TAURANGA HOSPITAL BOARD’S ESTIMATES

Bay of Plenty Times, Volume LVIII, Issue 10356, 17 April 1930, Page 5

TAURANGA HOSPITAL BOARD’S ESTIMATES

No Increase in Maintenance Account. CAPITAL LEVY HIGHER. A special meeting of the Tauranga Hospital Hoard was held in the Board’s Room at the Tauranga Hospital yesterday. Present: Mr T. Lochhead (Chairman), Mrs G. E Burton, Messrs J. Hume, J. A. McGhie, Colin McNaughton, B. C. Robbins, A. B. Morton and H. Cuff. The meeting was called to consider the maintenance and capital estimates for the year ending March 31, 1931. Mr H. Lewis, county clerk, wrote as follows: “At the last meeting of my Council alarm was expressed re the report of further expenditure by your Board in respect of capital expenditure on further accommodation for nurses, the figures quoted being an estimate of from £IOOO to £6OOCT.

With the decrease in prices of farm products it was considered that the present burden of the hospital levy is as much as can be borne by the ratepayers of this county.” Dr T. FI. A. Valiutine, DirectorGeneral of Health in a letter regarding additions to the nurses’ home, stated: "I am forwarding the sketch plan prepared by the technical inspector (Mr Johnson), but at the same time I am communicating with • Dr Shore, Director, Division of Hospitals, with reference to the comparatively large female staff employed by your Board, more particularly Iho domestic staff. I am requesting Dr Shore to look into this question and he will doubtless communicate with you on the matter. The suggestions of your Board with regard to the Te Puke Hospital are agreed to, and a sketch plan of the modified requirements is being forwarded to you.”

Dr R. A. Shore, Wellington, in a. letter dated April 2, stated: "On going through the particulars in connection with' your hospital, I hud that the female staff of the Tauranga Hospital totals twenty, divided into nursing staff and domestic staff of thirteen and seven, respectively. As the average number of occupied beds in your institution is between twen-ty-two and twenty-three, it will bo apparent to you that the total of the female staff is somewhat out of proportion to the number of occupied

beds. I should be pleased, therefore, if you would give me some statement as to the necessity of having such an apparently large female staff attached to your institution, and I would also be pleased if you would go closely into the matter with a view to seeing if the number of the staff cannot be reduced.” The Director-General of Health forwarded copy of a report by the Inspecting Accountant regarding his recent visit. He added; "I should be glad if you would bring the report before your Board "and I wish to draw special attention to the Inspecting Accountant's comments regarding the high cost of salaries and wages at the Tauranga Hospital.” Mr C. W. Beggs, Inspecting Accountant, in his report dated March 26, stated: “I visited Tauranga on the 22nd-24th ultimo and submit the following brief report: “Patients' Records and Accounts.— Particulars of patients admitted are taken on a suitable form of admission sheet, and on discharge patients are interviewed by the Secretary to glv6 them'an opportunity to pay their

accounts or make arrangement for the paymeht of same. The Secretary has a good form of columnar fees journal in use, but brings into account each-month only the fees receivable in -respect of patients discharged during the month. I pointed odt that it is advisable to enter up monthly the accrued fees of all patients who Uiave .been in hospital during that month, and also that accounts should be rendered monthly in respect of patients in hospital for lengthy treatment except where the patient is personally responsible for his own fees. The patients’ accounts are well kept and actively followed up. "Private Wards.—The hospital contains several single bed wards, which when not utilised for eases requiring special nursing, may be engaged by a patient at a rate of fifteen shillings per diem. The occupant of a private ward may engage his own medical attendant and is responsible for the fees of such medical attendant. This arrangement appears to be satisfactory in Tauranga, but is, I think, unique so far as .the public hospitals of the Dominion are concerned. The Board has, I notice, several very doubtful debts on its books owing by private patients and as these wards are meant to be engaged by only

those In good financial circumstances | I consider that the fees of private patients should be either paid in advance or guaranteed by the medical attendant. "Patients’ Fees. —The total fees collections at the time of my visit Indicated that the previous satisfactory average was’being maintained. “Hospital Expenditure.—The expenditure under the various headings was within the Board’s estimates, with the exception of that for salaries and wages. The cost of salaries and wages at the Tauranga Hospital has been comparatively high for some time past and the Board should endeavour to reduce expenditure in this direction. It would appear that both the nursing and domestic staffs are on a liberal scale for a hospital averaging from 22 to 23 occupied beds per diem. In this connection it should bo mentioned that the cost of any staff over and above what is necessary is not represented only by the salary paid, but it may also involve the Board building extra staff accommodatlou which otherwise would not be required. "Stores Record.—Official orders are used as far as possible for ordering stores. Issues from the hospital store are made by the matron daily on internal requisition from the wards, kitchen, etc., and in order that the quantity consumpiou of main lines may be watched and comparisons made with other hospitals I suggested that a form of tabular register be kept to record the daily issues from the hospital store. “In conclusion I would mention that the Secretary's books are neatly hept and up-to-date and I desire to acknowledge his assistance and courtesy during my visit.” The Director-General of Health wrote under date April 7: "With reference to your letter of the 22nd ultimo, forwarding statement of the Proposed capital expenditure for the current year I concur in the inclusion of the proposed expenditure In the estimates to be submitted to the Department during the present month. It will be understood, however, that the Department reserves the right subsequently to recommend the withholding of the consent of the Honourable the Minister in respect of any capital expenditure ex-

