EPIDEMIC EXPENSES.

Taranaki Daily News, 20 February 1919, Page 3

EPIDEMIC EXPENSES.

ATTITUDE OF HEALTH DEPARTMENT. DISCUSSED BY HOSPITAL BOARD. Tie matter of the payment of expenses incurred in connection with the recent epidemic was again before the Hospital Board at its meeting yesterday. The chairman pointed out that although since the last meetiag of the hoard the epidemic accounts had been cleared up and sent to the Department, a matter of very great importance had arisen in relation to the epidemic patients admitted to the general hospital. In some of the larger centres the campaign against the epidemic was conducted by the Mayor and councils, the local hospital boards being released from all responsibility in the matter. In New Plymouth, the Mayor was instructed by wire from the Minister of Public Health, to appoint a citizens' committee to fight the disease. This was carried out promptly, the committee including several members of the Hospital Board. The organisation formed successfully combatted the disease for about three weeks, and was disbanded as soon as the epidemic showed signs of abatement. All the work was conducted under the personal supervision of the medical superintendent of the hospital. On the breaking up of the epidemic committee all the matters relating to it were taken over by -the Hospital Board as a going concern. There were 19 temporary hospitals established in the country districts, under the care of Drs. Blaekley and Wade and qualified nurses and V.A.D.'s. The whole system was connected by telephone with the general hospital, and was under the direct control of the medical superintendent, who gave the committee his whole time gratuitously as a citizen, so that practically every case became a patient of the aeneral hospital. In the old hospital building several wards were prepared, with all the necessary appointments, at a large expenditure to the Board, who took in all the serious cases from the outside temporary hospitals. From these all the dangerous ca;es were taken to the main hospital so that they could have the benefit of all possible care and attention, Maoris and Europeans being treated alike. Under these conditions the board understood the Department would make no distinction between expenses incurred in the temporary hospitals and the general he ■•- pital. This apparently is not the case, and Mr Fraser stated that at an interview he had with Dr. Valintine in Wellington last week he had been informed that the Department, while willing to pay all the expenses of the temporary hospitals, was not prepared to do the same with regard to the general hospital, and that the board would have to I foot its own bill in that connection. Concluding, the chairman said he believed the Tarauaki Board was the only one that would be saddled with this expenditure, because it had done what, it thought best in the interests of the patients. He moved therefore, that a letter pointing out the peculiar circumstances under which the Hospital Board had been made responsible for the cost of treatment of a very large-number of epidemic patients, be sent to the Minister, and that the Department be asked to reconsider its decision, and to take the board's case into its favorable consideration. DR. WALKER'S POSITION. Mr Fraser then read a letter written by the medical superintendent in regard to his position in connection with the epidemic committee. Dr Walker stated that he met the Mayor of New Plymouth and the chairman of the Hospital Board, and agreed to do everything in his power a* the crisis, not only as hospital superintendent but as a citizen and private practitioner. The Mayor was the chairman of the organisation, which included all available help, "professional and otherwise, in the town. This organisation was created in response to the telegram from the Minister of Public Health, and I am confident that I state the feeling of those associated in\the work that they acted as citizens of the Dominion in a time of peril and as the direct local representatives of the Public Health Department. As a result, the New Plymouth Hospital became, pro tern, a fighting unit of the Health Committee, and its routine work was! practically abandoned in the emergency, j Cases of" gravity were undertaken in hospital for obvious reasons, and the institution occupied its natural place in the scheme so successfully adopted here. In conclusion, he stated that he acted as the board's medical superintendent and also as a professional member of the Mayors organisation, occupying the position in the same spirit that was shown by every individual member of the New Plymouth Health Committee. Mr Haloombe pointed out that there was no other course open to the board than that which it had taken. There was no medical attention available in the country. The local doctors were working in with the Health Committee. Even some of the temporary hospitals got little medical attention, and the only thing to do was to send the serious cases to the general hospital. He was of opinion that the Department should pay for such cases treated. Mr Morgan said it was evident that Dr Walker had acted in the matter in a dual capacity—both as medical superintendent of the hospital and as a private practitioner. The general hospital was for the time being turned into a temporary epidemic hospital, and all its other work was pet on one side practically. He thought the Government was bound to pay the expenses incurred in that respect. The accounts had all ! been scrutinised and ceTtitied to by the | district committee and also by the board's special committee. He favored a deputation waiting on the Minister. They might keep 0:1 writing to the Department and would receive the most courteous replies, and that would bo the end of it. Mr Campbell pointed out that a big sum of money was involved, the expenditure incurred i" going to Wellington to interview the Minister might be mnney well spent. Ultimately it was resolved that the chairman and Mr F. J. Hill should wait on the Minister at Wellington and present the board's claims to him. PAYMENT FOR MEDICAL SERVICES. The Public Health Department wrote further to a telegram in reference to the matter of payment for medical services during the epidemic, stating that Aba PfUMKtnm would wtf rwoaiiw j&mv

