H.—3l.

Accordingly, a contract was let to take down, remove to, and re-erect the Mangonui Hospital at Kaitaia. By careful planning it has been possible to shift the different buildings without materially interferring with normal hospital activities. The buildings are now all placed in position on the new site at Kaitaia and within a few weeks the hospital should be operating as, a complete unit. The opportunity was taken at the same time to alter the design of the buildings to make the hospital more convenient and better equipped. Through the generosity of a local resident a new X-ray unit will be installed. (2) Building Operations. Southland. —The main building activity during the year was the completion of the plans and specifications of the new hospital for Southland at Kew. The various sections of the hospital are beino- tendered for separately, and a commencement ffas now been made with the main ward block. The administration section, including kitchen and the Nurses' Home, should be commenced in the near future. The negotiations on this hospital have extended over many years, and when the hospital is completed it will be in accord with modern requirements. Here, as in the new hospital at Napier, there is a large proportion of small wards, and the large wards contain only twelve beds. In the latter, instead of being arranged at right angles to the length of the ward, the beds will be placed parallel to the main walls. This is a new departure for New Zealand. New Plymouth.—The operating theatre has been redesigned in order to cope with increasing work. The new block will be much more convenient, and should meet the requirements of the hospital for some years. Further building operations are contemplated at the hospital, including the reorganization and extension of the kitchen block, accommodation for chronic tuberculosis patients, and extensions to the Nurses' Home. Dunedin. —Plans and specifications for the new administration block at Dunedin Hospital have been finalized, and a contract let for the work. This will involve demolition of the present central block, which was part of the original Dunedin Exhibition Buildings. The cost of this work is being met from building fund established by the Board over a period of some years. Coromandel Hospital.—A new Nurses' Home has been erected at the hospital. Other building activities were : Additions to shelters for chronic pulmonary tuberculosis at Whangarei; modernizing the heating and hot-water system at Te Kopuru Hospital, strengthening of the wards at Gisborne ; increasing the veranda space at Taumarunui ; new block of shelters for male patients at Waipiata. (3) Transfer of Departmental Institutions to Hospital Boards. With the exception of Queen Mary Hospital at Hanmer, the only institutions still under control of the Department are the St. Helens Hospitals at Invercargill, Dunedin, Christchurch, Wellington, and Auckland. The King George V Hospital at Rotorua has been transferred to the Waikato Hospital Board, which has been given financial assistance to enable necessary alterations to the buildings to be effected. The transfer of Pukeora Sanatorium to the Waipawa Hospital Board was also completed. (4) Accommodation for Patients suffering from Chronic Pulmonary Tuberculosis. In some of our hospitals there is no special accommodation for this type of case, with the result that much of the available veranda and balcony space of the general hospitals is occupied by these patients. In view of the comparatively high incidence of pulmonary tuberculosis amongst the nurses of general hospitals, this position is most unsatisfactory. As the ancillary services and conveniences of a general ward are not designed to cope with these additional infective cases, the difficulties of carrying out a proper nursing technique are very great, and it reflects great credit on those in control that the technique reaches a high standard. The extra work and strain, however, devolving on the nursing staff is considerable. Where necessary, therefore, the Hospital Board is urged to provide or combine with adjacent Boards to provide special accommodation for these patients. The Boards generally realize the importance and urgency of the matter, and some already have excellent housing, whilst others have the necessary building schemes under consideration. In addition, there are in our hospitals many cases of surgical tuberculosis who have long periods without active surgical treatment and during these periods require only absolute rest, food, and sunshine, all of which are essential to their treatment. In the absence of other accommodation these patients must remain as inmates of the hospital. (5) Overcrowding of Hospital Wards. In some of our hospitals in order to cope with the increased demand for accommodation the authorities have put beds in wards additional to the normal capacity and also brought into permanent occupation the verandas and balconies. In order to give the patients reasonable comfort verandas have gradually been glassed in ; thus interfering not only with the normal natural ventilation of the wards, but in a large measure preventing the patients from the wards being placed on the verandas on suitable days. There is an instance where a ward designed for twenty-four beds had as many as forty beds in occupation. As none of our wards are artificially ventilated, whereby the amount of air entering can be varied according to demand, the amount of fresh air entering a ward is, therefore, when.gross overcrowding occurs, not always up to accepted standards.

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