THE PUBLIC HOSPITALS.

New Zealand Herald, Volume LVIII, Issue 17964, 14 December 1921, Page 11

THE PUBLIC HOSPITALS.

f-J AMENDING LEGISLATION./ " - : -- : FINANCIAL PROVISIONS. | SUBSIDIES ON'OLD BASIS, SSA'.' '

|C PROPOSED CHANGE TOO COSTLY. [BT TELEGRAPH.— SPECIAL REPORTER.] -' WELLINGTON. Tuesday. Th« TT 'Spitals and' Charitable Institu- | "tions Amendment Bill was introduced in the Hon." of Representatives to-day. It is a measure of 31 clauses, containing, as Ihe Minister explained on its introduction, certain provisions recommended by tho officers of tho department in consequence oi shortcomings and anomalies in ' the present law, and also some clauses leqtured hy the hospital boards. The Bill . j 3 intended to como into force on April 1 next, but is to apply immediately upon being passed in respect of election appointments and other formal matters covered by its provisions. It is stipulated at tho outset that in future no hospital board shall appoint any medical officer (including an' honorary medical officer), or a matron, master, manager, house steward, or engineer, without first obtaining the consent of the Minister to such appointment. This appiies to secretaries of boards also. By the Act of 1909 no such appointment (jould be made until 21 days after the Minister had been notified, unless his consent had previously been obtained. A considerable amount of financial adjustment is made by the Bill. By tho principal Act bequests t» hospitals were given a Government subsidy at tho rate yf 10s in the £, and gifts or voluntary contributions at the rate of 24s in the £. Tho former rate is raised to the £ for £ basis, and the latter reduced to samA scale, so that both are now the same?

Detailed stipulations are made in respect of the estimates prepared yearly by the boards. The expenditure side is to show separately what is maintenance and what is capita] expenditure, and the capital expenditure is to show further what portion it U proposed to borrow in terms °' section 10 of the Act of last year, which empowers boards to borrow by debenture or bank overdraft, with the consent of the Minister, for building purposes. Tho estimates are to be confirmed at a special meeting of the board to be held not later than April 18 each year, and to be forwarded to the Minister not later than April 21. The Minister is to have' the power of requiring the board to amend its estimates if they do not meet with his ap- , proval. Failure to render the estimates or to amend them if required will entail the withholding of the Government subtidy. Any deficiency in the- revenue of the board for the preceding financial year is to be included in the estimates, and to be reckoned as expenditure for the year then current.

Levies on Local Bodies. From the estimates then to be rendered there is to be calculated tho "net estimated expenditure" of the board, which is to consist of the gross expenditure, less receipts other than contributions from local bodies and Government subsidies. The l»ard is then to apportion among the contributing local bodies the net estimated expenditure in the same way as laid down in the 1909 Act, and furnish copies of the rstimatej as required, by the 1913 amendment The, apportionment of the con-tributing-Imsl body is then to be'considered a debt pavable by that local body to the board, and stipulations for recovery sicrflar to those contained in previous legislation are provided. A change is being made enabling the.local body to pay its contributions by monthly instalments, due at the end of each month", and in the event of failure to pay any such instalment, interest at a rate to be determined by the Minister for Finance shall become payable bv the local body on all cr portions of instalments, which are overdue by 14 days. V-- ' ' •, Variations are also made in the method -...'* by which deficiencies in the estimated ex- | penditure by boards iri any given year 1,',-, may be made up. : .When it appears''that . the expenditure other-fhan^capital expends?. - diture is going to;bo.greater than the \ i estimates provide,- 'the .Einance i Minister i.-"'' may make up*. tHe without any ;.,I'.' further authority .provided by •v't' Ate clause. '\ deduction ■with interest is to~ the sub-, sidy payable year to that board.' a deficiency in the capital ecp,e.iiditufe,'the board may make a supplementary apportionment among the contributing local bodies, recoverable in* the same manner as the original appropriation." Indigent Patients. Section 72 of the 1909 Act prescribes that where s hospital board has granted relief to an indigent person who has lived less than the prescribed time in its district, it can recover the money from the board under, whose jurisdiction the recipient had last lived for the qualifying, time. The Bill proposes that this shall not obtain in the case of a patient in hospital. ?

