SPECIAL REPORTS ON HOSPITALS IN NEW ZEALAND. (BY THE INSPECTOR OF HOSPITALS.) [In continuation of H.—18, presented this session.]

Appendix to the Journals of the House of Representatives, 1885 Session I, H-18a

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1885. NEW ZEALAND.

SPECIAL REPORTS ON HOSPITALS IN NEW ZEALAND. (BY THE INSPECTOR OF HOSPITALS.) [In continuation of H.—18, presented this session.]

Presented to both Houses of the General Assembly by Command of Sis Excellency.

AKAROA. This hospital was visited by me to-day. There are only two patients resident; one being an old man of seventy-three years ; —in no sense a proper hospital case ; —the other a young boy from the Christchurch Hospital, suffering from chronic disease of the hip-joint. There have been as many as five patients resident at one time since my last visit, a year ago. The building is maintained in good repair, and everything about it is clean and orderly. The only fault I have to find is with the bedroom occupied by the warder and his wife, which is both dark and damp; and has, I believe, been the cause of a recent severe illness. A small and useless portion of the outside verandah should be removed where it obstructs their own window; and a proper terminal to the chimney and ventilating shafts would remedy the dampness. These matters might be executed at trifling cost, the warder being by trade a carpenter. The patients are treated here with much kindness and attention. April 21st, 1885.

ARROWTOWN. This day, accompanied by Dr. Donaldson, the Medical Officer, I have inspected the hospital. I find three patients in residence, viz :—Two males and one female. One of the former will be discharged to-day, having recovered from a severe injury. As usual I find this establishment in perfect order. It is one of the best arranged, and neatest, small hospitals in the colony. The number of patients treated here, however, is small. The reputation which Dr. Douglas has gained, by long experience and long residence, tempts patients to avail themselves of the Frankton Hospital. There were, however, on one occasion, since my last visit, seven patients resident here at the same time. Some of these were admitted suffering from erysipilas, and were treated in the detached fever-ward. This ward still requires a porch, or enclosed verandah. The late warder, a carpenter by trade, has erected, at my suggestion, a building which contains a mortuary and wash-house, with a carriage-shed in the centre. This is quite suitable for its varied uses, and the cost was only that of the materials. Dr. Donaldson is now the Medical Officer ; and Mr and Mrs. Rintoul, Steward and Matron. December 7th, 1884.

ASHBUKTON. There are this day seven in-patients under treatment; all of the male sex, and all proper hospital cases. None of the private wards are occupied. Since my last visit, about a year ago, a change has been made in the staff" of the hospital. Mr and Mrs. MacKay are now the master and matron, and are evidently very industrious and efficient officers. A great change for the better is observable throughout the whole establishment, which I found in excellent order. The female wards upstairs have never yet been painted or distempered. This should be done both for appearance and for sanitary reasons. The same remark will apply to the two rooms occupied by the master and his wife. These might be papered at a small expense. I notice that the kitchen has been cleaned and coloured, and a great improvement made in the hot-water supply to the bath upstairs. The wards are very neatly kept. The linen is scrupulously clean, and new I.—H. 18a.

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counterpanes have been purchased. The stock of blankets and linen is ample. In the surgery I observed that the instruments have been carefully cleaned and arranged. A number of flowers have been placed in the large corridor. These I find, as well as a large number in the garden, have been provided at the master's own cost. A very marked improvement is apparent in the grounds of the hospital, which are rapidly being brought into good order after a period of entire neglect. The kitchen garden is being cultivated and cropped, and flowers beds have been made and trees planted. Improvements are also in progress as regards the drains running from the hospital. I visited all the detached buildings. The fever hospital has not yet been used ; and, when required, will be found very defective ; there being no nurse's room, kitchen, bath-room, closet, nor even a cupboard. The wall on one side of tha building very damp. The mortuary requires some repairs to its ceiling. The laundry is a very good one, and has just had its furnaces repaired. April 25th, 1885.

AUCKLAND. The number of patients in the hospital to-day is eighty-three: sixty-seven males and sixteen females. These numbers do not include four Lascar seamen, who have been treated in the neighbouring Kefuge for what would appear to have been starvation, resulting from bad and insufficient food while at sea. The whole of the patients have been seen by me, either on the 15th, 18th, or 19th of the present month, and they have all had the opportunity of conversing with me, no hospital official being present at the time. I received no complaint whatever; but, on the other hand, much testimony regarding the comforts and kind treatment afforded by the establishment. The hospital has been fully occupied of late, and it has been necessary at times to place extra beds upon the floors of the wards. Most of the patients whom I saw are proper hospital cases ; about six of them might with propriety be placed in a Kefuge. I learn that it is in Contemplation to set apart a room in the Refuge for chronic invalids, who will have the services of a skilled nurse. If this measure be carried out it may perhaps relieve, to some extent, over-crowding in the hospital. Additional space should be provided by the erection of detached fever-wards. At present there are three patients suffering from Typhoid ; they are being treated in the general wards. The fever-ward for females is unoccupied. Since my last visit a considerable amount of painting and decoration has been done. The wards have now a painted dado, with stencilled border, and are distempered in color above. The pantries or sculleries, lavatories, and bath-rooms are also newly painted, the material used being Silicate paint, which admits of much washing when thought desirable. Some additional pictures have been presented, and a new form of bedside-card, giving particulars of each patient, brought into use. The female ward has been provided with sixteen new capboard lockers, of neat pattern, two of which I saw also in the men's accident-ward. Of the order and cleanliness which prevails throughout the establishment, it is impossible to speak too highly. The bedding, which I examined, I found to be very good, and well-attended to. One or two of the woven-wire mattresses might with advantage be introduced, being both comfortable and economical. The wards altogether present an appearance of great comfort. Cut flowers abound ; and the patients seem well supplied with literature and games. A diet-scale has been adopted, and certain extravagant items curtailed. The consumption of stimulants is still large, although much less than was formerly the case. A certain amount is supplied to the refuge, which received to-day six ounces of spirits. Drugs are not kept in large quantities, but are. procured as required. There is no accumulation of old stock in this department. A considerable addition has recently been made to the surgical instruments and appliances. The hot water supply has been re-arranged, and the noisy tanks which formerly stood in the ward-kitchens have been removed. This is a great advantage. The present mode of heating the water is, however, wasteful of fuel; and the lead-lined tanks will inevitably burst at no distant date, and flood the roof of the building ; lead, from its alternate contraction and expansion, being an unsuitable material for such a purpose. The kitchen-ranges are both nearly worn out, and will require to be replaced by new ones. The cooking appears to be well done, and the soup, which I tasted, I found very good. A small cool larder has been erected, at my suggestion, beneath the steps at the back of the hospital. It is very conveniently situated, and answers its purpose well, and at a very small cost. I noticed here an ice-safe recently presented to the hospital. lam sorry to say that the new mortuary has not yet been commenced. The old one continues a source both of annoyance and danger. Some addition has been made to the stabling accomodation, and a coal-shed erected. This is too small, and offers no convenience for the breaking up and mixing of coke with the coal before use. The disinfecting-chamber is not in the builder's hands, though long since planned and agreed upon. The delay is a matter for regret. The male servants employed are twelve in number ; two of these are patients. There are three porters, two ward porters, one male nurse, two cooks, engineer, messenger, and two scullery-men. This seems to me a large staff for so small an establishment. Ten of these persons take their meals, at much inconvenience, in the kitchen, which is both too small and too warm for such a purpose. The dispensing is now performed by the house-steward, from whom I obtained much useful information. Eegarding maintenance-money, I find that J42 5s (nett) was collected during the past four weeks. This appears to me very satisfactory. Miss Crisp, with her staff of nurses, continues to give great satisfaction. lam glad to find that her personal

comfort, and also that of the resident medical officer, have not been lost sight of by the Committee. 19th July, 1884.

My inspection of the Hospital has occupied me during a great portion of three days, viz., February 21st, 23rd, and 28th, 1885. As usual, I have visited every portion of the building, and conversed separately with each patient. 1 have also examined the registers and other books, and made a number of enquiries regarding matters of expenditure. There were, upon the first day of my visit, no less than a hundred and one in-patients under treatment; including ten cases of typhoid fever, distributed through the general wards. Considerable overcrowding existed, and several beds had to be made up on the floor. The number had been reduced yesterday (28th) to ninety-six. Everything connected with the wards, the bedding and clothing of the patients, I found in excellent order, and beautifully clean. I was present during two meals, .which appeared to me satisfactorily provided, cooked and served. The kitchen is in good working order; the two ranges having been re-set since my last report. The small larder, fitted up under the outside staircase behind the hospital, is a great boon. The stock of bedding and linen, though not large, is sufficient. Some trouble occurs in getting the mending done at times, which would be remedied by the purchase of a sewing-machine. This I recommend to be granted. Out-patients attend daily, as heretofore; about twenty new cases are added to the list each week. The dispensing is now performed by a paid official, who has no other duties. The steward has been relieved of this work, and might, in my opinion, be able to collect the maintenance moneys, or to act as secretary. The structural additions and alterations have been few. The old mortuary remains a source of offence and danger, the propose!, new one not having been commenced. A disinfecting chamber has been built, but is faulty in some of its details; the first trial rendering it unservicable. In the construction of the furnace, allowance was not made for the expansion of the iron fittings. This, and not a too large fire, as alleged, was the true cause of the displacement of the brickwork. An outer door of non-conducting material, is also a matter of necessity. The repairs should not be delayed now that fever is prevalent. A mess-room has been found for the servants in the basement, but the proximity of the boiler-house must make the temperature almost unbearable at times. In the course of my inspection, complaints were made to me by a male patient named Smith. These related chiefly to Dr. Bond, the Eesident Medical Officer, but reflected also upon the whole medical staff and the committee. After listening to the man's statements, of which I made some notes, and which have recently been brought prominently before the public, I was somewhat surprised to learn from him that his principal grievances dated back some seventeen months. John Smith admitted that he had an opportunity of complaining to me shortly after their occurrence, and that he was not deterred from doing so by the presence of any hospital official at the time. He stated, however, that " as the other patients made no complaint, he thought he would not do so." No doubt the committee would have made enquiries into these matters if acquainted with them at the time ; and it appears to me to be obviously unfair to listen to them now, after the departure of many fellow-patients, who might possibly have been able to explain or refute the charges made. I have felt it my duty, in common fairness to Dr. Bond, to enquire privately, concerning his conduct and treatment, of every patient in the hospital who was capable of giving any information. Without any other exception, than that of John Smith, their replies were favorable to him, and many expressed gratitude for kindness and attention received at his hands. That Dr. Bond is interested in his work, and efficient in its performance, I have no doubt whatever; but, whatever may be the result of the inquiry now pending, I do not hesitate to state my opinion that neither he, nor any other medical practitioner, can long remain in charge of the Auckland hospital, unless the order lately made by the committee be rescinded, viz., that the Medical Officer shall never be absent from the hospital for more than one hour without providing a proper medical substitute, who must be actually at the hospital. This is the interpretation of the rule given to Dr. Bond, and I characterise it as tyrannical and unnecessary, though no doubt framed with the best intentions. The occupants of all the principal wards are, almost without exception, proper subjects for hospital treatment. The basementfloor is still occupied by chronic cases, many of whom, however, do some useful work. The need of increased accommodation is very pressing, and would be met for a time by the erection of a fever ward, and additional rooms for the hospital staff. In the course of my inspection, I visited a new building recently erected in the " Domain," at a short distance in front of the hospital. This, I was informed, was the small-pox hospital. It is a wooden building of three small rooms. The two end ones being obviously intended for patients, and the central one for their nurse. Behind is a small wardrobe or store. It appears to me that the City Council have not been well advised in the erection of this hospital, which contains neither kitchen, pantry, scullery, bathroom, nor even a closet. If small-pox appeared, in one or two cases only, these could equally well have been treated in a tent, while with a larger outbreak of the disease, this new building would be totally useless. The need for some isolating wards is shown by the occupation of an old cottage near the Eefuge, for the treatment of a female suffering from typhoid fever, and delivered prematurely of a child. Such a patient could not with propriety be retained within the hospital proper. I have also paid a visit to the adjoining Refuges, which contain a number of chronic and helpless patients. These are visited regularly by Dr. Bond, who is also

