H.—7a

8

it formerly was. American cane-bottomed chairs have replaced the wooden forms in the wards, where I also noticed an excellent new six-fold screen on castors, and two new children's cots. In the male surgical ward a movable table, with spray-apparatus for washing wounds, has also been added. The consulting-room has been improved by the removal of the bookcases to the readingroom ; and case-books have been provided for use by the visiting medical and surgical staff. Telephonic communication now exists with the city, and thereby with nearly all the individual members of the staff. Warning of accidents is frequently given in this way, and preparations made accordingly. The utility of such a system might at some future time be extended by providing an ambulance-van, to be always in readiness at the hospital. Some outside painting has been done, the carpenter's shop enlarged, and some new gates provided for the garden. Forbidden articles were formerly often passed in here. The out-patients' waiting-room and consulting-room have also undergone improvements, though still not what could be desired, I found the patients very contented and comfortable. The wards, with their various offices, were scrupulously clean, and the bedding in good order. Tea was being served during my visit. The medicines are placed at the bedside of each patient, which is not a plan to be commended. Poisonous applications are kept in a locked cupboard. In some parts of the hospital the beds are too closely placed for safety, the lying-in ward being the most noticeable in this respect. Additional room is here much needed. The number of children who are to be seen in the hospital suggests the desirability of a special ward for this purpose. Another want is a proper hot-air disinfecting chamber. This might be an adjunct to the laundry, and used also in wet weather as an ordinary drying-closet. At the Cumberland Street laundry may be seen a construction which is very good for this purpose, and which has two drying-chambers. One only is here needed. The operating-room is small, and the light not very good. An ordinary daylight reflector suspended over the table at an angle of 45 degrees would much improve it, and might be close to the ceiling. I have examined the registers and other books, and suggested that some further particulars be recorded on the admission of each patient, which would be useful in establishing his identity in case of death. A monthly medical report is now presented by the Eesident Surgeon to the Committee, and contains useful information. Eepayments for maintenance and treatment continue to be looked after as before, the amount charged being 2s. 6d. a day, but to seamen 3s. The sum of Is. is also charged, where practicable, for each outdoor prescription dispensed : from this source about £10 10s. monthly is derived. The outpatients are carefully scrutinized. Thirty-eight were seen this morning. The total for last month was 705, and for August 755. The consumption of wine, spirits, and ale does not appear to be large at present. Only English malt liquors are used. The hospital is (in the absence on leave of Dr. Roberts) under the charge of Dr. Davies, who appears to be able and energetic in his duties. New rules have been made for the regulation of visitors, and for preventing the introduction of unsuitable articles of food and drink. It is certain that something was needed in these matters. Mr. Burns conducted me through this well-managed establishment, and gave me valuable information. I have a high opinion of his capacity for the office of Secretary and House Steward. sth October, 1883.

Visited 12th April, 1884. Found 100 patients occupying beds, viz., 71 males and 29 females. There was the usual proportion of chronic cases, and the above numbers do not include five old men who are boarded out at the cost of the hospital. Out-patients are seen daily. Under this category 300 new cases and 465 reapplications were dealt with during the month of March. All are required to sign a declaration of inability to pay for advice or medicine; nevertheless there can be no doubt that there is great abuse in this matter. All parts of the hospital were clean and in good order. The lying-in wards I found empty. These are improperly placed and ill provided. The single room for noisy patients is just opposite, and no bath-room exists. It would be well to provide a detached building for this special use. Dr. Davies continues to act as Resident Surgeon, in the absence of Dr. Roberts in England : of his zeal and efficiency there can be no doubt.

DUNSTAN. Every part of this establishment and its surroundings has been inspected by me this day. At present there are four in-patients, three males and one female, who is attended to by her daughter. All may be looked upon as chronic and incurable cases, with the exception of one who will shortly be discharged. One large ward is unoccupied except as a lumber-room. Here two cases of scarlatina have been treated since my last visit. The total number of patients in hospital at one time has not, since that time, exceeded nine. A few out-patients attend, and are prescribed for in a book kept for the purpose. The dispensing is performed by the Wardsman. All the patients told me that they were very well attended to, and made very comfortable. I was glad to notice a good many improvements. Some ornamental flower-beds have been formed, and some trees and shrubs planted : this will very much improve the look of the grounds. The hospital has been painted externally, and the male ward cleaned and coloured. The kitchen would be all the better for the same treatment. The water-closets have been converted into well-kept earth-closets, in which, however, dry ashes are used. Drain-pipes have been ordered for enclosing the open drain from the kitchen. A basketwork Bath-chair has been procured, and two good bed-rests. I also saw three very excellent hairmattresses, just procured and not yet used. The bedding and linen are of good quality, and this together with the whole establishment, I found very clean and orderly. Dr. Lewis has succeeded Dr. Wardale as Eesident Medical Officer. 12th October, 1883.