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apparently extraordinary output per head of the laundry staff, but, on the other
hand, it is not practicable to attempt to attach a value in units of efficient workers
to any number of unpaid inmates employed, who may vary from very useful
assistants to individuals employed merely to keep them occupied.
Conclusion
It is quite clear that some years yet must elapse before many obligations
inherited from the metropolitan poor-law authorities, which involve the Council
in substantial cost, can be extinguished. Moreover, in the process of reorganisation
of the service it has become obvious that both economy and efficiency can be
ultimately attained only by the provision of much new plant and equipment,
structural alterations, additional staff, etc. All this means considerable immediate
expenditure, a large portion of which, in accordance with the Council's policy,
is chargeable to annual maintenance costs, and is therefore reflected in the cost
per bed. The heads of account mainly affected during any one year by such special
expenditure above the average are surgery and dispensary (surgical or X-ray
equipment, and the like); furniture and equipment (bedsteads, lockers and other
ward equipment); and "special works" (substantial non-recurring minor alterations
or extensions).
Grouping of hospitals.
In the grouping of the hospitals in the following tables a notable departure
from the procedure of former years will be apparent. Under the provisions of the
London County Council (General Powers) Act, 1934, section 58, the Council has
become empowered to group establishments wholly maintained by the Council, in
cases where the activities are similar, to permit the application of a flat rate of
charge for maintenance in respect of each group for all purposes of recovery of cost
of maintenance under prior statutes, and the tables in this volume are therefore
arranged in conformity with the revised groupings.
This grouping for the purpose of applying a "flat-rate" charge has one
important administrative result—that where it is desirable for medical reasons to
send a patient for special treatment to another hospital within the same group,
objections on the part of the patient do not arise on the grounds of difference in
cost.
Detailed particulars of the work carried out at each hospital are shown on the
pages facing the corresponding tables.
Means and averages.
Columns have been provided in the majority of the tables showing in respect
of the weekly costs at the hospitals within each group (i) the means of the costs in
the group, and (ii) the average cost per patient for the group. The costs under
(i) are provided to show at which of the hospitals the costs are above or below the
"mean." This information is valuable for purposes of administrative control,
inasmuch as it shows, not only as regards the total costs but also as regards the
detailed heads at each hospital, the extent of the deviation from the mean of that
detail cost.
The average costs under (ii) represent the net expenditure at all the hospitals
comprised in each group divided by the total number of patient-days in each group,
and they therefore show under all heads of expenditure the "average weekly cost"
to the Council of maintaining a single patient in that group of hospitals.