THE DISTRICT HOSPITAL.

Shannon News, 30 April 1929, Page 3

THE DISTRICT HOSPITAL.

POLICY AND ADHINIST RATI ON

ADDRESS BY MR G. A. MONK.

By courtesy of Mr/C. Blenkhorn, the Horowhenua Borjugh represent;!- ' five on, the Palmerston Hospital Board (Mr G. A. Monk) gave a short address at the former’s election meeting on Friday, his remarks throwing a great deal of light upon the policy arid operations of the Board. Mr, Blenkhorn reminded Mr Monk that in 1924-25 the Borough’s levy for Hospital purposes was £315 and this year it was within a pound or two of £6OO. That was in live years it had practically doubled and took nearly id in rates. He wondered where it was going to stop. Admittedly the increase in hospital maintenance was a very hard problem and was occupying the attention of the best brains in the country. The Borough would like to know .if it eould be given a little easement. , The Mayor (Mr T, Hobson), who presided, in calling on Mr Monk, stated that he represented the Otaki, Levin and Shannon Boroughs on the Board. WHY HOSPITAL COSTS RISE.

- Mr Monk said he would be more at home if aiddressing them on Power Board affairs and would “particularly like to have a fly at our friend, Mr Roe’,” who had been asking questions about Power Board matters. He appreciated very much, however, being given an opportunity to say a few words in regard to Hospital affairs. During the past few years hospital costa had 1 gone up considerably throughout the whole 'of the Dominion. Though the population had increased the inerteaste in [hospital levies was greater, nor did he think that there had been more sickness to account for the larger expenditure. One factor that was perhaps w-as responsible was the growth of scientific knowledge and the desire to take more rapid measures at the outbreak pf sickness to restore tire patient to health. It must be recognised that a sick person was,a liability and a healthy person was an asset. The desire, to make people well quickly was one of the causes of the increase in hospital admindsitration. METHOD OF RATING. He felt that the people he represented did not fiiily understand how the hospital rates were levied. In' fairness to the Board, he had to point put that they had nothing to do with the manner in- which the levies were made. That was done by Act of Parliament, which the Board was there to administer. There were three channels through which the Board derived revenue: (1) receipts, from hospital patients; (2) hospital levies made on the local bodies in the district; (3) Government' subsidies on the amount collected by levy. There was another channel namely by voluntary contribution, which did not no'w amount to a very great sum. The levy was bas-, ed on the capital value of the land in each local body district. He knew of no fairer method of rating than upon the ability to pay and the abil ity to pay was indicated by the capital value of a district.' Subsidies on the levy were paid by the Governmonl to the extent of £1 for £l, but thar did not mean that every £1 earned £l. It depended on the amount of the capital levy and the population, and the subsidies ranged from 14s 3d to 26s in the £l, For. some years Palmerston by reason of its lower levy received the lowest possible subsidy, and he illustrated how one Act of Parliament could defeat another Act. It was provided that in. no year could subsidies exceed £1 for £1 for the whole Dominion'. If it did then each Hospital Board was asked to reinburse the Health Department. Three years ago when Palmerston was drawing the lowest subsidy authorised by the Act, the Board was asked to return to the Health Department a sum of £BOB with the. result that for that year Palmerston actually; had a lower subsidy than that contemplated'by the Act. The subsidy had now risen and was 16s in the £l, and even if they had to refund £SOO it would not reduce the subsidy below What was allowed by the Act. As a result of an agitation by the Hospital Boards, an Act was passed last session under which it was impossible for a local body to get less than the minumum amount contemplated. I

WISDOM OF SEPARATION. Mr Monk then referred to the movement in 1918 to have the Horowhenua County severed from Wellington Hospital District and attached to ■ ■Palmerston. That agitation was startt, ed by the late Messrs Venn and Gar dener, the main reason , being that there was greater community of intcr- ;• est with Palmerston and the Horo- ■ whenua patients were going there. As , a result a considerable saving in ex- ■ ' penditure had been made. At the present time , the Horowhenua County with the three Boroughs in its area . paid an annual contribution of £SOOO 11.,I 1 ., to the Palmerston Board, If it had < remained with Wellington it would n,ow be paying about £B7OO. He paid a tribute to the nioneers of the separation movement for their foresight.

