H.—3la.

Emoluments and Supekannuation. Maternity nursing undoubtedly taxes both the time and the strength of a nurse more than any other branch of the nursing profession. Where employment is regular, as on a hospital staff, the wage she commands may be sufficient to maintain the nurse in modest comfort, though allowing but a small margin for saving. On the other hand, in private nursing or in small country hospital practice periods of unemployment caused by the irregular character of the work may so encroach on the nurse's earnings as to leave her with quite inadequate means of livelihood and little or no more possibility of putting anything by. While under existing economic conditions it might not be practicable to increase the nurse's fee to a figure more commensurate with the services given, it is clear that some form of superannuation is highly desirable. At present no such provision exists. Disciplinary Measures. It was pointed out by a representative of the Nurses and Midwives Registration Board that at present no legislation exists to enable the Board to discipline midwives and maternity nurses who have been guilty of breaches of the Nurses and Midwives Registration Act. While a midwife or maternity nurse who is guilty of a major offence may be struck off the register, no penalty can be enforced for minor offences. Recommendations. After detailed consideration of the present position regarding the training and control of midwives and maternity nurses the Committee advances the following recommendations :— (1) That in the interests of efficient training the present " closed " system be adhered to in training schools for midwives, and that in these schools the appointment of tutor midwives be given consideration. (2) That short compulsory refresher courses be held for practising midwives and maternity nurses. Such courses should be free of cost. (3) That no measures be taken which might have the effect of reducing the efficiency of midwives' training. (4) That an adequate system of superannuation for midwives and maternity nurses be introduced. (5) That legislation be enacted conferring on the Nurses and Midwives Registration Board powers for imposing adequate discipline on the midwives and maternity nurses under its jurisdiction. 10. TRAINING OF MEDICAL STUDENTS IN MIDWIFERY. The first specific directions regarding the course in midwifery at the Otago University Medical School are found in the University statutes published in the New Zealand University Calendar for 1882, wherein it is laid down that no student shall be admitted to the final examination for the degree of M.8., Ch.B. until he has shown evidence of having attended a course of not less than sixty lectures in midwifery and the diseases of women, and of having attended six confinements. This regulation remained in force until 1911, when the number of compulsory attendances at confinement was increased to twelve, " of which at least four shall have been attended under proper supervision at a maternity hospital." In 1923 the number of compulsory attendances was raised to twenty, and in 1936 it was laid down that at least eight of these were to take place in the University Maternity Hospital. Prior to 1931 the subject of obstetrics was taught by a lecturer assisted by two tutors, who attended abnormal cases and gave instruction in ante-natal examination. This latter consisted of the palpation and auscultation of at most six cases. In normal cases students conducted deliveries under the supervision of the Matron or Sister in charge ; they were usually summoned when the birth of the child was imminent, and were given no opportunity of observing the different stages of labour or of making internal examinations. The difficulty of providing case material for students was in some degree eased by their admission to St. Helens Hospital, Dunedin, and by the courtesy of the Salvation Army authorities arrangements were made for a limited number of cases to be attended at Redroofs Hospital. In 1931 a Chair of Obstetrics and Gynecology was established by public subscription, and a whole-time Professor appointed. The Professor's activities have hitherto been seriously hampered by the limited and inconvenient conditions under which teaching has had to be carried out at the Batchelor and St. Helens Hospitals, both of which are converted residences and lacking in modern equipment. At the present time, however, a far-reaching change is being effected in the training of students in midwifery by reason of the fact that a modern obstetric teaching hospital of twenty-six beds has been opened; superseding the two small hospitals—the Batchelor and St. Helens. It is equipped with facilities for conducting every type of case, and all case material is used for the benefit of students, no nurses being in training in the

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