BOTTLE LAKE.

Star (Christchurch), Issue 11948, 6 March 1917, Page 5

BOTTLE LAKE.

HEALTH DEPARTMENT'S REPORT.

ON INFECTIOUS DISEASES

HOSPITAL.

DR FBENGLETS RECOMMENDA-

TIONS

In accordance with a, request made j by the North Canterbury Hospital j Board to the Department of Public Health some time ago, a report has been prepared by Dr J. P. Frongley on the Infectious Diseases Hospital at Bottle Lake. The report, tho text of which is given below, is not complete, and the remainder of it is to be for-1 warded to .the board at a later date, j A QUOTATION. \ Dr Frcngley commences his to port' with a quotation from the report of November '23, 191U, signed by Drs Ulackmore, Pearson and Lester: —"Up to this vear vhe children havo clone well at Bottle Lake"

Tho report ' continues as follows: I have the honour to report that in response to the request of the North Canterbury Hospital and Charitable Aid Board, and pursuant to the provisions of section 7-± of the Hosoitals and Charitable Institutions Act, 1909, I visited and inspected the above institution on February 16 and 17, and made inquiry into the conditions incidental to the"use of the above hospital for the accommodation of cases of infectious diseases. more particularly scarlet fever.

TO ALLAY ANXIETY

'Hie primary consideration with regard to the good or ill results of the care and treatment of patients at any hospital must always bo—what in the main have been the results of such care and treatment? The majority of cases at. this hospital have been children. Because of the public notice recently given to this institution—whether °by way of tentative adverse criticism or in vhe sense of reasonable questioning—it is likely there .are parents in and around Christc-hurdi who anxiously dread that the health of their offspring may have been detrimentally affected by residence therein. It is with a desire, a-s it were at a glance, to immediately allay their

anxiety that I ti-~,c the above quotation prominently as a sub-heading. lost by reason of the necessary length of this report con tin i rug solicitude .might needlessly be added. to their cares. I am heartily in accord with and entirely support thi.t opinion. Furthermore, I am satisfied, speaking generally, that it is to the. unusual circumstances of the recent epidemic. and not to the attributes of the site and surrounding of the hospital per so that the causes for criticism must he attached. HISTORICAL. Only us lately as 1909, hy the Hospitals and Charitable. .Institutions Act of thait year, were the statutory enactments for hospitals for infectious diseases placed on a .satisfactory basis. Christ church City Councillors -and members of the local bodies with experience of earlier years would, I think, sympathise- if I had written " on an undcrsttandable basis." Prior to 1900 such an institution as a definite hospital for infectious disease, was practically unknown in New Zealand. There did not appear to be power to require them to be provided ruder the old Hospitals Act. To meet the deficiency the Public Health Act, KOO, provided for the erection of such buildings. Bui; these enactments left it to one set of local bodies to provide such buildings, and another to mainfcar.i thorn -and care for the patients housed therein. Furthermore, the Hospitals Act was administered by me Go/ernment Department and infectious diseases hospitals; were under another—the Public Health Department. About 1900 the fear | of the introduction of plague i stimulated public opinion to the need f or .such buildings, yet the anomaly was that scarlet fever had been almost ylivays pi eminent to ft greater or less degree, and placrue was only anticipated. The evils of plagne were imaginable—of scarlet fever, well known. Another strange feature was that thomzh the public had been accustomed to have cases of _ scar let fever attended to in their midst—that, is, at their own homes—nevertheless any medical officer of the Public Health Department of these days h only ton well aware of the insistence with \rhich public opinion demanded that diseases hospitals—even for such a well-known disease as scarlet fever—should be looted in as out-of-the-way places as possible. 'Midst such statutory and administrative confusions, complicated by public apprehension of mistaken dangers of infectious diseases hospitals, with anticipations of far from'disinterested and strenuous oppos : tion by the owners of ,land in the vicinity of other possible sites, the Bottle Lake (so-called) Hospital had its birth and infancy. * QUESTION OF SITE. . This site was acquired bv the Christchurch City Council in 1900. It was transferred to the North Canterbury Hospital Board in 1003 for the purpose* of an infectious diseases hospital for Christchurch and adjacent districts of Lyttelton, New Brighton, Sumner and Wools ton Boroughs, and portion of the Sehvyn County. Under the Hospital, and Charitable Inditutions Act, 1!)00, it was transferred to the North Canterbury Hospital .i,nd Charitable Aid Board the Infectious Diseases Uns'tal iY.r the North Canterbury ciis.;ct. In 1910 the- institution consisted of that portion of the building which is now being remodelled, and a series of huts made of canvas and iron, originally designed with the intention of providing the then partially tried principle of op-j.rt-air treatment for infectious diseases. It is, I think, only fair to say that the distance of this location of au infectious diseases hospital was mainly determined by a strident "'Don't bring it near us.'' The area is hounded on one side bv the; Bottle Lake Road, and actually the nearest paint of the area is on the circumference of a four-mile circle from Cathedral Square. I reached this point in forty-eight minuter (twenty-four minutes by tram and a walk of twenty-four minutes). It is quite erroneous to call the hospital ''Bottle Lake Hospital," for Bottle Lake itself is at least one and a quarter mile beyond the hospital gate. Whatever arguments, therefore, can be advanced as to inaccessibility obviously must have been of more weight in years past than now. The growth of Christchurch and its facilities in trams and motors brings it, as itwere, nearer this hospital. If there be people who think a more accessible site desirable, I should like to mention circumstances at Auckland by way of .impressing caution. There the Auckland Hospital and Charitable Aid Board possesses an infectious diseases hospital site of about eleven acres, on a point of a peninsula surrounded on throe sides by harbour waiters. Its gate is three miles and a half from, the general, post office in a straight line, and five miles and a half by shortest road. At the time of acquirement there were but two or tjiree houses in the vicinity. , Many residences have been located there in late years. A fairly frequent motor- J bus service has now been provided from the nearest tram line. " Despite the initial inaccessibility the poetiou to-day is

