HOSPITAL LEVIES.

Dominion, Volume 6, Issue 1763, 30 May 1913, Page 6

HOSPITAL LEVIES.

LOCAL BODIES' COMPLAINT.

EXTRAVAGANCE ALLEGED,

REFORMS SUGGESTED. Representatives of contributory local bodies met in tho Mayor's room at the Town Hall yesterday in order to make a united protest against the increase in the levies imposed on them by the Wellington Hospital and Charitable . Aid Board. Tho Mayor of Wellington (Mr. J. P. Luke) presided, and there were also present Messrs. W. Galloway (Hutt County), F. T. Moore (Makara County), E. IJ.1 J . Bunny (Lower Hutt), 11. Findlay U'etone), F. Townsend (Miramar), C. Ciilhio (Karori), F. Iloldsworth (Onslow), B. K. Gardner (Levin), 0. Jerusalem and Thompson (Johnsonville), aud If. 11. Webb (Upper Hutt). The chairman said that one must recognise the fact that under tho present Act the members of the Hospital Board were not in such direct 'contact with the contributing local bodies as they had hitherto been. Now there was popular representation, whereas formerly the local authorities severally clectcd representatives on tho board. He did not suppose that anyone harboured any special giievance against any single members of tho board. Having been chairman of tho board for soino timo he recognised that there was need for improvement in hospital work, but he thought too that some discrimination ought to be excrcised in tho matter of who should be admitted to tho hospital and that fees should always be collected from those able and willing to pay. In tho year 1910-11 tho amount contributed by tile city was 48782, in 1911-12 it was .£8943, in 1912-13 it was jCIO,OrB, aud in the current year it would be 413,G23. Last year the levy amounted to 2Jd. on the annual value, but this year it would be 3d. This was ft very sudden increase. He thought there was a possibility of making a nroper protest without in any way jeopardising the efficiency of the hospital institutions. To Stop the Waste, Mr. F. T. Moore said it seemed to him that one item of 43000 for general additions of a permanent nature to the hospital buildings should not have been called up in one year, but should have been spread over several years. Generally it seemed to him that members of the Hospital and Charitable Aid Board looked upon themselves as public alms-givers. Half the money being found by tho State and half by the local bodies, they sci;med to think it did not matter whether they charged fees or not. He cited one case of a patient who olfered to pay half of what he owed, and a member of tho board had moved that the whole lot be forgiven him. The secretary had on another occasion produced a bundle of accounts and stated that he believed "strong" letters would bring most of the amounts in. Tho amount involved was 41000. lie (Mr. Moore) had wailed to seo whether anyone would move in tho matter, but no member said a word, until he eventually moved a motion embodying tho secretary's suggestion, which was carried. He thought the local bodies should be empowered to collcct the fees, for tho local bodies wore better able to judge than tho central authority as to who were able to pay. If this were the rule, he thought that instead of onesevtnth of the fees being collected, onetliird would Ire obtained. Too many doctors could get people into the hospital, and they were too ready to sign certificates. The result was that people with imaginary ills ws-ro sent in, and others were admitted and kept for months for observation purposes only. This was becoming a heavy burden on the institution. Then there was tho cost of alcoholic and venereal caws, which, it seemed to him, should not bo treated in the hospital at all. They should be dealt with in a place which was a semi-prison, where the culprits, for they could not bo called victims, would, bo compelled to work to pay for their treatment. M,any well-to-do people "shunted" their old relatives into tho board's institutions when they were quite well able to keep them outside. Numbers of people, too, obtained medicines at, the hospital for nothing, or next to nothing, who could well afford to git them at a chemist's. Ho considered tho salaries paid to some officers who were housed i'id fed at the hospital "were extravagantly' large. Ho believed that beforo any cases, except those of accidents, could be admitted to tho hospital, the local body concerned should sign an order certifying that the caso was a proper ono for treatment in' the hospital. If this woro done, and the local bodies were allowed to collect the accounts, thero would bo less indiscriminate admission of people not badly in nefcd of medical treatment. Law Amendments Needed Mt. 13. P. Bunny (Lower Hutt) said ho thought thero should be <souio provision in tho Act by which only a certain percentage of tho revenue or any local body should bo available for hospital levy. In ' Lower Hutt the levy was one-tenth of tho whole revenue, and in Onslow one-sixth. Ii might be, very shortly, that local bodies yo-uld be cripplod by these heavy contributions. In actual practice, tho local bodies found nearly all tho money for expenditure, but they had no chance of reviewing estimates for thousands of pounds worth of expenditure. The Hospital Board was dominated by the representatives from Wellington, and this was surely anomalous. The revenues of the other local bodies wero absolutely committed to a number of men who knew nothing about them. He thought tho local bodies should have direct representation, and that eacli local body should have only ono vote. This would prevent tho revenues of any local body from being crippled by people who know nothing of their resources. An additional _ safeguard should l>c provided by making it obligatory on the board to submit estimates of expenditure to the local bodies. Further, thero ought to be a scale of charges according to the ability of patients to pay. Some paid the 30s. a week rate who could woll afford to pay tho higher rates demanded by a private hospital. If a man said lie could not pay the fees imposed, he should be'required to sign a declaration that he was without means, and there should then bo an investigation as to what his resources really were. The reason why the board wero so lax about tho collection of fees was that members, as they were now chosen, had no interest in providing tho money. Ho would suggest that a committee be set up to investigate the matter, and confer with the Inspector-General (Dr. Valintine), and draw up n memorandum ceiling forth wliat they required. If they did this they might, get some relief, and lie had by examination of' the accounts of the local bodies satisfied himself that their finances could not long stand the strain 'Of the heavy levies now collected. He believed tho general Government should be asked to nay a larger share of the cost of hospitals. The Burden too Heavy. Mr. F- Townsend agreed with Mr. Bunny that if something wero not done to curtail tho expenditure on hospitals and charitable aid,"the local bodies would liave verv little liionev for other purposes. He thought. Mr. Moore's t'on that the local bodies should collect the accounts n very good one. Mr. ('■ Cathie (Karori) endorsed the remarks of previous sneakers as to the need for closer supervision of expenditure, and of the collection of fees, but lie did not believe, as had l.een suggested, that an appeal should be made to the General Of/wen*. Mr. F. Holdswcrth (Onslo\v)_ said the proportion of rates lo be paid to tho Hospital Board was becoming intolerably lnrro for small boroughs. Internal economies were all nullified bv ibis expenditure on the hospital, no aereed with the prnnos.il that the consolidated fund should be drawn upon more largely. The effect of this would bo lo remove the burden from the ratepayers and lilace it upon the general taxnavers. Ho supported other speakers in the matter of n scale of charges, and the, collection; of fees due. It was evident., to his mind, that there was a scandalous laxity about the collection of accounts, ns shown by tho fact that in one year .CIOOO had been cllecled out of 421.000 due. Mr. W. Galloway (Hutt County) said ho was satisfied thai, ill" leak-are of funds was through the hospital, and that AYellinglou representatives were tho canso of it." He knew of one woman who had applied for charitnble aid who had property worth 4COO, carrying a mortgage of I

