OUR HOSPITALS

Dominion, Volume 10, Issue 2974, 11 January 1917, Page 6

OUR HOSPITALS

i mamm conference 1 11 n LARGE INCREASE IN COST t OP ADMINISTRATION h STANDARDISATION OF SUPPLIES A conference of the delegates from Now Zealand hospital boards opened in Wellington yesterday. Mr. H. Baldwin (chairman of the Wellington s Board) presided. The Minister of - Publics Health (Hon. G. W. Hussell) - and the Inspector-General of Hospitals f (Dr. Yalintine) attended. Tho chairman welcomed the delc--3 gates. He said that the chief question ) was 'that of the standardisation of hos- , pital supplies. There were, of course, r some nrticles which could not be stantl- ) ardised, but others could. By standardisation, Melbourne saved £'5000 a year on drugs, and New Zealand ought to save £20,000. Mr. Russell went on j to say that ho thought it would have been better had the conference originated with tho Government, instead of with one particular hoard. However, he would bo glad to meet the delegates and discuss matters after the conference, so as to mako tho proceedings as useful as possible. . Ho expressed ap- ' preeiatiou of tho work done by tho boards throughout tho Dominion, tho honorary surgeons, and the staffs in general. On the subject of tho cost of hospitals, Mr. Itussell said that tho total' cost of hospitals and charitable aid in 3916 was £665.000. Enormous Jump in Expenditure. Thero had been an enormous increase an the expenditure of late. In 1906-7 the expenditure was £288,000, or 6s. 4{d. per head, and in 1915-16 it •was £631,000, or 11s. 5Jd. per head. Careful and rigid inquiry should bo made—it was absolutely necessary—in order that hospital hoards and he could guarantoo to the public that they were getting full value for all that .great expenditure. Of tho money raised in 1915-16, £249,000 came hy way of Government contributions, and £208,008 was raised by local bodies. Sometimes there was a tendency on the part of the boards to chafo at Government control and Departmental requirements in connection with expenditure. Hβ wanted them to understand that tho boards were spending not only the money raised by the districts they represented, but also an equal amount subscribed by the peoplo of the Dominion, nnd the Department stood to represent tho latter amount of money. The control by tho Government of hospital expenditure might have to bo tightened. Exactly how that could best bo done ho was not yet prepared to say, but he thought it might bo necessary' to ask tho hoards to submit estimates of expenditure before their lovies woro mado on the local bodies, because whatever levy was made on tbo local bodies reacted on the Government, which had to subsidise tho amount raised by levy. Ho was satislied, also, the Government would have to exercise a greater right of control in the matter of staff appointments. At present tho law was not satisfactory regarding tho appointment of medical superintendents, matrons, and so on. Tho Government ought to be in a position to exercise- a. power of veto, after consultation with the board concerned. It was quite possible that during tho coming session of Parliament some of these matters might, bo brought "up. Relief Expenditure. Regarding tho payments by persons relieved by hospitals, ho congratulated tho conference on tho fact that thre had been a steady increase, as revealed by the following figures:— £ 1912 64,000 1913 :.... 77,000 1914 84,000 1915' 89,000 1916 99,000 So that thero had been an increase of £35,000 in five ypars, and yet a great deal was still to be done in tho way of organising hospital services in order to mako thefee who could do so pay their fair share. This needed organising on a business basis. In this respect the Wellington Board stood comparison with other boards badly, but, of course, he did not know if there were any special reasons for it. Tho numbers of patients in tho year ended March 31, 1916. were: •Wellington 4.978 Auckland 4,932 Duncdin 3,427 Christchurch 3,665 The recoveries from those assisted were: £ ■ Auckland 11,472 Christchureh 11,552 Dunedin 6,831 Wellington 6,755 An Interjection. Rev, H. Van Staveren: Could not the Minister put that down to thero being a lot of Government "hangerson" in Wellington? Mr. Russell: Whatever the explanation, I have been under the impression that Wellington is quite as wealthy as other cities. Anyhow, there is more ready money here. It is simply a matter of applying business principles, and I am inclined to think the Government will have to appoint an inspector in matters of this kind, so that we shall be satisfied that beforo a man has his debt written off by a board every effort has been mado to pay tho amount. Mr. Baldwin: That would be welcomed. Mr. Russell: I am glad to hoar it. A delegate: Tho board has to prove that the person has the money. Another delegate: You can't recover unless a man has tangible assets. Mr. Russell said that in_ ono small Waikato district the recoveries amounted to £4709, yet in the great Wellington district the total was only £6709. Maintenance Charges. The expenditure on tho maintenance of the general hospitals last your was £289.000, or £111 for each of the 12.600 persons in the hospitals. Details of this £111 were:— Provisions £27 Surgery and dispensing £10 Domestic and establishment £31 Wages and salaries ;..••■ £42 Taking the entire purchase of pro- . visions there was £27 per bed to workon, and he thought that if a proper i scheme wero devised a very large saving could he effected. If ono consolidated purchase wore made a. large saving could bo secured on drugs, furniture, drapery, and all the other genoral necessities of tho institutions. Ho did not think that could bo made 1o iipiilv to food, which would need to be . considered separately. A delegate: You might arrange for n > Customs -remission. ; Mr. Russell: T don't think my col- ' leagues will allow the hospital boards to escape Customs, but if tltf Minister imported the stuff (Laughter;) MY. Russell thought the conference ' should arrance for a consolidated store ; in Wellington which would cover the ■ hospitals, including the St. Helens Homos. Tho goods could be bought , there by the institutions at cost nrico, \ and a considerable saving should bo i effected. Ho believed arrangements could be made, with little trouble, to

