113

Narrative.

his Honor the Superintendent took charge of the Hospital in the end of July. At that time, patients were attended by Messrs. Cusack and Vickerman, each taking charge of all patients entering in alternate months. Thus, at the end of December, say, Mr. Cusack would have had charge of all patients who entered in December, October, August, &c.; while Mr. Vickerman would have had charge of all who entered in November, September, July, &c. The Committee at once arranged that Mr. Cusack should have sole charge of the Hospital, and requested his Honor the Superintendent to provide for the medical care of the Gaol, Lunatic Asylum, and Taranaki Buildings. Mr. Vickerman was at once appointed to this post, and the vote of the Provincial Council for medical salaries (£200) divided equally between the two surgeons.

The Committee then proceeded to effect some slight improvements in the date set, and in the ventilation and arrangement of rooms, allotting a better room for the female ward; and introduced the earth-closet system into the latrines, with manifest advantage. The approaching completion of the New Hospital made it unadvisable to attempt any more sweeping and expensive alterations or improvements. The Committee introduced a more strict and methodical manner of keeping the accounts. They also ruled that the manner of admission should be by certificate, signed first by the Hospital Surgeon, testifying to the fitness of the case medically, and countersigned by a member of Committee, testifying to the fitness of the case pecuniarily.

The Committee becoming more than full about the end of October, the Committee, anticipating a constant increase, applied on the 1st November to the Provincial Executive, that a temporary barrack might be erected in the Hospital grounds. This application was refused, the Executive being of opinion that a shorter course would be, if necessary, to hire a house for some existing patients. However, the number of patients immediately after that began to decline, and the Hospital has not since that been quite full; although the sudden influx of half-a-dozen patients might any day necessitate the hiring of extra accommodation, so inadequate is that of the old house.

After watching for two or three months the working of the Hospital, and after conferring with Mr. Cusack, the Committee came to the unanimous conclusion that the working of the Hospital would probably be most efficient under a resident surgeon. Accordingly, on November 23, with the concurrence of the Executive, they wrote to Holmes Coote, Esq., Chief Surgeon of St. Bartholomew's Hospital, London, to ask him to select a surgeon willing to come out to be house surgeon of the New Hospital, and to take charge of the patients in the Gaol, Lunatic Asylum, and Taranaki Buildings. Terms offered—£200 per annum, with rooms, board, fire, and for two years certain, but without the right of private practice.

And on December 11, being unanimously of opinion that the system of nursing in the present Hospital much needed improvement, and that the best way to improve it would be to get out from England a hospital nurse, the Committee further wrote to Mr. Holmes Coote, to request the surgeon whom he might send out to Nelson to select a good experienced hospital nurse willing to come out and serve in the Nelson Hospital. Terms offered—£60 per annum, with board and lodgings, for two years certain.

With the sanction of the Executive, free passages were promised in both cases.

Increase of Patients expected.

The Committee anticipate a larger number of patients during the coming year than during the last, for three principal reasons:—

1. The diggings in the northern part of the province, although spreading at a slower rate than was at one time anticipated, seem likely to increase, and therefore, to send an increased number of patients.

2. The instructions of his Honor the Superintendent to Hospitals on the West Coast are, to send to Nelson such bad cases, or chronic and tedious cases, as can bear removal: and this for a double advantage—to the patients, of change of air and better medical advice; to the public purse, of a cheaper rate of expense per head. It may also scarcely be said that the great majority of patients in Hospital cannot pay their expenses there.

3. The number of female patients has been very remarkably small hitherto. This is owing, partly owing to an impression in some quarters that there is no fitting accommodation in the present Hospital for female patients. The Committee expect that when the large new improved Hospital has been opened, many more female patients will apply for admission.

On these grounds, the Committee have allowed, in the Estimate of Expenses for the coming year, appended to this Report, for a considerable increase of the number of patients.

At the end of February, Mr. Cusack left Nelson to reside in Wellington, and two applications for the surgeonship of the Hospital were made to the Committee, who, after explaining that the appointment was only temporary, pending the expected arrival from England of a house surgeon, appointed Dr. Squires.

The new Hospital is expected to be ready in about three months. In view of this much superior accommodation of the New Hospital, and the impression on the part of diggers that the chances of recovery are better at Nelson than at Brighton, Charleston, or Westport, as also for other reasons already brought forward, the Committee expect a considerable increase of patients as soon as the new Hospital shall be opened. They therefore recommend that provision be made by vote of Council for the remuneration of a Visiting Physician and Surgeon, only to be applied if found absolutely necessary. Vide detailed Estimate appended.

The Committee presume that water from the new service will at once be laid on to the new Hospital. They recommend some additional planting for shelter, and also the formation of a garden, and especially of a kitchen-garden, near the new Hospital. The hard, unbroken character of the ground there make the formation of a garden far beyond any resources of labor the Committee are likely to have at their command; once formed, the Committee hope to have it kept up without any further assistance.

In view both of sanitary precaution and also for the better maintenance of discipline, they strongly recommend the adoption of a Hospital dress, or uniform. This item is allowed for in the estimate proposed.

The Committee recommend that, with one or two exceptions, none of the bedding and none of the old wooden furniture of the present building be removed to the New Hospital, but that it be entirely fitted anew.

In their estimate, they have allowed nothing for shelves, fixed cupboards or dressers, and such like fixtures, presuming that such fixtures, if not already provided for by the contract, will fall under the head of public works. In drawing up the estimate appended, they have studied to keep to the closest economy compatible with efficiency.

The Committee desire to acknowledge the kindness of his Lordship the Bishop of Nelson in devoting to the relief of destitute patients leaving the Hospital.

Recommendations.