HOSPITAL CHARGES

Timaru Herald, Volume CXLIII, Issue 20667, 4 March 1937, Page 5

HOSPITAL CHARGES

QUESTION OF RECOVERY SECTION OF ACT UNDER FIRE The attention of the Hospitals Conference was occupied for a considerable period yesterday discussing remits dealing with the recovery of charges between hospital boards. The Wellington and Tauranga Boards moved: “That Section 92 of the Hospitals and Charitable Institutions Act, 1926, and its amendments be abolished.” North Canterbury and Waitaki moved: “That Section 92 of the Hospitals and Charitable Institutions Act be repealed.” The two remits were discussed together. Mr J. Glover moved the motion on behalf of Wellington, stating that it was not the first time the remit had been before conference, and for that reason it would not require a great deal of explaining. There were one or two reasons, however, why they were in favour of the abolition of the section. The first reason was that it created difficulties and brought various boards to loggerheads and for that reason it would be better to abolish the section. Patients on admission had to be seen for the necessary information, and this was often vexatious. The section was parochial in spirit, and if it was to be retained, then it would have to be reworded. Another point was that the section entailed a great deal of extra clerical work. In Wellington alone they had to keep one man on this work, and nothing else. They wanted to do their best for patients, and discard everything that might hinder their recovery and the abolition of the section would do much to this end. Mr L. B. Evans (North Canterbury) seconded the motion.

Mr P. Lumley (Tauranga) said that it was gratifying to find the larger boards helping them in their long drawn out fight. There was no section of the Act which had caused so much friction as the one urder discussion. Mr J. Rodman (Waitaki) said that if the national health scheme camo about, then some change would be necessary. The question was largely one of detail of administration, and secretaries appeared to be more conversant with the matter than members of boards were. They were agreed that difficulties did exist, and it seemed generally agreed that some change was necessary. Remits Opposed

Mr A. J. Phillipps (Palmerston North) said that he had been instructed to oppose the remit. Similar propositions had come forward previously from the larger boards, but generally they had been accompanied by a proposal to give grants to base hospitals, and the present proposal seemed to be a move in the same direction. He asked if those supporting the proposition would be prepared to break down the barriers and say that the subsidy rate should be given right through. Another aspect was that they sent a number of special cases from their own district to Wellington, for instance, for treatment. Even If the section was abolished, they would continue to send special patients, but would they get any cases from Wellington? The abolition of the section would penalise boards such as their own. Mr A. Rees (Hawke’s Bay) said that there appeared to be a landslide in favour of abolition, and they were going to do their best to stop it. He pointed out that it would be an injustice to the smaller boards to abolish the section. A good many people went to certain towns because they were reputed health resorts, and should they become a charge on the hospitals in those districts? The carrying out of the section required only a little patience. It was not difficult to trace where people came from. He had all the electoral rolls for New Zealand and he could find any particular persoi. in five minutes. (Laughter).

Mr F. Castle (Wellington) spoke in favour of the remit, stating that he considered that the hospitals system would run far more smoothly If the section was abolished because a source of friction would be removed.

They had to place hospital service within the reach of all, regardless of domicile, and he did not think any board would abuse this opportunity. A Wrong Move The Rev. C. W. Wood (Auckland) opposed the remit, stating that he thought it a wrong move to do the right thing. He was in agreement with a national system of hospital servicing, but to do that they would have to alter the incidence of taxation. So long as it remained as it was, it would be unfair to remove the section. He had never heard any instance of boards being at loggerheads. If the section was done away with, the Auckland Board would lose nearly £9OOO a year. Another difficulty would be that of accommodation. There would be a tendency to centralise and this would not be in the best interests of the whole Dominion.

Mr W. E. Broderick (Wanganui) spoke in support of the remit, stating that Mr Wood had given them only one side of the question. He asked how many outside patients admitted to the Auckland hospital had been able to pay their own fees. The question of indigent cases came into the matter very largely, and if the section was done away with, a lot of unpleasantness would disappear. Mr E. H. Potter (Auckland) opposed the remit. He said that it looked as though some boards were desirous of extending their boundaries, and in the interests of the smaller boards it would be tetter to stick to the present system.

Mr C. O. Morse spoke on behalf of the Waipawa Board, and said that if the section was abolished, this board would have to seek a measure of protection. If a national health scheme came into operation, a good many of the present troubles would disappear. Mr J. Macfarlane (Auckland) said he did not consider that the question was a national one. He said that if one was a member of the Auckland Board, and saw the outside cases which had to be handled, they would agree that the obligation to keep those people should not be on the shoulders of the Auckland people, but of those in the districts from which the patients came. Members might not know it, but they had to take outside patients to the exclusion of their own, and it was not right. He moved an amendment that consideration of the remit be deferred pending the bringing into operation of the national he .Ith scheme. The Hon. F. Waite (South Otago) pointed out that if the remit was carried, it would mean that a number of other remits would go by the board. Main Points Mr A. F. Quelch (Otago) said that the question had come before the conference on many occasions. It occurred to him tha„ the best thing he could do was to get down to the main points. One was that the Act caused a lot of work for the secretaries of the boards. They were asked to submit suggestions to the Department for the carrying out of the Act. but the fact that it caused extra work was not sufficient reason why the section should be repealed. No board could be charged with not giving efficier.': service, so why should people go from one district to another to try to avoid payment. Otago had the training college for medical students, and for that reason many people drifted to Dunedin for treatment. If the section was repealed it would mean £3OOO a year to the ratepayers of his district. The matter might be difficult to adjust, but they had to be just to their ratepayers. He also instanced the drift to Dunedin of many people because of the reputation of one of their doctors as a goitre specialist. If the remit was carried, it would be an injustice to the Dunedin ratepayers.

Mr J. F. Thompson (Wairarapa) submitted that the clause had outlived its usefulness. They contended from their figures that the burdens and benefits were substantially equal. What they gained from one part of the clause was lost from another part of it. They had to remember that the Crown bore a large proportion of hospital expenditure. The amendment on being put to the meeting, was heavily defeated. Mr A. H. Carman (Wellington) discussed the figures quoted by Auckland, and said that the £6OOO loss which Auckland had emphasised would not be a total loss, as part of it would be collectable from patients. Auckland received more than 50 per cent, subsidy, so that half the amount would be recoverable from the Government. Boiled down, the amount which the Auckland Board would lose did not warrant the time that had to be expended on investigation. A vote was then taken on the motion, and it was declared carried.