HOSPITAL SYSTEM

Manawatu Standard, Volume XLIX, Issue 248, 18 September 1929, Page 2

HOSPITAL SYSTEM

VARIOUS ASPECTS EXPLAINED. ADDRESS BY MR J. K. HORNBLOW “The hospital question is one of most vital importance to the Unless we can build up a healtny nationhood, we will not have any prosperity despite a fine educationa system,” said Mr J. K. Hornblow chairman of the Palmerston Nortn Hospital Board, in addressing tne Lunch Club yesetrday on various matters in connection with the hospital SJ Mr il. A. Eliott, who presided in introducing Mr Hornblow stated that the hospital question was a large one, and there was no one more competent than Mr Hornblow to deal with it. In his opening remarks Mr Hornblow referred to the presence of Messrs L. R. Bryant and C. R. Luke. He had sat with the former on the Hospital Board 29 years ag6 and could testily to the excellent work be had done. All Luke’s father had lor many years done yeoman service for the V elhngton Board and was still carrying on the good work as chairman. LOCAL INSTITUTION.

Touching for a moment on the local institution, the speaker paid a tribute to the managing-secretary, Mr A. JPhillipps. There were only two men in New Zealand, he stated, as competent to manage a large hospital. In indicating possible developments of the hospital system, Mr Hornblow stated that there were many things to be done to bring it to the point lie hoped it would reach. One of the most important things to his mind was for the Health Department to get lecturers to go among the people and teach them how to live. The present mode of living was the cause of many illsl'hey had such experts in California to-day. The Americans were of the opinion that if the people knew how to live they would live to a greatei age and in a much more healthy condition. , i The first hospital legislation, _stated the speaker, was passed in 1885 and prior to that there was no definite system. This Act created a number of hospital districts, a Government subsidy being given on voluntary contributions. Right from the start the system had been meant to provide loi the indigent. At the outset it had been undei the direct control of the local bodies. A further Act was passed in 1999 and this was amended and consolidated in 1926. This set up 47 hospital districts. “TOO MANY HOSPITALS.” In Dr Valintine New Zealand had one of the best men in his own line in the world. He claimed that 22 districts were sufficient and would be in* finitely more efficient. Hospitals equipped with the latest medical devices should be put in the large centres and made thoroughly efficient. He (the speaker) was in agreement with the Director-General of Health. Experts of the world were of the opinion that the establishment of base aus pita Is and the cutting down of smaller institutions was necessary. Reverting to his statement about the origin of the system in 1889, Mr Hornblow pointed out that to go back to the old way of local bodies controlling the hospitals would not be economic as it would tend to create more small institutions instead of a fewer large The objeet in the local hospital was to give an institution complete in every detail. They had the bacteriological department, with a complete laboratory and there was also an X-ray plant so that exploratory operations were unnecessary. Supposing Palmerston North had to look after its poor and distressed, with a similar institution they could not do it for what it was costing them to participate in the present hospital. “SYSTEM SECOND TO NONE.” The system of financing fne operations of hospitals in New Zealand was second to none in the world, continued Mr Hornblow. At the commencement of each year the expenditure and the revenue from patients fees were estimated and the deficit was made up by levies on the surrounding local bodies supplemented by a Government subsidy. The subsidy was £1 for £1 on capital expenditure and on a sliding scale, varying from 14s to 26s for £l, on maintenance costs. The principle adopted was that the higuer the levy the higher the subsidy and vice versa. Palmerston North’s subside last year had been 16s Id. Hospital rates did not exist in England where a voluntary system prevailed. The English Government had had to give the hospitals Targe grants, however, to assist the finances of these institutions. In Australia the system was much the same. New Zealand lea the world in hospital matters, but it had not yet reached its objective. Personally, he thought that ' n ,,^r e future a contributory system would be devised. Investigations on these lines were being carried out, but he could say no more about that at present. DEMOCRATIC REPRESENTATION.

Ho hoped that no Government would ever alter the democratic principle of the people electing their representatives on the boards, continued Mr Hornblow. The people slmulrl never agree to contributing authorities nominating their appointees. That was-the people’s right and should be jealously guarded. Amy contributing authority had power uiiaer the Act to call for a commission to investigate cases of maladministration should such exist.

The Health Department knew that the boards had administered hospitals more economically than the department could. An instance of this was the likelihood of the department placing sanatoria under the control of the ’ boards. This would probably take place within the next 12 months. Mr Hornblow continued that he looked forward to the day when a ward for chronic cases would be established in Palmerston North to deal with indigent incurables. It had been the ambition of the late Sir James Wilson to have a T.B. clinic established in the middle of the town so that many people might be saved from the terrible scourge. That had been done, but on the previous day tho board had unfortunately decided to close it down as the lack of support was such that its continuance was not warranted. In conclusion, Mr Hornblow stated that to the best of his knowledge every £1 that had been 6j>ent oh the Palmerston North Hospital had been well spent and value had been received for it. When ihey had as much knowledge of the working of it as he had, they would realise that it was economically administered. They were going to make it second to none in the Dominion. They were not going to penalise the cut districts of the board’s area. In this connection they were giving young women the bhst of training before sending them out to care for those at a distance from the Hospital under the district nursing scheme. Mr J. R. Cunninghame, in moving a vote of thanks to the speaker took the opportunity to thank Mr Hornblow for the fine service he was doing tho district. As far as the T B clinic was concerned the lack of support, he felt, had been largely due to ignorance of its existence.