H.—3la.

The Arawa Trust Board has instituted a health-insurance scheme which provides for the admission of maternity patients to this ward at a cost of £1 to the Trust Board, which collects from the Maori where possible. The district nurse, who has been six years in the district and gained the confidence of the Native population, states that in the quinquennial period 1932-1937 there have been only four deaths among the Maoris, which would make an approximate death-rate of about 3 per 1,000. This is about half that of the general Maori maternal death-rate. She states that the Maoris attend the ante-natal clinic regularly and that they are willing to stay in hospital from ten to fourteen days. She says, "It has been hard to get them into hospital, but when they get there they don't want to leave. I think it is absolutely necessary that the nurse in charge of a hospital should be thoroughly sympathetic with them and should appreciate the psychology of the Maori." In her opinion, the Arawa Trust Board's insurance scheme is of great benefit and she states, " owing to the insurance scheme they do not feel they are receiving charity and the Maori is very sensitive about that." Besides the greater safety to the Maori woman when she is confined in such an institution as the Rotorua Hospital, there are distinct benefits in inducing her to breastfeed the baby, a practice which, according to the district nurse's statement, is becoming more general. There can be no doubt that the education of the Maori in the Rotorua district as to the benefits of hospital treatment has been most successful and might with advantage be copied in other districts. Owing to the greater popularity of the hospital it has been in the last few years necessary to quadruple the number of maternity beds in that institution. The Committee understands that it is intended to increase the number of district nurses, and it appears that it is advisable to do so as soon as the right type of nurse is obtainable. 10. TAUMARUNUI HOSPITAL BOARD DISTRICT. The Taumarunui Hospital Board serves the three rather remote central North Island (King-country) counties of Taumarunui, Kaitieki, and Ohura, in which all the transitional stages from bush country to pastoral land are still to be seen. Most of the centres of population are distributed along the Main Trunk Railway, with a few along the branch line to Stratford. They include Taumarunui Borough (2,504), Ongarue (355), Okahukura (213), Owhango (504), Raurimu (278), and Ohura ' ... Ohura has shown a 60 per cent, increase in population m the past ten years, and the rest of the district has shown a moderate development. The main roads in the counties are good, but there are still some places off these roads to which access is difficult. Taumarunui .—Taumarunui Borough and the neighbouring areas are very well served. There is a Hospital Board maternity hospital of eight beds which, though housed in a rather old building, is well stafied and gives efficient service. It is open to the doctors of the district. The Board accepts responsibility for those who cannot pay. Such patients are allowed to choose their own doctor, and his fee is paid by the Board. The hospital fee is £3 3s. per week. Ninety-five cases were treated in this hospital last year, giving an average of 3*65 occupied beds. There are also two quite satisfactory private maternity hospitals of the usual country-town type. Each has four beds, and the fee is £4 4s. per week. There is practically no domiciliary attendance. No difficulty is experienced in giving satisfactory ante-natal service. Ohura. The Committee considered the position of Ohura, thirty-two miles from Taumarunui on the Stratford line, where there is a growing population and where a doctor, subsidized by a medical association, is resident. A nurse at one time had a small maternity hospital subsidized by the Board, but this is not now functioning. Opinions of the residents differed as to the advisability of re-establishing a maternity hospital there ; some considered that the expense was not warranted and that the women would still prefer the facilities available at Taumarunui, while others considered that such local provision was needed. The Committee rather inclined to the view that a small maternity hospital would be helpful. The residents of some of the more remote outlying settlements are naturally at considerable disadvantage. Most of them arrange to come down to Taumarunui for short period before confinement, and the Board hospital does actually take m quite a few waiting patients. 2—H. 31A.

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