OUR HOSPITALS.

Dominion, Volume 1, Issue 220, 10 June 1908, Page 9

OUR HOSPITALS.

NATIONAL CONFERENCE. RELIEF OF THE POOR. SPEECHES BY MINISTER AND IN-SPECTOR-GENERAL. An important conference on hospital administration and charitable aid was opened yesterday morning in the Sydney Street schoolroom. ; Delegates to: the number of about 130 were in attendance from hospital and char.itable boards and trustees of in-, stitutions in all parts of Now Zealand. The order paper comprised nearly 200 remits from these bodies, suggesting amendments to tho Hospitals and Charitable Institutions Bill which had been circulated amongst them for the purpose. The conference was opened, by the Hon. G. Fowlds, Minister in charge of the Department, and Dr. T. H. A'. Valintine, Inspector-General of Hospitals, presided. SPEECH BY THE MINISTER.

... The Hon. G. Fowlds, in welcoming tho dolegates, expressed the. hope that, as was the caso • when ,tho Acts of 1885 and 1886' were introduced, the new Bill would not .be in .any sense of the word regarded as a. party measure;'. H? believed they would all recognise that public opinion had demanded an amendment of. the law. The chief principles of the Bill were: (1) That the . Committees of Management • should be essentially local. i (2) That such Committees should bo • amenable to ' public; opinion by : being elective. "v; '• (3) That the expenditure on s the various . institutions should .bo somewhat localised. (4) That the Government, out of consolidated revenue, should meet a reasonable proportion, of .the cost of the institutions. These were the. cardinal; principles of the Bill ; which -was introduced by Sir Julius Vogel in 188-5, and which subsequently became to a certain the.'law: which; still govorned our: hospitals and charitable ' aid system. They, would notice, however; that

two of the first-mentioned principles, the election of 'local committees never becamo law. -Consequently they had been again .introduced in the present Bill. The other chief principles of the Bill were: (5) Tho mapping out of the Dominion into AJnrger hospital districts. . - '.{6) Tho direct election by the ratepayers of "tlko Boards controlling the: Committees. Such 'to have longer continuity of office. ) - : (7) slhat the District Boards should control lyospital and charitable aid. '". (8) 'Putting a. limit on the establishment of separ'at'e-.institutions. (9) j The Central Department assuming more /'control, and especially with 1 regard to buildings and appointments. Objects of the Conference. He would not dwell on the various princpies e-mbodied in this Bill. Ho- would have to facej the - subject .'in another place, but they, might. be. suretljat. the-suggestions and .'resommondations of the Conference would carry if eight?;, when the Bill was being discussed in .Jt '.-ivas freely recognised that . there ■ wojre a great many gentlemen present who haai for a'great number of years had v considerable experience in the local admini- :: Btratipm: •of Acts y'; iiow • governing tho tfiospitul and. charitable aid system. . It with , a . view of. 1 getting, such gejjitlemen '■], j together;.'.,. that; -.-A the , l)epartm/ent adopted the suggestion of the. Conference'of last year, and called this conference' after _ circulatiiig the Bill ; among* the,various bodies concerned. - It was thougnt'.that those-who would have to administer' the laws proposed should have, at any rate, some; say in the. framing oP tho Bill. . This. was : not necessarily the.actual Bill, which it'was proposed to introduce, and there was little doubt that some of the remits . already- submitted would be included in the draft of the new Bill,

