TWENTY-SIXTH ANNUAL REPORT OF THE PENSIONS DEPARTMENT FOR THE YEAR ENDED 31st MARCH, 1924.

Appendix to the Journals of the House of Representatives, 1924 Session I, H-18

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1924. NE W ZEAL A N I)

TWENTY-SIXTH ANNUAL REPORT OF THE PENSIONS DEPARTMENT FOR THE YEAR ENDED 31st MARCH, 1924.

Presented to both Houses of the General Assembly pursuant to Section 70 of the Pensions Act, 1913.

The of Pensions to the Hon. the Minister op Pensions. g IR Pensions Department, Wellington, 30th June, 1924. I have the honour to furnish herewith, for the information of Parliament, the report of the Department relating to war, old-age, widows', Maori War, miners', epidemic, and sundry pensions for the year ended 31st March, 192-1. A report by the Medical Administrator of Pensions on the medical branch of the Department appears as Appendix I. The. following comparative statements relate to the annual value and gross payments of all pensions ndministered by I he Department for the past two years : —

Pensions in Force, and Annual Value.

Gross Payments.

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Class of Pension. At 31st Number. [arch, 1923. At 31st March, 1.924. Annual Value. Number. Annual Value. War Old-age Widows' Maori War Miners' Epidemic Boer WarSundry pensions and annuities Civil Service Act, 1908 26,460 21,181 3,411 669 544 569 75 90 88 1,349,857 770,295 195,747 32,781 .33,826 43,120 3,173 7,638 22,954 23,166 21,468 3,526 589 580 457 72 93 74 £ 1,213,126 780,664 209,739 28,861 36,634 25,881', 3,100 7,891 19,702 Totals 53,087 53,087 2,459,391 50,025 2,325,603

Class of Pension. 1922-23. 1923-24. War .. Old-age Widows' Maori War Miners' Epidemic Boer War . . Sundry pensions and annuities Civil Service Act, 1908 .. 1,489,392 755,324 188,021 34,004 33,447 52,371 3,058 7,262 26,937 1,315,560 767,805 202,818 30,,350 36,081 32,702 3,146 8,033 21,115 Totals 2,589,816 2,417,643 Cost per head of European population £2 0s. 9d. £] 17s. Id.

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The following figures relate to the war and other pensions paid by tin- Department during the year on behalf of other Governments : —

LEGISLATION. Following upon the report of the War Pensions Commission, which investigated the whole question of war pensions in the preceding year, amending legislation was enacted on the. 29th August, 1923, the main features of which were provisions for (I.) The setting-up of an Appeal Board. (2.) The payment of economic pensions. (3.) Clothing-allowances of £8 and £6 per annum to upper- and lower-leg amputees. (4.) Increased attendant's allowance, from £1 to £3 a week. (5.) Increased pension for certain arm and leg amputees. Appeal Board. The members of this Board consist of a Chairman, the first appointee being a Judge of the Supreme Court, and two medical men. one of whom is appointed by the New Zealand .Returned Soldiers' Association. Sittings are held in rotation at Auckland, Wellington, Christchurch, and Dunedin, the Chairman travelling to these centres and adjudicating with medical men residing there. The earlier legislation providing for a purely medical Appeal Board has been repealed. Seven hundred appeals have been lodged to date, of which number 415 have been dealt with as follows :— « Appeals dismissed — Assessment . . . . . . . . . . . . 152 Attributability . . . . . . . . . . . . 64 Not under Act . . . . . . . . . . . . 3 219 Appeals upheld — Assessment .. .. . . . . . . .. . . 127 Attributability . . . . . . . . 30 157 Appeals adjourned . . . . . . . . . . . . 24 Appeals withdrawn . . . . . . . . .. . . II Pensions made permanent . . . . . . .. . . 4 415 The distribution of the cases dismissed and upheld in the various districts is shown hereunder :--- Dismissed. Upheld. Wellington .. ... .. .. .. ..23 19 Dunedin .. .. .. .. .. ..II 17 Christchurch .. .. .. .. .. ..59 41 Auckland.. .. .. .. .. .. ..126 80 219 157 Economic Pensions.- These consist of three classes, as follows :—- -(1.) A maximum of £1 10s. weekly to disabled soldiers. (2.) A maximum of 10s. weekly to widows of soldiers, with 2s. (id. weekly for each child receiving pension. (3.) A maximum of £1 weekly to widowed mothers of deceased soldiers. In each case the income of the pensioner affects the. grant. Regarding class 1 (i.e., economic pensions to soldiers), these have taken the place of the previously payable supplementary grants of £1 a week payable under section 4 of the 1917 Act, and the 10s. a week granted under the Finance Act, 1920, and are also payable under certain conditions to soldiers whose disablement is of such a nature as to militate against their obtaining or following re muni'rati ye employment. Soldiers pensioned for minor disabilities do not receive economic pensions,

