67

H.—3l

Another regrettable feature which must be noted, particularly this year, is the greatly increased amount of oral sepsis, as well as other focal sepsis, among entrants for treatment. Full extraction has been necessary within the Sanatorium in a great many cases, both Service and civilian. There is naturally much diffidence among the private dental practitioners of the neighbourhood over the handling of these cases, and the work must therefore be done in the Sanatorium. The proportion of civilian patients is gradually increasing year by year, though the percentage of Service patients has remained steady at 40 per cent, for some years now. The increase in the number of patients treated this year represents, therefore, an increased use of the institution by civilians. I am glad to be able to report the resumption during the year of vocational training for Sanatorium patients. This is due entirely to the efforts of Mrs. T. H. Lowry and the Red Cross workers of Hastings and Napier, who by organizing a Red Cross gymkana at Hastings in November last have provided money to pay for the service of an instructor in cabinetmaking. The class has been commenced again recently, and patients are availing themselves of the opportunity provided to learn. The idea of the work is not to train pupils to be expert in any trade, but we are content that the tuition they receive gives them occupation for their many enforced leisure hours. Adequate training to become expert enough to earn a livelihood belongs to another phase of treatment of the tuberculous —viz., after-care, &c.—a direction in which we have not yet made any beginning. One other matter calls for brief comment in this report, and that is the increase recorded in the average individual days' stay in Sanatorium. This has been calculated in a more thorough manner this year by taking the number of patients discharged during the twelve months and dividing the collective days' stay by the number who completed treatment. No account, as in former years, has been taken of the number in hospital at the commencement of the year, nor those remaining in hospital. The result shows that the average period of treatment at this Sanatorium is correctly stated as 146-7 days, as against 131 last year. The period now given, five months of twenty-eight days, is short enough, and still far short of the ideal in treatment that patients should be kept as long as such treatment is indicated. The principal factor shortening this stay in Sanatorium is economic. We might do well to study the Canadian system of maintenance grants for indigent patients. Staff Changes. —Dr. H. D. Matheson was appointed on the 20th February last to replace Dr. G. M. Scott as Assistant Medical Officer, retired for health reasons. Patients and staff regret Dr. Scott's severing his connection with this institution after so many years' service in the Department, and all join in wishing him many years of good health and happiness in retirement. Buildings.—No replacements nor extensive alterations have been carried out during the year. I would draw attention to urgent needs outlined again in this year's estimates, such as the concreting of the lavatory-floors, reroofing the shacks in iron to replace malthoid, and the matter of improvement to the entrance to the Sanatorium. X-ray Department. —The number of films taken during the year has been 336. For the third year the plant has given continuous excellent service without any expenditure, other than films, being necessary. Dispensary.—The value of drugs used for the year has totalled £262 9s. 7d., a decrease of £29 on last year's figures. In view of the increased number of patients under treatment, this reflects economy in the use of medicines and dressings. Orchard and Kitchen Garden.—We have received vegetables and fruit to the value of £348 4s. 4d., for which return wages amounting to £415 9s. 3d. are paid to one head gardener and two undergardeners. Our requirements have not been met again, and £93 1.65. 6d. in addition has been expended in supplementing these supplies. The comparison does not represent by any means a payable proposition. Red Cross Society.—The lives of the patients have been very much brightened, and their stay here made much more enjoyable, by the continued visits of the various ladies' committees of the Red Cross Society. The society, as mentioned elsewhere, has been responsible for the resumption of vocational training in both leatherwork and carpentry classes. The number of patients at present attending the leatherwork and raffia-work classes stands at forty-five, and this is a fair daily average throughout the year. Fourteen men are enrolled as members of the cabinetmaking class. I must again record sincere appreciation of the society's contribution to the welfare of all patients here. Gifts and Services to the Sanatorium. —I would like to acknowledge also the kindness of many people in this district in supplying valuable prizes for the various sports participated in by the patients. The list includes Mrs. J. D. Ormond, silver cup for bowls ; Mr. L. A. Bowen, gold medal for bowls ; Mr. J. P. Smith, four handsome gold-mounted buttons as trophies in rink play at bowls ; Mr. W. D. McKay, two silver buttons for golf putting ; and Mr. D. Cody, two years' subscription to the London Sphere and a quantity of records. Mr. J. P. Smith also deserves our thanks for again spending a fortnight at this institution for the purpose of relevelling the bowling-green, for which purpose he kindly supplied his own special apparatus. To the various bowling clubs of Hawke's Bay our thanks are also due for their visits to the Sanatorium and the arrangement of friendly matches with the patients. In concluding this report I would like to place on record again my appreciation of the staff as a whole for good work performed and loyal co-operation throughout the year.