■y».' . A Page of History.. . Thfi' Acts of 1885 and '• 1886 were regarded st .the . time.ins , tentative measures, and it said much ..for.;tho,'Onginal framers that they had stood the . test' of 23 years, despite- the' advancement; and -altered conditions of the-' Dominion, social-and btherwise; There were hospitals now; in, districts which at the time of the. framing and passing of the Bill were nevor .dreamed of, and in considering the Bill retrospectively, it was exceedingly interesting to. read speeches in. Hansard when it was being framed. Especially had he-been struck', by Sir Frederick Whittaker's almost prophetic-utterances on.the likely effects -.f those Bills.'\ That statesman did not share the optimism of Sir Julius Vogel with regard to separate institutions, which were introduced with a view to stimulate privato charity for-their maintenance. In 1884, the year before the -'Bill was. introduced, of the 31 hospitals, 14.jyero maintained entirely by the Goi oramehtj'the . remainder- getting subsidies ranging from £1 to £3 for every £1 collected. The sums derived from voluntary contribu-tion-i. then amounted, to about one-ninth of the cost of the upkeep of the \ hospitals of the then Colony. . Now, they Had fallen to about one-thirteenth. In 1884 the expenditure on hospitals was £67,826, and on charitable aid, £34,6-19; total, £102,575. At that time the population of the Colony was 552,590, 1906-7 for which, year the cost was: for hospitals, '£185,942; charitable aid,; £102;866;' total, £288,808, so 'that, while the population had not doubled, yet the expenditure,had nearly trebled.' 1

Increased Expenditure. .- , Though tho expenditure had gone'up out of all proportion, to; tho increase in population, he would admit that the .idvancement of medical and surgical science,, and'the exigencies of nursing had greatly increased the cost of hospital administration; but nevertheless this .great increase gave need for ample reflection. The increase in charitable aid seemed'to'have gono without tho bounds of reason, despite the wave of prosperity which, the Dominion had experienced during the last 12 years. There was something wrong' somewhere, and he sincerely' trusted thjt one..-result of their deliberations would be a reduction in. this cost,, especially stint on outdoor relief, which'could not but have a bad effect on the Dominion at large. (Applause.): ; Mr. J. P. Luko (Wellington) moved a vote, of thanks to the Minister for attending, and for his address.' This was seconded by Mr. W. H. Cooper (Christchurch), and carried unanimously. The Minister, having acknowledged the compliment, withdrew from' the Conference. . ; , ■

INSPECTOR-GENERAL'S ADDRESS. Dr. Valintine then delivered his opening address. ••After' welcoming tho delegates,.he assured, them that the Bill, which embodied the views-of his. predecessor, the late Dr. Macgregor, was'not . one which'tho Minister wished' to thrust down their throats. What wis wanted was not specifically that or some other Bill, hut tlie best Bill. What was wanted was'a hospital and charitable *id Bj.stein that would make itself felt in ••■ll part') of these islands, not only, as was tho caso at present, in the districts immediately surrounding tho towns, but also in'the 'lr remote country districts—the back-blocks— and he believed' that, to a; certain extent, this end could gradually bo attained, provide'!" the bed-plates of each district were caiefully, laid.

Needs of Each District. Each district ought to bo self-contained and provido accommodation for (l) tho actually sick, (2) tho chronic and incurable, (3) tho consumptive, . (<!) the aged and infirm. Such a district .-should further havo the moans of providing- for tho, indigent poor by means'of (5) a carefully watched system of outdoor relief, which might be extended as tho occasions—industrial and otherwise—de-

