Hospital Levies Reduced By Almost 10 Per Cent

Manawatu Times, Volume LV, Issue 6837, 19 April 1932, Page 4

Hospital Levies Reduced By Almost 10 Per Cent

Board Considers Estimates The P.N. Hospital Board met yesterday to consider the estimates of receipts and expenditure for the coming- year m order that the levies to be demanded of the contributing local bodies could be / ascertained. Reductions were effected m all departments with the result that the levies will be less by 9.8 per cent, compared with last year when there was a reduction ol 10 per cent.

"In submitting the suggested estimates for 1932-33, I have to report that these estimates have been prepared, having regard to the present, financial condition and the desire to give further relief to our own ratepayers, and to the Government’s decision to further reduce the total subsidies payable to hospital boards by 10 per cent..” reported the secretary (Mr. A. J. Phillipps). ' ■would point out that during the post year our major item, hospital maintenance, we have kept below- the last csti mate, and in'these estimates a further reduction in this item is proposed. If the estimates as now submitted are n,looted hv the board, expenditure can bo impt within the limits of the reductions made, provided that admissions to hospital'■■continue to bo controlled along the lines that the .medical superintendent has recently been carrying out, and tint the board again impress upon the whole of the start the necessity for endeavouring to assist to keep down expenditure. The large, drop shown in 1), 3 hospital maintenance expenditure is ■not a sudden cut now being made. During the past year, in anticipation of tnc for further reductions from month to month, steps have been taken to reduce expenditure below the reductions which were made in the last estimates, and the present monthly rate ot expenditure is considerably below onetwelfth of last year’s estimate. Ihe number of patients in recent months Ims fallen off, resulting in the average for tho year being 171.6 in the main hospital and 10.7 in the maternity home, as unst 101.fi and 9.S respectively for the preceding year. Of course, the numbers for the preceding year were influenced by tho Jfapicr earthquake. "In preparing these estimates no consideration lias been given to a general reduction in the salaries scale, ns I consider that it is possible for tho board this year to further reduce the levies on local bodies and to comply with the Government’s 19 per cent, ‘cut’ Vithout inflicting a further cut on salaries am.

wages. "In last year’s estimates, the total levy (including maintenance and capital) was reduced from £26,373 to £23,726, a reduction of 10 per cent. A still further reduction to £21,404 is now proposed, This is a further 9.8 per cent, on last year’s levy.” MAINTENANCE RECEIPTS Voluntary contributions and bequests: Estimate lost year, £1700; actual receipts, £326 13/6; proposed estimate, £250. There is an amount of £luoo sti to come from the Halford estate. It is now expected that this will be pa.t over within the. next month, and part of the present bank overdraft will be met by this payment. The estimate of £230 is to cover the usual donations from tho District Nursing Committees and any other small voluntary contribu-

tions. Subsidy on voluntary contributions and bequests: Estimate last year, £l/00, actual receipt.?., nil; proposed estimate, £250. Under this heading there i,i" from the Government at March 31 a sum of £226 13/6, which is being offset against tho Government advance received. In addition there is an amount nf £ISOO which will bo duo from the Government as a subsidy on the £1390 mentioned under the, last Hem. Tins also is being offset against the Government advance. The amount, of £259 is m provide for the subsidy for the district nursing work for the next. )cai, and subsidy on casual voluntary contributions. Patients’ Payments

- Estimate last year, £14,000; actual re-..f-iplrs £1.4,104 0/S; proposed estimate. £II.OOO. The actual receipts from patients’ fees for the past five years have been as- follows: 1927-28, £7804; 1928-2.), £1,0.138; .1929-30, £11,643; 1930-31, ill 1.024.* 1931-32, £13,194. The increase in the Tees for the past year oyer the preceding year is due to the tees rereived for patients from the earthquake '•area. '"ln placing the estimate this year ‘at/ £II.OOO the board is estimating what aft"considers to be a, high iigurc, ami This will only be achieved if economic conditions do not. get progressively worse in the next few months. The board has standing on its books a large number of good accounts which will eventually be collected, and how far it can hope to effect collection of some ol: these during the current year is exceedingly difficult to estimate. However, it feels justified in placing £II,OOO on the estimate.

