HOSPITAL EXPENDITURE

Dominion, Volume 13, Issue 19, 17 October 1919, Page 3

HOSPITAL EXPENDITURE

QUESTIONS ABOUT SUBSIDIES,

In tho annual report of tho Public Health Department appears the following references to hospital administration: During the past yoar Iho Department lia-s given further consideration w the question of subsidies, and the Minister instructed that an amendment of the Act should bo drafted embodying a scale of subsidies in which half the net maintenance expenditure of hospital boards would 'be borno by the Government, or, in other words, an average subsidy of £1 for ,£1 is guaranteed no matter what tho aggregate maintenance expenditure amounts to. The subsidy, however, to individual boards would be based upon a sliding scale above and below ouch averago according to the needs of the district, i.e., a district whose hospital levy is above the average rate of levy in iho pouind on rateable capital value would receive over pound-for-pound subsidy, and the district whoso rate of levy is under the average would receive less than .£1 for -J!l, thus tending to .eoualise the burden on rates throughout the Dominion. The Department recognises that it cannot, as under the present scheme of 6inbsidy, rely upon arbitrary figures as being determining fnctors as to whether a board's administration is extra vngant or economical, nor, indeed, in view of tho foregoing can it rely uoon a penalising scale of subsidy for checking extravagance in expenditure. It recognises that the subsidy must be given according to a hiarfd's needs, and that it lies with the Department by closc -supervision and inspection to prevent negligence or extravagance. The Department is at present obtaining . belated returns from boards, which in many instances ensure no more than rough comparisons between institutions, and only show the -mnin' directions of increase in expenditure. Tho rnero publication of such records, even if they were reliable and were compiled upon a consistent basis, is of no value by itself, and requires to be associated with regular and systematic inspection of the business administration of the boards. To this end implications were cnllcd for the position of lay inspector of hospitals, i.e., an inspecting house steward, who would be known as tho inspector of supplies and establishment, and this appointment was lining considered when the influenza epidemic broke out. • Nothing, however, could be done, nnd tho whole matter wan recently reconsidered, when it was decided that there was need for two appointments, viz., that of an inspecting accountant to thoroughly investigate and report upon more particularly the office side of boards' administration, and an inspector, to report upon the domestic and establishment side of the institutions themselves. . The appointment, of a purchasing officer was nlso considered to assist boards in obtaining their supplies to the best advantage. The Department has already taken steps in regard to the appointment of tho inspecting accountant and the purchasing, officer.