EFFECT OF ACT.

Auckland Star, Volume LXX, Issue 32, 8 February 1939, Page 13

EFFECT OF ACT.

HOSPITAL ASPECT. MINISTER EXPLAINS. SCOPE OF MAIN BENEFITS. CONFERENCE Or BOARDS (By T«li*r»i*.—Own Corespondent.) NEW PLYMOUTH, this day. Priority in the li«t of remit* for the eighth general conference of hospital boards, which opened to-day at New Pl \ mouth, are those referring to the Social Security Act. It wa« appropriate, Ihi-refore, that the Hon. P Fraser wit h thla subject in his opening addre/* to the conference thi« morning The opportunity, said the Minister, wnn a suitable one for giving « n outline <>t the arrangements proposed in connection with tho«e hospital board service* coming within the -cope of the main henentu under the Act, na.nelv, Iwwpltal benefit- and maternity, benefit"ft ha* been emphasised by representative, of the medical profession, and I'} 7 ™ey n,ee «i »>y the Government," continued Mr Fra#er, "that the arrangement., for the provision of medical pharmaceutical, hospital, maternity and other benefite should be developed not only a« parts of a. comprehensive plan of curative service*, but also in coordination with the preventive phase* of public health administration.

Inauguration Date. "Having regard to the negotiation* that would have to be inducted, and to tho arlmini«trative arrangements, it wa» foreseen at the time the legislation wag framed that until the arrangements for any particular benefits were complete, or nearly complete, it would not lie practicable to name the date of commencement. For the preoent, in accordance with the Act, effort* are being chiefly directed to the making of arrangement* for the four main benefits, medical, pharmaceutical, hospital and maternity. Aβ a necewiary preliminary, consultations are being carried on with representatives of the medical profes«ion and eteps are being taken to arrange other consultations. "I wish to take this opportunity of inviting the further co-operation df hospital board* in connection with this matter. I wish to preee on with the nrrangement*, and to be in a position very soon to indicate the date on which thoee benefits are to commence. That is a point of special moment to ail those closely connected with the existing system, including friendly societies and other bodies which hftre voluntary hospital benefit echeme* operating. The Government i« naturally anxioiie to have the benefits in full operation ae soon as possible." Hospital and Maternity. The Minister, after detailing the provision* of the Act relating to hospital iirul maternity benefits, explained that the type of institution which the Minister may approve m a hospital under the Act may include the Karitane hospital* maintained by the Plunket Society, and the Home of Compaction hoepUftlf, While the definition of "hoe pital patient" , Iβ wide enough to applj to person* admitted to a hospital tot treatment, isolation, examination, obeer vntton or medical restraint. Out-patient consultations and treat ment, Which .came within the range o

the general practitioner services would, when the** tmrriwm were arranged, ceaee to bi-pTOvfcled at public hospitals. Or tain other out-patient services provided at the public hospital* would, however, be developed or continued. Out-patient service* in this category mentioned by the Minister were:— (a) Vmnmity and emergency attention.' (b) X-ray examination and treatment, radium treatment and other special exam i nations and treatment. (c) Laboratory service. (d) Consultations with specialiete at tuberculosis, cancer, opthalmic, diabetic, etc., clinics. Some of th«M aervkee, the Minister continued, wmy be tk* etfbjeet of payment from the food from the Inception of hospital benefit, whilst othere may be Included only wiHrt ike teUtire epedallet and consultant benefit Is provided. Aβ for control over admission and dweharge at hospitals, the Mintater explained that in most case* tile patient Would secure admission on the recommendation of his medical attentoWlt, but the diecretionary power to refueo admission muet remain tested in the institution's medical oflleers, edbject as regards public hosplUl* to the overriding authority of the WreetorGeneral of Health in particular eaee*. The reason for thi* was that the patient w*i not in all ease* the sole factor in determining whether institutional care Iβ necessary or .whether domiciliary «are I* eufficient. The paticnt'e home conditions artd locatvon nad frequently to be taken Into account the availability of accommodation wae another Important factor. Further, until public hospital* could meet all reasonable* demand* on them, there would still occur from time to ttm« the necessity for deciding priority of admission.

Hoefit«l PeyMMtc Di 9 cu«ing th. leg*l jrottotoiii lot fayment to ho»dt«l* tot tr**tlH«it. the Iwinmter pointeJi out th*t thew did not tree from liability any t*™ o 'V,| iM liable to pay compenjatiqn of n* ma £* In respect to ho-plta treatment. After «on«ultation. rejfnlatiom * ou,d . *? framed defining the type of * eotninff within the icope of »«P»W« benefits for in-patiertti, particularly ae affecting private hoepitale. "It is not, of contu.««d the Minister, "intended that the Boc'*| Security Fund will pay the full «*t oi •are, or indeed at a scale WV™*™*' Ing ordinary charges, but at » "»i" that will in the ca* of h« B P ,t represent on avera** *********** th, amounts ordinartlf collated IfIIJgJJ "A coneequence of th* of hospital benefit may be a coniidernble alteration in the preeent honorary »v*tem of medical staffing. The introduction of hospital benefits may cause an increased demand for hospital treatment. Even under the preeent condition* there ifl a diortag* of aecoffltno<l»tion, and boards may therefore be under the neewsity of pfovWilte' »»rtie t. odiral attendance petldfttg the Irtattgilration of the general practitioner aer-

vice under the Act, and also to extend the district nursing service. I am desirous that theee factors shall be given due weight when the rate of payment to hospital boards its decided upon." Accommodation Shortage. Discussing a return which had be*n prepared detailing the available hospital accommodation of the Dominion, the Minister said it was notable that in the past ten years, while the population had increased by 10.2 per cent and hospital bede by 13.5 per cent, the number of in-patients had increased by 34.T per cent. An estimate had been made of requirements over and above additions n course of construction or for which tenders had been let, and it appeared that the number of bedn needed was at present at least 1000. This need would, he suggested, be mainlv filled by additions at the main hospitals. Social Security Finance. Mr. Fraeer concluded his references to the Social Security Act with some important comment on its relation to hospital board finance. "The introduction of free treatment in public hospitals," he said, "may result in increased demand* on these institutions, but the introduction of medical hrnentt 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 hospital*, while such out-patient services a* 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 boards' finance from the payment of monetary benefits under Part 2 of the Social Security Act, to which again ehould be added the saving in administration costs in reepect to charitable aid administration and patients' fees collections, the operation of the Act," concluded the Minister, "ehould be of considerable financial assistance to boards."