The following figures show the fees collection on a per occupied bed basis for the past nine years: 1.923-24, average number of occupied beds .102, fees collected per occupied bed £29; 1924-25, .424, £4.4; 1925-26, 131, £54; 1926-27, 127, £53.7; 1927-28, 163, £44.4; 1928-29, 188, £51.2; 1929-30, 181, £60.7; 1930-31, 201, £50.3; 1931-32, 182, £7O. In dealing with these figures it must be remembered that the current year’s collections have been affected by the Napier patient's, and secondly that in the current year the numbers dropped below the number for the previous year. It is interesting to note that apart from the Napier patients, however, collections for the past year arc within a few hundred pounds of the amount collected in the previous year. To effect this result at least 50 per cent, more routine office work has been done on patients’ fees this year. Charitable aid recoveries: Estimate last year, £1450; actual receipts, £1417; proposed estimate, £1250. This item consists of pensions of inmates of the Old People’s Home and miscellaneous charitable aid recoveries. In view of the “cut” in pensions which seems likely. it is necessary to reduce this estimate, and, furthermore, there are fewer pensioners at present in the home than

Ihcre were at the corresponding period last year. . Bacteriological laboratory fees: Estimate last year, £500; actual _ receipts, £'lsl 3/3; proposed estimate, £450. Tho laboratory revenue has again dropped during the past year, The Government grant°of £l5O was reduced to £.135, and tho amount of work sent in by medical practitioners has been reduced. The fees recovered for Iho previous year were £535.

Awapuni farm receipts: Estimate last year, £250; actual receipts, £2.10 8/4; proposed estimate, £3OO. These receipts arc from the sales of pigs, surplus produce and stock from the Awapuni farm. Short-pavmcnt of Government subsidy, 1931-32: Estimate this- year, £739 18/S. This year, instead of being required to refund any amount under section 8 of the Hospitals Act, the board is receiving £736 18/S as a short-payment; on account, of last year’s A total amount of approximately £.13,000 was short-paid by the department, and tho Government has now advised that this board's proportion is as above. Miscellaneous receipts: Estimate last year, £500; actual receipts, ii - S/4’, proposed estimate, £2OO. The amount received last year inclucicd certain ic funds duo from the Napier Hospital Board. The amount of £2OO is. approximately tho usual amount of miscellaneous receipts in a normal year. MAINTENANCE PAYMENTS

Expenditure under this item is divided into tho following headings; Provisions, surgery and dispensary, salaries and wages, and domestic and establishment. Provisions Estimate last year, £5300; actual expenditure. £4575 19/11; proposed estimate, £4500. The reduction that lias been made in this item is duo partly to lower prices as against the previous year. Further, greater economy in the use of foodstuffs has been insisted on during tho year. It is interesting to mention that the cost of provisions per person subsisted per annum for the year ended March 31, 1031, was £lB IS/. For that year no other hospital of over 190 beds recorded a figure below £2O 14/. Tho following information is also of interest, giving the total quantity and value of the foodstuffs consumed during 1931-o2:

were used. Surgery and dispensary: Estimate last year, £3000; Actual _ expenditure,, £3ISS 16/9: proposed estimate, £2750. The fact that the expenditure was in excess ot tho estimate on this item is due partlv to tho fact that certain accounts incurred at tho time of the earthquake were not paid until April, 1931 Some effective economy has been carried out in the use of dressings during the rast year, although the figures do not disclose this, owing to the system of indent 'buying. Salaries and Wages