mand. In each district therefore there should be:— ' : (1) Tho . Base Hospital.: • (2) Subsidiary, or, Cottage Hospital. ' (3) 'Infectious Diseases Ward. (4) Tho Consumptive Annexe. (5) The Old People's Homo. (6) Chronic and Incurable Wards. (7) A system of poor relief co-operating . with private charity. ' (8) A system of district nursing. Hospital Requirements. Ho would deal with each of those essentials in,turn. The base hospital should bo large enough for tho requirements of the district, and-should bo stalled and equipped as thoroughly as modern scienco could-devise. It should bo reserved solely for tho acutely sick, and should be tho only hospital in tho district recognised as a training school for probationers. The subsidiary or cottago hospital should, necessarily vary in 'size ' and equipment-according to the district surrounding them. In many instances they would have to bo well staffed and equipped,. but not to tho same- extent as tho baso hospital. . In others they should merely bo a cottago with a nurse in charge, where first aid could bo administered until tho patient could with safety.be moved to the' base hospital. .No attempt to train probationers should be,made in these hospitals, which should be staffed by registered nurses. An infectious disease or isolation ward is a necessary' adjunct to every hospital, so that cases of infectious disease can be isolated promptly. _ Tho size of the ward should naturally bo in proportion to the hospital to which it is attached. The consumptive annexe should bo attached to' the hospital base, or ' subsidiary,\as;' the case may be, in that part of tho district likely to afford tho best climato for the outdoor treatment of consumption, and where there would be land 'enough adjoining to allow the principles of. tho open-air treatment to bo followed out.' Separate accommodation would'of course have to be made for curable and indigent incurable cases, but not necossarily at tho same hospital. The, Old People's Home is, of course, a necessity, and little need be said, about it, except that its . accommodation should be so arranged that a careful classification of the. inmates' could be made so that the really unfortunate and deserving poor should-not have to_ occupy the same room,as the less desirable inmates, which, aro to be found in such, institutions. ' Incurablas. ; ' ■ ' The- chronic and incurable -ward should be reserved for-indigent, chronic and incurable patients,; and should be erected in'.the'immediate vicinity of and administered in 'conjunction, with the Old People's Home. It Was- most undesirablo that these people should be treated in the wards and in the immediate neighbourhood of a general' hospital. Tho admission to the wards of. the chronic and incurable not only tended to acute cases from being admitted to the hospital, but many patients were reasonably reluctant to enter a hospital where such cases, predominated.'. Further, there .were many .chronic patients who would stay* in a hospital for a great length of, time without paying or attempting to pay maintenance fees, but if they wero sent to the chronic and' incurable ward of an old people's home 'either the patients themselves or their relatives would make a great effort to pay such maintenance fees, or to support them outside. Ano.ther argument in favour of" having the chronic: ward so situated was that-.a number of the aged in. old people's homes were on of acuto illness, and at . any moment might require skilled nursing. In regard to a system of poor law relief co-operat-ing with private charity,, ho woirid - suggest a".Hianipulation of what is known as the Elberfeld system. -

- For the Back-Blocks. He now came to the person who supplied the link in the chain between tho base hospital and tho back-blncks—the district nurse. The establishment in our remote country districts of a'nursing system would be a great boon to those people , who had to face the hardships and discomforts of back-block life. He '.had'' seen, women, so cut iff by distance and bad'roads that, they had. not 'seen'one of their, .op year's end; to year's end. Knowing what he knew of tlie hardships' of the back-block pettier, it would' ill-, become him if. he did not speak out'on their behalf... . From a', professional point of' view, it was mtist unsatisfactory.; to treat a case a long way from'home. Of what, avail a journey at considerable expense to the patient, if the doctor's orders.were not carried out? He knew what'it was to ride away from such cases feeling that if he could have,-left a- good nurse in charge the prospects of the, patient's recovery-would nave been/infinitely better. If boards established district nurses in the back-blocks, they would benefit a class of people who are all. the more worthy of consideration, because' one -hardly ever hears them complain; .

