H.—22.

My T.ord, — Wellington, Ist October, 1909. I have the honour to submit to Your Excellency the report on Hospitals and Charitable Aid in the Dominion for the year 1908-9, by the Inspector-General of Hospitals and Charitable Institutions. I have, &c, GrEORGE FoWLDS, Minister in Charge of the Hospitals and Charitable Aid Department. Tbe Inspector-General of Hospitals and Charitable Institutions to the Hon. the Minister in Charge op Hospitals and Charitable Aid Department. Sir,— Wellington, 15th September, 1909. I have the honour to lay before you the following report on hospitals and charitable aid for the year ending 31st March, 1909 : — Expenditure. T 1907-8. 1908-9. Increase. £ £ £ Hospitals .. .. .. .. 210,780 236,803 26,023 Charitable aid .. .. .. 104,416 . 112,818 8,402 £315,196 £349,621 £34,425 Hospitals. Receipts, £266,402. {Vide Table II.) There is an increase of £4,982 in voluntary contributions. The increase of £595 in patients' payments is in proportion to the admissions, which were 19,653, as against 19,160 of last year. An improvement in this source of revenue may reasonably be looked for, especially as there is an increasing tendency on the part of persons who are able to pay to take advantage of our public hospitals. At present payments by patients barely amount to one-eighth of the total receipts. There is little or no uniformity on the part of hospital authorities, either as to the scale of maintenance fees, which vary from £1 to £2 25., or as to the measures taken to enforce payment. Uniformity; though much to be desired, is, however, difficult to bring about. The scale of fees and the measures taken for collecting them depend to a large extent upon the general prosperity of the district in which the hospital is situated. But hospital authorities might do much more as regards collecting maintenance fees from patients who are known to be in a position to pay them. Expenditure, £236,803. (Vide Table III.) As the cost of medical and surgical treatment is steadily increasing, it behoves us to look well into what economies can be effected in the several departments of a hospital, without being unmindful of the comfort of the patients or those who look after them. Capital Expenditure, £55,837 —an increase of £16,338. For this can be shown five new buildings and several handsome additions to old existing institutions. In a rapidly developing country a decrease in expenditure under this item can hardly be looked for. For the most part the Dominion got fair value for the money, but in some instances the workmanship, especially in plastering and general finish, was very poor. Chiefly is this to be noticed in the new hospitals at Wcstport and Greymouth, and in the renovated wards at Christchurch. The recently opened hospital at Hamilton seems to be well finished, as are also the new wards at the Auckland Hospital. Provisions, £42,485. The increase of £3,075 in this item does not seem large ; but, nevertheless, it is one in which considerable saving can be effected without in any way stinting the patients. Speaking generally, hospital authorities buy their foodstuffs at reasonable rates, but it is interesting to note the varying prices paid. For example, the 41b. loaf at Taumarunui costs BJd., at Oamaru 4|d., whilst at Waimate, which is only thirty-three miles therefrom and in the centre of the wheatgrowing district, the cost is 7d. Milk varies from Is. 6d. per gallon at Taumarunui to 7d. per gallon at Christchurch. Butter varies from lid. to Is. 2d. per pound. The prices paid for meat also vary considerably. But economy in purchase is of little avail if not backed up by economy in use. It is surprising to "find the number of hospitals in which it has not been considered necessary to weigh the stores on delivery. In one hospital I found the meat many pounds short of the delivery-note, and similar discoveries were made with regard to the shortage in the milk and bread supplies. In one hospital the 4 lb. loaf was from 2 oz. to 8 oz. under weight. In another hospital, irrespective of the fact whether there were forty or sixty patients, exactly the same amounts of meat, milk, butter, &c, were being ordered weekly.

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