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expected to attend the obstetric cases, when necessary. I learn that sixteen confinements took place here last year. An additional nurse has recently been appointed, which addition to the staff, I consider necessary, and recommend accordingly for approval. Ist March, 1885.

BLENHEIM. I have been occupied to-day in inspecting this hospital, which has now nine patients. Seven of these are of the male sex ; the other two are females, one of them being a young girl. No serious case is at present under treatment, all being able to get up during the day. One of the patients has lost an arm, near the shoulder-joint, from severe injury in a flax mill. I find that only one case of fever has been admitted during the present year, but there have been several instances of diphtheria. Everything was in good order and clean. Games, books, and papers are liberally supplied, and general contentment prevailed. Some small improvements have been carried out in the hospital ; but these are, very properly, of a temporary nature only, the building having been condemned as unfit for further use. The garden shows a good crop of vegetables ; the result of the Warder's labour. The Committee are fortunate in having the services of so good a man ; evidence of his efficiency and industry being everywhere noticeable. He is assisted by his wife and a young servant. The largest number of patients, simultaneously treated, has been fifteen. I visited the site, newly acquired by exchange, of the intended new hospital. The distance from town, (one-and-three-quarter miles) will, I fear, be found troublesome. The land appeared to be of poor quality, and its extent unnecessarily large. Apart from these circumstances I have no objection to raise as to its suitableness for its purpose. It is to be hoped that the new building will be commenced very shortly. An eligible tender for the whole work has been accepted, but a further subsidy from the Government appears to be a matter of necessity before the contract can be let. I made a number of enquiries as to the finances and general working of the hospital, and received much useful information from Mr Dodson, M.H.K., and from Dr. Cleghorn, the visiting Medical Officer. 31st December, 1884.

CHKISTCHUKCH. The hospital contains to-day, sixty-seven patients, viz:—fifty males and seventeen females. There is accommodation for a much greater number, and several of those who are now inmates would, more properly, be located in a Eefuge. All of these patients I saw and conversed with, finding general contentment to prevail. No cases of infectious disease are at present under treatment: syphilis excepted, of which there are several at this time. A great deal has lately been done in renovating the buildings, both externally and internally. The wards would present a handsome appearance were it not for the massive, sarcophagns-like, fire-places which take up so much room in their midst, and which are the cause of much trouble from smoke and dirt. Two open fire-places in the walls of each ward would be preferable ; and I recommend that the experiment be tried in one of the wards. The cost would be trifling only. I found everything very clean and orderly ; the bedding particularly so. New counterpanes, in colours, with very neat patterns, have been introduced with good effect. The other alterations calling for remark are the construction of a meat larder, beneath the water-tank staging, near the kitchen ; and the re-building of the three bridges across the creek. The former was a very desirable improvement, and the latter was rendered necessary by decay. The work was done by home labour, with the assistance of some of the " unemployed "of the district. As regards the hospital drainage :—The town sewer has been constructed, with Government aid, as far as the boundary gates ; but no connection has yet been made with any hospital drains. Liquid refuse is discharged into the creek as heretofore. The quantity is small, but the practice is very objectionable. The grounds and gardens are kept with the usual neatness, and present a very charming view. 20th April, 1885.

There are to-day fifty-eight patients under treatment, of which number forty-two are males and sixteen females. These numbers are unusually small, and a good many are either incurable or chronic cases. Since my last inspection the three large wards, with the adjoining small rooms and offices, have been thoroughly cleaned and painted. In two of them the floor has also been stained and waxed. The work is well done ; but the appearance is " heavy," owing to an injudicious selection of colors, and the use of the same tint both for the dado and the wall above it. The large corridor, the older wards, and other portions of the buildings, have also been entirely renovated in paint or distemper. This work was done cheaply by " unemployed " workmen, who received from four shillings to four shilling and sixpence per day. The laundry is now undergoing a like process. No fever-cases have been admitted for some time past; but I inspected a plot of land, some four-and-a-half acres in extent, lately acquired from the Domain Board for the purposes of a detached hospital for infections diseases. The site is a very appropriate one, and the ground has been cleared (also by the " unemployed ") and is now chiefly planted with a crop of potatoes. I visited every part of the establishment, and found everything

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clean and in good order. An excellent pianoforte has lately been presented by subscriptions ; but, as regards articles of ornment, the wards will not bear comparison with those of many other hospitals in the Colony. It is a matter for surprise and regret that the drains are not yet connected with those of the city, although a very large sum was voted by the Government for this purpose. The delay appears to be unaccountable, all expenditure thus far having been beyond the boundaries of the hospital estate. The creek, therefore, continues to be polluted as heretofore. On examing the books I find the consumption of alcoholic stimulants to have been very large, although a very sudden diminution appears to have occured after attention had been drawn to the matter by the Government. It appears strange that the laundress should require four ounces of brandy daily. I had the opportunity of going through the wards with Dr. Bobinson, the Eesident Medical Officer ; and I afterwards spoke privately to each patient. No complaints whatever reached me. Mr. Bell, the Steward, is a very efficient officer, and studies very closely the econonical working of the establishment. The books are well kept. The gardens are well cropped with vegetables and fruit, and the ornamental grounds in excellent order. 13th December, 1884.

COKOMAISrDEL. Accompanied by Dr. Atterbury, the Visiting Medical Officer, I inspected this hospital on 18th February, 1885. There were four patients under treatment. Of these, one was suffering from a severe attack of typhoid fever, and the others from severe accidents sustained in mining and bush work. The register shows that six beds were occupied at one time in July last. The warder is at present assisted by a man who takes charge of the fever-patient. Everything I found in very fair order, and the patients seemed quite contented. . The rooms were all clean, and a few improvements had been made since my last visit, such as the fixing of a small range (with boiler) in the kitchen. A new warder has been appointed since I was last at Coromandel. If it were practicable to secure the services of a married couple, the result could not fail to be beneficial in many ways. At the same time I wish it to be understood that I have at present no particular fault to find. The kitchen-garden has fallen into neglect ; but, with a number of severe cases to attend to, the warder can have had very little time at his disposal for this occupation. 20th January, 1885.

CEOMWELL. There are this day four patients under treatment in the hospital; three males and one female. All may be fairly considered as suitable cases for admission. In July last, nine cases were under treatment at the same time. There have been no cases of fever admitted since my last visit; but I may, nevertheless, point out the advisability of erecting a detached building for this special use. The building is maintained in good repair. The kitchen requires painting, but I am informed that arrangements have already been made for this work. Everything is very clean and orderly throughout the establishment. No complaints were made to me upon any subject. Dr. Stacpoole appears to give much attention to the patients, but his work must be materially increased by the unnecessary distance of the hospital from the township. I examined the register and found it properly entered up. 7th December, 1884.

DUNEDIN. On a portion of 30th April, and Ist and sth May, I have been engaged in an inspection of the Dunedin hospital. I have also had the opportunity of conversing with the Chairman of the Committee upon various matters relating to its management. There are now on the register one hundred and eighteen patients; seventy-eight males, and thirty-five females. Five males of this number are boarded out as they belong to the Eefuge class, and no accommodation exists for them in the hospital, where a large ward is entirely occupied by similar cases. The average number of beds occupied of late has been one hundred and ten. A large number of out-patients come for advice daily. Under this category there were, one hundred and seventy-five new cases admitted last month. The receipts during that period, from the shilling fees charged for medicine, amounted to £13 18s. The waiting-room for out-patients is too small; and when filled, as it was on the occasion of my visit, becomes stuffy and oppressive. Some relief will be afforded by the erection of the pnyposed ophthalmic-room, which will also enable the operating-theatre to be materially improved. The out-patients department, as well as the large entrance-hall, has been painted since my last visit, also some portions of the exterior of the building. I found the whole establishment in its usual good order. The bedding is not what it ought to be; many hard pillows, filled with straw, being in use still. I learn, however, that these will shortly be replaced by others of more suitable material, and that eighty-five hair mattresses have been ordered. The whole of the patients were spoken to individually, and no complaints were forth-coming. At present there is no infectious disease under treatment in the wards. One patient, convalescent from a mild attack of typhoid fever, will shortly be discharged. The sanitary state of the building is good; but the drainage system is radically bad; the earthenware pipes running

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through the basement frequently becoming choked, and giving much trouble and offensive odour when being cleared. I have given this matter some attention; and, with some modifications, have approved of a plan prepared by the Public Works Department, for remedying the present defective arrangements. I find the books properly kept. The cash book shows that £44 was received last month, from maintenance-money and other sources. Some small additions are needed to the stock of surgical instruments.

