H.—3la.

The main need, as the residents themselves state, is a competent doctor in the district. They also urge, however, the great need of a small maternity home where the mothers could be confined under more satisfactory conditions and saved the expense, anxiety, and discomfort of. travelling to Westport. Such a maternity home would undoubtedly be an inducement for a doctor to take up the practice. Summary and Recommendations. It was clear from the evidence taken and inspections made that many parts of this district are unprovided for in regard to maternity facilities. Whilst in some of the country townships the resident doctors carried out the ante-natal supervision of pregnant mothers, the distance of the Kawatiri Hospital precluded them from attending the confinements, and the Committee is definitely of opinion that the position calls for early action. Westport. As stated previously, Kawatiri Hospital is a house converted into a hospital and is definitely unsuitable to enlarge or improve, and the Committee is of opinion that the time has arrived when a new hospital should be built adjacent to the public hospital. The evidence showed that if additional beds were available more mothers would enter Kawatiri. The sale of the hospital and the section on which it stands would provide money towards the erection of the new hospital. Granity, Ngakawau, Millerton, and Stockton. The Committee believes that with a population of three thousand concentrated in these four nearby townships and served by two doctors there is a legitimate place for a small maternity home. It is recommended that a maternity home of three or four beds be built and maintained by the Buller Hospital Board at Granity, to be staffed by a nurse with both midwifery and general qualifications. Karamea. The Committee considers that the claims of this community are most justifiable. It is clear that the economic circumstances of the residents and the comparatively small number of maternity cases in the year would not allow of any private provision of the necessary facilities. It is therefore strongly recommended that a small maternity home be built and maintained by the Buller Hospital Board at Karamea, under the charge of a nurse with midwifery and general nursing qualifications. 36. INANGAHUA HOSPITAL BOARD. This Board serves the Inangahua County, whose area is 949 square miles and contains the townships of Reefton (1,441) and Waiuta (601), also a number of smaller settlements. It is bounded on the north by the Nelson and Buller Hospital districts and on the south by the Grey Hospital district. On the east is the central range of mountains. The principal industry in this district is mining. The public facilities are seven beds in the maternity hospital attached to the public hospital and under the control of the Medical Superintendent, who is the only doctor resident in Reefton. For the year 1936-37 there were eighty-one patients confined, nearly all of whom were attended by the doctor. The fee is £4 45., but indigent cases are attended free. Nembutal is used to a limited degree, chloroform being more generally used. An ante-natal clinic is run by the Sister under the supervision of the Medical Superintendent, who sees every patient. There are no regular days for the clinic, nor are ante-natal records kept. At Waiuta, which is twenty-six miles distant, there is a resident doctor employed by the Medical Association, and also a Class C midwife, but no hospital. The doctor attends on the average twelve maternity cases a year. Half of these go to the hospital at Reefton and the other half are confined in their homes on the score of economy. They receive £3 from the Medical Association and £6 from the National Provident Fund. The doctor is financed by the Medical Association at Waiuta and receives £2 2s. for maternity cases. This fee includes all ante-natal work. This basis of payment is laid down by the Medical Association, but the association does not guarantee the £2 2s. The Committee consider that the needs of this district are satisfactorily met, but regards the fee paid to the medical attendant as unsatisfactory. 37. GREY HOSPITAL BOARD. The area of the Grey Hospital District is that of the Grey County, 1,594 square miles, containing Greymouth (8,115), Brunner (998), Runanga (1,647), and a further population of 5,698 in the various smaller settlements in the district. The population shows an increase of per cent, over the last ten years, most of which has been

50