lSSL
. VICTORIA.
PUBLIC CHARITIES.
REPORT OF INSPECTOR
FOR THE
HALF-YEAR ENDED 301'H .JUNE 1881, ·
AND
ROUGH DRAFT OF PROPOSED AMENDING BILL;
TOGETHER WITH
ADDITIONAL REPORTS.
PRESENTED TO BOTH HOUSES OF PARLIAMENT BY HIS EXCELLENCY'S COMMAND.
15~ ~utbotifl! :
JOHN FERRES, GOVER~MENT PRINTEU1. MELBOURNE. No 23 . ,.
Al'Pl!OXJMATE COST OF REPORTS. ... £ 8, ll• Propafa.tion, &c.-Not given. E'rintlng (V25 copces) 85 10 0 . PUBLIC ·CHARITIES OF .VICTORIA,
'/'
Inspector's Office, Treasury, 25th July 1881. Sm, . I do myself. the honor• to submit a half-y~r's Report of my ~ork. as Inspector of; .Public Charities. : $ince my appointment· to that position I have inspected the following charities :-'·· ' .. .. . :-' . . · ·HospitalS'.-Melbourne, Alfred, . Homreopathic, Inglewood, Creswick, Dayl'esford, Clunes, Amherst, Maryborough, Maldon, Dunolly, St. Aruaud's, Kilmore, Heathcote; Bendigo, Castlemaine, Ovens, Ballarat, :-· ··, Mooroopna; and Wangaratta. · J:$enmmlerit' Asy(ums.-Melbourne, Bendigo, Castlemaine, Ballarat; Ovens,. ' and the Home of the Immigrants' Aid Society in Melbourne. Other Institutions.-· Melbourne Blind Asylum, Ballanit Orphan Asylum, . Ballarat Refuge. Also the accounts of the following societies :- ·;," · Clunes, · Creswick~ Ballarat Clothing, Daylesford, Eaglehawk, Kilmore, 1 · Maldon, St. Arnaud, Maryborough, Talbot, and Buninyong.
, Of the.'benevolent· ·societi~s it will suffice to say generally that they are doing ' .I l ' . good work in a most ·economical manner, and that, with one or two exceptions, the a~co~nts are well' kept. My reports upon the i~stitutions inspected will appropriately constitute appendices to this Report. The. Royal Commission, .in recommending the appointment of an Inspector of Public Charities, said, " What appears to be desirable is that the :whole management of _each ch~1jty, shol!-ld p~ P,erioqically investiga:teq, an? .a regular audit at the same time r'n.~~e o_n·he~alf, not _of_ ~h~.,~~bscribers, .~ut of the State, and. o.f the municipal and loca~ 'cor:[ior~~ions." '' 'I have;. ac~ing up?n ~he instructions' given' nie ~t the tin1e 'of my ~ppoin~~~t; taJr~n that as setting forth ·my ~uties, and made' as close a~ examimitioJ;t pf the acc.ounts of institUtions visited; 'the 'four principal Melbourne charities exc~pted, as the unpreparedness of some of. the ·institutions for such an inspection rendered practicable. For the reaso~ set forth in my reports, my inspe~tion of the Melbourne charities was preliminary. · ·' There are four general questions under which· the administration of publi~ elee~osynary relief may be conveniently considered, viz_. :- . -1. The nature and extent of relief available. 2. The general effect of the relief socially. 3. The management of institutions.
