HOSPITAL BOARDS.

Otago Witness, Issue 3808, 8 March 1927, Page 51

HOSPITAL BOARDS.

?i ANNUAL CONFERENCE. ADDRESS BY MINISTER. CHRISTCHURCH, March 2. The annual conference of the New Zealand Hospital Boards’ Association was commenced to-day, when delegates were present from all parts of New Zealand. The conference was opened by the Minister of Health (the Hon. J. A. Young), and the delegates were welcomed by the Mayor (the Rev. J. K. Archer). The president (Mr W. M. Wallace (Auckland) occupied the chair. There was an” attendance of over 100 delegates and representatives of the Health Department. CIVIC WELCOME. The Mayor of Christchurch said the only real way of utilising the whole of the public hospitals for the whole of the people was to come to reasonable terms with the medical profession. He hoped that the conference would tackle the question of making the hospitals open to all the citizens. He felt that it could be done without the need of private wards. Better working conditions should be provided for the nurses. "There, are no private hospitals that, in my opinion, can come up to the public hospitals for equipment,” said the Chairman, in replying to the Mayor. “I think that the people who provide that equipment should have a chance to use is.” He added that he was desirous of making the hospitals open to all, but, if it were to create anything in the way of class consciousness, he would light it to the last ditch. MINISTER’S ADDRESS. The Hon. J. A. Young said there was no parochialism in hospital affairs, but the boards looked at the matter from a national viewpoint. The Mayor had touched on a very important .matter in respect to the limits on' admitting people to public hospitals There was machinery under the Hospitals Act to permit of hospitals being regarded as community hospitals in the widest sense. The commission which sat at Palmerston North a few years ago made it perfectly clear that all ratepayers and contributors, and others who were not so foitunate to own property, had the right of entrance to the public hospitals. “I trust that principle will never be departed from,” said Mr Young. He felt sure that if the hospitals were widened in their service to the public they would find that the medical profession would stand behind the Government and hospital boards. It was only a matter of arranging the details. Public health nursing offered a wide field of activity to the hospital boards, said the Minister. Whilst the first and primary duties of hospitals was to care for . the sick and injured it was equally their duty to take steps to prevent disease. If there were a system, trained women could go into the homes and teach the people to prevent disease. New Zealand had 5.4 beds per 1000 of the population, as compared with 1 per 1000 in Great Britain, but the money spent on the prevention of disease was far better spent than that spent on remedial institutions. Hospital expenditure was still going up, and 73 per cent, of it was found from the public funds, added Mr Young. The-cost of maintaining a patient to-day was 15s 9d a day, including overhead expanses, and the average charge a day was 9s. Out of that 9s an average of 3s 6d a day was collected. The contributions from public funds in the way of levies and subsidies were as follows since 1914-15:—’ 1914-15, £443,000; 1925, £1,238,000. During the same period the amount expended per head of the population had increased from 7s 9d to 20s sd. To-day there were 5.4 beds per 1000 of population as compared with 3.4 beds per 1000 of the population in 1914-15. Since 1914-15, 40 • new hospitals had been erected in New Zealand, although most of these had been erected as maternity hospitals. The amount that the Government now had to find for hospital and charitable aid, including the cost of the Government’s own hospitals, was £700,000 per annum. Referring to administration and efficiency, the speaker said that the boards should look for weaknesses in the administrative arrangements. The average fees collected for the year were £65 for each occupied bed. Those boards that had collected less than £6O a bed last year should seriously look into the matter. "So far as the hospital finance system is concerned there is no better in the world, but, notwithstanding that, it should not deter the public from coming forward with voluntary contributions to help the boards in the good work that they are doing,” said the Minister.

The elective system of electing hospital boards was supported by the Minister, who said that it would be maintained as long as he was a Minister of the Crown. In the case of many boards he thought that he should, as a Minister, recognise the voluntary work put in by the members of the boards. He wanted to mention four names. The first was that of Mr C. M Luke (Wellington), who had just, celebrated his seventieth birthday. More than a quarter of these 70 years had been given to the service of humanity. Then there was Mr William Wallace the chairman, who had seen 35 years of service on public bodies. Then, m the case of the North Canterbury Board, he was going to take a risk and say that it was one of the best boards in the Dominion, and there was Mr H. J. Otley, the chairman of the North Canterbury Board. The speaker also referred to the work of Mr W. E. S. Knight, of Dunedin. The Chairman, in reply, said that one thing that had struck him was the vocational training in regard to the social welfare work. He tliought that something could be done if the Government took note of the remit which had been passed time and time again in regard to making defaulting husbands carry out vocational work. He also referred to the provision of maternity nurses for country hospitals, and said that_ they had found it hard to get fully trained nurses to go to their country hospitals. The Minister” said that in regard to defaulting husbands, there had been a distinct advance in the method of collecting fees, but if they could produce some workable scheme he would be prepared to consider the matter very carefully.

