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Hokitika Guardian, 24 April 1926, Page 2

Tim details of the report ol l)r McEachorn on the New Zealand hospital system follow, generally, tiie precis given in advance of the reporL. The visiting expert from, Canada gives the hospitals high praise, and that at least is some set off to the high cost the institutions are to the ratepayer and the taxpayer. The hospital system as it is to-day in New Zealand is the result of a steady progress of evolution marching with the times and fitting in with the needs of the country for tire time being, 'the system has grown up with the place, and the fact that there are to-day some Jorly-six hospital districts is due to llie need of them as an urgent and necessary requirement when they wore established first. There lias been a process of changes going oii since those earlier times when the hospitals were first established. At the beginning the means of communication was not what it is to-day. Ye have but to recall the first Y’estland hospital built at the South Spit, with n river between the town and the institution, to realise how circumstances alter cases. Then the situation was central and served very immediately the Totara and Southern districts. But as the northern district came more into opulence, the hospital had to be moved and was brought to the exceedingly line site it occupies now. Shifting population has worked its effect, and that factor combined with the means of cnmiiumicnlioli governed till) early erection of the- hospitals. The expert suggests now that there are too many districts and there should be more centralisation with the aim to reduce the hospital districts from forty-six to twent.v-one. lie suggests the four metropolitan centres and seventeen base hospitals. It is noticeable that as far as the Y’est Coast is concerned, he proposes only one institution and that centred at Grcymouth. From Kumnrn to Jackson Bay under the scheme proposed the district would be far Loo unwieldly for one institution to give service or satisfaction to the scattered communities. Yet while wo see only one base hospital assigned to the AYest Coast, four are allotted to the Hast Coast, namely, Invercargill, Oamnru, Timarit and Ashburton, If these four are necessary for territory admirably served by railways and good roads how much more is a greater assignment to the Y’est Coast than proposed, where there is a crying need for rail connection, and in its place poor and difficult raods with unbridged rivers?

Tin-: hospital report proposes a more ambitious scheme of medical aid than is at present in vogue. Paving patients are to he catered for on more elaborate lines; stalling is to be more superior; so that the upkeep will be more expensive. A more costly staff, etc., means a high cost whether patients are forthcoming or not. The reforms suggested seem to suggest more detailed expenditure, and the recoveries from paying patients are the most direct means for financial aid. A greater community effort is proposed by way of voluntary gifts, etc., and there is a very practical proposal bo draw in organisations of women to help by supplementing the work of the trustees. There is a good field in that respect for women’s work. Oil the whole the reforms so far as they indicate, mean greatly increased cost. This will have to he borne by the ratepayer and the taxpayer. The country desires well-served institutions and appears (even from the report) to be endowed with them. In particular, the metropolitan institutions are well spoken of. and the hospitals ns a whole seem to he patterned on them. Hospital administration, like expenditure on education, is costing a great deal of money, but it is not being begrudged because of the community value of the outlay. Still there must be a limit, and particularly at the present when advice is being tendered on all sides for economy in the public service and with the local liodies. On the whole, therefore, it would appear that the process of evolution with regard to hospital needs might in the main take its course. The people have to foot a heavy bill yearly for hospital levies— : the money coming from the rates. The balance required has to be found by the general taxpayer out of the consolidated fund. In considering any reforms, it is necessary to take into account the extra burden which will he placed on the people. There is also the dislocation of present arrangements to be considered in any radical scheme of centralisation, whether the end justifies the means to lie adopted. Seeing that the Dominion has a very fine hospital system and a good report as to general results, it is well to consider -whether it is necessary at this particular juncture to adopt reforms which might 'have an effect not at all palatable to the people as a whole.