id., over , the previous year, i'l'lie in-patients' fees this year for the Wellington Hospital amounted to £1051 2s. <td., an increase of £114 10s. 3d., and out-patients' fees £515 9s. i)d., an increase of £126 15s. Id. Under the heading of' contributions and donations there is a falling off of £Sls 'ss. 10d., no bequests having been, received, and no endowments of beds or cots. The bands' collection amounted ts £13 Is. lid., Christmas donations £135 lis., and tho' 'Hospital Saturday and Sunday collection £424 10s. 7d. These contributions and donations were supplemented by the Government subsidy of 245. in tho £, amounting to £104(S 2s. lid. • "The patients admitted to the Wellington Hosptial numbet 3795, whilst a total of 40G4 were under treatment, an increase of 801 over the previous year. The numbsr of occupied beds per diem was increased from 258 to 293. Under all heads the expenditure for. the year just ended amounted to £53,902 4s. 7d. This includes £3870 12s. Id. on account of the Cliiklreu/'s Hospital, and £12G4 15s. 3d. for the Out-patients' and Pathological Block. This shows a decrease of £2782 compared with the prevftus' year. There is an increase of £1106 in provisions, £646' surgery and dispensary, £471 in the domestic and establishment. Salaries, £8982 2s. Sd., and wages £5290 Gs. Bd.,\show an increase of £970 and £-195 respectively. Tile general additions amount to £3160, being £75 less than the previous year, but there is an increase of £120 in miscellaneous. "For Otaki Hospital . and tho Sanatorium the expenditure is £1224 Cs., and £2917, being £245 less for the hospital, and an increase of £230 for the sanatorium. Ohiro Home totals £2795, being £1 9s. 9d. more than in 1912. Charitable aid this year, which includeo maintenance of children £5211, out-door medical relief £100, makes a total of £7719, compared with £7501 of the previous year. . "Tl\e Children's Hospital was opened ia JJarch, 1912, but not occupied until April. This hospital, which made for additional accommodation in the General Hospital, ,a'nd tho large increase of occupied beds per diem from 258 to 293, accounts in a great measure for the additional expenditure in tho hospital. A 1 district mirse for nursing among the Maoris in the Otaki district was appointed early last year:, This nurse's salary Is paid by the Department, but her travelling expenses and rent of room aro tho board. The Estimates. , "In the estimates for the ensuing veai tho Finance and Property Coinnwtteo hayo had a special meeting for further considering same, and it was unanimously resolved that tho estimates be allowed to stand as; adopted by tho board at its last meeting. The estimates, have been based upon the actual expenditure as far as maintenance and general upkeep is concerned. Tho general additions, or what is capital expenditure, amounts to £3770, compared with the amount of £3160 Bs. lOd. expended last year. In each of theso amounts there is £1500 for repayment on account of loan. . "There is no margin .allowed for any material increase of patients, though tho board.as building a diphtheria ward, a maternity ward, and the balcony and verandah, which will, all tend to provide for additional available accommodation. "The Department's annual report for year ended March 31, 1912, has come to hand. It interesting to note that the number of occupied beds is three .more per diem, than in Auckland Hospital'. The cost per bed, after deducting patients' payments for the four centres, is as follows:—, Occupied beds. £ s. d. Wellington 258 77 4 • 0 Auckland 255 84 3 0 Christchurch IGO 105 7 0 Dunedin 14G 100 8 0 Mr. J. Trevor, chairman, said the board could congratulate themselves on having run their hospital on economical lines, ana at tho lowest cost per lied, but there was probability..of more money requiring to be found during tho year. At the same timo lie did not think it would be possible to reduce expenses at all.. Last year the levy iiiado upon the local authorities was £15,G87; this year it was £21',220, an increase of £5533.' The subsidy paid by tho Government last year was £15,109, this year it would be £19,550, an addition of £4441. The" total amount of levy and subsidy was £40,770, which showed au increaso of £9974 over 1912-13. The Wellington \City Council's levy this year was £13,623 os. Bd., beinjf an advance of £3544 165.. Sd.; tho previous year's levy was £10,078. Bad Finance Previously? Mr. H. Baldwin presented a report showing why it had been neccssary to raise the levies for tho year. "In the estimates for IDI2-13," he stated, "the amount required was £41,519, of which £28,511 was tho net amount estimated for tho. Wellington Hospital. In this expenditure th'Gi'o, was provided tho sum of ,£BOOO for an out-patients' and bacteriological block, and £1675 _for alterations and additions to the present buildings, leaving for maintenance of the Hospital, interest on loans, and payment on account of loan, tho sum of- £18,83(1. It was found that to raise this amount there would be a considerable increase in tho levies to be paid by the local bodies, and, aflor considerable discussion, it was decided to raiso £8000 for the out-patients' arid bacteriological block by way of loan. This reduced tho amount to £20,511 to bo provided for. In going into this matter, I find that tho board on March 31, 1912, had a credit balance in tho Bank of New. Zealand of £6128, which included £3699 in the Children's Hospital fund 'account, imprest account £560, outstanding rents (estimated) £160, levies and subsidies £574, making a total of £7122. This amount being deducted from the sum of £20,511 left the sum' of £13,089 io be raised for the hospital. These -reductions reduced the estimates of £44,519 io £29,--097. I would also point out thill: tho printed balance-sheet for 1911-12 shows a bank balance of £6339. oil No. 2 account £560, mil standing a?