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In this country great care is being taken in the selection of cases suitable for neurosurgical treatment. STAFFING During the year there has been an acute shortage of medical officers. This has meant the working of very long hours by the medical staff in maintaining the standard of treatment in our hospitals as well as endeavouring to meet the requests from sources outside the Division for psychiatric opinions and reports. The female nursing staff shortage has continued. At most of the hospitals there were occasions when the effective strength was more than 50 per cent, below the authorized establishment. This means that very long hours have to be worked during a week. Sometimes the Matrons have been faced with difficulty in providing sufficient staff to meet basic essential needs, let alone anything else. Psychiatric nursing is not receiving the recruits which it needs. The public has a responsibility in this matter. PREVENTIVE PSYCHIATRY The medical staff of the mental hospitals carry out a large volume of psychiatric work outside their hospitals. There are two aspects of this work : (1) Clinical. —Many out-patient clinics are held away from Mental hospitals, and consultant services are given to public hospitals and to various Government Departments such as Pensions, Police, and Child Welfare. The vast majority of the persons seen at these clinics never reach the stage of having to enter mental hospitals. A large proportion continue to remain in employment as economic units of the community. The figures for one very busy mental hospital show 1,169 out-patient consultations ; also, 456 in-patients of the adjacent public hospital were given psychiatric examinations. This is an established part of the work of the Division, and it is of great value to the community. (2) Education. —It is pleasing to record the increasing public interest in the work of our hospitals, and more especially in the application of mental hygienic principles to the general community for the improvement of mental health as well as the prevention of nervous and mental illness. Talks on mental hygiene have been given by the medical officers to various organizations during the year. It is important that this growing interest should be nurtured. CONDITION OF THE BUILDINGS Many of the buildings are old and should be replaced. Temporary improvements have been made to older wards, which will have to be used for years yet. Maintenance is particularly heavy at Seacliff owing to the moving ground on which the hospital is built. Maintenance work has been carried out at all the hospitals, but the progress is not keeping pace with the requirements. This is due to shortage of labour and materials. Our own artisan staff do what they can, but they are numerically small, and for much of the work we depend on the Ministry of Works. The officers of the Division are gravely concerned at the lack of progress.

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