4. The revenue. of the charities. , C I 4
1. It cannot, I think, be doubted that in no way has the liberality of the community been more marked than in the provision made for the relief of the sick and destitute. Ample provision has been made for the alleviation of physical suffering, and there is probably no occasion, under ordinary circumstances, for anyone to be in absolute want. It is beyond question that several of the country hospitals do not nearly come up to the standard of what such institutions should be, while in some cases there is grave reason for improvement to be demanded. But it must be borne in mind that, even as they are, they are immensely superior in ordinary comfort nnd convenience to the homes of the bulk of their patients, and that the latter, as a rule, are inmates for brief periods, to be treated for some temporary ailment or sudden accident. In view, therefore, of the consideration that it is in several cases question able whether the limited and fluctuating population will warrant the expenditure that wQuld be requisite to make these institutions all that they should be, or even warrant their continuance at all, a high standard of excellence, involving, as it would, an exceptionally high cost per head, can scarcely be looked for. It must suffice, I think, to have those which are in settled districts, the centres of large populations, a~d which may be considered permanent institutions, suitably fitted for their work. Of the benevolent asylums I need merely remark that, Melbourne excepted, they are well fitted for their purpose on the whole, and. seem to me to be quite sufficient for the requirements of the populations they serve. Indeed it will be a wise policy, and tend to economy, to lessen the demands upon those institutions by fostering benevolent societies, which will he, practically, encouraging the boarding-out work. 2. But while the wants of the sick and the needy are provided for, in many eases with a lavish hand, .there is quite sufficient reason for the fear that either local causes, or the very general desire to provide speedy relief, has led the colony into an unduly extravagant system, by needlessly multiplying local hospitals. The Royal Commissions of 1862 and 1870 both drew attention to this point, and made recom mendations which, had they been acted upon, would have saved much expenditure and placed matters on a sounder footing than they now are. I do not pretend to have acquired sufficient information during my brief. term of office to enable me to advance an authoritative opinion as to the general effect of the relief afforded on the social system of the colony. But I have taken special pains to see and question the out-patients of country hospitals wherever it was practicable for me to do.so, to learn the circumstances of the in-patients, and the nature of the checks adopted to prevent imposition. The result has been entirely confirmatory of what has . been said respecting the pernicious influence of a system of relief, the administration· of which lacks proper discrimination. That noble bulwark of manliness, a true indepen dence, has in many eases been manifestly broken down, while in some cases committees · have not hesitated to tell me that, as business men in the locality, they could not incur the odium which too close a scrutiny of the· claims of applicants to relief would certainly bring upon them. The members of one committee told me plainly, when I was discussing this point with them, that they were glad the Government had sent an inspector, as that would enable them to plead that they must. now apply a more stringent rule. But I apprehend that neither the visit of a Government inspector, nor anything eise, will remedy this undoubted evil so long as unduly large Government grants are available for the construction and maintenance of hospitals in small country towns. Self-interest will be altogether too strong for public morality. Besides, for very shame's sake, once having obtained the hospital, it must l)y some means be kept supplied with patients, and in many cases this is accomplished by taking in those who are simply "benevolent" cases, and who would, if left to a local Society, have what little they 5
could earn supplemented by a small weekly donation .. Out of 581 inmates of the hospitals I have visited, no' less than 82 are returned by the officials themselves as being properly "benevolent" cases, and my own opinion is that an impartial medical investi gation would, at the very least, double that number. And apart from this aspect of the case, it is notorious throughout the country that persons well able to pay for medical advice resort to the hospital. It is not an infrequent thing for persons whose circumstances permit their driving their own buggies thus to seek gratuitous relief, and I have before drawn attention to an illustrative case in which a person known to have means drove his wife to the hospital, left her there for some weeks, and when applied to .refused even to subscribe to the funds. Yet, at the institution where this occurred, the.officers are under instructions to admit patients. on subscribers' tickets "without question." I do not hope to be able to devise a method by which imposition will be ·entirely stopped, but I believe that the observance of a few simple rules would· tend .very materially to check it. For instance, no hospital should receive Government or municipal grants that did not rnake it an absolute condition of admission, in all except emergency cases, that a statement of circumstances and a certificate of poverty be given. 