PUBLIC HOSPITAL.

Press, Volume LX, Issue 18051, 17 April 1924, Page 6

PUBLIC HOSPITAL.

THE YEAR'S WORK. SOME CRITICISM.

At yesterday's meeting of the North Canterbury Hospital Board, the chairman Mr H. J. Otley, said that as this was'the annual meeting, it would be fitting for him to review the work of the past year. The public failed to realise that the Board had to administer 15 institutions, and the cost was much greater than it would have been if it was under only one or two heads. An unexpected expense during the year was the Children's Fresh Air Home, which the medical men had recommended as a preventive against disease, not a cure. The Board had also increased the infectious diseases hospital by 50 , beds, and a new cottage hospital at Akaroa had almost been completed. The speaker said that he was sure the outlying districts appreciated and deserved these facilities, and deserved up-to-date hospital accommodation as much as the townspeople. . The Akaroa, Bangiora, and Leeston Hospitals would be .in operation in a short period. Thero was also another big expense looming up in the provision of a new hospital at the Chatham Islands. The islands were attached to Canterbury, and therefore it was the duty of the province to provide hospital facilities for the inhabitants. Nearer home there had been a request from Cheviot for a hospital, and another hospital had been asked for on the Peninsula. There was an average of 875 patients in all the institutions controlled by the Board, and 322 attendants. The special departments provided by the Board had grown from small things. The pathological department had done wonderful work, and in Dr. A. B. Pearson the Board had one of the best men in the world for this type of work. The dental department had grown by leaps and bounds, and a«ain, the Board had a most cap-able-officer in Mr Eattray. The X-ray department, under the. charge of Dr. Neil Guthrie, had progressed marvellously. Dr. Guthrie was so keen in keeping himself up to date in his work that he was going to America at his own expense to make further study.

Private Wards. • Financially matters had gone rather hard but he could say that not one penny had been spent inadvisedly since he had been on the Board. The cottage hospitals had more than justified their existence. With regard to private wards, Mr Otley said that he was very disappointed that the proposal had been turned down. The Christchurch Hospital should have privato wards, for it was most unfair that any man or woman who_ had _to pay rates could not bo admitted _ into the hospital owing to their superior financial position. .The Board would have to* make arrangements for them to comein, and if necessary they could pay their own doctors. Young men, growing up in business, at present were faced with a big expense if they had to go to private hospitals. With regard to the Nurses' Home, this was an urgent work, but one that had been continuously shelved. The nurses were now getting one day off a fortnight, but that was only half the holiday they were entitled, to. This matter could not be put'right until there was ample accommodation for nurses. There sliould be no difficulty in obtaining land from the Domains Board, which was sympathetic, but a-Bill would have to be put through to complete the-mat-ter. In conclusion, Mr Otley said the -year had been a very satisfactory one. Ho extended his thanks to the' wholo staff, from the medical superintendent and matron, for their loyalty to the institution.

Financial Report. Tho Hon. E. Moore, chairman of the Finance Committee, in moving the adoption of tho committee's report, said he' wished to refer to the work of the past year. lie had not„opposed any reasonable expense, and the fact that the year had finished with a debit balance of £11,004 showed that funds had been provided freely. | With regard to the amount, the expenses of such a big institution were certain to increase. The population was increasing, and so the Board's liabilities would increase. The main institutions which had exceeded their votes were the base hospital by £3286, the sanatoria by £2324, the Fresh Ai* Home by £lll2, tho pathological department by £6BBB, the dental department by £953, and the Kaikoura Hospital by £B9O. Next year the levy 'on local bodies would be less by £1139, because of the increased Government subsidy of £1 2s Bd, against 14s 3d last year. Ho had to thank the_ Government for this increase, for it was a decided saving to the local bodies. Last year the sum of £1307 had to be paid to tho Board's bankers in interest, the large amount being due in some measure to the laxity of some of the local bodies in paying up their contributions, . This was unfair to the good payers, who had also to shoulder a shaTe 'of the interest. The estimated expenditure for the coming year was £168,240, compared with £147,029 last year, an increase of £21,211. The following statement from the Finance Committee's report showed the expenditure in 1923-24 and the estimated requirements for. 1924-25:

Add short received account estimated receipts •.. .. ,861 168,210 Leas estimated revenue, account maintenance ! • . • ■ • 40,300 Bequirements account maintenance £127,940 The overdraft last year, continued Mr Moore, was over £30,000, and the secretary wrote to the Government for an extension to £ 35,000, which was granted. Some £40,000 was still reauired, and he asked the Board's autho-

rity to raise a further loan, the following table being in explanation:— Total amount required for: £ B> d . Maintenance ~ 127 9JO 0 0 Capital ~ T6S 0 0 £152,709 0 0 The rate of subsidy -prill "be about £1 2s 8d per £. Tho amount to be raised by levy will be: ■Maintenance Capital „ 2,SS-i 0 0 c , ~ , 62,310 16 i> Subsidy Slain- > ■ tonance .. 68,013 3 S Subsidy Capital 2,351 0 0 ■ 70,397 3 3 Total ~ ~, £132,708 0 0 Lass • year the Maintenance Levy wa s .. 55,369 15 7 Capital ~ 7.550 0.0 -Total ~ £63,449 15 7 Expenditure to be met by Loan: Extension of Pathological Department .. 1,350 0 0 Cheviot Hospital 8,000 0 0 Deep Therapy X- ' Bay .. 3.500 0 0 •Oxford Hospital Extensions .. 1,000 00' Christchurch Hospital Nurses' Home .. 30,000 0 0 Sanatorium Nurses' Home 2,000 0 0 Memorial Home Nurses' Accommodation 2,000 0 0 Total .. £47,850 0 0

With regard to subscriptions to the Board's loan, Mr Moore said that stories had been circulated that it was not a suitable investment for trust moneys and that the Board had no rating powers. These were contrary to fact, and he gave them both an emphatic denial. There was no local bodies' loan better for investors, for the Government was a partner, together with other Wal bodies.

