8.—4 a,

Division of Dental Hygiene. 647. The total cost of the school dental service for 1930-31 was £51,137, while the cost for 1931-32 was £44,896, or a reduction of £6,241. The cost of this Division has risen rapidly from its inauguration in 1922, as is shown by the following statement: — Year ended 31st March, £ Year ended 31st March, £ 1922 .. .. .. 11,840 1928 .. .. .. 32,095 1923 .. .. .. 12,407 1929 .. .. .. 35,496 1924 .. .. .. 16,054 1930 .. .. .. 44,286 1925 .. .. .. 17,031 1931 .. .. .. 51,137 1926 .. .. .. 20,115 1932 (estimated) .. .. 44,896 1927 .. .. .. 30,353 648. In addition to the above, the local Dental Clinic Committees are contributing approximately £4,800 in cash to the Department, and also pay certain local expenses for maintenance which would have a cash value of approximately £4,000 in the aggregate. 649. The Division also is controlled by a special Director and there are four District Dental Superintendents. In addition, there is a Superintendent of the Dental Clinic and Training School at Wellington, and. three instructors. 650. The organization appears somewhat top-heavy and the positions of Director and Superintendent of the Dental Clinic and Training School might well be combined. 651. The administrative headquarters of the Division occupy rented offices, and we see no reason why this should be necessary. The headquarters of the Division should, in our opinion, be at the Training School, thus leading to a saving by way of rent and office expenses. There cannot be efficient and economic control under the present system. 652. There are at present 203 dental clinics, of which 130 are what are termed " main centres " and 73 are " sub-bases." At each of these centres regular and systematic attention is provided for the children of a definite group of schools, and each child receives attention twice a year from the time the child commences-school until he or she leaves the Fourth Standard. 653. Special buildings are provided for each local clinic, the cost being approximately £300, and clinics are not established until the local community agrees to find one-third of the cost of the building. The Department then provides the technical equipment, while the local committee finds non-technical furnishings to the value of approximately £20. The local committee has, for some years, been required to find the cost of maintenance, exclusive of dental materials and the salary of the attendant nurse. 654. During 1931-32 there was a change in policy, under which a charge of £30 per annum was imposed on all dental clinic committees in respect to each dental nurse employed, and the estimated revenue from this source for 1931-32 was £4,800. This £30 approximately covers the cost of dental materials. 655. As to the services carried out by the Division, we are impressed by the fact that at the 30th November, 1931, the number of children under the care of the School Dental Service was approximately 69,000, whereas the number of children attending the primary schools of the Dominion exceeds 200,000. 656. We are definitely of opinion that this service should not be allowed to expand, for if the whole of the children attending the State and sectarian primary schools were under the care of the School Dental Service the ultimate cost to the Government would be in the vicinity of £100,000 per annum. We recommend that no new trainees be enrolled and that every effort be made to reduce the cost of the service. We further recommend that local committees be required to find an additional annual sum of £70 per nurse employed, making a total of £100 per annum per nurse. In the event of any committee being unable to find this sum the clinic should be closed. The scale of charges for operations at the Dental Clinic in Wellington, which is also the Training School, should be revised, in order that the charge to parents may be brought into line with that which would require to be imposed by Dental Clinic Committees in other centres. 657. The adoption of our recommendations may result in some of the present dental nurses being thrown out of employment, but by virtue of their training they might perhaps be afforded facilities for engaging in private practice for the dental treatment of children up to, say, twelve years of age. If these nurses are capable of carrying out dental treatment in the employ of the Department, they should also be capable of engaging in private practice within the limit suggested. At the present time they are precluded by statute from engaging in private work. 658. In the event of future extension of this service, the principle should be established that Government assistance should be limited to a subsidy not exceeding £1 for £1 on local contributions for buildings, equipment, and salary. 659. The savings recommended may be summarized as follow :— £ Additional contributions from Dental Clinic Committees .. .. 11,500 Salaries of Superintendent, &c. .. . . .. .. .. 540 Rent and office expenses .. .. .. .. .. .. 300 Uniforms for nurses .. .. .. .. .. .. 150 £12,490

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