HOSPITAL BOARDS.

Otago Witness, Issue 3755, 2 March 1926, Page 16

HOSPITAL BOARDS.

ANNUAL CONFERENCE. PROBLEMS OF ADMINISTRATION. The second annual conference of the Hospital Boards’ Association of New Zealand was opened in the Maheno-Mararru Hall on Wednesday, Mr William Wallace (Auckland) pesiding. The following delefates were present: Mangonui—R. T. Wrath all; Kaipara—.J. H. M'Carroll, Thomas French; Auckland —William Wallace, Mrs Ethel Kidd. B. J. Havbutt, E. 11. Potter, John Rowe, H. A. Sommerville, Dr E. C. Maguire; Waikato—J. P. Bailey, W. I. Conrad i; Thames—W. E. Hale, George Tonge; Waihi —S .H. Brown; Tauranga—Thomas Lochhead. D. Grant; Bay of Plenty—L. Buddie; Tauinarunui—L. S. Ford, A. S Laird; Cook —Mr Coleman, George L. Evans; Hawke’s Bay—J. B. Andrew, E T. Rees; Waipawa—W. H. Rathbonc, J. J. East; Dannevirke—D. Drummond, Taranaki —M. Fraser, S. Vickers, E. Holder; Stratford—C. D. Sole; Hawera •—F. Gillanders, C. M. Haggitt; Wanga»ui —E. E. Fletcher; Palmerston North— J. H. Vincent, J. K. Hornblow, A. J. Pliillipps; Wellington—C. M. Luke, W Appleton, G. Petherick, Mrs A. M'Vicar Dr D. Macdonald Wilson, J. Cole; Wairarapa—E. G. Eton, Fisher; Wairau •—Charles Nees, Mrs Redwood, G. Mitchell; Picton—C. Peek J. Blizzard; Nel Son—C. M. Rout, G. P. Chapman; Buffer ♦-—Hon. W. H. MTutyrc, E. W. Powell; Lnangd'nua—C. Novin; North. Canterbury —H. J. Otley, H. E. Hollaud, W. E. Leadley, Mrs Herbert, Dr W. Fox, W S. Wharton; Ashburton—W. T. Lill Alex. Prentice; South Canterbury—Rev. T. W. Potts, Mrs Unwin, H. G. Nayler; Waitaki—A. Fraser. J. Roduia i, W. Bmnpter, A. Sievw right; Otago—W. E. S. Knight, A. F. Queleh, J. W. Sourr, Mrs Macdonald, Dr Falconer, John Jacobs; South Otago—Hon. A. S. Malcolm: Vincent—J. Smart, James Ritchie, Mrs K Ray; Maniototo—E. Morgan: Southland Mohr. Mr.theson, T. Pr.vde: Wallace and Fiord—S. Fowle, J. C. Thomson, George O. C'ussels. The Health Department was represented by Dr T. H. A. Valintine '(Director-general of Health), Mr E. KilJh'k (secretary of Department of Health), Mr F. J. Fenton (inspecting house niauager, Department of Health), and Dr Chisholm (medical superintendent for (lie Department of Health). There wore also present: The llou. J. A. Young (Minister of Health), Dr M. T. MaeEachern (associate director of the American College of Surgeons), Sir Trilby King (Director of Child Welfare), and Sir Lindo Ferguson (Dean of the Medical •Faculty of the Otago University). MAYORAL WELCOME. In a brief speech of welcome, the Mayor (Mr IT. L. Tapley, M.P.) said that though there had not Been a conference of hospital boards held in Dunedin before, he was glad the ice had been broken •t last. He was pleased, also, to see

that the delegates had got beyond the Empire City of Wellington for the holding of their conference. It seemed a pity that all the cities should not have an opportunity of sharing in the deliberations of the boards, and it seemed to him that all the centres should receive the benefit of having conferences held in them. He wished to congratulate the boards on the work they were doing, and he thought it was a splendid thing for men and women to give up their time in such work as that of a hospital board. Continuing, Mr Tapley said that it also gave him pleasure to extend for the first time a eivic welcome to the new Minister of Health, the Hon. J. A. Young, whom he wished to congratulate on his elevation to Cabinet rank, and who, he was convinced, was the right man in the right place. He was also pleased to welcome Sir Truby King, whose name had extended beyond the realms of our own Dominion, and was now known the world over. Another source of gratification was the fact of being able to tender a welcome to a visitor from our sister Dominion, Canada, Dr MaeEachern, who, as they all knew, would be able to give them some very valuable information regarding the medical methods in vogue in Canada and United States. The President thanked Mr Tapley for his remarks, and concurred with him in regard to holding conferences not only in the large centres, but also in the smaller towns, many of which possessed large hospitals. In introducing the Hon. J. A. Young, he conveyed a message from the late Minister of Health, Sir Maui Pomare, who tendered his sincere thanks for the loyal co-operation and help given him by the boards and the various executives during his term of office, and extended to his successor his congratulations and THE MINISTER’S ADDRESS. The Hon. Mr Young thanked the Mayor an I the president for the welcomes extended to him. He said he felt there was no portfolio of more importance than that of Public