Two mergers of hospital districts are contained in the Bill. The Wairau and Picton districts aro to amalgamate,, and v are to be known as Wairau, while the Grey and Inangabua are to combine ,as the Grey hospital district. I A scbedule'of the 1909 Act defines certain institutions as "separate institutions." to which certain sections of the Act are 1 to apply. These are the Mercury Bay and the Oamai-u hospitals, the Wellington Convalescent Home, the Jubilee Institute for the Blind, the Reefton Ladies' Benevolent Home, the St. Andrew's Orphan.aga (Nelson), the Wellington Society for the ißelief of the Aged Needy, the Wellington Ladies' Christian Association, ajid the Charleston Hospital. Certain pre- ' scribed portions of the Act arc made*to apply to them by the Bill. These institutions, with the exception of the Mercury Bay and the Oaraaru hospitals, are no longer to cone under the section providing for tJhe payment of Government subsidy on bequests, gifts, and expenditure. Control of Private Hospitals.

Various alterations are made in the fw hi it affects private hospitals. Under 'lie Act. the term "private hospital" applies only to an institution Khere there are two or more patients at *he same time. The Bill makes it possible for an institution with only one patient to be registered as a private hospital and he subject to the law on the vtnatter. The license fee for private hospitals is increased from 10s a year to ',s*lsh an amount not .exceeding £5 as may ■ ;do prescribed. Insufficient or unsuitable . ecjuipnHTi is added to the grounds on w hich the license for a private hospital maybe cancelled. To the clauses prescribing who may be manager of a private h k&spital is- added the stipulation that :j *here a medical practitioner is manager, of a medical and surgical hospital, there roust also be a registered nurse on the staff and resident; in similar circumstance fnr a maternity hospital, a registered midwife must be employed and resident, while where a medical practitioner is manager of an institution tthjeh is both a maternity home and a niedical and surgical hospital, he must hive associated w<th him and resident a registered nurse and a midwife, or one member of the staff who combines both !|ualifications. When the Bill passes into aw. to person not qualified in the terms F' of the 1909 Act to be manager of a 'p. private hospital ic to receive a license either by fresh grant or by transfer. V "ewer is granted to issue regulations preM scribing the equipment and staff to be Maintained in connection with private l|| hospitals, regulating or prohibiting the i V performance of any clas B of surgical opera- | : tion in private hospitals, and regulating £" or prohibiting the admission of any class K of patients into private hospitals, either generally or with respect to any specified ; ota of private hospital.

Among the miscellaneous provisions is one empowering:any local ailthority, with tne : ap})roYal of the MinisterJfoi Internal Attairs, arijl any-hospital board; with.tK» approval the Minister for ; Health,, to contribute "out of it 3 general .funds' lor W assistance and development^ : am/ society pr institution for tho.-iproWctic-u of health.or the relief,of the\: indigent. i *7^PI Minister's 'Explanation, tv Explaining'the Bi!l on ite introduc(ion, the Minister, Hon. C. J. Parr, said there had. not previously been any fixed date tor the boards'to render their estimates nnd delay had. caused the department trouble in tho compilation of its own es•jmates.. In regard to the approval by tiie Minister of the appointment of officers, it was essential to have tho best men to have efficient service, and it was well that tho Minister should have tho final voice. It had sometimes happeued that officers had been appointed who had not been competent to do tho work. Mr. D. G. Sullivan (Avon): Whv not in the case of the officers of city councils and other local bodies? The Minister: Because the Government ("ids ton shillings in the £ for tho salaries of these people and I think it onlv a fair thmg, in the case of a difference" of opinion, that tho Minister should have some say. Mr. M. J. Savage (Auckland West): If that clause becomes law government by bodies becomes a thine of tho past. The Minister: Ido not think so. He repeated that the department had to find one-half of the salaries

Subsidies on Expenditure. With regard to the question of subsidies, continued the Minister, thore would bo no change in the law this year. It was trus that the present schedule of subfidies was not working as satisfactorily in some instances as could be wished. .'lne Royal Commission had recommended the institution of a new scale on a different basis, but unfortunately its adoption would entail on the Government the finding of £60,000 more 'every year in Edition to the present aggregate total of something like £420,000 a year. This matter, which required very careful consideration, had already received the attention of the Government and more particularly of the Minister for Finance. It was regretted that it was not possible in the present financial position to find £60,000 a year for additional subsidies. He could not go beyond the £420,000 already being provided. The burden on the Consolidated Fund for the subsidies had grown rapidly. It was £190,000 a year in 1914 and to-day was the figure stated He was not suggesting that extravagance had been the cause of this. The cost of everything required had grown, particularly in the case of equipment and medical necessaries. In the same, way the cost of maintenance had gono up tremendously. Nevertheless as the Minister for Finance was not ahle to find the <«tra money, the bringing into existence of a new scale was something which the Government had had to postpone.