-j What the District Nursa Could Do. Fortunately .. there ■; are- "few idistricts unconnected with the telephone, and in the event. of illness the■' district nurse could ring-'up the nearest doctor, describe the 'symptoms,, temperature, etc., of tho patient, and'give indications whether : or ,not it would be necessary for him' to visit the patient. She could, carry out faithfully his .instructions, and report from day to day on the condition of the patient. By such . means much distress and money might be., saved the backblock settler. The district nurse could also locally supervise the midwivos of her district, and periodically inspect their kit and (instruments to see that are kept properly clean. In case of - .accident, she could render first-aid, and accompany the patient to . the nearest hospital. She could 'be the "eyes and ears" of the' Board under which sho served; and,- having made herself acquainted with tho condition's of the 'various families in the district, could be better able to give information' as to the circumstances surrounding those persons applying for charitable relief. Nor would such a nurse bo a great expense to the Boards She would be in a position to know .what 'the peopjo could afford to pay for her services, and advise 'the Board accordingly. He-believed that'a great portion of her salary could be paid'by,'! these means. If'the scheme'did not", provo too expensive, additional nurses could be gradually appointed, so that no part of the hospital cdistrict would bo without its, district nurse, and the gaps in the chain would be;. complete. /.' Under the samo'conditions, the district , nurse could attend to-those incurable-cases which might, be reluctant to go to the incurable ward in tho Old People's Home. From many country districts they heard of demands for Government subsidies to encourage medical men to settle, and such requests were some--r timcs granted, but . not enough was given to' allow £he doctor appointed to make a fair living. Would not those districts bo better served ,by a district > nurse in conjunction with a doctor at a distance? The money raised locally by the settlers, after payiiig the nurse's salary, would be bettor spent in guaranteeing the expenses of the doctor's visits, wjlen the nurse considered his services necessary.

Amalgamation Needed. . : The. hospital. districts would have to be fairly large ones to justify the upkeep of the several institutions indicated, and it would be necessary for district boards to ] have, under their control charitable aid, as well as hospitals! Larger districts would allow tho boards to tako a wider view of hospital administration, and decide where their base hospital and cottage hospitals would bo situated. This would havo. tho effect of limiting tho constant demands for new institutions. Our hospital and charitable aid systems were so closel.v interwoven that any attempt to define their respective .limitations resulted, and would result, in disputes between the controlling authorities. At Dunedin and Wellington thero are practically four boards controlling hospital and charitable aid, two separate institutions anil two boards—two boards spending tho money of the two boards wlio found, it,. What •wonder then that disputes arose among those bodies as to which was responsible for certain eases. Tho niattor .was. too absurd. If. the Conference did nothing olse, lie hoped it would agree on the need of. putting tho control of hospitals and charitable aid under oiio largo and representative board. (Applause.) The institutions • of' each _ district should bo controlled by one board, with local committees to carry out the details of management. It would also be necessary to ensure to the board and committees a longer continuity of office, so that the policy of the Board would not bo liable to perpetual alteration. (Applause^

Debatable Matter. The more debateablo provisions of tho Bill were the mode of election, tho limitation of separate institutions, tho reduction of subsidies, and tho increase of Government control. He would not turn to tho more debatablo provisions in tho Bill, viz. (1) Tho mode of election. (2) Limitation of separate institutions. (3) Tho proposed reduction of the subsidies. (4) The Government assuming more con- ' tr °lAs regards tho . mode of' election, many of them wero aware that there had been a constant demand for reform in this direction, so that tho Boards should be more directly representative of those entitled to vote for members of local bodies; indeed, thcro were not a few who considered thai tho hospital franchiso 'should' even bo further oxtonded. In regard to the mode of election, there had been a constant demand for moro direct representation, and he believed that the extension of the franchise as indicated in the Bill would have tho effect of obtaining; tho services of many excellent men, who with no ulterior motivo would make a special study of hospital and charitable aid matters, and who would confine their public duties to hospital and charitable aid work. Tho taking ovor of separate institutions by the Boards would, lie felt sure, commend itself to all who had considered tho subject. (Hear, hear.) Tho history of these institutions was that when once incorporated, public interest died, and the trustees had to come on the district board to malco good' tho .ever-increasing deficits. (Hear, .hear.) There wore only two of these institutions in tho Dominion, which' wero independent of. the rates—at Mercury Bay and Oamaru. There were therefore forty-one separate institutions for which tho board of the district had to find funds, though they had no say in the management. This was an entirely wrong principle, and tended to extravagance. . On the other hand, hospitals under boards were supported as generously by the public as separate institutions. It was to bo lioped that if separate institutions were to be retained, they would bo made to rely on their own income, and the Government subsidy of 245. in the pound on contributions, and" that no grants from the rates would be entertained.