only 425. There were other cases almost as bad, and there was need for a uioro strict supervision than was now exercised. Evasion of Payment. Mr. H. Findlay (Pctonc) said ho agreed generally with what had been said, and he believed there was a scandalous amount of evasion of payment. It seemed to liiui that the wholo community was going wrong; thero was no effort to pay in many cases, and there was, ho contended, dishonesty all round. The l>oard was too apt to say to. a debtor, "Don't bother, old man; it will be all right." and if this went on and grew, it would lie ruinous. Doctors in charge of friendly society cases, ho said, sent pt.licnts to the hospital to get out of tho troublo of looking after them. In view of the present laxity about payment, it would be much bettor if the wholo cost of hospitals and charitable aid wero borno by tho general revenue, and if this were none, no man receiving less than 4150 a year need bo asked to pay for treatment. Tho extra taxation could be levied on beer, pianos, motor-cars, and such luxuries. Then, if a drunken man fell down and broke his leg, ho would have paid at least something for his maintenance in the hospital. Air. 0. Jerusalem (Johnsonville) did not agree that tho local bodies should bo asked to collect accounts. Tho Hospital Board had officers paid to do this work, and they should not be allowed to pass it oil. In any case, outlying district patients did not often shirk payment; most of the loss was on city patients. Tho clerks of local bodies might bo asked to supply information, but they should not be asked to do the collecting. Mr. J!. 11. Webb (Upper Hutt) said he endorsed' most of what had been said, but he wished to protest against insinuations made against the medical profession. He had known many eases of men who bad been refused, certificates by medical men, and these patients had obtained admission to the hospital by other means. It was not true that doctors sent members of friendly societies to the hospital because they were troublesome to treat outside. Tho Cause of Waste. Mr. B. E. Gardner (Levin) said he hardly agreed with Mr. Bunny's suggestion. They would get little satisfaction from tho Government, lie would suggest rather that a committee be set up to draft proposals for different administrative methods, and submit these to tho board. Ho showed how in spite of the incrcaso in organised charity by way of old ago pensions and the like tho cost of tho hospitals was increasing very rapidly. Tho out-patients' department was the cause of very great loss. One man had tho right of certifying whether all tile 200 now out-patients coming to tho hospital every week were fit persons to receive such treatment. And no ono man could learn all about so many patients. This, however, might be remedied shortly, for a committee had been set up to investigate tho matter. He did not object to people using the hospital, for tho charges of medical men were often extortionate, but patients should bo classified, nnd charged according to their means. He pointed out that distant local bodies could not get nearly the same benefits from the hospital as Wellington city. Mr. Bunny said ho did not wish to press his point about going to the Government. He was most anxious that tho committee should bo sot up, and afterwarjs tho committeo could decide how t\ey wero to set to work. Proposals to be Drafted. Mr. Luke said Wellington city had paid 4J per cent, of their total revenue for hospital purposes, and now they would pay (1 per cent. Ho did not believe, as had been suggested, that doctors were too anxious to send patients to tho hospital. Ho thought tho delegates should form a committeo to consult with tho board, and to ask them to cut down their estimates. It would not be so easy to move tho Government as some delegates inight.suppcse, and in tho meantime they might do good by approaching the Hospital Board. Mr. Bunny said ho did not agree with this proposal. Mr. Gardner said he would like to seo a resolution passed for the nationalisation of all tho hospitals of tho Dominion, but this proposal was ruled out of older by tho chairman. v Mr.'Bunny moved that a committeo bo set up to determine what steps should bo taken to bring about a change in tho prosent system of hospital control. Several members agreed that it vyould bo useless to approach the Hospital Board, for no reduction of levies could bo obtained this year. Mr. Luke alono uiged that they ought to approach tho Hospital Board first,' and that the delegates should report to their several local bodies that the conference had thought changes in the Ijw nccessary, and ask for suggestions as to what changes tho Government bo required to make. Mr. Bunny's motion wns oarried unanimously. It was decided that the conference meet as a committee next Thursday morning, and that beforo the committeo moot Mr. Bunny, with the assistance of any delegates on whom ho desired to call, draft proposals for the committeo's consideration. '