CAREFUL ADMINISTRATION. Mr ,Morik next dealt with the economical running of the Hospital. The average daily 'occupied beds in the V: institution was from 180 to 190. The average yearly cost per bed of the folv lowing hospitals which had accommodation for from 100 to 200 patients was as follows: Palmerston £166, Wanganui £lB3, New Plymouth £l9B, ; Cook County £2lB. It appeared therefore that the Palmerston Hospital wa3 •'fairly well conducted. The capital I ■ value of the Palmerston district was , J ; 21 millions and of Wellington 47 millions. Palmerston’s levies were £22,000 annually and Wellington’s £67,000. MOST PATIENTS COME FROM v/b TOWNS.,, , : . The-- had been a good deal of eon-

troversy in the district as between counties and boroughs ever the relative number of patients coming from each particular district. The figures showed that most of the patients come from'the towns whereas the bulk of the money come from the counties. Last year the figures as to patients were as follows: — .jKiwitea County 48 Pohangina County 18 Oroua County 153 Kairanga County 202 Manahvatu County 194 Horowhenua County ... , 136 Feilding Borough 232 Palmerston Borough ... 1234 , Foxton Borough 125 . Shannon Borough 94 Levin Borough 102 Otaki Borough 43 Rongotea Township ... 37 Forty-three per cent, of the patients come from Palmerston and their valuation was little more than Horowhenua County. CHARITABLE AID BURDEN. ’ There had lately been a very rapid rise in charitable aid. Last year they estimated for £3BOO and actually paid £4452. This year the estimate was £4500. In 1926-27, the total levy was £16,630, and now it was £22,000, a rise of £5300 in four years. In 1926-27 the average daily number of patients was 116, and to-day it was 180 to 200. The Board had had to face the extension of the buildings, and the lower brickwork was just complete, but there were already enough patients in the hospital to occupy all the accommodation that would be provided. Extension of the hospital also involved adding to the nurses’ quarters, and this would be the first item on the building programme. For an expenditure of £5300, they were practically taking into the hospital another 50 per’ cent, of patients.' Superannuation contributions for staff and nurses were costing £SOO per annum, but so many of the younger nurses withdrew from the scheme on leaving the Hospital that he was wondering whether they had not made a mistake. FEES FROM' PATIENTS.

The collections from patients had increased from £7600 a year or two ago to last year. He had heard it said that they were too severe upon patients, but if anyone went into the institution and could produce sufficient evidence to show that they were unable t,o pay, the Board was not there to “dun” them. The Board, however, said Dat people who could pay should pay, and. they would be “dunned” if they did not. The worst feature of the business was the patient who was not in a position to pay, but took no, notice of communications from the Board. A great deal of time was wasted by the staff over such people. It was the duty of those unable to pay to establish the fact by satisfactory evidence. The Board had no desire to harass people who had been ill. HOSPITAL FARM PAYS.

He stated there had been a good deal of criticism of the Hospital Farm in Palmerston; but it supplied all the milk they required all the year round, and showed an actual profit of £250. Its establishment was entirely justified. They had. an Old People’s Home at Aivapuni Avhich Avas growing in size, and now had fifty inmates. In conclusion Mr Monk said he desired to thank the electors of Shannon, Levin and Otaki for giving him the privilege of representing them. He felt it was a privilege, for any man to be given an opportunity of working for the welfare of his-'fellow men. In this particular case they were working for those who were ill and needed it most.

Mr Roe moved a vote of thanks to Mr Monk for his able address on hospital matters, Avhich had cleared the air considerably. This Avas carried by acclamation.