Government. Number at Class of Pension. 31st March, 1921. Annua! VllillHi. Average Pension. Payments, 1923-24. £ 101,858 25,125 24,618 18,746 143 2,859 5,623 56 47 44 218 47 119 244 E Great Britain War .. .. 1,800 Army and civil . . 533 War' .. .. 553 Army and civil .. 86 War" .. Civil .. .. 24 „ .. .. 23 \ 145,793 Australia India South Africa 24,703 29,137 168 3,008 5,991 Crown colonies . . Totals 3,022 £178,972 £208.800

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The following shows the number of claims for economic pension received under each head between the Ist September, 1923, and the 31st March, 1924 : —

The number and annual values of the economic pensions granted during the same period are included in the following figures : —

The following figures show the weekly rate of statutory pension payable in those eases where economic pensions were granted to soldiers :—

The annual values of the increases granted under all heads of the Amendment Act of 1923 anas follows :— Annual Value. £ Sections 3 and 4 : Economic pensions (soldiers and wives) .. .. 43,316 Sections: Economic pensions (widows) .. .. .. .. 3,276 ~ 6: Economic pensions (widowed, mothers) .. .. .. 5,408 „ 8: Clothing-allowances ... .. .. .. .. 3,126 ~ 9 : Attendants' allowances .. . . . . .. . . 856 ~ 16 : Increases to amputees .. .. .. .. . . 606 £56,588

Soldiers' Widows' Widowed mothers' Pension. Received. 940 150 295 Granted. 633 107 184 [ Declined. 282 40 108 i Outstanding. 25 3 3

Payable prior to 1923 Act. Granted unci lei- 1923 Ac. Total Economto Pensions. Pension. Number. Amount. Number. Amount. Number. ! Amount. Soldiers' Wives of soldiers' Widows' Widowed mothers' .. £ 1,284 78,312 633 £ 41,392 1,924 3,276 5,4-08 £ 1,917 119,704 1,921 166 5.252 184 5,408 59 J ,976 107 184 1,343 80,288 924 52,000 2,267 132,288 i

Weekly Rate of Statutory Pension. Percentage of Disability. Number of Pensioners. £ s. d. £ s. d. 0 15 0 0 17 6 10 0 1 2 6 to 1 7 6 .. 1 10 0 112 0 I 12 6 to I 14 0 .. 1 15 0 1 16 0 to I 17 0 .. 2 0 0 and upwards 50 75 80 6 I 29 38 96 44 12 56 5 90 1.00 1,630 1,917

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WAR PENSIONS. Total Claims lodged to Date.

Gross Annual Value of all Pensions granted to Date.

Summary of Annual Liability at 31st March, 1924.

Prom Soldiers. Prom Dependants. From 1st September, 1915, to 31st March, 1916 Year 1916-17 Year 1917-18 Year 1918-19 Year 1919-20 Year 1920-21 Year 1921-22 Year 1922-23 Year 1923-24 798 3,958 8,1.48 14,749 11,493 1,081 367 198 160 68.1 2,017 3,754 5,292 3,990 1,878 891 635 550 Totals 40,952 19,688

From 1st September, 1915, to 31st March, 1916 Year 1916-17 Year 1.917-18 Year 1918-19 .. .. Year 1919-20 Year 1920-21 Year 1921-22 Year 1922-23 Year 1923-24 Number. Annual Value. Average Pension. 1,214 56,488 46 5,316 285,707 53 10,587 780,057 73 16,954 1,167,081 68 15,183 872,627 57 2,207 163,713 66 945 63,685 67 625 43,867 70 551 40,836 74 Totals 53,582 3,474,061 64 NoTE.T-The number of pensions granted, as shov the values of which, however, form part of the pensi included in the annual-values total. m herein does not include children's pensions, jns payable to parents (or guardians), and are t

, T> . Number of Number of . , „ , Average Class of Pension. Pensioners. Children. Annual Value. £ £ Soldiers (permanent) .. .. .. 6,784 j .. 333,946 49 Soldiers (temporary) .. .. .. 7,731 .. 407,847 53 Dependants of disabled soldiers .. .. 807 1,205 62,916 78 Widows (without children) .. .. 592 .. 51,793 87 Widows (with children).. .. .. 843 1,385 131,563 156 Other dependants of deceased soldiers — Parents .. .. .. .. 5,655 24 198,164 35 Other adult dependants .. .. 212 7 6,911 ,32 Guardians of children .. .. 542 753 19,986 37 Totals, &c. .. .. 23,166 3,374 1,213,126 52

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Summary op Payments. The payments for war pensions show a decrease during the year, the figures compared with those of the previous year being as follows : - 1922-23. 1923-24. £ £ Payments made in New Zealand .. .. .. 1,395,447 1,219,513 I'llyments made in London .. .. .. 60,878 59,064 Payments made in Australia .. ... .. 32,130 33,625 Payments made in Canada .. .. .. ll(i 2,229 Payments made in South Africa .. .. . . 107 397 Oilier foreign payments .. .. .. .. 338 732 Allotments paid after casualty . . .. .. 376 Totals .. .. .. .. .. £1,489,392 £1,315,560 Summary of Total Payments to the 31st March, 1924. £ From Ist September, 1915, to 31st March, 1916 .. .. .. L 3,910 Year 1916-17 . . . . .. . . . . .. . . 180,389 Year 1917-18 . . .. .. .. .. .. 515,445 Year 1918-19 .. .. .. .. .. .. .. 1,199,755 Year 1919-20 . . .. .. .. .. .. .. 1,812,419 Year 1920-21 .. .. .. .. .. .. .. 1,886,952 Year 1921-22 .. .. .. .. .. .. .. 1,726,174 Year 1922-23 .. .. .. .. .. .. 1,489,392 Year 1923-24 . . .. .. .. .. .. 1,315,560 £10,139,996

Pensions payable outside New Zealand as at the 31st March, 1924.