>ets, levies, and subsides £slt, rents £lli(i, making a total of £760(1. The balance-sheet also shows (Hitstanding .'labilities of un presented cheques and sundry accounts amounting to £3603. This year's estimato is £41,000 net, being an increaso of £1181, not a decrease as the framing committee, thought. Tho uniount to be raised this year is £12,023 more than last year." That Increasing Cost. ,'Mr. li. R. Gardener drew atention to tho rapidly increasing cost of hospital and charitablo aid administration, and this in tho face of the vast amount now being paid out by the Old .Ago Pensions Department. lie. argued that the whole system of imposing levies was "absolutely rotten to the very core." Some districts were paying away a. 'fourth of their income for hospital levy, and other districts were paying so little that it was a litem "lira-bite." Dr. .Valiutinu made an explanation, of

the reasons for the disparity in the levies raised in diliereut districts. The levies," lib said, wero.ail imposed on the tame basis exactly—'on the basis of valuation. In Wellington, lor instance, levies were lugh because the city had more institutions to maintain thjui had some districts. A comparison of levies merely was certainly not lair. Of coui'so hospital expenditure hail gene up, .anil ho did not seo how anything else could ho expected under present conditions. A Jot of hospitals had been erected in wood, and nonall tne.w wooden hospitals wero falling in for renewal about tna same time. Under fills head ho cxpected the increased expenditure of capital alono to be .180,(100 in tile next five years. Demands oil tiieir institutions wero very much greater than they wero a few years ago, 'J-Here was no prejudice against going into a general hospital now. Very little was heard of "experiments," and "char-ncl-liouses" nowauays. The public knew that in public hospitals they would get the best treatment possible "in the jjoniinioii. And people were not content to go into a hospital and bo mixed up with incurable and infections cases in the same ward. Special accommodation was now demanded for consumptives, incurables, infectious ca=es and even children. There wero other ventures in the field of philanthropic work' which hospital boards wero taking up— and taking up very rightly— such as district nurses. If they were to advance they must expect to pay the piper. 'l'lio chairman said that another bi» item in the increased cost of running hospitals was the renovation, and ini'provement now considered necessary in sanitary connections, which now cost more tnan twice as much as they to cost. On Questions of Policy. Mr, D. M'Larcn said he would regret to seo expenditure going up if it were wasteful. But it was possible for a civilised community to spend too little on this class of .work, and lor that expenditure to be wasteful. Actual money might be saved, but'losses would bo incurred which would be very much more seriously. felt by the community , than loss of inere' money. They must recognise that a great deal of what lie called developmental work was to be done, and institutions were now necessary which were not needed in -the early period of the Dominion's history. ill'. L. M'Kenzie said ho did not object to increases which were necessary, but it did seem to him that they were doublebanking m tlio erection of a bacteriological and a pathological block, simply because tho Government institution did not give them an adequate service. They should rather have insisted upon tlie' Government improving their service. And while the cost was going up the fees remained the same, "\Since peoplo wore coming into tho hospitals who did not come m before, they should be required to pay higher fee 3. Many of those who received treatment at the Public Jiflspita* could well aftord to pay more and tiier should. be compelled to pay them. Ee did not. suggest that the rates for poor people should bo raised. Mr, J. K Fitzgerald said he dissented entirely from the statements made bv Mr. M'Kenzie. The Government had done very valuable work in pathological research, and he applauded' the Government for it. Now that the science was getting out of its infancy the Government required to bo relieved of the burden. He did not think it_ was right to suppose, as Mr. M'Kenzie seemed to think, that people who could afford to pay tnc fees for a private hospital should not be in the Public Hospital, lie thought the Hospital in Wellington was conducted in a manner which reflected credit' on the board. Mr. J. W.. M'Ewen said that in his opinion tho estimate before them was a reasonable one. More people were using tho Hospital than ever before, and if people went on using them more and more, hospitals would bo "tho cemeteries of tho medical profession." Ho was of opinion thc.t having regard to tho increasing extent to which tho public were using the Hospital, „ tho growtli. of the expenditure .was not moro than a natural growth. The Apportionment of Levies. The usual formal resolution adopting the estimate wa>' carried unanimously. Under tho resolution tlio apportionment of tho amounts payable by the contributing local authorities was. determined as follows ' ' ' .i s. (1. Wellington City Council 13,023 0 8 Horowhcnua County Council... 1,506 10 4 Hutt County Council 1/17G 10 8 Makara County Council 593 15 4 Lower Hutt Boro. Council... 1,011 !) 1 Petono Borough Council 903 1 4 Miramar Borough Council GS!) 13 4 Karori Borough Council 391 4 8 Onslow Borough Council • 369 4 4 Levin Borough Council 199 13 0 Fastbourne Borough Council... 135 4 4 .rohnsonville Town Board ... 157 IG. 8 Upper Hutt Town Board ... IG4 7 4 Otaki Town Board 97 19 8 ' ■ ,£21,220 0 I)