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The St. Helens district midwives service is discontinued, the Hospital Boards really responsible for this service in their districts having declined to assume the responsibility. The midwifery nurses posted out in country towns will now be able to carry on private visiting practice with a fair prospect of success, as they are well known and appreciated in the districts. In the future it is hoped to re-establish this service on a temporary basis to enable nurses to establish a practice. SECTION 3.—PRIVATE HOSPITALS. The number of private hospitals in the Dominion during 1921-22 was 282. During the year thirty-four new licenses have been issued for private hospitals and nineteen have been transferred. Inspections have been carried out more frequently now that Nurse Inspectors are attached to each of the large centres. Improvements have been made in the equipment of the hospitals more recently established, and alterations made in many others to bring them more into accord with the requirements of the Department. The hospitals owned by registered nurses and midwives, whose proprietors are usually anxious to do all they can in this direction, are at a disadvantage with those owned by medical men, who have the double source of income of the fee for medical attendance or surgical operations as well as that for accommodation and nursing, and can therefore afford to spend more on building and equipment. The fees charged by the nurse proprietors for accommodation are also lower than those charged by medical men. With regard to private maternity homes, the licensed proprietors are much hampered by the allowance under the Hospitals Act of one ease at a time in an unlicensed house, thus lessening the admissions in the authorized places. It is hoped to debar, by legislation, the reception of any cases at all for payment in private houses, as the number now legal is frequently exceeded, and excuse made that the cases were either before or after expected time. H. Maclean, Director, Divison of Nursing. PART VI. SCHOOL HYGIENE. SECTION I.—CONTROL AND ADMINISTRATION. This is the first year during which the school medical work has been directly under the control of the Department of Health, and there can be little doubt that the resulting closer association with the other activities of this Department is a, very great advantage. The guidance! and co-operation of Dr. Truby King, Director of the Division of Child Welfare, is especially valued in connection with the propaganda of tho division. The fear that the transfer from the Education Department would tend to dissociate the work of school medical, officers from the education system has been shown to have little foundation. Where close co-operation is of such practical importance — namely, with school-teachers and Inspectors, Education Boards and School Committees —the co-operation is of a direct nature between the school medical officers and those concerned, and not likely to be affected by the changes of departmental control. Stafe. The staff of this division, as in the previous year, numbers thirteen school medical officers and twenty-seven school nurses, with the same districts as detailed in my last report. « Conduct of the Work. While tho general description of school medical inspection given in my last report need not be repeated, it is perhaps well to emphasize again that the work of tho school medical officer is not a mechanical routine of inspection of children and official notification of parents. All school medical officers recognize that the sympathetic understanding and willing co-operation of the parents is indispensable to the success of the work. To obtain this co-operation some officers invite the parents to be present during the inspection of their children and hold, as it were, an advisory clinic over the individual cases ; whilst others meet the parents collectively at the school, give a short address and answer questions. Owing to the practical difficulties involved in personally meeting large numbers of parents, especially when extensive districts have to be covered, some officers prefer to establish this personal relationship by an elaboration of tho formal notice sent to parents into a more detailed letter of advice : the effect of such a notification thus approximates to that of an interview, and certainly a much larger number of parents can be reached where in many cases personal interviews would not be possible. By whatever method the parents' co-operation is sought, it is gratifying to note the growing interest which is undoubtedly being taken in the subject of children's health and the parents' steadily increasing appreciation of the services of the school medical staff. I should refer to the invaluable work done by the school nurses. Much of their work is of an exacting kind, and calls for the exercise of patience and tact. Besides assisting the school medical officers in the examination of the children, school nurses visit thousands of homes both in town and country ; much of their work, which is of a social and missionary nature, is difficult to measure, but bears valuable fruit in the treatment of defect and disease, and. in rectifying conditions which make for ill health. One medical officer in expressing appreciation of their work says :" I look back with incredulity to tho years before school nurses wen- appointed and" wonder how I faced the work."

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