HOSPITAL SUBSIDIES.

Manawatu Herald, Volume L, Issue 3965, 6 July 1929, Page 4

HOSPITAL SUBSIDIES.

INCREASED SUM WANTED.

BURDEN ON RATEPAYERS.

DEPUTATION/TOIMBET MINISTERS'.

With the object -ok agreeing upon some united action .being takeii to induce the •;Government to increase its subsidies to hospitals, representatives-- contributing local bodies in the ! Palmerston North Hospital Board’s district, met in conference yesterday at the suggestion of the Eaii’anga County Council.' At the request of the Pohangina County Council, the question;of allocation of the levies was also discussed.

THE DELEGATES. Cr. J. Batchelar (Kairanga County Council) presided;'and'others present Avere the Mayor (Mr A. J. Graham) and Cr. Hodgens, representing the Palmerston North Borough Council, Crs. Hunt, Perrett and Bovoe (Manav'atit County), Mr Blenkhorn (Mayor of Levin), * Crs. McLean and Hair (Kivvitea), Crs. Hyde and Thwaites (Sliannoh), Crs. Strachan and HoAA’ell (Pohangina), Crs. Monk and Catley. (Horowlienua), Moody (Kairanga), Mr C. Taylor (Mayor of Feilding), Air N. C. Harding (town clerk of Peilding). The Oroua County Council, Otaki Borough Council .and Rongotea Town Board were hot represented. Messrs J. K. Hornblmv (chairman) and A. J- Phillipps (secretary, of the Hospital Board) Avere also present. Tlie chairman extended a hearty welcome to the representatives, especially the Hospital Board chairman and secretary. He stated that, in 1920-21, the levy imposed on the Kairanga County Council was £1359, but by 1925-26 it had increased to £2783, and n special rate had to be struck to meet the charges Avliich Irad hitherto been paid out of revenue. Since then the levy had increased until it was hoav £3920, just short of £4OOO. The rates collected for the year amounted to £BOOO, and practically half the revenue Avould have gone in hospital levies hut for the striking of a special rate. Consequently, they had decided to meet to assist the Hospital Board to obtain increased subsidies'. Air Hornblow thanked the Kairanga County Council for the invitation to attend and hear the opinions expressed concerning the vexed question which had been considered from time to time. The board appreciated the satisfaction expressed at its administration from tune to time by the contributing local bodies, with, perhaps, one exception. BOARD’S LARGE AREA.

The board’s area was one of the largest in the Dominion, and extended from Waikanae in the south, practically to tlie border of Hunteiwillein the. north, and from the .Wairarapa on the east to the Rangitikei on the Avest. While local bodies were concerned Avith public utilities such as roading, the Hospital Board had to safeguard the health of the people. The board had under its control the Palmerston North Hospital, the Otaki Hospital and the Maternity Hospital. It had to care for the aged and needy and' maintained the Old Peqple’s Home at AAvapuni. It had charitable relief to administer and tuberculosis sufferers to care for. It Avas the aim of the board to establish district nursing and midAvife facilities. The administration of the board Avas on sound lines, and in 1928 it Avas able to record a loAver cost per bed than any other hospital over 70 beds. The hospital Avas crowded, and the additions had been amply justified. Even today the middle of the wards had to be used to provide accommodation. Originally, the scheme of distribution of subsidies Avas on a flat rate of £1 for £l. Then population' became the determining factor, but the latest system gave a subsidy of 15s 6d net in the £l. The board had always sought increased subsidies. The population of the board’s district was 56,000 approximately and the capital A'alue £30,999,685. The Palmerston North and Feilding boroughs' together provided half the patients and in the past year there were 2667 admissions to the hospital. The actual number of patients from each borough, county or local body Avas as folloAA’s:

