The Hospital System

Patea Mail, Volume LIII, 9 March 1932, Page 2

The Hospital System

Dr. Campbell Begg’s Proposals Mr A. T. Christensen Speaks Out Some Interesting Figures Quoted

At the meeting of the Patea Hospital Board, held yesterday, Mr. A. T. Christensen made some very pertinent remarks with regard to the new system of hospital management proposed by Dr. Campbell Begg, of Wellington.

Thu Hawera Hospital Board wrote asking support for a resolution protesting aguigst the proposed changes in the hospital system. The Palmerston North Board also wrote and suggested that before any proposal to alter the existing system is considered by Parliament the matter should first be investigated by Hospital Boards at a general conference. The Wellington Hospital Board wrote forwarding a copy of recommendations adopted with regard to the proposed changes in the present hospital system. In moving that the Patea Hospital Board protest against any change being made in the present system until the matter had been thoroughly discussed by a conference of New Zealand Hospital Boards. Mr. A. T. Christensen said ho would give the following figures taken from the latest official year book and Departmental reports illustrating how ridiculous was the proposed scheme and how unfair it would be on the smaller hospitals. Total cost to public funds of hospitals in the Dominion for the years 193.1-32, 1930-31, and 1929-30 respectively,, ;is £1,290,4.73, '£1,591,515, and £1,583,769. Cost per head of population for the same period, 17s 3d, 21s 3d, and 21s Bd. Bate of levy per pound of rateable capital value for the same years, 0.219 d, 0.274 d, and 0.281 d. This shows a reduction of over £301,000, but since the annual report was printed the Government has made a grant of £75,000 owing to the great demand for charitable aid. Average number of beds occupied per 1000 of population: 1930-3.1, 3.9, 1929-30 4.1. Average maintenance cost of general hospitals controlled by Hospital Boards: 1930-31 £204.5, 1930-31 £205. Cost per patient treated: 1930-31 £l2, 1929-30 £l2. Sources of revenue received, percentage of total revenue arc as follow:

were closed down a saving of only £250,000 would be made, while several million pounds' worth of capital expenditure in the closed hospitals would be lying idle. The thing was an at surdity. Dr. B.egg argued that specialised treatment would be available ti all patients if the hospital work weia centralised. The country doctors ol New Zealand, however, had proved that they were quite capable of handling practically all cases, whilst at the present time the special cases were sent away for special treatment. With regard to the cost of the smaller hospitals, Mr. Christensen pointed out that the Government subsidy in Patca was Ids 6d in the £, Stratford Ids 9d, Hawera 16s 9d, Auckland 19s 2d, Wellington 19s lid, and Dunedin 22s lid. This went to show that the economy advocated by Dr. Begg should begin in the larger hospitals and not in the smaller, Mr. Christenson went on to say that the rate of levy .per £ of rateable value showed that the smaller hospitals, compared more than favourably with the larger. For example, Dunedin's levy was .330 d in the £, whilst Patea’s was only .085 d; Wellington’s being ,23dd and Auckland .2ddd. The capital and maintenance cost of the local hospital was amongst the smallest in the Dominion, whilst its management expenses were actually the lowest in the Dominion. With regard to the charges for treatment, again the smaller hospitals showed a substantial saving to the public, when compared with the larger institutions. The Auckland, Wellington, and Dunedin charges were £d 4s for adults per week and £2 2s for children, whilst Patca's charges were £3 17s and £1 18s 6d respectively. Stratford’s charges were £3 10s and £1 18s Gd, The Patca Hospital, Mr. Christensen said, had never cost the ratepayers a penny for erection, and the same could be said of the Nurses’ Home. The hospital was thoroughly up to date -with an expert surgeon and doctor, who was quite capable of coping with any case that came along. The spirit of fellowship and goodwill existing between the institution and the people had been responsible for several substantial bequests being made. If the feeling got abroad that good treatment could only be obtained in the larger hospitals, they would not get such good doctors in the country. The centralising of hospitals would create class distinction and cause untold discontent. A poor person could not travel long distances to see a sick relative and great hardship would result. Under the proposed new scheme a Manutahi patient would have to go to Wanganui and his family would have to travel thither to see him, entailing a journey of 100 miles, and at a conservative cost of Gd per mile, a cost of at least £2 10s. Frequent contact with relatives and friends played a large part in the healing of the sick. Only that morning ho had seen a little child in the local hospital who had cried for his mother, and had brightened up considerably on being told that ho would soon sec her. A scheme that compelled relatives to make long journeys to see those near and dear to them who were sick was a diabolical one. In addition to the expense already mentioned, there would be the extra cost of transporting the dead from the large centres to the districts they came from. British fair play demanded that the question of altering the present hospital system should be fully discussed by the boards concerned before 54 of them were wiped out of existence. Anyone could see that the scheme had beer worked out on paper only, and had not been gone into in a practical manner. The resolution was seconded by the chairman and carried unanimously, and it was resolved that a copy of the resolution be sent to the Hospital Boards' Association.

Auckland: Government subsidy, 40.9; levies local bodies, 37.3; fees, 15.5. Wellington, 40.0, 35.9, 17.1. Taranaki, 37.2, 32.4, 26.3. Stratford, 29.3, 33.2, 30.1.

Patea, 27.3, 31.4, 37.6. Continuing, Mr. Christensen said that Dr. Begg, who was an eminent medical man of outstanding ability, had given not the slightest indication in his proposals as to how the £500,000 was going to bo saved. Dr. Begg had stated that according to the highest authorities, two beds per 1000 of population were sufficient.- The official figures showed, however, that Taranaki, with a population of 70,000, had no less than 265 beds occupied, made up as follows: Now Plymouth 153, Stratford 33, Hawera 78, or 125 beds more than Dr. Bogg’s estimate, New Plymouth alone having 13 more occupied beds than Dr. Begg had estimated for the whole of Taranaki. Was Dr. Begg going to debar these people from hospital treatment, or did he suggest that they must not be sick? All this advice came from Wellington, whore there were clinics, and the -.best medical advice was available, and yet what did they find there*? 3.9, or nearly 4 occupied beds for 1000 of inhabitants to-day, or nearly double what Dr. Begg says should be sufficient. Why did hot Wellington show better returns? All the leading hospitals in New Zealand —Wellington, Auckland, Christchurch, and Dunedin —showed double the number of occupied beds that Dr. Begg says should be sufficient. The cost per occupied bed in Wellington per annum was £232 ss. The cost in Patea was only £195 Is. The cost of food in Wellington was £25 3s per patient per annum, in Auckland £27, Dunedin £22 9s, Hawera £2O os, Stratford £l9 Is, and Patea £24 4s, proving that the smaller hospitals compared more than favourably with the larger ones, particularly with regard to the medical and nursing staffs. Let Dr. Begg reform the larger hospitals first.

Continuing, Mr. Christensen said it the 54 hospitals suggested by Dr. Begg