5

H.—7

for action ; that the hospitalization of the institutions now in progress, and the. gradual introduction of women nurses in male hospital and reception wards, will further tend to educate the public, whose idea of mental hospitals seems to be derived from the worst cases and not the well-conducted, many of whom are on parole ; that the tendency to extend parole is meeting with encouraging success ; that a person is either insane or not insane,; that the, insane, if fit for it, can be efficiently treated in our reception hospitals without entering the main institution; that the "not insane" are outside our province, but any person who feels unstable can be efficiently treated as a voluntary boarder, and resume his place in the community as others have, without the popular stigma ; that numbers of persons, known to each of those present, now doing good and important work, were patients under reception orders treated to recovery; that there was certainly a want, in the community of consultants, and each of the medical officers present expressed his willingness to devote an afternoon a week to an out-patient clinic at the nearest general hospital if arrangements could be made. They would, as honorary consultants, see any patient sent to them by a doctor, and advise on his case. This is a very generous offer on the part of busy men, and I can see much good come through its being properly carried out. I trust, therefore, that the Hospital Boards will take it up. Should the Hospital Boards consider it necessary or expedient to open a small ward for in-patient treatment in connection with the clinic, there is provision in the existing Act by which this can be carried out (vid-e section 123, subsection (6)). Another subject discussed was the separation of the domestic and nursing divisions, especially in regard to the preparation of food and kitchen supervision. The kitchen rearrangements at .Auckland were at last approaching finality, and complete rearrangement and reorganization was indicated at Seacliff and Porirua, where in the present position, not altogether the most desirable, the kitchens cannot be extended. The, officers concerned were informed that a sum would be asked for to carry out the necessary work. I then introduced a subject which had suggested itself to me when the Domestic Economy School was started in Dunedin- namely, when a sufficient number had graduated to permit of selection for the fulfilment of our particular needs, that one, graduate should be appointed to each of the institutions and placed in charge of the domestic arrangements, especially the kitchen and laundry, as I felt confident this would relieve some, of the higher officials of much responsibility and anxiety, leaving them more time for their other duties, and I believed it would prove beneficial for the patients—the main consideration—and at the same time, in all probability, lead to actual economy in administration. The classification would be that of a higher officer. I thought it right to point out to the conference that my experience of long ago in the Old Country was not exactly favourable to such an appointment, unless the officer had a large measure of tact; that where the spheres of the housekeeper and Matron approached each other disagreements arose, were arbitrated upon, and apparently settled ; but one, could not help feeling that relations of armed neutrality existed between the officers, which did not conduce to harmonious working. After many such trials the office of housekeeper was abolished, and her duties were absorbed by the Matron. In the retrospect it seems clear to me that failure was due, to the Matrons being fully qualified while the housekeepers were good enough practical women, who had no scientific foundation for their rulo-of-thumb knowledge and faith in themselves, and that this inferiority was detected by tin 1 , Matrons. The, members in conference, glad to initiate any policy making for the better working of their institutions, were to consider each how his institution could best adapt itself to the new order, and I undertook to ask for your support in making one or two such appointments, experimentally in the first instance. You will be, aware, sir, that the nursing staff is trained by lectures and demonstrations, and that at the. end of three years' service, is examined on mental nursing and kindred subjects, and on passing are placed on a Register of Mental Nurses. There are quite a number on the Register at present, and I propose that it should be printed with the present addresses of those who have left the service, generally to be married, as I believe that such information would be, useful to persons in their vicinity in cases of urgency. At the examination held in December last, the following passed and their names were added to the Register : — Auckland : First Grade- John Alexander, Eva Mariana Gall, Eileen Hamilton, George Hepenstall, Kathleen Arabella Margaret Hill, Mary Agnes McNoe. Porirua : First Grade—Gertrude Bonner, Herbert John Freeth, Arthur Hustler, James George Young ; Second Grade—James AlexanderAnderson, George Harper, Robert Nichol. Christchurch : First Grade—David Aiken, Agnes Hone. Scaclifi' : First Grade Doris May Charlton ; Second Grade—Henry Frederick Bennett. I find the names of those placed on the Register as a result of passing the, examination held in December, 1921, were inadvertently omitted from my last annual report. They are a.s follow : Auckland : First Grade -Samuel Donnell, Lucy Blanche Skipper ; Second Grade —Martha Halliwell. Porirua: First Grade William Francis Mansfield, John O'Sullivan, Lucy May Wilson; Second Grade William Joseph Bannin, William Harding, Charles Huckstep, Muriel A. S. Matthew, John Paterson, Robson Young Peacock, Thomas Readymartch, Charles Sheldon, George Smart, Weir Stoddard McMorran. Nelson : First Grade— John Benjamin Darcio Kern]), Elsie Louisa Heslop ; Second Grade, —Harold George. Munoastor. Hokitika : First Grade--- Edgar Moore Hatton Dawson, Eileen Smith, Mary Dale, Alexander Askew ; Second Grade- -Thomas Austin Sumner, John Leonard Hughes. Christchurch : First Grade—Catherine Mary Garlick, James McGuinness ; Second Grade -Cyril Joseph Stafford Moore. Seacliff : First Grade Donald McMillan, Margaret Mulrinc, Robert Stuart, Charles Mollison Duncan, James Kinmond, Rose Venus Rains, Mabel Braimbridsre ; Second Grade James Henry Brook, Bridget Kathenne Ilickey. 1 have again to express my indebtedness to the District Inspectors and Official Visitors for their advice and help. Ido not think the community realizes the very great and gratuitous service that