The Dominion WEDNESDAY, APRIL 23, 1913. HOSPITAL EXPENDITURE,

Dominion, Volume 6, Issue 1731, 23 April 1913, Page 6

The Dominion WEDNESDAY, APRIL 23, 1913. HOSPITAL EXPENDITURE,

It is not surprising that some' of the. contributing local bodies are becoming alarmed at the heavy increase in the expenditure for hospital and charitable aid purposes in the WelJlington district. The levy which has been struck for the current year (1913-14) amounts to £21,220, which is 110 less than £5533 .more than that for 1912-13. This big i.ucrcase is partly accounted for by the fact that oil March 31, 1912, the board's estimates showed liquid assets to the amount of £3723, while on March 31 last this item had fallen to £<111. Tliis, of coursc, reduced the sum available for expenditure by £3312, and the increase of over £2000, which still remains, is accounted for by the growth of the institutions controlled by the Board causing a corresponding growth of expenditure in administration, and by rises in the price of supplies. After taking all these things into consideration, the plain fact stands out that the total levyjumped from £14,022 in l£)ll-12 to £21,220 in 1913-14; and on ■ the top of this we havo tho candid admission by the Board's treasurer that "there is no knowing where it will end." The contributing bodies are , certainly getting uneasy,, and unless the position is fairly faced by the Board serious friction is sure to result. It must bo admitted that our Hospital and Charitable Aid Boards are nowadays expected to cover much more ground than in the past. The latest and best methods for the prevention and curc of disease must be oinplbycd. We expect our hospital to be up-to-date in every respect, and the desired efficiency inevitably entails additional expenditure. Moreover, there has bucu a remarkable iucrcusc

in the number of patients treated. In-patients have risen from 2M4 in IUOG to 40G4 in 1913, and out-patients from 11,597 to 17,9<'i4 in the same period, an increase quite disproportionate to the increase 'of population.

. If these patients were, all paying for the use uf the hospital and the services .of its staff, the financial strain on the ratepayers would not be so severely felt, but it is a very serious matter to find that there are bad debts on the books to the amount of between £'!<!,000 and £15,000, this sum being spread over a number of years. No one wants to drag the last penny from poor patients, but more stringent measures appear to be necessary to ensure that the privilege of free treatment is-not abused. This raises a very big question, but it will have to be faced sooner or later, and the sooner the better. The contributing bodies arc evidently going to call a halt, and the time has ccrtainly come for the whole situation to be carefully reviewed before any further extension hi the Board's sphere of operations is undertaken. The difficulty to be overcome is to prevent the heavy increase in expenditure and at the same time keep the Board's institutions thoroughly up-to-date. In an interview which we publish in another column, Mit. E. I'. Bunny, Mayor of the Lower Hutt, states that the present position has arisen from the inability of the Board to "distinguish between what may be desirable and what is really neccssary." This'is a sound point; but it is not an easy matter for a layman to draw the line between necessities and luxuries in such a matter as the treatment of disease, and when a responsible expert reports that certain new buildings and appliances are required if the efficiency of a public institution such as a hospital is to be maintained, it is a serious matter for the governing body to ignore the request. The line must, however, be drawn somewhere, and the time seems opportune for a careful,' investigation of the position with a view to getting somewhat nearer to the ideal of economy with efficiency than has yet been reached.