H.—22

7

I would particularly draw the attention of those interested to Miss Maclean's remarks as to the training of midwives in the Dominion. It would indeed be a fatal mistake to initiate any alteration that might tend to lower the standard of the State examination, and to " let loose " on the public Inexperienced women with the brand of a State certificate. Far better than this would be to repeal the Midwives Act of 1904. Before this Act became law, the public at any rate knew what they were doing when they employed unqualified midwives. Midwifery cannot be taught by lectures, but only by actual attendance on cases. The Department is endeavouring to obtain for trainees the fullest experience in this direction that can be obtained under existing conditions, and no serious difficulty in meeting the requirements of this country is anticipated. In conclusion, I take this opportunity to express my thanks to Miss Maclean, Assistant Inspector, for much loyal help, and to Mr. Killick, chief clerk, who joined the Department in October last, for many valuable suggestions concerning the clerical work. T. H. A. Valintine, Inspector-General of Hospitals.

REPORT ON NURSES REGISTRATION, MIDWIVES, AND PRIVATE HOSPITALS ACTS.

Sir,— Wellington, 27th April, 1908. I have the honour to report concerning the administration of " The Nurses Registration Act, 1901," " The Midwives Act, 1904," and " The Private Hospitals Act, 1906." The Nurses Registration Act. Since the last report two examinations have been held under the Nurses Registration Act- — in June and December. One hundred and thirteen candidates came up for the preliminary examination in anatomy and physiology, and of these eighty-two passed. For the final examinations in general nursing there were seventy-six candidates, and sixty-three passed, and their names were placed on the register. It having been considered advisable by the Registrar of Nurses that a Board of Examiners should be appointed to act, when called upon, for a certain number of years, Drs. Young, Hogg, Bennett, and Shand, Wellington; Drs. Acland, Talbot, Irving, and Anderson, Christchurch; Drs. Williams, Blomfield, Riley, and Newlands, Dunedin ; Drs. Aubin, Purchas, McDowell, and Marsack, Auckland; Drs. Simpson, Scott, and Morice, West Coast; and Nurses Palmer, Holgate, Turner, Maude, Thomson, Tombe, Greene, Morrison, Thurston, and Gosling consented to undertake these duties. Their office being a continuous and settled one, it is hoped that they will study the question of nurse-training and examination, and that their advice and co-operation with the Department in these matters will be of great value. In order to obtain as uniform a standard of examination in practical work as possible, the centres for examinations were made five, being the four chief towns and the West Coast. It has been by some considered a hardship for the nurses to leave their own hospitals for examination, but when it is considered that the fee of £1 covers examination and registration, and includes certificate and badge, for which in many places an extra charge is made, and that the nurses have no further expense in keeping their names on the register, the advantage which is gained by passing a central and more university-like examination more than counterbalances the inconvenience of attending at a centre. -The fact of having to compete with nurses from other training-schools is a great incentive to both trainers and teachers to work up to as high a standard as possible. The probationers in country hospitals are paid at a higher rate than those in the larger towns, and should therefore be able to save during their three years the few pounds necessary to expend in attending the examination which admits them to a profession in which they can at once obtain employment at good fees. The receipts of fees for examination amounted to £91 10s. ; the expenses, in examiners' and supervisors' fees, to £102 17s. It is proposed, during the present y'ear, to make an alteration in the State examination for registration, by giving up the preliminary examination in anatomy and physiology which has been held at the end of the second year, and accepting the certificate of the training-school in these subjects, thus leaving for the final examination the more important and practical part of medical and surgical nursing, to which more time will now be devoted. The question of training probationers in private hospitals has been frequently brought up during the past year. It is felt that certain private hospitals of a recognised standing, with satisfactory equipment, and under the management of a fully certificated matron, should be able to give a better training than many of the smaller public hospitals. This is true to a certain extent, and in view of the great difficulty in this country of obtaining a sufficient number of trained nurses to carry on the work which awaits them, it is undesirable that any suitable means of bettering this state of affairs should be lost. At the same time, if it is wished that the nurses trained in the Dominion should be recognised throughout the world, the standard must not be lowered, but rather improved. At the present time the fact of hospitals of under forty, and even under twenty beds, being allowed to send up their trainees for State registration in the same period as the large hospitals has made the training of New Zealand nurses so unequal that the fact of holding a certifi-