H.—3la.

Recommendations. It is recommended that additional accommodation be provided at Kawakawa. 5. HOKIANGA HOSPITAL BOARD DISTRICT. The Hokianga Hospital Board district comprises Hokianga County and extends from Kaihu on the northern boundary of the Kaipara Board's district. It takes in the west coastal area as far north as Herekino, and on the east joins the Bay of Islands boundary. The population of the county is 8,636, of whom 4,928 are Maoris. Rawene. Facilities in the Hokianga district are provided at the Rawene Hospital where there are at present seven maternity beds. The fees are 9s. per day, plus £2 2s. confinement fee. The number of cases attended in the year was 108, of whom about thirty-six were Maoris. It is stated by the Board's Secretary that Rawene Hospital also serves to some extent Kaikohe and the county surrounding in the Bay of Islands territory. The Board also states that there is insufficient accommodation to take in all Maori cases, as they would have, roughly, another one hundred cases a year, and would require seven more beds. Over half the population in this area is Maori, and their birth-rate is about two and a half times that of the European. There is no domiciliary confinement among Europeans, but in order to take in all Maori cases further equipment and staff would be necessary, although there is building accommodation available. District Nurses.—Two district health nurses are stationed in this area, and one stated she had attended fourteen Maori confinements in seven months, but the majority are attended in their own homes either by husband, relatives, or Maori midwives. Any cases presenting difficulty are sent to hospital by the nurse. This nurse stated that after experience of hospital the Maoris prefer this method of confinement on account of more relief from pain, easy labour, and general treatment received. All cases cannot, however, be provided for as the accommodation is very limited. Ante-natal and Post-natal Treatment.—Ante-natal advice is given as far as possible by the district nurses or by the doctor, who travels round the district weekly. There is difficulty in giving post-natal treatment on account of scattered population. Pain-relief— In this hospital special study has been given to the question of painless confinement, and the Medical Superintendent has submitted a detailed account of his research in this connection, tabulating results in 100 consecutive cases, comprising 34 Maoris and 66 Europeans, and giving the technique used. Recommendations. _ The Committee recommends the provision of more maternity beds, staff, and equipment in order to cater for more Maori cases. Extension of the district nursing service for ante-natal and post-natal treatmen is also advised. 6. KAIPARA HOSPITAL BOARD DISTRICT. The Kaipara Hospital Board district extends from the Auckland Board's boundary at Kaipara Heads, taking in the West Coast area as far north as Kaihou, to the eastern boundary of the Whangarei Board as far south as Mangawai on the East Coast. It includes Hobson County and Otamatea County. The population of the district is 13,841, of whom 1,851 are Maoris. The chief centre is Dargaville (population 2,176). Facilities in this district consist of two public maternity hospitals under the control of the Kaipara Board, one at Te Kopuru, and one at Paparoa. There is also a private hospital at Dargaville doing about twelve cases annually. Te Kopuru. This is an eight-bed maternity annexe, serving Dargaville Borough and Hobson County. The fees are £4 4s. per week. Of the 126 cases attended in the year, 25 per cent, were Maoris, and it was stated that Maoris are encouraged to come into hospital in an endeavour to prevent the damage which results from labour under Native conditions. Forty-four per cent, of cases are doctor-attended. The Medical Superintendent states that the efficiency of the hospital would be improved by the appointment of a house surgeon, and that the hospital is just able to give sufficient service for present numbers. Pain-relief is given to an average degree.

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