Central Control. : The opposition to central control was deeply impressed upon the people of our race, and he trusted he was Briton enough to appreciate this opposition—(hear, hear) —but nevertheless he was strongly of opinion that, both as regards hospitals and charitable' aid, especially the latter, there were . good arguments to support such..a step, apart from the fact that tho'Government found through the subsidies half the expenditure of hospital and charitable aid. If any of the delegates present could but accompany him on his tours of inspection he would soon be ablo to convince him that there was need for Boards or Trustees to submit plans of buildings: and extensions. Just a caution at tho right time would, have made all the difference and saved much money. He admitted that at the,present time, almost without exception, Boards were submitting to tho Department nlans of new buildings, etc., but neverthe less the powor of Department approval should be granted by ;law.

Appointments. As regards appointments,' tho same might be said, though liero again he would frankly own that, as regards the hospital surgeons, the appointments made had _been' excellent. Personally, it was a responsibility ho could very well do without, but with the exception of patients there was no single' individual more concerned in the appointments than the man who held, his own position.- , Honorary Staff. Speaking generally, he was not'in favour of . honorary staffs,, except iu large centres, but in the latter' places they; were essential for the public and profession alike, and considering how freely they gave their services to the public he thought that members of the staff should be put'ona sounder footing and their' interests. better secured. . A board could do this by preventing, hospital abuse, and. by.,re- l elccting those'surgeons and physicians who'best studied tlio interosts of the institution. At. present'some boards did neither. x Now, it was very hard to say whero hospital abuse began and where it . ended, but care should bo taken that hospital beds were not taken up by those who could afford to pay' for treatment in a private hospital, to tho exclusion 1 of their poorer'but equally, ill neighbours. (Hear, hear.) -.- It was ..not fair that those who. could well afford pay should avail themselves of tho gratuitous services.of the. honorary staff. Many people said that a member of an honorary staff got recompensed in other ways, and that'was more or less true, but the chief gainers wero the public (poor and rich alike), who had in their midst a number of physicians' and surgeons specially skilled'in their art, an art in which. of all' others experience and constant practice were everything. It would indeed be a bad. day for New . Zealand if the best-men did not seek olectiori on the honorary staffs of our hospitals. They should not, therefore, be 1 discouraged when conscious of having done their duty faithfully and well, they fair to be re-elected, as happened tho other day to a member of tho profession who had done more disinterested and devoted work in tho'interests of his. local. hospital than any other man in the land..

The Supply of Nurses. As regards the appointment of matron, there was also very good reason why this should also be vested in departmental cottrol. A nurses' register was kopt in which was recorded the training school and general hospital record of each nurse, and no ono was better qualified to know and find out the capabilities and character of a nurse than the assistant inspector (Miss Maclean). In order to secure the. services of the ' best nurses in hospitals, they must hold out hotter prospects to such nurses than was dono at present.-' Under this heading a system of classification was recommended. The difficulty of getting nurses for qui'-public institutions was. every day becoming more apparent. He felt confident , that if nurses were assured- a definite prospect of promotion, reasonable pay, and a chance of a pension at the end of so many years' servico it would go a long way towards remedying the present deficiency.. Ho consider**! that time was now opportune to discuss some scheme for pensioning nurses, so that those who had grown grey m their honourable calling need not feel the pinch of poverty in their declining years.

