THE PUBLIC HEALTH.

New Zealand Herald, Volume XLVIII, Issue 14819, 24 October 1911, Page 8

THE PUBLIC HEALTH.

HOSPITALS AND CHARITABLE INSTITUTIONS.

DR. .VALINTINE'S REPORT.

DECREASE IN BIRTH-RATE.

[HX TELEGRAPH.SPECIAL CORRESPONDENT.]

Wellington, Monday. The annual report of Dr. Yalintine, Inspector-General of Hospitals, upon public health and hospitals and charitable aid in the Dominion was presented to Parliament to-day. In opening, Dr. Valintine stated that the report should have been presented in July, and attributed the delay that has occurred to tho difficulty in getting some hospital secretaries to furnish their returns, some of which did not come to hand until September. The Inspector-General suggests an amendment to the Act making it incumbent on hospital secretaries to furnish their returns by a specified date. Public Health. The public health report is for the year ended December 31, 1910. The birth-rate of the Dominion was 26.17, as against 27.29 in the previous year. The actual number of births was 25,984 in. 1910, as compared with 26,524 in 1909. Victoria excepted, where the birth-rate is 24.55, New Zealand has the lowest birth-rate in Australasia. The death-rate in 1910, was 9.71. In the previous year it was 9.22. The infantile mortality rate per 1000 births was 67.7, as against 61.6 in the previous year The death-rate from tubercular diseases (7.36 per 10.000) was the lowest hitherto recorded in the Dominion. In the previous year there were 8.23 per 10,000. The actual number of deaths was 731 in 1910 and 800 in 1909. Dr. Valin-

tine declares himself hopeful that the steady decrease in death-rates from these diseases will at least be maintained. It is hoped that during the coming year a scheme for the medical inspection of school children will be put into operation. Vaccination. Alluding to the scare which arose when the Knight of the Garter arrived at Lytlelton with a case of smallpox aboard, Dr. Valintine states that such events will always cause anxiety to the Department while the population is practically unprotected against smallpox. He mentions that out of 20,000 infants born every year in the Dominion, only five per cent, are vaccinated, and while not advising a repeal of the present law, lie states that it would be necessary to repeal it unless it is to be more vigorously administered than heretofore, and in the event of an outbreak of smallpox to provide by Order-in-Council that all persons within a certain area be vaccinated unless they can show satisfactory evidence of recent vaccination. Almost without exception hospi tal boards have appointed the necessary officers to give effect to the change in the law making them responsible for the control of infectious diseases.

Cost of Administration. Though the receipts in the Department of Hospitals and Charitable Aid have increased by £50,000, and levies on local authorities have increased by only £2513, the expenditure on new buildings has increased by some £20,000. Payments by patients increased by £5241, and from this source one-sixth of the total hospital expenditure is now ' derived. The cost per occupied bed has decreased steadily during the last four vears. In 1907-8 the cost was £128 Bs, in 1908-9 £110 ss, in 1909-10 £100 7s. in 1910-11 £96 19s. The cost of hospital and charitable administration has increased for the year by £3152. The Inspector-General states that this was anticipated, and that, in fact, a larger expenditure was feared. He adds that many of the boards recognise that they consist of too many members, which not only militates against effective work, but increases travelling expenses. The cost of administration, it is stated, will not diminish. The increasing responsibilities devolving on boards necessitates a larger executive staff or an increase in pay to officers who have to assume larger responsibilities. "Speaking generally," Dr. Valintine remarks, "our hospital secretaries are not paid in proportion to their responsibilities." He adds that this is one of the worst forms of hospital economy.

Act Working Well. "So far," tha Inspector-General remarks, " there is every reason to believe that the new Act is working well and meeting the difficulties that brought it into being. At the Hospitals Conference in June last, no serious alterations of the law were suggested. The troubles that have arisen have been largely administrative. That the boards are too large is generally admitted, but the boards have not taken sufficient advantage of their power to form committees. In some cases trouble has arisen between the chairman and tho principal committees, and in others antagonism has arisen between the committees and the board, which has brought about that very state of affairs that it was hoped would be obviated by the new Act." Dr. Valintine remarks that when once a committee— of competent men—has been appointed, it should be allowed considerable latitude by its parent' board. It is irritating to members of a committee who have, perhaps, spent hours in discussing a subject, to find their recommendations animadverted upon by members who have not given the same time to the subject. In nine cases out of ten the committee is right. The Inspector-General states that a great deal of time, irritation and expense would be saved, and the work better done, if the reports of the committee were adopted after its chairman had answered a few questions. Decrease in Free Relief.

The cost of indoor charitable aid in 1910-11 was £62,848, and of outdoor relief £33,051. In the previous year the figures were respectively, £64,336 and £38,988. There is thus shown a total decrease of £7425. Dr. Valintine considers this distinctly satisfactory. He mentions that this is the lowest expenditure since 1904-5, and adds that the/ do crease not only speaks for the general prosperity of the Dominion, but alfyo for a better administration. He foreshadows a further reduction in the cost of outdoor relief, now that the boards have .provided officers for inquiring into the circumstances of applicants and recipients. Referring to nurses, the Inspector-Gene-ral states, inter alia, that he obtained the permission of the predecessor of the present Minister to offer, through, the Colonial Nursing Association, assured' positions to a limited number of nursed who might care to try their fortunes in the Dominion on arrival. These, nurses will be drafted to vacancies on '' the permanent staff of the general hospital, or take, as per agreement, any duties, assigned them.