H.— 22a

6

not. No doubt the ground taken by the Board, after an inquiry had been held, was that Dr. Neil had approached its Chairman (Mr. Garland) about the'case. It also complained that the doctor had been absent from duty for seven days leave, in contravention of Rule 12. These grounds for dismissal were merely ostensible. There is in evidence a statement by the Chairman, made at a prior meeting of the Board, that if he were a member next year he would do his duty and move a resolution in the direction of getting rid of the honorary staff ; and it would seem, from the manner in which the inquiry was conducted and from the various reasons from time to time put forth by Mr. Garland for the dismissal, that it was determined on by the Board before ever the inquiry was held. In our opinion, the dismissal, assuming the Board had power to dismiss, was without any justification. Taking the view that Dr. Neil took of Wallis White's operation —a view which the evidence has borne out —it was not only the doctor's privilege, but his duty, to at once communicate with the Chairman ; and it must not be forgotten that the only justification for the Board's arriving at the conclusion that Dr. Neil was absent without leave was his omission to sign the honorary staff's attendance-book, as required by Rule 16, an omission which the doctor satisfactorily explained to the Board. Food supplied to Patients. A large number of the witnesses, having been patients in the Hospital, complained to us of the quality of the food supplied to them. They described the fish as frequently rotten and served with scales on, and the fowls served with feathers. Other patients, on the contrary, stated that the food was all that could be desired. We do not express any definite opinion as to the quality of the food. Its inspection is by Rule 68 cast on the Senior Medical Officer ; this duty was relegated by him to the House Steward. The Matron of the Hospital should, we think, be charged with this duty ; her knowledge of the requirements of the different wards would, we conceive, enable her to perform it satisfactorily ; and, moreover, it appears to us to be much more the province of a woman than a man to superintend the distribution of the food to the patients. Hypodermic Injections. It was proved that in one ward the male nurse or wardsman was in the habit of leaving open the cupboard containing poisons during his frequent absences, and that it was a common practice for one patient to administer hypodermic injections to others. Such dangerous carelessness deserves severe reprobation. Out-patients' Department. One of the complaints of the Auckland Division of the New Zealand Branch of the British Medical Association is that there has been a recurring tendency to the erection of an out-patients' department, in spite of the rules against it. There is no out-patient department at the Hospital itself. Rule 163, which deals with the matter, appears to be strictly followed. There is a pharmacy, which is situated about a mile from the Hospital, where persons of straitened means can attend and receive medical advice and medicines gratis. We think this is a very satisfactory arrangement, and that no objection can possibly be taken to it. The Maintenance of Clinical Records and other Books op Record connected with the Hospital. We find that most of the Hospital records and other documents produced to us in evidence were incorrectly and carelessly kept. The entries in the clinical record-books were of the most perfunctory character. In many cases the result of treatment is not given, there being merely an entry of the name and disease from which the patient was suffering. If operated upon, the word " Operations " appears ; the effects of the operation one is left to imagine. The best-kept books in the Hospital were those produced by the nurses. We forward as exhibits in this connection three record-books—namely, two case-books, marked respectively " 1, R. 8.," and " 2, R. 8.," and also what appears to be an ad-mission-book, marked "3, R. 8." The latter contains, on page 9, an entry of admission of Wallis White on the 18th May, 1904. Case-book 2, at page 146, under date 17th May, 1904, shows an entry —" White, disease necrosis, operation." There is no other entry in the name of White about that date. The Auckland Hospital Operation-book, attached hereto, shows, on page 79, the description of the operation on Wallis White. The duration of the operation is there stated to be forty minutes ; the actual duration of the operation was 120 minutes. In Case-book No. 1, at page 10, is the entry of the case of Maud Mclndoe. The particulars are entered in two different handwritings. The description of the disease, " fibroid tumour," which appears to be in the handwriting of Dr. Collins, and must have been entered after the operation, is shown by the post-mortem examination of the excised uterus by Dr. Savage to be incorrect; while the entry as to the consultation on the case, inserted below Dr. Collins's entry, is in a different handwriting, and bears a date antecedent to the date of the operation. We refer to this as an instance of the careless and deplorable manner in which the clinical records of the Hospital have been kept. For this carelessness the Senior Medical Officer is responsible by the regulations to the Board (see Rule 54). The Commission opened its sittings on the 15th October, sat on twenty days, and concluded taking evidence on the 10th November, 1904, having examined ninety-three witnesses. C. D. R. Ward. R. Beetham. S. E. McCarthy.