Rctiuction of Subsidies. H3 now came to a provision in the Bill, which he feared had not a single supporter in'that room—that was tho proposal to gradually reduce tho subsidies. (Laughter and applause.) He thought tho Department should put up a fight for it. This proposal was directed at the expenditure oil outdoor,charitable relief rather than at hospital expenditure. It was true that some reform was effected in our poor law administration. Ho would refer them to tho valuablo report , of Mis.; Kirk on outdoor relief in • tho district 1 surrounding Wellington. They would see that people in receipt of charitablo aid had been buying gold-rimmed spectacles, bicycles, chocolates, and he knew not what, at the expense of tlie ratepayers, and f ■some of the poor who wero just struggling to keop off the rates. Such a system was absolutely monstrous. . It was perhaps rather early for liiui, after 18 months of office, to advocato any particular scheme, but , he felt tint tho administration of charitablo aid ty outside bodies must bo stopped, and tho Government. subsidies should bo withdrawn from th'it branch of administration, so that the expenditure might corno in as great a proportion as possible out of the rates. That would be the'only way to keep it within ■ reasonable control. It was the duty of tho Stato to seo tliat no man was starving, but the recipients of charitable aid should not' be put in a better position than their struggling neighbours. (Applause.) He recommended the adoption of a modification of the Elberfcld system. He thought something of the kind could very well bo applied to this country. It had acted very satisfactorily ,11 Germany, and what the Germans could do, a patriotic, and public-spirited British community should be able to achiovc. Ho was quite- aware that many of tho boards realised tho evils of tho present system, and tho dangers into which it -was drifting. There wore delegates present who wore qualified to .Express" valuable opinions on thiß subject.

Ii was the greatest of tho problems before them, and it was ripo for action. They had como there conscious of their power to make or mar tho Hill. ' He trusted they would cause a measure to lie framed that would not only do credit to those who framed it,' buc would bo in tho best interests of the sick and needy, whilst preserving the moral fibre of the people of these islands.. (Applause.) PROCRAMME OF THE CONFERENCE. Consideration of the Bill was preceded by a brief discussion on. the procedure to uo followod by tho Conference. The hours of sitting were fixed as 9 a.m. to 12.15 p.m., and 2 p.m. to 5 p.m., evening! sittings to bo held if necessary. ■ Tho Chairman ruled that each board or institution should have ono vote irrespective of the number of delegates present. Tho votes would'bo' recorded with the names of the institutions or boards.

It was resolved to consider the Bill clause by clause, remits to be moved by the delegates as tho clause affected came before tho Conference, but before much progress had been made it was found that this method was not giving general satisfaction, and the Conference therefore adjourned, leaving a small committee to draw up a scheme of procedure, and report after lunch. On tho Conference resuming, the committee/ of which Mr. Galloway (Otago Benevolent Institution) was chairman, submitted the following recommendation: — " That the delegates shall agree amongst themselves who shall record tho ■vote of his board or institution. That the voting bo recorded on a looting paper.' That the following questions bo considered .seriatim: (a) Whether hospital and charitable matters, be administered by one board; (b) election of boards—who is to elect?; (e) of election of boards —basis of representation; (d) continuity of office; (e) abolition of separate institutions; (f)- reduction of subsidies ; (g) Government control; (h) tho Bill taken clauso by clause." This programme was agreed to by tho delegates, and tho discussion was begun again do novo.

THE AMALGAMATION PRINCIPLE. Mr. J. P. ; Luke ~ (Wellington Hospital Board) moved:—' "That hospitals and charitable aid should be administered by one board." Tho Hon. C. M. Luke, M.L.C. (Wellington Hospital Trustees), supported the proposed amalgamation. Speaking as a representative of a separate institution, be claimed that, though there had been waste in connection, with such institutions, tho administration had been in other cases very satisfactory. Ho had been for 24 years almost continuously a member of tho Wellington Hospital Trustees, and chairman for several years, and ho bolidved that no institution ■ was better conducted than that one. The work of the hospitals arid other institutions . was so' interlocked that the administration should be United. What' was no,tv gained by separate boards would bo secured under the new system by tho committees. , Mr. Maxfield (Wairarapa) objected to -his amalgamation of Wairarapa with ,the City of Wellington in regard to charitable aid, though ho approved of tho principle of combining . hospital and charitable administration.

Mr. Galloway (Otago Benevolent Institution) supported tho proposed amalgamation on tho ground that it would obviato much waste of power. Moreover, at present, it frequently happened that the membors of ono body shifted responsibility for individual case.j to some other body, and so tho sufferer had to wait. Mr. J. London (Dunedin Hospital Trustees)'said amalgamation would be in the interest.sof economy, and also of'tho sick ,and suffering. Tho town and country issue should be kept out of the question, and all the more so on account of _ the likelihood that the wholo cost of administration would ultimately be defrayed out of public fuuds. 1 The resolution was carried by 63 votes to 4. .