that year by year for some time past increasing pressure is being brought to bear upon that Hospital Board raid this Department with a view to a site being obtained elsewhere, inevitably stili mora remote if the demand bo acceded to. THE IDEAL CONDITIONS. In the light of present day knowledge and experience an ideal acreage ol a modern hospital for a progressive town woiiid be one sufficient to contain a general hospital with all its accessories, a maternity hospital, '' chronic '[ ward, and old people's home, and infectious diseases buildings for at least three distinct types of disease. The Christchurch Hospital grounds do not lend themselves to this ideal. There is nothing of much advantage or practical value to be gained by seeking a iceation for the infectious diseases hospital nearer to the main hospital. From an administrative standpoint once away from the main hospital one mile is little different to tour. .Finally, if 1 had good reason to recommend the acquirement of a new location my past experience of fifteen years in almost all parts of Now Zealand would prompt, me to warn the board that it should have in [view: —(a) At least twelve months be- | fore arriving at finality; (b) endiess | utters to the press against any new | sue proposed; (c) strong under-cur- ; opposition—medical, parochial, 'political and commercial; (d) no ! greater number of persons being satisj lied with the final selection whatever I it may bo than with the present locaI tion.

Visitors have no place where infectious diseases are being housed. When the patient is convalescing, especially on account of the long quarantine period which scarlet fever imposes, it is reasonable to allow a parent or friend to see and talk to a child patient across an " air-break " of at least ton feet, but no encouragement whatever should be given to such visits. CONCESSIONS TO VISITORS. Parents and relatives must be permitted to see a seriously ill or dying patient if they so desire. Here special precautions must be enjoined by the medical and nursing staff during the visit. Again there arc many mothers who like to personally fetch their children home after the long sojourn in hospital and then free from infection. .Some, consideration should given in these instances. It is hardly fair under the circumstances to plaee a monetary find inconvenient burden upon a parent who has already borne the trial of having a, child sick for weeks. I am not altogether satisfied that the Board's ambulance arrangements are all that might be expected of a board of its standing. SOME RECOMMENDATIONS. I recommond. that the board should give furiiher attention to such arrangements and at the same time consider therewith these points : (a) That a motor be provided to enable all cases discharged from Burwood Hospital to be put down in Cathedral Square or at their oavu homes, whichever be the nearer, at a small charge. (b) That this motor be used to enable visits being made by parents and relatives _to n seriously ill or dying patient, at a small chatge. (c) That this motor be allowed to be used at a small charge to take out a parent or relative or friend desiring to meet such patient, about to be discharged. (d) That this inciter shall, under no circumstances, be allowed to bo used for ••visitors," whether psrents or relatives or friends, whilst the patient concerned is in quarantine. SUITABILITY OF SOIL.