Health. Without a proper constitution in the individual there was a poor chance of mental development and a poor chance of the foundation being laid which made for the welfare of the community. Conferences such as theirs were calculated to do an immense, amount of good—they gave members of boards a stimulated interest in their work, and by the. co-ordination of various views and opinions made for great good. In his new oflice he felt a souse of his great responsibility. He was following a gentleman—Sir Maui Pomure—who linl lone distinguished service. He hoped that the same happy relations that had existed between the hoards, the association, and his predecessor would continue to exist with him. Having been a member of n hospital hoard, and having held many public positions, he knew something of the work of hospital boards and of the working of the Hospitals Act. Ho paid a tribute to the services rendered by members of hospital boards, and expressed his acknowledgment as Minister of the exeel- ’ lent work done. They were faced ns boards with many problems. He would mention four problems: organisation, finance, administration, and service. In connection with finance they wore entrusted with the expenditure of large sums of money, and whatever

representations the conference desired to make to him on the subject of finance, on other subjects he would be pleased to listen to and give his careful consideration. In regard to organisation, it was only experience that could teach them that. The result of the exchange of thought and experience at the conference would be very helpful to them. The question of administration—management and elficiency of control and conduct—was one for themselves. The service rendered was a magnificent one—it was a humanitarian service in every way. In this matter there was a tremendous field in New Zealand for the boards, for the department, and for himself as Minister. There was a great need for maternity wards. Even in the outer districts, where hospitals were hardly needed, there seemed to be a need for maternity service by the establishment of wards or the organisation of a nursing service to go into the homes of the people.— (“Hear, hear.’ ) Mr Young went on to refer to the necessity for education regarding maternity matters, and said that it was pleasing to note that Dunedin’s record in this respect was particularly praiseworthy, as it had the lowest rate of infantile mortality in the Dominion. With all our advanced civilisation, proceeded Mr Young, we were getting away from some of the principles of Nature—there was a great work to be done in teaching people the laws of health. Preventive was better than curative medicine. The more that was spent on preventive medicine as against curative medicine the greater the benefit to the community. Although the well-equipped and well-con-ducted modern hospital was a cardinal need in every civilised community, an) although there would always be a need l’or institutions for the healing and treating of the sick and injured, their policy should be the maintenance of good health and the prevention of disease among all sections of the community. Money spent in preventive medicine was, on social and economic grounds,, a far better investment than spending it on remedial institutions. The fence at the top of the precipice was far better than the clinic at the bottom. The problem must be tackled at the first opportunity by the spread of the correct (scientific) knowledge to l>e for the service of the new-born babe—in fact, for the pregnant mother and the pre-natal child. The State had its duty, and that was to ninke available to all, irrespective of rank, creed, class, or social circumstance, the very best opportunity to avail themselves of good health. They pridod themselves that the doors of their institutions were open to all.—(Applauso.) That was as it should ever be. His udvico to them was to jeulously keep within their own hands tho control of the services .which they rendered.—(Applause.) They should keep in view the fact that their institutions were for every section of the community. “Always keep your doors open to ovory section of the community,” continued the Minister. “That being so, the control should bo in the hands of the people responsible for finding the finance and the carrying on of the work.”— (Applause.) Mr C. M. Luke (Wellington) said that ho had served under various Ministers and although he had considered that a high degroo of administrative ability had been reaohed by Sir Maui Pomare, ho considered that there was a great probability of his successor being equally successful.