OLD-AGE PENSIONS. European. Maori. Total. Pensions in force at the 31st March, 1923 .. .. .. 20,135 1,046 .. 21,181 Now pensions granted, 1923-24 .. .. .. .. 2,280 269 2,549 Deaths during 1.923-24 . . .. .. .. .. 1,779 911 Cancellations, 1923-24 .. .. .. .. .. 379 13j *>*>* Net increase . . . . . . . . . . . . 287 Pensions in force at the 31st March, 1.924 . . .. .. 20,257 1,211 .. 21,468 Tear 1923-24. Total European population at the 31st March, 1924 .. .. ..« .. 1,293,934 Total European pensioners, sixty-five and over, at the 31st March, 1.924 . . .. 15,158 Female European pensioners, sixty to sixty-four, at the 31st March, 1924 . . 5,099 Percentage of European pensioners to total European population .. .. .. 1-56 New claims lodged .... .. .. .. .. .. .. 3,215 New claims rejected . . . . . . . . . . . . . . . . 636 Annual liability at the 31st March, 1924 .. .. .. .. .. £780,664 Average pension 4 . . . . . .. . . . . . . . . ■ £36 7s. Gross expenditure for year . . . . . . . . . . . . . . £767,805 Increase on figures of previous year .. .. .. .. .. .. £12,481 Cost per head of European population .. .. .. .. .. lis. lOd. Credit from national endowment . . . . . . . . . . . . £33,337 Refunds paid to Public Account .. .. .. £2.253 Number of pensioners in homes and hospitals .. . . . . . . 968 Amount paid to controlling authorities of these . . . . . . £38,682 Number of pensioners in mental hospitals . . . . . . .. . . 94 Amount paid to Mental Hospitals Department on account of these .. .. £3,051 Unpaid instalments as at 31st March, 1.924. .. .. .. .. .. £2,752 Instalments forfeited and subsequently paid .. .. .. .. .. £3,909

Soli tiers Wiv ' e8 of Soldiers. Depei idants. — Annual Liability. Other Dependants. Permanent. Temporary. Temporary. Widows. Great Britain Australia Oilier countries 1.18 8,3 13 144 12 274 11 25 1 188 72 4 712 57,009 180 33,017 10 2,937 Totals 214 443 24 264 902 92,993 214

