H.—3l.

Obstetric Hospitals. Maternity benefits under the Social Security Act include free domiciliary and visiting nursing, free public hospital care, and largely subsidized private hospital care, as well as medical care. The scale of payments introduced has on the whole improved the position of the obstetrical nurse very considerably as far as private practice is concerned, and so should result in more nurses being inclined to practise obstetrics. On the other hand the new legislation is raising fresh problems in those trainingschools where the medical attention is limited to the teaching staff. It is essential that an adequate amount of clinical experience should be available in the training-schools for teaching purposes, or the whole quality of our training system will fail. Now that obstetrical nursing has become a service subsidized by the State it is essential that the standard of service should be maintained, and even raised. As a beginning it is proposed to hold a refresher course for obstetrical nurses in each health district annually. In the meantime these courses are optional, but it is questionable whether they should not be made compulsory for nurses whose practise is not of a high standard. The position in regard to the number of obstetric nurses passing the annual examination, and who are practising, is as follows : — Maternity Nurses. Registered Nurses. 1932. 1933. 1934. 1935. 1936. 1937. 1938. 1939. Number sitting .. 152 158 170 190 195 201 218 216 Number passed .. 143 148 108 180 189 193 207 212 Unregistered Nurses. 1932. 1933. 1934. 1935. 1936. 1937. 1938. 1939. Number sitting .. 35 43 33 34 43 36 46 43 Number passed .. 30 35 30 33 37 30 44 40 Mid wives. Registered Maternity Nurses who are also Registered Nurses. 1932. 1933. 1934. 1935. 1936. 1937. 1938. 1939. Number sitting .. 45 48 53 57 58 55 54 49 Number passed .. 39 44 47 53 56 54 52 49 Registered Maternity Nurses who are not Registered Nurses. 1932. 1933. 1934. 1935. 1936. 1937. 1938. 1939. Number sitting .. 14 14 18 14 9 19 11 17 Number passed .. 11 12 13 13 7 17 10 15 Public-health Nursing. At the beginning of 1939, forty additional district nurses and four additional Nurse Inspectors were appointed to the staff. It will be understood, therefore, that last year was a year of stabilization, inaugurating new staff and adjusting boundaries. Some areas are still too large, and require further subdivision, but the increase will enable much more intensive educational work to be achieved. Group health teaching has extended both amongst children and adults, particularly in Maori districts. Mention might be made of the women's institutes in the north, the school clinics in the East Coast district, and the Maori Women's Health League in the South Auckland district. In the South Island for the first time a definite effort has been made to break away from the specialized fields of work and introduce a more generalized programme, paying more attention to tuberculosis in all its forms. A family-record system has been introduced, and, though not in general operation, is being gradually extended. In addition, an analysed weekly work return for all district nurses is now in operation, which will assist supervising officers to check the way the work is developing. Tropical Nursing Service. Numerous changes have also taken place amongst nurses seconded for duty to one of the tropical stations during the year. There are now thirty-six New Zealand nurses in this service. Since the outbreak of war nurses are rather reluctant to accept these positions, hoping for opportunity for active service. It must be appreciated, though, that this is an essential service, and that in entering it nurses are assisting their country to care for those entrusted to its care. During the year Miss J. Flint, of Auckland St. Helens, succeeded Miss Becker as Matron of Apia Hospital ; Miss Riekman, of Central Auckland Health District, succeeded Miss McPhail at Rarotonga ; Miss L. Peirard returned from Aitutaki and was appointed Matron at Ranfurly; her successor has not yet taken up duty. Miss Hawkes returned to Niue for a second term. Post-graduate Course. At the termination of the 1939 course it became necessary to vacate the rooms at the Wellington Hospital where the post-graduate course has always been conducted, owing to the expansion of the hospital services. Great difficulty was experienced in finding suitable accommodation, but finally a temporary arrangement was made by taking over the ministerial residence in Molesworth Street. One of the future developments will be a proper school; as the course has extended its activities this has become more than ever necessary.

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