H.—3la,

The Board makes no provision for indigent oases to be attended by a doctor if difficulties arise. The hospital has three beds and takes about eighty cases per year. The fees are £4 4s. per week or £5 ss. per week for a single room. There is a small Maori population in the district, and four or five Maori confinements take place in this hospital each year. There is also a small private hospital with three beds, in which all cases are attended by the doctors. The fee is £4 4s. There is practically no domiciliary midwifery. Patients in the town attend the doctors regularly for ante-natal advice, but full supervision is difficult in the case of women living in the outlying localities. Takaka-Collingwood District. The Committee has already reported on the particular difficulties of the TakakaCollingwood area. The position may be more briefly restated. Takaka and Collingwood are the two natural centres in a scattered and relatively isolated district whose communication with Nelson is impeded by the steep and difficult road over the Takaka hill. Collingwood. District served. —The district surrounding Collingwood branches out in four directions. To the south it goes to Onekaka ; to the south-west to Bainham and the surrounding districts, a distance of fifteen to twenty miles ; to the north it goes to Puponga, a mining village about seventeen miles away ; and to the west there are settlements extending down the West Coast as far as fifty miles from Collingwood. Present Facilities. —The only maternity facilities in Collingwood are provided in the home of an elderly nurse. Though she has rendered excellent service in the past, she is now seventy-five years of age and is not physically able to carry on such onerous work. The patients are required to care for their babies during the night, as the nurse feels herself unable to get up at night. For the past eighteen months the Nelson Hospital Board has subsidized this nurse at the rate of £50 per year, but it is obvious that, with many of the residents in poor circumstances, no private nurse could earn reasonable wages in such a hospital unless a subsidy of a substantially larger amount were given. About thirty infants are born each year in the district, and a considerable number of women go to other centres for confinement owing to the inadequacy of the existing facilities. There are no trained maternity nurses or midwives available in the district for domiciliary attendance. A district nurse, subsidized by the Hospital Board, was resident in the district for a time, but she was unable to maintain a practice and left some years ago. Moreover, even if skilled assistance were always readily available, a large number of the houses in the district, as in all districts, are not suitable for domiciliary maternity attention. The scattered district over which the medical practitioner has to travel also makes attention in the homes extremely difficult. From all points of view it is clear that the needs of this district cannot be met by any system of domiciliary attention. The Committee received a number of deputations from representative organizations who stressed their need for adequate maternity institutional facilities in Collingwood. Recommendations. The Committee is satisfied that a maternity hospital is urgently needed at Collingwood, and recommends that steps should be taken by the Board to ensure its construction without delay. The Committee recommends that the hospital be a three-bed one, with one singlebed ward to provide for the temporary admission of an accident case. The hospital should be of a design and construction and situated on a site approved by the Health Department's technical advisers. Takaka. Takaka is also the centre of a fairly extensive district, the maternity needs of which can only be met by the provision of a maternity hospital at Takaka. Unfortunately, the position is complicated by a local dispute between medical practitioners and sections of the public. The number of confinements at Takaka and district is between thirty and forty per annum. Existing Institutional Facilities. —The only facility available at present is the home of a maternity nurse, who takes one patient. Previously there was a maternity hospital with four beds, but owing to the local dispute the hospital has been closed and the midwife in charge has given up the license.

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