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To attempt to limit the spread of a disease so infectious as scarlet fever unless adequate means of isolation are available is as hopeless as the task urged upon Canute by his nobles. Compulsory notification, combined with strict isolation of the early cases, is the procedure we ought to be able to carry out, and this, I regret to say, has been impossible in any large centre with the exception of Christchurch, and there only after the epidemic was in full swing. The Public Health Act of 1900 cast the onus of providing for the care and treatment of infectious diseases upon the shoulders of the local authorities. This, I consider, requires alteration, and an amendment with the object of relieving local bodies of this burden has been framed for the consideration of the present Parliament. Hospital Boards are the proper agents to undertake this work, and I am glad to say that with one exception these bodies have willingly lent their aid, though even they are hampered in the work. The whole question of hospital-administration requires reconsideration. Greater powers should unquestionably be given to the Inspector-General, and I am pleased to see that the trend of opinion is in that direction. That the Government, required as it is by statute to provide half of the total expenditure on hospitals, should have absolutely no say in the spending of the money is ridiculous, and tends to extravagance. At present the Department has to be consulted as to plans, site, and cost of all hospitals for infectious disease, but something more is necessary. It should not be competent for the local agent, without restraint or supervision, to dispose of the moneys jointly subscribed by the general Government and the districts directly in receipt of the benefits of the hospital. To centralise the administration of general hospitals or hospitals for infectious diseases, except in special instances, as is done in many countries, is not always in the best interest of the institutions or the people occupying them. No sooner does the general Government take over the management than all local interest and enthusiasm in the institution ceases, with, as a consequence, many of the little luxuries which while permissible as private donations may not be justifiable debits to the State. It is only fair to put on record the great sacrifice of time, energy, and money which is annually being made in the prosecution and fulfilment of what in some instances is only too thankless a task by members of these boards. The only desire of the Department is to help them in the work. Small-pox. In the report which I had the honour to submit for your consideration last year attention was drawn to the unprotected condition of our children with respect to this disease It was pointed out that with the close and constant intercommunication between countries where the disease existed and our own colony it was improbable that we should continue to enjoy the immunity which we hitherto had. However careful the officers of the first line of defence might be, an accident was possible —a case might escape the cordon, and, before we knew, small-pox might have claimed its many unprotected victims. The picture which I painted has, unfortunately, been exhibited in Tasmania, and we ourselves narrowly escaped its reproduction in New Zealand. Protective measures, such as quarantine, inspection, and fumigation, however faithfully carried out, can never be regarded as an absolute safeguard. Vaccination alone deserves that title. A lengthened period of quarantine, or a very rigid system of inspection, may prevent a person suffering from the disease from entering the colony, or, if admitted, he may be detected and isolated ; but a system of disinfection has yet to be devised which will be at once practicable and effective. After all, the danger to be feared from infected people is much less than that from infected clothes. We endeavour, as far as we can, to disinfect all the personal belongings of passengers from infected areas, but we must not blind our eyes to the fact that the success attained in this respect is but a modified one. To thoroughly disinfect the clothing of all-comers from infected countries is, however desirable at the present time, a mere theoretical excellence. The Legislature has decided that the employment of the only consistently effective antidote to small-pox shall not be compulsory. With the wisdom of this I am not concerned. Legislation too far ahead of public opinion must, as was pointed out in my last report, be always unsatisfactory and difficult to carry out, and while any section of a community is logically convinced that the introduction of any particular enactment was wrong, it would be idle on the part of the Executive to bring it into force. From a very wide acquaintance with all classes in the colony, I have come to the conclusion, however, that much of the apparent antagonism towards vaccination is merely a matter of sentiment or want of knowledge. lam emboldened to affirm this, not only because of the opinions I have heard expressed, but because of the ready response there has been by the public to the

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