He had been associated with hospital boards since 1885, and he realised that there* was a great deal to do in bringing our institutions as up-to-date as possible, and the extent to which this could be done depended largely on how- much money was available. Ho thought he was voicing the opinion of the assembly when he laid that they should have in their ba.-<e hospitals the very best and most modern appliances available, and he was sure that the conference would open the oyes of the local bodies to the great need of the most modern appliauces available for use in the hospitals of the Dominion. He looked forward to the day when the system obtaining in New Zealand hospitals would be considered as a pattern for the rest of the world. Mr H. J. Otley (Canterbury) agreed with the previous speaker, and expressed appreciation in advance of the work Mr Young was going to do He knew that in the new Minister of Health they had a man who not only knew what to do, but how to-do it. Regarding the question of hospital systems, he emphatically believed that that in vogue in New Zealand was the finest in the world, as everyone paid his share. Dr Valintiue said that after the Hon. Minister’s address there was very little left for him to say. He could say, however. that although he had of late travelled widely in Great Britain and in Europe, ho had returned perfectly pleased with the New Zealand hospitals. This meeting was a memorable one, in that they had with them a very distinguished visitor in Dr MacEachern, who had come from Canada full of the latest and newest ideas, and was in New Zealand at the invitation of the British Medical Association to investigate and advise on our hospital systems. DR. MACEACHERN’S REPLY.

Dr MacEachern thanked the previous speakers for their welcome, and said that there was no meeting he would rather attend than a hospital conference, or a meeting of hospital trustees, who. were giving greater service than they realised, or the public appreciated. A member of a hospital board should recognise that the work his position entailed required that he must be prepared to do three things—to give up his whole time to the work of the’board,-to make it his hobby, and to turn his talents to account for the board’s benefit. A board should realise that its three essential functions were to care for the sick, train the staff, and look after the organisation of the institution. His visit to New Zealand, said Dr MacEachern, meant much to him, as he hoped it meant much to them Prior to coming to New Zealand, he had looked over the hospitals in Victoria, but his investigations of the methods in vogue were not such a pleasant feature of his trip* as the fact that he had been enabled to confer with the trustees of the hospitals all over .the country, and had received questions, given answers, ana joined in round-table conference which were of immense benefit to all concerned. The hospital policies of all countries wero not the same, they differed widely, and by placing these policies together in the melting pot, each could take from it what he wanted. He, personally, would be glad to discuss any knotty problems with any of the boards —that was his life work for when all was said and done, they all.stood on one common ground, that of service to the patient. It should be realised that every unit in an institution was respon sible for the patient's welfare, and in the three groups attached to every hospital—the superintendent, the personnel, and the medical staff had to co-operate—one could not do without the other. There were six requirements that had to he considered in caring for the patient in the best way, and these were organisation, co-ordination, co-operation, efficiency, economy, and the best service which could be rendered In conclusion, the speaker stressed the importance of considering the policy of New Zealand hospitals as a whole and not isolating the institutions of the smaller centres. In America, much success had accrued from the standardisation of hospitals, but it should be remembered that standardisation m a restricted sense was bad. and the system should be worked on general linos so as not to curtail individuality. He wished to tell them that he was not in New Zealand, as some had appeared to believe, to s ‘upset the apple cart,” but that he was here to serve them in any way possible and to be at their beck and call night and day, with the object of ultimately improving service to the patient. Mr S. <l. Ilarbutt (Auckland), in moving a ote of thanks to Dr MacEachern, said that the main object of the conference v.as to sift the grain from the chaff and discuss hospital board methods to their mutual benefit. Mr J. K. Horn blow (Palmerston North) seconded the motion, which was carried by acclamation. PRESIDENTIAL ADDRESS. Mr William Wallace gave a comprehensive and interesting address and presented the first report of the Executive Committee for the nine months ended December 31, 1925. The report of the Executive Committee was adopted. REMITS. The following remit from Butler was brought up by the Hon. W. 11. MTntyre —“ That while the present system obtains only ratepayers be eligible to vote at Hospital Board elections.”