H.—3l

Reports of Divisional Directors. Public Hygiene. Dr. Ritchie in this report gives further statistical information for the year. Throughout the Dominion close attention has been given by officers to problems of general sanitation and water-supplies. The policy of co-ordinating the work of local authorities in matters of sanitation and health have been actively pursued. Special attention has been given to the administration of the Food and Drugs Act and the Dangerous Drugs and Poisons Acts. A much higher standard in the keeping of records of dangerous drugs and poison records is reported. The supervising of milk-supplies and health camps and measures to deal with the measles epidemic entailed much additional work. School Hygiene. The problem of nutrition of our school-schildren has received close attention by officers of this division. The School Medical Service health leaflets on "Suggestions to Parents," "The School Lunch," " Care of the Eyes," &c., were revised and widely distributed. Some work has been done in the formation of a health centre in the Central Wellington area, the main objects being (1) to provide closer and more frequent supervision and inspection of school-children in the area ; (2) to provide more assistance for the teachers in the planning of health activities and health teaching ; (3) to facilitate and stimulate the working of the Junior Red Cross in the schools in the area ; (4) to reach by means of pre-school clinics pre-school children not attending kindergartens ; (5) to participate to a greater extent in the formation of hygiene and sanitation in the school; (6) to assist medical officers of health to a greater extent in communicable disease control; (7) to form classes of instruction for mothers ; (8) to do more intensive home visiting for the purpose of health supervision by urging correction of defects and by discussing disease prevention and control; (9) to meet in conference the members of existing organizations in the area so that overlapping may be overcome ; (10) to provide suitable training ground for post-graduate and student nurses. Dr. Mary Champtaloup reports in this connection that a health education group has been formed, the membership of which was drawn from all parts of the special health area of the city. Meetings are held periodically, and co-operation is being generously given by the staffs of the Plunket Society, the Taranaki Street Kindergarten, and primary schools. This is a form of health work which could, with advantage, be adopted in other centres. Not only is it a means of public education, but an agency for co-ordinating work in the district, and a nucleus for the development of a health centre. Hospitals. The maintenance estimate of all Boards for the year provided for a net expenditure of £1,483,889 7s. Bd., of which £724,843 9s. Id. was required to be contributed by levy from local authorities and £759,045 18s. 7d. by subsidy from Consolidated Fund, a total increase of £202,023 2s. sd. compared with the requirements of the previous year. In a few cases it was necessary for Boards to exceed the expenditure provided for in their estimates. The increase in estimated hospital expenditure —viz., £252,436 15s. 6d.—was mainly responsible for these increased requirements, but it is worthy of note that estimated recoveries from patients fees and charitable aid increased by £76,968 13s. Id. compared with the estimate for the previous year. A further reduction of £27,030 in charitable-aid expenditure to recipients of outdoor relief is gratifying. It is anticipated that payments to be made to Hospital Boards in respect of hospital and maternity benefits under Part 111 of the Social Security Act, 1938, which are expected to be available early in 1939-40 will afford a substantial measure of relief to the contributing local authorities and the Government. The increased monetary benefits under Part II of the Act will also materially assist in this direction. Full statistical and financial information based on the final accounts for the years operations will be published in a special appendix to this report. There was again considerable activity in building operations of Boards during the year, and this was reflected in the increase of £43,163 15s. 3d. in the estimated amount to be contributed by levy and subsidy for capital purposes. In the loans section of the estimates expenditure of £1,482,631 18s. 2d. was provided for, an increase of £898,412 Bs. sd. over that of the previous year. Nursing Division. Miss Lambie, in her report, outlines the various measures taken for the, development and improvement of nursing in New Zealand. Reference is made to the conclusion of a four-years' statistical study on the health of nurses inaugurated by the International Council of Nurses. The findings have been referred to the Tuberculosis Committee of the Medical Research Council. Among other matters to which attention is drawn are nursing education, post-graduate course for nurses, hospital staffing, and recommendations of the Training-schools Matrons' Conference forwarded to all Hospital Boards on the staffing of hospital wards. Maternal Welfare. The Committee of Inquiry into Maternity Services completed its work and submitted a valuable report. A deficiency was revealed in maternity services, particularly in rural areas, and especially among the Maoris. Attention is drawn to defects in hospital accommodation for maternity cases available in most of the towns. The Committee in its summary of recommendations found that the tendency in New Zealand was for attendance by both doctor and midwife, or doctor and maternity nurse in all cases, on women during pregnancy and labour, normal or abnormal, rather than attendance by midwife in normal cases, with a doctor acting in a supervisory capacity and available in abnormal cases.

2—H. 31.

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