THE WAIPA POST Printed on Tuesdays, Thursdays and Saturdays. THURSDAY, 19th APRIL, 1928. HOSPITAL EXPENDITURE.

Waipa Post, Volume 36, Issue 2146, 19 April 1928, Page 4

THE WAIPA POST Printed on Tuesdays, Thursdays and Saturdays. THURSDAY, 19th APRIL, 1928. HOSPITAL EXPENDITURE.

A RECENT statement by the Minister of Lands, that the burden of local taxation on country settlers was rapidly becoming intolerable, has been vigorously challenged, and some of the writers in our contemporaries have quoted the Local Authorities' Handbook as the authority for figures showing that of the rate revenue collected by all local bodies 57 per cent was provided by the towns and 43 per cent by the country. These statistics have their undoubted value, but it is necessary that they shall be subjected to a close analysis before Mr McLeod's statement can be dismissed as ridiculous and inexcusable. In respect of one form of local rating—that imposed for the maintenance of the hospital and charitable aid system -—there is some reason for the complaint that the country settlers are being required to carry a burden that is greater than they should be expected to bear. It is, of course, generally known that the public hospitals of New Zealand are under the control of hospital boards, and capital expenditure is under the supervision of the Minister for Health; but we venture the opinion that not many people realise that during the last ten years for which figures are available, in addition to rebuilding or extension of existing hospitals, no fewer than forty new hospitals have been established. Naturally, in these times of increased cost of living, the cost of maintenance has almost doubled during that period and capital expenditure increased by leaps and bounds. The cost per head per "day of each patient in a public hospital is not less than 15s, but the average charge made is not more than 9s a day. Payments by patients total to not more than 20 per cent of the cost of mainatenance of hospitals, which are supported mainly by Government taxation and local rates. There are 46 hospital districts in New Zealand. When the Hospital Act was framed in 1908 the Health Department proposed only 20 districts, but Parliament more than doubled the number, and is not likely to make any substantial reduction. Forty-six districts with 48 boards seem to make for too cumbersome a framework, and militate against both efficiency and economy.

In passing, a point worth noting is that a patient in a small district, who is without means, cannot enter a large hospital in an adjacent district unless and until the board of the former district guarantees payment. But to revert to the question of how the cost is borne by town and country dwellers. The Heatlh Department, while holding that the existing system under which the difference between the cost of the hospital and charitable aid system and the amount received from those able to pay for maintenance and treatment in. hospital is made up by taxation on the ratable capital value, admits that at a time

when many members of the farming class are, in effect, paying rates and taxes out of capital, it is " not entirely unreasonable for them to complain." In this admission the Department penetrates to the root of the trouble. But the whole matter of the growth in hospital expenditure may well excite concern. It is disquieting not only to country settlers but also to residents in the towns.

Some towns, and cities, too, have to face increased levies, and they do not exactly appreciate the fact. Our Dunedin contemporary, the Otago Daily Times, has been at some pains to compile comparative figures to convince objectors, for Dunedin has had ah increase in local rating. " The increase in the rate of levies there during the past decade has been 62 per cent, and, when this is compared with an increase of 23 per cent in the population, it is difficult to conceive that it has not been disproportionately great. A correspondent asserts that no less than 77 per cent of the huge shortage in hospital maintenance fees falls on the shoulders of country ratepayers. Details of the grounds upon which this calculation has been based may perhaps be needed before it can be acceptable as wholly incontestable, but there is direct official confirmation of the view that, if the hospital levies were collected on any basis other than that of the capital value of land, the country would have to make a contribution to the maintenance of the hospital system substantially smaller than it is now making. This confirmation is contained in a series of data set out in an appendix to the last annual report of the Health Department: Population of counties (41 per cent), £514,524; population of boroughs and independent town districts (58 per cent), £822,042; ratable capital value of counties, £332,126,628; ratable capital value of boroughs and independent town districts, £233,183,350; total, £565,309,978. Total levies of Dominion for 1927-28 (0.266 d on ratable capital value), £625,919; of which counties and road districts pay £367,733; and boroughs and independent town districts pay £258,184; if paid entirely on a population basis, counties and road districts would pay (or 0.174 d on ratable caiptal value), £240,954; boroughs and town districts would pay (or 0.396 d on ratable capital value), £384,965; if paid on a 50-50 basis, counties and road districts would pay (0.222 d on ratable capital value), £304,344; boroughs and town districts would pay (or 0.331 d on ratable capital value), £321,574.