men to medical men who in the ordinary course of practice attended persons unable to pay. The circular continued: "No, doubt all medical men found their practices temporarily increased through the epidemic, and although a great number of their patients will not be in a position to pay the accounts, yet the Department cannot see its way to guarantee the profession against bad debts which, in the ordinary course of practice, its members have to face. A national duty was imposed upon everyone during the epidemic, and no profit should be expected to be made therefrom. In special instances, however, win-..: a naedicnL man performed work outside the sphere of his ordinary practice, payment therefore will be considered by the Department upon the claim being sent thereto with a full explanation of the circumstances. This embraces: (1) Attendance as a medical office at a temporal-;- influenza hospital, for which a daily lee will be paid, the amount to be determined on full particulars being furnished to the Department. (2) In the case of medical men who temporarily gave up their ordinary practice to work on the block system, full particulars should be furnished to the Department so that in the event of the medical men being losers thereby an equitable fee may be paid them for such service. (3) In the case of medical men having been requested by the District Health officer, Hospital Board, or other competent authority to visit outlying districts, or Maori settlements in connection with the epidemic, and who did not receive private fees for so doing, a reasonable fee will be paid on the account being submitted, with full particulars to the Department. (4) In he case of medical clubs where the medical officer's work has been very much increased, and where, owing to the burden on the club's funds by reason of payments to its members through death or sickness, the club is unable to give its medical officer an adequate increase in his remuneration, the matter will be given consideration by the Department on full particulars being'supplied, and a recommendation made thereon. Any other special circumstances not provided for in the foregoing will receive due consideration upon such being submitted through the Hospital Board to the Department." ASSISTANCE TO WIDOWS * AND ORPHANS. The Public Health Department wrote in respect to assistance for epidemic widows, widowers, and orphans as follows:—(1) The relief of children left as orphans will be administered solely by the Minister of Education to whom all cases should be referred, (2) Widows without children are not to be assisted under this scheme. If in necessitous circumstances, they must seek assistance through the" ordinary channels. (3) Relief is to be granted to widows will, children on the following lines: For each boy under 10 years, and for each girl under 18 years, if the child is not in employment, 10s fld per week, or such less sum as may be dej cided upon in the mnnner hereinafter pre- | scribed, according to the merits of the case. The widowed mother may also be assisted according to her circumstances, up to an amount not exceeding 2js per week. In some cases it may ho necessary to assist the children, but not the mother, who may be otherwise provided for. Each ease'should be considered on its merits, the primary object in every case being to assist in the upbringing of the children. (4) Widowers with children arc to be assisted only where such assistance is neee.sary to keep the home together for the benefit of the children. Except in extraordinary cases, there should be no weeklypension for the children of widowers. Assistance to widowers who are able to work should take the form, of an allowance up to 25s per week to provide a housekeeper or woman in the home for the benefit of the children. As a general rule no payment should be authorised for the family of a man who is earning regular wage.s amounting to or exceeding £3 10s per week, unless there are very special circumstances, such as large number of children to keep, (a) Cases of Maori orphans, widows and widowers will be administered bv the Native Affairs Department, to which all applications should be referred. (ti) Cabinet has determined that the relief to be afforded through hospital boards should be administered by special committees appointed under 'Section 6-1 of the Hospitals Act, 1009. It is recommended that a committee of seven be appointed for each hospital district. Three of the members should be outsiders, and women should be represented on the committee. It should be known as the Social Welfare Committee. The administration of this relief should be separated as far as possible from I Charitable aid operations of the board, although it is recognised that the officers of the board will be of great service in operating the scheme. The Government cannot see its way to establish new boards for the special purposr; of this relief, neither is it desirable to hand the work over to the Pensions Department, which relies largely uppn the police, for advice and information. It is considered as the Government pavs practically half the total cost of your 1) -rd's operations, and subsidises' the board's capital expenditure, bequests and voluntary contributions, the State can well look for the assistance of your board in extending relief to those who have suffered through the epidemic. (7) All payments authorised should be based upon applications sent in. (8) The Social Welfare Committee is to review all allowances quarterly, and a quarterly report of its operations shall be sent to the Department. (9) The Govemmen desires that the scheme, should be administered on reasonably humanitarian lines and in a sympathetic manner. IN CASE OF RECRUDESCENCE OF EPIDEMIC. A circular was also received setting forth matters that might well be taken into consideraion in he event of the Dominion being visited with a further outbreak of the epidemic. The chairman said it was evident from the tenor of the Department's letter that a recurrence of the epidemic was ..not unlikely. It was also plain from the letter that should such a fresh outbreak occur, it would be the fault ol tile board if it was allowed to spread. He suggested that a special meeting of the whole board as a committee should he held to .no into the matter, and consider what should be done to carry out the recommendations of the Department. Consideration of the other letters relative to the epidemic matters could also be given then. i It was decided to meet on Saturday, j March Ist. I