2nd. That in all cases these statements should be verified by inquiry. 3rd. That .whenever such a proceeding is warranted by the facts, the parties on recovery, or the relatives responsible, should be called upon to. pay, or be sued under power to be given by Statute, in the event of their refusing. 4th. The certificates and particulars of proceedings to be kept for the information of the Inspector at his annual visit. And 5th. Any glaring case of failure on the part of a committee to proceed to be counted mal-administration, punishable by forfeiture of part of the grant. In these remarks I refer, of course, almost entirely to the medical charities. Imposition in regard to the others is no doubt less extensive, and would probably be sufficiently provided for by insisting upon proper inquiry, and giving authority to proceed against relatives within certain degrees. It is, I think, to be regretted that the Melbourne charities did not ·continue the services of an Inspector of Impositions. 3. I may say briefly that, apart from the question of economy, the general ·management of institutions is good, with rare exceptions. But . that the cost of management is in a large proportion of cases upon a very extravagant scale is evidenced by the average cost per occupied bed, a difference, as will be seen by ·Appendices 2 and 3, that no variation in prices will account for. For instance, it is impossible to find a sufficient ~eason for the patients at the Alfred Hospital costing £60, .those at Ballarat £62, or those at Beecl1worth £53, while those at Castlemaine cost only £38. Were the institutions not maintained out of public funds, a too lavish .expenditure would be unwise, but under existing circumstances the most rigid economy consistent with efficiency should be practised. I have had Appendix No. 1 prepared in order that the outlay under each of the principal headings of expenditure at the institu- · tions visited may be seen at a glance. I need only say with regard to this question that an examination of the accounts shows, in many cases, that the tables provided for .the membert~ of the staffs are supplied almost regardless of cost, delicacies that would never be tolerated on a dietary scale being freely procured. It is, I am satisfied, an . unwise system that permits the senior officers to be rationed by the management, and for all others there should be a fixed diet scale. The almost entire absence of check upon an improper disposal of stores, which must also tend to extravagance, is a feature at first sight difficult to account for. But astonishment ceases when it is remembered that the affairs of these institutions are administered entirely by persons busily occupied with their own affairs, and who are in nearly every instance unacquainted with any method of bringing to account and. checking the store transactions and the dieting 'a£·~ldtge' instittftioils beyon{P that ·ivhi'ch· they may~have acquired:'·locally; ·-Yet inrmo ·pai-t' ofttlle·'-work·of these ·institutions is there· greater necessity· for vigilant oversight~ 0n~th~ q.utlstion· :of dieting, &c;, I shall have ·a '"few remarks. to offer·further on .. ·~~> <·•·:4. The inequality which marks the distribution of the Go:vernment•·grant':ls h~d·in itself;':and;.'as has··been pointed ·,out,. is :calculated to become auencouragemerit :ro:'~ma;lli·:.locai c6ntributions. ratller than an incentive to liheral support. · In one'~ase :whicJ:l·:JJ:.have''had·to ·bring··Urider•notice the maintenl:tnc'e of the institutiorr·has:been largely dependent·'upon an 'tul.uuly large· Governmertt·grant.aml'a: bank overdraft, while th~·.ordiiiary revenue ·has be-en a:~tually diverted ·to: create an·'endowment fund.· :.d.n
·knothet. ;,district:~t was··hiformeu: :that. ·:the. rrietliod of distribution. had caused·•.the :aaoptian of':a'siniilar colfrse to be:ad¥ised.
8<1:·~:::~ ; · . .N Jfi;J,Qh institutiQns :;ts .Blind and :Oeaf and.PlJ.mb, Asy;lUD1s. ·... ,f),Q!)Q_ ·.. . "J. 1. :~_l!f, . . ' . . . £53 005 . .. - . \.,f(;. ,·i_~·.·~- .• ,;' ' . .' ,.~,_.,, ~ ' 1 ~t.,i .\ ' ...... ·.·L1-!.'.\ ·:;,,.:':_~t~L-.·,-·J'..- 4 1. 1 ! ,_:· .. ·, .J~Iimicipali~~es . .•...... ,45,QQO.. . . 1 ...,, · LocW. squr()es · · ... ,,;· " · · ·· ···' --:n !.':.:'- ~ ;-. 55~900'' · · ~
.-.:A·::.:·/" ~ · . u # of f • P _ ·. :." .. J,. •• Y·: r .,.,~~:. :}.:
I, ; ~' •' tL . '<• .:: ; !!U t.'.i" ...· J. :, .·J:
611 :._ ;Q:Qspi!;a!s, 1,725; ~t.,~45 ...... ·· '·"· ..... ,. ... '·i".i .· £77,625, ... ~. F .;.::'£~ .·, at .£17_ ·.:· ..· • • ;, '' _.. .·:: •• Bepev~~:nt_ A,sylu;n~, ~,118,, 1 ,~.--·' .~'.' ·c..~._, ~~!Qo_( .. " • ·,_~-- ., .' :) Orphanages, &c., 906, at £15 12s...... 14,133 , il:· Special for Provident Dispensaries; 1 ·---~; ,'h'.t'.Asylnms, .•• ~ , :~... v ·~·•...... ~··· __. .•-- ••• :: : •••. :.~· _ ... 5,000·~. ·:·.: - 1~~ •,.•.• The raJeF!.:~Ppdfied.above are, o~. ~Ollrse averages. In some cases less will suffice, and in others it '\\rill be fair to allow more ; but that the averages ·are sufficiently high is clear from the fact that, as regards hospitals, several country institutions, and, as regards asy-lums- and .orphanag.es, ~e:veral in ~nd abou~ Melb_ourne;:which oab.soro: a large proportiori-pf .the money.:Y.oted, are maintained at mucb.Je~;~s rates ..than- those ·spycified (.vide Appendix No. 5 ). The high cost. of some ?f;.thejnstit11tio~s is indefensible· on th-e ground of public charity, and, .where the average· quoted, is riot .considered:.sufficient; the excess, unless in. exceptional cases, should Qe, proyided .Py private benevolence. I entertain little doubt, howeve:r:, .that; when the G receipts last year by about £11,000, and yet is in excess ~f the estimated Government grant. It is believed that the effect of an enforced municipal contribution will be to lessen private donations, and I think this will be the case to some extent at first. But I do not anticipate that they will b~ materially affected in the centres of population, especially as the Government grant will still depend upon them. Besides, it is to be· noted that the endowment funds of several institutions have now reached such sums that the interest will annually add an increasing item to their revenues. Again, by giving managers power to recover, I am satisfied that either expenditure · will be decreased, 'o'r that much larger sums will be obtained from inmates and th~ir relatives. I believe,.'therefore, that the sum estimated,, £55,000, is quite within what can be obtained for maintenance purpo~es, and, as the grant will be given, I assume, only on . bona .fide private contributions, 'it will nec'essarily be less than the revenue obtained from local sources. I have stated the grant at possibly £63,000, but it may not reach that sum, as the increase to societies will have a tendency to lessen the number to be maintained in hospitals. The following will show approximately the rev~nue from · Government grant and municipalities under the present and the proposed systems :- Present. Proposed. Grant (as voted) .£110,000 .£63,000 Municipalities, say 7,000 45,000 .£117,000. .£108,000 3. By the creation of hospital and benevolent asylum districts there will, I anticipate, be created a feeling against any further unnecessary multiplication of charities, as, before a grant or municipal contribution can be obtained for any new chanty, each of the bodies interested must be consulted. 4. It is of course difficult to provide machinery of a simple character to ensure economical administration. I do not place much value on the proposal to have local bodies and the Government represented on boards of management, because I find that such representation practically obtains now, and it is a rare thing, I believe, in the country at any rate, for committees not to have members of local councils and a Government officer as members. The best course, it appears to me, would be to make the Government grant proportionate to a · reasonable expenditure, as well as to the amount of contributions collected. In order that this may be arrived at, I propose that the Inspector· should annually give a certificate for each charity, stating what he considers to be a reasonable rate per occupied bed ; that each charity should have an opportunity of criticising that certificate, and that then the Governor in Council should make an order determining the rate on . which the grant should be based. I have, however, provided for municipal representation outside of the Melbourne district. Within the Melbourne district it would be difficul~ to arrange for this, and, besides, I have proposed a council of advice. · . 5. I have before referred to the question of dieting staffs by scale, but it is a question which, like most of the abuses t4at exist, enters largely into the general matter of administration. For all these questions, which will vary mU:ch according to localities and circumstances, it appears to me to be better to provide generally rather than specifically. For that reason I have proposed (clause 10) that the Governor in Council may, in certain cases, insist upon reforms being effected, or, " in the event of failure to comply, order a discontinuance of the payment of the grant and the municipal contribution. 9 . 6. In. proposing the creation of a council of advice for . the metr9politan chari.iies, wliich, by reason. 9f'thei~ number and influence, require speciai.oversight, I nee~·do ·11o more 'than· quot? .the.1vords I used \vhen first :inaki~g-th~ !ecommendation, " Acting witli. such. a council ,fo~- the metropoii~, .the Inspector' will i1ave .greater power to. deal 'with abuses in cou}\try "districts; and 't4e HQno~able 'Hie Trea~urer \'\rill probably .be strengthened b)/its-advice.. in 'demaiuHng:·th~t.the.d~arities subsidized· by the State shall exerc;ise eco~omy::r · . _ · ' ·· ·'" · . 