A HEAVY LEVY

Dominion, Volume 9, Issue 2775, 19 May 1916, Page 6

A HEAVY LEVY

HOSPITAL COST THOSE WHO CAN PAY AND DON'T SOME ALLEGATIONS CONFERENCE OF LOCAL BODIES. The levy of over ,£25,000 which the U elliiigton District Hospital Board has made on the contributing bodies for the current year has provoked much discussion, aud led to criticism o{ the present system of financing hospitals,- and, occasionally, to criticism of administration of the institutions.. Most of the contributing bodies discussed the matter when .their bills arrived, and yesterday the Mayors, and ciiairmcji of these bodies met at the Huct County Chambers aud further ventilated the subject. The meeting was convened by the Johnsonville town Board for the purpose of discussing the increase in the levy, and "also to take steps to enforce payment of all outstanding hospital accounts." Mr: F. T. Moore (chairman of the Johnsonville Town Board) presided, and there ' were also present Messrs. A. -Monk (chairman, Horowhenua County Council); C. C. Crump (Mayor of Onslow), J. .W. M'Ewan (Mayor of Petone), H. J. Monaghan (chairman, Mnkara County Council), M. Welch (chairman, Hutt County Council), F. Townsijnd (Mayor of Miramar), G. H. I*. Burn (Mayor of Ivarori), P. Robertson (chairman,-' Upper Hutt Town Board), and J. P. Kelly (Mayor of Eastbourne). Mr. J. P. Luko (Mayor of Wellington), and Mr. H. Baldwin (Mayor of Lower Hutt) wero uuVtte to be present. Mr. Beech acted as secretary of tlio conference. What Every Locality Pays, The levies made on the contributing bodies are:— £ s. d. Wellington City Council 18,272 14 0 Horowhenua County Council 3,110 2 0 Hutt County Council 1,712 0 0 Makara County Council 713 6 0 Lower Hutt Borough Council 1,253 18 0 Petono Borough Council 1,158 0 0 Miramar Borough Council',... 652 4 0 Ivarori Borough Council . 442 2 0 Onslow Borough Council 476 8 0 Levin Borough Council 259 2 0 Eastbourne Borough Council... 162 17 0 Johnsonville Town Board ... 199 18 0 Upper Hutt Town Board ... 199 17 0 Otaki Town Board 161 12 0 • Total levy £28,775 0 0 In opening the conference, the chairman said that tho Johnsonville Town Board felt that tho limit of endurance had been reached in the matter of these hospital levies, and that something must be done to call a halt. The problem was liow to do it. Petona had suggested nationalisation of tlie hospitals, but that would bo likely ;to lead to greater waste than even tho present 6yf,tei9. The reason why the levies were so great was that people did not pay for the treatment they , got in the Hospital. Tho Hospital . gave good treatment, and hundreds and thousands of people received the bonefit of the. institution. Yet, through the soft-heartedness of tho board and the Magistrates, tlio ratepayers ivero constantly called on to .make good tho money which was not collected. The remedy :he suggested, was the obtaining of tlio power to appoint a receiver.

Drink, Children, and Ghouls. Among those who did not pay wera some wiiose trouble was drink and venereal disease. Doctors said that torcy. to t'orty-iivo p'er cent, of tho cases treated in the hospitals were duo to thes l . diseases. Such peoplo should be put in prison camps and'mado to navvy and plant trees., Yet, at present, tho public were paying to inako these people wall. Anothor great 'drag on the ,public >vero deserted children. A. sum of .£3O, I WO a year was taken from the public for these little .ones. • For tho non-collection uf fees, doctors were in. a great measure io blame; they 'had the power to send almost anyone to the Hospital. Lodge doctors were the worst offenders;.as soon as a patient began to give them trouble they shunted him oil to the Hospital. Only the other day seven'or eight "moribund" cases were sent in. Most of them were children, and the, doctors who sent them in knew, when. they did iso that they could not live. The Hospital was. put to the expense of arranging their burials.'.' It looked as if some people ha I become so ghoulish that they shunted them off—they did it with their aged relatives, too—to the Hospital to avoid funeral expenses. Plenty of people who drove to races in motor-cars, and were always at the pictures, (lid not pay for the pospital treatment they were liabb to pay for.