I ceeding £250 In amount. lam glad to note that the question of additions to the nurses’ home has been held over.” The Chairman explained that the Committee previously appointed to consider the question of additions to the nurses’ home had held a meeting and was of opinion that the question be held over for a year. Mr Robbins said the letters regarding salaries and staff came as a surprise to him. He had always been led to believe they were running the hospital as economically as any in the same grade and had no idea they were over the mark in regard to salaries. As regards the

[ letter from the County Council there seemed to be a false impression. The j Board did not contemplate going to the cost of a building of £6OOO, but alterations to the extent of £llsO had been mentioned. It was cheaper in the long run to go in for a new building than to renovate an old one. At the previous meeting when the question in regard to accommodation was under consideration the Secretary made a statement that a loan of. £2OOO would fall due in twelve or fifteen months. The Board would then be in a position to raise a loan,

but did not contemplate going in for enormous expenditure. The' architect’s estimate was £llsO and the Board had referred the matter to. a committee to report upon. The letters from the Department’s officers were serious and he thought they should be referred to the medical superintendent and the matron and also a special committee to report upon. Mr McNaughton said he was pleased that the letters had been received from the Department’s officers. He had stated at the last meeting that the hospital was overstaffed and the letters boi'e out what he had said. Certain members had said they did not believe in patching an old building and advocated a new building. He referred to a letter signed “Staff,” which was published in the Bay of Plenty Times last month, criticising

a statement made by him (Mr McNaughtou) at a meeting to the effect that the hospital was overstaffed. It was like an old woman’s writing, but he took no notice of that sort of thing. He was a representative of the ratepayers and would do his ] duty. At the last meeting he said the hospital was overstaffed and the Government returns showed it was amongst the highest in the Dominion. He would still say they were overstaffed. He was pleased that the Board had received the report from the Department. Mr Morton asked if it would be possible to reduce the staff as this would affect the estimates. The Chairman said he was in favour of referring the question to the superintendent, matron, and a special committee. Mrs Burton said if the staff were reduced, it would be necessary to procure outside nurses when the hospital was full and this would mean additional expense. Mr Robbins said he did not know of any time on the Board when he led members to think he favoured an expenditure of £6OOO. He advocated a new building up to £2OOO in preference to making alterations to the old building now occupied by the nurses. He was not out for high expenditure. The country could not afford it, and it was not necessary. Mr McGhie in referring to the letter signed "Staff,” said if the letter were written by a member of the staff it was wrong of the staff to criticise the Board, and no one outside the hospital should have written such a letter over the uom de plume of “Staff,” as it was not fair to the staff to do so. Mr Morton said the estimate of

£6OOO was. given out at the last meeting. Mr Robbins stated that an expenditure of £6OOO was not countenanced by any member of the Board. The meeting proceeded to consider the question of estimates. Numerous details were given by the Secretary, Mr Lumley, who submitted provisional estimates. The Secretary pointed out that if the verandah to the private wards and the improvements to the matron’s rooms, estimated to cost £222, were deleted, this would reduce the capital expenditure. Mrs Burton stated that the money was raised by means of the garden fete and should be expended on the two works Indicated. Mr Robbins' pointed out that the money raised by the fete should be expended in providing another verandah and improvements to the Matron’s quarters. It was a special effort for a special purpose. Mr Morton stated that from information received since the last meeting he was against erecting the verandah.^ Mr McGhie was opposed to breaking the concrete walls in order to erect the verandah.

Mr Robbins maintained that the money should not be diverted from the special purpose for which it was raised Mrs Burton, as representing the Citizens’ League, advocated that the money raised by means of the garden fete should,be expended on the verandah for general use by patients and for improvements to the matron’s quarters. Mr McNaughton said he did not understand that the money raised by the fete was for any special purpose. The Chairman said he could not see any great necessity for the verandah for the private wards. He thought it would be a nice thing if a verandah were erected outside the matron’s rooms. He w T ould not like to see any increase in the levies on the local bodies this year. Mr McNaughton said they must expect as a result of the fall in the prices of products that the payments from patients would be reduced this year. Mr Robbins contended it would be unfair to the public and those who promoted the garden fete to divert the money and he strongly protested against the suggestion to divert it. The money was raised for a special object and it was not a large amount. I Reductions could be made in other directions. Mrs Burton said there were a large number of people who worked exceedingly hard for some months in preparing for the garden fete, and that money should not be diverted. She questioned w’hether the discussion was in order. Mr Robbins then rose to a point of order and contended it had been decided at the previous meeting that the garden fete money should be, expended in erecting a verandah for patients 'use and in providing improvements to the Matron’s rooms. He asked for the Chairman’s ruling. The minutes were referred to and showed that Mr Robbins’ contention was correct. The Chairman ruled that it would be necessary to rescind the motions. Mr McNaughton gave notice that the motions bearing on the matter be rescinded. Mr Hume urged that at the present time in view of the drop in the prices of products that all capital expenditure should be cut out this year.

