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1905. NEW ZEALAND.

HOSPITALS AND CHARITABLE INSTITUTIONS OF THE COLONY (REPORT ON THE), BY THE INSPECTOR OF HOSPITALS.

Presented to both Houses of the General Assembly by Command of His Excellency.

The Inspector of Hospitals and Charitable Institutions to the Hon. the Minister for Public Works. Sir, — Ist July, 1905. The Act under which this Department has been working since 1885 was a compromise between the centralising tendency to strengthen the General Government and the provincial spirit which had previously been the chief factor of the national development. When the Hospitals and Charitable Aid Act was before the House, the forces which made for local jontrol of our public institutions were still so strong that any harmonious adjustment of central control, and the demand for local administration, was impossible. When the provinces were abolished, no attempt had been made to organize our system of local government to fit it for the exercise of the functions which must devolve upon it. The chief objects aimed at by our Act were to limit by creating large districts the tendency to needlessly multiply separate institutions, and to secure equality and uniformity of taxation for buildings and maintenance by direct taxation. The latter of these objects was successfully attained so far as to cast half the cost on the rates. An attempt was made to prevent the killing of charity by giving special power to elect trustees, and a subsidy of 24 shillings in the pound for voluntary subscriptions ; but this has disastrously failed in its purpose, and the power to elect trustees has in some places been an unmitigated evil. Except in times of spasmodic activity, the subscribers dwindled and became indifferent, and their meetings were hole-and-corner conferences of self-seekers to run the institutions. If ever their seats were in danger they were always able to get back by getting elected to represent some of the outlying local bodies. The results of this can only be surmised. The determination of our people, so characteristic of our race, to have control of the spending of the money raised by taxation in their own districts has completely broken down the first of the two main objects of the law. Every year, in spite of my incessant efforts to prevent the undue multiplication of hospitals and other institutional foci of charity, vicarious because raised by taxation, their number goes on increasing. Last year our hospitals and charitable aid expenditure was £259,615, and our total population is 908,114. Outdoor relief ought no longer to be subsidised by more than a third, and abolished by a date to be fixed. Our large hospitals should be made to depend on direct taxes and local contributions, and our smaller hospitals ought to be closed as the means of communication make it possible. Only cottage hospitals should be maintained in many places where fully equipped modern institutions are aimed at. These cottages should be centres for the operations of certificated nurses who are also qualified midwives, and they could have trained helpers sent from the centres when bad cases turned up which could not be sent at once to the larger hospitals and when night nursing would be necessary. Comparatively few properly equipped hospitals could overtake all the most important hospital cases, and the others should be closed without hesitation,

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