THE SICK AND POOR

Dominion, Volume 9, Issue 2830, 22 July 1916, Page 10

THE SICK AND POOR

PUBLIC HOSPITALS STATE ASKED FOR GREATER SUPPORT CHANGE FORESHADOWED NATIONALISATION OF INSTITUTIONS URGED. » Representatives of the local bodies (who find the greater portion of tho money out of w ; hich the Wellington Public Hospital is financed) waited on the Minister of Public Health (the Hoh. G. W. Russell) yesterday, and outlined a grievance concerning the system by which the Stale subsidises the institution. They claimed that the rate of subsidy should be increased from file existing lGs. 3d. per XI to at least ,E1 per «Cl. They asked, also, that,the sanatoria of 'the country should be nationalised, and that two-thirds their cost should be borne by the State. After hearing the spokesmen, Mr. Russell said that he thought a easo had been made for a review of the subsidy system,- but declined to express an opinion on the question of nationalising any of tho institutions. He promised to have a new subsidy system drawn up by next session', and declared that during the same session he would introduce legislation to forco ' the hospital boards 'to obtain tho State Department's sanction of proposed expenditure, because at present the State had lo pay out hugo sums . of money for hospital work, but had iio control over the spending of it. The questions were introduced by Mr. H. Baldwin (Lower Hutt), who is Chair, man of the Wellington Hospital Board. Mr. Baldwin said it was felt that the way the subsidies varied from time to tinie was unsatisfactory, in-so-much as it affected the rate of levy. In 1913-14 subsidies pAid were: Auckland, £1 Os. 9d. in the £; Wellington, 18s. 3d.;' Canterbury, l<is. 9d.; and Ot-ago .ill Is. 9d. He understood that the Wellington subsidy for the next year was to be IBs. 3d., and the Auckland 19s. 3d. Ho did not know the others. Mr. Russell: Canterbury, 15s. - 3d.; Otago, it Is. Sd. In reference to the question of dealing with consumption, Mr. Baldwin said tho i>oard felt it was not a district matter, but a national affair. The receipts from the Otaki Sanatorium were £108 last year, whilst the expenditure wns JC279*. He trusted the Minister would bo able to have the subsidies better adjusted. State "Not Doing a Fair Share."

Mr. 1\ Castle, tho mover of the resolution passed by the Hospital Board, said the Government was not bearing a fair share of tho burden, particularly in Wellington. The reduction of Wellington's subsidy relieved the general taxpayer at the, expsnse of the local people. A recent hospital report, stated that the object of the operation of- the scheme was that the Districts with a higher valuation should get a lower rate of subsidy, and the poorer districts a higher rate of subsidy, and that a check should be put 011 extravagant administration. He held that a high rateable value should not be allowed to presuppose that tho people were any lietter oil .or that there Were leas poor people ill the district than in a district/ with a low valuation. 1 - Moreover, it could not be said that there had bcon extravagance in tlie administration, of the Wellington Hospital. The subsidy should be at least £J. for JJI, ns the service rendered by the hospitals was more national than locals In England the Commission on Venereal Diseases reported that 25 per cent, of'the cost should be a charge on local rates, and that the oilier 75 per ceilt. should bo paid by the State.

Mr. itussell: I'cs, but, you "must remembsr that the local authorities in England do not receive subsidy. To got at tlic proper position from that point of viow you have to remember that in this case the whole {responsibility is thrown on the localities, whereas in New Zealand half tin round terms) is paid b.v the Government. . . '. In connection, with the veneienl proposals I put before the House, I proposed that the State should pay 7a per cent, of the cost. Speaking in advocacy, of the nationalisation of the whole of the sanatoria, 3lr. li. K. Gardener (Levin) said that at present New Zealand was only playing with tile disease of consumption. Subsidy System Will be Reviewed, Keplying lo the representations of the deputation, Mr. Jtussell said that since he had- been in oflioa he had had such a rush ot' war work that some of his ordinary .Departmental work had not been as thoroughly examined ks it otherwise would have been. Jt was under Mr. l.'owlds's administration in J!!(]'.) that the change in the basis of subsidising the hospitals was introduced, and it wa's looked on as a tentative change. Mr. l.'ussell i'eit that tho system must be reviewed. The deputation: ilea-, hear.. However, in tho few remaining days of the session, it would not be possible to introduce legislation, but he would have a scheme'drawn up for next session. He (iid not see why a large city like Auckland should draw a larger subsidy than Wellington. Therefore lie admitted that a ciise lot- reviewing tiie system had been made out. It would be impossible to have a Hat rate of subsidy throughout the Dominion. The object of the subsidy system now in vogue whs to regulate the giv.nt according to "the needs of the districts.