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Total claims lodged to date .. . . . . . . . . 81,963 Total claims established ~ .. .. 64.097 Total deaths .. .. .... .. .. .. 34,1.69 Total, cancellations . . . . . . . . . . . . 8,460 Grand total paid since 1898 .. ..' .. ~ .. £10,926.880 Total credit from national, endowment .. .. .. .. £391,782 WIDOWS' PENSIONS. European. Maori. Total. Pensions in force at the 31st March, 1923 .. .. .. 3,237 174 .. 3,411 New pensions granted, 1923-24 .. .. .. .. 694 36 730 Cancellations, 1923-24 .. .. .. .. .. 580 35 615 Net increase. . . . . . . . . . .. . . 115 Pensions in force at the 31st March, 1924 .. .. .. 3,351 175 .. 3,526 Total children in receipt of pensions at the 31st March, .1.924 .. .. .. .. 8,036 Year 1923-24. New claims lodged .. . . .. .. .. .. .. .. 720 New claims rejected .. .. . . .. .. ~. ... .. 105 Number of children on whose account pensions granted .. 1,792 Annual liability at close of year .. .. .. .. .. .. .. £209,739 Average pension . . . . . . . . . . . . . . . . £59 10s. Gross expenditure for year .. .. .. .. .. .. .. £202,818 Increase on figures of previous year . . . . . . . . . . £14,797 Cost per head of European population 3s. 2d. Refunds paid to Public Account .. . . . , . . . . . . . . £272 Unpaid instalments as at 31st March, 1924 .. £930 instalments forfeited and subsequently paid .. .. .. .. .. £1,256 Average of total family of pensioners . . . . ... . . . . . . . 3-98 Average of family under fourteen years . . . . . . . . . . . . 2-45 Total, claims lodged to date .. .. .. .. .. 9,867 Total claims established . . .. ' . . . . . . . 8,313 Total number of children benefited .. .. .. .. 20,61.4 Total deaths .. .. .. .. ... .. .. 179 Total guardians appointed .. .. .. .. .. 101 Total cancellations . . ... . . . . . . 4,709 Grand total paid to date .. ~ .. . . .. £1,197,412 MAORI WAR PENSIONS. European. Maori. Total. Pensions in force at the 31st March, 1923 .. .. .. 508 161 669 Deaths during 1923-24 .. .. .. .. .. 69 11) Cancellations, 1923-24 .. .. .. .. .. 1 ...I 8J New pensions granted, 1923- 24 .. . . . . 1 . . 1 Net decrease . . . . . . . . . . . . 80 Pensions in force at the 31st March, 1.924 .. .. .. 439 150 .. 589 Year 1923-24. New claims lodged . . . . . . . . . . . . . . . . 3 Number of pensioners previously in receipt of old-age pensions . . . . . . . . 104 Annual liability at close of year .. .. .. .. .. ... .. £28,861 Average pension . . . . .. . . . . . . . . . . . . £49 Gross expenditure for year . . .. .. .. .. .. .. .. £30,350 Cost per head of European population .. .. .. .. .. .. 6d. Decrease on figures of previous year . . . . . . . . . . . . £3,654 Pensioners in homes and. hospitals . . . . . . . . . . . . . 54 Amount paid to controlling authorities of these . . . . . . . . . . £1, 497 Unpaid instalments as at 31st March, 1924 .. .. .. .. .'-. .. £146 Instalments forfeited and subsequently paid . . . . . . . . . . . . £151. Total claims lodged to date . . . . . . . . . . J ,884 Total claims established .. .. .. .. ~, .. 1,696 Total deaths .. .. .. .. .. .". .. 1,103 Total cancellations . . . . . . . . . . . . 4 Grand total paid to date . . . ... . . . . . . £463,302 MINERS' PENSIONS. Total. Pensions in force at the 31st March, 1923 . . . . . . . . . . . . 544 New pensions granted, 1923-24 .. .. .. .. .. .. 88 Deaths during 1923-24 .. .. .. .. .. 48) Cancellations, 1923-24 .. .. .. .. .. .. -4) ,J/ Net increase . . .. . . . . .. . . . . 36 Pensions in force at the 31st March, 1924 .. .. .. .. .. .. 580

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Year 1923-24. New claims lodged . . . . . . . . . . . . .. 119 New claims rejected . . . . . . . . . . . . . . 24 Annual liability at close of year .. .. .. .. .. .. .. £36,634 Average pension .. .. .. .. .. .. .. £63 3s. Gross expenditure for year . . .. .. .. .. .. .. £36,084 Increase on figures of previous year . . .. .. .. .. '.. .. £2,637 Cost per head of European population . . . . . . . . . . . . 7d. Credit to vote from gold duty .. .. .. .. .. .. £3,498 Unpaid instalments as at 31st March, 1924 .... .... £232 Instalments forfeited and subsequently paid .. .. .. .. .. £343 Total claims lodged to date .. .. .. .. ~ 1,220 Total claims established . . . . . . . . . . . . J ,052 Total claims rejected . . . . . . . . . . . .145 Total deaths .. . . . . . . . . . . . . 314 Total cancellations . . . . . . . . . . . . 158 Total amount paid to date . . . . . . .. . . . . £180,493 Total credit from gold, duty .. .. .. .. .. £30,704 Total amount paid on account of funeral expenses .. .. .. £3,038 Number of Pensions at each Hath at the 31st March, 1924. Annual Value. £ 181 at £91 per annum .. .. .. .. .. .. 16,471 103 at £65 per annum .. .. .. .. .. .. 6,695 296 at £45 10s. per annum .. .. .. .. .. ... 13,468 580 £36,634 EPIDEMIC PENSIONS. Total. Pensions in force at the 31st Maroh, 1923 .. .. ... .. .. .. 569 Cancellations, 1923-24 Net decrease .. ' .. .. .. .. .. 112 Pensions in force at the 31st March, 1924 .. .. .. .. .. .. 457 Year 1923-24. Annual liability at close of year . . .. . . .. . . £25,886 Average pension .. .. ... .. .. .. .. £56 13s. Gross expenditure for year .. .. .. .. .. .. £32,702 Decrease on figures of previous year .. .. .. .. £19,669 Cost per head of European population .. .. .. .. 6d. Unpaid instalments as at 31st March, 1924 .. .. .. .. £68 Instalments forfeited and subsequently paid .. .. .. .. £121 COST OK ADMINISTRATION. £ Salaries .. ... .. .. .. .. .. .. 21,272 Temporary assistance .. .. .. .. .. .. • 7,277 Advertising .. .. .. .. .. .. .. 22 Exchange and commission on money-orders, &c. .. .. 320 Fees for certificates of age . . . . . . . . .. . . 8 Fuel, light, power, and water . . . . .. .. .. 70 Interpreters' fees . . . . . . . . .. .. .. 1 Medical fees .. .. .. .. .. .. .. 7,400 Office-cleaning '.. .. .. .. .. .. .. 32 Office fittings and requisites . . . . . . . . . . 87 Contribution to Post-office for payment of pensions .. .. .. 15,902 Postage, telegrams, and rent of boxes . . .. . . . . 2,552 Printing and stationery .. .. .. .. .. .. 1,715 Kent of offices .. .. .. .. .. .. 633 Telephones . . . . . . . . . . . . . . 63 Transfer and removal expenses . . . . . . . . . . 33 Travelling-expenses of officers and pensioners. . .. .. .. 4,997 Expenses, War Pensions Appeal Board .. .. .- .. 922 Repairs to typewriters arid office fittings . . . . . . . . 53 Overtime .. .. .. .. .. .. .. 128 Sundry payments .'. . . . . . . . . . . 10 £63,497 Number of officers on staff at 31st March, 1924 . . . . . . 157 Percentage of cost of administration to total payments for year (£2,626,443) 2-4

