E.— 7.

,'

in so doing, as rest for a time in bed is a recognized treatment for some phases of mental disorder) these low proportions indicate that the general health at all the institutions has been good. The proportion in the previous year was 3-04 (m., 2-21 ; f., 4-08). The above includes those patients who are the particular care of the nursing staff, and it is satisfactory to note that the proportions of the various classes requiring special oversight, care, or control is substantially the same as in the previous year. Employment. Every patient who is physically able and can be trusted is encouraged to work according to his or her capacity. That work is not mainly a matter of supplying milk, vegetables, and other produce, of cooking the food, of washing and mending the clothing, and of keeping the institutions clean ; it is mainly a form of treatment which engenders a feeling of contentment, most valuable to the administration, promotes the physical well-being of the workers and the cure of the curable. This aspect of the subject has already been touched on in the remarks upon dangerous patients, and one might safely supplement those remarks by stating that double the present staff would be insufficient to control the same number of idle patients, that the statutory maximum charge for maintenance would need to be increased, and that the discharges would drop very materially. Applications have been received for cancellation of maintenance charges on the ground that the patient is employed, hence these remarks. Of course, there is no idea of reducing employment; quite the contrary —one feels the necessity for expansion. I need but instance the case of the Auckland Mental Hospital, where, with an estate having an available area for farming considerably short of 200 acres, there were last year on an average over 320 male patients fit for employment. The proportion of patients usefully employed averaged 64-65 per cent, (m., 69-74 ; 1, 57-48). Accommodation. A start has at last been made at Tokanui. Recognizing that the permanent building would not be ready for some months, a very efficient building for 50 working-patients has been completed by daylabour. Also in progress are the cottages for married attendants. They are of the bungalow type, and have a living-room with a dining-alcove and a deep verandah, three bedrooms, a bathroom, kitchen, and offices, arranged to minimize labour and admit sunlight for some hours into each of the rooms except the kitchen. One of the cottages the Medical Superintendent, Dr. Crosby, will occupy until a house is built for him. These buildings are at the Te Puhi end of the estate, where there is ready access to the railway-station. By the time that the present site accommodates 300 patients, good roads will be constructed to the heart of the estate, and building operations will be transferred thither. Dr. Gribben was detached from the head office to direct the developmental works and superintend the erection of the building above referred to. All the land is good and easily worked, and the estate is exceptionally well watered. At Tokanui the Government possess a very valuable property. I was bitterly disappointed at the abandonment at the eleventh hour of the intention to meet the overcrowding at Auckland by building on the reef-site. The matter has been very thoroughly gone into, and it was recognized with the large increase of population in the town and the North of Auckland district that the Mental Hospital must increase in size, also that the land on the main estate was taxed to its uttermost to provide an area for the working patients and the supply of produce for the institution. Dr. Beattie was positive that a large adjustment by transfer to Tokanui could not be a regular policy, though the transfer of a few might be, because his patients were chiefly drawn from the town and were frequently visited. Looking ahead, therefore, the simplest solution lay in building on the Mental Hospital Reserve —a rocky site not suitable for farming-operations —wards for patients who do not work, leaving the main institution, and with it the Wolfe Bequest Hospital, for the accommodation of the active workers, for the infirm and sick, for the newly admitted and the convalescent, thus allowing a very fair classification to be carried out by certain alterations and readjustments in the main building. Plans were prepared for the accommodation of 250 patients, and tenders were eventually received for the erection of the first instalment to accommodate 150. Meantime, by permission of the Road Board concerned, we had made the uneven rocky connection between the main road and the reef-site (the Mental Hospital Endowment reserve), a practicable road for carting. Had the work been proceeded with we would at this date have been purchasing furnishings and making other preparations for the transfer of the patients, and the Auckland Mental Hospital would have the immediate prospect of spare accommodation and adequate means of classification in permanent buildings. But, to cut a long story short, an agitation, which proved successful, was got up against proceeding with the building, on the ground that the town would soon extend towards and encircle the area, and that land-values would drop; that the Town Council intended to immediately proceed with the erection of workers' homes on its reserve, and it was stated that the placing of a mental hospital or a branch of one within 30 chains of these buildings would render them unfit for their purpose, and would reduce the value of the reserve by 50 per cent. I have to thank you, as Minister of Public Health, for having come to the rescue of the Department in this quandary, by placing at its disposal the quarantine buildings on Motuihi Island. Alterations are nearing completion, and by the time that this report is presented there should be no overcrowding at the Auckland Mental Hospital. This temporary expedient will give time to design and carry out permanent buildings. The levels of some sites on the present estate have been taken and the plans of these have just come to hand. The site for the women's building is well and suitably placed ; but, having in view future extension, I do not consider any site on the present estate well adapted for buildings for male patients of the class for whom accommodation is needed,