H,— 18b.

1885. NEW ZEALAND.

HOSPITAL MAINTENANCE AND MANAGEMENT (MEMORANDUM ON, BY INSPECTOR OF HOSPITALS).

Laid on the Table by the Hon. Mr, Stout, with the Leave of the House,

The Inspectob of Hospitals to the Hon. the Colonial Secbetaey. The number of the colonial hospitals is thirty-seven. None have been either added to the list or taken from it for several years, with the solitary exception of the Sanatorium at Eotorua. Some small additions have been made to the accommodation for patients at Gisborne, Hokitika, Invercargill, Kumara, Napier, New Plymouth, Queenstown, Tham.es, Wanganui, and Westport. In several instances the chief reason for providing a local hospital has been the want of a resident medical practitioner, for whom no sufficient inducement existed in the absence of a Government subsidy. It is scarcely necessary to point out that this is a very extravagant way of subsidizing a surgeon, to whom the salary paid is often quite disproportionate to the hospital work which he is called upon to perform. Setting aside this reason, which should scarcely be a matter for Government to consider, I believe that the following hospitals might, without inflicting any great hardship, be at once abolished —namely, Arrowtown, GreytoAvn, Patea, Picton, Waimate, Akaroa. Arrowtown is only about ten miles distant, by a good road, from the Frankton Hospital, which, with the alterations and additions now in progress, will amply suffice for the whole district. Greytown is within easy distance by rail of Masterton Hospital, which possesses ample accommodation. Patea is accessible by rail from both Wanganui and New Plymouth. A new hospital is required at the former town, and room can be provided for any cases from Patea. Picton Hospital patients can be all received at the new T hospital to be erected at Blenheim. Waimate Hospital is totally unnecessary. Abundance of vacant accommodation, of very superior character, exists at Timaru Hospital, within easy distance by rail. Akaroa Hospital is a mere offshoot of the institution at Christchurch, and is not wanted. - The expenditure upon these six hospitals considerably exceeds £3,000 annually, of which sum considerably more than one-half is contributed by the General Government. In the next category I place the following hospitals —namely, Charleston, Coromandel, Clyde, Kumara, Eiverton, Eoss and Waipawa. Some of these are very little used, while others are within reach of more important towns where complete establishments already exist. Upon careful consideration of their circumstances, it may be found practicable either to close some of these hospitals or to reduce the cost of their maintenance. Charleston has, upon my last two visits, been quite empty. A salary of £150 a year is paid to the visiting surgeon. Westport Hospital is about eighteen miles distant by road. Coromandel is within easy distance by water of Grahamstown and Auckland. There are usually two or three patients under treatment there ; the salary of the medical officer being £200. Clyde is within an easy journey, by road, of Cromwell Hospital. Kumara is about sixteen miles by tramway from Greymouth and twenty-two from Hokitika. At both of these towns complete hospitals exist. Eiverton is within reach of Invercargill by railway, and, though the journey is now a very slow one, this matter may be improved. Eoss is about twenty-two miles south of Hokitika, on a good road. There are usually only three or four patients here, for attendance upon whom the medical officer receives a salary of £200. Waipawa.—The patients now treated at Waipukurau Hospital might be sent by rail to Napier. It will be necessary to provide accommodation for a few additional beds at Cromwell, Hokitika, Invercargill, and Napier, if the whole of the above-named establishments be closed ; but if proper " refuges " be provided the increased accommodation need be neither extensive nor costly. Large districts of the colony are at present destitute of any hospital accommodation within reasonable reach. lam not in a position to judge of their requirements from my own knowledge ; but as population increases new institutions will be needed. In arranging for the future maintenance of the colonial hospitals several important matters demand attention : Firstly, the present want of any system of subsidizing is fast doing away with any local efforts to raise funds. In many places all charitable donations have long ceased entirely. Secondly, the provision of free hospital treatment by the Central Government is pauperizing the population to an alarming extent, and taking away inducements for thrift. Thirdly, extravagance