HOSPITAL FINANCE

Dominion, Volume 11, Issue 195, 7 May 1918, Page 7

HOSPITAL FINANCE

"ENTIRELY UNSATISFACTORY" CITY COUNCIL'S PROTEST APPEAL TO BE LODGED ■ A special meeting of the WeiTinglon City Council .was held last night to consider tho Hospital Board's estimate of expenditure and levy for the current year. Tho Mayor (Mr. J. p. Luko, M.l'.) presided, and thoro were present: Councillors G. Frost, A. R. Atkinson, C. B. Norwood I, M'Kenzio,. M. F, Luckic, J. Castle, J .h Fitzgerald, E. A. Wright, ?V- P -,f ,y? ltch ' J - °- Shorhnd.W. H. I\*™M< w - J - Thompson, and W. T. Hildreth. A memorandum placed before the counJ2i ten y° ars "go «ie levy was 439622, while for 1918 it was 4323,055, iln , lnc '', ra?o Of appvoxinntely 140 per ?,°. n J;. \ w JOars ago tho population of Wellington Stood at (13,807, and this year Jt is i 3,3&5, an increase of only 15 per cent, approximately. The growth of tho •.levy to. ■ population is somethirg abnormal- A comparison of Inst year's levy . With this year's was as follows:Amount Population. Levy. per head. « ni - 43 s. d. Ml" 73,183 ■ 16.572 l 61 '•'MS 73,305 ' 23,055 6 3& The Mayor said .the council had viewed ■with alarm the increased cost of hospital and charitable administration, and had determined at its last meeting to make an appeal against the now levy. Tho ligures that had been for .yarded' to tho council by tho Hospital Board showed that there had been very largo increases, anil some of the figures required explanation. Wellington .city was called upon to contribute about 72' per cent, of tho total revenue required by the Hospital Board. Ho had made 6ome comparisons ■between,tho Wellington nnd Auckland hospital figures, nnd had found that in many respects Wellington charges woro as low or lower. Bnt the charge for salaries and wages per occupied bed was ■4128. K. in Auckland and 4354.2 in Wellington. The total charges per occupied bed wero 4395.45 in Auckland and 43115.3 in Wellington. He felt that the renl question before the council was whether or nor, tlio existing system of hospital control should be maintained. He did not regard national control with favour, sinco it would create a group of bureaucratic 'Officials and reduce local interest and . sympathy. The change would not be in tho best interests of tho .hospital. He felt that tin Wellington Hospital Board had faced many difficulties that did not trouble hoards in'other centres to the same extent. But he could not exonerate the board for its failure to collect fees from ;patients who were able to pay. Ho moved that the Finance Committee should bo instructed' to prepare the noees.fiary information and documents in support of tho appeal already authorised by the council. Councillor Frost (-econded the motion. Ho said that under tho old constitution tlio contributing local bodies had elected tho Hospital Board, and this system hnd . produced better results than tho present system, under which tho pcoplo elected the board, whilo othor local bodies had to find its revenue. An increaso in tho cost pi hospital administration probably was inevitable at the present time when all costs were rising. But the levy proposed by the board this year was staggering, and he felt lhat the proper course for the council' was to ask for the reconsideration of the levy or for the amendment of the law to make tho Hospital Board directly responsible to tue people. Tho present indirect system did not make for economy. The matter concorned all local bodies, and it ought to bo discussed at the next municipal conference. The hospital boards would do batter work if they collected their own rates direct from the peoplo. Councillor Fitzgerald said that if the Finance Committee was going to prepare tho necessary data in support of the appeal the council need not deal with the matter further. He knew that tho Hospital Board was just as keen to protect publio interests as the council was. Councillor Luckie said tho council at ' present had not enough information to enable it to preparo a statement in sup- ' port of its appeal. ■ The Hospital Board's own figures did not present all tho facts required, and tlio council would bo exN pected to give chapter and verse in support _ of its appeal against the board's proposed expenditure. Councillor Luckie proceeded to quote figures to show that the Hospital Board had not spent money in accordance with its estimates. It appeared that money .voted for particular purposes had been ■ spent in other directions, >md it was impossible to tell from the accounts just what had happened. The board 'had spent money in exoess cf last year's estimates in many cases, and had seldom nndor-spent. This meant that the board was committing itself in advance, and that the council must .be nsked to find money for purposes for v.hich votes hnd already been made. Tho position •was entirely unsatisfactory. Tho . Hospital Board should either be required to collect its funds direct fiom the ratepayers or should contain representatives of the council. Members cf the board said- now that thoy represented the peoplo just as much as city councillors did,

