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2
As a result, large quantities of stock have either been transferred, thereby
obviating the purchase of new materials, or disposed of by sale.
It has been found possible to reduce the quantities of stock of all kinds held at
hospitals at any one time, representing a reduction of value from approximately
£250,000 in 1930/31 to £145,000 in 1934/35.
Outdoor
dispensary
service
On 1st July, 1933, the opportunity to supply medicines to out-door cases in
certain districts was thrown open to all local chemists, instead of being limited to
certain approved firms. The following figures indicate the extent to which advantage
has been taken of the scheme :—
Year ended
Prescriptions dispensed.
Value
Average cost per prescription
31st March, 1933 43,700 £1,593 8.7d.
31st March, 1934 66,756 £2,427 8.7d.
31st March, 1935 85,466 £3,134 8.8d.
The number of chemists who have availed themselves of the arrangement is
already 780 (73 before the change) and the area covered is being extended, thus
accounting for the increase in the number of prescriptions dispensed.
Costings and
financial
statistics
It was pointed out in previous reports that, as a result of the greatly differing
standards of expenditure and practice adopted by the late authorities, and
prevailing both at the date of transfer and in the subsequent transitional period
when salary, wage and dietary scales varied so much, the costing figures published
for the Council's earlier years of control could not be regarded as affording fair bases
for critical comparison of one hospital with another, though they do in fact reflect
the actual conditions which prevailed during those years. For this reason, changes
in practice and in accounting should be borne in mind and allowance made therefor
when comparing, in detail, the tables in this report with those published for earlier
years.
Apart from these changes, the costs are still affected by the differing standards
and conditions referred to above (p. 1), and the rectification of differences of cost
will be continued until such uniformity as is possible is attained.
The financial tables embodied in this report distribute the total net expenditure
on in-patient treatment for each hospital for the year 1934-35 under selected
sub-heads.
The heads relating to expenditure upon staff pay show in total over the past
five years an increase in cost per patient per week. This is due to the necessity for
strengthening the staff in certain directions, mainly nursing staff, and to the
regrading of the numerous classes of staff taken over from the late authorities.
The full effect of these operations will not be seen until the staffs have been well
established in the new grades and equilibrium has been attained, i.e., the point
reached at which the balance between new staff and those at the maximum of the
scales is normal.
Main factors
in costing
Important factors influencing cost of maintenance per patient per week in a
hospital are:—
Percentage occupation of the available beds.
Salaries and wages of staff.
Engineering and works services (including wages).
Cost of provisions, drugs and dressings.
Percentage occupation of the available beds—
Given a reasonably level expenditure on the main services, the most important
single factor influencing the weekly cost of maintaining a patient in hospital is the
relation between the number of beds provided and the average number occupied.
A comparison of percentages of occupation and an understanding of the reasons for,
and effects of, variation in them is therefore essential if costs are to be judged
correctly.
With the exception of provisions, drugs and dressings, all major cost items depend
on the number of beds provided and not on the number occupied, but, as the weekly
cost per patient is arrived at by dividing total expenditure by the number of beds
occupied, the influence of percentage occupation on the weekly cost per patient is
apparent. There are so many factors not within the control of the hospital which