. Palmerston North 1290 > Feilding 235 Levin 129 '.Shannon 102 Foxton " ‘ 110 Rongotea 60 Otaki 41 Kairanga 154 Oroua 156 Kiwitea 39 AlanaAvatu 154 Pohangina 59 Horowhenua 93 Other districts. . ... 46 Tlie flat rate scheme had no economical basis and favoured some boards at tire expense of others, but it was disregarded in 1909, when another scheme Avas drafted. An arbitrary schedule Avas laid doAvn, and the determining factors were rateable value per head of population and rate of levy per head of population in assessing the subsidy. One district, however, might have a much higher rate ' of capital value per head of population than another, and the AAeakness of the population factor was obvious. SUGGESTED SUBSIDA’. In 1920 the population factor was disregarded in a neAV scheme. On the proportional scheme,-now existing the highest subsidy Avas given where the levy Avas highest, and tlie loAvest subsidy where the leA’y Avas lowest. The present method of assessing levies Avas economically sound, but it was undoubtedly a feasibility for the Government to'spread the burden over the general taxpayer. He suggested that the basis of levy should not be interfered with, but that a subsidy of 22s 6d be - sought. Had that been in operation the board Avould have saved £2500 last year. They were only on the fringe of tackling some of the big hospital problems; expenditure Avas going to increase, and the time Avould come Avhen additional demands would liaA-e to be made in the board’s area to provide adequate accommodation. They had to deal Avith incurable cases such as cancer. Last year, an extra £BOO had to be spent on unemployment relief, the board being compelled to provide for that on* of its charitable grant, and for that reason there Avas a strong claim for an increased subsidy. When the time came for ail increase—and it mustthe board Avould not be.actuated by a policy of extravagance, but one for tlie alleviation of suffering Alatters bad gone more smoothly and economically under hospital board administration. Whatever they did they should retain their hospitals, continue the democratic direct representation, and maintain their control. Hospitals Avere be ing used by all members of the community and Avere no longer institutions for the poor. The doors Avere open to all, and there Avas a greater number of people taking advantage of the facilities provided. The principle of poor relief by taxation on the land Avas consequently a much lesser one than ten years ago. Alaternity homes were being established, and the standard. of genera] hospital treatment was high. Formerly, the maternity institutions Avere controlled almost exclusively by the Government and now they came

