THE OTAGO DAILY TIMES FRIDAY, MARCH 4, 1927. HOSPITAL EXPENDITURE.

Otago Daily Times, Issue 20039, 4 March 1927, Page 8

THE OTAGO DAILY TIMES FRIDAY, MARCH 4, 1927. HOSPITAL EXPENDITURE.

Ik his address at the Hospital Boards’ Conference the Minister of Health offered some interesting comments on the subject of hospital expenditure. This expenditure is still going up, as Mr Young observes, but that is apparently inevitable. The hospitals provide an indispensable national service, and it is essential that they should be maintained in a state of the highest efficiency. Against their monetary cost there is an offset in benefits conferred the value of which is, of course, not measurable, but the mere consideration of which makes it manifest that upon hospital maintenance at least there can be no grudging of expenditure by the country. That the funds provided for hospital purposes shall be carefully administered is, of course, very necessary. On the average it costs, as the Minister has pointed out, 15s 9d per day to maintain a patient in a public hospital—this including what are termed overhead expenses—while the average charge made upon the patient i.s 9s per day This means that 6s 9d per day is thus lost to the community, apart from reimbursements received from the patients themselves. All patients are not, however, in a position to pay for maintenance in hospital, though none the less entitled to receive it, and the amount recovered from patients averages only about 3s Cd per day. This means that the hospital boards fail to receive nearly two-thirds of the charges levied by them, and that over 75 per cent, of the cost of hospital administration is provided by the public, either through subsidies from the Government or levies made upon the local authorities and charged by them on the rates in their respective districts. The proportion of the cost that falls on the public is distinctly high, and yet reference to the annual report of the Health Department shows that the amount received from hospital patients has been increasing gradually from year to year, greatly to the Department’s satisfaction, though comment is made upon the great disparity noticeable in the sums collected by the various boards and on that still existent in their scales of charges. While a majority of the boards seem to have adopted the maintenance fee of 9s per day recommended by the Department some years ago, the Department itself has recently raised the question of the sufficiency of this charge. It may be suggested that an increased charge for maintenance will only bear more heavily upon those patients who are able and willing to pay, and, without providing much additional revenue, will increase the measure of the shortcoming of those who pay only in part or not at all. It is not necessarily desirable that the charges made upon patients should reflect increases in the overhead expenses connected with the upkeep of hospitals. The Minister of Health was certainly speaking by the book in affirming that the money devoted to the prevention of disease is expended to better purpose than that which is spent on remedial institutions. That view is quite in accordance with modern opinion, and has the endorsement of the medical profession. To combat and defeat disease after it has taken hold is good, but to discover how to keep it at a distance is far better. Sir James Barrett, speaking of the work of the Medical' Congress upon his return to Australia, observed that a gratifying feature of the gathering consisted in the emphasis placed by all sorts of practitioners upon the value of the prevention of disease. This ho affirms to have been the dominant note of the Congress, and the circumstance has, of course, its significance in relation to the future.