H.—3a,

14

register of patients is kept by the Medical Officer, and there is also a diary, in which are recorded the visits and recommendations of the Committee, with other matters. An inventory is well and regularly kept. A member of the Committee visits the hospital at least once a week, with great regularity. A. Church of England minister also attends weekly, but there are seldom any other visitors than the friends and relatives of the patients, and a very few presents are received. At the time of my visit there were three beds in the male division occupied, and a female was expected in the afternoon. Patients are admitted by an order from some member of the Committee, subject to the approval of the Medical Officer. Accidents are provided for without any formality. No fixed dietary is in use, but the meals are liberally provided and well served. A good detached ward gives accommodation for two or three infectious cases. Nothing could exceed the good order and condition in which I found everything pertaining to this institution, and which reflects the highest credit upon the Committee and the Medical Officer. The Steward and Matron devote their whole time and energies to their work, which they carry out with great ability. Of them the patients spoke to me very warmly, as regarding their kindness and attention. It is a matter for regret that so little is done by the town residents in the matter of visiting the hospital. I recommend that a kitchen range, with boiler, be procured, and that the building be painted externally. 11th December, 1882.

NAPIER. The hospital stands on very high ground a short distance from the town, and commands an extended view of the sea and the surrounding country. The building is constructed of wood, with an iron roof, and appears to be in good general repair. The grounds are well kept. There is a good kitchengarden, and a number of flower-beds and grass-plots. There is a large ward and a small private one for each sex. A room intended for the use of convalescent patients has also been converted into a fever-ward for males. The large wards are lofty and handsome rooms of great width. They are lighted by sash-windows, above each of which is a flap, opening inwards. Openings in the ceilings and vertical tubes assist in the ventilation. Gas is used for lighting, and an open fireplace in the end wall is intended to heat the ward. It is, however, ill placed, and its use necessitates the removal of a bed ; its influence is not felt at the outer extremity of the ward. Small projections at the corners of the outer walls contain closets and bath-rooms with lavatory basins; a small intercepting lobby, with cross ventilation, intervening between each of them and the wards. The beds are placed about two feet from the walls, so that access can be had to the patients on all sides. The floors are of plain wood, those portions behind the beds being stained and varnished. The walls are distempered in a pink tint, and the wooden ceilings whitewashed. No bedside or other carpets are in use in the large wards. There are iron bedsteads of a good and neat pattern. Well-made straw paillasses and hair mattresses, with chaff or flax bolsters and feather pillows, form the bedding. The bed-clothes are of excellent quality and scrupulously clean and well kept. Bedside lockers are provided, having a box above and a cupboard below. Small metal brackets are intended for the medicines; and a press contains the spare linen and appliances. Two good tables with American-cloth covers, a chair commode, and two or three Windsor chairs complete the furniture. More chairs are required, as many of the patients have no other seat than their beds. Good framed pictures adorn the walls, and numerous books and papers are in use. A general appearance of comfort and cleanliness prevails in these wards and their adjuncts. The fever-ward is not so suitable for its purpose, and has no closet or lavatory accommodation. When filled with patients suffering from typhoid fever there will not be entire freedom from risk of infection of nurses or others ; and it is quite unfit for the use of patients suffering from scarlatina. There are here five beds, three of which are occupied by cases of typhoid fever. The private wards (one for each sex) contain, each of them, a patient suffering from this same disease; they are comfortable and lofty rooms, with two beds, washstands, chest of drawers, tables, carpets, and various ornamental objects. Better provision for the isolation of those suffering from infectious diseases is a desideratum. The convalescent patients now take their meals in the servants' hall, which is a suitable room near the kitchen. Altogether there are now twenty-four patients in the hospital, with each of whom I had some conversation. No complaint whatever was made to me upon any subject. There is a deficiency of rooms for the occupation of the staff. A male warder sleeps with his patients; and the Matron occupies two rooms intended for ward-kitchen and nurses' room. Two rooms only are available for the Resident Medical Officer. A small room serves as kitchen and scullery for all the wards : there is here no proper convenience, and the place is dirty and untidy. Considerable allowance, however, must be made for this state of things, as a nurse and two servants have recently left, and have not yet been replaced. The kitchen is in good order; but, with its fittings, is inadequate for the cooking of so large an establishment. It will shortly be enlarged. The adjoining store-rooms are in the best possible order, and the supplies of good quality. There is here no Steward, but these departments are under the care of the MatroD, of whose capabilities I formed a good opinion. The operating-room, at the back of the hospital, is a small room with concrete floor, and has no fireplace. The dispensary is well stocked with drugs; surgical instruments are few in number, but a supply has been ordered in London. A good Board-room, near the entrance of the hospital, contains a very nice library for the patients' use. Here I inspected the various books and sheets in use. Prescriptionbooks for both in- and out-patients are carefully kept by the Medical Officer, who also performs the dispensing. General registers of patients and case-books are kept by him in a very careful manner. There is also a patients' property book, and a general inventory of hospital property, which last has recently been corrected by the, Matron. The sum of 3s. a day is charged to patients who can afford to pay, and are not subscribers to the hospital. Those who subscribe £1 Is. annually appear to be entitled to become'-in-patients or out-patients during the whole year without further payment. The diet-scale was inspected, and also good and well-kept tables of rations and extras. A detached building contains a small workshop, a capital washhouse and ironing-room, and a coach-house, used as a lumberroom. Near this is a small mortuary. Considerable storage is provided for rain-water, and the town