Estimate last year, £15,500; actual expenditure, £15,483; proposed estimate, £13,750. The present personnel of the hospital shows a reduction on the personnel twelve months ago, and this year there are a large number of nurses who arc sitting for their final examinations. Of 25 nurses who are due to sit for their final examinations at some time during the current year, it. is proposed to retain the services of only eight, and to fill a maximum of tc-n. vacancies by new appointments, a reduction in nuising staff personnel of 11. _ One sister fins recently resigned and it is not proposed to fill her position. A further sister, who is shortly resigning, will not be replaced. A reduction has been made in the grounds staff during the year by the transfer of one gardener to Otaki, and a reduction of two has been made in the laundry staff. Ono further reduction is proposed in the staff of portcis. With these economics it is possiblo to allow the probationers this year to have their ordinary scale increments, which were withheld last year, and at the same time to reduce the total estimate for hospital ’salaries and wages by the amount of: £1750. Domestic find establishment exponditurc: Estimate last year, £8500; actual expenditure, £9027 12/5; proposed estimate, £7500. The main expenditure charged to this item is expenditure m connection with tho engine room, laundry, light and power, and domestic expenses, including replacements of linen, hardware, etc. It is possible this year to show a substantial reduction in the estimate on this item. The over-spend-ing last year is more apparent than real, as* owing to the possibility of trouble in the coal mines the board purchased considerable stocks of coal in January, and has carried forward over £3OO worth of coal more than was on hand at March 31 of the previous year. The installation of a a automatic stoker gives promise of a substantial reduction being made in the coal bill. Special steps were taken early last year to conserve electric current. Stops aro now being taken to reduce the consumption of steam and gas by insisting on greater caro on the part of the staff. Launcby costs have been further reduced during the year. Summary of Hospital Maintenance

Under tho various sub-heads in this item tho maternity homo expenditure has been included. It is hard to put into force any further economics at the maternity home owing to the increasing demand for treatment. For the past year the averago number of occu-

Levy last year, £19,826 7/; proposed levy, £17,804, .The estimates grant to the local bodies a rehate of £2022 7/ on the maintenance levy, as well as £4OO on the capital levy. As previously mentioned, this rehate is equivalent to a further 9.8 per cent, reduction.

pied beds was 10.7, as. against 9 8 in the preceding ycav, and while the home remains full it is difficult to reduce most of the items ol expenditure. However, somo savings have been effected in connection with the maternity home during tho year, and the total amount provided on these estimates tor salaries and wages is £872, as against £937 last year. Tho number of patients treated at, the maternity home has increased as follows in the past three years: 1930. 221; 1931, 297; 1932, 325. In summary, the hospital maintenance ance estimate as compared with the previous year is as follows:

Otaki hospital maintenance: Estimate last, year, £1250; actual expenditure, £1256 10/6; proposed estimate, £IOOO. The Otaki Hospital is a comparatively expensive institution to maintain, owing firstly to the fact that the number of maternity cases coming forward for treatment is considerably less than the buildings and plant can deal with, furthermore, the board has in the past adopted the system of employing two nurses and a matron, in addition to a cook and a housemaid. As the average number of occupied beds for tho past year was 2.18, a reduction in this staff is now essential. The total number of patients under treatment last year was 58. Old People’s Home maintenance: Estimate last year, £2050; actual expenditure, £2llO 15/10; proposed estimate, £IBSO. The expenditure at the home during the past year was over £2OO less than in the preceding year. Very little in the way of repairs and renewals is nccossarv at tho home this year.

Charitable Aid Estimate last year, £5000; actual expenditure, £5635 8/10; proposed estimate, £2500. Unemployment relief included in tho above amount amounted to £2200. This - amount was spent on relief to able-bodied unemployed. The estimate has been reduced on the assumption that the Government will carry out its expressed intention to take over tho cost of reli.cf to unemployed this year, but it may be three months before the Government relieves hospital boards of this expenditure, If this is so, some further povision may have to be made. Tho Palmerston North. Central Relief Committee, which has now spent well over £2OOO, this week will reach, the end of its resources, and if this board is to assume tho whole burden of relief to able-bodied unemployed for the first three months of this financial year the amount to be provided will have to be sufficient to cover the board’s normal expenditure, plus practically the whole of what the various relief committees have boon expending, as it cannot bo anticipated that voluntary contributions to any extent will be forthcoming for relief purposes this winter. With n view to reducing present charitable aid expenditure the secretary proposes immediately to visit each house for which the board is at present paying rent, inquiring personally into the circumstances, and to submit a comprehensive report, to the next meeting of the welfare committee with a view to a substantial reduction in the amount the board is paying as charitable aid rents, and a saving in. this direction has been allowed for in these estimates. District nursing rEst.hnalc last year, fSSO; actual expenditure, £478 16/9: proposed expenditure, £420.

