83

f1.—31

Tin.' selection of some of the candidates has not been carefully made, ami valuable time has been lost, and expense incurred, by the women sent not being suitable. Some have failed to pass the probationary period. As they are sent from a distance, it is impossible for the Matrons of the St. Helens to see them before their entrance, and therefore they have to be given a month's, and in some instances two months', trial. 'I he Hospital Hoards by whom they are recommended do not realize that it is necessary for these pupils to be more than honest and industrious women. A certain amount of education is necessary in order to comprehend and apply the instruction given. In the 1 circular sent, emphasis is laid on the necessity of a fair education. The wife or daughter of a farmer in the district, of about thirty to thirty-five years of age, one who knows the country and is known b\ the settlers, and who has her home there, is tin- proper person to send for this training. It will be no difficulty to her to return to her home and take such work as conies in her way. But for a stranger settling in a sparsely peopled district the means of living might be precarious, and. without being supplemented by a subsidy from the Hospital Board, not sufficient to maintain her for the term of two years she has contracted Io stay at a certain place. This is recognized by the Central Midwives Board, London, and at a special meeting to consider the amendment of the Midwives Act. 1902, a resolution was carried that any amendment should provide for "subvention from public funds of midwives who are unable to maintain themselves in sparsely populated and poor districts." I may in this connection draw attention to another resolution passed: that the amendment also provide for "adequate and certain remuneration of medical practitioners called in under the Boards' regulations." The inspection of midwives has been carried on. Many women have been reported as working as midwives though unregistered. These have in some instances merely had a warning sent to them thai (hey are laving themselves open to prosecution ; but in cases where such a warning previously given lias been disregarded the offenders have been prosecuted under the Midwives Act. Light women were prosecuted foi acting as midwives and convicted and lined. while many others reported as so acting illegally were warned. A number of women were also prosecuted under the Private Hospitals Act for carrying on unlicensed maternity hospitals. A number of women have been suspended for varying periods -mostly one month- on account of having attended a septic case. I may emphasize the fact that in only one instance has the midwife so suspended been a certificated woman. In this one instance the woman possessed the certificate of the C.M.8., and in virtue of that was registered in New Zealand. She showed such ignorance of her work and of the most ordinary rules of asepsis that the District Health Officer doubted the authenticity of her certificate. This was afterwards ascertained, however, to be genuine, and she was permitted to resume her practice after an extended suspension and a warning for the future. The Dumber of registered mi lwives is now 1.01'). 1,008 of these, so far as can be ascertained, are practising. The untrained registered women still largely predominate, but at present they are decreasing owing to death and to the elderly women giving up work. It will not be long, however, before the position is reversed, owing to trained women being added each year in larger numbers to the register. The reports of the several maternity hospitals here follow, but in a general way we may note (1) the success in instituting breast-feeding in cases which have never succeeded in nursing before; (2) the almost total lack of ophthalmia neonatorum ; (3) the good results of prophylactic treatment in cases of albuminuria during pregnancy; (4) the benefit of advice and care of the expectant mother, ami in cases of disease, such as heart-trouble or phthisis, of some ante-par turn treatment in the hospital. The statistical reports of the four State Maternity Hospitals show a steady increase in the outdoor work, there having been 355 births in the last twelve months, against 328 in the previous vear. Inside the institutions the numbers have not increased, there being 803 births. In two of the hospitals there were no maternal deaths, although many complicated cases were admitted, and the deaths in the other cases were —one in Wellington, moribund on admission, three in Auckland, one being outside the hospital. Considerable success has been maintained in the establishment of breast-feeding in cases hitherto unable to nurse. The pupils have, so far as possible, been instructed in the artificial feeding of infants, and in the few cases of motherless or premature infants, these are kepi in hospital some months, in order to afford as much practical experience as possible in the feeding of older infants. Tut: Private Hospitals Act. During the vear since Ist April, 191(1, the private hospitals, with a few exceptions in verydistant places, have been visited and inspected. The manner in which (he smaller class of these places is now conducted has very much improved. In the larger ones carried on by trained and qualified nurses there has not been the same need I'm- improvement; but from time to time there are alterations, and these are usually in the line of more up-to-date and more comfortable accommodation. The registered midwives who carry on the larger number of small private hospitals appear glad of advice from the Inspectors, and eager to make their houses more fit for the reception of patients. During the vear fortv new houses were licensed, thirty-one gave up their licenses, and seven were transferred to new holders. Total number licensed ... ... ... ... ... 218 For medical and surgical ... ... ... 52 for maternity only ... ... ... ... ... 135 For medical, surgical, and midwifery ... ... ... ... 31 It is not desirable to have medical, surgical, and midwifery cases in the one house, and in the larger towns licenses are not granted for all eases; but in the country it would be almost