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APPENDICES.

APPENDIX I.—MEDICAL ADMINISTRATION. The following table sets out the nature of the disabilities for which war pensions are being granted. In many cases a pensioner is suffering from more than one disability, but in this classification only the dominant disability is considered, so that the total number of these is the same as the total number of individuals in receipt of war pension on the 31st March. 1924. Wounds — Permanent. Temporary. Total. Upper extremity .. .. .. .. ..1,577 600 2,177 * Lower extremity .. .. .. .. .. .1,648 858 2,506 Head and neck . . .. .. .. .. ..440 289 729 Thorax .. .. . . 356 292 648 Abdomen .. .. .. .. .. .. 160 109 269 4,181 2,1.48 6,329 * Amputations — Upper extremity . . . . .. . . .. 430 8 438 Lower extremity .. .. .. . . 584 17 601 Double .. .. .. .. .. .. 39 .. 39 1,053 25 1,078 Special senses — Ocular — Totally blind .. .. .. .. .. 21 .. 21 Loss of one eye .. . . .. .. 337 9 346 Other disabilities of eye .. .. .. .. 150 33 183 508 42 550 Auditory .. .. .. .. ..261 84 345 Nasal .. .. .. .. . . . . . . 2 16 18 Respiratory system- - Pulmonary tuberculosis .. .. . .. 6 1,462 1,468 Other diseases . . . . .. . . . . . . 23 929 952 29 2,391 2,420 Circulatory system .. . . . . .. .. . . 95 358 453 Nervous system — Organic, disease. .. .. .. .. .. 27 31 58 Functional disease . . . . . . . . . . 30 827 857 57 858 915 Insanity .. .. .. .. .. .. .. '■ 2 28 30 Gastro-intestinal .. .. .. .. .. 43 271 311 Genito-urinary .. .. .. .. .. .. 43 121 164 General diseases # ~ . . . . .". . . ". . 93 848 941 Fractures (not due to wounds) Upper extremity • . . .. .. . . .. 54 28 82 Lower extremity ... .. .. .. .. 52 40 92 106 68 174 Diseases of bone .. .. .. .. .. 14 18 32 Injuries of joints (not due to wounds) .. .. .. 204 242 446 Spinal disease .. .. .. .. .. .. 9 81 90 Deformities .. . . . . . . . . .. 38 23 61 Disease of skin .. .. .. .. .. .. 3 8 11 Miscellaneous .. . . .. .. .. .. 43 101 144 6,784 7,731 14,5.15 It will be seen that pensions are classified as " permanent " and " temporary." When a disability reaches a condition which may reasonably be regarded as final and stationary a permanent pension is granted. This is desirable in the interests both of the pensioner and the Department. A man in receipt of a permanent pension has a feeling of security in regard to his pension, and he is not subjected to the annoyance and inconvenience of undergoing periodical medical examinations. At the same time he knows that, should the disability for which he is in receipt of pension become worse, he will be re-examined on. application to the Department, his pension adjusted accordingly, and any necessary treatment given. From the point of view of the Department the administrative work and expense (often considerable) associated with the constant review of temporary pensions are avoided. Wounds. —lt will be noted that a considerable number (about one-third) of the disabilities classified as "wounds" are still in receipt of temporary pension. These are cases in which inflammatory processes have, persisted or recurred, scars are painful, foreign bodies have required removal.

