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Statement showing bed capacity of vaval hospitals, beds reserved for the Navy, allocation of beds to the Veterans' Bureau, and number of Navy and Veterans' Bureau patients in naval hospitals on November 20, 1924

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Mr. FRENCH. How does the hospital rate for the Veterans' Bureau, which you state was $3.61, compare with the hospital rate for the Navy?

Admiral STITT. The Navy is lower, sir. The Navy rate is $3.24. as compared with the Veterans' Bureau rate of $3.61.

INCREASE OF VETERANS' BUREAU PATIENTS DUE TO NEW LEGISLATION

Mr. FRENCH. What additional civil and naval personnel would you say is occasioned by the Veterans' Bureau patients?

Admiral STITT. They agreed to give us last year 365 hospital corps men. For 1925, this present year, they have reduced the number to 250, with the idea that the number of Veterans' Bureau patients in our naval hospitals would fall off; but as a result of the legislation of June last we are now caring for the highest number of Veterans' Bureau patients that we have ever carried in our naval hospitals, and it is increasing to such an extent that the Budget Bureau took off $50,000 from our Medical Department appropriation, which pays for civil employees largely, with the idea that the Veterans' Bureau would utilize our hospitals to a greater extent this winter, and that the increase in their proportion of the charges would care for a greater number of those employees; in other words, as they increased, the Navy would have less to bear.

Mr. FRENCH. Are they now encroaching on your moneys, or de they about pay their way?

Admiral STITT. They pay their way, sir; but it is very fortunate that the Navy demands on our hospitals at the very points where they particularly need general medical and surgical beds are limited, as in New York, with our hospital of more than a thousand beds.

and in Boston, Mass. Our hospitals at New York, at Chelsea, and at Philadelphia are the only hospitals for Veterans' Bureau beneiciaries in those districts; that is, for general medical and surgical cases. They have tuberculosis hospitals and neuropsychiatric hospitals, but we are fortunate in being able to offer them beds where they ack provision for general medical and surgical cases.

VALUE OF NAVAL HOSPITALS

Mr. FRENCH. You have given us the cost of the hospitals at plant 1pon the basis of original cost. How do these costs compare with costs of modern hospitals with modern conveniences to care for the same number of patients, assuming that we were to have the same type of a hospital as our most generally approved institutions?

Admiral STITT. The total book value of land and buildings used for hospital purposes by the Navy is $22,735,443.18. As many of these buildings were constructed prior to the year 1913, the book value does not represent their present or replacement value. A fair basis of comparison with costs of modern hospitals would be the average cost per bed for Government hospitals erected within the past year, which is about $3,500. The total bed capacity of the 20 hospitals being 7,474 will bring the value, on the basis of $3,500 per bed, to $26,159,000. The value of the land, which is included in the book value would be in addition to the $26,159,000 replacement value of the buildings.

NAVAL HOSPITAL FUND

Mr. FRENCH. Preceding the first item in the bill is a reference with regard to the naval hospital fund. Will you insert at this point a short description of that fund, what it is, its status, and the estimated expenditures for 1925; also the probable expenditures for 1926? Also under the law, certain indefinite appropriation is made each year automatically for Navy fines and forfeitures. Will you insert a short statement there indicating what that is and the amount? Admiral STITT. I will be glad to do so.

HISTORY OF THE NAVAL HOSPITAL FUND

By the act of July 16, 1798, Congress provided for the relief of sick and disabled Seamen through a tax of 20 cents per month per capita, and authorized the President to purchase land and erect hospital buildings from the moneys so collected.

The act of March 2, 1799, directed the Secretary of the Navy to impose a like tax upon the officers, seamen, and marines of the Navy, and to pay the same to the Secretary of the Treasury, and provided further that the officers, seamen, and marines of the Navy should receive the same benefits and advantages as were then provided for the sick and disabled seamen of the merchant vessels of the United States.

The single fund established by the two acts above mentioned continued until by the act of February 26, 1811, Congress established a board known as the commissioners of the Navy hospitals, consisting of the Secretary of the Navy, the Secretary of the Treasury, and the Secretary of War, and by the same act voted the sum of $50,000 out of the marine hospital fund to be paid to these commissioners, and to constitute the beginning of a separate naval hospital fund.

Since February 26, 1811, the naval hospital fund has had no connection with the marine hospital fund or with any other funds of any kind. The commissioners were authorized and required to procure suitable places proper sites for naval hospitals and to cause the erection of hospital buildings.

On July 10, 1832, Congress made further changes in the basic law, by which the commissioners of Navy hospitals were released and discharged from all further trust connected with the naval hospital fund, and the Secretary of the Navy was constituted the sole trustee; all the powers and duties theretofore imposed by laws on the commissioners of Navy hospitals were transferred by the act of July 10, 1832, to the Secretary of the Navy, and all acts and parts of acts contrary to the provisions of this act were repealed.

