HOSPITAL FEES.

New Zealand Herald, Volume XL, Issue 12268, 12 May 1903, Page 3

HOSPITAL FEES.

AN INCREASE DECIDED UPON. THE FRIENDLY SOCIETY ARRANGEMENT. At yosterday'n meeting of the Auckland Hospital and Charitable Aid Board several matters arising cut of the inquiry instituted by the local bodies into hospital management came up for discussion, the most important being that referring to the fees charged to hospital patients and the arrangement for admitting members of friendly societies at half fees. Mr. G. J. Garland, chairman of the Board, presided, and there were also present: Messrs. J. Bollard, M.H.R., Jno. Court, P. Dignan, A. Bruce, A. R. Harris, A. P. Friend, John Patterson, J. R. Walters, and Jno. McLeod.

At the request of Mr. A. R. Harris, the following return, showing the cost per patient of running the hospital since 1893, was read by the secretary:lß93-4, daily average cost per head 4s 4£d, for an average of 98 patients ; 1894--5, cost 4s ljjd, patients 104; 1895-6, cost 4s 6d, patients 102; 1896-7, cost 4s 64<J. patients 119; 1897-8, cost 4s Ijd, patients 121; 1898-9, cost 4s 4£d, patients 130; 1899-1900, cost 4s 9d, patients 139; 1900-01, cost 4s sjd, patients 139 ; 1901-02, cost 4s Id, patients 167 ; 1902-3, cost 4s 7|d, patients 191. Mr. Patterson asked how it was that the fee had been fixed at 4s when the cost had always exceeded that. There had been neglect of duty somewhere. He always thought the Board made a profit on the 4s. (Laughter.) Mr. Bollard said there were not 10 per cent, of the patients who paid full fees, so that if they put on another sixpence per day the result to the Board would be very trifling. Much had been said about a large number of people going to the hospital who could well afford to pay for treatment elsewhere. That was not the case. The returns of patients paying full fees showed it- was not the case, and he had more than once accused the Fees Committee of collecting fees at the point of the bayonet. A good deal had been said about the chairman (Mr. Garland) going to the hospital. Well, he (Mr. Bollard) was a good deal responsible for Mr. Garland going there. Mr. Garland might have gone to a private hospital had it not been that he (Mr. Bollard) strongly advised liinr to go to the publio hospital in order to maintain the confidence of the public in that institution. The Chairman then moved, " That in future the charge to all patients who aro inmates of the hospital be increased from 4s per day to such sum as it actually costs from year to year, the charge to take effect from May 1 in each year." Mr. Bollard: Would you put the farthing in?

The Chairman: Most certainly. I understand that according to law we cannot make a profit out of any patient. Mr. Bruce held that it would be exceedingly inconvenient and confusing to alter the charge each year. It would be more convenient if they took an average of ten years and struck the fee at that for a time.

The secretary stated that the average of the ten year: would be about 4s 4d, and a suggestion was made , that the fee might be fixed at 4s 6d. The Chairman called for a show of hands in favour of 4s 6d, and a similar show in favour of his motion to make the fee the actual cost as arrived,at from year to year. He made the result four votes on each side, and 6aid he would give his easting vote in favour of his own motion, but somebody discovered that there were nine members at the table, and when the secretary cast his eye round the table to find out who was responsible for having moved to make the charge 4s 6d, no member would own to having proposed such a motion. The ohairman then put his own motion to the meeting, and it was carried unanimously. The hospital' fees for the ensuing year were therefore fixed at 4s 7;jd per day, liable to alteration at May 1, 1904, if the aveftige cost per day for the year ending March 31 of that year varies from that of the past year. FRIENDLY SOCIETY PATIENTS. Mr. Bollard, in accordance with notice, moved for the abolition of the arrangement whereby friendly society patients are admitted to the hospital at half fees. He said ho was not hostile to the friendly societies; he had a groat respect for them, and believed they did a great deal of good, but there had been a great deal of comment on this arrangement by representatives of local bodies, arid he thought it should be abolished and let members of friendly societies go to the hospital on tho same footing as other patients. He was satisfied that if they took 1000 friendly society patients and 1000 ordinary patients they would find that even at half fees the friendly society patients paid more than tho others. He had no doubt about that, but in view of the comments made he held the arrangement should be ended. He held that a man with a wife and family, getting an income not exceeding £100, should not be charged fees at all. He did not believe the founders of the institution ever intended that such a man should pay fees. Every case should bo taken on its merits* _ and on the accounts presented to patients there should be a footnote to the effect that patients unable to pay could appear before the Fees Committee and show causo why their fees should be reduced. Many patients when they got the bills got into a state of worry and excitement about their inability to pay. They did not know that the Board could relieve them of part of the responsibility. Mr. J. R. Walters seconded. He said it was not generally known that they did not get even 14s for all friendly society patients. Children of friendly sooiety members when under ten years of age were charged only 7s. That was ridiculously low. He did not think it fair that country people should have to work hard early and late to maintain members of the friendly societies in the city at half fees in the hospital. If the friendly societies desired to support the hospital let them give a donation, which would carry a subsidy from the Government. Mr. A. P. Friend said, as a member of the Board, not associated with friendly societies, he would be pleased to accept a guarantee of half fees from any society for its members, or from any employer for his employees, rather than run the risk of getting nothing at all. If the Board could only get a guarantee from all employers of labour that they would pay half fees for all employees sent to the hospital on account of accidents, the Board would score in the matter of fee 3. He held that if the Board gave up this guarantee they would have to fish for their money, and very hard fishing it would be. In view of the forthcoming inquiry he held that the matter should be allowed to stand over. He moved, as an amendment. " That the matter be deferred till the result of the inquiry instituted by the local bodies is announced."

