HOSPITAL COSTS

Manawatu Standard, Volume LX, Issue 125, 26 April 1940, Page 12

HOSPITAL COSTS

ESTIMATES FRAMED. LEVY SLIGHTLY LOWER. Costs for all departments of the Palmerston North Hospital were discussed at. the annual meeting of the Hospital Board on Wednesday, when, as reported earlier, the total levy on local bodies was fixed at £44,802, as against £40.191 last year. There wasj tt full meeting of the board, those present being Mr J. A. Nash (chairman), Mrs M. Aitehison, Messrs J. Hodgens, M.P.. J IT. Williamson, O. P. Jensen, F. J. Ryder, V. E. Smith, T. Greene, J. Boyce, D. Coin’s, W. Howell, M. 15. Perreau and G. A. Monk. Detailed statistics of the expenditure in tlic past financial year, with the proposed figures for the current .year were given in a lengthy reportbv the managing-secretary (Mr A. J. Phillipps). THE MAINTENANCE SIDE. Dealing with the maintenance receipts, the report stated that the cash in hand and due from other sources totalled £6374 4s 9d. The report continued: We commenced last year with a cash balance of £BS in the maintenance account. We have finished this year with a cash balance in our maintenance account of £2642. This is the balance after repaying an amount oi £9R! which has been owing from maintenance to the capital account since 193 S SO in respect of Otaki Sanatorium payments and after making an advance to the loan account on account of architects’ fees of £1396 and paying out of the maintenance account as progress payments on account of the emergency ward the sum of £3731. The payment in connection with the emergency ward will of course appear in this year’s capital estimates and the amount will be refunded to the maintenance account during the year, so that we have to add to our opening cash balance of £2642 the amount of £3731, which makes this item £6374. The surplus arose this year due chiefly to the fact that- our estimates last year did not provide for as much as we received from the Social Security Account. Patients’ payments, Palmerston North Hospital, Otaki Hospital, district nursing, outpatients, etc. —Estimate last year, £16,000; actual receipts. £30.560 11s; proposed estimate. £34,000. As regards the estimate of patients’ fees for the coming year, apart from the social security payment it is estimated that we will receive £5500 from all other sources. The patients’ payments in respect of the old accounts (those which were due when the social security scheme was introduced last year) are gradually lading off and I think that it is going to be difficult for us to realise more than this amount. As to the estimated payments from the Social Security Department this year, we are estimating our costs on the ba.sis of an average number of 230 occupied beds for the General Hospital, nine for the Maternity Home and seven for the Otaki Hospital. On this basis the collections from the Social Secttritv Department will amount to £28.500. Otaki sanatorium fees.—Estimate last year, £12,500; actual receipts, £13,455 16s lOd; proposed estimate, £14,000. The hospital boards, including our own, who wore previously liable for the whole of the patients’ fees at the Otaki Sanatorium received substantial relief under the social security scheme, and for this year the Government will be contributing 6s per day for each patient and the board of the patient’s district the balance of the fee, namely. 5s per day. Awapuni Home inmates’ fees, patients’ payments and relief, department recoveries.—Estimate last year, £5000; actual receipts, £SIBB 4s 3d; proposed estimate, £5600. Of the amount actually received, £2580, was paid under the social security scheme by the Government for the maintenance of patients in the chronic wards and £1995 was collected as part of inmates’ pensions. The average number of chronic patients has been 20 men and 14 women. Bacteriological Laboratory fee.—Estimate last year, £1200; actual receipts, £1716 12s sd; proposed estimate, £I6OO. Awapuni Farm receipts.—Estimate last year, £100; actual receipts, £142 8s 4d; proposed estimate £IOO. This 'item consists of revenue received in the sale of any surplus produce from the farm and the sale of any live stock. Miscellaneous receipts. - Estimate last year, £600; actual receipts, £7BB 12s 4d; proposed estimate, £7OO. MAINTENANCE PAYMENTS. Palmerston North Hospital and Maternity Home maintenance. —Estimate last year, £67,900; actual payments, £74,565 6s 4d ; proposed estimate, £79,900. Details of the expenditure for the past year under this item a,re as follows (shillings and pence being