PRESIDENTIAL REMARKS. In opening his presidential address, the President said that he felt that he must make reference to certain items on the question of invalidity pensions, particularly as regards T.B. cases. One point could not be too strongly emphasised. “Unless some regular provision in the way of a temporary pension is made for breadwinners affected by tuberculosis, our efforts to persuade patients to undergo early treatment will show but slight success,” said Mr Wallace. “It is difficult to see how a scheme of contributory pensions will meet the position, as the majority of' cases which we have in mind are in indigent crcumstances. They could not come under a contributory scheme.” Referring to the hospital fees of injured workers, the speaker said that he was pleased to see that the Government had announced its intention of having the operation of the Canadian law of accident compensation investigated. “Our immediate difficulty appears to be that, under the Workers’ Compensation Act, at present provision is made only in respect of loss of wages —now up to 66 per cent. — with the addition of a small amount for medical expenses. Hospital expenses in the larger sense are not expressly provided for. Under the scheme operating in some of the States of Canada definite provision is made for the loss of wages up to 100 per cent., reasonable medical and hospital expenses and for getting the injured worker back into employment. One cannot but feel that, so far as we are concerned, a great sum is absorbed in expenses that might well be diverted to paying the hospital accounts of industrial accident cases, and at the same time actually relieving the burden of industry. “I hope that an opportunity will be taken later in the proceedings to discuss the question of unemployment which, for some time past, has been, and still is. a very anxious one. It is a serious question whether hospital boards should have to deal with the relief of the able-bodied.” He thought that the money should come out of the Consolidated Fund. Whilst it was desirable that we should be ready to receive immigrants of the right type into the country, it should be ascertained that the country was capable of properly absorbing them. RESOLUTIONS PASSED.

It was agreed, after a lengthy discussion—That the executive be authorised to confer with a like number of representatives of friendly societies, and with representatives of the Department of Health, withx a view to formulating a uniform agreement acceptable by all the boards and friendly societies. Dr Valintine addressed the conference on the want of uniformity in the staffing of hospitals. He proposed to call together, within the next few weeks, a committee of medical men to discuss staffing and other matters connected with the medical administration of hospitals. If possible, he would arrange for the executive of .the association to meet this committee. The executive’s recommendation regarding a uniform system of records was agreed to. The report o the executive on combined buying by the hospital boards and of standardisation of equipment and supplies was adopted. The question of increasing the widows and children’s benefits under the superannuation scheme was referred to the Parliamentary- Committee, which is to consider the anomalies in the various superannuation schemes. It was decided to ask the Government to amend the fourth schedule of the Act to ensure that no board should receive a subsidy less than 14s per £ of maintenance levy. “That with the new of enabling nurses to qualify for senior positions in hospitals, and for the higher branches of the nursing profession, this conference strongly urges the Government and the university council to make provision immediately for the institution of a post-graduate course for nurses,” was moved by Mrs Macdonald (Otago Hospital Board) and agreed to unanimously. The following officers were elected: — President, Mr William Wallace (Auckland) ; vice-nresidents—Messrs W. E. S. Knight (Dunedin), C. M. Luke (Wellington), and H. J. Otley (Christchurch); Executive Committee —the office-bearers and Messrs F. Gillanders (Hawera), J. Matheson (Invercargill), J. H. M’Carroll (Aratapu), J. B. Andrew (Napier), and the Hon. Mr M'lntyre (Buller) : auditor, Mr G. F. Judd (Wellington). Palmerston North was agreed upon as the locale of the next conference.

THE CONCLUDING SESSION. CHRISTCHURCH, March 3. The Hospital Boards’ Association concluded its annual conference to-day. A remit that the support of the association be given to the movement for the inauguration of a Hospital Matrons’ Council was moved by the Taranaki delegates. Several speakers gave the remit very strong support, and the motion was carried by a large majority. The decision was greeted with applause. “I think that some of the hospitals are taking advantage of these young men,” said Mr M. Fraser (Taranaki), "in giving them less than £lOO per annum. They have hard and responsible work.” This remark was made in the course of the discussion on a remit from Palmerston North proposing that graduates from the University Medical School should be called upon to enter into a 12 months’ engagement wnen taking a position with a hospital board. The complaint was that young medical men only stayed two or three months at the secondary hospitals, and went off to the larger ones to get more experience. It was stated that some boards paid them £9u per annum. “Why should we pat a hobble on young students?” asked another delegate. The Chairman (Mr W. M. Wallace) considered that it was a matter for each board to arrange, and another delegate remarked that the proposal was unfair, as other medical men on the staff could determine their engagement by giving the prescribed notice. The remit was rejected. During the discussion of tuberculosis, Mr G. B. Logan (Hawke’s Bay) endeavoured to raise the subject of having a medical inspection of all over the age of 40, but he was not allowed to by the chairman, .who insisted on his keeping to the subject. When the general business was called, Mr Logan said that he wpuld like members to take. into consideration the establishment of diagnostic clinics in the various centres in New Zealand, both for the sick and well. All over the age of

40 should submit themselves for an overhaul. It was said that the general practitioners should do this, but they did not have the equipment. He would like first of all to see clinics established in Wellington and Christchurch, to which doctors could send patients for a general inspection. The system had worked admirably in America. There were no further remarks, and the subject lapsed.