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5
Laundry.—In certain cases, where the hospital has a laundry which
carries out washing for other establishments, the cost of laundrywork for the
hospital itself may appear unduly low. This is due to credit for the laundrywork
performed for the other establishments being set off against the local
cost at a fixed rate, year by year, this charge including an annual proportion
in respect of special works to maintain the laundry, which are only required
at intervals of some years and of which the expenses are defrayed in the year
in which they are incurred.
In considering comparative costs in the case of a large group of hospitals, it
must be borne in mind that there are, and always will be, in each individual
hospital many influences at work affecting the cost per bed which cannot be curtailed
or removed even by the most determined of economists, except to the detriment of
the patients. These factors are, of course, well known to all experienced hospital
administrators, but are apt to be overlooked by those who study hospital finance
from a purely statistical point of view.
Out-patients'
departments
During the year organised out-patients' treatment was provided at 23 of the
general hospitals, and the allocable expenditure upon these departments has been
excluded from the total expenditure in computing the costs per in-patient.
Antitoxin
establishment
and
pathological
laboratories
The cost of the Belmont antitoxin establishment, the group laboratories and
the histological laboratory is spread over the hospitals to which sera and other
material are supplied, and for which specimens are examined and other services
rendered, and is, therefore, included as part of the cost of maintenance of those
hospitals. Smaller laboratories are maintained at a number of the general and
special hospitals, and the cost is included in the expenditure of those hospitals.
District
medical
service
The cost of the district medical service is kept distinct from, and is not included
in, the expenditure of the hospitals. The total cost of this service during the
financial year was £40,024.
Ambulances
The costs of maintaining the two sections of the London ambulance service
for the financial year 1934-35 are set out in table I in this volume. No allowance
for depreciation has been made, as the cost of supplying new vehicles to replace
wastage during the year has been included in the figures.
During the period in question a system of mutual support between the two
branches of the ambulance service was put into operation with a view to securing
greater flexibility. This entailed overlapping of the functions of the two branches
and has naturally affected the costs. The cost is based on the total work
performed by each branch, but at the same time particulars of the work properly
belonging to each branch are shown.
Laundries
Table J in this report provides a comparative return for the year ended 31st
March, 1935, of the results of the laundry service. It will be seen that this table
includes not only cost figures but other statistical information of general interest.
The table is based on patients' washing, including clothing, bedding and house linen
and on staff washing, including house linen, etc., uniforms and personal
clothing.
When considering this table it should be borne in mind that a number of laundries
wash for establishments other than the hospital at which they are situated.
In calculating the costs of washing in a laundry all the washing done is taken into
account, but in calculating the number of pieces washed per occupied bed, for example,
only the washing which relates to the occupied beds at the hospital concerned is
included, so that it will not be practicable to reconcile the figures in certain columns
with the items appearing in other columns of the table.
There are certain other elements depending upon purely local conditions, types
of patient and the like, which cannot be dealt with adequately in tabular form or
indeed in any brief form which would enable a reader unacquainted with the local
conditions to assess them satisfactorily. For example, the output per head of laundry
staff is based strictly on the paid staff and takes no account of the number of inmates
employed, which is given in the last column. This results, in one or two cases, in an