A FIRST CHARGE

Evening Post, Volume CV, Issue 150, 29 June 1928, Page 6

A FIRST CHARGE

- PUBLIC HEALTH HOSPITAL COST CHAIRMAN'S REVIEW Speaking at a meeting of the Wellington Hospital Board yesterday afternoon, tho chairman (Mr. C. M. Luke) dealt at some length with tli'o question of increased hospital cost, and maintained that "tho health of tins people is a first charge upon the community." "I think the time has arrived," said Mr. Luke, "when a statement should bo made by this board concerning the criticisms, that we have seen from time to time recently in tho columns of the Press. Inferontially, and by direct statement or statements, it has been said that the cost of hospital administration has so considerably increased of late that it borders upon extravagance. "Concerning our own institution, some months ago I stated that I hoped we would not need to increase- our annual demand upon the Government a,nd tho local bodies in-.tho Wellington Hospital District-1-!, repeated that at- the time of the opening of our ■:, new administrative block and new wards. Subsequent events proved that when we had finalised our annual accounts I found that .there had been a considerable increase in the Social Welfare Department amounting to & 10,145. These accounts were quite unforeseen, and a matter over which,' asa hospital board, we have no control. The responsibility has been thrown .upon,-the. hospital, boards to provide, during these.periods of unemployment, sustenance for those needing it. The membership having so considerably increased the last two y.ears explains the extra cost by the board, but I maintain that this burden of providing for the unemployed should not be taken into account as part of hospital costs. Upon.investigation in this matter we found that in Wellington we were making better provision than in some of the.other big centres. MODERN TREATMENT. "Touching upon the hospital side of our work, it is admitted that we had to provide for increased demand on v our resources in this direction; for instance, last year the number of occupied beds was 561, recently our numbers have gone up to 687, with a long waiting list. Already our resources are taxed to the utmost. But I hold that it is imperative for tho community to provide for the sick and afflicted to the extent at least for those who are unable to afford ■ medical treatment outside. The health of the community I maintain is a first charge upon the community. By vote of the people, the responsibility has been cast upon us to make this provision., Modern requirements have made the cost greater owing to the providing of up-to-date and scientific' appliances. I cannot for the. life of me believe that the community desire that we should lag behind in this respect. EFFICIENT SERVICE. "As to the criticisms of constitution of hospital boards, this is a legislative matter. It is frequently stated that hospital boards are : dependent upon local bodies for their finance —this is true as far as it goes, but doubtless the legislature in forming the present Act ' made that necessary to avoid providing j extra machinery and- considerable cost ■: in providing separate rating powers. The clamour recently raised for direct representation on hospital boards is not new. Under the Act of 1885, which provided for a hospital board of trustees, together with district hospital boards, the duty of the latter was to allocate to each local body the proportion of funds necessary for carrying ou hospital work. This body met approximately every three months, or at such times as it was found necessary. Tho clamour at that time arose mainly by this body who possessed the powers'for this purpose. The board of hospital trustees comprised those who were appointed as representatives from tho various locaj bodies, together with the representatives of contributors; in this respect I claim there was direct" representation. I had the honour of working under the Act of 1885 for about 25 years, and am conversant with the conditions , that obtained at that time. It was stated then by those who desired a change in the Act of 1885 that by means of direct representation the costs of hospital administration would bo reduced. They failed to see tho proportion of direct representation that ' they already had under that Act. The present Act was brought into force to remedy what was thought defects of tho Act of 1885. Under the present Act the boards as now constituted by the widest franchise gives the people1 the representation they desire. I repeat that the means of raising the necessary capital for the carrying on of the institutions is in order to avoid the necessity of sepftrato machinery for the purpose of raising the necessary funds. If direct representation is given, the Government surely would be entitled to .an equal proportion representing that part of the finance provided by the Government. "However, this matter is a matter for tho legislature. The whole purpose, of hospital organisation is to provide a maximum of efficient service to the community consistent with due economy. In this connection it may be stated that upon' the authorities throughout the British Empire, the Continent <of .(America, and other countries it is stated the length of life during the last 40 or 50 years has been extended to approximately 15 to 17 years. Is this a justification for the. expenditure and' the labour put into this phase of our national life?" Mr. Luke* concluded by moving that A copy of his statement be handed to the Press, and be entered on the records of the board. . . In seconding the motion, Mr. F. Castle said there was no doubt the criticism of hospital expenditure every year when the levies were being made were influencing the people in the direction of thinking that hospital boards were extravagant in their expenditure. People did not fully realise tho pressure put upon hospital boards to keep the institutions up to the demands of modern modical science. The boards did not spend money unless there was need for it; there was medical, urge and public urge behind the expenditure. The Act did not lay down a policy for. the boards. It was supposed by many that hospitals were intended for the accommodation of people who could not afford to pay for outside treatment; but there was nothing in the Act to show that. that was the hospital policy of tho country. It would appear, however, that the system was developing into the provision of a State service! He thought the question would have to be faced of providing either free service or that payment be made in accordance with the medical and nursing service rendered. The motion was adopted.