H.—3la.

Stratford has shown a 12-32 per cent, increase in population in the last ten years. The maternity services of Stratford district are very complete. There is a modern maternity annexe of ten beds at the Stratford Hospital. The fee is £3 3s. per week. Cases not desiring the services of a private doctor are under the supervision of the Medical Superintendent and are actually attended by him at confinement without further fee. The annexe is also open to patients desiring the services of their private doctors. The hospital charge is the same, and the doctor's fee is a matter of private arrangement. A well-equipped ante-natal clinic has been organized and appears to be functioning satisfactorily on the usual hospital clinic lines. Hospital Board patients are supervised by the Medical Superintendent, and private patients are referred from the clinic to their own doctors as necessary. Analgesics, while not as extensively used as in some hospitals, are being gradually introduced. The annexe is a training school for maternity nurses, but some difficulty is being experienced in getting sufficient pupil nurses —probably because they are attracted to larger training schools. Private-hospital provision is available in the maternity wing of a " mixed " hospital owned by two local doctors. The hospital fee is £4 4s. per week, and the wards are roomy and attractive. The doctors in charge of this hospital have been pioneers in the wider use of pain-relief measures, and prefer to do all their own ante-natal supervision. The extent to which hospitalization is practised in this district is indicated by the figures for the year ending 31st May, 1937 : — In public hospital annexe .. .. .. 11l cases. In the private hospital .. . . .. 95 cases. In midwives homes .. . • • • 23 cases. In private homes .. .. .. .... 3 cases. Domiciliary attendance of either public or private type does not, therefore, present any problem. Summary. The Committee considers that the arrangements in this district are admirable and an example to many in that a complete service within the means of all classes is available — public, intermediate, and purely private facilities of very satisfactory type are provided. 27. HAWEEA HOSPITAL BOARD DISTRICT. The area covered by this Board includes the larger part of South Taranaki dairying district and a good deal of rough back-country where the residents are engaged in sheep-farming and some timber-milling. The larger centres of population are Hawera (4,639), Eltham (1,896), Kaponga (406), and Manaia (606). There has been very little change in the population of this district in the past ten years. Hawera. Hawera is a district in which the only public maternity assistance is by way of payment by the Board to the private hospitals of the district for the treatment of indigent cases. The payment is £5 ss. per case ; a fee of £1 Is. in Hawera and £2 2s. in Eltham, Manaia, and Kaponga is paid to the doctor when his services are required in such cases. About thirty patients per year receive this assistance. There is no public ante-natal clinic, and the Committee was not certain that these publicly assisted cases received adequate ante-natal supervision. There are four private maternity hospitals with a sufficient number of beds to meet present needs. Their service appears to be satisfactory, and the fees are moderate (£4 14s. 6d. to £5. ss. per week). None of the hospitals is large enough to maintain a night nurse. The total number of beds in these four hospitals is fifteen, and the number of admissions for the year was 216. The doctors give ante-natal supervision personally, and anaesthetics and analgesics are used to the average extent. Here again the Committee could not but contrast the incomplete public service given with that obtainable in towns where a maternity annexe was available. The payment to the private hospitals for indigent cases is hardly a fair one, and the fee paid to the medical men is unsatisfactory. The general objections to the subsidy system from the patient's point of view are also apparent. The Committee considers that there is a definite need in a town of the size of Hawera for a public maternity hospital for the benefit both of the indigent and those of limited means. An " open " maternity annexe is recommended.

3—H. 31A.

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