H.-22.

With the growth of the State Maternity Hospitals and the Medical School Maternity Home in Dunedin, which, with the Christchurch St. Helens Hospital, has been in existence for less than a year, and has therefore not had time to train more than one pupil for examination, a large number of midwifery nurses should be added to the register each year, the present average, with the number of pupils that can now be trained during twelve months in each place, being thirty-five. This, with the addition of nurses coming into the Dominion from elsewhere, should gradually and in an effectual manner meet the demand for properly trained women. A very important feature of the training of the midwives at the State maternity hospitals is the stress laid on the necessity of every possible means being used to induce mothers to nurse their infants. That efforts conscientiously and carefully made are attended with success is indicated by the fact that the number of mothers unable to nurse among the patients confined at St. Helens, Wellington, or attended by the nurses, in one year, is only 2J per cent., and in each case these women were incapacitated from performing their natural functions by disease. There have been instances in all these hospitals where patients confined of their fifth and sixth child, and previously unflble to nurse, have by the proper treatment been enabled to do so. This strongly emphasizes the fact that practical and theoretical teaching must be combined, and that practical training must be carried out under the close and constant supervision of a well-trained matron, rather than under a doctor, however efficient, whose time and for superintending is necessarily limited." It has been suggested that untrained registered midwives should be allowed to attend the course of lectures at the State maternity schools, in order to gain more knowledge of their work. This course was tried when the schools were first established, but, although a few women availed themselves of the opportunity, it was found not desirable to go on with it. The course of lectures being delivered in conjunction with study and practical work, under the supervision of doctor and matron in the hospitals, was not adapted either to the requirements or the understanding of the, for the greater part, uneducated women who were otherwise eligible. Moreover, as the nature of the work in the hospitals, and also the outside calls of the medical attendant, rendered it impossible to adhere always to times arranged for lectures, it would be extremely difficult to arrange for outsiders to attend. I may add, however, that the few applications that have been made by registered midwives to attend have not been refused. A more practicable and at the same time more valuable means of instruction for these midwives would be by a system of individual inspection and supervision, and lectures delivered at suitable tiroes and places to these women alone. In this connection may be quoted an extract from a letter addressed by the Central Midwives Board, London, to the Privy Council, concerning the training of midwives : — "It must be remembered that nothing but the course of training, with the attendance on twenty labours and puerperia, stands between what may be absolute ignorance and responsibility of the gravest and most vital character. Only those who have had on the one hand to deal with the raw material, and on the other hand with the same material after training, and in face of one of the grave complications of childbirth, can fully appreciate the extreme importance of making such, training, though strictly limited in scope, as thorough and practical as it can possibly ; be made. To place upon the roll women whose training had in any way been scamped would be to produce a state of things far worse than that which the Act was framed to abolish; for, whereas before the passing of the Act the name of ' midwife ' carried no official weight, since the passing of the Act the name ' certificated midwife ' carries with it the authority of Parliament, and implies that its holder has either been adequately trained, or (in the case of a bona fide midwife) has'at least avoided conviction for malpraxis and removal from the roll." Sf. Helens Hospital, Wellington. From the Ist April, 1907, to the 31st March, 1908, there were 132 patients admitted, and 135 births took place. There was one maternal death. Fifty patients were attended at their homes: there were 50 births and 2 deaths of infants. Receipts from patients' and pupils' fees, £548 lis. Bd. ; expenditure for maintenance, £825 Bs.; expenses, less fees, £276 16s. lljd. The work at this hospital has been carried out under very great difficulty throughout the year. An outbreak of scarlet fever occurred in July, and another in September, at the' time when the epidemic was raging in Wellington. The house was altogether in an insanitary condition, and it was realised that the attempt to disinJect it sufficiently for further use as a maternity hospital was useless. Therefore, at the commencement of the second outbreak, a house was taken to receive the incoming patients. A new house of twelve rooms was secured, and- has been in use ever since. In some ways, especially as regards the site, which is beautifully sunny and bright, this house is better suited for the purpose than the old one, but it' is too small (there is room for only ten patients), the nursing accommodation is most inadequate, there are no means of isolation for any case requiring it, and there are many other disadvantages. The new and up-to-date hospital building, for which the plans have been ready and the money voted for nearly two years, is most urgently needed, and is only being delayed by the difficulty of getting a suitable site. There have been several changes on the staff. Dr. Perkins, who was in charge for nearly three years, retired in February, and Dr. Agnes Bennett was appointed in his place. Miss Wyatt, Matron since the inception of the Hospital, resigned her position in October, 1907, and Miss Eleanor Brown, then acting as Sub-matron, was appointed to the matronship. Miss Edwards, Sub-matron up till April, 1907, was appointed Matron of the Napier Hospital at that time. There are six pupil-nurses in training at present, and thirteen have been turned out from this Hospital.

2—H. 22.

9