—The remit was rejected. A further Buller remit — “ That the present system of raising local body levies by means of rates be abolished, and in lieu thereof a flat rate per capita be struck on all male adults” — was also moved by Mr MTntyre, who pointed out that the single men of tlvcountry contributed practically nothing towards hospital expenses, and said that it remained for the conference to decide whether or not some more equitable system of taxation should be devised. Mr C. M. Roach (Buller) seconded the remit. . Mr 11. J. Otley opposed the remit, and contended that the present system of taxation was the finest in existence. Mr E. W. Powell (Buller) pointed out that the Buller board did not expect the remit to be carried outright, but it would be quite satisfied if the matter were referred to a select committee for discussion and report to the next conference. He moved us an amendment in this direction. Mr W. P. Spencer (North Canterbury) said that he considered that whilst the present system of rating was all light, it should be on benefits received. —The remit and amendment were lost. The following remit was received from North Canterbury—“ That the Government be still urged to amend the Hos-

pitals* Act to enable hospital boards to receive money on temporary deposit, the limit in this direction being that at no time shall the deposits in hand exceed the amount owing to the board us levy and subsidy.” l —The remit was adopted. Mr L. D. Ritchie (Wanganui; moved—'’That the Government be recommended to amend the existing regulations governing hospital accounts to provide that returns set out in first and second schedule of such regulations should be audited by the Government Audit Office.” The remit lapsed. The following Waihi remit—‘‘That hospital boards charge single men (without dependents) actual cost of maintenance whilst in hospitals”—was considered, and lapsed for want of a mover. The Otago remit—“ That subsection 6of section 72 of ‘The Hospitals and Charitable Institutions Act, 1909/ be amended by adding the following words thereto — viz, or any other public or [Private institution where a person has been sent for any special punrpose”—was adopted. South Canterbury presented the following remit:—“That the association is of opinion that the salaries of all nurses undergoing training in the public hospitals of the Dominion should be made uniform.” Several members from outlying districts contended that this scheme would be unworkable, particularly in the ease of nurses employed in country hospitals, and the remit was rejected. The following Ashburton remit was considered: —“That in view of the fact that the Government has recognised the national aspect of the treatment of tuberculosis, in that it has erected sanatoria in the North Island, this conference is of opinion that the time has arrived when increased subsidy should be made for the South Island.” Mr Killiek (Department of Health) pointed out that it was the function of the boards, and not of the Health Department, to attend to the administration of these institutions. Mi* A. F. Quelcli (Otago) said that the main thing w'as, if possible, to prevent tuberculosis, and that the department should provide advisory officers who would be in a position to advise what course should be adopted with tuberculosis cases. This, he suggested, would go a long way towards checking the disease in its incipient stages. Mr C. M. Luke (Wellington) stated that a procedure similar to that outlined by Mr Quelch was being carried out in Wellington. North Canterbury forwarded the following remit:—“That the Government be asked to provide a special sanatorium for tuberculosis patients who, owing to criminal tendencies or filthy and objectionable habits, ere unsuitable for admission to ordinary sanatoria, and who yet are a menace to the public health, and it is desirable should be compulsorily detained until such time as the disease is arrested.” In speaking to the remit Mrs Herbert (Canterbury) said that she had been appalled by the conditions obtaining in the homes of many undesirables who were suffering from tuberculosis, and that the purpose of the remit was to urge that special accommodation be provided for such cases. It was not right that respectable consumptive patients should be forced to occupy the same sanatorium as drunkards and undesirables. Mr Setirr (Otago) said that cases such as that instanced