A national health service : draft memorandum on the government's proposals
1944-04-14 1944 1940s 14 pages - 6 - conflicting statements to have caused anything but dismay and a profound sense of insecurity amongst those who are interested in the survival of the voluntary hospitals. In fact, of course, the service is far from free to all as has since been admitted; indeed a...
| Institution: | MCR - The Modern Records Centre, University of Warwick |
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| Language: | English English |
| Published: |
14 April 1944
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| Subjects: | |
| Online Access: | http://hdl.handle.net/10796/D83F5144-CCE3-4CB8-B360-82597787A49E http://hdl.handle.net/10796/6A2FFC7F-526D-4A4C-BCF3-64F6DA979A43 |
| Summary: | 1944-04-14
1944
1940s
14 pages
- 6 - conflicting statements to have caused anything but dismay and a profound sense of insecurity amongst those who are interested in the survival of the voluntary hospitals. In fact, of course, the service is far from free to all as has since been admitted; indeed an examination of the financial set-up in Appendix B of the White Paper indicates that the hospital service is to cost approximately double what it cost in the last financial year before the outbreak of the war, without there being apparently any immediate addition to the existing hospital service. We desire to emphasise at once that no comprehensive hospital scheme could be acceptable to the voluntary hospitals which, by its very nature, and the pronouncements of the government in relation to it, would render it completely impossible for the voluntary hospitals to enjoy a continuation of that voluntary support which is an essential part of their make-up, and is the basis of their freedom and autonomy. 13. - Payments by Local Authority The proposals for the payment to hospitals of public monies contain features which the voluntary hospitals could not accept. Briefly, these proposals are that the voluntary hospitals, in common with the local authority hospitals, shall receive an annual grant from government funds of say, £100 for each bed provided under the scheme. The remainder of the income necessary to provide for their expenditure is to be made up of payments from the Joint Authority of the area, and of such monies as might be donated from voluntary sources. If the proposed financial arrangements are retained, this latter, it is contended, must dry up in course of time, with the result that the voluntary hospitals will have to rely for the vast bulk of their income on these payments from local authorities. A system based on contractual payments by Joint Authorities to voluntary hospitals would in any case be open to grave objection on the ground that it would tend to restrict the patient to hospital services in the area of the Joint Authority in which he happened to reside. Even if the administrative structure were so adjusted as to meet the objections of the voluntary hospitals, a situation in which they relied almost entirely for their income on the goodwill of the local authorities would reduce them to a position of subservience which could in no circumstances be tolerated. It is clear that some other method must be found for providing the voluntary hospitals with the means to carry on their work, and it is emphasized that whatever method is ultimately decided upon must be such as will leave room for the necessary incentives to the public to continue their voluntary support. 14. - Essential Modifications to Financial Proposals. It would seem that a satisfactory alternative is to be found in a simple modification of the proposals contained in the White Paper, namely, that the voluntary hospitals should receive no payments from the Joint Authority and that the whole of the exchequer payment in respect of their services should be paid direct to the voluntary hospitals. Since our proposal is not necessarily that the sum total of the exchequer payment for hospital services should be increased, it would follow that there might be a corresponding decreased in the exchequer grant made to the local authorities. This, however, would be counterbalanced by the increased amount available to the municipal hospitals from the local rates by reason of the absence of any liability on the Joint Authorities to make service payments to voluntary hospitals. The advantages of such an arrangement are apparent. Firstly, since the commencement of the war most voluntary hospitals have received payments from government funds for services rendered in connection with the Emergency Medical Service. These payments, largely because they have been made centrally, and are specifically stated as being for services rendered, have not affected the flow of voluntary money to the hospitals. It is considered opinion of the voluntary hospitals that payments from the rates would, on the other hand, operate very definitely against this flow of (contd.)
292/847/2/33 |
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| Physical Description: | TEXT |