HOSPITAL AND CHARITABLE AID BILL.

Wairarapa Age, Volume XXXI, Issue 9049, 26 March 1908, Page 5

HOSPITAL AND CHARITABLE AID BILL.

CRITICISMS AND RECOMMENDATIONS.

REPORT OF A SUB-COMMITTEE..

The sub-committee appointed at a. recent special meeting of the Wairarapa District Hospital Board to make recommendations respecting T the new Hospitals ar.d Charitable Aid Bill, presented its report yesterday, at the annual meeting of the Board. The? report, which is appended, was adopted without discussion, and) Messrs E. G. Eton and F. G. Moore(chairman and secretary, respectively), wero appointed delegates to the Conference to be held in Wellington in June to discuss the proposed* measure. It was also resolved to send copies of the recommendations to the various local bodies interested. The following are the main conclusions arrived at: — Sections 3-s.—That the. strongest possible objection be taken to> the proposal to unite the Wairarapa with the Wellington Hospital District, on the ground that, if giveneffect to, the liability of the present Wairarapa Hospital District for hospital maintenance will be nearly doubled. Assuming that the cost of maintenance in Wairarapa for 190S-9 will be about equal to that for ] 907-8, it may be set down at £5,600. The estimates for 1908-9 for the Wellington Hospital maintenance are authoritatively given at £25,000 (the figures are really a little over that sum). In the two districts therefore the maintenance is estimated to reach £30,600. The valuations are as follow: —Wellington District, £22,000,000; Wairarapa,. £11,000,000. On the pro rata basis therefore the Wairarapa District: must contribute one-third share, namely, £10,200, or a sum very nearly equal to double its present liability. (It is tiue the foregoing figures include subsidy—but this doea not affect the increase, which would still remain proportionately the. sanie.) The Wairarapa District Hospital Board and the local contributory authorities within the district have in the past vehemently protested against the iniquity of uniting this district with Wellington for the purposes of charitable aid, and this Committee is of opinion that the proposal to inflict further, and much more serious injustice upon the district, should be resisted to the uttermost.

It is recognised, however, that probably through sea-bourne .traffic the chief ports of the dominion are entitled to some special provision to meet the cost of dealing with what may be designated as foreign cases. This provision should be made out of the Consolidated Fund—net drawn from the country districts in the vicinity of the ports. Sections 6-12. The Committee is of opinion that the present system of election of members is infinitely preferable to that provided by the new Bill—whLh has at least two objections:—, (1) It is certain to prove more costly. (2) Under it, it seams quite possible that a sec of representatives might be elected either as committeemen, or members of Boards, who are not members of any local authority, and therefore not concerned in the raising of the funds required. Experience dictates that this system leads to highly extravagant management. Section 18.—Giving the District Board "general superintendence and control of every institution within its district which is wholly or partly maintained out of the funds of the Board's a provision likely to give rise to much friction. If the Committee cannot be trustedto properly manage the affairs of any institution it would be better to leave the management entirely to the Boards. Sectiun 23.--The power to appoint officers, matrons, nurses, attendants, and servants jshould be extended to Committeemen and Trustees of separate institutions, as well as Boards, and the provision that the appointment of a medical officer or matron shall be subject to the approval of the Minister should certainly be eliminated as an unwarrancable interference with the functions of the Board, or Committee as the case may be. Section 24.-—The power to make provision for supplies of medicine, etc., etc., should be conferred upon Committeemen, and Trustees of separate institutions, as well as Boaids. Section 25b.—The Committee is decidedly of opinion the position of Chairman should be maintained as an honorary one. Section 30c—It is suggested the sub-clause in question be worded "Contributions from Local Authorities." The revenue derived from this source is in no sense a "grant" (which implies a voluntary contribution or donation), and tne term is certainly misused in this case. Section 31.—The proposals contained in this section with regard to the gradual reduction of subsidy during the six years following the passing of the Act meet with the unqualified disapproval of this Committee. Under existing conditions a very laree number of persons in the dominion escape liability for contribution towards the cost of maintaining its hospitals and of charitable aid; one-half of the total cost is a direct cost upon the land; to increase this by 50 per cent, will inflict a very grave injustice upon land owners, and it is only right that the remainder of the people of the dominion should, so far as it is possible to compel them tb do so, through the Consolidated Fund, bear not less than une-hatf of the burden. The provisions contained in subclause (4) of this section (giving the Minister power to withhold subsidy) are of such an autocratic nature that the Committee is confident the clause should not have been introduced—and suggests that it be eliminated altogether. Section 37 (3).—ln view of the ever-increasing nature of the hospital and charitable aid expenditure, contributory local authorities should be empowered to make the hospital and charitable aid rate in addition ' to, and in excess of, their ordinary maximum rating power—otherwise

