H.—3la,

Blenheim. Public Maternity Hospital Facilities. —The Marlborough Hospital Board controls a maternity annexe of twelve beds in which 150 to 160 cases are attended yearly, with an average of 6-2 occupied beds. Patients come from a radius of sixty miles. The hospital fees are 9s. per day or 12s. per day for a private ward. The hospital is of the " open" type and is a training school for maternity nurses. The midwife in charge attends fifteen to twenty cases a year without a doctor, all other cases engaging their own doctor. The Medical Superintendent of the general hospital lectures to the maternity nurse trainees, but does no practical obstetrical work. If an emergency arises in a " no-doctor " case, the Sister in charge calls one of the local medical practitioners, who attend gratuitously. No sedatives or anaesthetics are administered in " nodoctor " cases, and sedatives are used sparingly in other cases. Ante-natal Care. —An ante-natal clinic is conducted at the hospital. The Sister in charge does all the supervision of the midwife cases and co-operates with the doctors in the care of their patients. The Plunket nurse also does a little ante-natal work, but refers most cases to the hospital clinic. There are two district nurses attached to the Marlborough Hospital Board; one with headquarters at Picton and the other at Seddon. Representations were made to the Committee that the district nurse stationed at Seddon should be provided with a car, in order that she could give ante-natal care to women in the area between Awatere and the Clarence River, and that similar arrangements should be made for the district nurse stationed at Picton to give ante-natal supervision to the women in her country district. The need for a waiting home and convalescent home at Blenheim was expressed, and it was also stated that home help was exceedingly difficult to obtain. The suggestion was made that the establishment of training centres for home help in different areas was desirable. Private-hospital Accommodation in Blenheim. —There is one private maternity hospital in Blenheim with six beds. Ninety-six cases were attended in the hospital last year. The fees are £4 4s. per week. All cases are " doctor-attended " and sedatives and anaesthetics are used. In the opinion of the medical practitioners of the town the private maternity hospital's facilities are sufficient. Havelock. —There is a cottage hospital at Havelock with four maternity beds. The number of cases for the year was forty-two, giving an average of 1-4 occupied beds. The fees are £4 4s. per week. There is one doctor resident in the district, and his midwifery is practically all done in the hospital. In cases attended by the midwife alone no anaesthetic is given ; in cases attended by the doctor chloroform anaesthesia is used. Some criticism of the conditions of staffing was made to the Committee by representatives of the Women's Division of the Farmers' Union. The Sister in charge has no trained nursing assistance, and therefore, apart from five weeks' holiday in the year, has almost continuous responsibility. There has also been some difficulty in obtaining assistance on occasions when the number of patients exceeded four. The district is widely scattered, and patients have frequently to come by launch from the Sounds, involving considerable expense as well as transport difficulty. Largely owing to these reasons, very little ante-natal work is done in this area. There are a number of Maoris in the district, but only a few of them are confined in the hospital each year. Maori housing conditions are poor, and to many of the houses there is no water-supply. The medical practitioner receives a salary for attendance at the hospital and a subsidy from the Health Department for attendance on sick Maoris, but this does not include payment for attendance on maternity cases. There is also a district nurse to Natives who does general preventive and educational work, but no maternity work. Picton. Practically all the midwifery cases of the district are attended in a five-bed maternity annexe controlled by the Marlborough Hospital Board. The hospital is open to the local doctors, who attend all cases. Sedatives are used sparingly, but chloroform anaesthesia is given in all cases. Quite a number of Maori patients now seek admission, although they usually stay in hospital only a few days. The hospital fees are £4 4s. per week. Patients frequently come long distances by launch, involving transport difficulties and considerable expense. The need for accommodation for waiting mothers was stressed.

45