The area held by the board is 187 acres 1 rood and 2d perches. The area proper of the hospital is fenced off wjtn a barbed wire- " air-breai:." A recognised public Health text book commences the chapter on soils and building sites thus:—" Ine neaim oi a locality is intimately connected with the nature of the soil on whicn houses are budt .It is generally believed, that the most porous soils—the gravel and sands —are the healthiest, because they are the driest, and t-hii. view is in the main correct'. . .

Tiie silt upon which the hospital buildings are erected is sand. Tiiat such sand makes a dry warm site is best impressed by suggesting the difference between garden.ng at New Brighton compared with other parts of Christchurch with the sub-soil water at an equal depth. For this Department to contend that a sand site is totally -unsuitable for budding purposes* would be to stultify itself hopelessly To start with it would have

to be prepared to prove and prove conclusively that the sicklier rate and!

death rate of persons living on sand soil in a largo pari; of the Christchurch suburbs, from New Brighton inwards, is 'greater than in those residing on other soils. The common natural instinct of man, which is sounder than n modicum of science sittings, would prompt him to prefer a dry sand soil to live on rather than a clay or gravel or other formation if his selection only rested with the question of toil. SUB-SOIL WATER.

The following tests were made by Inspector Nicol to determine the height of sub-soil water and if any fluctuation arose from tidal action:--L>atc. Time. Dopih. Ili-diTide. ft. in. 13th 3.30 p.m. 0 4 8.10 a.m. 141 h 0.0 a.m. 6 4 9-2 <i.m "IS l, U.f) a.m. 6 1 10.46 a.m. 16th 3.3 p.m. 6 4 JO. ij> a.m. L'nii During- morning. 8 4 11.36 a.m. 10th 11.0 a.m. 6 4 1.21 a.m. The main hospital floor k 12i't 10in above the sub-soil water. The floor of one ward—to which 1 will refer again —is about 4ft 4in loner. It should be added it was originally erected only r* a playing room. There is no evidence 'that any part of the starface soil in and around the Hospital la damp. There is a very great difference between a damp soil and a dry soil above a high sub-soil water. It appears to me the Medical Sub-Commit-tee has failed to mak* that distinction. The Medical Sub-Coniniitiee states, "the ground water is at a high level •'"' If ilie levels as given arc '"high" then I am at a loss to know wnnt adjective to use for inhabited parte of Fendalton and elsewhere in the vicinity of Christ-church. Com-olnbly for Christchiireh res-dents tli" deleterious influence of ground wM-er yi'i- so on health is almost exploded How could ic be otherwise? In'view of comißon knowledge is not the general health of Christcmireh over half a century proof positive and enough? I can well imagine the howls' of execration— and deservedly—which would follow this Department, if it published brofi(least a statement that because of the height of sub-soil water the City of the Plains was a most unhealthy place. Like many another specious theory the adverse influence of ground water was " made in Germany" Pett'mkofer, over fitty years s« 0 in Munich, built on a sandy porous soil, endeavoured to establish the connection between outbreaks of typhoid fever and the rise and fall of subsoil water. We now know he lost sight of the fact, that Munich at the time was riddled with. cesspools, and that the outbreaks wore du& to pollution of the drinking water witb iho specific bacillus of enteric fever. Dr Bowditch, in America, and Br Buchanan., in a classic report in England, back in 1866, asscc'atcd ■ damp-ness'-of the subsoil with the causation of phthisis; His conclusions were ar-' rived at before the discovery of the tubercle bacillus (1882), and quite fail to answer the poser: if phthisis has a definite rehtion to dampness of soil, how then is it explainable-that the case rate and deaili rate for females

occupying the same localities as men is much lower than fo* males. THE SITE APPROVED.

If it bo contended by some unaccountable means that the Burwood site, because of tho dry sand soil and height, of subsoil water, is unhealthy, and a hospital there dangerous to the inmates, then logically the Hospital Board should also consider the "scrap- j ping" of the Christchurch Hospital, for surely on similar ground the argument is also against, that site. I hare, novever, yet to learn that tha health jf any patient has been affected by the .site of that hospital. It is I shown above that the height of the j subsoil water is not affected by the t'de:i. 1 have no evidence to prove that the subsoil water is in motion, j Observations, however, made by me at j ihe sewage farm and other know- ; ledire would lead me to believe it has . a definite flow and outlet. Attached will be found an important report aivl i rlan obtained from Messrs M'lntyre j and Levis, surveyors. T. recommend:) Thai the Bunvood site bo regard- { ed as suitable for the purposes of an i infectious diseases hospital. BUILDINGS.