Provisions. —- r l he expenditure on provisions for the past four years has boon ; —1936-37. £6016; 193 1 -38, £6640; 1938-39 £7404; 1939-40, £8499. During this neriod we have improved outmenus to’ a certain extent. Expenditure on provisions lias increased during the past year due partly to increases which have taken place in the cost of some of the major food items—for instance, the average price per Jb which we are at present paying for all kind of meat is 6.2 d as against 4.2 d at this time last year. Wo are consuming a total weight of over 90,0001 b of meat and fish ner annum, so that even a small increase in the price of meat is a substantial item in our expenses. I he average price' for fish at the present time is 7.3 d, as against 6.3 d at this time last year. The prices of most dry groceries have advanced, and tea Which was costing us Is lOd a lb this time last year at present is costing us 2s 7(1. The proposed estimate or iLooud ' will be necessary this year. Surgery and dispensary. —The total I expenditure on surgery and dispensary . 1 reciuirements for the past three yeais

has been as follows:—l937-3S, £5885; 1938- £6O-10; 1939-40, £7968. There have recently been substantial increases in the price of surgery and dispensary requirements and it is exceedingly” difficult to estimate on this item this year. The increase in X-ray work during the past year is accounted for partly by the fact that over 700 members of the Maori Battalion , were X-rayed at the Hospital. The Xray fees recovered from outpatients lor X-ray work during the year just ended were £1434, plus £365 recovered oil behalf of work done for the Maori Battalion. As against this the fees recovered from outpatients lor Xray work were £1324 during the preceding year. The increase in the outpatients X-ray work, apart from the Maori Battalion, is almost exactly 50 per cent., and from this it will be seen just how important it is that the question of adequate payment for this service under the social security scheme should bo completed as soon as possible. Salaries and wages. —The main features of the salaries item this year are; (1) The provision of the necessary amounts to enable the part-time stipendiary medical staff to be employed as from May 1, 1940. (2) An increase tin tho Palmerston North Hospital staff to enable the ward at present nearing completion to be opened next month. Tho average number of nursing staff to be employed this year will bo 143, as against 132 provided for on last year’s estimates. This increase is being brought about by larger numbers of senior nurses being required to live out. Of the 143 provided for on the estimates, it is estimated that 25 will be living out. The living out allowances at £7B each will thus tins year reach £1950, and part of this is an increase in the salaries item, as last year we provided for only 16 staff living out. Domestic and establishment.—Domestic and establishment expenditure includes expenditure on fuel and light, painting and general maintenance ot buildings, and renewals and repairs of hardware, linen, etc., laundry expenses and grounds expenses. Payments under this item during the past three years have been as follow: 1937- £14,835; 1938 39, £15,153; 1939- £19,065. We are carrying larger stocks than we had last year and the estimated payments this year amount to. £17,600 (£1468 less than we spent last year). Linen and drapery stocks have been considerably increased during the year and the value of the stocks in circulation at the end of “the year is over £BOO in excess of last year’s total. The reconstructed laundry is functioning most satisfactorily; All Otaki Sanatorium and Hospital washing is now done at the laundry. The following give the total number of articles washed for each ol the past three years: 1937-3 S. 910 806; 1938- 918.726;. 1939 40, 940 099. The cost per dozen pieces washed for 193839 amounted to lOd as against 8 9d for 1937-38. the increase being due to increased labour costs. The cost fit-cures lor 1939-40 are not yet available. Miscellaneous.—Miscellaneous hospital expenditure covers chiefly insurance nremiums. The amount spent for 193940 was £4Ol and the employers’ liability insurance cn---t £2Bl and public risk insurance £9B. General- —The number of inpatients in the years 1937-38, 193-8-39 and 1939- las been as follows: Hospital, 3430, 3432. /3447. Maternity - Home, 284. 287, 276. Similarly, the aV°rage number of occupied beds has -been : Hospital. 19.8 3. 2074. 2J6.5. Maternity Heme, 9.5. 9.6.'9.7. For fi-e year 1939 40. with the oneir’ng of the new ward, it is estimated that t'>e average number of oceunied heels will he 230. Otaki Hospital maintenance. —Estimate last rear. £24(10; actual payments. £3167 16s lid: pronosed estimate. £3400. It seems th n t the nnml>er of patients at Otaki will be eonsideraiily more in the future than hn.s been the c"=e i" the last year or two. Otaki Sanatorium ' maintenance.— Estimate last -rear, £l2 500; actual payments, £l3 316, 16s 3d: proposed estimate, £l4 000. Tho statistics f°r the years 1937-38, 1938 39 ami ]9?9. 40 are as follow: Patients. 140 100, l .Sit A'-p-nore number of occupied beds, 52.2. G4.G.” 64.3. Awapuni Home maintenance. —Estimate last year, £6900; actual payments, £6743 5s Id ; proposed estimate. £7900. The home has continued to he full throughout the year, the average number of patients and inmates being 62 6, rs against 62.5 for the preceding year. The staff was increased bv the appointment of a male nurse and further increases in the nursing and domestic staffs are provided for in these estimates. The additional staff is repaired when tho additional accommodation for female chronic patients and inmates which is at present being built is completed. Social welfare. —Estimate last year, £2100; actual payments. £2014 14s 4d ; proposed estimate. £2OOO. During the past three years the relief department payments have been: 1937-38 £3616; 1938 39, £2890; 1939-40, £2014. District nursing.—Estimate last year, £3500; actual payments, £3673 19s lOd; proposed estimate, £3BOO. During tile past year the work of all the district nurses has increased. Administration.- —Estimate last year. £4000; actual payments, £3923 4s; proposed estimate. £4IOO. Maintenance of patients in other institutions. —Estimate last year. £5000; actual payments, £4668 10s 2d; pro posed estimate. £SOOO. During the past year £4668 was paid under tins heading as against £5017 in the preceding year. The chief item is the maintenance of patients in the sanatoria on which this last year £3l-58 was spent. Expenditure under tins heading fluctuates, but with the numbers we have at present in sanatoria, a provision of £SOOO this year seems necessary. ' Interest on loans. —Estimate last year, £4000; actual payments, £3393 9s: proposed estimate, £3BOO. Board’s contribution to National Provident Fund.— Estimate last year. £800; actual payments. £9OB 3s lid; proposed estimate, £llOO. Awapuni farm maintenance. —Estimate last year. £I4OO ; actual payments, £1360 5s 4d; proposed estimate. £I4OO. The farm working account shows a. surplus apart from interest and depreciation amounting to £505. The corresponding surplus last year was £413. During the past year, owing to shortage in the milk supply front the farm, milk has been purchased at a cost of £177. Refund to Government to adjust subsidy.—Estimate! last year. £1950 Is 6d; actual payments, £1950 Is 6d;