As to the Otaki Sanatorium, the Minister suggested that some alteration inijlit be made in the way of endeavouring to secure the support o[ adjacent districts— 'J'aranaki, Wanganui, JLawke's Hay. Sir. Gardener: It has,been condemned' by the expert, Dr. Adams. Ml'.' llursell: Dr. Vnlintine tells mo it has not been condemned by the Department. Mi. liussidl expressed mnc'n sympathy with the country districts which found that their rates were being increased, 'i'luit, however, was not n result of (lie lowering of the Government subsidy, in Auckland the hospital rate for llllti, over the whole area, would amount to 1 wothirteenths of one peiiny. In Wellington the rate was one-fifth of a penny (heavier than in Auckland); in Canterbury, onesixth; and 111 Otago one-fifth. "Now," he added, "T come, to one of the enu-e- of the ureal increase in the rates and expenditurc in Wellington. Taking 1911-12, the not cost of maintenance expenditure per head o? the population in Wellington was 4s. 2d. J'y l!)U-1. r > it had risen to lis. jd. in Auckland, the figures were ts. r>d. and (>-•. lid.: in North Canterbury, Cs. lid. and Ss. Id.; and in Otago, Sd. and sb. lOd. The reason for this enormous increase was that in the "Wellington district one out of every 2.1 of the people used the hospital. In Auckland the ratio was one out of SO, in Canterbury one out of -13, and in Otnco one oul nf 3i-. Ho, for some reason or other, the Wellington Hospital was more used than were other hospitals. 4 Mr. I\ Towiisend (Jlirajiiar); Why? Mr. ftusssll: That is a matter for the board. Mr. C. M. Luke (Wellingtonl '• The notion has triil abroad that the hospital is for everybody, and I say it should not be so. Mr. Russell: It cannot be leeause you a re a seaport, for Auckland is a -euport too. . . . The board will have to consider that mutter. Expenses Rising. Voluntary Help Falling, Mr. Russell referred to what he termed "the big increase in our charitable aid expenditure." In IDOSS-10 hospital and charitable aid cost the Dominioii XliTi,(I0(i, ami in 1014-!o .S'i'S.fldn. In the same period the number nf persons under treatment rose from 21,000 to ot>,ooo. The l!overnment pnvments increased from ,CISO.000 in !!l!l-i'_' to .£217,00(1 in Ml, and in th?se years levies on the local authorities increased from - ( JMn,OOO to .£IBO.OOO. Here was a position which needed looking into, and he would recommend the Wellington Board to take notice of it— the voluntary contributions toward hospitals were decreasing. In 1011-12 the Dominion contributions were .£31,000, in

1!)H-15 -Ci 5,000. In Wellington the cost per head per occupied bed rose from £93 m 1911-12 to ,£lOl. Figures for other centres were:—Auckl&nd, .£9!) to iJIOS; Canterbury, «£l2O to ,£167; Otago, .£l2l to ,£IM. The recoveries per occupied bed in were.—Wellington, „£2O; .Auckland, JSI; Christchurch, ,£27; Otago, .£2O. "If this business is going on you will have to find some new plan by which the responsibilities of those who go into your hospitals shall be met as far as possible."

The Minister (lit! not wish to express any opinion regarding the proiwsal to nationalise the nospitals. It appeared to him, however, taking the .country from end to end, the feeling in favour of the proposal was growing. The question was one for the people of the country, through their representatives in Parliament. He was satisfied that a greater measure of control must in the future be exercised by the Minister ami the Department than had hitherto been the ease. The position was that the Government was compelled by law tu pay its sulsidy on whatever the boards chose to spend, and had no voice in the matter. Seeing that the State was committed, to so huge an expenditure, he would submit to Parliament next session proposals which would require the boards',, proposals to receive the sanction of the Department. Members of the deputation-. We have to get that now! Air. Russell: No. Mr. J. I'. Luke (Wellington): Tes; the inspector can stick tip anything now. Mr. liussi'll: No. The only control is over capita! expenditure exceeding .£250. . . . The only way I have any control is that I can refuse to approve tne plans. N T ext session, the-Minister added, legislation would be brought down requiring that estimates and expenditure should be approved by t.lie Department, before they could take'effect. Before the session ha would be pleased to confer with those interested in hospital questions.