H.—3la

SUBURBAN AND COUNTRY DISTRICTS. It is obvious that much, more remains to be done if the populous district for which this Board is responsible is to be adequately provided for in the matter of maternity services. At the present time, except for that portion of the city within reasonable distance of St. Helens Hospital, and the areas surrounding Warkworth and Waiuku, quite inadequate provision has been made for the remaining population. The Committee strongly recommends that immediate action be taken to provide additional maternity facilities by the establishment or subsidizing of maternity hospitals in— (1) (a) The North Shore district. (b) Onehunga. (e) Otahuhu. (d) Henderson. (2) In districts where the population is too small to warrant the provision of a special institution the Board should make arrangements with the existing private hospitals to take indigent cases and provide a fee sufficient to adequately remunerate the licensees and medical practitioners for their services. (3) That the Board should accept the responsibility for emergency cases which sometimes arrive at a private hospital when in labour and have to be admitted. These at present are attended at a total loss to the licensees and are definitely a public and not a private responsibility. (4) Here, as elsewhere, the Committee realizes the difficulty of frequent visits to ante-natal clinics by women living in suburban and country districts, but is of opinion that this could be largely overcome where no hospital facilities exist by a system of branch clinics working in conjunction with the main clinic, and recommends that action be taken to establish these where necessary. 9. WAIKATO HOSPITAL BOARD DISTRICT. This district is situated in the South Auckland Health District and serves the counties of Waikato, Waipu, Raglan, Piako, Matamata, Rotorua, Otorohanga, Kawhia, Waitomo, and Taupo. It covers a very large area of the North Island, and included in it are many thickly populated areas. The population is 120,705, of whom 15,647 are Maoris. During the past ten years the population of this area has increased by 26-44 per cent. The main industries of this area are sheep and dairy farming, timber-felling, and also some mining. It contains a number of small towns in addition to the two principal ones of Hamilton (19,337, Maoris 250) and Rotorua (9,228, Maoris 3,801). These are Huntly (2,482), Ngaruawahia (1,623), Morrinsville (3,092), Te Aroha (3, 251), Cambridge (2,694), Te Awamutu (2,688), Arapuni-Putaruru (2,194), Matamata (2,314), Otorohanga (2,160), Kawhia (2,227), Te Kuiti - Piopio (3,397), with several smaller townships in the south — Mokai (384), Taupo (523), Tokaanu (201), Awakino-Mokau (294). There is a large Maori population, the requirements of whom will be dealt with in a separate report. There are public-hospital facilities at Hamilton, Rotorua, Huntly, Matamata, Kawhia and Te Kuiti. Public-hospital Facilities. Hamilton.—The Campbell-Johnstone Ward attached to the public hospital provides nineteen beds with an average number daily occupied 11-2, and during the year 388 patients were admitted. It is staffed by a resident obstetrician and four trained midwives and ten maternity nurse trainees. It is an " open " hospital, the local doctors attending about 20 per cent, of the cases including all abnormal cases, most of the remainder being confined by the midwife in charge. The majority of the private practitioners attend their patients in private hospitals, of which there are five, providing twenty-eight beds and admitting (in 1936) 372 patients. Anaesthetics and analgesics are used to the average degree subject to the limitations of a " no-doctor " service. There is an ante-natal clinic functioning, and all patients are seen by the hospital doctors, and all cases showing any signs of abnormality are seen post-natally. In addition, a Plunket Society clinic provides a limited amount of ante-natal attention, and there are two district nurses residing in Hamilton, most of whose work is among the Maori population resident outside the town. This hospital is a training school for maternity nurses. Rotorua. —There is a public general and maternity hospital containing thirteen maternity beds, and for the year ending 31st March, 1936, 199 patients were admitted. There is a resident medical superintendent and a registered midwife in charge of the maternity block. The remarks in regard to the attendance of the doctor and midwife at confinements and ante-natal clinic at Hamilton apply also to Rotorua. The hospital is equipped with all facilities for maternity work.

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