H.—3l.

School Hygiene. Dr. H. B. Turbott since his appointment has given special attention to the strengthening of the School Medical Service. Definite progress has been made in organizing child-welfare clinics in conjunction with the Plunket Society. These clinics, covering ages of children one to five years, have already commenced. The campaign against diphtheria has been continued and intensified. Hospitals. Dr. Shore gives some information about hospital building activities and steps taken to provide accommodation for soldier patients. The estimates of requirements of all Hospital Boards provided for net estimated maintenance expenditure of £1,440,636 2s. 9d., which represented a reduction of £523,968 os. 4d. in the amount provided for 1939-40. As a result of this reduction the amounts to be constituted by levy and subsidy were respectively £191,890 4s. Bd. and £332,077 15s. Bd. less than the amounts for the previous year. The principal factors accounting for the reduction in requirements were substantial surpluses in the Maintenance Accounts of most Boards at the commencement of the year totalling £318,601 ss. 7d., compared with a total deficit of £26,303 os. Id. on Ist April, 1939, and the estimated increase of £484,471 15s. 4d. in patients' fees from all sources, due mainly to payment of maternity benefits and hospital benefits under Part 111 of the Social Security Act, 1938. The circumstances under which the surpluses occurred were referred to in last year's report. As an offset to the above increased amounts! hospital-maintenance expenditure showed an increase of £369,945 Bs. 9d. The estimates for capital requirements again provide for further increased expenditure, particularly for building programmes. The total estimated net capital expenditure, which is contributed equally by levy and subsidy, amounted to £279,974 14s. 7d., an increase of £38,208 lis. Bd. in the estimates for the previous year. The estimated expenditure from loan-moneys totalled £1,602,891 Is. 3d., of which £607,782 19s. 7d. had already been raised at the commencement of the year. Statistical and financial information will be published in a special Appendix to this report when the annual Income and Expenditure Accounts and returns of Boards are available. Nursing. Miss Lambie reviews the work of the Nurses and Midwives Registration Board and outlines the steps taken to ensure a high standard of nursing education. The post-graduate course had another successful year. An extra load has been thrown on the officers of the Nursing Division from work arising out of the recruitment of nurses and the maintaining of a proper balance between Army and civilian needs. Bursaries granted by the Joint Council of the Order of St. John and the Red Cross Sooiety have enabled the training of occupational therapists for work in connection with the military wards in the hospitals in the four main centres, while bursaries granted by the Department have enabled the training of additional occupational therapists for work in the convalescent military hospitals in Rotorua and Hanmer Springs. Maternal Welfare. Dr. Paget reviews the steps which have been taken to promote maternal welfare in New Zealand. It is encouraging to find that the measures instituted have resulted in a definite fall in the maternal death-rate. Nutrition. Dr. Muriel Bell joined the staff as Nutrition Officer during the year. In an interesting report she sets out her programme of work for the future. Dental Hygiene. Mr. Saunders reports a year of much activity. A notable event was the opening of the new Dominion Training-school for Dental Nurses and Wellington Dental Clinic. The treatment centres now number 351, and 108,848 children received systematic dental treatment. The number of dental nurses now in the field has increased by 34, while 139 student dental nurses are in training at the training-school in Wellington. Maori Hygiene. The following table shows a comparison between Maori and European vital statistics:: — Maori. European. Birth-rate per 1,000 of population .. .. 46-87 21-19 Infant-mortality rate per 1,000 live births .. .. ..87-22 30-21 Crude death-rate per 1,000 of population .. .. ..17-51 9-25 Crude death-rates per 10,000 of population — Tuberculosis, all forms .. .. .. ..41-32 3-88 Pulmonary tuberculosis .. .. .. 31 • 87 3-24 Other forms of tuberculosis .. .. .. . . 9-45 0-64 Influenza .. .. .. .. .. .. 4-17 0-77 Typhoid fever .. .. .. .. .. 1-32 0-04 From these figures it can be seen that generally the Maori rates compare most unfavourably with the European. Tuberculosis in all its forms takes a particularly heavy toll of the Maori people. As pointed out in previous reports, the problem is being grappled with through segregation of active cases, provision of hutments, improved facilities for diagnosis, and health educational work. An amount of £6,000 was included in the year's estimates for erection of hutments for treatment of tuberculous cases.

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