1 I but Hint argument did not moot the 1 case. Tim Hospital board (.'lection did not interest the public, end the City Council was blamed lor increased expenditure because it had to find tlio money. Councillor Wright mentioned that the charitable aid administration had not shown increases in expenditure to the same extent as tlio hospital administration. Tlio Mayor said that since the war the claims for • charitable aid had decreased. Councillor Wright said that the Hospital Board was now proposing capital expenditure for the creation of a Fever Hospital, and next year thoro would be a consequential increase- in interest and administrative charges. Figures coinparing Auckland hospital expenditure with Wellington expenditure demanded attention. The Auckland cost of 416 beds per diem was .iill,yi6, against the Wellington cost of .£19,578 for 361 bods, lie felt that .business control of tho Wellington Hospital was required. Councillor Shorlnnd raid '.hat lastye.ir tho board had got 4:600 for an electric lift nnd 43800 for an X-ray outfit. Tho money had been spent on other purposes, and now tho same sums appeared on the new estimates. lie suggested that hospital boards throughout tho l)o- ---| minion should prepare their nocounts on a common "bed day" basis for compnra.j live purposes. It would bo possible then to nee how tho money was spent and avoid misunilfrslandinijs. Councillor Fitzgerald: That might .prejudice tho health of patients. Councillor Castle said the Finance Committee hud already come to tho conclusion that tho appeal was of no use, and that tho money must be pnid. A committee that worked in this spirit ■ would not achieve much. Councillors: "Who said ihatr" Councillor Fitzgerald: "I said that." Mr. Castle mentioned that medical officers' salaries had advanced 100 per cent, owing to war conditions, and this accounted for much of the increase There was much to he said for tho nationalisation of the hospitals, in order that tho whole community might bear tho cost of a service that was national in character. The appointment of a business superintendent at the Hospitr,! would bo a good move. Ho know that there was some waste there, as there was. at ail public institutions. The system of allotting hospital charges'\ri(s not fair. Wellington people were required to pay heavily for hospital maintenance because their capital values r.nd rates were high. Councillor Bennett said tho cost of fuel at tho Wellington Hospital was about 4:7 a day. That charge scemci very heavy. The Mayor: "There are many fires to bo kept burning.'" Councillor Bennett thought that the question of hospital administration should be regarded from a Dominion point of view. Councillor Atkinson said that a changs of system offered the only hope of escape, from tho present position. The council could not sccuro a reduction of hospital expenditure,, since tho controlling board was elected by tho iieoplc, and dimply i levied on the other local bodies. Tho electors did not concern themselves at all about Hospital Board elections. Tlio public did not care, because iliey did not understand tho position. The Hospital .Board was elected on a Parliamentary franchise, and then the board was .ompowored to require other local bodies tr, collect money for it from Uiu ratepayers. Tho system did not provide direct responsibility, and it ought to bo altered. If the board was to bo elective, it should collect its own funds direct from tho ratepayers. Tho present Hospital Boards Act violated a sound principle. _ y The motion was carried unanimously. HOSPITAL LEVIES THE TREASURERS STATEMENT. A statement regarding hospital finance was made, by the, honorary treasurer of tho Wellington Hospital Board (Mr. V. Castle). "Tho Hospital Board's estimate of net expenditure this year," ho said, "is 4358,375, which is tho amount required from the Government and tho local bodies; 4:31,980 is the amount to be levied on JJio local Ixxlies, while tho • balance, 4:26,395, is payable by Govern- i ment. subsidy ■>

"Tho increase in levies on local bodies this year is 435803. Last year there was a decrease of 432598, so that it is possible the Wellington City Council's hospital rate may be in credit, for I understand no reduction was mado in this rato last year. But although the total increase in local levies by the Hospital Board is_ 435503, tho severance of Horowhenua increases the total amount payable by the local bodies by tho sum of 433204, which brings up the total additional amount required from tho local bodies to 439007. it may bo asked whother the severance of Horowhenua is in any way compensated by a reduotion in expenditure. There has been a reduction in expenditure on account of tho Otaki institutions, which are in tho severed district, and were taken over by the Government as from Jnnuary 1, 1917, and this reduction was rho principal cause of the decrease made in the levies last year.

"In considering the causes of increase in expenditure, 'consideration must bo piven to the fact that the war has raised the prices of provisions, coal, drapery, drugs, and r.ther materials, and also services, which aro required to maintain a largo hospital such as the Wellington Hospital. This was very ovident durinff tho past yoar, for, under the headings 'provisions' and 'domestic and

