H.—3la,

difficulty lies in the distances which patients have to travel, in some instances fifty miles It was suggested by several witnesses that an extension of the district nursing service would help to solve this difficulty. Maori Conditions. — The needs of a Maori population of 2,415 are served by one district nurse, who gives ante-natal supervision and attends patients in their homes in cases of difficulty. The nurse calls a doctor when necessary, but most abnormal cases are sent to the public hospital. Maori cases are not taken at the private hospital unless sent for some special purpose by a doctor, the reason for this being the prevalence of skininfections and the difficulty of isolation. There are no institutional facilities for normal Maori cases, the majority of whom are confined in their homes, either in Native fashion or by the district nurse. Summary and Recommendations. It would seem that, so far as the European population is concerned, accommodation is adequate to the needs of the district, but the licensee's difficulty in collecting fees militates against the smooth running of the hospital. Certain additions to the hospital and its equipment are required, but are beyond the means of the licensee. Chief among these is a proper nursery and better theatre accommodation. The provision of these requirements by the Hospital Board would make for improved service, and the Committee urges that attention be given to this matter. The Committee suggests that the Board be urged to follow the practice of other hospital boards in recognizing its responsibility for payment of a fee to doctors for emergency attendance on indigent cases. The Commitee recommends that adequate hospital accommodation be provided for Maori patients. A four-bed annexe at the public hospital would be sufficient, and until such provision is made little can be done to improve maternity services among the Maori population. In the interests of more effective ante-natal care for Maori women the Committee recommends an extension of the district nursing scheme, and suggests that, were the services of the district nurse made available to European as well as Maori residents of outlying districts, this would be of great assistance to patients living too far from Opotiki for regular ante-natal attendance. 18. WAIAPU HOSPITAL BOARD. The eastern and northern boundaries of this district, which includes the counties of Waiapu and Matakaoa, are formed by the coast-line and extend from Tolaga Bay in the south to a point midway between Hick's Bay and Cape Runaway in the north. The main hospital centre is at Te Puia Springs (275 inhabitants), a popular health resort. A good road four miles in length leads to Waipiro Bay (378 inhabitants), and Tokomaru Bay (483 inhabitants), where the present maternity hospital is situated, is a distance of seven miles to the south. Te Araroa (354 inhabitants) on the north coast, and Tiki Tiki (478 inhabitants) twenty-five miles inland, are districts mainly inhabited by Maoris. Ruatoria (653 inhabitants) is the principal centre on the road between Te Puia and Te Araroa. The total rural population of the district is 8,134, a general increase having taken place during the 1926-36 intercensal period, amounting to 25-74 per cent, in Waiapu County and 22-04 per cent, in Matakaoa County. There are no railways, and communication is by roads, which in the main are good, but in parts are subject to flooding in wet weather. Telephone communication is satisfactory. An interesting feature of the district is the supply of natural inflammable gas which is collected at Te Puia and used by the residents for lighting and heating purposes. Sheep-farming is the principal industry. Tokomaru Bay. A four-bed hospital belonging to the Hospital Board has hitherto catered for the needs of the greater part of the district. It is proposed, however, shortly to remove to more convenient premises at Waipiro Bay. Most cases are attended by a midwife, but the doctor at Te Puia, seven miles away, is available for emergencies and also attends twice weekly for ante-natal and other consultations. The cases attended are mostly Maoris, white patients preferring to go to Gisborne for confinement, on account of the impossibility of getting a single room at Tokomaru Bay. Te Puia and Waipiro Bay. The general hospital and doctor's residence are situated at Te Puia, but there is no maternity annexe. The gift of a property at Waipiro Bay for conversion into a maternity hospital has recently been accepted by the Board. This house was inspected by the Committee. It is pleasantly situated and well built, and though the necessary alterations must, of necessity, be costly, the Board is of the opinion that the value of the gift outweighs any possible disadvantages. Board members pointed out that, while Ruatoria is geographically the centre of the district, Waipiro Bay is more accessible for the doctor

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