Private and Government Funding: The Case of the Moncton Hospital, 1898-1953

IN JANUARY 1941 HOSPITALS WERE a cross-roads never before reached in history, Moncton Hospital superintendent Alena J. MacMaster informed her board. An entirely new philosophy of hospital financing had come of age, she said. now seemed widely accepted that and voluntary philanthropy as a source of revenue would be supplanted by or alternative forms of support.1 In reality, as MacMaster was well aware, this shift of responsibility was not a sudden epiphany but rather had been underway at her own institution throughout the interwar years. She also knew that this transformation of public attitude and policy was far from complete. Nevertheless, her remarks revealed quite a substantial change in hospital funding perceptions compared to the optimistic expectations of the Moncton Hospital's first president, George B. Willett, roughly 45 years earlier. As he stated in 1895, It was not proposed to build this hospital on the charity plan. A few years later, he was elated that receipts from paying patients [had] considerably increased2 and were becoming ever more important. This reliance on private support contrasted with MacMaster' s 1941 perception of a shift to government or alternative forms of support. But both situations were some distance away from the late 1950s, when hospital care insurance measures and a Public Hospitals Act, as Hugh J. Whalen noted, vested control of hospital services largely in provincial hands and imposed a premium-type insurance program applicable to all users.3 To a considerable extent, the Moncton Hospital completed the journey from a largely privately funded hospital to an increasingly governmentally funded institution during the 1898 to 1953 period. In the area of major capital expenditures, private donations had been supplanted by grants from various levels of government. Operating costs were, by the 1950s, met by enhanced provincial contributions, by a more substantial municipal and county role in hospital finances and by patient payments, whether direct or from a third party (government or hospital insurance schemes). A focus on changing patterns in hospital finances from the vantage point of a single institution allows for exploration of an often neglected issue which is

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