HOSPITAL FINANCE.

Levin Daily Chronicle, 9 February 1918, Page 3

HOSPITAL FINANCE.

The following informative urticle has been specially written for the "Chronicle' by Mr J. K. Horn blow, editor of the Foxton Herald, and a member of the Palmerston Hospital Board, with the view of acquainting the public with the Board s extension policy. it is the first authoritative statement on the subject yet published and will be found to give a lucid and striking outline of the Board's difficulties and programme. IN the Horowhenua district (judging by a recent editorial in the Horowhenua Chronicle) there appears to be some hesitation as to the capacity of the Palmerston North Hospital Board carrying through a re-organisation scheme costing as much as £55,000. Writing with a knowledge of the Board as a working body, as well as a good grasp of the details of the scheme, we would beg the sympathy of readers, both in this and the Horowhenua district, in briefly elaborating the matter. The public elects the members of the Board, and has a right to first-hand evidence as to their representatives knowing every detail of the business going on. The first essential, however, is to recognise the member's limitations. It is one thing to detail the work of an ordinary local body and quite another, even with the best intentions in the world, so to detail the work of a hospital board. The technical side of the latter looms so large, the actual business is so encumbered with medical, surgical and administrative details, that a large part of the responsibility tends naturally to be delegated towards a department outside the control of the Board.

IT is necessary to recognise the benefit of this outside control, as exercised by the Minister for Public Health and his officers. They are responsible for the discipline, the nursing, training and the surgical personnel of all the 73 establishments for health purposes in the Dominion, and they see that no radical departure is made which is likely to disturb the homogeniety, the evenness of the surgical, medical, and training opportunities of all those establishments. Were it otherwise, were hospital bofitds allowed to make their own arrangements, it is certain that while some hospitals would be ideal, many would gravitate between the extremes of providing inessential surgical luxuries and the neglect of even the most modest surgical material and environment.

YET control by a Department is not without some drawbacks. The tendency of a department is. always to standardise, to level the average of its undertakings in order that no charge of preference shall be made against it. The result often is that a hospital board under such a long official overlordship becomes indif-fex-ent, its work becomes stagnated, and its accomplishments merely an automatic registration of what somebody thinks somewhere. Under such conditions it is impossible to expect members to maintain interest. If a suggestion or an opinion has to await at every turn the advice, the leisurely consideration, the further enquiry, the tentative assent and ultimately the tardy final permission of a Department (which has no particular wish to initiate a reform unless it is common to 73 institutions), it is not unreasonable to expect from single members many divergent opinions and ideas.

WHAT really is an odd thing with the Palmerston Hospital Board is not that it is taking no interest, but, paradoxically enough, that, by taking such a great interest, it should give the public the idea of exactly the opposite. Hitherto most of the matters have been in the hands of the Department, and now —well, let us get on to the re-organisation scheme. The reasons which have compelled the Board to reconsider the whole problem of the public district hospital are as follow: — 1. The present ground space is inadequate. '2. The buildings are at present too close together and overcrowded. 3. The original wooden ward blocks are fast becoming decayed and out of date. 4. Horowhenua district demands a special and additional accommodation, both for men and women. 5. The planning of the present hospital does not allow of ordinary expansion, and there are buildings, sueli as the old nurses' home and the consumptive annexe, for which no permanent use can ge found. 6. Broadly speaking, the work of the hospital, whether surgical, medical, operative or special, is now done in two main wards, of which the verandahs have to be used for ground space for beds. 7. There is no scientific side to the work of the hospital. * * * * TO meet these factors the Board has decided on the following measures : — 1. That ground, amply sufficient for the next generation, shall be purchased. 2. That the best hospital architects obtainable, Messrs Crichton and McKay, of 'Wellington, shall incorporate in one big plan all w those spaces, buildi ings and additions which it is | conceivable that a large hospi- ' tal in a prosperous and grow- | ing district is likely to need ! within the next ten years. 3. That IV- -wi p U t in hand as rioon tipossible two men's

wards, two women's wards, a kitchen, and an administrative block and other additions. 4. That the work of the hospital be separated into medical, surgical and special departments, in - order to hasten recovery of the patients, and give them the best chance of skilled attention. 5. To build an X-ray room, and a bacteriological department, in order to put the work of the hospital on a scientific basis. These buildings to form the memorial to the late Dr.- Martin. 6. That a bacteriologist be appointed to work the laboratory, and Dr. Stowe be appointed X-Ray specialist on his return from England. 7. That a maternity home be maintained, to provide the best opportunity for a healthy motherhood amongst the poorer class. 8. That a children's department be initiated, with a view to making provision for the rising generation, so that they can be assured of a fair chance of health, become an asset to themselves, a credit to the Hospital, and a paying proposition and a source of pride to the country of their birth. 9. That some portion of the proposed loan may very properly, therefore, be placed upon the shoulders of the next generation. * * * * THAT is the scheme, and it is now in progress. Instead of being able to look to the Government for the usual subsidy of £ for £, the Board is told now to raise the whole of the money by loan. The Public Trustee at the last meeting of the Board insisted upon knowing how much was likely to be wanted, and a sum to cover all the commitments had to be stated; £55,000 was taken finally as the sum, because the Board was not yet in possession of the architects' estimates. They will be given at the nest meeting. * » • HOROWHENUA may be sure that its wants will be secured under the proposed plan. Public confidence is essential for public work, if it is to be successful. That confidence can only be obtained by putting all the cards on the table.