7. In accordance witli the ..views of the Royal Co~n1ission, and of the recom mendation I have myself m~de,: I ·have o~itted ·from· the schedules the hospitals at Amherst, Creswick, Heath~ote, J;nglewood, and 1\faldon. Daylesford, at present hospital and asylum, and. wbich ({an only be considered as a temporary institution, is placed in the h~spital schedhle o~ly ; and Belfast, a hospital, is provided for in the asylum schedule,. the district alloted to it having the hospitals at Portland and :warr nambool. The· Pleasant Cre~k' rustrict has two hospitals( but· it will probably be a ·question with the residents whether one shall not be closed. The three districts about vVood's Point have each a hospital, the average number of inmates in which were-Alexandra, 3!; l\1ansfield, 7; and the Upper Goulburn, 13. At least one of these should be closed. The power of re-distribution provided for in the proposed Bill will enable these and other changes to be made as occasion may arise. :Maps have been prepared showing the division of the colony into districts in accordance with Schedules 1 and 2, which are available if required. The remaining features of the draft measure do not, I think, call for special comment here. There remain, howeverj one or two matters to notice. The need ·of uniformity in the system of dealing with the financial affairs of the institutions, both for statistical purposes and convenience of audit, is generally admitted. Some time since the Sydney Government required the charities of New South 'Vales to adopt a uniform system, and samples of their books were placed at my disposal. Before deciding to recommend any system, ho1vever, I thought it best to make myself acquainted with the systems in use at the leading charities, and if possible to adopt that which would combine simplicity with efficiency, and had been practically tested. The Ballarat and Castlemaine systems, each of 1vhich are based upon the same principle, offer combined nearly all that could be desired. From these, therefore, I have constructed a set of books, and having made various alterations, suggested by Mr. Audit Commissioner Agg and the Under Treasurer, l\1r. Symonds, who were good enough at my request to carefully examine them, submitted them for your approval to be printed and recommended to the charities: During the half-year I have had, by direction, to make special inquiry into certain matters affecting the management of the Melbourne Hospital, Melbourne Benevolent Asylum, Castlemaine Hospital, and Bendigo Benevolent Asylum. On . these matters reports have been sent in. Another matter which has been under public notice related to the burial of destitute inmates, and arose through a case ·which occurred at the Alfred Hospital. In consequence of this case I inquired of the leading denomi nations as to there being ariy difficulty in the way of securing the services of a clergyman at the time of burial. The answers, as may be imagined, were all to the same effect, there being no difficulty, providing a request is made. This is what the officers of the charities . do not appear to do, hut the committees should henceforth cause it to be done; I am indebted to a Treasury clerk, whose services were kindly lent me by the Under Treasurer, for Appendices 2 and 3. Having no clerical ~ssistance, and my work of inspection being somewhat behind, I have not hnd time to cl~eck either of the tables, No. 23. B 10 but I do not doubt they will be founq to be correct. ·Appendix 2 will differ somewhat from the statement of cost per head given in my reports upon individual institutions, because the return shows the gross cost under each heading, whereas in the separate reports certain allowances have been made. I will only say further, with regard ·to that return, .that the variations show clearly that there is ample room for economy. It only remains for me now to acknowledge the courtesy a,nd prompt attention to my inquiries which I have met with at all the institutions visited. I have the honor to be, Sir, Your most obedient servant, H. F. NEAL, The Honorable the Treasurer. Inspector of Public Charities. APPENDICES. APPENDIX No. 1. AN ACT TO AMEND THE LAW RELATING TO HOSPITALS AND OTHER CHARITABLE INSTITUTIONS. PREAMBLE. PART I. 11 1. " G OVernor " tO mean G OVernor Ill . COUUCI 'I • " m.anagers"' . " tO mean Interpretation of committee managing. "Order" to mean Order of the Executive Council, &c. terms. 2. Clause 1 of Act No. 220: rnsutuUollB 3. The districts shown in Schedules Nos. 1 and 2 shall be hospital and ~::~:~ uenned. benevolent asylum districts respectively within the meaning of this Act. 4. The Governor may, on the receipt of a petition signed by not less than suMt,-tstonot twenty-five ratepayers resident within any district prayin~ for the subdivision of such districts. district, order such subdivision and the creation of a new district : Provided that before any new district is created one month's notice in writing shall be given by the petitioners to every municipality contributing or liable to contribute under this Act to institutions existing within such district, and provided also that similar notice shall be given to the managers of all such existing institutions within such district, setting · forth the scope and obJect of such petition. . · . 