THE New Zealand Herald. AND DAILY SOUTHERN CROSS. SATURDAY, MAY 9, 1903. HOSPITALS EXPENDITURES.

New Zealand Herald, Volume XL, Issue 12266, 9 May 1903, Page 4

THE New Zealand Herald. AND DAILY SOUTHERN CROSS. SATURDAY, MAY 9, 1903. HOSPITALS EXPENDITURES.

The Local Bodies' Conference which met yesterday afternoon at the call of the Auckland City Council, has to some extent cleared the way for the effective consideration of what has become an intolerable burden. A representative committee of inquiry has been set up, which the members of the Hospital and Charitable Aid Board, who were present, promised to assist loyally, and we may anticipate that its report will enable some plan for curtailing expenditures to be arranged. Resolutions were also passed in favour of providing an infectious diseases hospital within the existing hospital grounds, and for resisting the encroachments being made by the Health Department upon local funds. Sweeping economies in the Board expenditures are evidently necessary. We are statistically informed that the Auckland Hospital has been conducted at a lower per capita cost and collects a greater percentage of this cost in fees from patients than any other similar institution, but the value of these statistics is immediately exploded when we are told that from some unexplained reason the cost is understated. The committee of inquiry will doubtless know more at the end of a few days as to what steps can be taken without interfering with the legitimate functions of the institution, but we are afraid that local representatives left yesterday's conference with as vague an idea of what is wrong as that with which they entered it. The returned contingenters, the medical staff changes, the sterilising plant, the Health Department, outdoor patients, medicines, nurses, and a variety of other persons, items, and incidents were quoted' as having assisted to swell the demands upon local bodies. All that is plain is that the usual policy of drift, long persisted in, has landed the Board in an j unpleasant position, that it must be \ set financially straight, and that future expenditures must be cut down. For years it has been running behind. The best thing the Board has done for a long time is the bringing of matters to a head, and thus forcing local bodies to take an active interest in what so deeply concerns them. As must always be expected in such crises, a series of guerilla attacks were made upon the administration. The question of a medical officer was re-opened, criticism upon the arrangement with the friendly societies was much in. evidence, and the Health Department found no

friends. We have to remember that a medical officer was appointed because the previous system was found unsatisfactory; that the arrangement with the friendly societies was considered a wise one, and that the Board has been thrust into surrender to the Health Department by its bare treasury. .We do not hold a brief for the Board, and have criticised it unhesitatingly upon occasion. But it is surely a mistake to treat its members as inimical instead of endeavouring to secure their cordial assistance in a reconstruction of policy. For the Board must know that the recent extraordinary increases in levies cannot be borne, and that it is the duty of all parties to cooperate heartily in the cutting of our hospital coat according to our revenue cloth. Least of all should a representative Board play into the hands of the Government and saddle their constituents with crushing infectious diseases charges which might so largely be reduced by harmonious local action. We ought to have a Greater Auckland, and an up-to-date city government, as the existing situation tells us, but until Ave have it, united and harmonious agreement between the various bodies is essential to the economical conduct of our affairs. The medical officer system should not be made to stand or fall by a short, and imperfect experience, nor the friendly societies be estranged by uncalled-for comments. The arrangement with the societies can' hardly continue after what has been said, but we doubt whether the rates will be benefited by its discontinuance. Frankly, the public wants a cheaper hospital without decreased efficiency. We . want it primarily for those who cannot get humane and scientific care in time of need in any other way. If it is to be used also by those who can afford to pay, they should be made to pay every penny that it costs. It is a thousand times better to lose the statistical position of cheapest by which we have been confused than to have to leave roads unmetalled in order to fill up a quagmire of debt and a depressing leakage of unrestrained outlay. As for the Health Department and its infectious diseases hospital demands, we have the mystic consolation that it is so domineering and insatiable as to be predestined to restraint. ; Only Russia or America could endure such an institution, the former because its people are born obedient, the latter because its officials are amenable. The worst we can say of Drs. Mason and Makgill is that they have a most courageous contempt for civic rights, and a most enjoyable faith in their own infallibility. Like all enthusiastic doctrinaires, they make bad masters. In the particular case under discussion, that of infectious diseases hospitals, they can point to the official statement that the existing hospital ground contains a garbage heap, and is the playground of the perilous rat. If this is correct, one of the pressing functions of the Hospital Board and its medical officer would seem to be to clean the grounds up. This would be cheaper than our having to foot the ponderous bill for Point Chevalier and its upkeep, and might further reduce expenditures by reducing the Hospital contributions to typhoid. But in any case, two separated hospitals, two distinct hospital staffs, and ; two independent hospital expendii tures—one of them absolutely beyond local control— too much for our sparsely-populated districts. It is too heavy a price to pay for that momentary panic of three years ago, in which Parliament gave us over, bound hand and foot, to the tender mercies of the Health Department. There would be little to fear were it not for the paternal simplicity of our governance, but as things are the Government cashes the Health Office drafts upon the subsidies due to local bodies, and sends them along the balance. Possession is always nine points of the law, but in this case it would be hard to find a buyer for the claims of local, bodies upon such autocratically garnished sums at two- ; pence in the pound, much less at ' two shillings. The only remedy is ; an amendment of the Health Act, 1 and the re-establishment of the local authority in all hospital matters. Unless this is managed it is merely a question of time when hospital control will be completely, instead of partially, lost, and when, instead of our being able to reorganise general hospital management in emergency, we shall find ourselves looking on while the Health | Department works its will and pleasure in every hospital, and the Government hands it all our road money with an approving smile.