H.—3l.

With Dr. Watt's administration had begun a policy of decentralization, the large health districts being broken up to form combined health units under a Medical Officer of Health, who was also School Medical Officer with a supervising nurse in charge of the area ; the area being again broken up into small areas, in each of which was located a district health nurse, who was responsible for all the public health services in that district. i The period of depression in a sense helped this organization, for as members of the start were retired replacements were made of the new type of generalized work or breaking down the specialized services which had previously existed. Similarly, the problem of the small training-school for nurses was assisted, as the hospitals which were used as such were cancelled and the controlling authorities advised to staff with registered nurses and nursing aids, so assisting in the absorption of unemployed nurses. Thus over a period of three or four years a reorganization took place which laid the ground for supervision on fresh lines, so that in 1935, with the advent of an expansion programme, the opportunity was offered for an extension of the decentralization policy with a more generalized public health nursing service. Between 1929 and 1938 New Zealand was divided from four into ten health districts, and the complete reorganization of the district nursing staff along these lines has taken place in rural areas, while in urban districts a beginning has been made to co-ordinate the many existing services more closely. Among the training-schools for nurses the loss of the small schools was far more than made up by the increased hospitalization of the sick, so that the actual number of nurses in training has increased by nearly one thousand over a period of ten years. New schemes of training such as the " block" system of teaching, when the nurses are withdrawn from the wards for periods of study, have been inaugurated, and some hospitals have adopted the living-out system for the registered staff who enjoy the freedom from hospital life. The State examination was enlarged to include a paper on nursing procedures, and tor the oral examination a practical examination in the wards of the hospitals was substituted. To help the small hospital to try and bridge the gap for the girl who must earn between leaving school and entering hospital, a new scheme for training nursing aids is to be inaugurated. This training will cover a period of two years, the first year being devoted to domestic science, and the second to elementary nursing duties. Should this registered nursing aid proceed to do her general training she will be given some concession in regard to her period of training. The new obstetrical training has become firmly established. There are twenty-six hospitals training maternity nurses and practically all registered nurses now acquire this additional certificate ; but the midwifery training is only given at the four State St. Helens Hospitals, and only those registered maternity nurses who are prepared to practise obstetrics are taken for training. B Recently Tutor Sisters have been introduced to these State hospitals, and an endeavour made to make the conditions such as will attract the best professional women to specialize in this service. The tropical nursing services were completely reorganized. In Samoa a training course was inaugurated for Native nurses which includes preparation in infant welfare and public-health nursing. Arrangements were made for the European staff to be sent on definite loan from the staff of a Hospital Board or from the Department for a period of two years, the Administration paying into the superannuation fund in New Zealand on their behalf during their absence. The same arrangements were made for the Cook Islands, and in 1935 the iiji Administration entered into a contract with the New Zealand Government that their nursing services should be linked to New Zealand in the same manner and come under the supervision of the Nursing Division of this Department. Miss L. M. Lea, a member of the staff of the Health Department, was seconded to be in charge in Fiji. This reorganization involved personal visits to the Islands by the writer so as to gain personal knowledge of the problems involved. For some years after the inception of the superannuation fund for nurses representations were made to the Government asking that the Hospital Superannuation Fund and the Public Service Superannuation Fund, to which nurses employed in the Government contributed, should lie made interchangeable. This principle was finally granted in 1938 and will enhance the position of nurses entering the Public Service considerably, as well as benefiting considerably members of the existing staff The post-graduate school, begun originally under such difficulties, has now a recognized place amongst not only nurses themselves, but also their controlling authorities. Many nurses have been granted bursaries by the Hospital Boards, the Department, and the New Zealand Registered Nurses' Association. It is only a matter of time before this school will become a school of nursing affiliated more closely, it is hoped, to the University. . The close relationship of the Nursing Division with the New Zealand Registered Nurses Association has continued, and various educational studies in regard to nursing technique have been carried out in conjunction with the association. The association has further expanded to twenty-eight branches and has developed a Student Nurses' Association, each training-school having its own council Such expansion has, of course, increased the functions and staff of the Dominion, office. The association, which was affiliated in 1912 with the International Council of Nurses, has for the last four quadrennial conferences sent representative' delegates to attend these important international meetings, and they have brought back much inspiration gained from this contact. In 1934 a Florence Nightingale Memorial Committee was set up in New Zealand consisting oi equal membership of the New Zealand Registered Nurses' Association and the New Zealand Red Cross Society. In 1935 a study scholarship was awarded to Miss E. R. Bridges, a New Zealand post-graduate student to take an advanced course in public-health nursing at the International Course at Bedford College,' London, and in 1939 another scholarship was awarded to Miss V. Armstrong, the Assistant Matron of Wellington Hospital.

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