HOSPITAL AMALGAMATION

Northern Advocate, 2 December 1936, Page 10

HOSPITAL AMALGAMATION

THE FINANCIAL SIDE;: REPORT TO BAY BOARD

At the special meeting of the Bay of Islands Hospital Board, held to consider an improved health service for the North, as outlined in the scheme submitted by the Hokianga Board, the secretary, Mr Stanley, presented the following x-eport: It will be noticed that the cost of the presenjt system for the four Northern boards is £27,853. To this must be added the extra expenditure necessary to make the service a free one. On reference to the list of proposed extra expenditure it will be seen that the first five items are as shown by the Hokianga Board, • while the remainder are, in the opinion of the executive, officers of this board, costs .yvhich will also be . incurred should such scheme come into operation. Those in addition to the Hokianga Board’s schedule are: (1) £2500 of extra expenditure that will be definitely incurred by the boards next year, due to legislation giving increased wages and owing to rising costs. 2. — £6OOO as salaries for private medical practitioners who would have to be paid by the combined boards as all medical services are to be free.

3. —£1200, which represents car allowance of £2OO each to above-men-tioned private practitioners.

4. —£900 for house surgeons which the medical superintendent is of opinion will be necessary. I would add that as house surgeons are at almost unobtainable, it is more than likely that this figure would have to be substantially raised.

5.—£400. This figure allows £IOO for each hospital as maintenance costs of an ambulance or other vehicle xf doctors, nfarses equipment' are to be taken to patients’ homes to give treatment, or to take patients to the X-ray if only one plant is to serve all hospitals.

6.—£100 travelling expenses for xurses if they are to be transfened from one hospital to another (as is suggested) during busy and slack periods.

Savings Disputed,

With reference fo suggested savings the Hokianga Board states that £960 was paid by Northern boards to the Auckland board last year for Northern patients in the Auckland hospital and shows this amount to be wholly saved. The Hokianga Board states that some are Sec. 92 patients and that payments are approximately balanced by receipts from similar cases. I entirely disagree with this statement and maintain that 80 per cent of this supposed saving would still have to be paid as it is incurred principally by peqjple travelling to other districts for business or pleasuse and being taken ill while in those other districts, and the greater part of the remaining 20 per cent would still have to be sent by medical superintendents to the centres, in this case Auckland. 3t is further stated by

the Hokianga board that £IOOO could be saved as a result of amalgamation but this cannot be seriously regarded as the items which could be purchased by boards conjointly are but a small proportion of the total hospital costs. To sum up, it will be seen that the annual cost of such a scheme as estimated by this board is £45,403 as compared ■ with £31,000 estimated by the Hokianga board.

Allowing for levy and subsidy „to be obtained through present channels under the present methods of assessment, it would ..be necessary to raise some £26,160 as a tax on each family in the area, which would woi'k out at £4 per family per annum. The Hokianga schedult allows for 100 per cent receipts from this source, but this would not be possible as many families, however willing, are unable to pay and a further amount would be lost owing to the movement of the floating population and these losses would make it necessary to still further increase the tax per family. Maintenance And Capital Costs.

Another item which must be taken into account but is not included in the schedule attached hereto nor in the .Hokianga board’s estimate is the maintenance cost of a central hospital, which, with its specialised staff and equipment would cost the combined boards approximately £Booo,per annum, of which approximately £I4OO would be the cost to the ratepayers of this county, equivalent to an increase in the hospital rate of 5-Bd, or, alternatively, would increase the tax, per family to approximately £5 5/ per year. Last but not least, it will be noticed that nothing is said regarding further capital expenditure on the existing hospitals which is bound to oc£ur and which would be in addition to all the costs mentioned above. Schedule.

Present cost of system to boards (1935-36), £27,853.

Proposed Extra Expenditure.—Specialist director, £2000; car allowance, £200; increases in salary to make medical superintendents full-time, £2250; three extra district nurses, salary, car allowance and housing, £1500; specialists from Auckland, £500; other local practitioners (6), £6000; car allowances, local practitioners, £1200; three house surgeons, £900; increase in present costs due to legislation, etc., £2500; ambulance or other vehicle maintenance at each hospital, £400; travelling costs nurses to and from hospitals, £100; giving a total of £45,530, which, when added to the £BOOO for maintenance of central hospital when erected, gives a grand total of £53,402.

Suggested Revenue.—Levy, £8856; subsidy, £10,338; family tax (at £4 per family), £26,176; a total of £45,370.