9

H.—3lb

the Matron has at times been overworked, and that having regard to the very responsible position which she holds her remuneration of £120 per year is not adequate. The submatron (Miss Broadley) gave evidence during the inquiry. She appears to me to be a thoroughly reliable, capable, and zealous officer. Her salary is only £80 per annum. The evidence satisfies me that the certificated nurses and pupil nurses have performed their duties satisfactorily, and have had a proper appreciation of their duties and responsibilities. I forward herewith the following statistics, dated from the opening of the Hospital in 1906 and completed to the present time, viz. : (a) Indoor cases; (b) outdoor cases; (c) patients transferred to the General Hospital; (d) deaths, 1906 to date; (c) septic cases, 1906 to date; and (f) lectures delivered in 1911 and 1912. (See Exhibit No. 61—A, B, C, D, E, and F.) It must be admitted that the results as shown by these returns are most satisfactory. Dr. Makgill, the District Health Officer at Auckland, referring to them said (see page 85), " I have seen the statistics of the home. I have compared them with statistics from other countries. Those of St. Helens are extraordinarily favourable to New Zealand and to Auckland. I think it is a great feather in the cap of the staff that they have kept the mortality and sickness returns so low, considering that they are the people who have suffered from the fact that their work has to be done in a building both old and unsuitable." (See also Dr. Valintine's evidence, page 79 et seq.) Mr. A. E. Skelton, counsel for the Timber-workers' Union, and Mrs. Nicol commented strongly on the destruction by or under the order of the Matron of certain records —viz., nurses report-books, Medical Officer's diary and charts, as stated in the evidence. In my opinion such records should not be destroyed except under the sanction of regulations made under the Act. The Matron stated on oath, and I have no reason to doubt her sworn testimony, that she destroyed the records without authority but under the honest belief that she was fully justified in doing so. She also stated that when she destroyed them she did not know or suspect that an inquiry such as the present one would be held. Questions were raised by the parties, especially by Mr. Skelton, during the inquiry as to (a) the suturing of ruptures of the perinaeum or other serious injury of the soft parts by Matrons, certificated nurses, and pupil nurses; (b) the administering of drugs to patients by Matrons, certificated nurses, and pupil nurses without the express authority and directions of a medical practitioner; (c) the delivery of Women by registered nurses and pupil nurses; and (d) the holding of consultations between medical practitioners in the event of the serious illness of patients or at the request of patients or their husbands or relatives. In my opinion these questions should receive early and careful consideration, and should be clearly and exhaustively dealt with by regulations to be made under the Act. During the inquiry Mrs. Nicol asked me to consider the following suggestions made by her, viz. : (a) That a resident Medical Officer should be appointed; (b) that the Medical Officer should not be in practice as a surgeon outside the Hospital; (c) that persons seeking admission to the Hospital should be entitled to appeal to a Magistrate or Inspector if refused admission by the officer in charge or in the event of the terms of admission as to fees, &o, being unsatisfactory to them, and that a Magistrate or Inspector should be empowered to order the admission of the appellant on such terms and conditions as he might impose; and (d) that patients should be admitted a reasonable time before labour commences. With regard to the suggestions (a) and (b) there is not in my opinion any necessity at present for the appointment of a resident Medical Officer, and I can see no reason why the Medical Officer of the institution should be prohibited from practising as a surgeon outside the Hospital, provided he takes the usual well-recognized and necessary precautions to prevent the spread of sepsis. &o.

2—H. 31b.