H.—3la

Otaki. Public-hospital Facilities.—A building which was formerly a general hospital is now used solely as a maternity hospital, and last year dealt with 116 cases. The building is old and inconvenient, but nevertheless serves a useful purpose in the district. It is under control of the sanatorium Superintendent, and the two local practitioners have the right to attend patients in the hospital and to charge their own fees. Patients come to this hospital from Shannon, where there are no hospital facilities, and from all parts of the district south of this locality. Private-hospital Facilities.—There is no private hospital in Otaki. Provision for Abnormal Cases.—Abnormal cases are dealt with at the Palmerston North annexe and at the Otaki Hospital. Ambulances, maintained by the Hospital Board, are always available for the conveyance of such cases. Provision for Unmarried Mothers.—Unmarried mothers are admitted to both the Palmerston North and Otaki Hospitals on the same terms as the married, and the same provisions for ante-natal care are available for them. District Services.—The Palmerston North Hospital Board employs district nurses, eight in number, covering the whole of its territory. Two stationed in Feilding serve the northern end of the district, and two in Palmerston North serve a radius of ten miles round the city. One nurse is stationed at Foxton, one at Levin, one at Shannon, and one at Otaki. The nurses co-operate with the matrons of the Board's maternity homes at Palmerston North and Otaki, particularly with regard to antenatal work. Patients wishing to enter one of these homes can do their booking through the district nurses. The nurses do not attend confinements except in cases of emergency. A charge of 2s. 6d. per visit is made for a nurse's services in medical or surgical cases, but ante-natal attendance is always free. In the event of a district nurse being compelled to attend an emergency confinement a charge of £1 Is. is payable to the Board. The nurses do the whole of the Maori work and the school work of the district in co-operation with the Health Department, the Department making the Board a special grant of £500 per annum for this purpose. Ante-natal Care.—ln no country district in New Zealand is the general public more fortunate in the provision of ante-natal services than in the Palmerston North district. Ante-natal clinics are conducted at both the Palmerston North annexe and the Otaki Hospital. Accommodation in the latter institution requires remodelling, and it is understood that the Board is taking steps in this direction. Patients who are prevented by distance from attending a clinic and who do not intend to book a doctor for confinement are attended by the district nurses, who are well equipped with all necessary articles, including sphygmomanometers. Every effort is made to get medical supervision for every patient on at least one occasion during pregnancy, and in no part of the district need any patient suffer from lack of proper ante-natal care. Ambulances are maintained by the Board and are at the service of all maternity patients should necessity arise. Ante-natal care of private patients by their own medical attendants is general. Maori Conditions.—The total population of the district is 2,194. The district nurses are gaining the confidence of the Maori women to an ever-increasing degree. In some outlying parts Maoris are still confined at home by Native methods, but this practice is steadily decreasing, the Maoris tending more and more to go to hospital. This fact is well shown in the returns to the Otaki Maternity Hospital, Maori admission having risen from three in 1929-30 to thirty-two in 1936-37. Summary and Recommendations. Hospital facilities ill the Town of Palmerston North are adequate and up to date, and the district service provided by the Hospital Board is second to none in New Zealand as regards completeness. At Feilding hospital facilities are inadequate to the needs of the town, and the Committee was informed that it is the intention of the Board to erect a maternity hospital there in the near future. Considerable discussion was heard by the Committee on the situation at Kimbolton, a farming centre seventeen miles north of Feilding, certain witnesses holding that the erection of a hospital there would be an asset to the district, which at present is devoid of maternity facilities. The opinion of Board members, however, was that the needs of this centre and surrounding districts would be better served by a hospital at Feilding, which would also considerably relieve the Palmerston North annexe. Formerly a district nurse was stationed at Kimbolton, but the work being insufficient to occupv her time she was withdrawn. Weekly visits are now made by one of the Feilding district nurses, who attends ante-natal cases as occasion arises. The Committee endorses the Board's opinion that the erection of a hospital in feilding is desirable and that such a hospital would serve the needs of the Kimbolton district better than a small hospital at Kimbolton.

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