It is a strange anomaly, common to j Home nnd New Zealand, that while j the public approve of the erection of \ good buildings for general hospitals and spici.il wards, e.g., children's wards, yet, though children are most concerned in infectious diseases hospitals, there appears to be an impre.s- i sion that anything is pood enough for j such diseases. This attitude is, I am j clad to sav, beincr changed in New j Zealand. Until 1914 the Department found no adequate amount of money \ being spent for infectious diseases in j Christchurch. Three new wards and accessories intended to be used in classifications-acute, ccnvalescing and disinfecting eases—were then erected. The board has now in course of construction two "classifying" wards for twenty-four beds each, and a "case isolation '" block of four separate I rooms. The new wards will be a great ' improvement, especially with regard to | aspect. Ample space is left between i these wirds. Proper means for carry- j in.g off rain water are being provided, j CUBIC SPACE. j In a. climate such a.s that, of Burwood (a) with .",n amount of bine sky—that is, clear light—such as is rare in England, (b) with an opportunity for flushing the wards with fresh air. such as is not possible with comfort to the patients in the more rigorous climate of England, (c) with the wards so designed as to provide for graduation or classification of the cases in time periods of reduced infection, (d) with ample facilities for open-air treatment; (e) with the "carrying 1 ' as opposed to the "aerial" convection of infections, nowadays:, well in the ascendancy, (f) with proof that even under less satisfactory conditions as to cubic space the children have done well, it is not reasonable to urge that the cubic space per bc-d should necessarily be the same as in an infectious diseases hospital in London or Sheffield. Generally the Hospital Boards in New Zealand have not rigidly adhered to the local government England plans, and without evil results. In some cases adecided improvement has been made. For example may be mentioned the scarlet fever wards erected by tha Welligton Hospital Board in 1910, of which tho Department has heard nothing but prai'o, and where the- results are "good. Actually the new Burwo/jd wards ,are an improvement on the Wellington wards in some particulars. VENTILATION. I am unable to realise what the- Medical menus by the words, "The ventilation, which is provided by natural means only ... is not sufficient." Surely it is not suggested that elaborate artificial systems of ventilation shall be provided in sUfth a climate in one-storey pavilions and in wards so constructed as to alloy/ of tho thorough passage of fresh air. Inot the. cry of to-day " open-air treatment,'' and what does that signify but taking advantage of natural means? The" board has now the oldest wards. These were far from satisfactory in many ways. The kitchen and accessories are remodelled and laundry facilities improved. OBSERVATION BLOCK. Regarding the observation block, itis quite sound practice to provide two or more pavilions for " straightforward'' eases of the prevalent disease, and a block containing small separate

ward-i. It' we must bow to local government Enplane! practice all I havo to say is that iviessrs Collins ;i.nd Herman havo .succeeded in designing froth sketch plans originated by this Department, a much improved' form of the L.G.B. plan 1). The whole question of the "barrier." the "cubicle" ami

"case-isolation" systems was gone into with medical representatives and members of the beard when the infectious wards of the Christchurch Hospital were planned. The. "harrier" ano "cubicle" systems were banned. This

Department provided at that tirno suggestions headed " Regulations for the ■use of an observation and case-isola-..ion ward' providing for the treatment of persons suffering from dissimilar infectious or contagious diseases or of infectious and non infect-tious cases. The Department certainly expects that any nurse placed in charge of the Bui-wood case-isolation wards will be trained properly. It seems to me from the comments on this ward by the medical sub-committee that they mii.se he unaware of the intended use of in? structure under the principles of case isolation. Instance."! can be cited from English practice where in spite of varied' nature of the cases and the hig'i of the diseases treated th't no infection was carried from one case to another under 'case-isolation." Of

course, it all depends on a high standard of musing and careful instruction by the doctor in charge. _ It should not be overlooked that the doctor practises "case-isolation.'"' day by day. Bo goes from infectious to non-infectious patient' and yet does not carry infection. A nurse can bo trained likewise-"

'There scemis to bo some ground for believing that cases have been sent cfi: to Bunvood Hospital upon an insufficient diagnosis of scarlet fever- '[inboard cannot be expected to specialJy design and erect numerous bfiildimrs in order to relieve some outride doctor of the need for making a reasonably accurate diagnosis. If the board talcs steps to require each case to be reported by the medical officer in charge whore the disease turns out not to be scarlet fever I think any carelessness in this regard will soon be ascertainable and can be put an end to. Tho needs for a sneeial operating theatre have in this Department's opinion been greatly exaggerated. Nevertheless, it has agreed to a room being fitted up for ear operations—the only likely urgent operations required. NURSES' AND MAIDS' HOMES.