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or where such conditions as injuries of nerves, ununited fractures, or involvement of joints, are still undergoing treatment with a prospect of improvement. Amputations. —During the year the supply of light-metal (duralumin) artificial limbs has been arranged. Extensive inquiry in London has shown the superiority of these over the old wooden limbs. These limbs are very much lighter, which is a matter of great importance, particularly to men with an amputation above the knee, especially if their occupations entail their moving about a good deal. The limbs are also much stronger, and require repair less frequently. These repairs also most often take tho form of replacement of wearing-parts, and can be effected by posting the limb to the workshop. Their fife is at least twice that of wooden limbs, and probably much more. As these limbs are not yet made in New Zealand, it has been necessary to arrange for their importation from England. Tho only part requiring actual fitting (tho bucket) is made in the Government Artificial-limb Workshop, and fitted to the limb when received. A cable code has been arranged with the manufacturers so as to avoid delay. As, however, these limbs vary little from a standard, it is anticipated that by keeping a stock of several sizes on hand the delay entailed in cabling the measurement will in most cases be avoided. In any case, however, every amputee is alreadyprovided with a duplicate limb, so that he may always have one available, and he would therefore suffer no hardship in waiting a month or two for the replacement of one limb. Arrangements have been made to have all amputees measured, so that it will not be necessary for them to attend the factory for that purpose. This will leave only one attendance (for fitting) necessary, and it is thought that in many cases, by the taking of plaster casts, even this attendance will not bo necessary. An expert was brought from London to instruct the employees in the Government Artificiallimb Workshop in the working of the metal and in the repair of these limbs. Amputees who have already been supplied with duralumin limbs have expressed their satisfaction with them, and apparently have no doubt of their superiority to the wooden limb. Pulmonary Tuberculosis. —It is not at present clear that the incidence of pulmonary tuberculosis has been increased by the war; an endeavour is being made to ascertain if this has been the case. The concentration of patients in sanatoria has tended to emphasize the prevalence of this condition, especially among returned soldiers. Ample sanatorium accommodation is available for tuberculous ox-soldiers at Pukeora (in the North Island) and the Upper Sanatorium, Cashmere (for South Island patients). Cases not suitable for treatment at these institutions are accommodated in the Wakari Sanatorium, Dunedin, in shelters connected with the public hospital at Auckland, and at other public hospitals throughout the Dominion. Each patient on leaving the sanatorium is provided with a specially constructed tent, or an allowance wherewith to build a shelter or makeapproved structural alterations to his house. The object of this provision is twofold :in the first place, it ensures that the patient will continue to live under suitable conditions after his discharge ; and, in tho second, that he need not then come into such intimate contact with members of his family or other associates as to endanger them by infection. A certain amount of furniture is also provided with this accommodation. By regular medical examinations by chest specialists the progress of each of these cases is carefully followed. Functional Nervous Disease (Neurasthenia and Hysteria). —lt will be noted that there are 857 of these cases in receipt of pension ; their proportion to all other pensioners is 1 : 16. The treatment and pensioning of these oases present the most difficult problems with which the medical administration has to deal. The genesis of many of these cases is similar to those which have become familiar where compensation is sought under the Workers' Compensation Act. An intense desire, often (perhaps generally) subconscious, to secure financial consideration for their disabilities leads to the development of a train of nervous symptoms which are -generally not difficult to recognize. Under tho Workers' Compensation Act, however, when the case is settled, these symptoms disappear, often with dramatic rapidity. Unfortunately, in the case of pensioners the course is different. Tho worse the patient becomes the greater is his pension up to a certain limit. To maintain the pension at tho maximum the disability has also to maintain a certain standard. It is difficult to conceive conditions better calculated to perpetuate functional nervous disease, especially when it is remembered that in the very nature of their condition these patients are defective in selfreliance and especially susceptible to suggestion. That in a considerable proportion of these pensioners tho nervous system, was originally less able to resist the disturbing effect of external impressions than normally appears clear from, the fact that many of these cases developed in camp in New Zealand, on transports, in England, at the overseas base in France, or, commonly, very shortly after reaching the front. An extremely common cause of the persistence of these conditions is tho undiscriminating solicitude of well-meaning associations and individuals. It is this cultivation of the nervous disorder by such- individuals (perhaps not always disinterested) which renders the obvious course of the grant of a final gratuity futile. This course, if it were possible, would complete the analogy with, cases under the Workers' Compensation Act and achieve its happy results. It is to be pointed out that the symptoms complained of by these patients are often concentrated on a particular organ, especially if some organic disability has actually previously affected it; for instance, such symptoms not uncommonly group themselves in tho abdominal region when the individual has suffered a previous attack of dysentery, which may have been quite slight and transient. If it has been necessary to retain patients in hospital for some considerable time such symptoms not uncommonly develop shortly before or after discharge (" hospitalization "). These patients are treated at the neurological centre at Hanmer Springs, which is admirably suited to tho purpose. The patients generally leave the institution greatly improved, with increased, self-reliance. Unfortunately, they constantly relapse whenever exposed to any anxiety or strain such as may arise in their domestic or business life. Tho returned soldier is just as likely to suffer in this way as the person who did not go to the war (and in some cases more so, not because of the strain to which ho has been subjected at the war, but because on his return to New Zealand he has dropped behind a little in tho struggle for existence). The clerk takes up land ;he has no knowledge of farming; his farm fails ; he and his family are in grave financial difficulties, and ho immediately develops neurasthenic symptoms. His failure he attributes not to his lack of knowledge, but to the fact that his health was ruined at the war, and his proof to himself and his family of this is the present state of neurasthenia. Domestic troubles are just as common. Tho civilian patient will admit these domestic troubles. The service patient blames the war and his condition for his altered