I have this day inspected every portion of the Dunedin hospital, with its out-buildings and grounds ; and have also examined the register and other books, and conversed separately with every patient. Of these there are now one hundred and twenty-four under treatment; viz : —■ eighty-one males and forty-three females. Of these some twenty-five belong to the chronic or refuge class, and five of them are boarded out at a cost to the hospital of ten shillings each per week. Some diminution is apparent in the number of out-patients, which may be attributed to the restrictions now imposed upon this class ; a payment of Is. being demanded for each prescription dispensed. Failing this payment patients are required to make a declaration of their poverty before a magistrate. The shilling fees reach a total of between £9 and £10 monthly. Since my last visit I notice that many improvements have been carried out.—The basement has been much improved by better lighting and ventilation ; the central part has been cleared and levelled ; two new staircases from the central hall above are now available for the male and female servants, who take their meals below. A very suitable room has also been fitted up in the basement for the separate treatment of excited or violent patients. The Lying-in Ward has been improved by the addition of a bath-room, lavatory, and closet; but it is not, in my opinion, suitable for its present use. A separate building would be far prefer able. Nothing has yet been done in the erection of a ward for children. The proposed disinfecting chamber, in connection with the laundry, has not yet been commenced. The operating-room has been enlarged by throwing into it an adjoining Warder's room. Some additional furniture has been procured, such as rocking and other chairs ; new bedsteads, &c. I found the whole establishment in very good order and scrupulously clean in every part. No complaints were made to me by any of the patients ; but, on the other hand, I received assurances from them that they were well and kindly treated. The Medical Officer was absent at the time of my last visit, but I received all the information I desired from Mr. Burns, the Steward and Secretary, 29th November, 1884.

DUNSTAN. The Dunstan hospital contains this day four patients; viz : —two males and two females. In April last seven were under treatment simultaneously. This is the largest number since my last report. I find everything very clean and in excellent order. The patients are thoroughly satisfied with their treatment. Some small improvements have lately been effected—the kitchen has been painted, and the garden further improved by additional flower-beds. There is a very promising crop of vegetables to be seen. A new drain has been made to take away the liquids from the kitchen-sink, and which formerly were offensive in hot weather. A chronic patient, long on the hospital books, has been sent to his friends in England by public subscription. Bth December, 1884.

G-ISBOKNE. This hospital was inspected by me on August 15th, 1884. I found seven men and two women resident as patients. One of the men is very aged, and appears to be retained on condition that he makes himself useful in the garden. The others are all proper subject for hospital treatment. One of the males occupies the private ward, for which he pays at the rate of £2 2s. per week. All appeared to be satisfied with their treatment and surroundings. I found the whole establishment clean and in good order. The bedding is well attended to, but some additional mattresses of a better kind are wanted, as well as some feather or kapoc pillows. I was glad to learn that two woven wire mattresses had been ordered in Auckland. A few unfrained pictures and some texts have been placed upon the walls of the wards. There is scope here for many more ornamental and useful items, such as cut-flowers, books, and objects of interest. A few volumes of books are to be seen in the corridor, but no addition seems to have been made to them for some time past. The kitchen and offices are kept very neatly. A number of shelves have been put up by the Warder, who, with his wife as Matron, entered the hospital service about two months since. I was glad to notice that he has also devoted himself to the improvement of the grounds, having made a new road of approach, put up several gates, planted a number of trees, and commenced the formation of a vegetable and fruit garden. No fever patients have required treatment in the hospital of late, and the Committee have let the detached hospital to a weekly tenant, at a rental of 155., with the understanding that immediate possession is to be resumed if needed. I consider that this is a judicious step. The building will be kept warm, dry, and well ventilated without requiring any attention on the part of the Warder or Matron. Before leaving, I had an opportunity of meeting with the Medical Officer, Dr. Pollen, who appears to devote a good deal of time to the hospital patients, August 16th, 1884.

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I paid a very unexpected visit to this hospital to-day between the hours of 6 and 7 a.m. Early as I was, the Matron was still earlier, for she had. already completed the weekly washing of the clothes and linen. I found four men and two young women under treatment, and learned that twelve beds had been occupied simultaneously last week. Altogether, twenty patients have been admitted since January Ist. The long spell of dry weather has resulted in the re-appear-ance of typhoid fever in this town and district. Two of the hospital patients are labouring under this disease, from which also a third is convalesent. Altogether, five cases of the disease have been here under treatment. Under these circumstances, the Committee have wisely caused the detached hospital to be vacated, and it is held in readiness should the fever become more widespread. One of the male sufferers is treated in the old detached ward, and a hired male nurse attends to his wants, the Steward being at present on sick-leave, necessitated by over work. A female night-nurse has also been temporarily engaged. I found the whole establishment in capital order. The bedding is in unusually good condition, advantage having been taken of the services of a patient, who is an upholsterer, to remake all the mattresses. Three new ones have also been purchased. Great improvements have been effected by the Steward in the hospital grounds. Flower-beds have been formed, and a good kitchen-garden is well cropped with vegetables. A cow is kept on the premises, and furnishes all the milk required. I was fortunate in meeting with Dr. Pollen, the visiting medical officer, who accompanied me during my inspection. The hospital appears to be in good hands, and is well managed. February, 16th, 1885.

GrREYMOUTH. On visiting this hospital on Sunday, December 21st, I found it occupied by twenty-four patients; of these, twenty-one were men, and three women. The total number of beds is thirty-six, and the whole were occupied in August last. There is, however, a large and good unoccupied ward still available for use. This is at present unfurnished, and is used by the gardener as a bedroom. A number of " refuge cases " continue to encumber this hospital, and this class has a natural tendency to increase as the colony grows older. No fever-patients have required hospital treatment this year. I found the whole establishment in very creditable order, and I heard no complaints from any of the patients, to all of whom I spoke individually. A good many improvements are to be noticed. A new and suitable mortuary has been built at the end of the kitchen-garden, the old one being now used as a tool-shed. A new iron roof has been laid upon the shingles of the older portion of the hospital. A new "pipe-drain has been laid, to carry away the liquids from laundry, bathroom, and kitchen-sink. In the convalescent-room, Venetian blinds have been fitted to all the windows, and a glazed book-case removed thither from the operating-room. I find the register and other books well and neatly kept. December 22nd, 1884.

GREYTOWN. On visiting this hospital on Thursday, November 20th, 1884, I found it tenanted only by the Steward and Matron, no patient being under treatment. I have never seen more than two beds occupied upon the occasions of my inspection, though I learn that as many as five patients were under treatment at the same time during the month of July. I found the hospital very clean, and in good order. In the wards I noticed that a new hair-mattrass and some new counterpanes had been procured. The surgery has recently been papered by the Steward. The outbuildings are well kept, but very little is done here in the way of gardening, beyond a flower-bed in front of the hospital. I think that this hospital might be closed, the patients being sent to Masterton, where ample accommodation exists for them. November 24th, 1884. -

HOKITIKA. The Hokitika Hospital is now occupied by thirty patients, twenty-five males and five females. These figures are below the average, which is about thirty-nine. Some four or five are " refuge " cases, for whom no special accommodation exists in this province. One, a female, is an exceedingly objectionable person. Her noisy and filthy habits render her totally unfit for association with any decent people. She now occupies a small ward recently built, and also renders the other one, across the corridor, untenantable. Having been proved, by long residence in gaol, to be incorrigible, I can see no other remedy for the disturbance she wilfully creates than to provide for her an inexpensive detached room, which might subsequently be found useful for purposes of isolating infectious patients. The two wards just alluded to form valuable additions to the hospital, and are well-constructed, lofty, and well-ventilated. Other improvements have been effected since my last visit of inspection. The ceilings of the wards have been relined with boarding; the old material having shrunk materially. Tobin's ventilating tubes have been adapted to the wards, with good .effect. A number of new mattresses and bed-rests are in use. Two fire-extinguishing hand pumps, with hose, are kept in the corridor. Telephonic communication with the Telegraph Office is arranged for. This should be so planned that it may be connected at night with the police station, otherwise it will be comparatively useless. The female

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ward, as usual, looks very bright and comfortable, and I am glad to notice material improvement in the same direction in those used by the male patients. A supply of comfortable chairs is, urgently needed here. Wooden forms are not suited for persons just risen from a sick bed. I have directed a requisition to be sent in to supply this want. The need for painting the interior of the hospital, and more especially the bathrooms, lavatories and closets, is very great. In their present state it is impossible to make them look presentable. Two small rooms have recently been made for the steward and dispenser, by enclosing a small portion of a back ward seldom used. This former room will serve for the accommodation of the out-patients. I find the registers very neatly kept. The case-book is filled with valuable notes by Dr. King, the Medical Officer, who is most painstaking in this work, and much liked by the patients. The president of the hospital accompanied me during my visit, but I afterwards had a private conversation with every patient; all expressed themselves as thoroughly satisfied. The grounds are well kept, and an additional piece of land is now cropped with vegetables. Some pigs are kept in a praiseworthy state of cleanliness, and are a source of profit to the hospital. December 18th, 1884.

