The Hospital Question

Northland Age, Volume 1, Issue 20, 1 May 1929, Page 4

The Hospital Question

(Contributed)

As a request was made at the meeting of the Kaitaia Ratepayers Association, that data be pub--1 shed showing the advantages of having one central hospital for the County, the following has been submitted for the information of ratepayers. It is generally understood that the forthcoming Election of Members to the Hospital Board will be fought on the Hospital question and it must be borne in mind by ratepayers that every vote cast for an Eastern Area Candidite will be the means of delaying discussion on the question of the establishment of the Maui institution at Kaitaia for at least three years.

There are many phases of the question, which to those in close touch with the position, are definitely in favour of the move to have one main hospital in a central position, the principle of which are : the distribution of the population; inaccessibility ol Mangonui to relations ot patients and consequent heavy cost of travelling; the high cost of conveying patients to and from Mangonui; anaesthetic question ; and the relative costs of running one main institution as against two as at present.

Taking the 1927 Census as a basis the distribution of the population of the County is as follows: Western Area, including Houhora, Awanui, Kaitaia, Ahipara, Herekino and Victoria Valley Ridings—6o7s. Eastern Area comprising Mangonui and Oruru Ridings have a population of only 1086. It will be seen from these figures that 84.8% of the population is in the Western Area and only 15.2% in the Eastern Area.

It has been stated that the desire of Western Area candidates to establish the m iin hospital at Kaitaia is parochial, but this statement cannot be established when the above official figures are taken into account, and it is not reasonable to suppose that when 80% of the population of any district wish for reforms in local Government, the questions under dispute can be brought under the term, parochial. The burning question regarding Hospital Board administration is the direct cost to Ratepayers by way ofi local rates, but in this particular case there are other indirect charges which could be considerably reduced by the establishment ot the main hospital for this County at Kaitaia, and particularly the cost of the conveyance ot patients and their near relations from the centre of population to the extreme limits ot the County Boundaries. A return compiled from Official figures and dealing with the.year just closed, discloses the following facts: The total mileage run in order to convey all patients treated during this period to and from the Mangonui Hospital, is 12100 miles which at 6d per mile amounts to £302. With the main hospital at Kaitaia this mileage would be reduced to 5560 and on the same basis would cost £l38 —the direct saving io the inhabitants of this County under this heading alone, by the establishment of the main institution at Kaitaia would be £164 per annum. This of course deals only with the conveyance of patients and a further saving equal at least to the foregoing, would be made by the reduction in charges at present borne by near relations of patients under treatment, when visiting the Hospital. It can be definitely stated

therefore that the saving to the County under this heading would not be less than £328 per annum. The anaesthetic question at the Mangonui Hospital is one which has caused considerable dissention on the Board in the past, the main issue in this connection being the cost of transport. Pa'imts at the present time are burdened with a charge of £5 5/for Anaesthetic Fees, whereas wi'h more than one doctor practising in this district, the cost would be reduced to a maximum of £2-2-0 for each case.

The next question to be dealt with is the cost ot running one main hospital gt Kaitaia as against the cost of maintaining two institutions as at present. In dealing with this question it is required first of all, to estimate what the cost of the change over would be and in order to obtain a reliable estimate of this cost the Board requested the Department of Health for an opinion, and the cost of increasing the beds of the present Kaitaia hospital to deal with 30 patients as a General Hospital, has been estimated by the Department at £19,000 (in brick.) « It will be said by opposition candidates that the Mangonui Hospital is now working at full pressure and that a thirty bed hospital would not meet the requirements of this district, ft must be borne in mind that the maternity ward at Mangonui is practically out of use now, as the Kaitaia hospital is treating most of these cases. It is apparent then, that with certain wards at Mangonui practically unoccupied an institution with the same number of beds would- meet the requirements of this district tor a number of years, and the increase in population would govern the future requirements in this connection.

The Government subsidy on capital expenditure is £ tor £, so that the capital cost to this County on an expenditure of £19,000 would be £9500, and the annual charge at 8%, which allows for 6% interest and 2% sinking fund would be £760. It is claimed by opposition candidates that this charge • will be a definite increased burden on ratepayers by way of hospital rate, but this is not so. In the first place staff requirements for even a small institution are considerable and in the case of the Kaitaia hospital, the cost under this heading for last year was £734 plus keep at 15/-per week, and amounting to £234 per annum a total of £968. This claim is supported by Government statistics, where it is shown that the Stratford Hospital District with a population of 9875 has an institution of 55 beds with a staff of 25. The two hospitals in this district with 40 beds, have at present a staff ot 24, 6 at Kaitaia and 18 at Mangonui, which with one institution could be reduced to 18, the present staff at Mangonui, at an annual saving as stated above of £968. Under two headings only, conveyance charges and reduction in staff, the saving to the district would amount to approximately £I3OO per annum, as against an increased charge for interest and sinking fund on loan monies of only £760. It cannot therefore be established that on the question ot cost, the removal of the main hospital to Kaitaia will be an extra burden, on ratepayers. It is proposed, provided that at the forthcoming Election, the Western Area obtain a majority on the Board, to proceed with the question of the establishment of the Main Hospital at Kaitaia, and when thik is accomplished to en-

deavour to dispose of the presen institution at Mangonui to the Government for use as a sanatorium, and in that event arrangements would be made to reserve a small number of beds in that institution for the use of emergency cases in that district, The cost to the Board for this service would be very small, as staff requirements in this connection would be very restricted.