THE OTAGO DAILY TIMES Monday, May 31, 1943. HOSPITAL FINANCE

Otago Daily Times, Issue 25239, 31 May 1943, Page 2

THE OTAGO DAILY TIMES Monday, May 31, 1943. HOSPITAL FINANCE

It is widely assumed that the Government’s proposals that will be announced in the Budget will include one under which the Hospital Boards will receive some measure of relief from the cost of the maintenance of patients. The assumption is supported by the fact that the Minister of Health has publicly admitted that the payment now made from Stale funds to meet the maintenance costs is inadequate. There may have been some reason at one

time for the belief, evidently entertained in departmental circles, that a payment by the Government to Hospital Boards of 6s per occupied bed per day would not be unreasonable in view of the fact that the boards had in the past all had to write off as irrecoverable large amounts representing the indebtedness of patients to them. It has in fact been stated on authority that the fees which the boards had been able to collect had not averaged more than 2s 8d per bed. But there was a wholly imperfect appreciation on the part of the Government of the effect which 1 the introduction of the social security scheme, with its offer of free treatment to patients, would have on the finance of the hospital authorities. Ministers Were disinclined to accept the view, which was almost unanimously expressed by medical practitioners, that there would be a heavy increase in the demand for hospital treat* ment, both in-door and out-door, when the scheme became operative. Nor, it may be surmised, was there any expectation that the cost of all supplies required by hospital authorities would increase so rapidly and so sharply as it has. The Social .Security Act came into force on April 1, 1939. The average maintenance cost of general hospitals only in the year immediately priof to this date was £254 per occupied bed. In the following year it was £272 7s, in 1940-41 it was £284 9s, and in T 941-42—the last year for \yhich complete statistics are available—it was £3lO 3s. There will have been a further increase for the year which ended on March 3L, last. When the increase in the maintenance cost is accompanied by a steady increase in the number of patients, it is easy to see why the Hospital Boards have found it necessary to raise the levies on the contributing local authorities so substantially as to have produced unavailing protests from one end of the Dominion to the other—unavailing because the funds must be provided to enable the Hospital Boards to discharge efficiently the onus that rests on them. In the twelve months preceding the date on which the social security plan became operative the number of inpatients in the public hospitals of the Dominion was A 14,451. In a period of five years it had increased by 23 per cent. The .number was 123,540 in the first year in which the social security legislation was in, force; it was 143,291 in the following year and 152,563 in 1941-42. In other words, the proportional increase in three years was as great as it was in the preceding five years. And the growing hospital population has necessarily had the effect of forcing the boards into expenditure upon the expansion of the accommodation provided by them. The case for their relief from some of the burden that has been thrust upon them is overwhelming. It does not seem to be at all material whether it is from the consolidated revenue or from the Social Security Fund that a contribution is made to the funds of the boards in order that their demands upon the ratepayers, through the local authorities, may be lessened. The liability should strictly be borne by, the Social Security Fund, but, as it Seems certain that it will itself make heavier demands on the Consolidated Fund than it has done in the past, it may be anticipated that it will be from the Consolidated Fund that payments will be made to ease the financial circumstances of the hospital authorities. From whichever source the relief is afforded, the general body of taxpayers bears the cost.