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state of feelings. The wife also bjames the stress of war. It is quite obvious that neither party would in any way consider that anything else was the cause, because it is natural to blame something, and also because that to which they lay the blame will bring in monetary assistance. It is difficult to know to what extent such relapses should be accepted as entitled to further treatment or pension when it is so clear that in the majority of cases the condition is constitutional and not reasonably attributable to service. It is clearly to be understood that the preceding remarks do not refer in any sense to malingering. Pure malingering is rare, although the partial form, which consists in an exaggeration of existing symptoms, is undoubtedly common. Hom.es for Chronic Cases. —There are a certain number of cases which require skilled nursing and more or less constant medical supervision for long periods, perhaps many years. As an example of such cases I may quote gun-shot wound or tuberculosis of the spine. The ward of a public hospital was clearly not a proper repository for such patients, nor, perhaps, would the hospital authorities be prepared to dedicate much-needed beds to boarders of such permanence. To treat these men in their own homes would be extremely unsatisfactory and expensive. One and sometimes two trained nurses would be constantly required, and in the majority of the cases the pensioner's home would be unsuitable for his case. To accommodate these cases there has been established in each centre a " Home for Chronic Cases." The accommodation of these Homes varies from twenty-three to thirty-six beds. Trained nurses and a part-time medical officer are employed at each. It has been arranged with the Red Cross Societies in Auckland, Wellington, and Dunedin, and in Christchurch with the combined patriotic bodies, that a committee of these bodies conduct the Homes and supply such "services of luxury" as has been regarded as their proper field. The ordinary maintenance of the patient is paid for by the Department, which exercises medical supervision, of the Homes. These Homes are all pleasantly situated, and the method of control renders the atmosphere really " homo-like." They are greatly appreciated by the patients, and their provision has solved the problem of the disposal of these unfortunate cases in the most satisfactory manner. Dental. —The Director of Dental Services, Mr. T. A. Hunter, very kindly continues to lend his valuable assistance to the Department in deciding questions of eligibility for and arranging the carrying-out of dental treatment. The following table sets out the numbers of applications for treatment as service patients during the year ended 31st March, 1924, and the numbers actually under treatment on 31st March, 1924 :—

As was anticipated, tho rate of decrease in patients undergoing treatment is a diminishing one, as the more chronic cases come to constitute a relatively larger proportion of the whole. Even with this expectation, however, the diminution has been disappointingly slow. During the last six months the numbers of pensioners under treatment have been practically stationary. Indeed, latterly the number of applications for treatment has increased, probably because it is considered that to be under treatment would justify a claim for the economic pension which was introduced by the legislation of last session. Expenditure in connection with the medical treatment of war pensioners for the year ended 31st March, 1924, and which is a charge against " war expenses," is as follows : — £ Salaries .. .. .. .. .. .. .. .. 6,848 Maintenance in hospital . . .. .. .. . . .. 90, 299 Out-patient treatment .. .. .. .. .. .. 3,880 Artificial limbs and surgical appliances .. .. .. .. 6,250 Travelling-expenses of patients .. .. .. .. .. 4,711 Accommodation for patients suffering from pulmonary tuberculosis .. 3,733 Expenses of Artificial-limb Factory, Wellington .. .. .. 1,363 Funeral expenses .. .. .. .. .. .. .. 774 Medical fees .. .. .. .. .. .. .. 442 Freight and cartage .. .. .. .. .. .. 370 Rent of offices .. .. .. .. .. .. .. 167 Dental treatment .. .. .. .. .. .. .. 142 Office fittings .. .. .. .. .". .. .. 16 Telephone and sundry expenses .. .. .. .. .. 12 £119,007 D. McGavin, 30th June, 1924 Medical Administrator of Pensions.

Medical District. Number of Applications during the Year ended 31st March, 1924. Receiving Treatment at 31st March, 1924. In-patients, j Out-patients. I Total. Auckland Wellington Christchurch Dunedin 633 827 333 502 93 148* 180f 77 20.1 218 176 152 294 366 356 229 Totals .. 747 1,245 2,295 498 * Includes patients in Pukeora Sanatorium. ■Sanatorium, Cashmere. j Inoludi is patients in Hanmer Hospital and Upper

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APPENDIX II—TABLES. Table I. —Number of War Pensions in Force at each Rate on the 31st March, 1924.

Table II.—Pensions granted, Deaths, and Cancellations in each Year, with Number in Force and Annual Variation.

Rate (nearest £1). Soldiers (Permanent). Soldiers (Temporary). Wives and Parents (on Account of Disablement). On Aocou; it of Death. Widows (including Children's Pensions). Parents and other Dependants, £ £ 261-300 .. 234-260 .. 201-233 .. 191-200 .. 181-190 .. 171-180 .. 161-170 ... 151-160 .. 141-150 .. 131-140 .. 121-130 .. 111-120 .. 101-110 .. 91-100 .. 81- 90 .. 71- 80 .. 61- 70 .. 51- 60 .. 41- 50 .. 31- 40 .. 21- 30 .. 6-20 1 28 15 74 7 36 19 18 23 62 35 77 223 387 352 266 1,092 248 1,243 1,911 667 1 2 3 8 521 45 44 33 13 148 26 206 106 2 344 220 879 182 1,105 3,487 356 1 5 12 1 30 1 8 50 11 130 29 14 168 29 144 18 63 73 20 3 25 59 33 105 5 66 165 18 60 330 59 24 8 66 452 2 87 1 i 12 10 11 41 9 178 82 504 51 1,566 3,312 89 41 360 9 Totals 6,784 7,731 807 1,977 5,867