In view of the increased provision for patients the nurses' home must be added 'to. Opportunity should at the same time be taken to remove it towards the north to a site on a line central to f<hp. observation ward, and tho fh-st pavilion and not less than 100 feet front line of that pavilion. A dirffhg-room, sun room and changing rooms must be added. A dinin°- room for nurses on duty must be provided. To provide rooms for extens ; on of case-isolation" rooms, <a likely demand for reasons given—it h also

necessary to rnova the maids home direct to tho north in tho back in line with the back of the nurses' home. RECOMMENDATIONS. I made the following recommendations : 1. Add to nurses' home, just moving; to site indicated. 2. Move maids' home. 3. Provide dining room for nurses onduty—for sito see plan attached- -- Convert old nurses'" dinrag-rcom into room for the 1814 ward, la place of that ail the west end. 5. Convert latter into room for ear eases awaiting or after operation. 6. Provide matron's office and drug store. 7. Lower 'verandah in front of patient-:' dining rooms and 1914 pavilion, to allow cf fan-lights being placed over verandah, as I in new pavilions. 8. Require that the play room ward bo only used in emergency, and then tor " disinfecting" cases, and have in mind its early reI rnova! and the erection of a third j pavilion. j 9. Require that the rules foT "caseI isolption" be prominently ex-■ in the case-isolation duty room and in the nurses' home, laid strictly adhered to by doc-

j tors, nurses and wardsmaids. 10. Require that any nurse ill j r''i!,--.rrre of observation ward be. i fully' trained in "case-isolation" : methods or so-called "aseptic nursing"--rules attached. 11. Roquiro nil cases not found to liav? been sent in suffering- from I scarlet fever to be notified- in i writing to the Public Health' j Committee. USPECT AND PROTECTION FROM j WINDS. j As already stated the pavilions will ! have tiiA best possible aspect. Gene- | rally the buildings are well protected from winds. Uiifortunately trees hare been cut down in the south-west angle. ■ I recommend : That when the new entrance drive is completed replanting of tba above portion of the belt t* { done next season. ' (Signed), ; *" j. p. frengley; .■ sub-soil water. Appended is a report from Messrs' Maciiityro and Lewis, dated February • 24, 1917, on the question of sub-soil I water, as follows: —'.' As instructed, . jwe have taken levels a view of ascertaining the height above highwater mark of the buildings and land.*; at Bottle Lake Hospital. The high ; I water mark spring tides adopted is the j Drainage Board one, 15.72 feeb below* | floor of Christchurch Cathedral. Thei ! concrete floor of verandah old building jis 17ft IJin above this high water ; mark, floor of maids' home 16ft. 7in, and buildings at eastern end 14fts 6inEliminating a few unimportant holes and hollows, we would give 12ft abovd high water mark as the average IoW. level. Several observations taken" ati': ! spring tides in the river opposite Burj wood' School go to show that the spring tides, probably on account of the re-, stricted channel and the current m river, do not rise to within 18in of the ; Drainaco Board level adopted ior high