Avithin the province of hospital hoards. The conference should press the Government for an improved subsidy, a 22s 6d subsidy on a 17s 6d levy shoAild be sought at present on the Dominion average. The proposal' to Avould he strongly opposed, while a reversion, to the population basis would be extremely unpopular, both Avith the Government and large communities. INCREASED LEVIES LIKELY. , The present minimum of 14s should he raised by ss, and the present maximum of 26s to 30s. He tho\ight that the conference might urge the Govern- | ment to set aside a sum of money for ! research work into contributory : schemes. They should not think that in the future hospital levies-were going to be IoAA-er. In the next four or five years they Avould have to be increased. The chairman thanked Air HornbloAv for his information and suggested that the Hospital Board should" approach the Government for an increased subsidy. The local bodies could then give every support. Mr Perrett stated that they Avere indebted to Air Hornbloiv for his explanation of the board’s policy. One important point was that people able to. pay should be made to pay lully lor hospital facilities.. There .was, an increased allocation for charitable relief, and tlie speaker thought that there was a good case for an increase in subsidies. It Avas only a matter of arriving at a reasonable request. . HEALTH PARAMOUNT FACTOR. The suggestion was made by Mr Taylor (Feeding) that the contributing local bodies should seek an increased subsidy, and enlist the support of the Hospital Board. The opinion Avas expressed by Air Small that health Avas. the paramount consideration. Immediately extra hospital accommodation Avas required they Avere faced with the burden of debt. The responsibility of providing buildings should be on the State, which Avas gradually handing over a measure of that to local bodies. It Avas probable that even next year further accommodation AA’ould ha\'e to be found at Palmerston North. The administration /of the institutions should he quite sufficient for the hospital boards. Tlie managing-secratary of the Hospital Board intimated that last year 11 out of 44 hospital districts received a loAver rate of subsidy than Palmerston North. . Air Howell held that the levies as betAveen the urban and rural areas Ayere inequitable. According to the 1927-28 figures the cost per bed to the Palmerston North borough was £3 8s; to Pohangina £2O Is 4d, and to Knvitea £59 10s. AIOTION FOR INCREASED SUBSIDY. Mr Taylor then moved : “That the conference urge on the Government to increase its subsidies to hospital boards to a minimum of 19s and a maximum of 30s in the £1 leA’y, Avith an average of 25s throughout the Dominion.” This was seconded by Air Perrett. The Hospital Board secretary intimated that the motion meant that the Government AA-ould liaA'e to find an extra £BO,OOO per annum for hospitals throughout the Dominion. The resolution Avas carried unanimously. . Wlien the question of the allocation of the le\ T y came up, Air Taylor suggested that the matter Avas not one for discussion at the conference, as any discussion aa-oaiM resoL-e itself into a question of county versus borough. The Counties’ Association, tlie Alunicipal Association and the Government could settle the matter. Mr Howell stated that he did not wish it to go forth that lie was antagonistic to all the boroughs in regard to the levy, but he thought that it would have been a suitable opportunity for such a discussion. He proposed that a commission be set up to go into the matter. Since the „ last commission conditions had been altered by- reason of the added responsibilities. Mr Strachan stated that the information given by the Hospital Board chairman had cleared up a lot of misunderstanding, and he Avas quite content to let the matter rest. The motion was then withdrawn. PATIENTS’ FEES. Air Strachan said that every effort should be made to obtain the full fees from those able to pay. The managing-secretary of the board stated that every effort was being made in the direction .mentioned and prosecutions had been instituted. Air Catley stated that the amount of fees received from patients Avas also his grievance. He kneAV it Avas difficult to determine a person’s ability to pay. He believed that closer vigilance should he exercised by an extension of the system of personal inquiry into cases of alleged hardship. Mr Taylor suggested that lists of outstanding patients’ fees be forwarded to local bodies lor consideration by their finance committees Avho knew local conditions better. The managing-secretary stated that the accounts Avere thoroughly combed and any information would bo welcomed by the board. The chairman said that bo assumed the hospital authorities Avould- watch the position. DEPUTATION TO GOVERNAIENT. Air Graham moved : “That the Alayors of boroughs and chairmen of the local bodies in the board’s district constitute a deputation to ‘the Government to seek an increased rate of subsidy.” Air Alonk suggested that, as a nucleus, they attempt to embrace the whole of the local bodies in tlie Dominion in the movement,- and “put tlie Avind up the Government.” He thought that the steps proposed could, lie taken: They should submit the matter to the counties and municipal associations in order to secure unanimity. .He .Avas certain that they Avould not obtain legislation this session in any event. They should take concerted action. It Avould bo a pity to let the movement languish because it Avas too small. The opinion Avas voiced by Air Taylor that it Avould be unwise to shelve the matter until the Avliole-of the local bodies in the Dominion took action. As a deputation they could at least start the ball rolling on the subsidy question from their own district and commence a discussion. DOAIINION-AVIDE AIOVEMENT. Mr Hyde supported tlie attitude taken up by Air Alonk.

Tlie vieAvpoint of - Ah’ AlcLean was that they should make' a start,- although lie concurred Avith" tht* suggestion for a Dominion-wule.. movbnlont later, " " •- ' ''• Alt? Perrett suav no-reason Avli.v both lines of action proposed should viu)t be adopted. The Avas advafieed by Air Alonk that, if tlie deputyttim waited on the Government from-.the JJospitql Board’s district, the Minis, Health should be requested to, sußmit the matter to tlie counties and municipal. associations witli the vie,AA r - to calling a conference. There could not.be any dissension on the matter and they must, be unanimous in asking for a higher subsidy. • Though they might haA r e the passive | agreement of other local bodies, stated Mr Thwaites, they should have their 1 active co-operation. My Hmyell also favoured a Dominion movement. Tire resolution proposed by the Mayor of' Palmerston North, avlio consontdtl to the embodiment of the suggestion that the Prime Minister and Alinlster ’of Health be requested to call a conference of the counties and municipal associations, Avas carried. REMOVAL NOTICE. REMOVAL NOTICE.