P1.—31

20

The Sanatorium farm is now under the control of the Superintendent of Experimental Farms Agricultural Department, and the change has been attended by marked improvements in many waysThe Medical Superintendent reports " Only twenty of the seventy-one cases admitted were in the first stage; of pulmonary tuberculosis—that is, 27 per cent. This is a low percentage, and could no doubt be considerably increased with systematic, selection of cases. I consider the results of treatment on the whole satisfactory. Out of seventy-one cases discharged 65 per cent, were sent out with disease arrested." In addition the Medical Superintendent also states that the " after-history reports " received from patients after discharge from the institution are on the whole satisfactory and encouraging. Pukeora Sanatorium. During the year an additional ward has been built, which is now in use as a general observation ward, with accommodation for twenty-five patients. This Sanatorium now has 175 beds available for use, and ordinary patients as opposed to " service " patients are being admitted in gradually increasing numbers. Much reconstructive work remains to be done at Pukeora, chiefly in the following directions : (1) Reorganization of engineering services; (2) reorganization of the kitchen, in which at present work is carried on with difficulty ; (3) additions to nursing staff quarters ; (4) provision of better examining-rooms ; (5) laying down the paths and roads of the institution in concrete or asphalt (many of the paths are exceedingly rough, and it is difficult to keep them presentable and neat) ; (6) the gradual reroofing of the institution ; (7) erection of a satisfactory steward's store. Certain of this work it is hoped to accomplish during the coming year. Much useful professional work has been accomplished during the year, and the " after-history reports " received by the Medical Superintendent are of a most encouraging character. I wish to call attention to the following extract from Dr. Short's annual report, with which 1 am in entire, accord : — " It is desirable that something should be said at this point concerning the character of cases admitted. So far as the ' service ' patients are concerned, it may be generally stated that the cases admitted have been suitable cases for Sanatorium treatment. One or two cases from outlying districts have certainly been admitted in a condition too advanced for any true hope of benefit, but such cases have never been available for examination by the officers of the staffs of the Assistant Directors of Medical Services of the districts concerned or of the hospitals under the administration of the Defence Department. The same, however, cannot be said for tho civilian cases admitted. A very large percentage of these have proved to be in a condition so advanced, in phthisis as to render sanatorium treatment of no avail, and many such cases have arrived in a condition of health so far advanced as to make a return to their homes, or to their respective Hospital Boards, impossible. It is well appreciated that even in moderately advanced cases the educational value of sanatorium treatment is in itself sufficient justification for admission, but in the cases to which 1 now refer even that factor could not nor cannot be availed of by the patients concerned. It is suggested that an urgent appeal be made to medical practitioners throughout the Dominion for earlier diagnosis and admission, to sanatorium for cases suffering from pulmonary tuberculosis. That much benefit may be done to patients suffering from this disease when given treatment in the early stages has been abundantly proved, and this institution is equipped on the most up-to-date lines for the treatment of such cases." To be really effective sanatorium treatment should be commenced at an earlier stage than is now in too many instances the case, and it is hoped that constant reiteration of this fact will help to bring about a better condition of affairs. I regret, to report the resignation, from ill health, of Dr. A. 11. Elmslie, the Assistant Medical Superintendent. This officer had given faithful and. devoted service, and his resignation was much regretted. The Medical Superintendent, Dr. Short, has had a trying year, but both he and the staff (nursing and ordinary) have worked hard and accomplished much. SECTION 3.—HEALTH DEPARTMENT MATERNITY HOSPITALS (ST. HELENS). The following are the figures giving a brief resumt't of the work done at those institutions during the year : —

St. Helens Hospitals, January-December, 1921.

Confinen tents in Insti tution. A verage Number of Pupil Nurses Resident. Town. Deaths of Infants. Confinements attended outside. Midwives qualified during Year. Births. Deaths of Mothers. Auckland Gisborne 331 88 60 283 261 145 140 1 7 4 1 10 5 Births. 228 5 2 87 151 76 2 11 4 4 13 5 3 19 14 9 7 Wanganui Wellington Christchurch . . Dunedin I 3 1 16 13 9 5 Invercargill .. i Totals 1,308 28 70 551 65