A Cry from Karon. Mr. Burn disagreed with the chairman's observations about the lodge doctors. He disagreed, also, with the suggestion as to appointing a receiver. That would be robbing Peter to pay Paul. Tho remedy (to his mind) was to go back to the old system of giving every local body representation on the' Hospital ■ board. He asked if inquiries were made (when a patient. was entering the Hospital) as fc> whether 'ho was in a position to p-.iy for the treatment he was about to . receive. If not, the administration was faulty. ' A return supplied respecting tho patients received from the Borough of Karori stated that in 191-1 tho number was. 51, in 1915 fifty, and in 1916 fortyfive; a total of. 149. If that return was correct, the largeness of the number astonished him. The amount collected In 1914 was iCI7 95.; in 1915. J>23.65.; and u. 1916, ,£25 ss. The average duration >■{ these patients' stay in the Hospital was: —In 1914, seventeen days; in 1915, twenty days; in 191G, twenty-four days. So tin amount for 1914 worked out at foiirpence halfpenny per day. In the last three years Karori had. paid towards tho Hospital JCIIG6 10s. 2d„ made up tlrus:--1914 levy, .£391 4s. Sd.; 1915 levy, -£328 14s. 4d.; 1910 levy, .£3BO 6s. Sd. 1 ; paid by patients, -SCO 4s. 6d. Can the Workingman Pay? Mr. M'Ewan said that in five years hospital expenditure per .head of New Zealand's population had risen from Gs. 2d. to 10s. o§d. Tho causes for tho increase wero varied. Ono was that the doctors now made more uso of the hospital than formerly; and there might be something in the point made by Mr. Moore, regarding lodgo doctors. Again, the hospitals were now better equipped, and so were patronised to a greater extent. He thought that the outdoor pationts' department in Wellington paid for itself. As to the ability of the patients to pay ,£2 2s. weekly, he must confess that in a great mauy cases they were not in a position to pay that amount. A workingman earning, say, .£3 weekly, paying rent and raisiiig a family of four or five, led a hand-to-mouth existtence when blessed by good health. But let sickness befall him! Could he, when restored to health, wipe out tho arrears which ha-.l accumulated for fcod, etc., and sot about squaring his hospital bill? A voice: No. Mr. Bam: I don't know that anyone wants him to. do so.

Mr. M'Ewan: I say that the man on ■ill camiot do it, and many are getting smaller wages. Mr. Crump -slated Hint he had seen the secretary of the Hospital Board on the subject, and the secretary maintained and assured him that though cases may occur where peoplo who have been under treatment tit tho Wellington Hospital, and were in a position to pay the maintenance fee, either in full or by instalments, evaded their responsibility, tlioy did not number one-half per cent. Mr. Cramp mentioned, too, that the board had power to sue for recovery of tho money. "Nothing so Helploss as a Child." "As to that that Mr. Moore mentioned, I would have lrft that out," continued Mr.. Crump. Mr. Moore: Why? Mr. Crump: Well there is nothing so helpless as a child, and I would take tliem all in, and say nothing. (Hear, hear.)

Mr. Moore: Let their own fathers piiy for them. (Further Hear, hoars.)

Mr. Crump: We can't afford to lose population, and it.iOOO is a small amount, Mr. Crump thought that Mr. Moore, as convener ot tho meeting, would have come forward with tome good suggestion. It was easy for anyone to pull the present schomo to picces; more difficult to formulate a better. The levy was luird on his district (Makara), as it amounted to an eighth of the revenue.

Mr. Monk stated that the levy took a fifth of the revenue of his district (Horowhenua), and then mauy of their people went to l'almerston North. He agreed with Mr. Moore that there was something wrong regarding the cost of tho deserted children, aud he thought that there was loss over the consumptives' sanatorium. He thought, too, that the chairman of the Hospital Hoard should be a paid man, and he remarked that Horowhenua was striving for separation from tho AVellington district.

Mr. F. Townsend spoke of Miramar as tho most badly treated of all the districts concerned. "Wo have not sent in on an average three patients a year, and yet we pay the enormous sum of .£360 a year." He .said that the present meeting did not know what it was called together for, and he urged that an endeavour should be made to get the Government to nationalise the hospitals.- Ho did not consider any good would be done by holding pettifogging meetings to try to interfere with the institutions, and he did not think war-time was the time to attempt such a thing. Mr. Crump mentioned that as a motion was to bo introduced by Mr. F. Cnslle at that afternoon's meeting of the Hospital Board, in favour of tho Government increasing its subsidy from 16s. 3d. to £1, it would strengthen the hand of the mover if this gathering resolved to approve that motion. A resolution as suggested by Mr. Crump was carried unanimously.