\ their finance may be very seriously hampered. Section 50 (functions of Committee to be under direction of Board). —The Committee is decidedly of opinion that it would be impossible to get anyone to act on a Committee under such restrictions as are imposed by this section, and fails altogether to realise with what object it has been framed, except to weave a web of red tape round the management of every such institution in the ( dominion; to"make such management j as difficult and complicated as pos- ■ sible; and to keep the Committees subservient absolutely to the will of the Board and the Minister. A Committee would certainly find itself in a dilemma should the orders of the Board and those of the Minister be at variance—as it does not appear which of these is to take precedence. This Committee is of opinion that such a provision would be absolutely unworkable. Section 51 (Incorporation of Institutions).—The Committee is of opinion that no separate institution should be incorporated without the sanction of the Board of the district in which the proposed institution will be situated. Section 69 (Board and Trustees to make by-laws).—lt is considered right that Committees should also have power to make by-laws for the purposes mentioned in this] section, in respect of the institution under their charge. Section 81 (Inquiries as to organisation or working of any institution). •—The scope of this section is so extremely wide as to warrant the conclusion that the Department, or its chief executive officer, desires to possess, and intends to have, the absolute control of every institution in the dominion.. The provisions are despotic in their nature, and, if given effect to, cannot fail to be a fruitful source of friction between all parties concerned. . The objects the framers of this . measure appear to have had in view are to deprive the existing Boards and Trustees of many of their present powers and much of their usefulness; to place the supreme control of every institution in the dominion in the hands of . the Minister, which means virtually in the hands of the chief executive offWu-s of the executive departments—by whose professional advice the Minister would be guided—to enforce compliance with this despotic system as it were at the bayonet's point, by withholding subsidy; and by direct, taxation to thrust a still heavier burden on the land. This being the opinion of the Committee, it must not be supposed that it views with the least favour the changes contemplated in the new Bill, which it has no hesitation in pronouncing to be much for the worse, compared with the existing Acts, and this notwithstanding that the present law has any glaring defects.

The Minister has asked for an expression of opinion with regard to the measure, and the Committee to which this duty has been confided by the Wairarapa District Hospital Board, has merely pointed out in the foregoing remarks what it considers objectionable, and in what manner, in its opinion, the measure, bad as it is, may be rendered somewhat less obnoxious. The Committee also takes this opportunity of placing on record its conviction that as long as the existing system under which hospital and charitable aid management is confided to Boards and Trustees, who have no concern in the raising of the necessary funds, remains in force, so long will there be extravagance in such management. The only possible way to secure economy would be to cast all the responsibility with regard to expenditure upon the contributing local authorities—both in respect of hospitals and the distribution of charitable aid. Each district should take charge af its own sick, and relieve its own poor. Every district could easily distribute its own aid, while those districts whioh are not financially, or otherwise, strong enough to support hospitals of their own, could send their cases to such hospital as they thought proper, and pay for their treatment and maintenance at a schsdule rate.

The alarming and constant increase in hospital and charitable aid expenditure during the last'twenty years, since the voluntary contribution system received its death blow through the introduction of rating for this purpose, is in the opinion of this Committee, ample evidence of the necessity for some alteration which will arrest this growing evil.