I water." REMODELLING THE HOSPITAL. THE WORK IX PROGRESS. * A VISIT TO THE INSTITUTION. At the invitation of the North Can* terbury Hospital Board, newspaper lenre-sentatives visited the infectious diseases hospital at l»ott'te Lake on Monday afternoon, and were shown the various buildings which are being erected or renovated in accordance with the board's scl'emo. for the provision of additional accommodation. The build ng which formed the nucleus of the hospital, a long one-storey structure erected fourteen year* orr o n 1!( i extended to double its ong-. in?l' length in 1914, was first visited, ■ This budding has been drastically re. ! modelled. The oldest portion th* ! interior of which was matchhned, has ! been .stripped of its wooden wall cover- '■ iv f r the imine-work sprayed with disi inrectant, and plaster substituted foi : +h° nwtch-lining. The whole building ! has hern rearranged, cleaned and rei painted. As now arranged, it includes ; a ward to accommodate twenty-bye pa- : tients: a small operating room, with an. adjoining bedroom, where the patient who has' been operated upon may remain for a day or two; the matron s apartments, comprising bedroom and sitting-room; office and drug store; maids' dining-room-, kitchen, equipped J with two two-oven ranees; and dinmg- ( rooms for male and female patients re- ! spectivolv. To this building there is to ! be added, at the east end, as recom- ' mended hj Dr Frengley, a nurses' din- ! ing-room. j A fair-sized building to the nortn- | east of the- nucleus building, used' as a ! ward, is also in course of thorough ! cleansing and renovation. This will j serve as a sort of emergency ward, acI commodating twenty patients. j The nuceus block lies with its length. j running from east to west. In front of I it there have now been erected three j long one-storey buildings'running north j and south, like the three bars of an : j E, with the nucleus building represent- ' ing the upright stroke. ,These build- ' ings, however, are separated front the nucleus building by several feet, of air 1 space. . The western-most of these ' throo new buildings is the observation ward, which contains four separate apartments, each to accommodate one naticnt, together with sun_ chambers, bathroom'? and a small kitchen aha other necessary offices. The two lower bars of the E are form* ' ed bv a. pair of pavilions almost identical in design, each comprising 'three ror.:ny wards, with broad veran '■ d'abs on i.u<* western fronts, and continued ro'irid tho northern ends. These \v:n\U arc also equipped with lavatories, and other offices, and they are built ' :on niuv. which raise their floors three. or four feet from the ground and bring [ (them in tbe same level as the nucleus 1 I bxiihhm:. v'r'cli is built on higher ' i poind. One pavilion is practically ' IcnnipleUd. while the other is in course lot' erecucn.

Direct!/ north of the observation. waul is nurses' home, and' a little to the v-ost is the maids' home. These build;-,!-* r.vo to be . shifted 100 feet further away from the new pavilions in n northerly direction, and are then to be raided to very considerably.

Ab the back, or south side of the nucleus block, the old laundry building is being rebuilt and enlarged to double its original size.

The caretaker's cottage has been removed to a Kite near the front gata, and the old path from the front gfate to the hospital is being replaced by .at new broad drive which winds picturesquely among the pine trees and arrives in front of the nucleus buildr ing. The old path, it should be stated, conducted the visitor to the rear of the establishment. A "tradesmen's entrance" is now being provided by a track leading from another* boundary road, this track running tfafc from the institution in a direction op-, posite to that taken by the entrance drive. Under the old dispensation visitors had to ring a bell at the front} gate and the caretaker had to walk a hundred yards or so to answer tin* call, -with a prospect of further journeys to carry messages to and from the matron or a patient. Under the new arrangement he_ will ba abl e to communicate with vispors across tho ten-foot air-break prescribed by regulation, and with the matron by telephone. As remodelled, the hospital will accommodate a minimum of 100 patients, and the board's officers estimate that it will accommodate 150 patients comfortably and 200 at a pinch. The very large verandahs,. vyhiph. are: a-'Jfsature of tho new pavilions, provide s/pbtett-

