OUR HOSPITALS

New Zealand Times, Volume XLVI, Issue 10605, 2 June 1920, Page 6

OUR HOSPITALS

NATIONALISATION ? TIME NOT OPPORTUNE, SAYS MINISTER. FINANCIAL DIFFICULTIES STRESSED. Tho Hon. C. J. Parr, Minister for Public Health, met with a very cordirJ reception when he rose to address the delegates at the Hospital •>nd Cha.iita.ble Aid Boards Conference yesterday. He said that he had accepted tho portfolio of Public Health with some diffidence, as he was aware that tho task would not be an enviable one As Minister in charge of Education, and having the best interests of tht children at heart, he came to the conclusion that the Departments of Education and Public Health would dovetail, so he accepted' the office of Minister for Public Health. PUBLIC-SPIRITED MEN.

New Zealand was exceptionally fortunate in possessing a large number of public-spirited men who gave their time without compensation in the interests of the public. Tho Dominion in this respect was more fortunate than any other country in tho world. The time had arrhe'd, however, when theso public-Epintod nien should rn ceive some compensation. It probably would not be much, and it was known that a number did not expect or desire compensation, but there wor» others who were not in a similar position, therefore he thought it .only righ* and just that some recognition of the work accomplished by members Df hospital boards should bo given. H(» had taken office at, a critical period. The world was upside down financially, industrially, and economically, and there was aggravation and unrest everywhere. The war had made citizens more humanitarian, more connidoration was ghen to the sick and the hurt, and it had brought people closer to each other. NATIONALISATION.

The hospital boards were concerned about the of hospitals, and support had been given to a resolution from Lawrence in this suggestion. The nationalisation of hospitals would mean that tho State would have to shoulder the whole cost. Ho would not express an on tho question, hut it was recognised that the tendency tho world over was nationalisation, and it wim snro to come in New Zealand'. .When that time did arrive it was only natural that the State would require, to take ovor th"o mutin control of hospitals. He was satisfied that before the State could control the institutions with success it would have to be prepared to pay for brains to manage the department. What could tho country expect when it was' only prepared to pay £BOO, £9OO, or £IOOO a year to officers of ability? He would like to let loose a business man with a salary of £2500 a year to take charge of tho i business portion of tho department. The scientific departments should bo governed as they were to-day, nnd scientists would have to 1 be consulted on scientific questions. Unless tho State was prepared to pay for brains lie would not desire to take charge of tho department and State enterprise. The figures placed before him by Dr. Valentine showed that tho sum of, £350,411 was contributed by (local bodies to the upkeep of hospitals, and the Government contributed £2fi9,p2l. The proposition of the local jvuthoritieb was that they should bo relieved of their contributions, and that the Minister for Finance should undertake tho j whole of the responsibility for admin- j istration as well as the providing of ■ funds. What rhance at the present time had he, as Minister for Publio Health, in going before Cabinet and asking foi th& proposition to be carried into effect, when the Minister for Finanoo was already staggering under great financial burdens? The time was not opportune to ask the Minister for Finance to find an extra. £330,000 a year, and thus place upon his shoulders a further burden. NATIONAL MEDICAL SERVICE.

In regard to policy measures 'the question of a national medical service would no doubt be discus***! by tho conference. Tho Medical Association at a meeting at Dunedin had recognised that a system of national medical service was desirable and it showed tho trend of medical opinion on the matter. Tho time was coming when it would have to be undertaken. All that was required to establish the system was to fill in _ the administrative with the financial side, but tho annual charges on tho Treasury had risen £11,000,000 in five years, and under tho circumstances he could not hold out any hope of the reform being effected this year.

BACK DISTRICT REQUIREMENTS. Tho time had, however, arrived when the State should establish eomo fion of a national service in the back districts of the Dominion. Accidents happened and sickness took place in back districts, and no medical service was available. A modified form of n national service should be set up, and ho had asked Dr Valintine to go into the question and see what could be done. It was urgently necessary that the settlers in tho back districts who were producers should not bo penalised for their enterprise when sickness or accident occurred in their families. Hospital boards had concentrated their energies, in a large measure, on the equipment and improvement of tlm largo hospitals, and tho outlying districts had not beoni considered to the extent that was desired. Tho claims of the country for better hospital facilities deserved the utmost sympathy and consideration. MATERNITY HOSPITALS FAVOURED.

Ho was strongly in favour of creating small maternity hospitals throughout the Dominion, but nothing should be dono which would tend to prejudico or weaken tho base hospitals in New Zealand. Tho maternity hospitals should bo be in ehargo of a nurso and midwifo, and? provision should bo tnado to accept surgical enscg no that first oid might bo administered prior to a caso being takcm to a base hospitaL' The i duties performed by nurses wero highly important, and tho suggestion that had been ma do that « system of superannuation for nurses should be established met with his hearty support. There wore difficulties in the way, but no doubt they could bo overcome. . ~ Continuing, JVIr Parr said there was a remit on the order paper in respect irt the treatment of tubercu--losis. Tho intention, evidently, was that the Government should undertake tho treatment of that disease. Ho had scrutinised the Act and had not been able in find anything that would place the responsibility of

treatment upon the State. The Act provided that hospital boards should treat all diseases, and ho could not countenance the State treating tuberculosis. » "A BURNING QUESTION." The question of subsidising wag a burninn- one. He had studied tho 4th scheduFo of tho Act, which provided, for subsidies, and he had found it difficult to follow. Tho scale was from 24s to 12s which was paid on a differential basis on capital values. He did not condemn the system, bnt it worked out hardly for hospital authorities in some instances —sufficiently to indicate that the system Khould bo reconsidered and revised. A flat rate, would- not work out justly, as some districts were wealthier than others, and .vould therefore receive advantages at the expense of the poorer district*.

COLLECTION OF PATIENTS FEES.

Ho was astonished to learn that the aggregate sum collected last yeai in patients' fees only amounted to £135,224, which worked out at 20.4 per cent, on the total claim mad© i'oi tees. It was not a percentage that left room for congratulation. Somo boards collected more than others. Taking the four main centre hospitals, oho collected 20 per cent, of its fees, another 16 per cont., a third 25 pur cent., and a fourth 17 per cent. Tli© collection of another hospital board was 11 per cent., while the hospital in a large district only collected 13 per cent., and thoro was one as low as 5 per cent.; but thoro were special circumstances in tho latter case. There were two districts that collected 40 per cent., and ono that collected 38 per cent. It would not be advisable to press poor people for fees, but it must he recognised that 20 per oent., which worked out to 4s in tho £, was a very low return. Tho system wanted overhauling. Fees wore provided for in tho Act, and while tho system remained on the Statute-hook, it should bo adhered to, and if properly carried out, it would no doubt relieve the local bodies in their contributions. Concluding, he said, as Minister, he wanted to give every assistance to boards. They were' doing the greatest work that could he done for a community, and there was no higher service than assisting tho sick and the hurt. (Applause.)