Sixth report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee D and appendices, session 1956-1957: Running costs of hospitals.

  • Great Britain. Parliament. House of Commons. Select Committee on Estimates
Date:
[1957]
Catalogue details

Licence: Public Domain Mark

Credit: Sixth report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee D and appendices, session 1956-1957: Running costs of hospitals. Source: Wellcome Collection.

    25/448 page 3
    29 January, 1957.] [Continued. Finance of the Service 10. Hospital maintenance expenditure falls wholly upon the Exchequer subject to the following qualifications : — (a) Boards and Committees have varying amounts of income of their own from endowments, gifts, etc., which are generally referred to as non- Exchequer funds. These funds may be divided into: — (i) those which were in existence on the Appointed Day, 5th July, 1948, and (ii) those which have been received since the Appointed Day under Sections 59 and 60 of the 1946 Act. The endowments in category (i) relating to teaching hospitals were vested in the Boards of Governors and freed from existing trusts. Subject to minor exceptions, the endowments of all other hospitals in the same category were freed from existing trusts and vested in the Minister who established a central fund, the Hospital Endowments Fund ; after the dis- charge of certain existing liabilities of hospitals the value of the securities in the Hospital Endowments Fund at the Appointed Day was approxi- mately £20m. Half of the income from this Fund is distributed to Regional Hospital Boards (who in turn may either distribute sums to Hospital Management Committees or retain them under their own control) and half direct to Hospital Management Committees. The use of funds received after the Appointed Day may be limited by the terms of the trust on which they are held but, subject to such trusts, hospital authorities are free to use their non-Exchequer funds for any hospital or research purposes they think appropriate. They are commonly used to provide amenities for patients and staff but they may also be expended on items for which Exchequer funds might be used if they were available and the Minister has been careful not to discourage such use. Although he has issued guidance from time to time on appropriate uses for non-Exchequer funds, the Minister has not thought it practicable to attempt to draw up an exhaustive list of such items. (b) Charges may be made for :— (i) appliances which at the request of the person supplied are of a more expensive type than the prescribed type or in respect of the replace- ment or repair of such appliances—see 3 (2) of the National Health Service Act, 1946. (i) Dentures (except at some dental teaching hospitals) and glasses supplied to outpatients—National Health Service Act, 1951. (iii) Certain appliances (surgical boots and shoes, wigs, abdominal supports and elastic hosiery) and drugs supplied to outpatients (with some exceptions)—National Health Service Act, 1952. (iv) Accommodation in single rooms or small wards, subject to the needs of the Service. Patients undertake to pay the cost of this accom- modation as determined under Section 4 of the Act of 1946. The charges originally prescribed were a maximum of 2 guineas per week for a bed in a single room and 1 guinea a week for a bed in a small ward ; these charges were increased from Ist June, 1952, to 4 guineas a week and 2 guineas a week respectively (see Appendix 1, Tables 5 and 6). (v) Accommodation set aside under Section 5 of the Act of 1946 for patients who undertake to pay prescribed charges designed to cover the whole cost of accommodation and services provided including an appropriate amount in respect of overhead expenses. Occupants of these beds may make private arrangements with doctors of their choice and pay them individually at rates not exceeding specified maxima (see Appendix 1, Tables 5 and 6). (c) In accordance with Section 37 of the National Insurance Act, 1946, contri- butions towards the cost of the National Health Service as a whole are
    digitised image 1
    digitised image 2
    digitised image 3