Administration: Estimate last year, £2200; actual expenditure, £2168 2/2; proposed estimate, £2OOO. During the year a reduction in the total salaries paid for administrative services to the extent of £llO was effected, and some further economies are being introduced to enable the reduced estimate to meet requirements. Maintenance of patients in other institutions: Estimate last, year, £1500; actual expenditure, £2622 16/6; proposed estimate, £ISOO. This .item is one on which it is exceedingly hard to estimate. ’flic amount spent depends on the number of cases which come forward in .the year whoso conditions necessitate treatment at special institutions. Interest on loans: Estimate last year, £4900; actual expenditure, £4987 -/; proposed expenditure, £4070. Contribution to National Provident Fund: Estimate last year, £700; actual expenditure, £3SO 12/9; proposed estimate, £3OO. • Awapuni farm maintenance: Estimate last year, £900; actual expenditure, £799 6/10; proposed estimate, £750. Miscellaneous payments; Estimate last year, £322 18/11; actual expenditure, *£B69 40/10; proposed estimate, £250. MAINTENANCE LEVY

In dealing with this item tho secretary pointed out that, despite the fact that tho board last year reduced its levy 40 per cent., only a small proportion of the local bodies made any re-

duction iu the hospital rale. One realised, of course, the difficulties that the local bodies had to contend with regarding the non-collection of rates, but in the interests of the ratepayers it would scorn reasonable to assume that the further proposed reduction this year should be passed on by tho local bodies to the ratepayers. The rate of hospital levy in the £l. on the rateable capital value for tho year ended March 3.1, 4932, for the following districts was quoted for general information: Auckland, .224 d.; Waikato, ,IG7d.; Wanganui, . 1 Old.; Palmerston North, . lS3d.; Wellington, .23 td.; North Canterbury, .216 d.; Otago, ,330 d.; Southland, .ISSd.

Govemment Subsidy Estimate last year, £14,536. 13/; proposed estimate, £13,377 0/5. The subsidy rate this year will be at 45/ in the £l. Last year tho rate was 14/S. It so happens that, a reduction in the total requirements gives a greater relief to the local bodies this year than it does to the Government subsidy, but in districts whore the average subsidy is above £1 for £1 the converse is the result. CAPITAL ESTIMATES

It was necessary to consider a good deal of curtailment of the capital proposals recently considered by the executive to comply with tho Government's decision to reduce the subsidy by 10 per cent. Last year’s levy, on which subsidy was paid at £l. for £l, was £3900, and consequently it. was necessary to reduce this to £3500. The difficulty ot : so doing would be realised when it was pointed out that it was necessary to provide £0274 for repayment of loans and sinking fund instalments, thus leaving only £726 for all other capital purposes. Of this £726 the board had as a commitment the cost of the mechanical stoker, £566 17/, and there was an amount of £53 standing as overdraft in the capital account which required to be raised by levy and subsidy. Thus for new items there was only available the sum of £lO6 3/. Provision from this amount was made for the following works:' £SO to enable No. 5 workers’ services fo bo utilised; this amount would be spent partly at. the farm and partly at tho hospital. £24 to enablo the old theatre block to be used for the massage department.. £32 3/ for miscellaneous capital items. Mr. G. A. Monk voiced appreciation of the work of the chairman, tho managing secretary and the'staff in proparing the estimates., lie felt sure that the board, under its resent management, would come out on the right side at the end of tho year. Other members of the board, spoke in similar strain.

Quantity £ s. d. 1100 6 4 Bread Butter Sugar Oatmeal .. 46,7121b. .. 11,4021b. .. 15,7711b. .. 4,1661b. 2.2421b. 440 19 1 571 5 0 119 10 7 45 2 0 148 10 3 For the year 17,707 gallons of milk

- r? g 5 c-!. 5 O p •p £ © '-w r't\ 2 <! Pk £ 24 £ £ s. d. £ Provisions 5500 ■1375 10 11 1500 Surgerv a n d dispensary . 3000 315S16 0 2750 Salaries and wages ., .. 15500 151S3 0 1 .13,750 Domestic a n d esta b .1 i s h - 0027 12 5 7500 Totals .. .. 32500 32245 15 2 2S300