HOSPITAL TREATMENT.

Otago Daily Times, Issue 20323, 3 February 1928, Page 10

HOSPITAL TREATMENT.

FRIENDLY SOCIETIES’ PATIENTS. PROPORTION OF FEES. AN INCREASE RECOMMENDED. (Special to Daily Times.) WELLINGTON, February 2.. The cost of hospital treatment in New Zealand to-day averages about 17s per day, while the patients arc charged from 9s to 12s per day by different hospital boards, but friendly societies are given a further reduction of from 35 per cent, to GO per cent, on these charges, a position which is not favourably viewed by the Health Department, whose opinion is that friendly societies should contribute a greater proportion than in the past. As a result of the Hospital Boards’ executive meeting recently a proposal is to be put before the hospital boards shortly recommending that a minimum of 50 per cent, of the charges paid by ordinary patients shall be paid by friendly societies for their members receiving hospital treatment. The question of the proportion of fees to be paid to hospital boards by friendly societies was one of the principal Subjects under discussion at the executive meeting of the Hospital Boards’ Association last week, which was attended by representatives from all parts of the Dominion. Terms were agreed upon as a guide in drawing up future agreements in the respective districts with a view to bringing about as much uniformity as possible. The first clause defines what constitutes membership and dependents entitled to treatment under the agreement. The next provides that the understanding is not to apply to charges for out-patient treatment, ambulance services jn respect ■ f maternity cases, treatment afforded for illness arising from immoral or disorderly conduct, supply of surgical appliances for use outside a hospital, or to radium or deep therapy treatment. These are to be matters for a separate agreement, if desired. The financial part of the recommendation is as follows: — The rates of charges for maintenance and treatment in hospital of members or dependents tv, be not less than 4s Gel per diem for adults and 2s 3d per diem for children under 14 years as may bo agreed upon. The liability of friendly societies in respect of individual patients to be liimted to 30 weeks’ continuous treatment for any one illness, and liability not to commence until six months after joining the society’s hospital fund. A prominent official to-day said that the above recommendations would be a great improvement on the past if they were adopted. The hospital boards would benefit financially, and friendly societies were not being asked to pay a- undue proportion or more than, in his opinion, they could afford. He understood that all boards' delegates accepted the recommendation, and also that the friendly societies were willing to accept them. This official referred to the great increase in hospital costs in all directions. From 1914-15 to 1925-26 hospital building expenditure had gone up 350 per cent., arid the cost of construction had increased 52 per cent, since the war. In the same period of 11 years maintenance costs had increased 129 per cent., and occupied lands had increased by 65 per cent. Hospital expenditure had increased by leaps and bounds, and it was necessary to keep a careful check not only upon expenditure, but upon revenue. The limitation to 50 per cent, would be a big step forward. A city gentleman who has had many years of experience in hospital board work and administration, and is much interested in the relations of the friendly societies to the boards, said: “ For some time friendly societies have been seeking to obtain from hospital boards a considerable reduction in the already inadequate fees they pay for the treatment and maintenance of some of their sick members in our public hospital. As friendly societies exist for the purpose of providing medical and other benefits from the accumulated contribution of their members, to encourage thrift and selfreliance, etc., and as the financial position of the societies in New Zealand appears to be very strong, the question arises as to why they are seeking to become a permanent charge on De rates and general taxation. If there is some other reason than poverty or inability to provide in the proper way for the payment of medical benefits for members, then it is time it was disclosed, for financial inability docs not appear to be the reason, if we can judge the position from the figures shown in ‘he registrar’s annual report for 1926. This report shows that the total funds are steadily increasing, in thgt in 1917 the amount was £27,052,753, the average per member being £29 17s. For the year ended 19°6 the corresponding amounts are shown as £3,337,683, and the average £35 6s Bd, In 10 years the total funds show ari increase of 62 per cent., and nearly 20 per cent, average per member. The following table was quoted as showing the accumulated capital and average capital per member in each of the Australian States in and New Zealand:— ' Average for State. Year. Funds. ™ e ” bt £ X S Wale* .. 1925 3,042,054. 13 8 6 Vi?tor£ a 163 1925 4.065,808 26 3 Yew Zealand ... 1925 3,136,23< If I S. Australia ... 1924 i-842,133 24 17 5 Queensland - 1924 14 7 fi Tasmania 3924 17 u in W. Australia ••• 1925 378,703 17 14 10

" So much for the accumulated capital,” continued the speaker. “ Now let u s see whether the sick and funeral funds are becoming depleted. The registrar’s report contains the following statement: ine total worth of the sick and funeral funds of 843 lodges at the beginning of 1926 was £2,724,840, and at the end of the year £2,907,435. The balance of gain for the year was £182,595, or £1 19s 4d per member in 1926 as compared with £106,514, or £1 3s 10d in 1925.’ “ With a surplus of £182,595 made in one year the onus is on the societies to show what it actually costs them now for hospital treatment in public hospitals, how many members are treated in this way, and what is the saving they make by obtaining the services of the honorary and stipendiary staffs in our hospitals in stead of employing their own medical men. On the face of it, it would appear that there exists no strong or valid reason why societies should obtain any discount on hospital fees, for they are able to pay, and in addition the ordinary hospital fees do not cover anything like the actual cost of service. Therefore, even if full hospital, fees were charged the position would still be that friendly societies would be obtaining some medical benefits for members at the expense of the btate. Members of hospital hoards should look well into this matter before granting further concessions.”

In his opinion, he considered it was prostituting the Friendly Societies Act, which never intended them to come on to the rates or the State in this way. He doubted also whether members of friendly societies realised the true position, or they would never endorse it. There was also an increasing tendency to place the whole of their cases on the hospital instead of making use of their own medical men. The matter will be brought before all hospital boards at one of the next two meetings,