., ~ ~,, ~ .^-r-o-»«?o»"iir«'^" r'tWVWTftEW* U«,«»^"«~».'''Ml.V I 'II», • - area toe now '■''• '' J .'''vi,.. BMround:-' is being, acec'epicee of er-riaMVd-.g: n-'-v 1 -", u;!1 y ■' site. It is intended to h-v --iev.il , and garden l.do'is m vho ""- :0, 1 a " ; vicinirv of the ware 1 .?, while ( _i he betwVeu tho two new part nous bo asphalted to serv-:- as a- ' , '\ l^ l ' ; ground foi' inveigle patients. 'Con- : and croquet courts are also to uo | ■■ Tho area at the back el" the nuceus ; will also be asphalted, and a : water-tower, 36 iVf. high niKi ; a tank capacity of .'a\)o or btOO i is to ho erected. various appliances oi j institution arc of up-ut-datc- pat- | elbov. -taps being provided in it-H - apartments; bare bec-n specially to prevent any risk |H>f carrying; infection on tho part of or attendants. H SPECIAL MKETINC OF BOARD. 1111 l FRKNGL'EY'S RKPOCT CON- i H BUH,DING RECOMMENDATION'S ■ ADOPTED. * A special meeting of the board was at the Bottle Lake institution tins to consider Dr Frengley's re~ ; present—Alessrs; F. Horreil D, M'Millan, W. M'Millan, P. Spencer. 0 Bradlev, I. Andrew, D. Bo;:::, 11. B. Sorenson. J. T. T ti. Patterson, li. J. Otlcy, I Ton K. Moore and Mc-dame-, WilH;oii, ('hri-ide and Green. ]>r Chesson, ■■district h<".,Th officer, was by MButvitai.ion. H| Tli" uu labors of the board first in1 tb c buildings erected and in ol erection, the inspection oceiiabout an hour and a half. On a-sembling in one of the new paBHvilions for formal meeting, the ehairindicate that the business of tho [■meeting was to discuss the matters upon in Dr Frengley's report Department of Pul>lio Health, which had been asked, on the motion tho Hoi: R. Mcore, to prepare a Teport, had to bear half tho cost of the and had therefore no inin the matter save that of public HHinterest. Dr Frongle-y had approved present site, and if his recommendawere carried out regarding the character and arrangement of btiildHjings, moans of conveyauco and so forth, board could rely upon l)aving an BJanstitution without a rival in New ZeaHlland. The board had undertaken heavy expenditure already, and lie thought thing to do v>'as to "go the whole hog" and :tdoi>t tho -vvh.olo of Dr Freuyley's recoinaiendations. Tho tlianks of the board were duo to Mr ■T_ D: Ijoaj?. chairman of the Public Committee, who h;:d glvon a deal of tiniH and attention to the j remodelling of tho institution. The j H board's archit-eet. Air Collins, estimatH ed thai- tho cost- of out tho H Tcoommendiitioiis would h$ as - Removal and additions, H maids' and tmrso-' homes, -£rj7o; ■ nurse>* dining-room. X'lSt): lowering of old i'-.iO; alteration of duty room in old building. £6O; total. ITi'}:*.). The lion 11. Moore said that his object- in mo vine; f,. r a report on the subject hau been a desiro to obtain an indepei:do->; t- and disinterested report on t!io subjort. lie had not had m mind ib-- f:\ct thr.i the "Public Health Department- w:i- u partuor with t-he board in the administration of this mstitufioo. The partial report agreed villi his ov.ti views in rotrard to the site, and lie hoped that the complete report would soon b e available. The North Canterbury Hospital Hoard had ijov, spurt,.! money on its institutions. aqol ii>ese c:::nparod more than favour- j a-hly with those in othv;r centres. J Airs Wilson said her objection to Dr FreuL'ley's report was that, it -was not en independent report, but tho report of an interested party. It, was a wordy and disjointed report, coutainino; pages of irrelevances and totally ignoring the tital qufijtiou of draina.gy>. They had had an independent- report from three xnedioai juen vifhout- bias in the matter, b;U- that report- was not before the board. Dr Chesson, in reply to a question, Said that Dr Fiviigioy'V report was not. coiio'ii'-etc. The second would deal with water supply and drainage. Mr Otlcy said that when the Government was asked to- make tho report tho board, had the idea thar- the Govern- . jntnt experts wero the best authority to appeal to. The three doctors who liad made tho X'revious report were asked specific questions, which they did not answer. The board knew the accommodation at the institution "was .rnadf-qiia-c, and " ; t asked advice concerning increased accommodation, 'lhat advice was not given in the three doctors' report There was no one in the room who co-aid tell him where to find a better site in the district than Bottle lake for an infectious disea3es hospital. He entirely concurred with Dr Frengley's report, and considered that- the board should carry out the recommendations in that report. It was quite possible they would have an epidemic • even under the new conditions, which would severely tax the resources of the institution. They could not help that. .In regard to the matter of drainage, they had taken the advice of Dr Chesson. and if Dr was not an an* ihority on drainage he had no business occupying J nis present official position. An undertaking had been given that the Walt-ham Orphanage would bo vacated at tho earliest possible, moment, and the sooner Dr Frengley's building recommendations were put into effect the better. J.le> aLo suggested the- ptar- . ■ chase or a pony and a daisy cart to Convey nurses to and from the nearest tramway stop. Afr Sorensen said that. Air Moore's arguments regarding his reasons for calling for a OoYerument report were not very sound. Tho speaker did not question the value or sincerity of J>r Frengley's report. He knew Dr Freng]ey to bo a most capable oflicer. The mistakes of the'past could not he remedied now. The site had been fixed permanently by the board and by the Department., and though the speaker had disapproved of ic from the beginning. it was no use arguing further against :t. Ho thought there iron Id be little difiV-uhy in future in dealing with cases at ihe institution- Tim septic tank had wee-red pretty we 4! up to date, and it might- hj" depended upon to give ts,«T,is-f.v-rorv .-■( rvio<-■ in the lutur". The bonvd. if it accepted Dr Frengley's reeommfMidaiions. could at least say it' bad done its be?t. Mr Norton expressed hi.s confidence hi the e?n acv of the reforms initiated at the institution. Members would now bo able, hj" said, to allay any public fe*irs recording the institetion. He wa? oipt" satisfied with the drainago nr r:in<!<nnoufs. Mr \ndrew said ho was pleased to • BP e the hoard was now unanimous in aepi'-i-.i'j- tb> site. He had always (on-a'-Ve-ed it o- good site. He heartily. ;-■mr.'-ed f v c buildings 'that- had been er-'.-T ml. and favoured the adoption of a?i of D- Frenglev's n^conmiendations. Mr P.rndley said bis mind was made m,' .'out ag'> that the present site was x l e ],„<.+. AH thai remained to do now - wmdd b» t-o br-ck up Dr Frengley's ' recommenda-tions. The- newspaper editor? who had written on this subject would now see that they did not know jinv more about these matters than ordinary men. ,Mr Bong moied the reception and adoption of Dr frengley's report so far ■ as it referred to buildings. He said the board now bad to pay the piper for pa.st mistakes. The institution, had cot been liberally treated in the past,' but he believed' 'there would be a ;,' change in the future. He had done his ' -best to please everybody; and it had ■ .]%bgux of Java. &* .& A

