H.—Bla.

20

Hospital Patients from other Districts. (h.) Your Commission is of opinion that Boards of hospitals taking in patients from other districts should not look to the Boards of those other districts for the patients' fees, except where the patient enters the hospital on the order of his Board. An exception, however, should be made in the case of the base hospitals at Auckland, Wellington,* Christchurch, and Dunedin, so long as the special contribution of subsidy for the maintenance of special Departments continues, when the Boards of those base hospitals should be compelled to admit any bona fide resident of another district needing special treatment, and should be permitted to charge the Board of the patient's district the fees incurred. Your Commission recommends that legislation be passed to give effect to the foregoing. Preventive Treatment. (i.) Your Commission received evidence upon the possiblities of preventive treatment being the means of reducing the number of hospital patients and thereby lessening hospital expenditure, and formed the opinion that it is practicable by propaganda work on the right lines materially to improve the health of the community. " I feel confident," said Dr. Herbert, of Wellington, " in stating that onethird of the diseased conditions which force patients into public hospitals is preventable " ; and he then emphasized the necessity of' medical inspection and physical training of school-children. Dr. Colquhoun, of Dunedin, was emphatic upon the necessity of " fresh -air schools " as a means of raising healthy school-children, and Hon. Dr. Collins, of Wellington, spoke on similar lines. Your Commission is of opinion that an increased effort to prevent disease should be organized by the Health Department, and attention should be directed towards ensuring healthy conditions in our schools ; the restriction of movements of infectious-disease " carriers," and those suffering from active venereal diseases ; proper inspection of children's teeth ; effective medical inspection of immigrants and ships' crews to detect infectious or contagious diseases ; destruction of rats, flies, and other vermin carriers of disease. Your Commission further considers that liberal encouragement should be given by the Government for medical research work, more especially in regard to diseases that are more prevalent here than in other countries. In witness whereof we have hereunder set our hands and seals, this thirty-first day of May, in the year one thousand nine hundred and twenty-one. Vernon H. Reed, Chairman. H. T. D. Acland, \ G. Shirtcliffe, Members . A. F. Hawke, W. H. Triggs, )

SUMMARY OF RECOMMENDATIONS. 1. (a.) The Government should contribute one-half of the capital requirements of the Hospital Boards. The basis of such contributions should be a flat rate subsidy of £l for £l on capital expenditure, and on interest on loans current in respect of capital expenditure. (b.) The cost'of minor capital works, and all plant and equipment, should be provided for otherwise than by loan. The cost of erecting buildings, or of making additions or alterations to buildings, or of purchasing land,may be raised by loans. Loans should be repayable by sinking fund within a period not exceeding twenty years for permanent buildings-and land, and ten years for wooden or other nonpermanent buildings. The Government should provide facilities for Hospital Boards to obtain loans on the most advantageous terms. 2. (a.) The Government should contribute one-half of the net maintenance requirements of Hospital Boards.