INVERCARGILL. Since my last visit some important structural alterations have been made (upon my advice) in this hospital. In the central block, the two small rooms on both floors have been thrown into one, by the removal of the dividing partition, and a central chimney-stack. These rooms now accommodate five beds each. Between the kitchen and the hospital proper a new building has been erected. This contains, on the ground floor, a good dining-room for convalescent patients, and a linen-store ; above is a good small ward containing four beds; and, adjoining it are bedrooms for a warder, the cook, and nightwatchman. The kitchen and old wash-house have been thrown into one, a properly ventilated ceiling put up, and an excellent large range fixed, with a good circulating cylinder for hot water supply. The result is a vast improvement, and not a costly one, as the old walls were made to serve again. Outside the kitchen a good pantry and a suitable laundry have been erected. In front of the hospital a good deal of asphalting has been done, and behind it, a large rain-water tank erected on brick piers. There is also an excellent new bathroom and lavatory. The subsidy granted last year by Government for the above purposes was very largely supplemented by local subscriptions, or the work could not have been carried out. The patients resident this day, number thirty-five; of these, twenty-four are males, and eleven females. Two or three only of the whole number are of the " chronic" class, and many very " severe " cases are to be seen ; two having lately undergone amputation of the thigh. With this population, the hospital is, in my opinion, much overcrowded. Wards containing five beds are only capacious enough for three. The register shows that, on a recent occasion, forty-two patients were simultaneously under treatment. No Refuge exists anywhere in the district. I learn that, up to the end of November in the present year, two thousand and twenty-seven out-patients have been treated. All who come are provided with orders from the committee, who enquire into their fitness for gratuitous treatment. A considerable addition has been made to the furniture of the establishment. Fourteen woven-wire mattresses have been purchased, and a number of comfortable chairs. I also noticed many attractive and well-framed pictures on the walls of the wards. All the wards are provided with electric bells, so that the patients can summon the warders in case of need. Everything I found in good order and very clean. I was glad to see that the use of sheets upon every bed is now made obligatory. The dispensing is now done by the head-warder, who also keeps the registers. All in this department I found in due form. I regret to learn that Dr. Wardale is about to leave the hospital service, owing to increasing private practice. He is very popular with the patients, and appreciated by his committee. The old lunatic ward has been several times in use as an isolated building for the treatment of fever, erysipilas, and a case of suspected small-pox. This building is quite unfit for further use, and should be pulled down and rebuilt without delay, in a more commodious form. In this way the pressure upon the limited ward-sj)ace may be temporarily met; but it is clear to me that a much larger hospital will eventually be needed for this important centre of population. December 2nd, 1884.

KUMARA. I INSPECTED this hospital on Sunday, December 21st, and found the Medical Officer and two members of the Committee engaged in visiting the patients. Of these, there were nine males and one female. With one exception, all were suffering from acute illness or severe accident. The accommodation afforded by the hospital has been at times severely taxed, and in the winter a number of old or infirm persons look to it for a home, there being no " refuge" in the province. As matters now stand, it will shortly become necessary to provide more beds, which would be best accomplished by throwing the Warder's room and store into the adjoining ward, and building a new Warder's room and a small room for female patients. I notice that three new mechanical bedsteads have been purchased since my last visit, and that hot water has been laid on to the bathroom. The wash-house has also been enclosed with a front, and fitted with

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bins for soiled linen. It was formerly merely an open shed, and this work has been done by one of the patients. The patients I found very well satisfied. The bedding was throughout beautifully clean, and, though some little untidiness was noticeable here and there, it was excusable on account of the severity of the cases under treatment, which must occupy much of the Warder's time. It should also be remarked that the flower-garden and kitchen-garden are cultivated by his labour, and that all vegetables used in the hospital are grown here, with the exception of potatoes. Dr. Monckton is now the Medical Officer. December 22nd, 1884.

LAWEENCE. This hospital was visited by me to-day. I found twelve male and two female patients resident, three others having been discharged within the past two days. The average number of patients under treatment during the past year was about twenty-two; but, in October last, as many as twenty-nine were resident upon the same day. It is to be regretted that this hospital is hampered with " refuge cases," there being now five of this class on the register. Only one case of fever (typhoid) has been admitted since my last visit. I found the establishment throughout in good order, but the wards are poorly furnished as compared with many of the colonial hospitals. Everything was clean, however, and the patients contented. The female ward has a smarter appearance than the other parts of the hospital. A considerable degree of untidiness was observable in some of the rooms used as store-rooms ; and the grounds immediately behind the buildings might with advantage be kept in a more orderly way. Many improvements have lately been effected. The old fever ward has been disencumbered of two cells which occupied its further corners ; and which, on a previous visit, I recommended to be removed. The result is a much improved room, while the bricks have served for the erection of a suitable mortuary and also for a covered ash-pit, both of which additions were executed by home-labor. In the kitchen I noticed a new range, with hot-water supply fittings. The residence for the Medical Officer, long since recommended to be erected, is now well in hand, and will prove a valuable acquisition, at a very small cost. The kitchen garden is well cropped, no paid labor being employed in this department. I had the opportunity of conversing with Dr. Withers, the Medical Officer, after my inspection ; he continues to render very valuable service to the hospital. The books are properly kept. The surgical instruments are poor and few ; others are badly required. December 9th, 1884.

MASTEETON. ■On Thursday, November 20th, 1884, I made my periodical inspection of this hospital, finding two male patients only in residence. One of these was a convalescent from typhoid fever; the other had sustained a severe flesh wound of the leg, while working in the bush. Since my last visit, as many as seven patients have been under treatment at one time, but the capacity of the hospital is sufficient for a much greater number. Everything in this establishment is always in perfect order. The walls have recently been painted blue, and the ceilings whitened by the steward. Additional pictures have been hung on the walls, and a clock presented. I also noticed one or two new chairs of a comfortable kind. The entrance-lobby of the fever ward has been lined with match-board and painted. The out-buildings are all very neatly kept. The grounds and garden are admirably cultivated and looked after. This hospital might very well serve for the Greytown district also ; it appears to be quite unnecessary to keep up two distinct hospitals in this locality, with their staff of Medical Officer, Steward and Matron. November 24th, 1884.

NAPIEE. This hospital was, yesterday, released from quarantine, which had been imposed in consequence of a patient having been admitted from the S.S. Waihora, while suffering from small-pox. The patient was shortly after conveyed to the Quarantine Station, where he died. Upon removal of the restrictions, five male patients and 1 female were discharged from the hospital. To-day, I find twenty-six in residence. Of these, seventeen are men, three women, and six children. Although several of them are suffering from obviously incurable diseases all are proper cases for hospital treatment. Out-patients attend thrice weekly ; to-day four have. been prescribed for. A single case of typhoid fever is now under treatment in one of the ordinary male wards, having been admitted during the period of quarantine. The children's ward has been completed and fully occupied since my last visit; in fact, it has been found necessary to place in it an extra bed; it now contains five bedsteads and two cribs. The ward is very neatly and appropriately furnished, and has a most comfortable appearance ; the floor is covered with linoleum, and with a good hearth-rug. A neat, corner cupboard, contains the medicines in use, and above it is a filter. Framed pictures, cut flowers, toys and picture-books abound ; there is also a well supplied nest of book-shelves. The female patients having been removed to the new ward erected for their use, the two front wards are now occupied by males. The room used hitherto by the 2.— H. 18a.

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Matron forms a good special ward with two beds; here, a very offensive case of cancer is, at present under treatment. I noticed some additions to the furniture, such as good folding screens, covered with cretonne. A dado has been placed in the ward kitchen, and a good new shelter or summer-house erected in the grounds. The hospital, generally, is a pattern of neatness and good order, and its condition is a certain proof of the interest taken in it by its managers and by the public; every part was thoroughly examined, including the out-buildings. A better larder appears to be required, and might be erected near the outer door of the kitchen, if means can be devised of excluding dust. The new official register of patients has been brought into use, and is carefully entered up. I examined the prescription-book, and also the daily list of stimulants issued. The amount of spirits and wine consumed appears to me to be large ; to-day the following have been issued:—wine, 300z.; spirits, 140z.; malt liquors, 8 pints. The provisions which I examined appeared to be unusually good. August 20th, 1884.

On Monday and Tuesday, November 17th and 18th, I inspected every portion of this hospital and its surroundings; I also saw every patient, and gave each one an opportunity of private conversation with me. I found beds occupied by thirty-five patients ; of these twentyseven were of the male and eight of the female sex, six of the number being young children. Regarding the suitability of the patients for hospital treatment, I have no fault to find. The whole establishment was in its usual good order, presenting an appearance of cleanliness and great comfort. Some complaints were made to me regarding the dietary; and as these were shared by a good many patients, I made particular inquiries into the matter. The bread, butter and milk I tasted, and found them perfectly satisfactory. The meat was represented to be of inferior quality, and badly cooked; there were also complaints as to the tea, and the want of variety in vegetables for dinner. I therefore made a point of being present at the next dinner, but was told that it was very good on that day. Some hints were made to me that extras ordered were either omitted or irregularly supplied ; and that opportunity was not afforded for complaining to the Visiting Committee. On representing the subject to three of these gentlemen it was flatly contradicted by them, and thoroughly disproved. I pointed out to them the necessity for a proper supply of vegetables, and was assured that they were purchased regularly. I also saw that the kitchen garden gave promise of a supply, having recently been put in order and cropped. It is my opinion that the above complaints are directed against the Matron, between whom, and the Resident Surgeon, relations are. very much strained. It certainly appears strange that I have never before had any complaint made to me on these matters, although several of the complainants are old residents in the hospital. The books were examined and found to be properly kept. I notice, with regret, that the consumption of extras, and especially stimulants, has lately increased. November 24th, 1884.

