509

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From Dr. W. H. Stmes, Christchurch. 1. How many years of practice in New Zealand? Forty-one years. 2. What is the average remuneration of lodge doctors? I have not attended to lodges since 1878. 3. Have medical practitioners and friendly societies been generally in amicable relations? The friendly societies, or some of them, seem to be always trying to improve their position at the expense of the medical officers. 4. Have expenses of doctors increased greatly of late years? If so, in what direction? Yes, in motor-cars, building, rent, and labour 5. Has the cost of medical attendance increased in the last ten years, or in twenty years? ■The fees are practically the same now as forty years ago: ss. for advice; 7s. 6d. for visits within two miles; two guineas for confinements. 6. Have the cost of drugs and quality of drugs varied in late years —that is, is a finer quality or more expensive kind of drug demanded now than was formerly the case? Ordinary drugs are about the same, but many special and some proprietary (patent) drugs have become usual, and are very expensive, chiefly on account of the duty. 7. Have maternity expenses increased, and in what direction? No, except as regards nursing. There are not enough nurses : the hospitals are quite unable to supply the demand. The situation would be greatly improved if nurses properly trained in private hospitals were allowed to qualify by passing examinations. The trained nurses, being so scarce, are very independent. We had about two years ago an outbreak of measles in the Deaf-mute School. Six little girls were isolated in one ward, and we wished to avoid any of the maids going into that room. The nurse I sent at three guineas a week refused to obey the Matron's orders to sweep tire room, and insisted on a housemaid doing it. So we dismissed her. Her only reason was that it was not a nurse's duty to do so. On the other hand, I wish to testify to the great improvement in nursing effected by trained nurses. Their skill and devotion to their duties are generally admirable, and I have myself very seldom had any occasion to complain. My own experience of them has made me very grateful for the change since thirty years ago. My only trouble is that there are not more of them. 8. Have maternity homes, State nurses, &c, been of pecuniary advantage to the poorer classes? The maternity homes are largely pre-occupied by patients who could afford to pay outside, to the exclusion of poor people in insanitary or crowded dwellings. Medical certificates should be required before admission. 9. Have high rents in cities a tendency to keep workers in slum districts or in insanitary dwellings ? The chief cause of the high rents for small cottages is the insecurity of recovering them. No Magistrate will make an order against wages. Many persons go from house to house without ever paying more than the first few weeks' rent. If rents could be recovered in Court they would be greatly reduced, probably 50 per cent. Doubtless this results in driving many families into slum districts and insanitary dwellings. 10. Speaking generally, is there greater tendency to disease in the average man or woman than was the case twenty years ago? The only disease which I know to have increased is gonorrhoea. Since the abolition of brothels, about twenty years ago, clandestine immorality has taken their place on a much larger scale. 11. If the cost of living, due to high rents, costly food, &c, is on the increase, would that account for a higher rate of nervous or mental disease? Increased cost of living must cause more mental strain, and therefore more nervous disorder, but I think a more definite result is the restriction of births. 12. Is there a greater air of comfort and independence among the artisan and labouring classes than formerly? Yes, except as regards the unemployed and unemployable. 13. If disease is increasing, does it appear most in town or in the country? If in towns, is there a dominating cause? In town, chiefly; though I know of one case in which a highly respectable(?) young lady, who has been employed in a very good business in Christchurch, was sent to take charge of a branch of the business in a small town in the country, with the result that about twelve young men were promptly under treatment for gonorrhoea. All other infectious diseases have greatly diminished in Christchurch and Lyttelton since the improvements effected in drainage and sewerage. I think, also, that the removal of so many families from the city to the suburbs, in consequence of the tramway facilities, has contributed materially to the general good health of the community. I know of no other dominating cause of increase of disease than the one I have mentioned. 14. Have you noticed any diseases arising from occupations (say, in bakers, wharf labourers, tailors, shop-assistants)? The only suggestion I wish to offer is that treadle sewing-machines should be prohibited for use by women in shops and factories, because I have found that they are often injurious to the health of girls and women. All such machines should be run by power.