HOSPITAL ADMINISTRATION
A MINISTERIAL STATEMENT. POLICY MATTERS DISCUSSED. {Pin United Pmtss Association.; WELLINGTON, June 1. Several matters of, policy were discussed by the Minister oi Public Health (Hon, C. J. Parr) when opening the Conference of Hospital Boards to-day. There was no other country to his mind where so many were to be found willing to give time and trouble without a fee for the good of the State as in New Zealand. It was not fair, he said," to ask chairmen of education • boards and hospital boards to neglect their own businesses unless *some compensation was given to everyone who had the administrative ability and 'the chance of placing hie or her services at the oall of the community. Tho time had arrived when the State should give some compensation for these services. He went on to deal with the agitation in some quarters tor a change in the system of administration, particularly to tho proposal for nationalisation. Nationalisation, he said, would carry with it the abolition in a great measure of the hospital boards now constituted. He had always been keen for the nationalisation of those enterprises which the State could carry on better than private concerns, but he must sav his experience had been that there were as many evils -with a bureaucracy as under other systems. There was one cardinal point, however, and that was that if the State undertook enterprises it should not hope for success unless it was prepared to pay for tho brains to manage them. Personally he would not bo prepared to undertake" the nationalisation of hospitals unless drastic reforms were made at headquarters. If nationalisation was found to be desirable, ho would separate the business from the 'professional side of the department, and until the State was prepared to do something of that kind he would not counsel the extension of State enterprise in any department, Pointing out what it would mean to the State to take over tho control entirely, he said that last vear the .ocal bodies' contributions amounted to £350,411. while the Government subsidy amounted to £287,021. Ik had some sympathy with the nationalisation scheme, but this was not the time to thrust an extra burdon on the State. Treasury. _ Proposals for some form of nationalising the medical service next en«-aired the attention of the Minister. To "him it seemed it was all a, matter of arrariTindetails, but with the fact them in the face that the annual charges had risen by £11,000,000 in the last five years, he could not hold out any hope of a reform being carried out this v- ;ir " I am in hearty sympathv." h e "said. "with the suggestion that tho time has arrived when the State should adopt snme modified form of national medical service for the back districts. We have to do something in regard to the backdistricts. The doctors have susuested a modified form of national medical service, and I have asked Dr Valiutine and other officers to see what can be done and how w e can help." The Minister spoko of the many claims for better hospitals in the "cotintrv districts. and said that while these should be inquired into- thormisrhlv he was against anything that would weaken the big or base hospitals. He strrnHv favored the creation throughout the country of small maternity hospital? presided over by a nurse-midwife, who would be able to give first aid and treatment to cases prior to their transfer to the larger centres. Referring to subsidies, he said he was not going to condemn the scheme altogether, but while thinking there should bo some differentiation he was free to confess that it seemed to him the workin" of the schedule in practice resulted in hardships to hospital authorities. It was sufficient for him to indicate that the schedule should be reconsidered and revised. Dealing with the patients' fee> Mr Parr said that the amount received by the boards worked out at an average of 20.4 per cent, of the total. The claims of the four big centres varied from 15 to 2o per cent,, while others went from ? to f° P r Mnt - He did not that the boards should bear hardly" on the patients, but it did not seem to him that 20 per cent, was the measure of the ability of patients to pav. Tho local bodies had reason to ask the question when they contributed £350,000, as against the £135.000 paid in fees. The Minister touched briefly on the suggestion that the nurses' superannuation scheme should be adopted, and agreed that something on these lines was desirable. It would be a difficult matter to arrange the details, but if the scheme was put before him he would do his best, Afted the opening addresses by Mr Parr and Dr Valintine (Director-general of Hospitals), a Tcmit was adopted advocating that provision be made in tjie Act to meet the expenses of the chairmen of hospital boards incurred in visiting the various institutions unded the control of the boards, and that provision be made for the payment of an honorarium to chairmen. ' The conference suggested £IOO as the honorarium. and also decided that a uniform fiat rate payment of £1 1r per meeting be paid to mombera as travelling expenses, irrespective of distance in Wli case. The question of levies and subsidies was discussed at considerable W-Hh many remits being submitted on subject. The present system of levvinV on land values was held to be inequitable A flat rate vast discussed, as was al<=o the proportion scheme proposed by the department and outlined in the' ' Journal of Public Health' for April. The matter was referred to a committee, to confer with departmental officers, and to report to the conference later.
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Evening Star, Issue 17368, 2 June 1920, Page 10
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961HOSPITAL ADMINISTRATION Evening Star, Issue 17368, 2 June 1920, Page 10
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