NASEBY. Ox the morning of April 27th, I made an inspection of this hospital. Since my last report, which was a very favourable one, matters here appear to have deteriorated. There have been changes in the staff; the Medical Officer having left, and the services of the Steward and Matron dispensed with, for reasons with which lam not acquainted. I cannot help connecting these changes with the appearances of neglect which are apparent in the establishment. It is, however, only fair to add that a liberal expenditure of money appears recently to have taken place, and that efforts are now being made which ought soon to regain for the hospital its former reputation for smartness and efficiency. The bedding is not according to modern notions ; but I learn that some new hair-mattresses have been purchased, as well as a Monckton's mechanical bedstead. There are some new paillasses in the fever ward, and I saw a number of new counterpanes in use. The pantry and bathroom, have been newly papered, and cocoanut matting laid down in the latter. The ceiling of the passage is very much stained and dirty ; badly requiring renewal also. In the wash-house I noticed a new enamelled iron boiler and a new wringer. The fever hospital has been cleaned and coloured, both externally and internally. Some progress has been made in removing from the garden the appearances of a period of neglect. I found the hospital well supplied with drugs and surgical instruments ; the latter in good condition. The register, prescription book, and case-book are properly kept, and the Medical Officer appears to be very regular in his visits. My enquiries show that maintanance-money is carefully collected ; there having been, during the last three months, only one " destitute " person under treatment. At present five patients, all males, are under care. They all expressed themselves to me as perfectly satisfied, and I could elicit no complaint. The largest number simultaneously treated since last report was nine. The whole of the work of the hospital is performed by the Warder and Matron, who are allowed the assistance of a paid washerwoman about once in a month. From what I have seen, I have no doubt that the next report of this establishment will be very good. April 27th, 1885'

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NEW PLYMOUTH. Considerable improvements have been effected at this hospital since my last visit of inspection. The detached cottage, formerly used as a ward for females, has been enlarged by the addition of two rooms, and now forms an excellent residence for the Steward and Matron. The old rooms (formerly occupied by these officers) have been thrown together; and, with an adjoining passage and storeroom, now form a capital ward for patients of the female sex, and also a surgery and dispensary. The old surgery is now occupied by a hospital-orderly. A quantity of new furniture has been purchased, viz : —Four iron bedsteads, four Eowcliffe's wire-mattresses, six palliasses, six hair-mattresses, blankets, two-rocking chairs, twelve Douglas chairs, and sixteen bedside cupboard-lockers ; all these articles were badly needed. A new wash-house has been erected, and also a bathroom and lavatory, as well as a detached closet for the use of female patients. Water is laid on from the town mains, and is available for fire-extinction now that 120 ft. of small rubber hose have been provided for that purpose. The total accommodation is now twenty beds, sixteen of which are for males and four for females ; the cubic space allowed being ample. At present seven males are the only occupants of the hospital—the lowest number for some time past. On examining the books, lam glad to find that maintenance-money is carefully collected here, the receipts last month amounting to £39 Is. Out-patients attend the hospital daily, except on Sundays. The hospital staff is unaltered since my last visit. I noticed great improvements in tha surroundings of the buildings. Much ground has been cleared, planted, and cultivated. All this work is performed by Mr. Drew, the Steward. The whole establishment I found in excellent order and scrupulously clean. A new range is required in the kitchen, and there should be a high-pressure boiler in connection with it. The colonial oven now in use is practically worn out. I had an interview with Dr. O'Carroll, who continues to give his best attention to the hospital patients. July 12th, 1884.

OAMAEU. Hospital inspected December 11th, 1884. Eight patients occupy beds to-day, three males and five females. One female died this morning. She had not been long in the colony, and was an invalid when she left England. The hospital is very clean and orderly, though somewhat bare of ornamental items. Some improvements have recently been carried out, one of which is the establishment of telephonic connection with the Exchange during the day, and with the Medical Officer's residence at night. Some additional furniture has been procured, and also a so-called portable bath, on wheels. This is both too cumbrous for the doorways, and too capacious for the present very limited supply of hot water. Money would have been better expended on a good kitchen range, with high-pressure circulating boiler. This is badly wanted. The feverhospital is empty, and I learn that very few cases of infectious disease have been under treatment this year. The books are properly kept. Very little maintenance-money appears to be forthcoming, the patients, as a rule, being too poor to pay. The grounds furnish excellent pasturage for three cows, which yield at present an abundant supply of milk and butter. December 11th, 1884.

PATEA. There are to-day two patients in the hospital, one of either sex. The man suffers from paralysis, of long standing; while the woman has angular curvature of the spine, for which she is under surgical treatment. Since my former visit the wards have been neatly papered, and the chimney in No. 1 has been boarded round and provided with a mantelpiece. The top of the staircase has been partitioned off from the top floor, and provided with a door. The result of these improvements is a great diminution of draughts in the wards, which have, moreover, an appearance of greater comfort than formerly. I noticed a number of illustrated papers here (a recent gift), and learned that two daily newspapers are also presented. The exterior of the building requires to be painted, and an inexpensive drain would prevent the flooding of its foundation by the overflow from the rain-water tanks. Although the establishment is kept clean and in good order, it has a poverty-stricken appearance. Some better bedsteads, bedding, and furniture should be procured by instalments, I had the opportunity of a conversation with Dr. Keating, the visiting medical officer, who evidently gives his best attention to the patients. The nursing and domestic work are performed by the Warder and his daughter. July 11th, 1884.

PICTON. This hospital has been put into good and substantial repair since my last visit. The bridge over the creek, which forms the only road of approach, has been entirely rebuilt. New piles have been placed under the building, and the whole of the flooring of the lower storey has been removed. This work appears to me to be well done. Upstairs, the Warder's room has been enlarged, and a new door inserted, as suggested by myself in a former report. A new boiler has been fitted to the kitchen range. There are to-day five patients resident, all of the male sex. Only one of these is a proper hospital case, the others being suited for a "refuge." Nine

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patients have been under care at one time during the past year. No females have been admitted. Mr. and Mrs. Bowden have been appointed Steward and Matron since my last visit. It is only just to them to say that the hospital has in no wise suffered from the change ; on the contrary, it is maintained in a most praiseworthy condition of order and cleanliness throughout. The garden is well cropped with vegetables, and one pig is kept. The only assistance given to the Matron is the service of a woman, three days in each fortnight, to assist in washing and scrubbing. I noticed a good stock of blankets and bed-linen, but there is a deficiency of shirts and other personal clothing for the patients. Complaints were made of the inferior joints of meat supplied, and of its poor quality. The meat is supplied under a contract, which will expire in March., 1885. The prices are 2d. and 2^d. for mutton and 3|d for beef. I have reason to think that there is good foundation for these complaints. The former contractor gave entire satisfaction. The Committee will doubtless give this important matter their attention. January Ist, 1885.

QUEENSTOWN. The hospital at Frankton contains to-day nine male patients and one of the female sex. One or two are suffering from chronic ailments, the rest having met with severe accidents, or awaiting surgical operations. The average number of patients under treatment during the past year is between ten and eleven. Seventeen have been resident simultaneously. A large, mining district is served by this institution, in w Thich much local interest is taken. Subscriptions and maintenance-payments are carefully collected. The amount received last month being £26 2s. I saw all the patients separately, and found them very grateful. Dr. Douglas, the Medical Officer, is held in high esteem. Making allowance for the old and dilapidated state of the buildings, I found all in good order and very clean. Since my last visit a new ward for females has been erected. It is intended that this shall eventually form one block of an entirely new hospital. The ward is intended for six beds, but is large enough for eight. It contains two small rooms at one end, which will serve for a nurse's accommodation and a private ward. At the other end are bathrooms and closets, divided from the ward by semi-circular and somewhat intricate intercepting lobbies. The walls of the ward will have a wood dado, with plaster above, and a wood ceiling. This kind of construction is unnecessarily expensive. If plaster is to be used at all it should have been continued down to the floor-line. No doubt the ward will be an excellent one; but I have advised the committee that it will not be prudent to follow the prepared plan for completing the hospital in the same style of building. Nor do I think the proposed disposition of the wards a good one for so excellent and extensive a site, and so favourable a climate. It appears to me, also, that the working of such an establishment would necessitate a large staff of nurses or servants ; and the central, or administrative, block does not furnish adequate accommodation. I have therefore prepared an alternative sketch, which meets with the full approval of the committee and the Medical Officer, and which, in addition, to being more economical, both in construction and working, will permit of the gradual completion of the hospital, and the utilization meanwhile of the older portions of the building. As matters now stand, the new ward will be almost useless. I therefore recommend the erection forthwith of the central block, for which a grant of money should be made by Government. When this is done, the small cottage, now occupied by the doctor, will be available for treating isolated patients. December 6th, 1884.

EEEFTON. I visited this hospital on Monday, December 22nd, 1884. Mr Preshaw, the secretary and steward, was present, and gave me all necessary information. There were only three patients resident, all being the male sex. I learn, however, that three others were very recently discharged, and that eight have been under treatment together upon one occasion. The three to whom I spoke, told me that they were perfectly satisfied. For order, smartness, and comfortable appearance this hospital takes rank as one of the best in the colony. The bedding is particularly good, and a profusion of pictures and other objects of interest adorns the wards. I notice with approval that a " push," over every bed, communicates with an electric bell in the steward's room. A new woven-wire mattress, and other things of useful character have been procured. Out of doors, I saw a new pan-closet lately erected for the use of female patients. The pathway from the road to the hospital has also been neatly fenced on both sides. The gardens, both for flowers and for vegetables, are in most creditable order. The dispensary at present is placed in a portion of the mortuary, divided off by a partition. The situation is not a convenient one, and no accommodation is provided there for out-patients. It appears to me that the central and oldest portion of the hospital should be rebuilt, with the view of remedying these defects and also to provide better accommodation for the steward and matron. I find the books well kept, and financial matters carefully looked after. The amount of donations and subscriptions average £300 a year ; entertainments produce £120 more ; and church collections some £20. About £120 annually is paid for maintenance by in-patients. No chronic cases are now in the hospital. Death appears to have been busy here with this class of late. No cases of fever have required treatment this year. The hospital evidently is carefully worked, and its managers are deserving of encouragement in their labors. December 22nd, 1884.

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EIVEETON. Tins hospital was visited in December 2nd, 1884. I found four beds only occupied; all the patients being of the male sex. The Eegister shews that on October 28th, last, there were thirteen under treatment. The comtemplated additions to the buildings have not been made for want of funds. The female ward (now empty) contains four beds, but is only large enough for two. It is evident that more accomodation is necessary in this part of the Colony; but, with an accelerated train service, Invercargill Hospital might very well serve for many of those now treated at Eiverton. I found the whole establishment in good order, the bedding being particularly clean. There is an abundant stock of blankets and sheets; the latter now being used on all the beds, which was not formerly the ease, owing to the reluctance which some of the patients showed to using them. I questioned the patients as to their comfort and treatment, and obtained satisfactory replies. Dinner to-day consists of roast mutton, baked potatoes, and maizena pudding. All the four patients are proper hospital cases. The grounds are neatly kept, and the kitchen garden is well-stocked with vegetables. December 2nd, 1884.

