11

H.—7a

General. The foregoing remarks dispose of all the complaints arising in the course of the inquiry of ill treatment or neglect of patients by the Medical Officers or attendants. In my opinion they all arise either from the disorganized state of the mind of the patients, or from the ignorance of the patients' friends of the pitiful state patients get into, not by reason of any ill treatment or neglect on the part of the Hospital authorities, but by reason of their mental ailments. I shall now deal with certain complaints arising during the inquiry, which arise from the deficiencies of the Hospital itself, and for which the Hospital staff is in no way responsible. 1. Reception Ward. On the male side of the Hospital there is not, nor has there been for many years past, any ward for the reception of new admissions. Patients on arrival have to be placed in the refractory ward with the worst class of patients in the Hospital. This, I submit, is improper, and should not be allowed, as it cannot tend to improve the condition of a patient, and in many cases must be harmful. The Medical Officers state that owing to the overcrowded state of the Hospital it cannot be avoided at present. I understand, however, that provision is made for the erection of a reception ward in the near future. 2. Classification. Owing to the overcrowding it is impossible for the patients to be properly classified, and so receive proper care and attention. For instance, patients whose mental derangement does not affect their table manners have to sit at the same table as patients who slobber into their food. The patients cannot be classified according to their various mental derangements. A suggestion was made during the hearing that patients should be in some way classified according to their social status, but this is obviously impossible. Something, however, should be done to separate the coarse or foul-mouthed from those of more refined instincts. Lunatic prisoners from time to time are sent to mental hospitals, and I understand no special provision is made for their custody apart from the other patients. This is obviously improper, and requires no further comment. A large class of patients are those who are certified as mental defectives on the ground of " senile decay." I am given to understand that in Great Britain the majority of these cases are to be found not in mental hospitals but in the workhouses —in fact, they are not classed as lunatics or mental defectives at all. These patients should be placed in a separate institution, as the majority of them only require a limited amount of care and attention, and do not require the services of trained mental nurses to look after them. 3. Hospital Treatment. For sick patients at Sunnyside there is absolutely no proper hospital accommodation. There is a ward called the " infirmary ward," but this has to be occupied by epileptics to the exclusion of all others. If a patient falls sick the only place to put him is in one of the single rooms which I have already commented upon in Mr. Tribe's case. This should not be in an institution such as a mental hospital controlled by the Government of the country. Friends of mental defectives have the right to expect all reasonable care, comfort, and attention for the patient, which would include adequate hospital treatment when necessary. In this connection the Medical Officers are of opinion that when a proper infirmary ward is provided, where sick patients can be cared for, it would be better to employ female nurses to look after the sick.

3—H. 7a.