H.—22.

At the beginning of 1907 there were 293 private hospitals licensed. At the present date there are 191. Of these, thirty-three have applied for, and been granted, licenses under the new Act. All the private hospitals, with the exception of one or two in the very far distance, were inspected during the year, many of them more than once. Some of those on the list when they were taken over by this Department had been given up, and the licensees had not troubled to notify the fact. As far as possible the regulations have been enforced, and the licensees have endeavoured to carry out directions given them; but the small amount of time to give to this inspection is not enough to do very much good. It is hoped, with more constant inspection and supervision, to improve the condition generally of the private hospitals, and, as so many of the smaller ones 'are for maternity cases, and are kept by registered midwives, the inspection, supervision, and instruction of midwives may very well be combined with the inspection of the accommodation for patients. The larger and better class of private hospitals for medical and surgical work are, foij the most part, conducted by properly trained and certificated nurses, and maintain a fair standard of efficiency. There are several of this description in each large town. What is really required now is the establishment of fairly well-equipped private hospitals in some of the smaller towns,,, In Tauranga one was opened during the year by Miss Ludwig, a fully trained nurse, which is of great use in that neighbourhood. In Te Kuiti a great want has also been supplied recently by Miss Hattaway, who has opened a home for general and midwifery cases. At. Marten Junction Miss Walton has a nice house for medical and surgical cases. At New Plymouth Miss Pike, a pupil trained at St. Helens, Wellington, has opened a maternity hospital, which was much needed there. Al Hawera Miss Pureed, a general trained nurse, and also a midwife trained at St. Helens, Wellington, has opened a hospital for general and maternity cases. At Hamilton Dr. Brewirf has built a private hospital for medical, surgical, and midwifery cases, and has, as Matron, a nurse trained in general work, and in midwifery at St. Helens, Auckland. Miss Bethune has a :good house at Hastings. In Auckland Mrs. Hughes Jones has a nice house for convalescent patients These are the principal additions during the year, though there have been a good many'smaller places started. '• • : --^ ><•->»■ ■ ■• One difficulty which has occurred in connection with the licensing of private hospitals has been that many women who have in good faith registered their houses have considered that they themselves were also registered. Others, again, have applied for registration as midwives'workirig under doctors, and were then informed that as they worked only under doctors there was no need for them to be registered. Until the new Private Hospitals Act came into force their position was safe as they did not require registration ; but the regulation that the licensee of a private hospital must be registered altered that position, and therefore in the case of anv woman who had applied during the proper time for registration as a midwife, and who was then eligible, but was informed that she need not be registered and rested secure in that information, her application was considered afresh, and if she were entitled under the Midwives Act to be placed on the Register at the time of her application, this was now done on payment of the fee. One woman only was found to be acting in defiance of the law, and continuing to take in patients after the expiration of her license Proceedings for the prosecution of this woman have been instituted. Others have been found Acting in ignorance or non-comprehension of the regulations, but on explanation, have promised 1 compliance. Some, also, have established hospitals without applying for a license, professing'ignorance of the necessity, but it has not been found necessary to institute proceedings against thehi _ A class of private hospital about which there has been a good deal of difficulty is that of the private sanatoria for consumptive cases. Of these there are three, one at Flagstaff Dunerfln belonging to Dr. Stevenson, non-resident, but who has a registered nurse as matron The other two are owned by unregistered and untrained women, and therefore are not eligible for relicensing In view, however, of the dearth of places in which phthisical patients who do" riot'wish to'enter a public institution can be taken, it has been found advisable to get a doctor in the neighbourhood to take the responsibility. Dr. Roberts, therefore, is responsible for Miss- Jackson's sanatorium at Cambridge. Ihe third belongs to a woman who has no training at all. She takes as many as twenty cases the greater number of these being sent to her by the Hospital and Charitable 1 Aid Board, Dunedin. The place and arrangements are not suitable for so large a number of patients and there is need of proper nursing for them, but that is difficult to obtain, and if the place' we're to be closed there is no place to send the patients. This place is at Rock and Pillar Central Qtago In connection with the private hospitals for maternity cases, it has been hoped that some of these which are managed by properly trained and registered midwives might have been able ] 'fo train a few pupils, either in conjunction with St. Helens lectures,, or by arranging a course : o'f lectures by a doctor attending. The number of beds specified in the regulations might be reduced so long as the pupils were able personally to conduct the necessary number of confinements th/fact of standing by the bedside of a patient while the doctor attended her not giving sufficient 'practical experience for a midwife-to understand how to conduct a case by herself. So far' however only one fully qualified matron of a private hospital for maternity cases has seen her way to'give tmml's this experience. Patients who enter these hospitals as a rule pay for the attendance of a doctor and a qualified nurse, and are therefore not inclined to allow one not so qualified' to attend them'. I have, &c, H. Maclean, ' T , , . n ,™ „. Deputy Registrar of Nurses and Mid-wives, and. .''■ The Inspector-General, Wellington. Assistant Inspector of Hospitals.

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