H.—7.

The Villa System. " The experience of each successive year adds to my conviction that in the villa system we have the means not only of ideal classification, but also of obviating all the objectionable features which loom so large in the public mind." At the end of another fourteen years I find no reason to modify the opinion thus expressed by me in 1923 in my annual report as Medical Superintendent of Nelson Mental Hospital. At the time this paragraph was penned we were making the first cautious advances in New Zealand towards the villa system, for which purpose we had acquired the old Stoke Orphanage property. There were not a few in the Department then who voiced grave apprehensions regarding the proposed changes, which are associated with the villa system —viz., the abolition of airing courts, the extension of parole to patients, and the nursing of male patients by female nurses. To-day we have three villa-system mental hospitals — Kingseat, Ngawhatu (at Nelson), and Hokitika —and their establishment has definitely opened a new and happier chapter in the treatment of the mentally afflicted. Even in the older institutions all additions are being made in the form of villas, and many of the villa-system methods have been adopted so far as has been! found, practicable. None of the villa mental hospitals have any enclosed spaces or airing courts, and exercise is taken by those who cannot be given parole in walking parties. lam hopeful that in time airing courts will disappear also from the old large institutions. So far as parole is concerned, I need only point out that the English Board of Control regards the position as satisfactory if 16 per cent, of the patients resident enjoy some measure of parole ; over all our hospitals our figure for parole is more than twice that and rises in our villa institutions to 45 per cent, at Ngawhatu and 86 per cent, at Kingseat. One matter which I regard as essential to the proper development of our mental hospitals is the extension of nursing by female nurses to the male divisions. I stated in the annual report of 1923, already referred to, that 90 per cent, of male admissions could be nursed by females, and further experience has certainly not led me to qualify the opinion then held. At Kingseat all but one of the twelve villas are staffed by female nurses, with the happiest results, and the same can be said of Ngawhatu. There is plenty of scope for male attendants in supervising farm and developmental work, but to ensure comfort and domestic efficiency within the ward or villa nurses are indispensable. One aspect of the villa system which is probably peculiar to New Zealand and which has proved a great success is the system of separate cooking done by each villa. Not only does this obviate the large capital cost of building and equipping a central kitchen, but we have found that the meals are better cooked and better served, and their preparation provides an interesting form of occupation for nurses and patients. Our experience in this matter has prompted an inquiry into the possibility of decentralizing the cooking in the older institutions ; there are difficulties, but no doubt these will be overcome. Programme foe Current Year. Included in the programme for the current year, are the following major works, which are either being planned or are already under construction :— Kingseat.—Hitherto the main activity at Kingseat has been the provision of villas to ease the overcrowding elsewhere, but with over six hundred patients in residence the time has arrived for the erection of the service blocks and specialized units. In this direction the store was occupied during the year, and the laundry, boiler-house, bakehouse, and butcher's shop are all well advanced. One of the most important units will be the Hospital Admission Villa, for which the plans are well forward, and its erection will be commenced before this report is published. The plans make ample provision for all the most modern forms of treatment, including massage, continuous baths, light, electricity, and X-rays, and the block also includes a laboratory, dispensary, and operating-theatre. Plans are being considered for the erection of an additional reservoir of 300,000 gallons capacity. The two next most pressing requirements at Kingseat are a Nurses' Home and an entertainment hall. Tokanui.—Extensive alterations are going on, to enable an interchange of male and female divisions to be effected. Porirua. —The new store will be completed shortly and the new kitchen boiler-house block will be commenced. The completion of these works will enable us to put in hand a much-needed remodelling of dining-hall and administrative block and to provide adequate visiting-rooms for patients' friends. Nelson.—lt is hoped to erect at least two male villas and thus allow for a reconstruction of the present main building at Ngawhatu to provide administrative offices, including stores. Hokitika.—Consideration is being given to reconstruction of the kitchen-stores block, which is now quite inadequate for the increased number of patients. It is intended during the year to erect two new villas to house fifty patients of each sex. Christchurch.—Considerable improvements are to be effected in connection with water-supply. Seacliff. —Additions to the Nurses' Home are under consideration, and a hospital-admission unit is necessary. Alterations, Additions, and Improvements carried out Last Year. Capital expenditure on new buildings, additions, and improvements effected during the year amounted to £142,108 19s. lid., and the following summary shows the principal items making up the total: — Auckland (£841). A new refrigerator was installed and additions to the Nurses' Home commenced.

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