Evening Post. FRIDAY, JULY 8, 1938.. CAESAR'S VERDICT

Evening Post, Volume CXXVI, Issue 7, 8 July 1938, Page 8

Evening Post. FRIDAY, JULY 8, 1938.. CAESAR'S VERDICT

When the local authorities, which contribute very, substantially to the cost of hospital services for the city and district, protested at the proposals of the Wellington Hospital Board for extensions to the hospital at an estimated cost of £750,000, the long controversy which, ensued was settled finally; by the appointment of a^ special commission to investigate the whole position. The personnel of the commission of three, Mr* H. j A. Yburig, S.M. (chairman), and Mr.. D. S. Wylie and Dr. H. HardwickeSmith, two medical men of wide experience and high reputation, was generally approved.1. The proceedings, which took several weeks and were fully reported in the Press, covered the ground thoroughly, and the evidence included not only the financial aspects, as they appeared to the local authorities, but the medical side; with experts from Australia as witnesses among others. After consideration of the evidence, the commission 1 has issued its report, with recommendations, published in yesterday's "Post." The report bears out in general the original observations on the inadequacy of the present hospital in many respects, but the commission recommends further expenditure of over £100,000, bringing the total cost from the £750,000 of the board's proposals to £863,075. i

There is iio necessity here to traverse the recommendations in full, as they are set put clearly in the published report. The outstanding item in the recommendations of the commission is* the Provision of a "combined general arid maternity hospital, with full-time <, out-patients' department" for the^JKutt Valley at an estimated cost/of £185,781. As the weight of evidence was strongly in favour of this departure, and public opinion, not only in the Hutt Valley and adjoining districts, but to a certain extent in the city also, supported the agitation for it, the recommendation can be regarded as justified. The proposal is for a building in i reinforced concrete, which will cost more than the alternative suggestion for a wooden structure, but will have the advantage of permanence and resistance to fire. The main new Centenary Hospital Block at Newtown, estimated to cost originally £465,000, is recommended by the commission for erection, with additions, the whole to cost, according to estimate, £496,380. The commission finds that^,"on the ascertained maxiimum demand'the present hospital is under-established by 414 beds" and is of opinion .that "to meet present needs alone riot less than 300 additional beds should be provided." The new block would contain 356 beds and the services provided would be sufficient for 500 beds, states the report. The other main items of the original proposal, the nurses' home, to cost £79,750, and the new boiler house at an enhanced estimate of £52,423, are confirmed. It is recommended by the commission that all the work should be not undertaken simultaneously, but in order of urgency, the additions to the Nurses' Home and boiler house at the main hospital first, and then improvements to the Children's Hospital, provision of a temporary ward, erection of Hutt Valley Hospital, and.lastly the new main block. The recommendations of the commission may be taken as the result of an "Appeal to Caesar," and the ratepayers to the various contributory authorities would no doubt be prepared to accept the verdict of added cost with a good grace •if it were not for the uneasy feeling that there is something wrong with a system where costs mount up out of all proportion to the growth of populaj tion. How is it possible, for instance,'to reconcile the latest hospital recommendations with the Government's proposals for free medical and hospital service under its Social Security scheme? Will the ratepayer be recompensed for his contributions or will he have to pay both ways, as a contributor to Jthe Social Security scheme and through his rates to the hospital levy? Should not a properly designed and directed health scheme stress rather, as the British Medical Association has urged, the preventive side of medical science than the curative, and thus reduce, instead of increasing, the need for larger and more elaborate hospitals? Is Mr. Parry's National Council of Physical Welfare to have no effect on the generalhealth of the community? These are questions, no doubt, outside the ambit of the commission's order of reference, but they do concern the general public, who do feel that there is a lack of co-ordination somewhere in the multifarious agencies charged with the care of the health of1 the citizen as an individual and in common with his fellows. The case of the Wellington Hospital has been treated in the present instance as a part of an existing

system, but that system may be subjected to radical changes as a result of new agencies created. Already there seems to be too little cooperation and co-ordination between existing agencies, such as the Plunket Society, the school dental service, the school medical service, and the Public Health service, together with the work of the general practitioner . under * the British Medical Association. The layman is largely at a loss in facing what is really a problem for experts, but it is the layman who has to pay for it all. He does not feel sure that the operations of the Social Security scheme, as so far explainedj are likely to clarify and simplify the issues. Indeed,, the impression is rather that they will add to the expense and complications, with the great body of general .practitioners, represented by the 8.M.A., apparently alienated by the intransigent attitude of the Government. In the meantime, there is the bill for £863,075 presented by the Hospital Commission for the plans now recommended. The ratepayer would like to be assured that it is all in the best interests of the community to which he belongs. ;