The Hospital System

Press, Volume LXX, Issue 21079, 2 February 1934, Page 10

The Hospital System

At a meeting reported in " The " Pross " yesterday the Canterbury Sheep Owners' Union decided to support a Timaru suggestion that hospital and charitable aid rates should be abolished and their equivalent charged on the Consolidated Fund or on a special levy on all persons more than 21 years of age. It will readily be admitted that the present system of hospital rating, whereby one local body levies the rate and another spends it, is not satisfactory. Not only does it prevent counties and boroughs from exercising a proper control over the rates levied in their areas, but it complicates and weakens the supervision of hospital expenditure by the ratepayers. It is doubtful, however. whether the best solution of the problem would be to charge the whole cost of the hospital system on the Consolidated Fund or on some special fund created by a national tax. Though local taxation is almost invariably less equitable in its incidence and more expensive to collect than national taxation, it ensures a measure of local control worth preserving at the cost of minor injustices and some ra expense. If the Sheep Owners' Union had paused to reflect that it was, in effect, proposing to throw the control of the hospital system completely into the hands of a state department it would probably have been more cautious. In any case, the important point is. not that the hospital rates are Inequitable, but

that they are unnecessarily large. The hospital system is overgrown and wasteful; and the immediate need is to rationalise and cheapen it. Two lines of attack present themselves. One involves a reduction in the number of small country hospitals and an effort to co-ordinate the work of the base hospitals. Reform in this direction has been advocated in reports of responsible officers oi the Health Department for at least 10 years as well as by competent outside critics. The other line of attack involves a reduction in the present excessive number of hospital districts. There are now 45; originally it was not intended that there should be more than 20; and the ideal number would probably be about 15. It is only necessary to compare the administrative expenses of the smaller boards with those of the larger to realise that small areas are both inefficient and costly. Last year the Government armed itself with legislative powers to close unnecessary institutions and to compel hospital districts i > amalgamate where this is considered desirable. If the Sheep Owners' Union wants to use its influence to the best effect, it should urge the Government to use tho=2 powers.