17

H.—3l

(c.) Government subsidies : There is no doubt that the large Government subsidies given tend to abuse and extravagance on the part of Boards, and this is especially noticeable in the administration of poor-law relief. Of especially evil influence is the 245. subsidy given on voluntary contributions. To obtain this extra 4s. from the Government there are some who exercise ingenuity that amounts to dishonesty. For example, a Board requires a new set of instruments, which for the sake of argument we will say would amount, at catalogue prices, to £100. The firm supplying the instruments charges the Board the full price, but the former returns £20 as a " donation." The Board thereupon claims 245. subsidy on this donation. Thus the Board gets its instruments for £56. Transactions of this nature are going on every day, but unfortunately are very difficult to detect. Again, the 245. subsidy often leads a Board into undertakings that it has not seriously contemplated. A body of well-inten-tioned persons decide that certain hospital extensions are necessary. A meeting is held ; subscriptions pour in ; the 245. subsidy is claimed; but the subscribers attach such unreasonable stipulations to the handling of their subscriptions that the Boards are often embarrassed by their generosity. The sanatorium or ward, as the case may be, must be in a position that the subscribers consider proper ; the question of efficient and economical administration is not their duty. In fact, speaking generally, Boards would at times be very much better off if they had erected the institutions out of their own funds —the rates and pound-for-pound subsidy allowed by the Government on capital expenditure. This abuse can now largely be checked by the Department withholding its approval of such expenditure. It will be interesting to see what ingenuity will be displayed by those claiming subsidy under the graduated schedule. Of course, these claims are carefully checked by the Department, but they will have to be very closely watched, otherwise local officers will soon find a way of increasing these Government subsidies. A careful audit is not only necessary with regard to matters of expenditure, but also as regards the data and statistics supplied by hospital authorities. The cost per bed is estimated by dividing the total expenditure by the average number of patients under daily treatment. Some Secretaries recognize that the larger the number of patients under daily treatment the lower the cost per bed. This tends to the " stuffing " of the patients register and to the increased stay (in days) of the patient. The returns and statistics of a hospital need almost as careful supervision as its accounts, for many of these returns are so made as to be absolutely misleading to the ratepayers and the public generally. Institutions in the North Island under Control of Boards. 1. Auckland Hospital District— Beds. 10. Cook County Hospital District— Beds. Base Hospital (Auckland) ] Base Hospital (Gisborne), (isolation, 8) 68 Infectious Diseases Hospital I .. 301 Old People's Home .. .. 26 Plague or Smallpox Hospital) 11. Waipawa Hospital District— ' Old People's Home .. .. 256 Waipawa Hospital .. .. 52 Chronic Ward .. .. 40 Dannevirke Hospital .. .. 40 2. Wellington Hospital District — 12. Wairarapa Hospital District — Base Hospital (Wellington) \ Base Hospital (Masterton), (isolaInfectious Diseases HospitaH .. 348 tion, 16) .. .. ..60 Chronic Ward .. .. J Secondary hospitals — Consumptive Sanatorium (Otaki) .. 34 South Wairarapa (isolation, 6) .. 22 Otaki Hospital (secondary) .. 18 Pahiatua (isolation, 4) 19 Old People's Home .. .. 147 Benal Solwajr Home .. .. 15 3. Hawke's Bay Hospital District — Chronic Ward . . , . 16 Base Hospital (Napier), (isolation, 14) 124 13. Hawera Hospital District — Old People's Home .. .. 108 Hawera Hospital (isolation, 6) .. 39 4. Waikato Hospital District — 14. Patea Hospital District— Base Hospital (Hamilton), (isola- Patea Hospital (isolation, 6) 28 tion, 13) .. .. .. 120 15. Coromandel Hospital District— Cottage Hospital (Taumarunui) .. 14 Coromandel Hospital (isolation, 4) . 24 Old People's Home .. .. 21 Mercury Bay .. .. 10 5. Wanganui Hospital District — 16. Marsden-Kaipara Hospital District— Base Hospital (Wanganui), (isola- Whangarei Hospital (isolation, 4) .. 20 tion, 12) .. .. 84 Old People's Home .. .. 31 Cottage Hospital (Taihape) .. 12 Northern Wairoa Hospital (secondary) 17 Old People's Home .. .. 38 17. Stratford Hospital District— 6. Taranaki Hospital District — Stratford Hospital . , .. 16 Base Hospital (New Plymouth), (isola- 18. Wairoa Hospital District— tion, 23) .. .. 76 Wairoa Hospital .. .. 23 Old People's Home .. 57 19. Bay of Islands Hospital District— 7. Thames Hospital District— Rawene Hospital .. .. 11 Base Hospital (Thames), (isolation, 6) 64 Mangonui Hospital .. .. 14 Old People's Home .. .. 38 20. Waiapu Hospital District— 8. Palmerston North Hospital District — Waiapu Hospital .. .. .. 8 Base Hospital (isolation, 17) .. 70 Camp Hospital (Tuparoa) .. 2 9. Waihi Hospital District — Cottage Hospital (Te Araroa) .. 2 Base Hospital (Waihi), (isolation, 6) 59 j 21. Bay of Plenty Hospital District .. Nil.

3—H. 31.