The Press THURSDAY, MAY 8, 1941. Social Security and Hospital Rates

Press, Volume LXXVII, Issue 23323, 8 May 1941, Page 8

The Press THURSDAY, MAY 8, 1941. Social Security and Hospital Rates

The Minister for Health, the Hon. A. H. Nordmeyer, ■ is belatedly beginning to doubt “whether we ought to continue the existing “ system of making local ratepayers responsible “ for a great portion of the cost [of the hospital “system].” The difficulties which, now, in a greater or less degree, face all hospital boards are the same difficulties which faced the North Canterbury Board last week when it came to take stock of its financial position. The medical benefits provided under the social security scheme have substantially improved the board’s revenue position by substituting for the small and variable amount collected in patients’ fees a larger and assured payment out of the Social Security Fund. Nevertheless, the board is this year compelled to levy the largest rate in its history; and the reason is that the increased demand for hospital accommodation created by the social security scheme and by military requirements necessitates an expansion of staff, equipment, and buildings. The position of the North Canterbury Board, which even now levies a relatively low rate, is better than that of the great majority of hospital boards. It is in poor districts, where the hospital rate is already high, that the shortage of accommodation is most acute; and in such districts, if the present financial system continues, the quality of the hospital service must deteriorate or the burden of an inequitable and inconvenient form of taxation must be increased. The Minister’s ideas as to how this situation should be remedied are depressingly vague and confused. “ We have come to the point,” he’ says, “ where “we have got to take a stand and see if we “ cannot get a more equitable system of rating. “We should be able to evolve a system which “would stabilise borough and county rates—a “ system where the cost of hospitals would be “ a national and not a local cost.’ ! If the Minister wants to nake hospitals a national and not a local cost, he has no option but to abolish hospital rates entirely. Such a step would find much support among county ratepayers; who have for years agitated against the inequities of the hospital levy, and would in addition greatly simplify local government. Counties and boroughs have a legitimate grievance against a system which compels them each year to levy large sums, over the spending of which they have no control. Abolition of hospital rates would, of course, involve modifying or even terminating local control of hospitals; and on other than financial -rounds there is much to be said for such a step. For nearly 20 years the New Zealand hospital system has been criticised by visiting experts and in the annual reports of the Health Department because, largely owing to'local control, there is too much duplication of facilities and too little specialisation. In consequence, progress in the more complex forms of treatment is retarded and there is needless waste. Moreover, the evils inseparable from local control of hospitals have been greatly accentuated by the multiplication of hospital 1 districts, of which there are now 42. The Government has recognised the need for a drastic reductioh in this number and has passed legislation which facilitates amalgamations. Like all similar legislation, it has been brought to nothing by local feeling. The .evils of local control appear to he incurable; and in the circumstances centralisation seems the only remedy.