PATIENTS’ FEES

Hawke's Bay Tribune, Volume XXIII, Issue 80, 16 March 1933, Page 10

PATIENTS’ FEES

SUGGESTED INCREASE HEALTH DEPARTMENT'S ACTION WAIPAWA BOARD’S DECISION. (By Our Special Representative).

A matter of interest to hospital boards throughout the Dominion and also to the general public—namely, the. suggested increase by the Department of Health, in patients’ fees —was the cause of a long and full discussion at yesterday’s meeting of the Waipawa Hospital Board. Opinion was not in favour of the increase, and some members spoke strongly against such a step, but it was generally recognised that the board had no alternative. However, after due consideration, it was decided not to take action at present, but to adopt a waiting policy, pending replies on suNjoet from other boards in the East Coasr area. The Waipawa Board’s charges at present are 9/- per diem plus operation fees, whereas the new charge is 12/- per diem for adults and 6/- for children, an increase of nearly 33 per cent. In dealing with the subject tn its report the board’s finance committee suggested that all operation fees under the new scale be abolished.

The discussion was introduced during consideration of the finance committee’s report, when a letter was read by the secretary from the DirectorGeneral of Health. The letter stated that the writer was approaching hospital boards whose scale of charges for in-patients was less than 12/- a day for adults and 6/- a day for children, to adopt these rates. Continuing, the letter stated: “I refer you to previous correspondence in this connection. On July 14, 1932, you notified your board’s view that charges should not be increased. It is felt, however, that all boards should come into line and raise their fees to approximate the cost of maintenance and treatment. The fact that cost is not charged those people able to pay, conflicts with the method of local taxation for hospital purposes, and in my view this is definite ground for criticism of the administration of some hospital boards.” The board was urged to earnestly reconsider the matter and to agree to the suggested higher scale of fees. BOARD’S ACTION LAST YEAR. The chairman, Mr W. H. Rathbone, referred to the board’s action last year, which was not agreeable to the increase in patients’ fees. He contended that the position to-day remained unaltered and that the time was even more inopportune for an increased scale of fees. He considered that the department was inconsistent. The government was in every possible manner reducing costs and interest charges, even to repudiating its own contracts. The speaker mentioned the conversion loan recently floated, which, he said, although it was announced as being voluntary, anyone could see it was compulsory. In the face of all this, the department was now asking the board to increase its patients fees by nearly 33 per cent. The board well knew what would happen if it did not do so, in view of what had taken place last year, when it was mooted that legislation would be brought down to enforce -the increase. The hoard now had no other alternative, and would be most reluctantly compelled to increase its fees. It was suggested that operation charges should be deleted. This would reduce the cost to patients so that even with the increased charge patients would not be paying any more than they were at present rather as shown by figures prepared in a report by the secretary, the new scale of fees would, if anything, make the cost of surgical treatment lower, as in the majority or cases the period of 28 days’ stay in hospital was not exceeded. For example, a person (at the present time) in hospital 28 days would incur fees at 9/- per day, plus £4 4/- operation fee. a total of £l6 16/-. Under the new scale with no operation fee, a 28 days’ stay at 12/ per day would represent the same charge, £l6 16/-. TREATMENT APPRECIATED. “1 don’t think for a moment that we will get any more money, on a percentage basis, than we have done in the past,” Mr Rathbone continued. Rather it will tend to make it harder to collect/ At present the majority of people appreciate the treatment they receive in our hospital to such an extent that they make an endeavour to pay. On the other hand, however, if the fees are increased they will probably not be so inclined!” Mr D. Mddy: Is the department likely to object to the operation fees being cut out? The secretary (Mr P. R. SmyTk): Not so long as we increase our fees to 12/-. The department’s argument is that the fees should be increased so that those in a position to pay adequately should be compelled to do so. Mind you, I think that it is only right that these soldiers and other men from the camps treated at our hospital should pay 12/- per day. I tried last year and received the 12/- per dnv for the treatment of these cases. Mr L. Glenny agreed that it would be detrimental to the board’s interests to increase its fees as the board had proved that it could administrate its hospital on a lower fee, whereas other hospitals were on a bigger fee, which should prove that the Waipawa body was right The secretary pointed out that those boards getting higher fees were getting a high percentage of collection. QUESTION OF OPERATION FEES. Mr N. G. Hawthorn suggested that the operation fees should lie retainer' on the accounts, and a footnote added, where the patient’s circumstances had been enquire 1 into, that if the account were paid within 28 days it would be reduced, to. say, 9/- per day. Ho thought that if this procedure were adopted patients would make ».n endeavour to pay. In the opinion of the chairman such a procedure was nut practicable. The secretary said he considered that it was so. It would mean, if adopted, the establishment of a foes committee, which would be an advantage and would bring the board into closer touch with its debtors The ease of local bodies offering a rebate on certain accounts if paid before a certain dale, was instanced by Mr Hawthorn, who staled that by 1 adopting this procedure the c local

bodies had been successful in collecting their rates. “Yes, but hai these local bodies no', given this rebate they would have collected more money,” said Mr R. A. Fraser. He suggested that the secretary should aquaint himself with a patient’s position before the account was sent out. “I am not in favour of increasing tho fees,” said Mr B. G. Atkins, “as the hardship will fall on those people who are not in a position to pay, which i* of course unfair.” Mr Hawthorne: But the board has no other alternative. RECOMPENSE FOR DOCTORS. Mr Atkins contended that should th* operation fees i»e deleted there should be some method whereby doctors could receive somthing for the operations they had performed. “Very few people arc in a position to pay 12/- per day,” said Mr Fraser.” I think that wc should wait and see what the other boards arc doing in the matter.” Mr T. P. Hunter: Mr chairman, 1 quite agree that this is a most inopportune time to iucrease our fees, but it seems to me that wo have no alternative but to fall in line. “I would like to see this matter delayed till the last possible moment.” M. Fraser repeated. “I still think wo should wait and see what the other boarls are doing. If wc take action now Danncvirko might get off with 9/per day, and then where would we bef” “It seems ridiculous that wo should increase our fees, especially in times like this,” Mr Atkins remarked. “Yes, but we are not our own masters —that is the position,” replied the chairman. He said that he understood that the Dannevirke Board at tho present time was not charging operation fees, whereas both Napier and Gisborne were doing so. After further discussion it was deci led that the question of the increase of fees be deferred, pending replies from other boards in the East Coaat area —namely, the Dannevirke, ll»wk*’» Bay, Wairoa, and Cook Boards.