COST OF HOSPITALS.

Hauraki Plains Gazette, Volume XXXVIII, Issue 5172, 31 August 1927, Page 1

COST OF HOSPITALS.

AN EXTRAORDINARY SYSTEM. MOUNTING EXPENDITURE. The following article appeared as an editorial in the August number of the New Zealand Medical Journal: The opening ceremony of the new Hawera Hospital afforded an opportunity to the Minister of Health and to the Director-General of Health to call attention t,o the increasing burden of hospital expenditure. The Hawera Jlospital buildings cost £9O 000 for the accommodation of 80 patients..

In New Zealand 73 per cent, of the revenue of hospital boards is derived from Government funds and levies on local bodies. The cost daily of treatment of a patient in a public hospital is said tp average 13s 3d, but in a full estimate this figure is higher, and is equal to the .tariff in a firstclass hotel patronised by the wealthiest people. The charges made by hospital boards is 9s> a day, of which only 3s 6d is collected. In fact, many of the boards consider it sound policy to contract with lodges at a full rate of 3s 6d, and this is a delightful system not for the country,, but for the beneficiaries. In one decade, namely, from 191'5 to 1925, the contribution from public funds for hospitals lias increased from £443,000 to £1,238,000. SHAMEFUL EXTRAVAGANCE. We have no hesitation in. calling this a shameful piece of extravagance, with a full recognition of the fact that, within reasonable bounds hospital treatment by the most recent methods is necessarily becoming more costly. In the decade under review forty naw hospitals were opened, in addition to extensions to existing institutions. The annual cost per head for every man, woman, and child has been multiplied by three in ten years and is now over a pound sterling. New Zealand is undoubtedly a healthy country. Is not our low infantile mortality said to be the envy of the world ? Yet New Zealand provides five and a half hospital beds per thousand of the population, whereas one per thousand is considered sufficient in tlie United Kingdom. The greater the amount of .accommodation the greater the number of because, with the excess accommodation, sick who might be outpatients or treated in their own homes are drafted into the wards. Observation iu the United States and in Canada shows that patients: in our New Zealand hospitals remain too long. W« have no poor-law medical service, though, of course, we should have to call it by a more euphemistic name, with the result that we treat mild_ cases of anaemia, ulcerated legs, and so forth in hospitals. It would be nearly as cheap to send these people to the best hotels and divide the profits with the publicans. AN AMAZING FACT. The admissions to public hospitals in New Zealand in the year 1922 were 392 per 10,000 of mean population, but in 1926 the figure rose from 392 to 484', an increase in four years of 23% per cent. In addition, in 1926, 66,000 people were treated as out-patients in public hospitals'. The l amazing fact emerges from these statistics that in New Zealand last year no less than one person out of every tjwenty-one took advantage of the public hospitals for in-patient treatment. The medical profession in the face of these, disclosures cannot remain for long supine, and there never was a time when the New Zealand branch of the British Medical Association needed more resolute leadership. The policy of this association has been too often to rebuff and humiliate its most faithful servants.

Mr Love, the Director of Charities in Victoria, stated at, an international hospital conference that the New Zealand system of hospital finance results in waste, and extravagance. Without endorsing this opinion, we are certain that our hospital system is overdue for an overhaul. Patients able to pay should be made to pay, unless, indeed, we favour a communistic system more at home in Moscow than in London. Hospital needs are not political or based on local rivalries or ambitions, and tne extension, or curtailment, and standardisation of hospitals should be under the control of a non-political board. All this the British Medical Association has advocated, but so far without much success. The Government apparently has more important matters to attend to. The public is apathetic, but times are bad, and if the hospital expenditure trebles again in the next ten years—and what is to prevent it ?—the taxpayer may at last begin to wonder if he is getting value for his money. It is only just to state that both the Minister and the Direc-tor-General of Health have publicly stated that economy in urgent and necessary, but, unfortunately, undei the present system their powers are limited, and enything may be done with the help of the catch-word “democratic.”

The editor of this journal strongly urged that the Conference on Hospitals, at which were to have been represented the Government, the hospital boards, and the medical profession, should have been held following on the receipt of the MacEachern Interim Report. However, it was unfortunately decided in the wisdom of the majority to postpone the Conference pending the receipt of the full report. After eighteen months this report has not appeared, and the Conference, where is it ? The tide was missed instead of having been taken at the flood, and all the voyage is bound in shallows.