H.—3la.

Hokitika. The only public-hospital facility is a six-bedded hospital provided by the Board at Hokitika. This hospital is a converted house and is leased to a registered midwife, who receives a subsidy of £150 per annum, which is intended to recoup her for admitting patients who are unable to pay any or only part of the fees, which are £4 lis. per week. The provision made by this hospital is, however, quite inadequate to meet the requirements of the district, in addition to which the building itself is quite unsuitable for the purpose of a maternity hospital. The hospital is frequently overcrowded, and patients have occasionally to be discharged on the tenth day of their puerperium to make room for those whom it is necessary to admit. Furthermore, the Committee is satisfied that the subsidy paid the licensee is in no way adequate to meet the purpose for which it is paid. There is no arrangement for the medical attention of patients who are unable to pay, and if the midwife, after engaging to attend a patient by herself, finds it necessary to call in medical assistance she has to depend on the gratuitous service of the doctors. There is no other hospital accommodation either in the town or in the district. Ante-natal Care. —For the women living out of Hokitika very little ante-natal care is available owing to the lack of transport and the distances to be travelled. Ross. There are no facilities whatever in this district, the nearest doctor being at Hokitika, and the cost of a visit of a doctor to Ross is £6 6s. Most of the mothers from here are confined in the maternity home at Hokitika, which is fifteen miles distant. Watakoa. This township is seventy miles south of Hokitika, on the main road to the Franz Josef and Fox Glaciers. A doctor is resident here and is paid partly by the South Westland Medical Association and partly by the Hospital Board. There is no midwife in practice, although a retired nurse has been assisting the doctor when available. The distances between settlements are long and, with few exceptions, the houses are unsuitable for confinements, there being no electric light and few other conveniences. It is considered that a small maternity hospital is urgently needed to serve the district as far south as Waiho (Franz Josef Glacier) and Weheka (Fox Glacier). Bruce Bay. Thirty-five miles south of Weheka is the timber-milling settlement of Bruce Bay, the population of which is at present augmented by a large public-works roading-camp. Owing to the fact that some of the bridges are not completed the locality is at times entirely isolated except for aeroplane transport. The Committee is informed that arrangements have been made by the Public Works Department with the Health Department to build a casualty station. It is considered that provision should be made in this little unit for the treatment of maternity cases. Summary and Recommendations. (1) The existing facilities in Hokitika are considered inadequate. It is therefore recommended that a maternity hospital be built in Hokitika, preferably in close proximity to the public hospital. It should either be staffed and managed by the Board itself, or leased to the licensee of the present hospital with a more adequate subsidy than is at present given. (2) Owing to the fact that the population is so scattered and that the settlements in the south of the district are so far from Hokitika, additional provision is required, and it is recommended that a cottage hospital should be built at Wataroa and that it should be staffed by a registered nurse who is also a midwife, with the necessary domestic assistance. It is advised that it should consist of a two-bedded ward and a single ward, and that it should be used principally as a maternity hospital, but should be able to admit as a temporary measure urgent medical and surgical cases, including accidents, until they can be transported to the main hospital at Hokitika. (3) The Bruce Bay settlement being so entirely isolated, it is recommended that maternity accommodation be added to the proposed casualty station. It is advised that this should comprise, on the patients' side, casualty and dressing room, waitingroom, two single bedrooms, bathroom, closet, and sluice-room, and, on the staff side, a combined dining-room and sitting-room, kitchen, two bedrooms, bath, W.C., scullery, and combined washhouse and fuel-store. It is recommended that this small hospital should be staffed by a person registered both as a nurse and as a midwife, together with the necessary domestic assistance. This should provide all the accommodation necessary for maternity patients who, in normal cases, would be attended by the midwife, and any abnormal case would have to depend on the doctor from Wataroa, whose access at present is by aeroplane. (4) Regarding transport, it is apparent to the Committee that, owing to the high cost of transport by aeroplane—£l2 for the return trip—and the lack of room in the

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