i. , i : 'i. ,; ■■■■-,.- : ': -. -e ,]. •■•'; :.. -■_ ■■■ '■ ''; : . n, : ii . 'iiie a::. .- . "i --' • -"■' ; -'-■'•■'"" [ !;y>:,. y,., . ; '.j-vond l tlu- board's Uit.ui:-:. ; i;iu,-, 'ue-:. b-.it .'.e ! dat-iura-- shoul.-! =:c oMTieO ! b-.u'ld;-::.- w«-'v- in cocy-e e- ere---mr.. _ j i Mr f'.,iey -----'i-d'-d '■'■'-■ ':'••.ti.e,!. -e .r.i ; ! t^e.-ifo-er'-'-■-'Publie ijcVdh l.'cu:7-iii-| I c,ee to have the ai'.d j I )-ecommo.-Hla ; ;:ous ]>"':> '.'ato eire'ri- ' - ! ->'< j P) ,vl'k. ; ,v fj; o s.}'bl.-> .nxvJKiv,:.. lb-. su--u j i that the Pul.Tio Health Coiemi'itce J ! shiuH b- "i-w credit M.r hpvmg put ; ■i most of this work in hand before he.- j { tile criticism was b-veited aganis. im-- j iustiunion. . . j Mr If. Pat tot son sp.-ke nriedy ni ; favour of the report. He it was; j really" a waste of time tor members t-e j discuss the matter. They must adopt j the recommendations. | 'Hie Hon l\. -Moore -suggested that j a telegram should be mtu- to the Min- j isfer of Internal Affairs acquainting j j him with the board's decision in tin's I | matter. They hod yet to get the Minj isi'er's authority to do 'the work. j A discussion, then arose- in regard j to the report of Drs lilackmore. Pearson and Lester. j Mrs Wilson said she thought- the j board had treated the doctors very ; rudely. I Air Boag said that one of the- doc- i tors told him since that- if the report { was not what the board' wanted they j should hf/v? sent' it back for further j information. Tim speaker replied that j a report which condemned the Bottle [ Lake site was of no use -to the board. ] Mr Spencer spoke in support of the j site. Sand was very healthy, he said, j They ought to sow the ground with { twitch, which would grow well ami j bind tho sand. _ j Dr Chesson, invited to speak, sa-id J he know the plans for xhi-i present ; work were prepared before newspaper j criticism made its 'a.ppeararioe. He j paid a. high tribute to the work done by Mr Boag as chairumn of the Public j Health Commit-too. The hoard could j rest assured that Dv Frengley's re- I port was absolutely unbiassed. He believed "bhe (partial report forwarded contained all the r.-iommendations which would be made. Mr Boag's motion, as amended, waa then put and carried unanimously. j