3
H.—B
Most of our centres of population are so widely separated by the physical configuration of New Zealand that we cannot, as is proposed in Victoria, attempt to effect a compromise between the taxpayer's and the humanitarian's view of the proper treatment of the insane, by thoroughly equipping, regardless of cost, one central hospital for the rational treatment of curable insanity. We should require to have such a hospital in each of our large towns, and no doubt this is the ideal after which we must struggle. For the present, however, this is beyond our reach. I recommend, therefore, instead of collecting all our acute and curable patients into one central institution, that the Government should relieve our overcrowded asylums by building a central refuge for chronic and incurable lunatics. The building for this purpose, containing a separate ward for idiots and imbeciles, ought to be as cheaply put up and as plainly furnished as possible. The staff should consist of an experienced lay superintendent with a comparatively small number of attendants and a visiting medical officer. The effect of this would be to relieve our asylums of all those cases who do not require much medical attention, and to enable us to concentrate our attention on the more hopeful patients. Admissions. On the Ist January, 1887, the number of registered lunatics was 1,613 : males 1,009, females, 604. Those admitted for the first time during the year numbered 341 : males 214, and females 127. The readmissions amounted to 75 : males 41, and females 34. Discharges. The percentage of recoveries on admissions during the year was, — Males. Females. Total. New Zealand ... ... 40-39 48-75 43-61 New South Wales ... ... 44-67 36-24 41-26 Victoria ... ... ... 38-43 43-89 40-84 South Australia ... ... 56-8 63-8 59-8 Queensland ... ... ... 41-72 41-43 41-63 England and Wales ... ... 38-14 45-56 41-99 Deaths. In 1886 the deaths were 57 males and 19 females; in all 76. For 1885 the total was 95. This year the total was 101: males, 74 ; females, 27. Percentage of deaths on the average number resident: — Males. Females. Total. New Zealand ... ... 7-15 4-40 6-13 Victoria ... ... ... 7-37 5-27 6-38 New South Wales ... ... 7-61 4-97 6-58 England and Wales ... ... 10-70 8-24 9-37 Auckland Asylum. The difficulties arising from the great overcrowding of this asylum, and especially the impossibility of anything like proper treatment either of the patients or the attendants, had roused the community to such a degree that when at length strenuous efforts were made to put things right very great embarrassment has been felt from the natural difficulty of reassuring the jealous watchfulness of the public. This has been greatly aggravated by the fact that the building operations necessarily increased for a time the evils to be remedied, both as regards the treatment of the patients and the comforts of the attendants. Their usual recreations were abolished, and some of their privileges had to be curtailed, for every available corner had to be used for dormitory accommodation. The Medical Superintendent moreover was obliged to exercise the most untiring vigilance and the most rigid discipline to prevent the occurrence of some public scandal. As will be seen from the accompanying entry of April, 1887, there was an outbreak of typhoid fever caused by the defective drainage on the female side. This was promptly rectified, and there has been no return of the fever. The new wing has now been all but completed, and authority to furnish it will at once be issued, so that the great pressure on the female side will be removed. The new male wing for which Parliament has voted the money will, I hope, now be undertaken, for the state of affairs on that side is little better than that which has has until now prevailed among the females. The old workshops, which were very inadequate, were burned to the ground. They have now been replaced by substantial brick buildings, which will enable a much larger number of patients to be usefully and healthfully employed. A very great improvement has been made in the appearance of the grounds in front of and around the asylum, and nearly the whole interior of the building has been completely altered. The gloomy dingy look of the day-rooms and dormitories has been removed, and the whole of the labour of cleaning and painting the walls has been performed by the staff and patients for the mere cost of the materials. Wellington Asylum. The excellent condition into which this asylum had been brought by Dr. Levinge was kept up by Dr. King until his promotion to Seacliff. Dr. Hassell, so well known for his good service in Wellington Hospital, was appointed to fill the vacancy, and, from a recent examination of the state of the asylum, I am confident he will be a reliable and efficient officer. The new asylum at Porirua has been of great service in relieving the overcrowding at Mount View ; and Mr. Wybourne, who was promoted to be farm-manager, has amply justified the confidence reposed in him. I have frequently visited Porirua, as has also been done by Mr. J. Mackay, the Deputy Inspector, and on every occasion the state of the asylum was most satisfactory.
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