by Mrs Herbert were to bo found in every town, and he would warmly support the mot ; on. Mr Killiek suggested that perhaps such cases could be isolated at the sanatorium of which they were inmates. Mrs Herbert vigorously opposed this suggestion and maintained that such a scheme was quite useless. Dr Valintine said that there was a provision in the Health Act to allow the removal of such patients. Mrs Redwood (Marlborough) also supported the remit, and said that compulsion was necessary to deal with undesirable consumptives. Mr Otley (Canterbury) also spoke in favour of the remit, which was adopted. BUSINESS CONCLUDED. The conference was concluded on Thursdav. when the discussion of the various remits look place. The following South Canterbury remit was brought forward by the Rev. T. W. Potts—“ That the Government be asked to assist financially hoards to return undesirable immigrants.” The President pointed out that the department had already provided for this matter. The executive had gone into the question with the Department of Health, and suggested that the conference should pass a resolution that the Government be asked to tighten up the rules governing the medical examination of all immigrants on arrival. Mr J. H. Vincent (Palmerston North) moved that the wor Is contained in the resolution be added to the remit. The motion was carried, and the amende! remit adopted. Another South Canterbury remit was “That the necessity of providing pensions for chronic invalids and their dependents be strongly urged on the Go\ eminent.” The Rev. Mr Potts moved the adoption of the remit, which was seconded by Mr G. Petheriek (Wellington) and carried. The following Ashburton remit was considered :—“The department be asked to request the Government to bring down legislation giving the hospital boards the right to have a charge on compensation in respect of those persons who are treated in hospital and become entitle! to compensation. Mr A. Prentice (Ashburton) moved, and Mr C. M. Luke (Wellington) seconded, the adoption of the remit. Dr Chisholm said that frequently firms which had claims pending sent the claimants to hospital and paid for their maintenance there. Mr W. Wallace stated that he knew of very few such cases. He suggested that the remit be referred to the executive, with power to net.—Dr Falconer remarked that Dr MacEnchern might bo able to explain the method that obtained in Canada. Dr MncKochern said that the Act in Canada provided for the compensation of the employees through a fund which was maintained by the employer. Tim fee for hospital expenses did not come out of the employee’s compensation, nml this schema had been a groat boon to the hospitals. Mr Wallace .moved—“ That the remit be referred to the executive, and that it Co instructe 1 to make an omlcnvour to securs an amendment of the law, or an arrange*

ment with the accident insurance companies under which the companies would be liable for the hospital maintenance of accidentally injured persons who wore insured.’' The motion was carried. The following North Canterbury remits were considered“ That in the interests of public health, legislation be obtained requiring municipalities responsible for populations of 20,000 or over to prepare town planning schemes for presentation to the Ministry of Health by a date to be arranged, along the lines of the English Act.” “That the Government departmental regulations in regard to inspection to dairies and dairy herds be revised, brought up to date, and more rigidly enforced.” “That the clause in the Municipal Corporations Act empowering municipalities to establish milk stations, etc., be ; reaffirmed.” ; The remits were taken together, and ] Mr A. IT. Holland (Christchurch), in moving their ad opt on, said that the time had come when preventie measures had to be thought of. At the present time, the local authorities might or might not, consult with the health officer in regard to unhealthy industries, new buildings, or town planning. Mr W. P. Spencer (North Canterbury) seconded the adoption of the remits. Mr E. H. Potter (Auckland wuu that he did not see why the remits should apply to cities of 20,C00 inhabitants. VYhon the j population reached that stage, the town was already made. He suggested that the remits should concern towns of not more than 3000 inhabitants. Mr Otfcley (Canterbury) said that he was quite agreeable to the alteration. Mr Homblow (Palmerston North) mam- ; tained that the matter should be referred ; to a special board—the Board of Health i for instance. , rT Mr Wallace pointed # out that too Hospitals Boards’ Association was not represented on the Board of Health. He contended that the _ association should have direct representation. Mr Holland moved ns an amendment—- “ That the number 20,000 should be altered to 