5. No institution other than those mentioned in Schedules Nos. 1 and 2 to this rustttutionsto Act shall be entitled to participate in· the contributions which municipal bodies are ~~~~~Tpat hereinafter directed to make towards the support of charitable institutions under this contributions. Act, or any grant directed by this Act to be made from the Consolidated Revenue, unless the Governor shall by order authorize such participation and specify in such order the proportion of such contribution or of such grant which such institution shall be entitled to receive. . And it shall be competent for the Governor at any time to vary or cancel such order : Provided that the Governor may also by order direct that a portion of the contribution which it is herein provided shall be payable to hospitals shall be paid to any provident dispensary, or that payable to benevolent asylums to any benevolent society or societies operating witl1in the district by which such contribution is to be paid. . 6. Clause 2 of Act 220. 7. Clause 3 of Act 220. p .ART !I.-INSPECTION OF CHARITIES. 8. The Governor may appoint an inspector of public charities, hereinafter Governor may called the inspector, ·whose duty it shall be to visit and inspect annually every charity ~;~~:~t~r. established or incorporated under this Act, to investigate the executive acts of the managers of such charities, and to examine the accounts and books connected therewith. He may make special inquiry, at any time he may consider necessary, into the management or method of administering relief of any such institution, and for the purpose of such inquiry he shall have access to all books, records, or documents connected therewith. He shall report annually to the Treasurer the result of his inspection, and such report shall be presented to Parliament, and a copy thereof be sent to each institution reported upon, and to each municipal body contributing towards the funds of such institutions. · · • 12 Inspectorshnn 9. At every such annual inspection the inspector shall ascertain the cost per certlly to cos!. head of the inmates at ea~h of the i11stituti<;m~ ·.rep01:te~l_upon, and shall present to the Treasurer, for submission to the (}overnor, a certificate setting forth such cost, and the deduction, if any, which. in his opinion should be made from su9h COSt in computing the Government grant to which, under clause 1'7 of this Act, institutions are entith~d. Gove:.:normny · 10. In the event of any report by the inspector seeming to the Governor to f~~::;:'n~~;:;,;~ indicate the necessity of interference in the management of any institution established under this Act, it shall be c01npetent for the Governor to reduce or altogether stop the amount that shall be paid to such institution from the Consolidated Revenue, or from municipal contributions, or from both, until such correction or alteration in the management of such institution luis been n1ade as the Governor may direct : Provided that no such reduction or stoppage shall take_ effect until at least one month's notice has been given to the managers of such institution of the nature of the complaint made and. of the_ reforms requi~~d. , , ...... · ·. Penalty for 11. Every public i11stitution established under this Act shall at all times submit refusing illllpection. to the inspection arid·. examination· aforesaid, arid any manager, secretary, treasurer, . trustee, or other officer resisting the inspection and inquiry of ·such inspector by ·wilfully refusing admission to premi&es, witl1holding books or accounts when applied for, or by any other act, shall be liable to a penalty not exceeding, for any one offence, the sum of Ten pounds sterling, to be recovered by summary process. pART III.-COUNCIL OF ADVICE.· Govc~normny. . 12. It shall be lawful for the Governor. to appoint four gentlemen:, one of ~~P:,:ete~~uncll whom shall be of the medical profession, to constitute with the· inspe~tor a council of advice, to advise the Governor on matters rel~ting to. the ma,nagement of and administration of relief by the institutions established under this Act within the district called the Melbourne district in Schedules Nos. 1 and 2. Any two memp·ers of such council shall have the like powers of inspection in regard to the charities within such district as are herein given to the inspector, and the· inspector shall be chairman of such counciL · · · · Meetings of council of 13. The council of advice shall meet at the office of the inspector at such times advice. as such council may determine, but not less frequently than ·once in every two months, and at all meetings three shall form a quorum. It shall present· annu;:alJy to the Governor, for presentation to Parliament, a report respecting the charities within the Melbourne district. · Mem bcrs mn y be replnced. 14. In the event of any member of the aforesaid coupcil becoming insolvent, &c., &c., or failing to attend three ordinary consecutive meetings of such council, the chairman thereof shall report such circumstance to the Governor, who may thereupon appoint some other person to act in the stead of such member. PART IV.-,M.AINTENANCE OF CHARI'l1JES. MunJcipalitics to contribute. 