The acts of February 26, 1811, and July 10, 1832, when later condensed, were reenacted into section 4810 of the Revised Statutes, which stood without change from 1874 until March 4, 1913, when it was reenacted by Congress without change in the original language except by the addition of a proviso, as shown:

"Section 4810 of the Revised Statutes of the United States is hereby amended so as to read as follows:

"'SEC. 4810. The Secretary of the Navy shall procure at suitable places proper sites for Navy hospitals, and if the necessary buildings are not procured with the site, shall cause such to be erected, having due regard to economy and giving preference to such plans as with most convenience and least cost will admit of subsequent additions, when the funds permit and circumstances require; and shall provide, at one of the establishments, a permanent asylum for disabled and decrepit Navy officers, seamen, and marines: Provided, That hereafter no sites shall be procured or hospital buildings erected or extensions to existing hospital made unless hereafter authorized by Congress.'"

In the earlier days of this trust fund sites were procured and buildings were erected at various times from its monies; in later times the three New England hospitals at Portsmouth, N. H., Chelsea, Mass., and Newport, R. I., were erected without one dollar of appropriation at a cost of $847,000, defrayed entirely from the naval hospital fund, and at other naval hospitals new buildings were erected and repairs to old buildings made, at an expenditure of approximately $2,000,000 more. The three hospitals mentioned at the time of their completion were proclaimed the best examples of complete modern construction in the United States. The naval hospital fund is not an appropriation, nor is it made up of moneys at any time appropriated by Congress; it is a trust fund which derives its revenues from within the naval service, and is administered by the Secretary of the Navy. who is its sole trustee; these revenues are:

(a) By the deduction of 20 cents per month from the pay of each officer, seamat, and marine (secs. 1614 and 4808, R. S.).

(b) By fines imposed on officers, seamen, and marines (sec. 4809, R. S.). (c) By the value of one ration per day day allowed for each officer, seaman, and marine during his continuance in hospital, the value of the ration for this purpose being specified under "Provisions," annually, in the naval appropriation act (ser. 4812, R. S.).

(d) By the relinquishment of disability pensions due officers, seamen, and marines during continuance in hospital (sec. 4813, R. S.).

(e) By forfeitures on account of desertion (naval appropriation act, June 7 1900).

(f) By proceeds of sale of naval hospital fund property, when so authorized, as by acts of June 12, 1858, and July 2, 1890, when the naval hospital fund was reimbursed for land transferred and sold in the sums of $50,000 and $92,000, at Chelse and Brooklyn, respectively.

EXPENDITURES

During the fiscal year 1924 there was expended from the naval hospital fund for all purposes the sum of $3,021,547.88. During the same period the fund was reimbursed to the amount of $1,990,696.21 from other appropriations, for subsistence of Navy and Marine Corps personnel in hospitals, and for the care and subsistence of Veteran's Bureau patients, and for Employees' Compensation Commission patients; the total expenditure, $3,021,547.88, less reimbursements, $1,990,696.21, leaves a balance of $1,030,851.67 as a charge against the surplus and revenues credited to the fund. In other words, naval hospital fund expended $1,990,696.21 for other appropriations and $1,030,851.67 for its ow balance.

It is estimated that during each of the fiscal years, 1925 and 1926, expenditures from the fund, exclusive of the building program (authorized in 1925 act, $2,257,500 and estimate for 1926 $790,500), will be $3,500,000, and that reimbursements for each year from other appropriations will amount to $2,500,000, leaving a balance of $1,000,000 to be ultimately charged against moneys credited to the naval hospital fund.

1 UNEXPENDED BALANCE

The unexpended balance to the credit of naval hospital fund on July 1, 1924, ras $3,493,483.32. As this balance does not reflect outstanding obligations or ccrued credits, it is necessary in order to show true conditions to deduct $200,000 s an estimate of outstanding obligations as of that date and add $903,664.91 or accrued credits for subsistence and for care of Veterans' Bureau patients, making a corrected balance of $4,197,148.23. In addition to the credits noted here is a balance of $1,931,981.39 in Navy fines and forfeitures that is available or transfer to the credit of naval hospital fund, making a total available balance f $6,129,129.62.

With normal credits of $1,282,000 accruing to the fund each year, from Navy nes and forfeitures $1,000,000, and from the hospital tax $282,000, and expendiures amounting to $1,000,000, there will remain approximately $282,000 each ear for the purpose of hospital reconstruction.

The corrected balance as of July 1, 1924, being $6,129,129.62, and receipts xceeding ordinary expenditures by $282,000, will leave a balance available for xpenditure during the current fiscal year of $6,411,129.62. Deducting the uilding program of 1925 ($6,411,129.62 less $2,257,500) leaves an estimated alance of $4,153,629.62, available July 1, 1925.

