HOSPITALS ADMINISTRATION.

Evening Star, Issue 21231, 12 October 1932, Page 6

HOSPITALS ADMINISTRATION.

It was not to be expected that any enthusiastic welcome would be given by the executive of the Hospital Boards’ Association to that part of the National Expenditure Commission’s report with which it is particuarly concerned. The commission advised a reduction in the number of hospital districts from fortyfive to eighteen. The executive represents, in about equal measure with larger ones, smaller hospital boards which would act quite inhumanly if they felt any strong desire for their own destruction. Nevertheless, the principle that there should be fewer hospital boards and districts was conceded at the last conference of the Hospital Boards’ Association. The condition which robbed that concession of all immediate value was that regrouping must bo the work of the boards themselves, to be done by negotiation and co-operation. Its speed would depend, therefore, on the zeal of the boards, which might be an absent quality. The commission would make its changes by legislation, potentially a much faster process. But, even so, its scheme is too big to be carried out in a hurry. There will be opposition to it from numerous quarters, and the executive of the Hospital Boards’ Association, meeting specially in Wellington, has done something already to provide ammunition for opponents. That is not to bo regretted. Both sides of the case should be fully displayed before a change of such importance is made operative. The statement which has been put forth by the executive may modify—it does not, we think, destroy—the benefits to be hoped for from the commission’s scheme. With causes unavoidable and legitimate that have contributed to the excessive increase in the cost of hospitals administration we have already dealt. The executive adds to them an increase since 1914 of no less than £200,000 in charitable aid relief and the new cost of soldiers’ and consumptives’ treatment, and draws attention to last year’s economies. All that, however, does not affect the position of hospitals, in no small number, much too large for the normal demands on them, which would hardly have arisen apart from the plethora of local control. The suggestion that hospitals—or, in the first instance, hospital districts—are never established for political reasons comes unconvincingly from the association after what lias been said in the past by members of hospital boards, and is specially unconvincing in this district. But it is one thing to avoid needless multiplication of authorities aud something less easy to mend it after vast capital expenditure has been incurred. The case which the executive makes against the working of the New South Wales and Victorian systems, where non-political boards are established, appears to be sound, but that does not mean that the number of districts in New Zealand should not be reduced. The call for their reduction is an old one, which, before the latest commission was appointed, was supported by some of the best authorities, and while the savings of reduction may have been exaggerated very real savings should ensue. It may be a paradox that while the commission wants fewer boards it would transfer their comparatively simple charitable aid functions to “ 313 county councils, borough councils, and town councils.” But we have recorded our opinion that that change would be unlikely to lead to economy, and the executive itself agrees that “ within certain limits larger districts tend to facilitate economical administration.” In its main bearing the case of the commission stands. The desire has been expressed by the hospital boards’ representatives that the whole matter should be further investigated, and that desire will be granted. The Prime Minister has announced that the recommendations which have been made will he considered by the commission which is to be set up after the session to inquire into the entire subject of local body finance and reorganisation. Some important recom-

mondations, therefore, ot the Expenditure Commission may have very little effect on our immediate finances, and yet be conducive to changes that will put a great deal of our system of public expenditure on a more reasonable basis for many years to come. That is the best value they could have.