BOSS. I have to-day inspected the hospital at Boss, where I had the advantage of meeting with the President, Mr. Malfroy, and the Medical Officer, Dr. Collins. There are three male patients now under treatment; the number is usually higher than this, and often reaches six or seven. lam glad to notice that this hospital has exhibited marked improvement since my first visit, about two years ago. It then had a most poverty-stricken and neglected appearance ; now, it is quite evident, however, that considerable interest is taken in the institution both by the Committee, the Medical Officer, and the residents of the district. Everything is changed for the better, and there is an appearance of smartness, comfort and cleanliness, which was absent on my former visit. A small Government grant, for repairs and alterations, had been very judicially expended, and made to go a very long way. The whole interior has been lined, painted and papered. The accident ward has had a large window put in, which is a matter of some importance, as the room also serves for operations. The female ward has had the partition removed which divided off a portion for a dispensary. The ward doors have been covered with baize. The kitchen is materially improved by an alteration made in the chimney. This has remedied the smoke and consequent dirt, formerly complained of. A good sink has been put up in the scullery, a small extension of the building, and a portion of the old disused dispensary^ provides two very suitable rooms for the Warder and his wife. The verandah has been re-floored and repaired. The whole exterior of the hospital is now well-painted, and in excellent repair. A good surgery has been made of a detached building, formerly used as a sitting-room by the Warder; and the mortuary and adjoining closets have been removed to a more suitable position than they formerly occupied. Finally, the premises in front and behind the hospital, have been levelled and gravelled; the whole being now enclosed with an excellent palisade fence. It still remains to re-build a portion of the Medical Officer's residence, which is absolutely unsafe from decay of the timbers. I strongly recommend an immediate grant of money for this purpose. There can be no doubt, from what I saw, that the patients are well and kindly treated here, and that the hospital is now in very good hands. December 19th, 1884.

EOTOEUA. On the 9th of August, 1884, I inspected the Sanatorium, the various buildings recently erected, the hot baths, and the land set apart for the township. The " Eefectory " contains a large room for meals, with kitchen, pantry, and scullery; above the latter are two bedrooms for servants ; in front are two ante-rooms, one of which will be used as a waiting-room, and the other as a dispensary ; above these is an office. The building has not yet been completed, the cement floor being still wanting, and the porch is unfinished. There is as yet no water supply. Eain-water tanks, either below or above ground, remain to be provided. I noticed several minor defects in the buildings, one of which is the faulty construction of the dining-room windows, which are so planned as to be incapable of being entirely closed. This matter will require alteration, as the situation is by no means a warm one at certain seasons of the year. The scullery is papered, and will soon be much disfigured unless varnished also, or provided with a wood dado. Near^'the back of this building is a two-roomed cottage, which will be useful as a store. On either side of the refectory a " hospital building" has been erected. Each contains a central sittingroom, opening into which are six small bedrooms. There is a small lobby, but no back entrance through which to carry away slops, etc., or to serve for access to the closets at the back of the buildings. There is also the want of a covered way or verandah, connecting the hospitals with the refectory, and which would be very desirable in rainy and inclement weather, in addition to forming a convenient place for convalescents to sit in. Begarding means of drainage, the sinks run at present into a bottomless concrete tank of small size. Whetherthe fluids will percolate away without fouling the springs remains to be seen by experience. I noticed several of the

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floors covered with soot, which had been washed down the chimneys during heavy rain. Mushroom tops should be fitted to prevent this occurrence. No furniture appears to have been provided for the hospitals. The tables for the dining-room are at present made by the foreman. Five cottages have been purchased, and three of them removed to the Sanatorium, two still remaining at Ohinemutu. I have no doubt that all will at once be needed when the bathing season commences. At the bathing-pavilion a number of improvements and additions have been made. The "Priests Spring" now supplies a large open air-bath for ladies. This has not yet been enclosed. It is constructed of concrete, which does not appear likely to be a successful material, being already somewhat corroded. The water here is not so hot as in the gentlemen's bath, seldom exceeding in temperature 90deg. Fahrenheit. Two small baths are also supplied by the same spring, and are available for special cases requiring separate treatment. A large tank not at present used, but always full, might be, at small cost, enclosed for the use of the Maoris. Eegarding the " Madame Eachel " Baths, the one in the open air for gentlemen is unfinished. Considerable difficulty has occurred in the conveyance of the water from the spring and the cooling-tank to the pavilion. Earthernware glazed pipes, procured in Auckland, proved a complete failure, rapidly splitting in numerous places : (I am disposed to question the goodness of their quality). The pipes have now been under-pinned with stones, and thickly incased with cement. Numerous cracks, however, have given trouble, and it is very doubtful whether the work will ever bear the pressure of water which is requisite. At present it has not been tested fairly. At the pavilion itself, one 2^-inch galvanized iron barrel has been fitted with brass stop-cocks to supply the water from this conduit to the various baths, and this material seems likely to last for a reasonable period. It is, moreover, proof against earthquake shocks, of which there were six occurrences a few nights ago, and which must render the use of cement unreliable. I therefore strongly recommend that a duplicate main of galvanized iron be at once laid from the " Eachael" spring to the pavilion (a distance of about two hundred yards), and there joined to the existing iron supply-pipe. In the not impropable event of a breakdown during the bathing season, the disappointment to invalids from distant parts of the world would be both cruel and unjustifiable. With increased facilities of approach now existing, a large number of visitors may be expected. These visitors constitute the best advertisement which the Sanatorium can have, but if they go away disappointed and unrelieved, an injury will be done which many years will not efface. I heard reports in several places in the North Island that some of the baths had been ruined, and that it was contemplated to abandon them. No doubt these rumours originated with interested parties, with whom the " wish was father to the thought;" but they will have a semblance of truth unless accident be guarded against, and unless the works, now in abeyance through financial depression, be speedily brought to completion. Considerable difficulty occurred in the month of March last, when fifty-two baths were given daily to visitors for one week. This number may be largely exceeded during the approaching season, and provision should be immediately made for dealing with it. I noticed that a " tennis ground" was in course of formation by the " local board," who are also making arrangements for planting the township with trees. Those which have been transplanted from the beds of seedlings have all done well. A valuable supply remains in the beds, but the plants are becoming damaged for the want of space, and the services of the gardener have been dispensed with, which appears to me to be a matter for regret, and likely to occasion the loss of valuable stock. His services are also needed for stocking a vegetable garden, without which, no supplies will be obtainable at any nearer distance than Tauranga. The two above-named springs are, at present, the only ones in use. Others in the immediate vicinity of the Sanatorium possess good reputation and still remain to be dealt with. Since my last visit, the Post and Telegraph Office, with other buildings, have been erected on the township. There is also a commencement of private enterprise apparent; a row of cottages already affords accommodation to two private boarders, and a " temperance " boarding-house is to be erected immediately by the same proprietor, nearly fronting the present residence of Dr. Lewis, the Eesident Medical Officer. From the constant inquiries made as to accommodation, I should judge that this venture, if properly conducted, cannot fail of success. 1 had the advantage of a long interview with Dr. Lewis, who gave me much valuable information, and appears sanguine as to the ultimate success of the Sanatorium when once fairly started. Hitherto, the appliances at his command have been rudimentary and imperfect. August 19th, 1884.

I have been occupied during the whole of this day in visiting and inspecting the Eotorua Township and sanatorium, with the various buildings recently erected thereon. It is greatly to be regretted that all Government works have been at an entire standstill since my last report. Instructions have, however, recently been issued to make arrangements for receiving hospital patients, and to extend the bathing accommodation. Private enterprise is beginning to awaken also. A temperance boardinghousp is in successful operation close to the bathing pavilion, and the rooms become occupied as fast as they can be finished. I met with two proprietors of town sections, who had come to look after their property, with an apparent view to its development, and I shall not be surprised to see a good hotel erected here at no distant date. Meanwhile the hotels at Ohinemutu are crowded with tourists and invalids, while twenty of the latter class are residing in " whares "at Whakarewarewa. The journey hither, via Cambridge, is now by no means a difficult one, and, with increased railway facilities, a prodigious influx of visitors may

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be expected, with a corresponding growth of the township. Although a large number of persons bathe elsewhere than at the Pavilion, yet the receipts have more than doubled those of anyprevious year, and on one occasion no less than fifty-nine baths were given in one day. The visitors, as before, hail from all parts of the world, and are of a class to benefit the colony by a liberal expenditure of money. Every facility and encouragement should therefore be accorded to them ; for, if well treated and benefitted by their trip, they become the best advertisement which could be devised for the Sanatorium. With regard to the hospital arrangements, I fear that another season must now be lost before patients can be admitted. No furniture has yet been procured, and certain modifications of the buildings are very desirable, and, in fact, almost necessary. These buildings were, in a measure, intended for the use of visitors, who might hire the cottages, and obtain their meals at the Government Eefectory. It is now, however, contemplated to devote them altogether to hospital purposes, leaving it to private enterprise to cater for the public. This, I feel sure, may safely be done, and the whole of the existing buildings will be needed for special uses. It is proposed to erect two additional " Priest's " baths on the shore of the lake, where a good deal of hot water now runs to waste. One of these will be set apart for the Maoris, in accordance with the terms of their agreement. The swimming-bath, called the " blue-bath," will be improved, and rendered more private. Several other springs and mudholes might, without difficulty, be utilized. A hot water supply from the " Kachel" spring is to be conducted to the laundry. This should be done by means of an iron tube, which could be cleaned or renewed at comparatively small cost, and which might be useful in drying the towels. A branch from it could also be led through the second " Priest's" bath, which is too cold for use, and has never been enclosed. In view of the annually increasing number of visitors, no time should be lost in rendering every spring and bath serviceable. It will be necessary to provide at least two light wheeled-chairs for the purpose of conveying crippled patients from the hospital to the Pavilion and back again. A tar pavement track should be laid down for them to travel upon. In the course of my visit I noticed some patients who had been sent to Eotorua suffering from diseases which could in no way be relieved by such a proceeding. The journey with some of them must have been most irksome and painful. It is very desirable that a pamphlet be issued, pointing out such affections as experience has shown to be either cured or mitigated in severity by these baths, and also pointing out the folly of sending incurable patients here to die, as I fear is sometimes done. The necessary statistics will be difficult to procure, as many of the visitors never come in contact with the Eesident Medical Officer. Either they have resolved, in the choice of baths, to act upon the advice of their local practitioner, or, as is frequently the case, they simply follow the practice of some friend or neighbour who has previously found relief, often from a totally different complaint. That the baths exercise a good effect over a very wide range of diseases, I get additional proof on every visit. Dr. Grinders, the recently-appointed Medical Officer, is likely to assist very materially in the development of their good reputation. March sth, 1885.

