HOSPITAL EXPENDITURE.

Otago Witness, Issue 3031, 17 April 1912, Page 13

HOSPITAL EXPENDITURE.

At a meeting of the Otago Hospital and Charitable Aid Board the chairman (Mr J. H. Walker), in speaking, to the report of the Finance Committee, said: On the 3rd inst. the Otago Daily limes published a leading article entitled " Hospital Expenditure." and I should like to say a. few words in reply. I only received an invitation to be present at the meeting of delegates a few hours before the meeting, and therefore had no notice of the various points to be discussed. In the report of the proceedings I am made to quote certain figures —viz. : Auckland, £47.792; Wellington, £51,687; North Canterbury, £59,425; Ota go, £47,472. These figures" were not quoted by me, but in the Otago Daily Times repcrt were used by one of the country members, and afterwards evidently inserted by mistake in my remarks. This can be vouched for by the secretary of the Otago Board or any of the delegates present. Any figures quoted by me were, either from Dr Valintine's report or from the office records. In estimating the expenditure of the Otago Board as compared with the other boards of the Dominion, I should like briefly to compare tho extent of control of each. The Auckland Board controls the Auckland Hospital, the Costlev Home fo.- Aged Poor, and the Auckland Convalescent Home; tho Wellington Board the Wellington Hospital, Fever Hospital, Otaki Hospital and Sanatorium OhLro Home; llie North Canterbury Board the Chrisfrmureh Hospital, Akaroa Hospital, Lvttelton Casualty Hospital, Bottle Lake 'Fever Hospital. Sanatorium, Memorial Home (Woolston), Samaritan Home (Christchurch), Taurangi Old Men's Home, Armagh Street Depot, Waltham Orphanage, Female Refuge (Linwood); the Otago Board the Hospital, Tuapeka Hospital, Port Chalmers Cottage Hospitaj. Tapanui Hospital. Kaitangata Cottage Hospital, Fever Hospital, Pleasant Vallev Sanatorium, Otago Benevolent Institution, Forth Street Maternity Hospital. From this it will be seen that in Canterbury and Otago a fair comparison may be made, as both boards control about the same number of institutions On the other hand, both Wellington and Auckland have fewer institutions to control, and, therefore, the cost per head is correspondingly less. The article stated: " The disparity between the cost in the Dunedin and Christchurch institutions has still to be explained." It must also be recognised that both Otago and Canterbury have a large country population to deal with as compared with Auckland and Wellington, and it is interesting to note tho population, rateable capital value, and cost per head of the four centres as follows:

The maintenance and administration is as follows:

Tho gross cost r>er bed 1 of Dunedin Hospital is £4 2s 9d more than Christchurch, l>ut the net cost is nearly £4 per bed less than Christchurch. That is, the ratepayers are saved £4 per bed in Dunedin, which is, therefore, the more economically managed of the two institutions. The difference in the gross cost is made up by the higher salaries of the nursingetaff, which is a fraction under £4 per bed, there being two less nurses in the Dunedin Hospital, though £566 5s more waa paid in salaries. Had ths Dunedin nurses been piiia' the same, salaries as tKe Christchurch nurses the ratepayers would have been saved £8 per occupied' bed as compared with the Christchuroh Hospital, or about £llOO. The patients' payments in Dunedin are higher, but this is compensated by the provision of bacteriological laboratories and an X-ray department, with paid stiffs, which acjd to the gross cost per head of thu Hospital. A more generous scale of dietary is allowed in the Dunedin Hospital, which is the most liberal in the Dominion. This is borne out by the statistics, there being £2 5s per occupied bed more provisions used in Dunedin than in Christchurch, and that at a period 1 when comp'aint was made of an alleged deficiency of food stuffs in the Dunedin Hospital, The increase in laundry, fuel, lighting, and domestic arrangements has had the earnest consideration of the board since its initiation, and the alterations effected should enable matters to be placed on a more economical basis. It has to be remembered that 1910-1911 «w tho first year of the new board, and any criticism in regard' to the expenditure that year is hardly a fair criterion of tho work of the board. In connection with the extra cost entailed by tho existence of the Mcdioal School, I stated at the meeting particulars which increased the cost —particulars which are evident to anyone who has any knowledge of the Medical School. In all medical schools the surgery and drug account is higher than in other "institutions, and tire Dunedin Hospital is no exception. There is also an extra operating theatre, with nurses, attendants, etc.; there are lighting, fuel, washing, laundry work, etc., to be found for the students, the cost and maintenance of a Maternity Home, and other items which need not be detailed. In quoting the figures raised in donations by Wellington and Dunedin I certainly admit an error has crent in, and the amount of £2256 is correct, as stated by the Times. In my opening remarks I stated they were from the Inspector-general's report for the year 1910-1911, and, therefore, any misapprehension was cerh'tinly not due to me. What, I stated in regard to Wellington was that their property and endowments brcueht them in a large amount of money annually, which, reduced their cost per head; also that, in their hospital maintenar.ee cost per patient there were included n number of patients in the Victoria Home, ai.d thai if the same course v ...-, pursue I in Dunedin the cost per patie::! in the- Hospital would

bo considerably reduced by the inclusion of a number of Hospital patients at present in the Hospital ward of the Benevolent Institution. If we take the question of the administration of our other institutions and compare them with other centres we hnd that wo have every reason to be gtatined with the result*, which are as follows: Benevolent Institutions.

The whole trend of the article is to show that in comparison with other centres we are more costly in expenditure, and I maintain that the facts as stated by me are oorrect, and can be verified by trie Inspec-tor-general's report, and show most conclusively that, comparing the nature and extent of tire work done in Otago, we compare favourably with any of the large 'hospitals in the Dominion, and in comparison with Canterbury wo cost the ratepayers less per head. Mr Walker added that the board had every reason to be gratified that the Hospital ccst was as economical as it was. The committee had endeavoured to bring matters in connection with the administration of the institution up to perfection by the introduction of a refrigerator, labour-saving applianoes, and other innovations, and the, ratepayers had no reason to say that the board was not doing its best to obtain economical administration. —(Applause.)

9 5s a" ft m c nbi s-'S- 3 . . 5 Sail's hm *-* ir*. Cn ~J SpJ *> 1 jplg q> o Population, o? — j Jcr t*5 M CM tOCO co oi cd ai FS *52 £2 5? Ra-teabl e capi tal wS value. CO — 1 f* SP 04 cn O h-* -f* WO' Net amount per head cjo j* of population req. for eo cS c»3cj< for expend, other than capital expenditure.

Average Patients patieiits G ross cost Net cost payment per dic-m. per bed. per bed Auckland. per bed 248 £ 80 6 9 £66 8 0 Wellington. £13 18 9 243 85 16 5 70 16 5 Duocdin. 14 9 3 144 116 13 2 92 17 8 Christcliurch. ' 23 15 6 138 112 10 5 96 16 5 15 14 0

cj a 1 Z 3 2 rf Cl, 32 Otago — Benevolent Homo 199 £21 4 1 Wellington — 122 23 19 0 Ohiro Home Auckland — 31 17 Cost ley Home 229 I Canterbury— 47 7 11 Taiirangi Home (male) 72 Memorial Home, Woolston (female) 69 38 19 a Maternity Hospitals.

Ota go Board — Forth Street Maternity 9 £ 84 15 3 Government — St. Helens, Christchureh 9 150 13 10 St. Helens, Auckland... 9 145 16 I St Helens, Wellington 8 165 18 3 St. Helens, Dunedin ... 7 203 10 11