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Hokitika Guardian, 16 January 1920, Page 2

In the course of an article dealing with the voluntary hospital and it* relationship to the State, the “Journal of Public Health” remarks that the present weakness in New Zealand is that, with the full power of levying -upon the rates and practically the same power .to draw upon the Government exchequer for its needs, it is possible for a hospital to be administered in a slack and unbusiness like manner, providing that an open scandal does not result. The means of the institution being practically unlimited, the ever-pressing fear of “the Wjolf at the door” is eliminated, together with its aailutary check upon unnecessary expenditure. From a' standpoint, therefore, solely of economy the voluntary hospital can advance strong arguments in favour of voluntaryism. A purely State-ad-ministered institution, however, should be able to advance die same arguments provided it docs not sacrifice efficiency to bureaucratic inelasticity and red tape. It should, moreover, be able to point to all the economy attaching to combination and amalgamation, such as cheapness in purchasing and the power to l»uy all lines in the best markets, which is not available in the case of a solitary institution. A hospital eontrol-

led by a local, authority possesses lieu ther tile advantages that would result from every hospital being controlled by the State nor those resulting from the enforced economy of a. voluntary institution; and this is more especially noticeable ill the caise of the institution in the less important districts, the Hbarci of Management of which could not afford to pay a highly trained and efficient secretary, ’the initiative and organisation, therefore, devolving on a voluntary amateur—e.g. the chairman —who may possess no knowledge or experience in his work, nor the necessary time to give to it. Moreover, his tenure of office is not permanent, and changes in the chairmanship may take place immediately a chairman has become thoroughly conversant with the administration of the institution.

Without, therefore, a most thorough detailed, and constant inspection of the administration, which in itself would be useless unless it became practically part of the administration, the administration of institutions in the smaller districts can by no means be economical or efficient?