Mr. A. Bruce said after six or seven years' experience on the Fees Committee he was of opinion that no section of the community paid as biff a proportion of the fees as the members of tTie friendly societies. That, he held, justified the arrangement. If they abolished this arrangement they would not get much more, from friendly society members than they now got from tho general public. He hod no connection with any friendly society, but as a member of the Board ho held that they ought not to take a step which would injure their finance.

Mr. .T. McLeod said he did not intend to vote, because as a member of a friendly society, he was an interested party. The standpoint the members of the Board should take was what would bring in the most revenue to the Board. Mr. Bollard admitted that the abolition of the arrangement would mean financial loss to the Board, but he brought the matter forward because the members of local bodies were talking. As a matter of fact, the representatives of local bodies did not know what they were talking about. Mr. Walters had referred to fees for children, but the concession made to the children of friendly society members was on the samo footing as the concession to members themselves, half tho ordinary fees charged for children. Then Mr. Walters was concerned about the people in the country districts, but the friendly societies had members all over the country districts, and tho conference paid fees for thern all whenever they went to the hospital. It was quite a fallacy to supposo well-to-do peoplo wont into the hospital. In Wellington the hospital trustees offered to treat friendly society members for 10s a week, but the friendly societies there did not see their way to accept it.

Mr. John Court said he would oppose Mr. Bollard's proposal simply and solely in the interests of the finances of the hospital.

_ Mr. John Patterson also opposed the motion. He said the average income of members of friendly societies would not exceed 7s a day, and he did not see how they could pay full fees.

Mr. P. Dignnn said he was going to vote against Mr. Bollard with the idea of getting the matter put off till after the inquiry by local bodies was furnished.

The Chairman said he had thrashed this matter out with the medical superintendent, and with the house steward, and he was satisfied that the friendly society patients actually paid the Board better than any other class of the community. Ho was certain that 75 per cent, of the friendly society members oould not pay a brass farthina when they were laid up in hospital. The Board should encourage thrift instead of discouraging it, and if it cost him his seat at the Board he would support continuing the present arrangement with the friendly societies' . conference.

•Mr. Bollard, in reply, said he frankly admitted that he brought forward this proposal to satisfy the local bodies. He was never, however, in sympathy with this arrangement, but he was content to let it stand till the local bodies challenged it. Ho held, moreover, that the arrangement with the friendly societies' conference was illegal, for the Board had no authority in law to make a compact with any society to admit their members at half fees. Such a compact was bad in principle, although it did bring in more money. The end did not justify the means. To show that he had no desire to snatch a vote on the matter, ho was prepared to let the matter stand over till the commission had finished their inquiry. Several members thought a vote should be taken on the subject, and be done with-it, but on the suggestion of the chairman it was decided to accept Mr. Bollard's offer and let the matter stand over till the completion of the inquiry by the local bodies.

ARRANGEMENTS FOR THE INQUIRY.

It was resolved, on the motion of the chairman, that the members of the Board, Dr. Collins (medical superintendent), Dr. Williams (chairman of the hon. medical staff), and the house steward attend the meeting of the Committee of Investigation on Friday. The chairman said the members of the Board had nothing to hide, nothing to fear, and nothing to be ashamed of. He was satisfied they all wanted to do their duty loyally, and that they wore quite satisfied to give the local' bodies every facility to get to the bottom of the whole thing. Mr. Friend, in seconding the motion, took pains to explain that the members of the Board who were present at last Friday's conference did not take part in the voting, and were not responsible for the resolutions passed. The secretary, at the request of Mr. Friend, stated what the levies on local bodies had been for the past five years— 5-34 th of a penny per £; 1900, l-7th of a penny per £; 1901, 11-18 th of a penny per &; 1902, l-6th of a penny per £ ; 1903, -id per £. TREATMENT OF INFECTIOUS DISEASES. The City Council's resolution asking the Board to fake over the control of infectious diseases from the Health Department was forwarded by the town clerk. The Chairman said this was reopening the whole question of the Board's relation to the treatment of infectious diseases. Under the Public Health the Hospital Board had no status with regard to infectious cases. They had no more right to take over infectious cases than they had to take over the lunatic asylum. He moved, "That the Board adhere to its former resolution." Mr. Friend seconded. Mr. Bollard moved, "That the matter stand over for a month to give the local bodies time to complete their inquiry." Mr. Dignan seconded, and said it would be ridiculous to pass any resolution on the subject till the inquiry instituted by the local bodies had been completed. Mr. Friend said the Board must stand their ground meantime, until the commission either told them they were incompetent to manage hospital affairs or justified their management. The Chairman said he would sooner put his resignation in the hands of the Board than take up the treatment of infectious diseases again until the Aot was changed. He would not do it. It was an injustice to the ratepayers, as it simply asked them to go back to the position which had landed the Board in trouble and made the inquiry necessary. On the matter being put to the vote the chairman's motion was carried.