MEDICAL DEPARTMENT

Mr. FRENCH. For the Bureau of Medicine and Surgery, for 1926, you are asking $2,195,000 as against $2,275,000 for 1925, and $2,265,000 for 1924. The first item is for surgeons' necessaries for 'essels in commission, navy yards, naval stations, and Marine Corps. Admiral STITT. Under the appropriation, Medical Department, Bureau of Medicine and Surgery, I would like to make the following

tatement:

The appropriation, Medical Department, for the fiscal year 1925, s an increase of $206,779.49 over actual expenditures for 1924. The mount expended in 1924 should not be taken as a criterion, inasmuch as in that year employees were reduced beyond the point of maintenance sufficiency, as noted in the general statement. In 1925 this deficiency is being corrected.

The appropriation requested for 1926 is a decrease of $110,000 as compared with the appropriation for 1925. Fifty thousand dollars of the decrease for 1926 is due to an expected increase in the number of Veterans' Bureau patients, with a resulting increase in reimbursements. The remaining $60,000 of the decrease is the result of improvements now being effected in administration.

The number of maintenance employees at hospitals were increased Turing the current year (1925), to make up for work deferred from ast year (1924). During 1926 it will be possible to operate on a normal force.

MEDICAL SUPPLIES, VALUE OF, ON HAND

Expenditures for the purchase of stock were reduced to the minimum during the past year. It will be necessary to make larger xpenditures during the current year and coming year to make up or deficiencies in stock. We have been using our surplus stock, the var stock, and constantly cutting it down.

Mr. FRENCH. How much is the amount for the item that I have ndicated?

Admiral STITT. About $517,000.

Mr. FRENCH. You say that you have been using reserve stock and decreasing them?

Admiral STITT. Decreasing them. We reduced our stock in the hree medical supply depots last year to the extent of $563,492.87.

Mr. FRENCH. Where are your medical supply depots? Admiral STITT. At Brooklyn, N. Y.; that is our principal one, and the purchasing one; Mare Island, Calif.; and Canacao, P. I.

Mr. FRENCH. What is the total rough estimate of the value of the stocks that you carry at these places?

Admiral STITT. The total stock on hand, exclusive of stock being sold at the present time, amounts to $2,875,322.17.

Mr. FRENCH. For how long a period do you estimate that would be a sufficient fund?

Admiral STITT. If it were a well-balanced stock it would last us approximately two years.

Mr. FRENCH. What is the ideal quantity of stock to have on hand at any given time?

Admiral STITT. One year's "normal stock," amounting to approximately $1,300,000, and one year's "active reserve stock," amounting to about $1,200,000. In other words, we should maintain a two year's supply, except in the "active reserve" certain items that are subject to rapid deterioration and items that are not carried on the war-time supply table would be eliminated.

Mr. FRENCH. Whereas this is deficient, it is deficient because it is not a balanced stock?

Admiral STITT. It is not a balanced stock. We have no surplus stock at the present time. We made a careful survey of the supplies. and declared surplus everything that we thought we were justified in declaring surplus, and that has been sold. In the last hearing, we had a column dealing with surplus. In the present statement, we show three types of stock, inactive reserve, active reserve, and normal stock; the normal stock representing one year's well balanced stock, amounting to $1,320,000.

Mr. FRENCH. What do you mean by the inactive reserve stock that would be necessary in the event of an emergency?

Admiral STITT. Yes, sir.

Mr. FRENCH. You do not mean that it is obsolete? Admiral STITT. It is not obsolete. In an emergency, it would be perfectly good stock, but it would bring very little if it were sold, because it has been manufactured especially for the Navy.

Mr. FRENCH. Would you at this point insert that table?

Statement showing condition of stock on hand July 1, 1924

Total

Inactive
reserve

Active

reserve

Normal stock

Medicines.

Antiseptics and disinfectants.

$454, 097. 40

$220, 097.40

$325,000.

Tablets

22, 967.46

7,967.46 15,000.

Hypodermic tablets..

64, 298. 26

34, 298, 26

30,000.00

Hospital stores...

15,556. 29

8,556.29

7,000.00

Surgical instruments and appliances.

11, 714. 14

1,714. 14

10.000.00

Surgical dressings.

499, 833.90

$233,500.00

116, 333.90

150,000.00

Hospital and nursing appliances.

Dispensary and laboratory equipment.

756, 486. 15

119, 096.07

387, 390.08

250,000

168, 215.72

14, 682.00

78,533.72

75,000.00

Bedding and linen..

174, 576.04

12,000.00

72, 576. 04

90,000.00

219, 187.99

Books....

94, 187.99

125,000.0

Stationery

27, 604. 40

17,604. 40

10,000 30

Dental material.

10, 448. 36

448.36

10,000

Microscopes and accessories.

X-ray apparatus and supplies

203, 292. 32

32,000.00

71, 292.32

100,000

8, 280. 54

20.000

Chemical reagents and laboratory supplies.

46, 430. 96

21, 430.96

25,000.00

30,851, 56

Biological products...

5,851.56

25,000(

Caskets and embalming.

4, 404. 02

1, 404.02

3,000.00

66,076.66

16,076.66 50,000

2,875, 322. 17

411, 278.07 7,155, 763.56 1,320,000 00

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