H.—3l

34

SECTION 3.—PRIVATE HOSPITALS. The number of private hospitals in 1922-23 increased to 282. During the year fifty-three new licenses have been issued for medical and surgical private hospitals and twenty for maternity homes. Forty-eight in country places have licenses for maternity as well as general cases, but such double licenses are not granted where it is possible for separate hospitals to be maintained. Especially for midwifery work, tho present law which allows of one case at a time being'treated in an unlicensed house militates greatly against the success of a qualified nurse in starting a maternity home in a country town. Five or six unqualified, women in a town receiving one case at a time —which allowance is frequently overstepped.—reduces the number she can depend on, and causes a very uphill struggle. Medical practitioners in the country towns should recognize more than they do the advantage of having a properly qualified nurse and a licensed private hospital, and refuse to attend patients in these unlicensed places. Should the law be amended, as proposed it should greatly assist nurses, but frequent inspection and the co-operation of Magistrates in imposing adequate fines for infringement of the law will be necessary to prevent the present unfair competition being still carried on. In many country places where the number of cases is not sufficient, with the small fees charged, to ensure a living for a nurse, I consider that a subsidy from the Hospital Board of the district should be granted at least to enable a start to be made. The establishment of maternity wards at or in connection with general hospitals does not meet the needs of private patients, and should not do so, as this again would be unfair to the registered nurse and midwife, whose training has been undergone to enable her to fulfil, this need of people able to pay for private attendance, H. Maclean, Director, Division of Nursing.

PART V.—SCHOOL HYGIENE. SECTION I.—ADMINISTRATION AND INSPECTION. I have tho honour to submit my annual report for year ended 31st March, 1923. (1.) Staff. The medical and nursing staff of this division numbers twelve school medical officers and twentyseven school nurses. Owing to the absence during the year of .Dr. Ada Paterson, the work of eleven medical officers only is represented in the figures which follow. The retirement from the service of Dr. H. A. Davies at the end of the year is much to be regretted. In the personnel of the school nurses there were a number of changes ; this is regrettable, as changes interfere with the continuity of the work, which depends so much on personal knowledge of individuals and local conditions. (2.) Figures relating to the Work accomplished. Owing to the development of the system, of monthly reporting, it is possible for the first time to give comprehensive figures relating to tho work of the division. Schools inspected — Of roll over 500 .. .. .. .. .. 129 Of roll 100 to 500 .. .. .. .. •. 289 Of roll under 100 .. .. .. .. .. 603 Total .. .. .. .. .. 1,021 Children examined— Complete examinations .. .. .. ■■ 53,752 Partial examinations .. .. .. .. .. 48,537 Total .. .. 102,289 Letters of advice and notices to parents regarding conditions requiring treatment .. .. .. .. ■• •• •• 34,198 Parents interviewed .. .. .. .. •• •• 3,556 Lectures and addresses to teachers and parents . . .. .. 114 Health talks given to school-children .. . . . . .. 876 ' The above totals refer to the work of the school medical officers : the figures for the work of the school nurses are as follows :— Children examined preliminary to the Medical Officers' inspection 42,349 Children re-examined to note progress and whether treatment lias been obtained .. .. .. .. •• 29,396 Total .. .. .. •• •• 71,745 Visits to homes in— Large towns .. .. .. ■■ •• •■ 8,018 Small country towns }. .. . . •. .. 1,725 Scattered districts . . .. . . • • .. 1,627 Total 11,370 Children taken to hospital or dental clinic .. .. .. . . 4,190 Much valuable work also is done which cannot readily be represented, in figures. Furthermore, records are necessary for two reasons : first, as essential to the intelligent and methodical following-up of the facts discovered ; and, secondly, to enable a systematic account to be given of the work accomplished. It will be clear from the above figures that some considerable clerical work is entailed.