The Hospital Budget

Press, Volume LXXVII, Issue 23318, 2 May 1941, Page 8

The Hospital Budget

Anincreslaeso great as 30 per cent. in the hospital rating in the North Canterbury area must attract the attention of ratepayers. Hospital levies,, already a substantial part of the total rate struck by local now assuming proportions which make it essential to, call every detafl of hospital finance into review. It is true that the percentage Increase over last year’s by the North Canterbury Hbspital Board, does not accurately measure the growth ’Of Expenditure; fpr, /as the chairman of the finance committee explained, this increase follows a substantial rate reduction last year, .. When a heavy surplus was piled up through the receipt, ’aiVfrpmvJttly, -..193 d, of social security payments for in-patients. Even so, the new ' budget imposes twlc(p the: taxation of 10 years ago. The upward curve apparent since 1936 has become, very steep; and the question is where and how the climb can be stopped.

The system of hospital finance is simple. Boards derive revenue principally from patients’ fees, a 'State subsidy, ahd levies on area local bodies. The social security scheme, providing sree In-patient service, substituted ,'f6p the uncertain and Inadequate total of fees paid by patients the assured and much greater total! payments from the Social Security Fund. For example, bie Christchurch Public Hospital/ received £38,640 from patients during the, financial year 1938-39; payments from the fund, in 1940-41, totalled £BO,BOO. Maternity benefits payments have also raised the board’s hit come} and the .extension of the social security scheme to the out-patiefita’ department will provide a further increase this year. Rate-; payers will naturally ask why, with its income assured and expanded, the board should make the heaviest rate demand in its histpry.First,civUiah demands upon hospital services have in practically every department steadily increased- ■ over the last 10 years, and sharply since 193&; In effect, they have been demands for larger staffs, more equipment, and extended'accommodation. In. addition, present and prospective military requirements have had to be met or prepared for. These facts largely explain the great increase of maintenance and capital expenditure in ;the last two years. They also exhibit the greatly increased responsibility of hospital authorities. It is not clear that they have risen to it. Ratepayers are entitled to ask for intensified care in reaching policy decisions, in undertaking capital expense, and in controlling maintenance. Although 'administrative standards , in North Canterbury are better than in many other areas, the framing of policy has suffered from indecision and short-sightedness. Hospital boards have had to face some unexpected diffl- ’ -culties, certainly; but they have had plenty of warning to prepare for heavier civilian demands, at least,-and they are being obliged to /improvise measures now because they did. not plan them'in time. It may be asked whether ' the North Canterbury Board, .together with Other boards,'bw been'regularly and .wisely /advised by the central authority, the Health Department, If the various, boards did not vjtoresee inevitable .civilian demands, , then the Health Department, certainly should have done* so. iNow that the State meets so'substantial a portion of hospital costs, its advisory and supervisory functions become more important than .'evert aijd/ if it niakes constant new demands boards, as-itlhas done and is still doing, it be able tb. ahow how'-they can be . economically and meV