H.--31

50

of the, Essex Home and the St. Helens Hospital has been arrived at. The careful work of the technical side of your Department has produced, after much consideration, plans for an excellent hospital of the best type. At the last moment opposition has again developed, but this time on grounds the exact reverse of those brought, forward in Wellington. The opposers of the scheme consider that the presence of the single girls will overthrow the object for which the St. Helens Hospitals were created. At the same time, and, so far as I know, with the approval of many of the people who oppose the Christchurch scheme, the Government is being urged to adopt a similar course in Dunedin. It is proposed and I understand decided, to create in this centre a. large maternity hospital which will embrace the existing St. Helens and the Batchelor Home. It is thus clear that the curious position has arisen that a scheme, opposed in. Wellington on certain grounds, is opposed in Christchurch on grounds that are directly opposite, while an identical scheme is received with general approval in Dunedin. In addition to this, opposition has been started to the teaching of medical students in the St. Helens Hospitals of Christchurch. Wellington, and Auckland. At the same time no objection of which I have heard has been received to the teaching of medical students in either the present St. Helens Hospital in Dunedin or in its enlarged successor. I am sure that much of the opposition which has been raised is due to insufficient knowledge of the necessities of the case. If you, Sir, could bring home to the general public the fact that much of the improved teaching, which should result from the rearrangement of the obstetrical side of the Dunedin Medical School, will be lost unless at the same time full facilities are provided for clinical work 1 believe all real opposition would cease. At the same time, it would be well to emphasize the fact that the new hospital at Dunedin cannot provide all the facilities that are wanted. Conclusion. Finally, Sir, I should like to bring to your notice the valuable assistance which has been so freely given to me by Dr. Elliott, as editor of the New Zealand Medical Journal. In every issue of this Journal he has found room for the various notes and comments on obstetrical matters with which I have provided him, with the result that it has been possible to bring before the notice of the medical profession many matters of interest and importance. I am also much indebted to the officers of the Department for their most kind and valuable assistance, and especially to the officers and staff of the Christchurch Health Office for help in the production of this report, and in many other ways. ST. HELENS HOSPITALS.—GENERAL STATISTICS SUBMITTED BY THE CONSULTING OBSTETRICIAN. The work of these hospitals has continued to yield the usual excellent results, and to be an object lesson to the other hospitals of the country. The gross maternal mortality during the year was five —i.e., 2-08 per 1,000 labours. Amongst these five deaths are included one; due to pleurisy, and two in-patients who were not actually confined in the hospital. I only mention this matter to show that every death of any patient who has once been admitted to the hospital is included. It is very desirable that the extern work of the hospital be increased. This is especially so in view of the facts that extern work plays an important part in the training of midwives, and that in future the four larger St. Helens Hospitals will alone be responsible for such training.

St. Helens Hospitals.—General Statistics, 1929.

i—i • I H) o t~j .• | PS ! fcn 03 T3 § ■ ajl'SP = ! S! !C3cS.S 1 l l ill §> i i i Totai - ill I 2 -C g -S I ® § !J 3' -5, 6 Q I I A £ 1 > | fl Total admissions .. .. .. 690 i 368 173 230 268 177 j 673 2,579 Total deliveries .. .. .. 662 352 171 200 255 172, 586 2,398 Primiparso .. .. .. .. 223 : 87 40 42 63 40 ! 177 672 Multipara .. .. .. .. 439! 265 131 158 192 132 | 409 1,726 Presentations — Vertex .. .. .. .. 623 320 148 177 237 158 466 2,129 88-78 Occipito-posterior .. .. .. 25 16 11 16 9 8 21 106 4-42 Pace .. .. .. .. 1 ! 2 2 1 2 2 j 10 0-42 Brow .. .. .. .... 1 1 2 1 5 0-21 Breech .. .. .. .. 19 j 12 6 4 7 5 16 69 2-88 Transverse .. .. .. .. 2 ! 1 2 3 8 0-33 Twins .. .. .. .. 8 3 2 1 1 10 25 1-04 Complications of pregnancy— Hyperemesis .. .. .. .... .. 2 .... 2 4 0-17 Hydramnios.. .. .. .. 2 2 17 13 2 4 4 44 1-84 Pre-eclamptic toxsemia .. .. 12:2 .. 2 2 2 40 60 2-5 Eclampsia .. .. .. .. 1 1 1 2 1 6 0-25 Nephritic toxaemia .. .. 16 2 14 9 3 1 45 1-88 Vesicular mole .. . . 1 1 0-04