1.1. Towards the support of the institutions specified in Schedules Nos. 1 and 2 to this Act, or such other institutions as may hereafter be established, every municipality shall contribute at the rate of one-eighth of a shilling in the £ upon the annual rateable value of all property withii1 such municipality, and such contribution shall be a first charge on the revenue of the council collecting the rates within such municipality ; and the treasurer of such council shall pay over the amount of such contribution, in two equal sums as near as may be, in the months of . January and July in each year, in the proportion and to the ii~stitutions SJ?e~ified in Schedules Nos. 1 and 2, or to such as may be hereafter authonzed to part1c1pate by order of the. Governor; and in the event of such contribution of one-eighth of one shilling in the pound· proving to be either in excess of or inadequate to the requirements of any such institution or institutions, the Governor may by order direct a decrease, increase, or re-distribution of such contribution as he may consider necessary : Provided that no such contribution shall exceed a sum of threepence in the £ of the annual rateable value of the property within a municipal district. Governor may 16. In the event of any municipality failing to pay over to the. managers of enforce payment of institutions or societies the sum directed to be paid as herein provided, the Governor contribution, may by order direct such contribution to be taken from any Government grant payable 13 or thereafter to become payaple to such municipality, or that such .·other steps be taken to enforce the payment of such contribution as may to the Governor seem necessary. 17. For the Financial Year 1881-2 there shall be paid to the managers oftheorontrrom institution~ "~p~~~!Jed in Schedules Nos. 1 and 2, from the Consolidated Revenue of the ~~~~~~ted colony, a sum of' £3 for every £1 of bond fide private subscriptions collected ~nd ·placed to the credit of the funds of any such institution ; .for .. the .year· 1882-3 a slltil of £2 for every £1, and thenceforward £1 for every~ 1 of such subscriptions ; ·and any institutions hereafte1~ established under this Act shall receive a grant not' exceeding the sum of £1 for every £1 of such_ subscription: Provided that no such g:tarit of £1 for £1 shall in any case exceed one-third the cost of maintenance of inmates within such institution, at such a rate of cost per head as the Governor may direct shall be the basis of such grant after receiving a certificate relating to such cost from the inspector as hereinbefore provided. L8. Towards the support of the institutions specified in Schedule No. 3 of this Grant to special Act there shall be paid to the managers thereof from the Consol!dated Revenue of the institutions. colony a sum at the rate of £2 for every £1 of bona fide private subscriptions, and any other institutions of a kindred nature hereafter established under this Act may, if the Governor shall by order so direct, receive a similar grant : Provided that no such grant shall in any case exceed two-thirds of the cost of maintenance of inmates within such institution, at such a rate of cost per head as the Governor may direct shall be the basis of such grant after receiving a certificate relating to such cost fi:om the inspector as hereinbefore provided. _ 19. No institution shall be entitled to 1~eceive municipal or Government aid contrtbuuon.s under this Act unless the private contributions herein referred to have been made ~~~~~;a::;r.r. towards the maintenance funds of such institution without any right of relief having accrued to the persons from whom such contributions have been received: Provided that nothing in this Act shall.interfere with the right of managers of such institutions to receive paying patients under such regulations as lllaY be approved by the Governor. · PART V.-INMATES. 20. No person, other than a paying patient, received undeT regulations as Inmates to oo aforesaid, shall be admitted into, or. receive relief from, any institution established f:~~~:;e~~~ept under this Act, unless such person is unable to procure at his or her expense such case•. relief as he or she lllaY require: Provided that no hospital shall refuse such relief as may be necessary in. cases of accident or illness of a dangerous nature. 21. If the Central Board of Health shall at any tinle recommend, and if it shall, nospltalsto in the opinion of the Governor, be necessary or desirable that at any hospital ~~~~v~~~~:!!;, established under this Act provision be made for the reception, isolation, and separate treatment of persons suffering from infectious or contagious disease, the Governor shall cause notice to be given to the managers to provide such accommodation, and the Governor may reduce or altogether stop payment of the amount to be paid to such hospital from the Consolidated Revenue until such provision shall have been made to the satisfaction of the Governor: Provided that no such reduction or stoppage shall take effect until after the expiration of at least three months from the date of the notice given to such managers. 22. Every person receiving relief from an institution established under this rnmatesand Act shall be liable to pay the cost of such relief, and the treasurer of such institution t~·i~~f!