One thing that led to an increase in the cost of hospitals, according to Mr. M'Ewan, was the fact'that ninny of the diseases could not be treated in the homes. Greater Care Advocated. Mr. Townsend suggested that the meeting should combine itself to the devis ing of a means of collecting'tho money due to the Hospital. He claimed that lie knew for certain that a large number of the people who used the out-patients' department could afford to get their adveo and treatment privately. If the responsible authorities were to devote more attention to getting that money in, a good deal would be done toward reducing the cost of the institution. He thought tins meeting should send forward a suggestion to that effect. As ■to the children they could not turn any child away. Neither could they turn away sufferers from disease; the Hospital was the place for the latter, not the home. He felt sure that fifty )>er cent, of the people who used tho Hospital could afford to pay for private treatment. The chairman said that Mr. Townsend'p fifty per cent, was much nearer the mark than the Hospital Board secretary's half per cent. Mr. Crump replied that if tho chairman had gone into the question, and takon out figures to support his words, he would accept hie observation, but otherwise he did not wish to see the secretary's figures discounted. The chairman: I am sure that that half per cent, is only Mr. Coyle's nersonal opinion, and he errs on tho side of soft-heartedness, and so do most of the members of the board. Mr. Welch said that Mr. Moore should be thanked for having convened tho meeting. His body sent five patients in a year to the Hospital and paid .£1712. ■ Mr. Crump: We can knock that into a cocked hat. Finally, it was resolved, oil tho mot'on of -Mr. Townsend: "That more care,should bo taken as, to the financial position of. the people whoare received for treatment at the out-patients' and in-patients' departments, and also that a greater effort should be made to collect fees. That before an account is written off reference, should - bo made to the local authority." Tho secretary wns asked 'to nroceed forthwith to the meeting of the Hospitil Board and communicate tho resolutions. GOVERNMENT. SUBSIDIES IN IMPORTANT DISCUSSION. At the meeting of the Wellington Hospital and Charitable Aid Board held yesterday afternoon,. Mr. F. Castlo (treasurer) moved: "(1) That in the opinion of this board the Fourth Schedule of 'the Hospital and Charitable Aid Act (which Jias caused the rate of Government subsidy on ordinary expenditure to fall from £1 per .£1 in 1911 to. 16s. 3d. per jBI in 1915) operates unfairly-in the Wellington Hospital district, and that tho Act should bo amended to provide a minimum subsidy of a ,Cl per .«1. (2) That expenditure for providing special accommodation and treatment for, consumptives should be subsidised by tlie Government so that one-third of the net expenditure would tall on the local contributing bodies aiid two-thirds on-the Government. (3) That the Government be nsked to legislate in tile above directions.'"

, Jf 1 , s ?? a ¥ 1 )? t,l ' s "lotion Mr. Castle Suited thflt ths loco.l bodies had had dur liiß recent weeks a topic of great importance to discuss in the rapidly-increasing levies that were being made upon them, particularly in the last five years. In the course of these discussions many stt'eesbeen made. One was . the" nationalisation oi the hospital work, which he personally- did not approve of. -Mr Castle then proceeded to point out hew it was that the Government did not substdise the. Hospita! funds, to the extent that it did in other centres owing to the system on which the subsidy was calciin ' a 'l a question of rateable value population and total expense. He «Zn\ -instance, that their subsidy should be as high as Auckland, but that was no t the case.. Wellington's position during the past five years respecting the cost of administration . was favourable. J.he cost of administration per occupied bed of the hospitals in the fonr centres q 7° 5 ,, aSfolWs Wellington, r-1 i" - 1 ■ £105 ' 3: ""Mrtiii, A 116.3; Ghristchurch, J3107.3. The average cost per bed over the past five rears follows ,£95.4; Auckteciv 9 iiii 1 Dun6din ' £mM; christ: In the Hospital report, written by Br. i'rangier in 1912, the following reason wns S 5l r +l n ?' Vl 0 Government subsidies on the rateable value of' the district per head: "The object of this schedule oi subsidies is to help the pooi-r districts while at the same time oenall itig extravagant administration.' It will I tins be seen that a poorer district with a low rateable value per head a holier rate o subsidy than a rich district whose high rateable value also m'e--8J!OT„a s . n .'y n ' )er ,°f poor to be proudX foi, and if a rich district is extravagant m its expenditure, and has to levy at a high rate per head of its pomiln-q°VJv''-7 h TCS a st! 1 - lov '' Pl ' ' s "bs[dv." So that if they were extravagant, everv other centre was more extravagant. He thought that Jie subsidy should never bp reduced to under £1. If that were done tho\levies would not have been fo beavr indeed 't was only during the five years during which they had been given tho reduced subsidy that the levies had increased so heavily. Mr. F. T. Moore seconded the motion and related what had bean decided nt that days conference respecting tho master. Regarding a statement by Mr Castle that Wellington was a shippin> port, and had to boar the burden of shipping accidents, he said he was quite sure that the skipping companies nisunvl their men, and he was sure they could get that money if they only pressed far it. "hey were" 1 extravagant in the use of their-Hospital—the hospitals were used by people that should not use them. And with the erection of these convalescent homes, ho beliovod they would be running round tho town to fill them, and Im thought that tho more institutions, they created the more pcoplo they would have to keep. At nomo, people took auothor viow—they regarded it shameful to have to go to a public institution. Mr. C. M. Luke thought- Mr. Castle had put his fiuger on tho spot when he said that it was not so much the increase in tho cost of goods and material, though in many cases the cost had increased 100 per cent., but because of the invidious position they were placed in in regard to the subsidies.

The Rev. Mr. Van Rtaveren also supporttho motion. They had a statement from tho Inspector-General that thov t.ould refuse no one admission to tho Hospital, so what was the pood of talking. Mr. M'Ewon thought that the hospital work could he done inoro economically hy the whole system being nationalised, with district control on ivoll-dofinod lines.