lSSL . VICTORIA. PUBLIC CHARITIES. REPORT OF INSPECTOR FOR THE HALF-YEAR ENDED 301'H .JUNE 1881, · AND ROUGH DRAFT OF PROPOSED AMENDING BILL; TOGETHER WITH ADDITIONAL REPORTS. PRESENTED TO BOTH HOUSES OF PARLIAMENT BY HIS EXCELLENCY'S COMMAND. 15~ ~utbotifl! : JOHN FERRES, GOVER~MENT PRINTEU1. MELBOURNE. No 23 . ,. Al'Pl!OXJMATE COST OF REPORTS. ... £ 8, ll• Propafa.tion, &c.-Not given. E'rintlng (V25 copces) 85 10 0 . PUBLIC ·CHARITIES OF .VICTORIA, '/' Inspector's Office, Treasury, 25th July 1881. Sm, . I do myself. the honor• to submit a half-y~r's Report of my ~ork. as Inspector of; .Public Charities. : $ince my appointment· to that position I have inspected the following charities :-'·· ' .. .. :-' . · ·HospitalS'.-Melbourne, Alfred, . Homreopathic, Inglewood, Creswick, Dayl'esford, Clunes, Amherst, Maryborough, Maldon, Dunolly, St. Aruaud's, Kilmore, Heathcote; Bendigo, Castlemaine, Ovens, Ballarat, :-· ··, Mooroopna; and Wangaratta. · J:$enmmlerit' Asy(ums.-Melbourne, Bendigo, Castlemaine, Ballarat; Ovens,. ' and the Home of the Immigrants' Aid Society in Melbourne. Other Institutions.-· Melbourne Blind Asylum, Ballanit Orphan Asylum, . Ballarat Refuge. Also the accounts of the following societies :- ·;," · Clunes, · Creswick~ Ballarat Clothing, Daylesford, Eaglehawk, Kilmore, 1 · Maldon, St. Arnaud, Maryborough, Talbot, and Buninyong. , Of the.'benevolent· ·societi~s it will suffice to say generally that they are doing ' .I l ' . good work in a most ·economical manner, and that, with one or two exceptions, the a~co~nts are well' kept. My reports upon the i~stitutions inspected will appropriately constitute appendices to this Report. The. Royal Commission, .in recommending the appointment of an Inspector of Public Charities, said, " What appears to be desirable is that the :whole management of _each ch~1jty, shol!-ld p~ P,erioqically investiga:teq, an? .a regular audit at the same time r'n.~~e o_n·he~alf, not _of_ ~h~.,~~bscribers, .~ut of the State, and. o.f the municipal and loca~ 'cor:[ior~~ions." '' 'I have;. ac~ing up?n ~he instructions' given' nie ~t the tin1e 'of my ~ppoin~~~t; taJr~n that as setting forth ·my ~uties, and made' as close a~ examimitioJ;t pf the acc.ounts of institUtions visited; 'the 'four principal Melbourne charities exc~pted, as the unpreparedness of some of. the ·institutions for such an inspection rendered practicable. For the reaso~ set forth in my reports, my inspe~tion of the Melbourne charities was preliminary. · ·' There are four general questions under which· the administration of publi~ elee~osynary relief may be conveniently considered, viz_. :- . -1. The nature and extent of relief available. 2. The general effect of the relief socially. 3. The management of institutions. 4. The revenue. of the charities. , C I 4 1. It cannot, I think, be doubted that in no way has the liberality of the community been more marked than in the provision made for the relief of the sick and destitute. Ample provision has been made for the alleviation of physical suffering, and there is probably no occasion, under ordinary circumstances, for anyone to be in absolute want. It is beyond question that several of the country hospitals do not nearly come up to the standard of what such institutions should be, while in some cases there is grave reason for improvement to be demanded. But it must be borne in mind that, even as they are, they are immensely superior in ordinary comfort nnd convenience to the homes of the bulk of their patients, and that the latter, as a rule, are inmates for brief periods, to be treated for some temporary ailment or sudden accident. In view, therefore, of the consideration that it is in several cases question­ able whether the limited and fluctuating population will warrant the expenditure that wQuld be requisite to make these institutions all that they should be, or even warrant their continuance at all, a high standard of excellence, involving, as it would, an exceptionally high cost per head, can scarcely be looked for. It must suffice, I think, to have those which are in settled districts, the centres of large populations, a~d which may be considered permanent institutions, suitably fitted for their work. Of the benevolent asylums I need merely remark that, Melbourne excepted, they are well fitted for their purpose on the whole, and. seem to me to be quite sufficient for the requirements of the populations they serve. Indeed it will be a wise policy, and tend to economy, to lessen the demands upon those institutions by fostering benevolent societies, which will he, practically, encouraging the boarding-out work. 2. But while the wants of the sick and the needy are provided for, in many eases with a lavish hand, .there is quite sufficient reason for the fear that either local causes, or the very general desire to provide speedy relief, has led the