H.—3l.

8

Fuel and Light. —Without doubt, in our larger hospitals much, expenditure might be saved under this item. Many of our systems of lighting and heating are duplicated and generally faulty and wasteful. Administration.' —The relative cost of administration to expenditure, generally speaking, compares very favourably with that of local authorities. The following is the percentage of administration to maintenance expenditure : 1908-9, 4-9 ; 1909-10, 5-3 ; 191,0-11, 5-4 ; 1911-12, 5-8.

Charitable Aid Expenditure. 22. As compared with last year there is an increase of £2,923 in this expenditure.

Though this increase is a slight one, there is little doubt that charitable aid is costing the country more than it should. The larger Boards exercise some supervision over the manner in which charitable aid is dispensed, but in the country districts this supervision is by no means what it should be. Public Health—£s,46B. 23. This is practically the first year the cost of this new duty imposed on Hospital Boards has been made apparent. Taking all in all, the cost is very small, and is practically confined to the expenditure involved in the payment of the salaries and travelling-expenses of Sanitary Inspectors. In some districts these officers' salaries are more than saved as a result of their reports on those in receipt of charitable aid. Many of these reports have shown the somewhat lavish manner in which poor-law relief has been administered in some districts, and the abuses that have been engendered by an indiscriminate doling-out of alms. Nurses. 24. The names of 155 nurses were admitted to the register last year. Of these, 111 were traine in New Zealand hospitals ; the remainder were registered on oversea certificates. At this rate there is little need to fear that the Dominion will be short of nurses, as was anticipated last year. Many hospital authorities now stipulate that applicants for probationerships must sign on for four years. By this means it will be possible for nurses, after passing the State examination at the end of their year, to devote the fourth year to the study of some special part of their profession. For example, no nurse should be appointed to an administrative position in a hospital unless she has a certificate of having given special study to, or having passed an examination in, hospital economics. The fourth year could be very well devoted to the study of specialties. The pay of nurses in our public hospitals has been considerably increased during the past two years, the salaries varying from £56 to £100 per annum—the latter sum being paid Sisters in one of our larger hospitals. A summary of the reports of Medical Superintendents and Matrons on the eight-hours system for nurses is embodied in the Assistant Inspector's report. It will be seen that the general opinion of those responsible is to the effect that the eight-hours system is for the good neither of patient nor nurae. With three changes of nurses each day, the sense of responsibility is undoubtedly lessened, so that the treatment ordered by the medical staff is not carried out as efficiently as where there are fewer nui es. Moreover, when anything goes wrong it is practically impossible to sheet responsibility home ; and again, when a nurse sees so little of her patient she can scarcely understand the course of disease as fully as would be possible if her hours of responsibility were longer. Midwives. 25. The names of 74 midwives were added to the register last year, 55 having been trained in the Dominion. There is now some hope of meeting the needs of the Dominion in this particular branch of work, especially as during the ensuing year three additional training-schools for midwives may be provided. The total number of midwives on the register is 1,097, of whom 415 are fully trained, and 682 untrained. On the 31st March, 1907, the number was 891, of which 102 were trained and 789 untrained. It will be seen that the number of untrained midwives is gradually decreasing through death and other causes, whilst the increase in the number of trained midwives more than compensates for this decrease. The following shows the number of trained midwives for the six years ended the 31st March, 1912 : — y. Number of x oar ' Trained Midwives. 1907 .. .. .. .. .. .. ..102 1908 .. .. .. .. .. .. ..143 1909 .. .. .. .. .. .. ..204 1910 .. .. .. .. .. .. ..276 1911 337 1912 .. .. .. .. .. .. ..415

Indoor Relief. Outdoor Relief. Total. 1908-9 1909-10 1910-11 1911-12 £ 68,012 64,335 62,848 64,651 £ 37,537 38,988 33,051 34,171 £ 105,549 103,323 95,899 98,822