proposed estimate, £2770 17s. This is a statutory payment. Otaki ambulance service.—Estimate last year, £700; actual payments, £605 U.s Oct; proposed estimate, £7OO. Palmerston North ambulance service. —Estimate last year, £1150; actual payments, £1291 10s sd; proposed estimate, £I3OO. During the past year our ambulances covered a total oy 39—519 miles in dealing with 102 i calls, 163 calls being received at Ota u and 864 calls at Palmerston North. The total number of calls in the preceding rear was 874. Miscellaneous payments. —Estimate Inst- year, £250; actual payments, £3oi 15s lid; proposed estimate, £4OO. Transier ol" amount due to capital account' at April 1. 1939. —Estimate last year, ; actual payments, £Jto 5s 2d; proposed estimate, . this item merely makes the adjustment necessary between the maintenance and capital funds. Architectural services to be recovered later from proposed loans.—Estimate last year, ; actual payments, £1396 7s sd; proposed estimate. £4UU. Advances on account ol Emergency "Ward.—Estimate last year, —; actual payments, £3731 11s 4cl; proposed estimate, . Levy and subsidy.— 1 1 he proposed levy oil local authorities i5_£37.478 1« 2d for maintenance and £7504 16s lOd lor capital, a, total of £44-982 18s a 1 * against £46 191 5s Sd last year and £4B 282 Os 3d in the preceding year. As against this the total Government subsidy, which yvas £SO 952 9s 0d in 1938 39, dropped to £45.373 9s od in 1939-40 pncl dronned further this year to £39.029 7s lid. The rate of maintenance subsidy has dropped as follows- 1938 39 £1 Is 3d; 1939-40, 19ft 7d: i 940-41, 17s 2d. The valuations and levies on the local bodies are shown in- the table belocv. CAPITAL PAYMENTS. Proposed items tor capital estimates. —Of the proposed expenditure ol £18.420 £3400 is in respect of works from the 1939-40 capital estimates. On the receipts side the cash in blind and Government subsidy clue provide sufficient funds to cover the works yvlncli yve are bringing forward. Sinking funds. —The sinking I und instalments ■ amounting to £6IOO are the instalments necessary to meet the sinking funds on the existing loans. In respect of the proposed new loans no sinking fund payments will become due in this financial year. Emergency Ward. —The estimated cost of the‘emergency ward is £6OOO. Advances on account of the emergency ward from the maintenance account amount to £3731 11s 4d and the estimate of £OOOO as shown on the capital estimates allows for this amount to be repaid to the maintenance account and the balance of the £6OOO is a commitment to meet the balance of the cost of erection and furnishing of the emergency ward. Proposed new items. —Staff quarters. Otaki Hospital. £3sofire escapes at Palmerston North Nurses’ Home. £200: new ambulance. £470; district nurse’s car, £200; Awapuni Homo furnishings, £200; instruments ajid eve department cqu’pment, £250; electrocardiograph, £350; basal metabolic rate machine. £7O; X-ray equipment £500; slicing machine lor Nurses’ Home, £9O; additions to the outpatients’ and ambulance entrance. £6O; laboratory equipment, £80; miscellaneous. £IOO. The report yvas adopted.

omitted): — Actual Proposed Payments Estimate £ £ Provisions 8,499 8,600 Surgery ami dispensary 7,968 7.6CO Salaries and wages 38,627 45.7UO Domestic and establishment 19,068 17,600 400 Miscellaneous 401 £74,565 £79,900