A Dissentient. Mr F. Horrell disagreed with both the chairman and Mr Moore. He said the Finance Committee had not looked after the finance as it should have done. There was no need to spend such a great deal of money, especially when the ready money was not actually available. Further, in many cases the amount of fees received was very small as compared with the expenditure. The whole system wanted a thorough overhaul.

Mr S. Andrew congratulated the Finance Committee on its report. He said he was glad to see something was being done in regard to the ■ Nurses' Home, and that the system of country hospitals was being still further developed. With regard to Mr Horrell's remarks about fees, there were & number of people who were quite unable to pay. "■ Mr M. Bethell said he regretted the great' to which there seemed no end. The .Board should Temember whence the money -came, and not place too big a burden on the taxpayer. He urged tho Finance Committee to keep the maintenance account down to bedrock, or there would be no end to expense.

Cottage Hospital Advocates. Mr W. E. Leadlcy said that while he did not agree with Mr Horrell's remarks, he was sorry to seo the Board faced with a big debit balance. At all cost, however, the Hospital must' proserve its' reputation as the most up-to-date institution in the Dominion. With regard' to the cottage hospitals, he was glad to hear the chairman did not think along the same lines as the Director of Health, who only recently had urged concentration on base hospitals. - At the same time the Board would have -to keop a tight hold on finance. Div P. C. Fenwick criticised the statement of the Director of Health, and said the cottage hospitals had quite justified their existence, if only for maternity cases. It was unthinkable to suggest bringing a poor woman 40 or 50 miles over alleged good roads. '.'l call them potholes," added the doctor. i

The Replies. Mr Otley, in reply, said he was glad to have all tho criticism the Board could give, but he assured the members that not one penny had been spent which was not wanted.' Mr Howell, however, had been unfair, for he had compared' 1914 figures with those of 1924, when the value ,of tho £ sterling was quite a different fatter. With regard to the allegation that spmo of the departments were a waste of money, if tho Board was wasting the ratepayers' money it should be kicked out. The Board wanted everything possible in -the way of cures for disease, and although ho regretted the huge expenditure tho Hospital must be kept up to date.

The Hon., E. Moore, in reply," strongly deprecated Mr Horrell's statements, and said lie was inconsistent, for when tho Kangiora Maternity Hospital was taken over Mr .Horrell was* one of the warmest advocates for the step, in spite of the fact that no provision had been made by the Board in regard to the financial part. He asked the members of the Board to point out any individual items in the finance report which were open to criticism. ■ He quoted the following figures to show that the Ohristchurch Hospital, per annual cost of bod, was the second cheapest in the Dominion: Auckland £124 0s 4d, Wellington 0s 4d, and Otago £147 2s 2d.

1923-2; i. : 1924-25 : Expen- Eeqmre- ■ v ' : Vote, ditire. •: meats. '£ £ ' £ Christchurca Hospital 62,000 65,286 ' 66,000 Dental department 3,200 4,153 4,500 Pathological dept. .. 3,500 4,188 4,509 Akaroa Hospital 700 ' 630 1,300 Amuri Hospital .. 1,000 1,497 1,300 Kaikoura Hospital ... 3,000 3,890 4,0„0 Lyttelton Casualty Ward SCO 63S 800 Oxford Hospital , .. 1,250 . 1,329" 1,300 Rangiora Hospital 1,250 1,099 1.30J Waikari Hospital 1,250 1,634 1,600 Leeston Hospital 1,000 Consumption Sanator. 18,000 20,324 20,0u0 Fresh Air Home 1,112 2,500 Tuberculosis dispensary 650 607 650 Infectious Diseases' Hospital | 5,000 5,876 9,000 Tuarangi ' •• 6,500 6,799 7,750 Essex Home ' 1,900 2,167 2,230 Memorial Home e,ooo 5,889 6,250 Orphanage 1,600 1,463 1,60(J Armagh street depot .. 500 439 500 Outdoor relief 6,500 6,859 7,000 Special Schools ' 400 337 400 liedical Subsidy and L District Nurse 6,700 1,092 1,250 General expenses i.. 6,873 6,800 Accident 300 300 300 St. John Ambulance Assn. . 125 125 125 Social Hygiene Society 300 257 300 Christchurch District Nursing Assn. 400 <00 400 Contingencies 1,000 628 1,000 Debenture Interest 1,200 1,133 3,200 (s: ix inon ths.). Debit balance 11,001 11,004 L47,029 1 :47,029 : 167,379 £