H.—lB.

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therefore, the element of outside influence is not to be lost sight of, and when it is said or implied that the administration of affairs was thwarted by a " cabal," I think it is this influence that is chiefly concerned. Both the House Surgeon and matron confess themselves to have been at times deficient in moral courage in dealing with matters as they arose, and they seem to have been apprehensive of some influence likely to prove too strong for them. Ido not think it necessary, even if it were possible, to determine how far this or that nurse may have associated herself with or sought the aid of such extraneous influence, nor would any good object be gained thereby, unless I could definitely pronounce that this or that nurse deserved immediate dismissal. But the evidence on the whole does not lead me to this conclusion. All the circumstances of the case must be taken into account: the natural feeling which induces every one to accept any help that offers for the purpose of averting an impending misfortune, and the tradition of lax discipline which had come down to them from the times of an older and. now effete system. These things considered, I am inclined to think that nothing has been done by the nurses which might not be condoned upon a promise of future observance of loyalty and proper subordination. I mean by this that those who, as I have before said, are capable of learning and accommodating themselves to the new system should be allowed to consider their positions secure so long as they co-operate ex animo with the heads of their department. Those, on the other hand, who are not so capable would come under the principles already submitted. But this procedure can, I think, safely be adopted only upon certain well-defined and well-understood conditions. The chief of these is that the Board should give a loyal and unflinching support to the House Surgeon and the matron in enforcing discipline and subordination, and every servant of the Hospital should understand that talebearing outside the walls would be visited with summary dismissal. It should also be made clear that for a nurse to carry any grievance direct to the Board, instead of through the matron, would be considered an act of distinct insubordination. It would hardly be credited in some hospitals that the Board permitted a nurse, without rebuke, to bring before it a complaint that she had been removed from one ward into another. Unless different principles from these are acted on, Ido not see how the best-devised reforms can be expected to succeed. Before going on to consider what outside agency may have been at work to foment dissatisfaction or .cause trouble, it is convenient here to mention the case of Brown, the wardsman and dresser, whose services, both as one of the old school and as exercising an objectionable influence in the Hospital, it has been proposed to dispense with. This man occupies a peculiar position. He has been twenty-three years a servant of the Hospital, and in that time has necessarily acquired a great amount of experience and knowledge in respect of accidents, wounds, and surgical cases generally. There can be no doubt that he has been a very useful man by assisting at post mortem examinations, and at operations, by dealing with cases of accident which come to the Hospital during the absence of the House Surgeon, and by attending to such cases in the wards as require some little recurring operation to be performed while the patient's bed is screened off from the rest of the ward. Mr. Brown's services are so highly rated by some witnesses that they seem to think his place could not be satisfactorily filled, even by a qualified assistant medical officer, a view of the matter which seems to me rather difficult to support by adequate reasons. But Ido not see how his services can be altogether dispensed with without the appointment of a professional assistant to the House Surgeon. Mrs. Neill suggests the annual or semi-annual appointment of an advanced student from the medical school at Dunedin. This might do very well if such a student could be obtained; but this would present difficulty, as his time would not count in the course for getting his diploma. But most probably a young doctor just qualified could easily be obtained, as there are doubtless many who would be glad of the chance of getting twelve months' hospital practice, even without salary, before launching out on their own account. I strongly recommend this suggestion to the Hospital Board, even without any reference to Mr. Brown, since, whether he goes or stays, there is no doubt that the House Surgeon has much more work than he can properly or efficiently perform. With regard to Mr. Brown himself, he has been supposed to have fomented mischief within and agitation without the Hospital. Of this I have had no clear and direct evidence, which indeed would be very difficult to obtain in such a matter; but there is one point upon which an inference may fairly be drawn. Those who have arraigned the general management of the Hospital have put in the front place among their charges the statement about the probationers attending operations. Now, Mr. Brown is the only person in the Hospital who seems to have taken a strong objection to the system, and the part he has taken in making it difficult of working has been already mentioned. The origin of this complaint may therefore with much appearance of probability be traced to him. At all events, the attitude which he has assumed on this subject is plain enough, and the freedom which he has permitted to his tongue in connection with it hardly warrants implicit confidence in his discretion or his silence respecting any other subjects upon which he may happen to think or feel strongly. However this may be, there can be no doubt that this officer is out of harmony with the modern system, and that his continuance in his present anomalous position of undue prominence cannot fail to hinder the various parts of the machine from falling into their proper places and working with the facility which is essential. The coarseness which could impute indelicacy of mind to a young woman in the performance of her duty unfits him for any work which may require his presence amongst the nurses in the wards, and the license taken in assuming the right to speak as if he had the direction of things in the operatingtheatre shows to what undue dimensions the office of wardsman and dresser has been allowed to grow. This is the natural result of a system which has permitted that office to become practically the office of an assistant-surgeon; but the anomaly and inconvenience of such a system are now manifesting themselves, and the sooner some alteration is adopted the better for the Hospital. A perusal of the charges formally made, and which I have now at some length considered, will be enough to suggest as an irresistible inference that a great deal of communication must have been going on between persons inside the Hospital and others outside. It is not necessary, and