THAMES. I inspected this hospital (at Grahamstown) on February 24th and 25th, 1885. Since my last report, important additions have been made to the buildings, a large ward having been erected for the accommodation of about eleven beds for surgical cases; and also a smaller isolating ward, and an operating room. The surgical ward measures about 41ft. by 21ft., and is 12ft. in height to the ceiling. It is lighted on two sides by six large sash-windows. These, with ventilators in the ceiling, will probably suffice to remove any vitiated air; but Tobin's tubes can easily be added if additional ventilation be found requisite. There is a large grate at one end of the room for a coal fire. The walls are plastered throughout, as also is the ceiling. The floor is of sound kauri timber. The operating room is accessible from this ward, across an entrance passage, by double doors. It is sufficiently large, and well lighted from above. The small ward will be found very valuable at times for troublesome or noisy patients. A small projection from the new building contains an earth-closet, with a swing-window. This will probably require additional ventilation, and would have been all the better if it had been built with a small intercepting lobby. At present the new rooms are not available for use, owing to the want of painting, distempering, gas-fitting, water supply, and furniture. I strongly recommend that the centre of the floor in all the rooms be covered with good linoleum floor-cloth, and that iron bedsteads, with woven-wire mattresses, be supplied throughout. These are both cheaper than, and far preferable to, any other serviceable kind, being practically indestructible. The walls should be well painted dado-high, and coloured above. The older portion of the hospital is quite fall, the total number now under treatment being twenty-three. Some three or four of these are old chronic cases. I spoke to them all individually, and found them perfectly satisfied. The establishment is in excellent order throughout; and, in this respect, presents a great contrast to the state in which I found it two years ago. I spent some time in examining the various books kept by the steward and dispenser. These show at a glance the expenditure upon all items of housekeeping. Great care is evidently taken to promote economy; the cost, of each patient, apart from salaries and medical extras, not reaching 9d per day. The appearance of " smartness," everywhere apparent, reflects the greatest credit upon this officer and the staff who assist him. The

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garden is, as usual, well kept, but a bad season for fruit and vegetables has rendered it less successful than usual. The keeping of pigs (within the borough) here has been prohibited. I paid a visit to the refuge, which might well serve as a model for other towns, both as regards arrangements and comfort. The meals are now conveyed hither, from the hospital kitchen, in a well-contrived enclosed waggon. The fever hospital at Parawai was also visited by me, but found untenanted. No patient appears to have been received here during the last twelve months. February 26th, 1885.

TIMARU. I have, this day, visited the Timaru hospital, and made a complete inspection thereof. There are now fifteen male and ten female patients in residence, twenty of whom may be regarded as proper subjects for hospital treatment; the remaining five would be more appropriately housed in a Eefuge. Every patient had the opportunity of speaking privately to me. All I found to be perfectly contented with their treatment and surroundings. In this establishment the indefatigable Steward, Mr. Jowsey, has always some improvements in hand; he is now occupied in renovating and decorating the wards and adjoining rooms. One of the large wards, with its belongings, has just been finished ; the floor is in splendid condition, and the walls are painted, stencilled and distempered in a most elegant manner; in fact, I cannot call to mind anything so pleasing and good of its kind, in the Old Country. The female ward is at present undergoing a like process ; the expense of the work being defrayed from a small endowment fund. Meanwhile, Mrs. Jowsey, the Matron, has been engaged in collecting a sum of money, with the view of purchasing some more luxurious furniture for the patients' use. Her fund already exceeds £83, and it is hoped that £100 will be reached. It is scarcely necessary to remark that, under the management of persons so deeply interested in its welfare, the whole establishment was found in the best possible order and scrupulously clean. The grounds are beautifully kept, and the garden gives promise of an abundant supply of vegetables and fruit. A better day-room is required for the convalescent patients, and the erection of a proper mortuary should be no longer delayed. The hospital affords accommodation for patients far in excess of its present number, and should be made to serve for a larger district than is at present the case. Dr. Drew continues to have the medical charge, and gave me all the information I needed. The main-tenance-money collected, has not amounted of late to so large a sum as usual, but it is well looked after, and obtained whenever possible. November 27th, 1884.

WAIMATE. ,On my annual visit of inspection to-day, I find that there are six patients under treatment, all are of the male sex, one being a little boy, who is watched over by his sister. All are proper cases for treatment; although one, a boy with disease of the hip-joint, has been resident here since the year 1879. The largest number treated at one time, since my last report, was fourteen. It is scarcely necessary to remark that the Steward and Matron, Mr. .and Mrs. Pettit, continue to maintain the utmost order and cleanliness in every part of the hospital, which has a most comfortable appearance. The Steward is constantly looking out for new apparatus and furniture for the comfort of his patients, and is very successful in procuring private subscriptions for this puipose. I noticed an ingenious mechanical bedstead, procured from America ; an invalid-lift, several reclining-chairs, and some convenient out-door seats; all supplied since my last visit. Another bedstead, the invention of Mr. Pettit, serves many purposes; and, though somewhat cumbrous in construction, exhibits considerable ingenuity. The large male ward has recently been cleaned and painted throughout, as also the kitchen and scullery. This latter portion of the building might, with advantage, be shut off from the rest by folding doors. The ward for females would also be improved by cutting a door-way into the adjoining nurse's room, in place of the present small window. Upon the roof of the hospital are four revolving ventilators; one only of these is connected by a tube with the opening in the ceiling beneath it. This defect should be remedied. The wards are well supplied with cut flowers, which are brought weekly by the pupils in the third class of the public school. The fever hospital is a very well arranged one, and is kept in constant readiness for use. Some cases of measles and erysipelas have recently been treated here, but it is not at present occupied. Some improvements have been made in the grounds ; small lawns have been laid down behind the hospital, and two paddocks, well fenced off in front. Here a cow is kept, which supplies abundance of milk to the hospital; the cost of its purchase was borne by the Steward, The registers are properly kept and maintenance money collected whenever practicable. April 25th, 1885.

WAIPAWA. The Waipawa County Hospital was inspected by me on Sunday, August 17th, 1884, and again visited on August 19th. I found thirteen in-patients under treatment, of whom eleven were men,

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and the other two little girls. The register shows that on June 30th last, the patients numbered fifteen. The whole of the accommodation available for males is now occupied, and it was found necessary this day to refuse admission to a new applicant for admission. One small ward contains three beds, and must be pronounced overcrowded. I made particular enquiries respecting each patient in the hospital, and found that all belong to the district for which it was instituted, and which appears to be an extensive and important one. I may add that one man only belongs to the "refuge" class, and it would be well if he could be boarded elsewhere. All the other patients were likely to benefit by hospital treatment; and several of them were suffering from the results of severe injuries. It thus becomes evident that some enlargement of the hospital will be required at no distant date. The excellent detached ward for infectious diseases I found in perfect readiness for occupation, each bed being made up as if in use. It has not hitherto been required for its special use. The whole hospital is kept in excellent order. It has an appearance of comfort and cheerfulness, and possesses a wide-spread good reputation. I had the pleasure of a conversation with the treasurer and secretary during my visit. The interest which he takes in the institution is unabated. The staff consists of Mr. and Mrs. Putnam and their daughter. Of their industry, ability, and kindness I have formed a very high opinion. Several small improvements are noticeable since my last visit. A corner-cupboard for medical appliances has been fixed in each of the two large wards; a lobby, with a good cool safe, has been erected outside the back door, near the kitchen; and two additional rain-water tanks have been erected for supplying baths. The surgery and dispensary has also some additional appliances. The erection of a properly-constructed padded-room is under consideration. August 19th, 1884.

WANGANUI. My periodical visit to the hospital was paid this day. There are now twenty-two patients resident, nineteen males and three females. Several of the former belong to the chronic class ; and it was recently found necessary, owing to the presence of a case of fever in the hospital, to board out four of them for a time, at a cost of £1 each weekly. No other patient appears to have been under treatment for fever since my last visit. All the patients had some conversation with me, and I received no complaint whatever. They are evidently kindly cared for. Dinner was served during my visit, and was liberal in quantity, and well cooked. I have very little to add to my former statements regarding the hospital. Small improvements continue to be made, but I hear nothing of the entirely new establishment which has long been contemplated and is much to be desired. A lavatory and w-ater-closet has been erected in a lobby adjoining the small central ward. A substantial fence has recently been provided at the boundary of the estate on three sides. In the back fence are gates near the mortuary, which might now with advantage serve for the town as well as the hospital. Some important additions (including a steam-spray apparatus) have been made to the stock of surgical instruments and appliances. The kitchen has been improved by the erection of a large sink and plate-rack. All the establishment is in good order, very clean and free from bad odour. The bedding is well looked after, but some better bedsteads and mattresses should be procured by degrees. The exterior of the older portions of the building requires to be painted. Frequent visits appear to be made by the committee. The whole of the nursing and domestic work (except the washing) is performed by the warder, with the assistance of his wife and a young man. No doubt can be entertained of their industry. July 10th, 1884.

WELLINGTON. I have been engaged in my inspection of this hospital on August 29th, September 2nd, 4th, sth and Bth, 1884. At the present time workmen are engaged in painting, white-washing and staining the wards and corridors, which had not hitherto been finished since they left the builders' hands. The result, when finished, will be very good, both as regards appearance and sanitation. In view of the latter, opportunity is being taken for improving the ill-contrived and badly-constructed urinals, which have given constant trouble during southerly winds. The absorbent concrete floors and plastered walls are here being covered with lead, and other improvements carried out. The adjoining earth-closets will be rendered more wholesome by discontinuing the use in them of spent gas-lime; a material offensive in itself, and possessing no virtues as a deodorizer or disinfector. Considerable difficulties have occurred in keeping one of the large wards empty for painting, and it has been necessary to place thirteen beds in the detached fever ward, to occupy the men's dining-room as a dormitory, and to use, for a like purpose, one of the nurses' rooms. Three of the wards may now be considered as finished. The walls have been painted, the ceilings white-washed, and the exposed portions of the floorsstained and waxed, or varnished. Coal-grates have been fixed in the hitherto open fire-places.. Two of the verandahs in the central courts have been taken down, thereby admitting more light and air into the adjoining wards, which have a much brighter and more cheerful appearance than formerly. A number of other improvements have been effected since the date of my last report; the most important of which is the erection of bath-room, box-room and closets for the 3—H. 18a.

