H.—3la.

There is reason to think that the ante-natal supervision of such patients is considerably short of the ideal and that ante-natal services through the agency of a district nurse would considerably help the position. There are a considerable number of Maoris in the district. The conditions under which they are living are not good, and most of the confinements are attended by the Natives themselves. The beginning of a service such as the Committee favours is, however, already in operation. The hospital is prepared to take Maori patients, and they are showing a willingness to come. The district nurse is already giving a considerable amount of ante-natal advice. The Committee commends this service and strongly advocates its development. Summary and Recommendations. (1) The Committee considers that the Taumarunui Borough and the neighbouring areas are very well served. (2) It is considered that a small maternity hospital at Ohura would be helpful. (3) The extension of the district nurse service to both Maoris and Europeans is recommended. 11. THAMES HOSPITAL BOARD DISTRICT. This district, which includes the County of Thames, part of the Hauraki Plains, and the western half of Ohinemuri County, extends from the Firth of Thames and the Waikato Boundary on the west to the Bay of Plenty on the east. Its northern boundary divides it from the Coromandel district, and its southern from Tauranga and Waihi. Two principal towns, Thames and Paeroa, have populations of 4,268 and 2,149 respectively. The former showed a decrease of 10-26 per cent, in population, and the latter an increase of 17-24 per cent, during the last intercensal period. Apart from the Hauraki Plain, the district is in the main hilly and rugged. Some of the old-established gold-mines are still being worked, but apart from this the population is mainly occupied in small farming. The mineral springs at Puriri are well known. Thames. Public-hospital Facilities.—The Thames Hospital maternity annexe provides a total of ten beds and is a training school for maternity nurses. The annexe is a converted school building and, while efficiently run, is inconvenient and uncomfortable. The main lack is of proper facilities for ante-natal work. Patients are examined in the bathroom, the waiting-room being a curtained-ofE corridor. No dressing-rooms are provided, and this causes undue delay and waste of time. Private-hospital Facilities.—A private hospital in the town caters for from thirty to forty cases per annum. The hospital is a mixed one, the ground floor being devoted to surgical and general, and the first floor to maternity work. No labour ward is provided, patients being confined in their rooms. Paeroa. Public-hospital Facilities.—A cottage hospital with five maternity beds is under the control of the Thames Hospital Board. From information received from various reliable sources in the district the Committee formed the opinion that an unsatisfactory state of affairs obtains with regard to this hospital. Though a Board hospital, it has no Medical Superintendent, nor is it under the control of the Superintendent of the Thames Hospital, cases being attended by the two local practitioners. The Sister in charge, though an employee of the Thames Hospital Board, is not under the control of the Matron of Thames Hospital. It was alleged that patients are not admitted, except on payment or guarantee of the required fee, and indigent patients are obliged to go to Thames annexe, a distance of nineteen miles. Equipment and accommodation appear to be adequate, but it was evident from a perusal of the hospital books that operations such as appendicectomy were performed at the hospital and that septic cases were by no means rigidly excluded. No provision is made for ante-natal supervision at the hospital. Private-hospital Facilities.—A private maternity hospital takes about fifty cases a year. The licensee stated that she found it hard to make ends meet. Though charging the low fee of £4 4s. per week, bad debts are frequent, and she has from time to time taken a number of indigent cases, for which she has apparently not asked for, nor received, any assistance from the Hospital Board. Provision for Abnormal Cases.—These are treated mainly in the Thames annexe. Provision for Unmarried Mothers. —No special provision is made for unmarried mothers, but they are admitted to the Thames annexe on the same terms as the married. Ante-natal Care. —Apart from private attendance, ante-natal supervision is carried out under very considerable difficulty, to which reference has already been made.

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