establishment,' tho expenditure exceeded tllu estimato of .£3859, and much of this was due to increases in prices. "The total iacreaso in estimated not expenditure over the estimate for last year is ,£9315. Tho principal items of the liicreaso aro as follow Provisions, •£*1708; surgery and dispensary, X2UO; domestic and establishment, ; rates and interest, <£1520; salaries and w.i-.'us, =£2000; miscellaneous, <£1130; repayment loans, i£3oo; boiler, X'looo. The incroaocs in the items 'interest' and 'repayment of of loans' aro duo to tho loan of ,£38,000 now boing expended in erecting tho new fever hospital in order to release tho present ono, v:hicli will bo used for diphtheria patients. 'Salaries and wages' increase is _ mainly due to provision for X-ray specialist, increases to house surgeons, etc. "With regard lo comparisons between Auckland aud Wellington hospitals bnsed on the qost por occupied bed thero is no doubt tho cost is higher in Wellington, 'i'iio figures for the yenr ending March 31, 1917, the latest oflicial figures available, aro:—Auckland, tolal maintenance per occupied ncd, ,£95.8; Wellington, total maintenance per occupied bed, J!115.G. There is a difference of ■£19.85 per occupied bed in favour of Auckland, but a conclusion based on ono year's operations is hardly fair. It is better to take the averago cost over a longer period. Tlio following figures show tlio average cost per occupied bed when tho figures for tho fivo years ending Starch 31, 1917, arc taken;— Auckland, total maintenance per occupied bed, .£97.8; Wellington, total maintenance pur occupied bed, XlO3. "Thero is a difference of .£5.6 in favour of Auckland, which means that the cost per occupied bed iu tho Wellington Hospital exceeded the cost in tho Auckland Hospital by 5 per cent, during tho period under consideration. Wellington also compares unfavourably with Auckland in tlio amount received from m-patients, but notwithstanding these differences it is difficult to see where a charge of extravagance and maladministration can be made out. "Tlio most important aspect in this matter ia tho burden of the levies which fall on local taxation, and their relationship to tho Government subsidy, which falls on tho general taxpayer. Tho luestiou to bo decided is this;—ls the jeneral taxpayer paying a fair sharo of ;ho cost of IpsplTal and charitable aid, ivliich is rapidly becoming of greater aational importance? Under tlio preiont financial.provisions tho local taxpayers aro being lorced to pay an increasing share of the cost, which means that a liniinishing share is tailing on the genmil taxpayer. This is clearly shown by ho following figures:— Levies on local bodies. Govt. Sub. 1911-12 .£14,021 . J214.021 1918-19 ,£31,980 420,395 "ilight years ago the local bodies paid ho same amount <k> tho fiovernmont. I'his year the local bodies are askou to jay .£5535 more than the Government ' übsidy. This is an inequitable tinau-; ;ial arrangement, and the sooner local j lodies realiso that tho local taxpayers • no boing penalised iu ordor lo relieve ! he. general taxpayer ttie belter, for the j training point lias been reached, aud j t is tiino tlio Government shouldered a | arger sharo of tho cost ot maintaining iospita.l and charitable aid. At least ivo-thirds of th« net expenditure ahoiild io borne by the central (joverninont, and he proportion should bo a iixwl oue, hot übject to reduction. Tho Government I iss admitted the principle Mini they I liould bom the larger sharo of the Qqst | 1' treating venereal disease, for they I iave agreed to pay 7S per cunt, of tho I ost. 'intj principle oiiould be extended j o tlit cost of treating consumptives and thois, tor thero ia nu i?roat difference in hoir national importance and their in.uenco on public health, between venereal ; nd other diseases." 1

THERIMU IN A HEAVY SEA SEAMAN WASHED OVERBOARD.. By Telegraph-Press Association. Auckland, Jlny G. Die steamer Khun, irom flokianga, while crossing tho Mamikau Bar this morning, was overtaken bv a heavy em, which completely ear-eloped the ste'amer, only her masts showing above the wator. Mr. Gash, tho chief mate, and a seaman named Howlnnd Christian were on the boat deck, and tho latter was swept overboard. It is almost certain he has been drowned. AU. Gash escaped by climbing into a boat c-n the davits. SECOND DIVISION LEAGUE » EFFORT TO RESTORE THE CHRISTCHURCH BRANCH. By Telegraph—Press Association. Christchurch, May 6. Mr. R. A. Armstrong, president of the Federated Second Division Leagues, who is at present in Christchurch, tu-day said that he had seen a number of members yf tho executive of tho Chriscchuroli League, and as a. result ho was satisfied that the present position was duo entirely to a series of unfortunate misunderstandings. In tho first placo the league's objects were clear, uud if tho constitution had been steadily adhered to the present position could uot havo arisen. Tho objects were these: (a) To assist tho Government to bring tho war to a victorious conclusion, ana to secure by constitutional mothods tho conservation of tho general welfare of all soldiers and their dependants in Now Zealand; (b) the abovo objects boing wholly national, tho league shall bo strictly non-party. Mr. Armstrong said that as the Christchurch League was now without executive, officers, ho had decided to call tho Canterbury Provincial Council togother to go fully into the matter, and decide what steps should bo taken to put the Christchurch League- onco moro on a sound footing. Asked as to the general opinion of the various leagues regarding tho recent happenings in Christchurch, Mr. Armstrong said ho thought it was now generally recognised by the public that the league was not in any way responsible for tjio aniondnient at the Sunday night public meeting, nor for tho public demonstration at tho barracks. Tho various leagues that ha'd expressed an opinion had all deplored tho apparently extreme attitude of a certain section of tho peoplo, but this must not bo taken as an indication of any weakening in tho league's attitude regarding constitutionally pressing for adequate conditions of service.