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KINGSEAT HOSPITAL Dr. Lewis reports : I have the honour to present the annual report for the vear ended 31st December, 1947. The total number of cases under care during the year was 1,036 ; of these, 974 were subjects of a reception order and 62 were voluntary boarders. The weekly average number resident during the year was 854. The admissions totalled 138; 106 were certified patients, of whom 24 were transfers from other institutions and 32 were voluntary boarders. Seventy-five persons were discharged during the year and 41 were transferred to other institutions. At the end of the year 38 persons were well enough to be on probation in the care of relatives or friends. Forty-nine persons died during the year. There was a change of local administrator in the middle of the year, Dr. Tothill, the Medical Superintendent, leaving to take up the post of Deputy Director of the Division. There has been a good variety of clinical types amongst the admissions, although seniles and unstable adolescents of somewhat inferior intelligence have predominated. Electro convulsive therapy continues to be a very useful adjunct to psychotherapeutic measures, particularly in depressive states. Sub-coma insulin treatment has been used with success in suitable cases. The general health of the patients has been good. The chronic patient population is ageing. The senile age group is becoming larger and for many years senility amongst our chronic population will be a problem. The hospital block cannot cope with the admissions and with all the physically infirm patients. On the female side a day-room downstairs in Yilla 13 is used as a hospital ward ; now that barely meets the demand. A sluice-room, &c., is being provided which will give relief to the nursing staff and improve efficiency. A similar position is arising on the male side, and it is proposed to equip Villa 3 similarly. The erection of a villa for the infirm is contemplated. A recreation-hall is an urgent necessity for the patients as well as for the staff, because this hospital is in the country thirty miles from Auckland and ten miles from the nearest township. There is no recreation-hall here, and for any gathering of patients for dancing, pictures, &c., a day-room or dining-room in one of the villas has to be used — such a room is totally inadequate. Another important requirement is a separate building providing living-quarters, mess-room, and kitchen for the male staff. Six additional staff houses are in course of erection at the settlement. Occupational therapy has been carried on in the wards. We have a class now in both disturbed wards on the female side. It is gratifying to note that we are to have one separate occupational building in the near future. The new Patients' Comforts Fund has been a success, not the least of the benefits being that the majority of patients appreciate having some money of their own in their pocket to spend as they wish. There is still an acute shortage of male and female nursing staff —particularly the latter. A great deal of overtime is being worked, but it is a constant effort to provide reasonable coverage for the needs of our patients. The nursing staff has helped willingly, and on the patients' behalf I acknowledge that help. One of our particular difficulties here in recruiting and holding staff is the distance we are from outside social amenities. To meet this a station wagon has been provided to supplement existing transport. A feeder service is run to Papakura after 5 p.m. and at midnight. The wagon is used to take parties to games, dances, pictures, &c. During the day the wagon is used for patients and other hospital requirements. This innovation has been a success and has been greatly appreciated by the staff. Farming-operations have been carried on as usual. The orchard promises more fruit than ever before. The production from the vegetable-garden has been satisfactory, but the abnormally wet spring necessitated much extra work.

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