Year ended 31st March. Number of Pensions granted. Deaths. Cancella- In Force at Tn orease Decrease tions. End of Year. inorease - JJeoiease. 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1.922 1923 1924 7,487 4,699 2,227 1,694 1,391 1,063 1,210 2,075 2,031 1,740 2,113 2,304 2,399 2,318 2,072 3,320 3,158 2,268 1,823 2,146 2,235 2,289 2,152 2,553 2,781 2,549 Uld-age. 38 786 815 935 1,064 928 890 1,038 1,097 1,189 1,112 1,169 1,423 1,469 1,569 1,479 1,582 1,539 1,610 1,535 2,013 1,798 1,880 1,578 1,763 1,870 Old-age. 6 7,443 71 11,285 3,842 292 12,406 1,120 388 12,776 371 622 12,481 .. 295 690 11,926 .. 555 476 11,770 .. 156 225 12,582 812 259 13,257 675 239 13,569 312 174 14,396 827 211 15,320 924 276 16,020 700 220 16,649 629 643 16,509 .. 140 300 18,050 1,541 274 19,352 1,302 277 19,804 452 320 19,697 .. 107 348 19,960 263 310 19,872 .. 88 370 19,993 121 428 19,837 .. 156 321 20,491 654 328 21,181 690 392 21,468 287 7,487 4,699 2,227 1,694 1,391 1,063 1,210 2,075 2,031 1,740 2,113 2,304 2,399 2,318 2,072 3,320 3.158 2,268 1,823 2,146 2,235 2,289 2,152 2,553 2,781 2,549 38 786 815 935 1,064 928 890 1,038 1,097 1,189 1,112 1,169 1,423 1,469 1,569 1,479 1,582 1,539 1,610 1,535 2,013 1,798 1,880 1,578 1,763 1,870 6 71 292 388 622 690 476 225 259 239 174 211 276 220 643 300 274 277 320 348 310 370 428 321 328 392 7,443 11,285 12,406 12,776 12,481 11,926 11,770 12,582 13,257 13,569 14,396 15,320 16,020 16,649 16,509 18,050 19,352 19,804 19,697 19,960 19,872 19,993 19,837 20,491 21,181 21,468 3,842 1,120 371 812 675 312 827 924 700 629 ■ 295 555 156 140 1,541 1,302 452 107 263 121 88 654 690 287 156 Totals 64,097 64,097 34,169 34,169 8,460 8,460

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Table II. —Pensions granted, Deaths, and Cancellations in each Year, etc. —continued.

G. C. Faohe, Commissioner of Pensions.

Approximate Cost of Paper. —Preparation, not given ; printing (725 conies). £17 10s.

By Authority : W. A. Cl. Skinner, Government Printer, Wellington. —l 924.

Price 6d.]

Year ended 31st March. Number of Pensions granted. Deaths. Cancellations. In l-'orce at End of Year. Inorease. Decrease. 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 791 657 421 458 444 421 509 1,349 767 627 523 616 730 Widows'. 3 1 2 4 2 6 11 18 8 3 12 8 3 129 193 208 338 285 335 319 516 642 598 536 607 788 1,313 1,540 1,788 1,890 2,021 2,192 3,211 3,444 3,421 3,343 3,411 3,526 525 227 248 102 134 168 1,019 233 "68 115 23 78 . Totals 8,313 78 4,709 Maori Ww, I 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 577 747 256 60 10 24 12 5 2 1 1 1 9 74 108 124 101 103 125 • 106 130 72 71 80 1 1 568 1,240 1,388 1,323 1,232 1,153 1,040 939 811 740 669 589 672 148 65 91 79 113 101 128 71 71 80 1 1 Totals 1,696 1,103 4 1916 1917 1918 1919 1920 1921 .. 1922 1923 1924 120 153 91 82 237 107 78 96 88 Miners'. 120 238 270 240 415 474 506 544 580 118 32 35 34 41 23 43 38 52 48 25 71 39 5 8 6 4 175 59 32 38 36 30 Totals 1,052 314 158 1916 1917 1918 1919 1920 1921 1922 1923 1924 1,214 5,316 10,587 16,954 15,183 2,207 945 625 551 War. 22 1,294 1,173 3,493 7,748 4,656 3,249 2,898 3,345 1,191 5,169 14,497 27,427 34,571 31,764 29,091 26,460 23,166 1 44 86 531 291 358 369 358 361 3,978 9,328 12,930 7,144 2,807 2,673 2,631 3,294 Totals 53,582 2,399 27,878 Number of pensions taken over from Public Health Department on 1st April, 1920 1921 1922 1923 1924 Epidemic. 939 27 6 117 172 114 112 849 683 569 457 90 166 114 11.2 Totals 972 515