T. R. INGLIS.]

31

H.—Blb.

be increased to £100 once the Hospital was properly started. There was no written agreement. There was nothing but a telegram. I got it from Mr. Seddon, asking me if I would be prepared to take the appointment at St. Helens. I wired asking for the conditions. I got a reply telling me part of the duties, and saying that he (Mr. Seddon) would see me when he came to Auckland. I saw him in Auckland. He told me what he wanted me to do in regard to St. Helens, which had not at this time been opened. He gave me verbally a sketch of my duties. He told me that the rules would be drawn out later —a printed set of rules, which we have since received—two lots. I agreed to a remuneration of £50 at the start, and I had his word that when the home was properly started—he said it was more or less an experiment starting the homes —and that when they were properly established my honorarium would be increased to £100. This interview took place six months, I should think, before the home was opened. St. Helens was opened on the Ist June, 1906. When I accepted the appointment there was nothing in writing setting out the duties I was expected to perform. There was no letter of appointment defining my duties. When I commenced my duties on the Ist June, 1906, I do not think I had any written instructions with regard to my duties. I had verbal instructions from Mr. Seddon and the Inpsector of Hospitals. From them I had instructions that I was to attend all confinements at St. Helens that required medical assistance, in the opinion of the Matron ; that I was to visit the home at such other periods as I thought fit, and at any time when the Matron required me ; that I was to deliver a course of lectures to the nurses twice a year ; that the medical administration of the Hospital was under my sole care, and that the Matron would report to me as occasion demanded ; that I was to attend district cases (outside cases) if the Matron or sub-matron required assistance ; that I was to approve by initialling the application form of all applicants to St. Helens. Mr. Seddon also instructed me as to what patients were to be admitted. Mr. Seddon told me that the home was intended for the wives of workers and country patients who could not be looked after properly in their own homes. I asked him for a guide as to the wages of applicants' husbands, and he told me from £2 to £2 10s. or £2 15s. a week, and to use my judgment with regard to the size of the family. I had to approve of the admissions to the home. This did not apply to cases of urgency. I cannot say if there were instructions as to urgent cases, though I think the point was discussed. Another point was that single girls were not to be admitted, but that we could attend them as out-patients. I made notes of these verbal instructions at the time. I have not got these notes. I destroyed them with a lot of old papers about two years ago. We had the rules then, and I did not think they would be needed any more. I was supplied with a copy of the Midwives Act and the gazetted regulations of the 27th April, 1905. I considered that my duties were regulated by the verbal instruction I had received and the regulations. I considered Regulation 9 contained one of my duties—that was, to deliver lectures. The verbal instructions I received were more elaborate than the printed ones. I considered the verbal instructions elaborated the printed rules, though I did not get the latter till later. I have given more lectures than required by the regulations. I have kept a record which I can produce of my work in connection with the Hospital. I received verbal reports from time to time from the Matron. I received no formal or official reports from her. I received a copy of rules [produced —Exhibit No. 65]. They bear the printer's imprint of 1905. They are called " Rules for St. Helens Hospitals." In 1911 I got fresh rules. I was not told that they would supersede the earlier ones. I naturally took it that they would. These are the only rules and regulations I have received. I have had a memorandum from the Department occasionally. Were I called in by the Matron to attend a case in the Hospital which was abnormal, or required the administration of an anaesthetic, I would attend and visit the patient as I would a private patient of my own motion if I thought she required it. If a patient went along all right and then developed symptoms indicating some trouble I certainly would think it my duty to attend such a case. I would attend and keep on attending such a case as long as it required me. I did not keep a case-book in the Hospital. One was kept there. It does not show the daily condition of the patient. In a general or mental hospital a case-book should be kept showing the state of each patient daily, if necessary. No case-book was kept like that here. Temperature-charts were kept. Examdnation-in-chief continued. —l remember seeing Mrs. Marsh in the Hospital. I keep what I call a day-book of my attendances. I keep no record separate from that of my own patients. I make an annual report to the Department. I suppose I saw Mrs. Marsh the day she was confined. I have no record except my memory. I have no record of the names of the patients I saw every day. I only saw Mrs. Marsh on a certain day, because I saw every patient on the days I was there. I do not remember if I was called specially. I now say that I think I was called specially. I think the Matron told me she was developing a rash. I saw Mrs. Marsh, and found her to be suffering from scarlet-fever. She was in one of the ordinary rooms —I cannot now say which. I had Mrs. Marsh isolated, and reported the case to the Health Department. I produce my notification and my covering letter. [Exhibit No. 49.] It is dated the sth July. I think I saw the patient before that. As far as I remember, she was moved to the isolation ward the day I saw her. I produce the reply I got from the Health Department. [Exhibit No. 48.] There was a tremendous lot of scarlet-fever at that time. The patient died on the 9th July. That day she developed a sudden attack of heart-failure. A chart of her temperature was kept. I saw the patient every day. The nurse in charge kept the chart. [Mr. Mays says it was destroyed, because it was kept ward in which was a scarlet-fever patient.] She showed signs of heart-falure within twenty -four Tiours of her death. The final attack was sudden and without warning. If the patient showed a rash within forty-eight hours of her admission I would say she was infected outside. The period of infection is four to twenty days, with an average of ten. That is according to Dr. Ostler, an authority on the subject. Pgave'instructions to. the' Matron to send word to the relatives'as soon*as it seemed'clear'to me as to her'actual state. It*is a'rule to admit relatives to a ward where patients are suffering from infectious diseases only when we do not think the patient will recover. While there is a chance of recovery, we admit no one but the Hospital staff. The patient's attack of scarlet-fever was mild, though scarlet-fever is always serious in a confinement