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use of the nurses. The linen-room has been removed, and a small store-room in front of the hospital adapted for this use. A sink, with hot and cold water supply, has been fixed in the nurses' dining-room. Commodious and handsome ward-tables, serving for a variety of uses, have been procured ; fifty feather pillows have been purchased, and other small additions made to the ward-furniture. In the lavatories shelves have been fitted up for pails and utensils. Telephonic communication has been established with the Exchange. Making due allowance for the confusion incidental to the presence of a number of workmen in the building, the whole establishment wa_s found in excellent order; good discipline and perfect cleanliness prevailed. The bedding was seen to be very good and well-attended to. I found, on the Bth of September, seventy-seven patients occupying beds; viz., fifty-seven males and twenty females, and I made particular enquiries respecting each of them. At least, twenty-five of the number are improperly kept here, being proper subjects for a Refuge. The embarrassment caused, and positive injury done, by sending persons of this class to the hospital, cannot well be over-rated. Three of them were taken in (upon orders), last week. They, themselves, derive no benefit from medical treatment, and the over-crowding caused by their presence seriously prejudices the chances of recovery of those who are really ill. There is now, not one vacant bed in the hospital; consequently, patients who might be benefitted by admission must be refused. Judging by the growth of this evil of late, it cannot be very long ere the whole hospital becomes a gigantic alms-house. In the event of a fever no ward is available for special use. I conversed with all the patients separately, receiving no complaints, with one exception; a male patient, convalescent from preventible disease, complained that he had been asked to employ himself. He appeared to me to be perfectly able to work, and I found that one of the honorary staff took the same view of his case, and discharged him the next day as " recovered." On the other hand I received a good deal of testimony as to kind and skilful treatment. The system of nursing continues to be very successful. The nurses evidently take great interest in their occupation, and vie with one another in making their wards attractive looking. I noticed a profusion of cut flowers on each day of my inspection. The detached fever ward is crowded, as above stated, with chronic cases ; thirteen being placed where proper space exists only for ten beds. It has been found necessary to remove the wooden partition which formerly divided and spoiled this ward. This building has never yet been white-washed or painted, and no arrangement has yet been made for carrying out this important work. A vast deal of work has recently been done towards bringing portions of the estate under cultivation, and in planting trees and shrubs. Those of the patients who could work have been thus employed, with advantage to themselves and to the hospital. The road-way from the bridge to the gates has been metalled and put into excellent repair by Asylum labour, given in exchange for pig's food. That portion of the road which belongs to the City Council is in very bad order, and must be very trying to patients when conveyed over it. Attention has been drawn to the matter by the Medical Officer. A great deal remains to be done before this hospital can be considered complete. Accommodation for both sexes suffering from fever; additional, and better rooms for the nursing staff; a better system of hot water supply ; these are the more important matters. Others of minor importance comprise a vegetable room, a better meat safe, a work-room, &c. Enquiries made show that, under better regulations, a considerable diminution has occurred in the number of out-patients, whose tickets now hold good for one month only. Eleven attended to-day. The consumption of stimulating alcoholic liquors is very large. The following have been issued to-day:—port wine, 65 ozs.; brandy, 28 ozs.; whisky, lOozs.; gin, 16 ozs.; ale (draught), 1-J- pints; stout, (bottled), 1J pints. Considering the small number of bona fide hospital patients, I regard this list as excessive. The dispensing of prescriptions is now almost entirely done (under the supervision of the Medical Officer), by a female nurse. I satisfied myself, by examining her, that she _is competent for this duty; and the knowledge which she has gained of drugs and their uses is most creditable to her. Several changes occurred in the Eesident Staff shortly after my last report. Dr. Hammond was succeeded by Dr. Mackellar (temporarily), and afterwards by Dr. Keyworth, who has recently resigned the office of Eesident Medical Officer on account of his health. He is succeeded by Dr. Chilton, who shows much activity and zeal in everything that can conduce to the improvement of the hospital and the welfare of the patients. Mrs. Moore was succeeded by Mrs. Kissling, whose qualifications, as Lady Superintendent, are of a high order. September 11th, 1884.

I have this day inspected every portion of the hospital buildings with their surroundings; have inspected the stores and books, and have conversed separately with every patient, no hospital official being present at the time. Since my last report-, the whole of the interior has been cleaned and renovated. The wards are now painted up to their ceilings; and the floors stained and waxed, where not covered with linoleum floor-cloth. The corridors also have been painted and distempered, as well as the kitchen with its offices, and the bathrooms and lavatories. The result is very good as regards appearance, and cannot fail to be beneficial from a sanitary point of view. The wards have now a handsome appearance, to which their furniture and decorative objects largely contribute. A portion of a legacy from the late Miss Lewis has been judiciously expended upon some excellent invalid-chairs, a number of framed pictures, and some four hundred volumes of books. Other articles were procured from a " Christmas Gifts" Fund,

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to which a number of our citizens liberally subscribed. Ward tables of a very superior kind, and affording facilities for a variety of purposes, have been provided. The fire-places have had grates inserted in them for burning coal, and a number of other improvements have been made, not the least of which is the removal of two of the verandahs, and the admission thereby of more light and air into the wards. A profusion of cut flowers is constantly supplied by lady visitors. Everything here I found scrupulously clean and in its right place. The adjoining small kitchen and nurse's rooms are very neatly kept. The closets and urinals at the back of the hospital have been greatly improved. The walls and portions of the floor of the latter have been lined with lead (at my suggestion), the old concrete being absorbent, and giving off strong ammoniacal odours. The evil has been remedied in great measure, but it appears to be impossible (with the prevalent winds)-to prevent bad smells entering the hospital at times from these places, which were ill-constructed from the beginning, having no proper intercepting lobby with cross ventilation. A commodious carpenter's shop has been erected, principally out of old material. The grounds immediately in front of the hospital have undergone great change for the better. What was formerly nothing but a wilderness is now a well-kept garden, with lawns and flower beds. A great deal of labour has been devoted to this work, which has been carried out with very small expenditure. The grounds behind the hospital are kept in a more orderly way than was formerly the case, but there is a great scarcity of out-door labour for this purpose. There are this day sixty-nine in-patients under treatment, an unusually small number. Of this number nineteen men and two women are fit subjects for a refuge. Three of the male patients are suffering from delirium tremens, one of them being very violent and noisy. They all occupy beds in one of the large wards, to the disturbance and great detriment of the other patients. There is no separate accommodation for such cases, the private wards being occupied for other purposes, and not being suited for violent persons. One of the wards is used as a day-room for for the nurses, for whom no accommodation exists elsewhere. Two others are given up to the Lady Superintendent. I have before pointed out the want of a small addition to the hospital buildings for the purpose of supplying these deficiencies. With the above-named exceptions, the patients are all proper inmates of a hospital. That they are well treated and kindly nursed I have not the least doubt; indeed, I had the assurance of each individual to this effect. The amount collected for their maintenance is too small here, as elsewhere. The matter is one which would well repay improved legislation, and an approved system of collection. I have examined the stores supplied and the provisions, which are of good quality. There has lately been considerable extravagance in the kitchen department, to which attention has been directed, with promise of material reduction in expenditure. The consumption of alcoholic stimulants remains unnecessarily high. This is a matter which rests almost entirely with the Honorary Visiting Medical Officers. Dr. Chilton is at present the Kesident Medical Superintendent, and I have formed a high opinion of his abilities in this capacity. February 9th, 1885.

WESTPOET. This hospital was visited on December 24th, 1884. I found eleven patients resident, ten males and one female ; five of the former are " refuge cases." The total number of beds in the hospital is sixteen ; since my last report some important additions have been made to the building. These additions are intended ultimately to form the central part of a much larger hospital, and will comprise an entrance passage, with four rooms and a store. At present the new space provided in this building is occupied by four beds, the remainder serving as a convalescent dining-room. It is intended, when funds are available, to build a new large ward for each sex, and a convalescent-room. It appears to me, on looking at the plan prepared by the architect, that the space allotted to the female ward should be reserved for a new kitchen. This will certainly be required, and demands a central situation near the warder's and matron's rooms. In view of the large works shortly to be undertaken at the harbour, and of the existence in the district of large collieries and quartz workings, it would appear necessary to enlarge and complete this hospital. I therefore recommend that a Government grant be made this year, so that a further portion of the work maybe undertaken. The old building is in substantial repair, new piles having been inserted about six months ago; but the window-sashes will require renewal at no distant date. Internally, the appearance is bare and poverty-stricken. Very little furniture exists, other than the beds and tables. A mechanical bed, some few chairs, and a folding screen have recently been procured, but there is a great, want of furniture and decoration. In the kitchen an American range has been introduced, but there is no proper hot water supply ; and, if a bath be wanted, the copper in the wash-house must be brought into use. I noticed that an additional closet had been erected, but this is not properly cut off from the hospital by cross-ventilation. Means have also been taken for adding to the water supply. The garden is well kept, and vegetables are successfully grown by the steward's labour. Regarding the condition in which I found the hospital, I am glad to report a considerable improvement since my last visit. Everything was clean and in its right place. Sheets are not used upon all the beds,, some of the "chronic" patients beings allowed to sleep between the blankets. This practice is not conducive to cleanliness, nor does it save labour in washing. Tt has been abandoned in the other colonial hospitals, all of which now use sheets on every bed. I examined all the books, and found them properly kept. The consumption of stimulants has

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diminished, and does not appear excessive. Regarding financial matters, charitable subscriptions appear to have ceased, as might have been expected. No entertainments take place for the benefit of the hospital, and I only heard of one annual subscription with a view to its benefit. Maintenance money produces about £100 for the year. It will be necessary to provide an outfit of surgical instruments; with the increasing importance of the hospital the Medical Officer cannot reasonably be expected to supply them all. December 24th, 1884.

By Authority : OtEOkge Didsbuey, Government Printer. Wellington.—lBBs.