3000 and that the remit should bo referred to the Board f Health.” The amendment was carried. Mr Walkoo moved that tha association i request the Government to give direct representation to the Hospital Boards’ Association on the Board of Health. The motion was carried. The Wanganui Board forwarded the following remit, which $ adopted:—“That the Government be recommended to amend the National Provident Fund Act to permit a retirement at the age of 48 for nurses employed by hospital boards, and he pension of such employees He computed on the basis of l-45th of salary) instead of l-60th) for each year of service, with a maximum of 30-45rh«. Any increased contributions required by these amendments to be met by the Hospital Board, subject to the usual Government subsidy on contributions to the fund.” Mr A. Sievwright, spoke to the following remit from the Waitaki Board:—That the words “or probationers” be deleted from section 2 of ‘The National Provident Fund Act, 1925.” Reason: The percentage of nnri'cs who have served the probationary period and who remain in the service of hospital boards is comparatively small. It would therefore be seen that registered nurses only should he eligible to join the scheme. This would also save a irreirt deal of time, wasted both by hospital boards and the National Provident Fund office in refunding premiums to those who have left th<* service. Mr Sievwright recommended that the remit be referred to the executive for report. On the motion of the Chairman this was agreed to. The further Waitaki remit -That the scale of contributions payable under “The National Provident Act. 1925,” should be revised. Reason: It seems inequitable that a person at age 45 should have to pay double the amount of premium to one at age 25. seeing that the amount of superannuation is based entirely on the number of years—was also submitted. It was decided that this matter should also he submitted t.e the executive. X-RAY FEE?. The committee’s report on the recommendation from the Director-general of Health, that a uniform basis and scale of charges for X-ray work undertaken by hospital board*, be adopted throughout the Dominion, was submitted by Mr Ottley (Canterbury), and the scale of charges recommended by the committee was placed before the meeting. The report was adopted. MATERNITY TRAINING FOIt NURSES. In moving the adoption of the remit from the Olago Board “That the Nurses and Midwives’ Registration Board be recommended to provide in tho regulations made under authority of the Nurses and Midwives’ Registration Act, 1925, that the future course of training for registered nurses shall be four years of which three years be devoted, as at present, to general nursing, six months to maternity nursing, three months to child welfare, Plunket; and three months to mental hygiene,** Mrs Macdonald said that Bhe claimed to have some authority to speak on the question, and that she considered that nurses looking the training mentioned in the last three items in the remit were not fully trained. Bhe claimed that by including maternity

training in the nurses' curriculum, the high rate of maternal mortality which was at present so prevalent, would be considerably reduced. Mrs M‘Vicar (Wellington) seconded the remit, and contended that a nurses' maternity and Plunket training should be provided whilst nurses were undergoing their preliminary training. Mrs Kidd (Auckland) and Mrs Redwood (Wairau) also supported tho remit. Th© Hon. A. S. Malcolm (Balclutba) said that ho would advise making tho terms of tho remit something to aim at, but not to incorporate them in a cast-iron rule. Dr Fraser (Palmerston North) moved that the remit be referred to the oxecutivo for consideration. Mr Stein (Dannevirke) opposed the motion, and said that in his experience, a surgical nurse did not feel inclined to go in tor maternity nursing. Also, a surgical nurse, when she obtained a position in a private hospital, would find herself in the position of having to perform both maternity and surgical work. lie also considered that the matter should be referred to tho Executive Committee for report.—The Chairman (Mr Wallace) pointed out that few nurses, if any, went into the profession for the sake of pecuniary gain—they mostly bocaino nurses for the love of their work. He agreed that it would bo preferable for rjiusos to take a course in maternity training, but he did not think it should be compulsory for them to do so. Mi 3 Herbert pointed out that if such training were made compulsory there would bo no place to train the nurses. Dr Fraser further moved that the words “with power to act,” be added to his amendment, which was carried. The further Otago remit: "That section ib of the Nurses and Mid wives’ Registration Act, 102 b, be amended by substituting the **ords ‘Twenty-two’ for the words ‘Twentythree,* was discusi'ixi and adopted. File following VVairarapa remit, was considered- “That the status ami salaries of masseurs and mass^m-cs bo defined in relation to those of other branches of the nursing profusion.’’ G. Eton (Waiiaru,-.;) spoke to the remit, wmeii, l>r Fraser moved* be subtr.e c; to draft a report. v/hii-h wm ‘carried. “ Mr E. H. Otlr.y (Canlorku..) * Indited t ie following remit ir; ru the Canterbury Board: ‘That i!»o JF.:.: .* i. . . as Act 13:0, bo amended as follower--"Section 5.—A inagisf.-iio may aEo in hi. discretion ante date any order rr.ndo mniar sub-section ?. cf m*« liv-i S of ;hc Felons Act, i9:0." "Section 51 (3). —The words T.nd r.o moneys shall be recovered under ihia to tion unices sued fer within two years after the same have become due unioss it is proved that ihq defendant at the time when the .• ■•.■•cvs became d ie was cf sufficient ahibiy to pay the same' should be repealed.” "flection 01 (e).—By the wife or widow of the perrons .o maintained or r-.-lievcd. ,{) s’ y t’tio v.'.ar relati*. o’ within r.he moaning of section 4 of tho Act of 1910 cf ary person o maintained or relieved.” ‘'Section 43.—Tho words at tho time of making of the Order’ ho struck cut and the words ‘is cr have ■ : V it: ari d in place thereof.’’ “Section 50. —‘Has been or is’ after the word ‘Order’ in the fourth lino thereof.” “Section 51.—After the word 'is' in the first line thereof the words ‘or has been.’ ” “Maintenance” in section 2 of tho Act includes the expense in connection with the confinement of the mother of any child. Mr Otley said that he would prefer that tho matter contained in this remit be referred to the Executive Committee. It was agreed that this course be adopted. The following Ashburton remit was considered: —“That in view of the fact that the Customs tariff does not permit of alcohol (Spirits Vini Rect) being imported free of duty by Hospital Boards when such is to bo used in the manufacture of external preparation—i.e., tincture of iodine, picric in spirit, etc., the Government be asked to extend the present concession to include th© manufacture of external preparations.” Mr Prentice, who submitted the remit* said, that he was agreeable to the matter being left in the hands of the executive. The Hon. W. H. MTntyre objected to the remit being referred to the executive and said that he considered that the conference could very well deal with the matter. —The remit was adopted. Mr Bud dell (Bay of Plenty) moved—- “ That the Government be asked to amend ‘ The National Provident Fund Act, 1925.’ by exempting part time secretaries from the compulsory provisions of the Act.” . The motion was carried. NEXT YEAR’S CONFERENCE. It was decided that the 1927 conference of the association be held in Christchurch. At the conclusion of the business of the conference, the President (Mr Wallace) called on Dr MacEachern to say a few words. Dr MacEachern said that he had enjoyed the discussions of the conference and he seized the opportunity of extending to the delegates a hearty welcome to the next conference of the American Hospital Association. He could officially welcome them on behalf of liis own body (the College of Surgeons), but he could only say that he knew that a formal invitation to attend the association’s conference would be forwarded to representatives of the New Zealand Hospital Boards’ Association at no very distant date. Those who did attend this conference could be sure that everything they saw or heard was “ gilt-edged,” and another thing was that they would have an opportunity of viewing a most comprehensive exhibit of the latest medical appliances in a court covering 125,000 square feet. He assured the conference that the warmest of welcomes would be waiting its represntatives when they visited the United States. Mr Wallace moved a vote of thanks to Dr MacEachern, whose opinions, he said, would have a far-reaching effect throughout the Dominion.

The motion was carried by acclamation and cheers; the delegates singing “ For He’s a Jolly Good Fellow.” Dr Valintine also spoke briefly, and stated that he did not associate himself in any way with Sir Lindo Ferguson’s remarks of the previous day—he thought he had gone too far. At the same time, it had to be remembered that Sir Lindo was Dean of their Medical School, and had done great service on behalf of the country. Dr Unwin, too, was a most

honourable gentleman, who was ready at any time to give his services gratuitously where necessary. In conclusion, the speaker said that he felt that the hospital boards were doing great work, and he offered them his sincerest congratulations. The conference was concluded by Mr C. M. Luke proposing a hearty vote of thanks to the president (Mr Wallace), which was carried by acclamation.