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]
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.
31/448 page 9
![29 January, 1957.] [Continued. (d) Visits by specialist officers of the Ministry (medical, nursing, engineering, catering, etc.) to advise or report on hospital services. (e) Attendance of the Ministry’s Regional Officers as observers at meetings of hospital authorities, whose circulated papers they also receive. (f) The establishment by the Minister of an experimental O and M service, which is available to investigate any aspect of an authority’s arrangements (at the authority’s invitation) and make suggestions for more efficient management. (g) Publication of documents of comparative statistics and costs. Hospital costing is dealt with in more detail in paragraphs 36-41 below. Growth of Expenditure 35. Appendix 1, Table 12*, summarises (under the approval subheads) the growth of total hospital expenditure in each year from 1949-50 to 1955-56. The main factors in this growth of expenditure (with rough estimates of the amount each has contributed) are :— £m. Increases in Pay ... ai a. Be te oi sth a7 33-8 Increases in Prices et ee 345 A. De att € 25°) Transfer of new services to hospital service (e.g., certain ex-Ministry of Pensions hospitals) ... ae Au, 2h 1:3 Other unavoidable increases, such as salary indvenients a naa 8-4 Net effect of developments and BEES meu offset by savings due to economies... a ts te ist eh hs 34-6 ToTaL 103-8 ns Appendix 1, Table 13+, breaks down for each year by types of hospital most of the expenditure shown in Table 12. Hospital Costing 36. Hospital costs are calculated separately for each of the types of hospital. These types are the same as those adopted for statistical classification. An excep- tion to this was made in 1953-54; the definitions of hospital types for statistical purposes were changed for the calendar year 1953 and were expected to be and indeed were changed again for 1954. In order to preserve comparability of costing results the old definitions continued to be used for the purpose of the 1953-54 costing returns. 37. The detailed cost figures are published annually by the Minister, the non- teaching hospitals in each category being grouped together for each Region, and the teaching hospitals in each category all being grouped together (except that those in London are shown separately from those in the Provinces). Regional and national averages are shown wherever appropriate. 38. The present system of cost analysis is based on the subjective headings of the accounts. The costs at each hospital are, under this system, calculated under between 40 and 50 headings. The aim has been to provide a figure of “the total inclusive net cost per week of maintaining an in-patient” at the hospital. For this purpose, the heads of expenditure are divided into two types: those which tend to vary directly with the number of patients (provisions, drugs and dressings, etc.)—Running Charges—and those which tend not to vary much with normal variations of occupancy (salaries and wages, fuel, light and power, etc.)—Standing Charges. From the total of Standing Charges are deducted certain receipts (direct credits). From the total of Running and net Standing Charges an attempt is made to eliminate the effect of outpatient expenditure (at present not separately ascer- tained) by assuming that five outpatient attendances represent the costing equivalent of one inpatient day and adjusting the total accordingly so as to arrive at “ the total inclusive net cost per week of maintaining a patient”. For certain types of hospital the 1955-56 Costing Returns also show the average cost per case, which is calculated by multiplying the weekly cost by the average stay per case. *-App, i p.371. t App. 1 pp. 372-3.](https://iiif.wellcomecollection.org/image/b32182466_0031.jp2/full/800%2C/0/default.jpg)
