H.— 3lb

8

" (c.) Fixing a scale of fees to be paid by patients who come to maternity hospitals for confinement or who are attended as patients outside the hospital by pupil nurses on their admission to any such hospital and by midwives on registration; " (d.) Providing for the admission to maternity hospitals of women who are unable to pay the prescribed fees and for their treatment and attendance as out-patients; " (<?.) Regulating the use and non-use of any instrument and drug by midwives, and defining what shall be deemed to be malpractices by midwives; " (/.) Providing for the right of any society or person on account of the gift or annual subscription of the prescribed amount to nominate a patient at any maternity hospital free of cost; and " (g.) Generally providing for anything which by this Act is expressed to be prescribed or which the Governor considers necessary in order to carry out the purposes of this Act." The only regulations made under the Act are those published in the New Zealand Gazette No. 39, of 27th April, 1905, pages 1022 and 1023 (see Exhibit No. 64 and Dr. Valintine's evidence, page 304). No examiners of pupil nurses have been appointed by the Governor under section 18 of the Act (see Dr. Valintine's evidence, page 79). The examinations have apparently been held by examiners appointed by the Inspector-General of Hospitals, and not in the manner prescribed by the Act. Under these circumstances it may be a question whether certificates heretofore issued to pupil nurses under the Act (see sections 4 and 8) are valid. Section 18 of the Act provides that the Governor may from time to time appoint fit persons to be Matrons of maternity hospitals established under the Act, and No. 5 of the beforementioned gazetted regulations provides that every maternity hospital shall be under the charge of a Matron appointed under the Act who shall have full control of the institution subject to the directions of the Minister. With regard to the appointment of the present Matron (Miss Ludwig), Dr. Valintine said (see his evidence, page 81), " She was appointed by Mr. Fowlds. There was no appointment by the Governor. There was no Cabinet minute. The appointment was made by the Minister without the Governor's warrant and without a Cabinet minute. The submatron was appointed in the same way. There is nothing in the Act with regard to submatrons." Miss Broadley is at present acting as submatron at the Hospital. There are no provisions in the Act or gazetted regulations relating to the appointment of submatrons. The Act does not provide for the appointment of a " Medical Officer," but No. 9 of the gazetted regulations provides that for every maternity hospital medical practitioners shall be appointed by the Governor annually to deliver lectures (not less than one every two weeks) to the pupil nurses, and by Regulation No. 10 of the same gazetted regulations such practitioners are required (a) to take pupil nurses out to cases of labour when practicable, and (b) to attend cases of labour in the hospital which are abnormal or which require the administration of an anaesthetic. It appears that Regulation No. 9 has not been complied with. Dr. Tracy Inglis has apparently been acting as " Medical Officer " of the St. Helens State Maternity Hospital in Auckland from the time the Hospital was opened in the year 1906 up to the present time, but it is at least doubtful whether his appointment was made in accordance with law (see his evidence, page 30 et seq and page 42). With regard to the general management of the Hospital by Miss Ludwig, the present Matron, who has been in charge since February, 1910 (see her evidence, page 33), the evidence justifies me in reporting that, having regard to the very unfavourable conditions under which the work has been carried on, there is no real ground for complaint. Tarn inclined to the opinion that