H.—3la

Silverdale. —The Board has a district nurse stationed here, and she attends about twenty-four maternity cases a year. The Committee is of the opinion that if it were more generally known that those unable to pay can enter free of cost more use would probably be made of both the hospital at Waiuku and that at Warkworth. These provisions, while possibly adequate in the districts they serve, leave the major portion of the population unprovided for in the Board's area. Reports and evidence received by the Committee show that the absence of public maternity hospital facilities in most of the outlaying parts of the Auckland district results in great hardship, inconvenience, and sometimes physical damage to mother or babe. It was stated that there is considerable difficulty for the Waiau Pa where there are no transport facilities except private cars, no visiting doctor or nurses. Doctors charge £4 4s. for a single visit. The nearest doctor for Mangawhiri and Mangatangi is at Pukekohe, twenty-two and thirty-two miles away respectively. The charge for an ordinary visit to Mangawhiri is £4 4s. and to Pokeno Valley, £3 3s. Representations of women resident in Makarau, Kaukapakapa, Wainui, Riverhead, Swanson, Henderson, Brown's Bay, Torbay, Takapuna, Devonport, Glenfield, and other northern boroughs, also those from southern areas, Onehunga, Otahuhu, Panmure, Mount Wellington, Huia, Onewhero, Pukekawa, Te Hohonga, Whangarata, Harrisville, Pokeno, Mercer, Mangawhiri and Mangatangi, Pukekohe, Puni, Paerata, Patumahoe, Karaka, and Drury all complained of the difficulty experienced by the mother whose means preclude any possibility of entering a private hospital. Representatives of the Women's Division of the Farmers' Union from Clevedon and Orere spoke of the difficulties experienced by women in reaching hospital twentythree miles away, with three' unbridged streams which, if flooded, may cause serious delay or danger. General. If application is made before the mother enters hospital the Board sometimes grants necessitous cases £2 2s. towards the cost of confinement at a private hospital, but only where for some reason satisfactory to the Board's officers the applicant is unable to enter St. Helens. This means that the nurse who takes such a case into her nursing-home and has to attend it in confinement and board and nurse the patient for ten days or a fortnight is very often a definite loser by the contract, and is in fact relieving a public body of its duty. Taking into consideration the loss sustained by nurses in accepting emergency indigent cases for which they receive no payment at all, it is obvious that a large part of the burden for caring for the mother needing assistance in the outer districts of Auckland is being borne by women who are conducting small private maternity hospitals. Having regard to the distances to be covered and the expense and time involved in travelling to central clinics from the outlying places, many women are debarred altogether from the benefits of ante-natal supervision and equally so with regard to post-natal attention. The establishment of the subsidiary ante-natal clinics and hospitals as recommended would do much to remedy the position. Summary and Recommendations. Auckland City. All the evidence goes to show that the present public facilities are being used to full capacity and that St. Helens Hospital is compelled at times to refuse even normal cases, whilst no provision can be made for suspect cases. Owing to the lack of adequate provision in the general hospital for the many abnormal cases admitted it is recommended that until the main obstetrical unit advocated in the report is established the Board should appoint an experienced obstetrician to the medical staff and set aside for such cases separate wards staffed with experienced midwives. To provide fully for the growing demands of a city of the size of Auckland, the Committee is of the opinion that there should be erected a thoroughly equipped St. Helens Hospital of fifty to sixty beds on a site sufficiently large to provide ample accommodation for present and future needs. A visit of inspection was paid to a site in Symonds Street on which stands the old Grammar School, now occupied by the Workers' Education Association and the Elam School of Act. Adjoining and belonging to the property is a large area of unused land ofEering considerable scope for building purposes and the provision of tennis-courts for stafE recreation. The locality is quiet though central and adjacent to trams, and the property is in a very high and sunny position. This site is recommended as a very suitable and desirable one for the purpose, though a site nearer to the general hospital might still be better.

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