ELECTION OF; BOARDS. Mr. J. P. Luko moved:— ~"That the.Board consist of members elected as follows: Ono or more members to be elected by each parliamentary elec- . torate. That as long as the Government contribute tho same amount of subsidy, as at present they be represented by ono or mora members on each Board." ; Tho mover said_,that thore could bo no more suitable basis of election than the parliamentary franchise and the parliamentary electorates. Tho difficulty of tho ,boundaries not coinciding 'could be got' over', i Tho present method was cumbersome and unsatisfactory; and did not lead to efficient work. (Crie.- of dissent.) Ho did not believe in mori centralisation than was necessary, but he thought that for the' purposes in question the Government could appoint very helpful members to the boards. The .Government, moreover, had-a claim to representation on account of its contributions, which ha:l of late years greatly increased, owing among other causes to the requirements i f the Public Health' Act, and the establishment of consumptive sanatoria. .-■ ? Mr. F. T. Moore (Wellington Hospital Boardj seconded tho motion. Mr. F. Bellringer (Taranaki Hospital and Chwitablo Aid Board) moved an amendment:—

"That the method of election of Hospital and Charitable Aid Boards continue as at present, and that Clauste 6 of tho amending Act of 1886 be a part of tlie. Bill," This was seconded by Mr. Tapley. , ' Mr. F. T. Moore (Wellington Hospital Board), in supporting tho principle of direct election, suggested that tho extra cost might be minimised by holding the along with the parliamentary elections. It was right that tho boards should be elected by tho peoplo who ultimately had to bear the cost of administration. ' • Mr. F. Horrell (North Canterbury Hospital Board) and Mr. Maxficld (Wairarapa) supported tho amendment. Mr. E. A. Tapper (Otago Benevolent Institution) favoured tho present system, but suggested that tho names of those proposed to be olectod should be published a fortnight beforehand. It would bo a mistake to introduce politics into charity. Mr. Galloway (Otago Benevolent Institution) said the present system had not worked well in Dunedm. For years past every election of the Boards had been irregular, and there had been insufficient public interest shown. '. Mr. G. Pa'yluig (North- Canterbury Hospital Board) supported the amendment. The mombers of local bodies did excellent work, and did not havo to revise their decisions, like Parliament. Tho_ members of the hospital and charitable -aid boards were picked from the local bodies, and wero a better class of men than would bo obtained by- popular election. Several other speakers ' supported tho amendment on tlie grounds of economy, and for other reasons already mentioned. Mr. Ritchie (Wanganui) said that mere sentimentalists. and other unsatisfactory members would be elected, by popular vote. Hon. 'C.'M.' Luko'favoured somo system of representation' proportionate to tho amount of funds contributed. > - Mr. W, H. Cooper (Samaritan Home Trustees, Christchurcli) suggested, that tho members' should be elcctcd along with the other local governing bodies. He also spoke of tho special, usefulness of lady members of tho boards. Mr. A. W. Hogg, M.P., declared that tho Bill was bad from_ beginning to raid, and t-lierp-was no principle in-it. Ho favoured tho present" system electing the boards. Tiie amendment in favour of tho present system of election was put, and carried amid applause. Mr. Galloway (Otago Benevolent Institution) moved'a further amendment:— • " That tho members of tho Board bo elected b.v tho persons who are entitled i for tho time being to elect mombers of local bodies in tho district.?' ' This was seconded by Mr. G. Loudon (Dunedin), but after discussion was defeated by a largo majority. A further amendment in favour of representation according to amounts of mcncy contributed was lost oil tho voices. Tho amendment in favour of the present system of election was then put as tho substantive motion, and carried with iinnlniis». The conference adjourned until 10 o'clock this moriiius-