1:1.—31a,

At Kaiapoi there is a private hospital, mainly maternity, owned by the local doctor but leased to a nurse. The Hospital Board pays a subsidy of £150 for attention to indigent cases. Of this, £75 is paid to the nurse and £75 is reserved for hospital maintenance. The nurse pays no rent, charges and collects her own fees (£9 9s. for tivo weeks), but in return for the subsidy must take indigent cases without fee. The doctor attends all cases. A number of Maoris from the neighbouring settlement are admitted, most of whom are indigent cases. There are no other private maternity hospitals in the district and, owino- to the generous provision of public hospitals, there is practically no domiciliary midwifery attendance. Ante-natal care is mostly given by the local doctors, but in some cases as at Kaikoura and Rangiora a number of patients attend the hospital clinics. Sedatives and anaesthetics appear to be used to an average degree. Maori Conditions. _ There are a few hundred Maoris living within a radius of twenty-five miles from Christchurch, the largest settlements being at Tuahiwi (148), Little Eiver, Wainui and Kaikoura. The conditions in the Maori homes are fairly satisfactory and compare very favourably with those m the North, the majority of the Natives living in European fashion. There is a growing tendency for these Maoris to come into hospital at Little River and Kaiapoi. The Committee considers that this should be encouraged. At one time there was a special District Nurse for Natives, but during the depression this service was discontinued some years ago. The Committee is of opinion that if it were recommenced the development oi ante-natal work among the Maoris would improve the Maori maternity service considerably. Chatham Islands. The North Canterbury Hospital Board is also responsible for the hospital service in the outlying Chatham Islands. Four maternity beds are provided in the small hospital there, and ten cases were attended last year. There is one medical practitioner who supervises these cases. Summary and Recommendations. (1) Christchurch City Area. The position in Christchurch is that although the St. Helens service in itself is excellent and although the Hospital Board has given commendable assistance in dealing with the maternity needs of those with small means, the maternity hospital facilities for both normal and abnormal cases are quite inadequate both in type and in number of available beds. By instruction, the Committee gave very full consideration to the site and scope oi a proposed new St. Helens Hospital, and its opinions and recommendations were incorporated m an interim report which has already been submitted. It is considered that, since some of these views have a general as well as a local application, it is advisable to quote a considerable portion of that interim report. The Committee stated :— Of the urgent necessity for the improvement of the public maternity hospital provision in Christchurch there can be no argument. The need has been realized for many years, but for various reasons it has not been found possible to proceed with the erection of a new hospital. It having been decided to take this work in hand, the Committee was asked to investigate and to advise on various aspeets of the project. I. The Site. The first question investigated was the most suitable site for the proposed hospital. has been taken from representatives of all those interested in the matter, and various sites examined. It is clear that the considerations which must weigh in the selection of a suitable position for a maternity hospital are :— (1) Area. (2) Environment. (3) Convenience of access for patients from all parts of the district, particularly for ante-natal and post-natal visits. (4) Convenience of access to the facilities of the general hospital. (5) Cost. It is agreed that, as far as possible, the hospital should be pleasantly situated, but, on the other hand, many sites quite suitable from this point of view alone are definitely unsuitable in other respects. The site chosen must not only be adequate for immediate needs, but sufficiently large to allow of reasonable extension of the hospital in the future.

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