H.—3la.

Recommendations. To sum up, the Committee strongly recommends that the Hospital Board should make arrangements — (1) For the respective local medical practitioners to undertake at a fixed fee the ante-natal and post-natal attention of the poorer patients living elsewhere than in Masterton. (2) For the attention of patients during labour by a medical man. (3) For the admission of patients to the hospital, public or private, nearest to their place of residence, the Board being responsible for the fees when necessary. 25. TARANAKI HOSPITAL BOARD DISTRICT. The Taranaki Hospital Board serves a long coastal belt of North Taranaki from Opunake in the south to the Mokau in the north. The district is essentially a pastoral one, with New Plymouth (16,424) as its main business centre and port. Waitara (1,806) has large freezing-works. Opunake (1,039) and Inglewood (1,254) are smaller country centres. The roads are good, but some of the settlements at the north end of the area are rather remote from the centres. There has been a moderate increase in the population of this area during the ten-year period 1926-36. New Plymouth. Public-hospital Facilities. —In New Plymouth there are no public maternity hospital beds for normal cases either under the control of the Hospital Board or under the control of the Department of Health. The Board accepts responsibility for indigent maternity cases, after application and investigation, by subsidizing certain of the private maternity homes at the rate of £3 3s. per week. A fee of £3 3s. is paid to the doctor when medical aid is considered necessary at the confinement. About forty cases are dealt with in this manner each year. Most of the abnormal midwifery cases of the district are dealt with in the New Plymouth Hospital, but it is the opinion of the obstetrician in charge of these cases that the conditions of staffing and accommodation are not satisfactory. Strong representations were made to the Committee by members of the medical profession and by representatives of women's organizations in favour of the establishment of a proper maternity annexe in association with the New Plymouth Hospital, in charge of a competent obstetrician and capable of dealing with both normal and abnormal cases. They advocate that such an annexe be an " open " one in which private practitioners could attend their own cases. Private Maternity Hospitals. —Private maternity hospital accommodation is, on the whole, satisfactory, although none of the homes is sufficiently large to allow a night nurse to be maintained. The number of beds is quite adequate, the wards are pleasant, and the fees are moderate. Ante-natal Care. —There is a small Plunket ante-natal clinic, but most of the medical men of the district are strongly of the opinion that in private cases the doctor should be entirely responsible for the ante-natal care of his patients ; the independent Plunket type of clinic is therefore not generally favoured. A hospital ante-natal clinic in association with a maternity annexe is, however, considered desirable. It was the opinion of the Committee that at the present time the community as a whole was not as adequately served in regard to ante-natal attention as many towns of a similar size in which ante-natal clinics were operating. District Services.—There is no organized district maternity nursing amongst Europeans. Most of the doctors use both anaesthetics and analgesics. Waitara. The maternity facilities at Waitara cannot be regarded as adequate. There is at present only one small private maternity hospital with three beds, working under considerable difficulty. The district is not a wealthy one, and it is difficult for private enterprise to maintain an efficient service. A public maternity hospital annexe at New Plymouth would afford some assistance, but the Waitara district itself is large enough to make some publicly assisted local provision desirable. A further reason for advising this course is the necessity for making provision for the considerable number of Maoris resident in the neighbourhood ; fuller reference is made to this point in discussing the Taranaki Maori position generally.

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