~tes to may recover by · . Provided that no person shall be liable to pay, if an in-patient, a sum greater than the cost last certified to by the inspector as the cost per head at such institution ; or, if an out-patient, a sum greater than the actual cost of medicines, instruments, or goods supplied, in addition to such sum for medical advice and attendance as may in the opinion of the court be equitable. 23. [To be drafted by Law Department. J Husbands, wives, parents, chil dren, !!able' and may be pro· ceeded against. pART VI.-MANAGEMENT. Also cost of maintenance to be recover11ble 24. Clause 4 of Act 220, with }'>roviso for on from the estate municipal representation of late Inmate. committees of institutions outside Melbourne district. 25. Clause 5 of Act 220. o 26. Clause 6 of Act 220. 14 27. Clause 7 of Act 220. 28. Clause 8 of Act 220. 29.. Claus~\ 9 of Act 220. 30. Clause 10 of Act 220. 31. Clause .11 of Act 220, with ·proviso as to day on which successors shall be elected. -:Also substitute July for January. 32. Clause 12 of Act 220. 33. Clause 13 of Act 220. 34. Clause 14 of Act 220. 35. Clause 15 of Act 220. Liability of hospital doctors 36. [To be drafted by Law Depar~~ent. J and officers to be limited. Endowment or sinking fund. 37. [To be drafted by Under Treasurer.] . 38. Acts to be repealed. ScHEDULE No. 1. HOSPITAL DISTRICTS. Name of District and Institution. Municipalities to Contribute. Rate of Contribution. Alexandra- Alexandra Hospital Shire of Alexandra One penny in the £. ( City of Ballarat I Borough of Ballarat East Shire of Ballarat I , Ballan I Borough of Browns and Scarsdale Shire of Bungaree Ballarat- i , Buninyong .•. Ballarat Hospital ••• Borough of Creswick ... i ... ~ Shire of Creswick (One penny in the £ . .I , Grenville , Leigh , Meredith I , Mortlake , Ripon Borough of Sebastopol i l , Smythesdale · ) Shire of Beech worth ... Beech worth- r , Bright Beech worth Hospital , Oxley , To)Vonga } Ooo P'""Y io the£. Y ackandandah ·t " Wodonga " City of Sandhurst r Borough of Eaglehawk I Shire of East Loddon ... l Borough of Heathcote Bendigo- I , Graytown .•• I Bendigo Hospital ... Shire "of Huntly ... \ Borough of Inglewood ~One penny in the£. Shire of Korong Marong I , l\1clvor I I Borough of Raywood ... I l Shire of Strathfieldsaye ) Borough of Castlemaine r , Chewton ... Castlemaine I .r One penny in the £. Castlemaine Hospital Shire of Mount Alexander ... i Mal don Metcalfe Two-thirds of one penny in the £. L Newstead One penny in the £. Clunes- " Clunes Hospital Borough of Clunes One penny in the £. Shire of Clunes One-fifth of one penny in the £. Colac- Shire of Colac· Colac Hospital Winchelsea } One penny in the £. " Hampden Daylesforcl Borough of Daylesford 0 Daylesford Hospital j- One penny in the·£. Sllire of Mount Franklin 15 HosPITAL DisT.RICTs-continued. Name of District and Inatltntlon. • llfnnlclpalit!es to Contribute. Rate of Cont.r!bntloa. Dunolly- Borough of Dunolly ••• Dunolly Hospital Shire of Bet Bet •· •• } One penn.y in the £ . ... {Borough of Tarnagulla Echuca- Borough of Echuca } One penny in the £. Echuca Hospital ... { Shire of Echuca Shire of Bannockburn .•• ') , · Barrabool · ,, Bellarine. .Qeelong- , Corio I Geelong Hospital r Borough of Geelong W eat )>One penny in the £. ,, NewtownandChilwell , Queenscli.ffe .. ; '''1 , South Barwon I l Corporation of Geelong ) Shire of Dundas Hamilton , Glenelg ... Hamilton Hospital Borough of Hamilton ... } On• ponorln th• £. Shire of Mount Rouse ... Wannon " Shire of Dunmunkle Horsham Wimmera Horsham Hospital " Kowrie f One penny in the .£. " Lowan " Shire of Broadford ') Kilmore Xilmore- " Goulburn Pyalong I Kilmore Hospital ' " ~One penny i~ the £. .... " Seymour .." Springfield " Yea ••• ) Shire of Glenlyon , Kyneton Kyneton- Borough of Malmsbury On• th• £. Kyneton Hospital Shire of Newham ... f p~eyln , Romsey Metcalfe One-third of one penny in the £. Mansfield- " Mansfleld Hospital ••• Shire of Mans:fleld One penny in the £. Shire of Talbot J!'o,,. lift"' of on• P"'nr In th• £, ,, Avoca Borough of Carisbrook Maryborough- , Majorca ... . Maryborough Hospital Shire of Lexton ... 1}'One penny in the£. Borough of Maryborough , Talbot Shire of Tullaroop J City of Melbourne , Collingwood , Fitzroy , Prahran ... Town of Emerald Hill ... l Hotham " Richmond r Borough" of Brighton ... I ,. Brunswick Essendon ... " Footscray... I .," Kew ,. Hawthorn I St. Kilda ... " Williamstown Shire "of Bacchus Marsh Berwick I . " Boroondara ••• The contributions to be one penny in the £, and Melbourne- " Braybrook ••• I paid as under :- Melbourne Hospital ... ",. Broadmeadows Eleven-twentieths to the Melbourne Hospital. Alfred Hospital ... Bulla Four-twentieths to the Alfred Hospital Homooopathic Hospital " Caul:fleld Two-twentieths to the Lying-in Hospital. Eye and Ear Hospital " Cranbourne ••• One-twentieth to the Homooopathic Hos Lying-in Hos~ital ••• " Coburg pital. Sick Children s Hospit!U " Dandenong f One-twentieth to the Eye and Ear Hospital. " Darebin One-twentieth to the Sick Children's Hos· " Bulleen pi tal. " . Eltham " Flinders and King· I " Gisborne " Heidelberg " Jika ... I " