Cost estimates are derived for services provided at the Milton Cato Memorial Hospital (previously known as the Kingstown General Hospital) using the step-down accounting method Both total and average unit cost estimates are provided Among the findings of note is that the cost per patient per day spent on the Maternity Ward is 57.4% higher than for the Surgical Ward. Even with the 1995 increase in user fees, the levels of subsidization for inpatient services remains relatively high at 78%-96% for public patients and 43%-72% for private patients. Ancillary services werefoundto have lower levels of subsidization and in most cases the full costs were recovered from private patients. Laboratory services are not subsidized.