purchase stores at great reductions on 1 the prices now heing paid. Ho was i ;iot satisfied that tho present system of allocating tho Government, subsidy to | J hospitals was satisfactory; ho could not ] see wny the rate sVioukl vary. PURCHASE OF SUPPUES. I STAXDAR DISATIQN SCHEME CARRIED. When remits were considered the conierenee first o£ all took the question of tho standardisation of supplies, and passed tli3 following resolutions: — 1. That this' meeting approves of standardising all goods and medicines as far as possible used in the hospitals of this Dominion. '2. That this conferences of Hospital Boards approach the Minister in charge of hospitals with a- view to inducing tho Department tf> undertake tho importation and distribution of hospital supplies. The Minister congratulated the conference on its resolutions. Standardisation was generally adopted nowadays, he said. Th-jro should be no dilficiilty regarding the second resolution, hut he ■suggested that a committee of not moi-o than seven leading members of the conforoiicß should meet tho Inspector-Gen-eral and himself. The resolutions seemed (o apply to imported stuffs, and ho wanted to say that as a Now Zealander he was in favour of using Now Zea-land-mado good's as much as possible. The committee was set up, and in the evening the following scheme was submitted to tho conference-:— 1. That each Hospital Board's secretary be requested to prepare a schedule of tho supplies obtained for tho past year under the following headings:— (a.) Drugs and surgical requisites.(b.) Furniture and hospital equipment. (c.) Other recurring items. It is not considered possible .it present to apply tho scheme tf provisions in any form. The extension to the scheme of articles of food wliich are imported may be matter for consideration later on. 2. That a Committeo_ of Management bo established, to consist of— (n.) Tho Inspector-General of Hospitals, or such delegate as he may appoint to attend' meetings. (b.) Other members of tho Public Service whose Departments are large purchasers of stores. (c) Tho chairmen of the Wellington, Chvistehurch, Dunedin, and Auckland Boards, or their delegates. 3 That in tho first place purchases be confined to those lines which are most largely used in all hospitals, leaving to tho boards the purchase m tho ordinary way of those drugs and necessities which do not -bulk largely m the annual expenditure. 4 That in connection with requisites under the heading of ''furniture' an examination and report bo made as to what aTO suitable standards of puichasos (for example) of— (a.) Bedsteads, (b.) Blankets. (c.) Sheetings, and material. _ (d.) Crockerywa-re, and similar classes of goods. ' 5 That, on tho compilation ot tlie probable orders for a year's supply, tenders bo invited by tho High Commissioner for those goods that, must he imported, and by tho secretary of the bureau for those goods which can be manufactured in New. Zealand; and that similar tenders bo open to tlio importers of Now Zealand, whoso prices, including all charges, sliaH bo compared with tho tenders received iroiii Great Britain, with charges added. Financo. That upon receipt from, each hoard of its .list of requisites for the year, together with a statement showing the amount paid by tho lio.wl for the goods scheduled during the provaous year tho board forward to the Inspec-tor-General a cheque representing onehalf the cost of the year's supplies—it being clearly understood that in no casoVill the cost under this scheme oxceed what tho board has paid for the samp goods during the previous year. It will ho the business of each board tn see that its account is in credit with tho bureau. 0 Tho honrrl adopted tho scheme, and thanked the Minister for the assistance ho had given in drafting tho scheme. OTHER PROPOSALS. Other matters were dealt with as follows — • •' North Canterbury moved: "That it bo a recommendation to tho Government to amend $lio Act in such manner as to give power to hospital and charitable aid boards to borrow money for capital purposes." Tho Minister advised against such borrowing power, and the motion was lost. A motion from North Canterbury was carried to the effect that tho Government subsidy should be 'on a uniform basis. It was resolved to form a Hosnital Boards' Association on the lines of tho Municipal Association. On the motion of the Wangamii delegate it was resolved that the Government should bo asked to extend the present system and control the whole of tho tuberculosis oases, and erect new institutions Mf necessary under Stiito control. On the motion of Buller, it was resolved: "That section 85 of tho Act should bo repealed, and the cost cf maintenance of children committed to industrial schools be'paid direct by the Government and not by tho boards as at present." Education Boards. Wellington moved:—"That, inasmuch as there are reasonable grounds •for doubting tho legality of the action of the Education Department iii regard to recoveries on account of inmates of industrial schools for whoso maintenance hospital and charitable aid boards aro liable, as set forth in tho said Department's circulars of September 26 and November 16 last, all hospital and charitable aid boards of the Dominion co-operate with and assist that of the Wellington district in obtaining a decision of tho Supreme Court upon the matter." The Minister said he was not certain that tho Education Board was acting strictly within the law, and the matter iras held over till to-day. At about 10 p.m. the conference adjourned till to-day.