colony into an unduly extravagant system, by needlessly multiplying local hospitals. The Royal Commissions of 1862 and 1870 both drew attention to this point, and made recom­ mendations which, had they been acted upon, would have saved much expenditure and placed matters on a sounder footing than they now are. I do not pretend to have acquired sufficient information during my brief. term of office to enable me to advance an authoritative opinion as to the general effect of the relief afforded on the social system of the colony. But I have taken special pains to see and question the out-patients of country hospitals wherever it was practicable for me to do.so, to learn the circumstances of the in-patients, and the nature of the checks adopted to prevent imposition. The result has been entirely confirmatory of what has . been said respecting the pernicious influence of a system of relief, the administration· of which lacks proper discrimination. That noble bulwark of manliness, a true indepen­ dence, has in many eases been manifestly broken down, while in some cases committees · have not hesitated to tell me that, as business men in the locality, they could not incur the odium which too close a scrutiny of the· claims of applicants to relief would certainly bring upon them. The members of one committee told me plainly, when I was discussing this point with them, that they were glad the Government had sent an inspector, as that would enable them to plead that they must. now apply a more stringent rule. But I apprehend that neither the visit of a Government inspector, nor anything eise, will remedy this undoubted evil so long as unduly large Government grants are available for the construction and maintenance of hospitals in small country towns. Self-interest will be altogether too strong for public morality. Besides, for very shame's sake, once having obtained the hospital, it must l)y some means be kept supplied with patients, and in many cases this is accomplished by taking in those who are simply "benevolent" cases, and who would, if left to a local Society, have what little they 5 could earn supplemented by a small weekly donation .. Out of 581 inmates of the hospitals I have visited, no' less than 82 are returned by the officials themselves as being properly "benevolent" cases, and my own opinion is that an impartial medical investi­ gation would, at the very least, double that number. And apart from this aspect of the case, it is notorious throughout the country that persons well able to pay for medical advice resort to the hospital. It is not an infrequent thing for persons whose circumstances permit their driving their own buggies thus to seek gratuitous relief, and I have before drawn attention to an illustrative case in which a person known to have means drove his wife to the hospital, left her there for some weeks, and when applied to .refused even to subscribe to the funds. Yet, at the institution where this occurred, the.officers are under instructions to admit patients. on subscribers' tickets "without question." I do not hope to be able to devise a method by which imposition will be ·entirely stopped, but I believe that the observance of a few simple rules would· tend .very materially to check it. For instance, no hospital should receive Government or municipal grants that did not rnake it an absolute condition of admission, in all except emergency cases, that a statement of circumstances and a certificate of poverty be given. 2nd. That in all cases these statements should be verified by inquiry. 3rd. That .whenever such a proceeding is warranted by the facts, the parties on recovery, or the relatives responsible, should be called upon to. pay, or be sued under power to be given by Statute, in the event of their refusing. 4th. The certificates and particulars of proceedings to be kept for the information of the Inspector at his annual visit. And 5th. Any glaring case of failure on the part of a committee to proceed to be counted mal-administration, punishable by forfeiture of part of the grant. In these remarks I refer, of course, almost entirely to the medical charities. Imposition in regard to the others is no doubt less extensive, and would probably be sufficiently provided for by insisting upon proper inquiry, and giving authority to proceed against relatives within certain degrees. It is, I think, to be regretted that the Melbourne charities did not ·continue the services of an Inspector of Impositions. 3. I may say briefly that, apart from the question of economy, the general ·management of institutions is good, with rare exceptions. But . that the cost of management is in a large proportion of cases upon a very extravagant scale is evidenced by the average cost per occupied bed, a difference, as will be seen by ·Appendices 2 and 3, that no variation in prices will account for.