The Press Monday, December 14, 1931. Hospital Board Finance.

Press, Volume LXVII, Issue 20419, 14 December 1931, Page 10

The Press Monday, December 14, 1931. Hospital Board Finance.

We printed a few days ago a review of the finance of Hospital Boards in the Dominion, in which it was stated that they will probably have a deficit of £.100,000 at the end of their present financial year. The Government has already promised the Boards £75,000 as extra assistance, and it is impossible not to be disturbed by the probable necessity of finding another £25,000 in such difficult times. According to a report by the executive of the Hospital Boards. Association, the main cause Of the additional deficit has been the action of the Government in cutting down the estimates of the Boards. The trade depression has naturally greatly increased expenditure on outdoor relief, which is provided by the Hospital Boards and by the Unemployment Board as well. In cutting down the estimates of the Hospital Boards, the Government apparently expected that the increased revenue of the Unemployment Board would enable it to assume most of the burden of outdoor relief. This hope has not been realised, with the result that Hospital Board finance is now in a tangle. It must however be noted that, although the Government seems to have started with the excellent intention of bringing unemployment entirely under the Unemployment Board, it has allowed unemployment, possibly by faulty estimating, to become the joint burden of the Board and the local bodies. As unemployment is a national concern, and as the sharing of a task by two unconnected sets of authorities creates a danger of overlapping and waste, this is most unfortunate. There is the further point that unless the government makes up the deficit—it has indicated its willingness to do so in part—an extra burden will, in the following financial year, be thrown on Ihe local authorities contributing to Hospital Board expenditure. It will bo regrettable if this does happen, because most contributory authorities are grumbling already at the size of the levy. Last February, for instance, three County Councils protested against the expenditure of the North Canterbury Hospital Board. Without venturing at all on a discussion of Hospital Board administration, it is possible to sympathise with the uneasiness of the contributory authorities. Ir is undesirablo that money should be raised by one authority and handed over to another to spend, for it means that effective supervision by the ratepayers is being macle very difficult. Furthermore, it is disconcerting for a City j Council trying to keep rates in its area down to a reasonable total to have to levy a rate each year the size of which it cannot control.' The contributory system of finance was tried in England in connexion with the now extinct School Boards and found to be thoroughly objectionable and wasteful. We are not suggesting that there is not adequate supervision of Hospital Board expenditure; on the contrary the Minister for Health has almost unlimited powers of forcing economies on the Boards. But the Minister's knowledge of local conditions i 3 necessarily and the economies he insists on may, as in the present instance, be ill-advised; nor.is spasmodic control from the centre ever as valuable as intelligent. watchfulness by ratepayers. It would be more reasonable if Hospital Boards were made rating authorities, or failing that, were, composed of representatives of the contributory bodies. -Neither arrangement is ideal, but nothing better could be done without a general overhaul oE the system of local government. For it must also be noted that in addition to this confusion of control there is a confusion of functions. There does not seem any good reason why She provision of 'relief to destitute persons should be mixed up with the administration of hospitals. The latter function ought to belong either to the central Government or to the local bodies who provide relief works in conjunction with the Unemployment Board. The Christcliurch City Council is at the moment subsidising two different systems of outdoor relief, and yet has no responsibility for destitution within its area. The whole situation calls for immediate enquiry.