PUBLIC HEALTH.

Press, Volume LVI, Issue 16850, 2 June 1920, Page 7

PUBLIC HEALTH.

CONFERENCE OF HOSPITAL BOARDS. STATUTE-IT ~TI IHS MH7ISTZ3L (T rJ-03 ASSOCI.VTTON Tnf.F.CP.A.M.) WELLINGTON, June 1. Several matters of policy were ursrussed by tho Minister of Public Health (the Ken. C. J. Parr), when opening the conference of Hospital Boards today. Thero v.as no other country, to his mind, where so many were to bo found willing to give time and trouble without fee for tho good of the State; as in New Zealand. It was not fair i to ask chairmen of Education Boards and Hospital Boards to neglect their own businesses wit-hour- some compensation. There ought to be given to everyone who has administrative_ ability tne ehanco of placing his services at the call of the community. The time had arrived when the State should give some compensation for these services. He went on to deal with the agitation in some quarters for a change* in the system of administration, particularly to the proposal for nationalisation. Nationalisation would carry with it tne abolition in great measure of Hospital Boards as now constituted. He had always been keen for nationalisation of enterprises which the State could carry 011 better than private concerns, hut he must say his experience had been that thero were as many evils with bureaucracy as under other systems. There was ono cardinal point, however, and that was that if thy Stato undertook enterprises it could not ■ hope for success unless it were nrepared to pay for brains to manage tfiom. Personally he would not be prepared to undertake the nationalisation of hospitals without drastic reforms at headquarters. If nationalisation were found desirable he would separate the business from the professional side of tho Department. Until the State were prepared to do something of that kind 110 would not counsel the extension of State enterprise in any Department. Pointing out what it would mean to the State to take over control entirely, he said that last year local bodies' contributions amounted to £3-50,411, while tho Government subsidy amounted to £287,021. Ho had some sympathy with tho nationalisation scheme, but this was not the time to thrust an extra burden on the Stato Treasury.

Proposals for some form of nationalising the medical service engaged the attention of the Minister. To him it f-eemed that it was all a matter of arranging details, but with the fact staring them in the face that annual charges had risen by £11,000,000 in the last five years he could not hold out any hope of reform being carried out this year. "I am in hearty sympathy," he said, "with the suggestion that the time had arrived when the State should adopt some modified form of national medical service for back districts. We have to do something in regard to back districts. The doctors have suggested a modified form of national medical service, and I have asked Dr. Valintine and his officers to see what can be done and how wo can help." The Minister spoke of many claims for better hospitals in country districts, and said that while these should be enquired into thoroughly, ho was against anything that would weaken the big, or base, hospitals. He strongly favoured the creation .throughout the country of small maternity hospitals, presided over by a nurse-midwife able to give first aid and treatment to cases prior to tneir transfer to larger centres.

lteforrinjr to subsidies, the Minister eaid that ho was not going to condemn the schcme altogether, but while thinking there should be some differentiation he was free to confess that it seemed to him that the working out of the schedule in practice resulted in hardships to hospital authorities. It was sufficient for him to indicate that the schedule should be reconsidered and revised. I>ealing with patients' fees, Mr Parr said that the amount received by Boards worked out at an averago of 20.4 per cent, of the total claims. The lour Dig centres varied from l(j to 25 per cent. He did not suggest inat Hoards should bear hardly on patients, but it did not seem to hiin tnat iu per cent, was the measure of the ability of patients to pay. Lodal bodies had reason to ask tne question when they contributed £350, lAX) against £135,000 paid in. fees. Me touched brielly on a suggestion that a nurses' superannuation scheme should be adopted, and agreed that something on tnese lines was desirable. It would be a difficult matter to arrange details, but if a scheme were -put beforo Mm Jie would do his gest. The conference, after opening addresses by the Minister, and Dr. Valintino (the "Director-General of Hospitals) adopted a remit advocating provision' in tiie Act to meet the expenses of tho chairman of hospital boards incurred in visiting the various institutions under the control of the Boards, and that provision be made for the payment of an honorarium to chairmen.

The conference suggested that £100, be the amount of the honorarium.

It was also decided that a uniform flat rate payment of £1 Is per meeting bo paid to members as travelling expenses irrespective of distance in each case. The system of levies and subsidies was discussed at considerable length, many remits being submitted on the subject. The present system of levying on land values was held to bo inequitable. A flat rate was discussed, as was also a proportional scheme proposed by the Department, and outlined in the "Journal of Public Health" for April. The matter was referred to a committee to confer with the Departmental officers and report to the conference later.