ROLE OF PRIVATE HOSPITALS

Press, Volume LXXXIX, Issue 27098, 22 July 1953, Page 10

ROLE OF PRIVATE HOSPITALS

“ESSENTIAL PART OF SYSTEM ”

SUBMISSIONS FOR ST. GEORGE’S Private hospitals were, and would remain, an essential part of the hospital system in New Zealand, because they provided an. alternative service of a type desired by the people and advantageous to them, because they reduced the financial burden of the public hospital system on the public purse, and because they helped maintain the standards of medical service, said Dr. L. C. L. Averill, chairman of the executive of St. George’s Hospital. With Dr. Averill were Mr L. A. Bennett, a member of the executive, and Mr 3de G. Robilliard, the auditor. Messrs Bennett and Robilliard also made submissions for the Limes Hospital, Ltd. In private hospitals, a patient could choose his own doctor, and had the physical and mental privacy he might desire. That was denied him in a public hospital, where the training of nurses and medical students was an important part of the hospital’s function, said Dr. Averill. Because of the demand for hospital beds, delays in treatment frequently occurred if patients had to wait for a bed at a public hospital. Those delays could be obviated only by the attention of private specialists in private hospitals.

“By reducing the number requiring admission to public hospitals, more beds are provided for the elderly sick in public hospitals, who might otherwise be excluded,” Dr. Averill said. “Every available bed in a private hospital is one fewer to be provided for from taxation.” Reducing Cost to Taxpayer The gross costs for every occupied bed in the Christchurch Hospital last year was 53s sd, paid by taxation, Dr. Averill said. The corresponding contribution from taxation to St. George’s Hospital was 15s 9d, being 9s a day from the Social Security Fund, paid on behalf of the patient, and a maximum direct subsidy of 6s 9d. After applying the adjustments necessary to arrive at the true differences it was estimated that the cost to the taxpayer was 46s a day in the public hospital and about 21s a day in the private hospital, Dr. Averill said. Every private hospital bed kept open led to a reduction of about 25s a day in the cost to the taxpayer. Were private hospitals to disappear, there would be added the high capital cost of providing further public hospital beds—about £4OOO or more a bed.

To continue their efficient service, private hospitals needed, in addition to revenue for the care of patients, money for maintenance and modernisation, local body rates, provision for rising expenditure, and in the case of privately-owned hospitals, a modest return on capital) to shareholders, Dr. Averill said. At present assistance by the Government was 9s a day social security contribution plus a varying subsidy, with the maximum 6s 9d. To qualify for the subsidy, it was almost necessary for private hospitals to show a loss, and there was provision only for minimum maintenance and none for modernisation. Rising costs could be met only by increasing patients’ fees, which was likely to force them into the already overburdened public hospitals. It was submitted that the present method of assistanue, or any extension of the social security grant to the patient was not the best way to help private hospitals. Private Specialists ‘lt is generally agreed that the medical services of New Zealand are maintained at a high standard,” Dr. Averill said. “It is contended that one of the factors concerned is the continued existence of private hospitals in that only by that means will private specialists be able to remain in practice. If private hospitals close, within a short time all hospital treatment will have to be carried out by full-time medical officers in public hospitals. In such circumstances, it will not be possible for more than a limited number of medical graduates to earn enough to justify highly qualified specialisation. In the long term view, the number of specialists will be reduced, and the beneficial effects of competition between parttime and full-time specialists will be lost. The intangible results are that in time the standard of medical practice will fall.” , Dr. Averill, for his executive, made the following recommendations: — (1) The present method of financial aid be replaced by a direct subsidy for each occupied bed each day, such subsidy to be related to the cost of public hospital beds. (2) All hospitals should be placed on the same basis in paying local body rates. (3) State loans should be made available for capital development and improvements in private hospitals at low rates of interest. Dr. Averill said the subsidy suggested should be from 50 per cent, to 60 per cent, of the cost of a public hospital bed. Of that the! private hos-