SOCIAL SECURITY

Wairarapa Times-Age, 9 February 1939, Page 8

SOCIAL SECURITY

EFFECT ON HOSPITAL BOARD FINANCES

OUTLINE BY HON P. FRASER.

REDUCTION IN OUT-PATIENT SERVICES LIKELY, (By Telegraph—Tress Association.) NEW PLYMOUTH. February 8. An outline of the arrangements proposed in connection with those hospital beard services coming within the scope of the Social Security Act, was given by the Minister of Health, the Hon P. Fraser, when opening the conference of hospital boards today. The Minister also touched on the question of hospital finance in relation to the Act. “For the present, in accordance with the Act, efforts are being chiefly directed lo the making of arrangements for the four main benefits, medical, pharmaceutical, hospital and maternity," said Mr Fraser. “As a necessary preliminary, consultations are being carried on with representatives of the medical profession and steps are being taken to arrange other consultations." He added that he would appreciate the further co-operation of the Hospital Boards’ Association.

“I wish to press on with the arrangements and to be in a position very soon to indicate the date on which these benefits are to commence,” the Minister continued. “That is a point of special moment to all those closely connected with the existing system, including friencTly societies and other bodies who have voluntary hospital benefit schemes operating. The .government naturally is anxious to have the benefits in full operation as soon as possible. “Out-patient consultations and treatment qf a character that will come within the range of the general practitioner services (under medical benefits) will, when these services are arranged, cease to. be provided at public hospitals. Certain other -out-patient services provided at public hospitals will, however, be continued or developed.

"A consequence cf the inauguration of hospital benefit may be a considerable alteration in the present honorary system of medical staffing,” said Mr Fraser. “The introduction of the hospital benefits may cause an increased demand for hospital treatment. Even under present conditions there is a shortage of accommodation, and boards may, therefore, be under the necessity of providing some domiciliary medical attention pending the inauguration of the general practitioner service under the Act and. also to extend district nursing services. lam desirous that these factors shall be given due weight, when the rate of payment to hospital boards is decided upon. “The hospital accommodation question gives great concern. I have an up-to-date return supplied m by the Acting Director-General of Health. This return goes ill to considerable detail. It is notable that in the past ten years while the population has increased by 10.2 per cent, and hospital beds have increased by 13.5 per cent, the number of in-patients has increased-by 34.7 per cent An estimate has been made of requirements over and above additions in course of construction or for which tenders have been let, and it appears that the number of beds needed is at least 1000. The need will be mainly filled by additions at the main hospitals. SCALE OF PAYMENTS.

“It is intended that the scale of payments from the fund to hospital boards in respect of hospital benefits will be determined by careful regard to the position of boards.

"The introduction of free treatment, in public hospitals may result in increased, demands on these institutions, but the introduction of medical benefits assuring adequate remuneration to medical practitioners for domiciliary medical attention should, of course, be a definite factor in reducing the number of cases sent to hospital. "The inauguration of medical benefits will also permit of considerable reduction in the out-patient services of public hospitals, and such out-patient services as are of special character and are necessarily continued at the hospital may be the subject of payments from the fund.

"With the payment from the fund for hospital treatment, and in respect of maternity care provided under maternity benefit, as well as the relief given to hospital board finance from the payment of monetary benefits under pari 11. of the Social Security Act, to which should again be added the saving in administration costs in respect to charitable aid administration and patients’ fees collections, the operation of the Act should be of considerable financial assistance to boards,"

BOARD’S PROBLEMS. SHORTAGE OF 1500 REDS. (By Telegraph—Pless Association.) NEW PLYMOUTH, February 8. “Since our last conference drastic changes have been made in many directions as a result of which hospital boards have encountered many difficulties in altering the form of their management of hospitals." said Mr J. W. Dove, president of the New Zealand Hospital Boards' Association,- at a conference of the association in New Plymouth today. He mentioned the shortening of hours and the effect this had had in an increase in staffs and the inevitably higher cost of administration.

“This all means further increases in maintenance charges and. as hospitalisation for all illnesses is steadily increasing, all boards, specially larger ones, are confronted with the necessity for increasing their bed accommodation. At present there is a shortage of at least 1500 beds. If the system of hospital finance is wrong, then the electors should exercise their rights and return members to the legislature who will alter the system. "I would here like to sound a note of warning. From time to time suggestions are made that the greater pro-

portion of hospital finance should be provided from Government funds: also that responsibilil.v for the cost of certain lypos of iroaimcnl should be that of the Governmcnl. The cold fact is that without local financial responsibility there cannot be local control.”