H —3lc

INTRODUCTION This report presents a precis of the proceedings of a Conference convened by the Honourable the Minister of Health, Miss Mabel Howard, and held in Wellington on 29th and 30th June and Ist and 2nd July, 1948. The members of the Conference were representatives of the Registered Nurses' Association, the Hospital Boards' Association, Hospital Medical Superintendents, the Obstetrical and Gynaecological Society, the University of Otago, the Plunket Society, and the Department of Health. Dr. Doris C. Gordon, Director of Maternal Welfare, who was about to relinquish her office, had submitted to the Right Honourable the Prime Minister various proposals concerning the maternity services of the Dominion. The object of the Conference was to obtain expressions of opinion from representatives of organizations especially interested in problems of maternal and infant welfare in New Zealand. The Honourable the Minister of Health opened the proceedings, and, whenever possible, presided. In her absence the meetings were conducted under the chairmanship of Dr. T. F. Corkill. The order of reference was set out as follows : 1. To consider and recommend standards of care for mothers and infants in State and private maternity hospitals, wards, and annexes. 2. To inquire into and submit suggestions relating to building programmes for maternity hospital purposes covering (a) centralization, (b) decentralization, (c) incorporation in, or (d) detached from existing buildings. 3. Whether obstetrical work should be separated from all general hospital contact, and whether maternity nurses should live in obstetrical "hospitals. 4. How best to establish uniformity in maternity nurse training, pediatric care, and research. . 5. How to safeguard under the law maternity patients and their children from incompetence or negligence or malpractice of any doctor. 6. To what extent have nursing standards in obstetrical care been affected consequent upon staffing difficulties ? 7. The advisability of establishing an Obstetric Council from which the Minister could obtain advice on matters affecting the maternity services of New Zealand. 8. Such other matters as may arise in the course of its inquiries. The Conference found in the course of its discussions that certain of the items in the order of reference proved capable of amalgamation, while, for purposes of this report, it has further been deemed desirable to group together the remarks on those subjects which are clearly related to one another. Several important matters were added to the -agenda under the general heading set out in Item 8. In the report which follows it will be necessary to make reference from time to time to the Committee of Inquiry of 1946 or to the report of that Committee, sometimes referred to as the " 1946 report." It is desired to explain that the committee referred to is the Committee of Inquiry into Maternity Staffing which sat under the chairmanship of Dr. T. F. Corkill. The use of the terms " open " and " closed " maternity hospitals, wards, or annexes in the present report follows what has now become established practice in connection with maternity institutions, though the usage is different from that which .ajjplies in connection with general hospitals. By an " open " maternity hospital or ward is meant one in which patients are attended by their own doctors, who act in their private capacity ; by a " closed " maternity hospital or ward is meant one in which patients are attended by duly appointed members of the hospital medical staff in the course of their duties, whether such doctors are members of the full-time or of the visiting staff.

3