Mr Morton moved—That the estimates as submitted by the Secretary, be adopted. Mr Hume seconded. In reply to Mr Robbins, the Chairman said that provision was made in the estimates for the erection of the verandah for patients and for improvements to the matron’s rooms. If the notice of rescission were carried the item could be deleted. The motion was carried. The Secretary pointed out that the capital levy would be £132 more than last year. Later Mr Robbins, in referring to the question of staff and salaries, said it was an important matter, and he would like to see the question considered by a full meeting of the Board. He moved —That a special meeting of the Board be held on the afternoon of the next ordinary meeting on May 29. The motion was seconded by Mr Hume and carried. THE ESTIMATES. The Estimates for the year ending March 31, 1931, as adopted by the Board, were as follows: 1. Maintenance Account. Receipts. Reed. Est. 1929-30 1930-31

The amounts shown in parentheses are the estimated receipts for the year 1920-30. The maintenance levy will be practically the same-as last year, but the capital levy shows an increase of £132.

£ s. d. £ s. d Subsidy outstanding . 37 17 8 (37 17 8) Voluntary Contrib. 548 19 4 100 0 0 (150 0 0) Sub. on Vol. Contrib. 548 19 4 100 0 0 (150 0 0) Patients’ payments 2^28 2 7 2500 0 0 (2600 0 0) Char. Aid Recoveries 8 3 4 8 50 0 0 (40 0 0) Rents, Interests, etc. 75 10 0 75 0 0 (80 0 0) Mis. receipts 1 0 0 4123 13 7 2825 0 0 (3057 17 8) Overdraft at 31/3/30 69 13 8 4193 7 3 Main, levy 3167 10 4 3167 0 6 (3167 10 4) Main. sub. 3172 0 1 3169 0 1 (3172 0 1) 10532 17 8 9161 0 7 (9397 8 1)

Payments. Paid Est. 1929-30 1930-31 £ 8. d. £ s. d. Overdraft 14 1 1 69 13 8 (115 2 2) Hos. Main. 6292 7 9 6004 6 8 (5980 15 8) Char. Aid, indoor 14 14 3 25 0 0 (13 0 0) Char. Aid, outdoor 316 6 4 320 2 5 (305 1 6) Medical As. 105 0 0 105 0 0 (105 0 0) Dis. Nursing 314 17 2 279 1 10 (250 0 0) Nat. Nursing 53 15 9 50 5 0 ' (58 0 0) Admin. 727 0 6 704 17 11 (741 19 6) Other Boards 469 14 0 429 0 0 (464 0 0) Rents, Rates, etc. 41 9 2 20 0 0 (80 0 0) Int. on loans 870 0 0 870 0 0 (870 0 0) Int. on Over. 157 16 0 130 0 0 (125 0 0) Nat. Prov. Fund 61 7 1 100 0 0 ' ' (100 0 0) Refund of sub 55 19 3 43 13 1 (55 19 3) Old Hosp. Te Puke 4 11 10 10 0 0 (10 0 0) Mis. Paym’ts 121 0 10 (123 10 0) Transfer to Capital 912 16 8

10532 17 8 9161 0 7 (9397 8 1) 12* Capital Account. Receipts. Reed. Est. 1929-30 1930-3 i - £ B. d. £ s. d. Sale of Cap Assets ii 0 1200 0 0 (1600 0 0) Appi’o. from Main. 912 16 8 Overdraft 844 3 11 1757 11 7 1200 0 * 0 (1600 0 0) j Cap. levy 550 0 2 682 10 0 (550 0 3) Cap. Sub. 550 0 . 2 682 10 0 (550 0 2) 2857 11 11 2565 0 0 (2700 0 4) Payments. Paid Est. 1929-30 1930-31 r -■ . £ s. d. £ s. d. Overdraft 1981 4 2 844 3 11 (1880 3 i) Loans, sinking funds 750 0 0 750 0 0 (750 0 0) Cap works 47 4 9 920 16 10 • (19 17 3) New equip 79 0 0 50 0. 0 (50 0 0) 2857 11 11 2565 0 0 (2700 0 4)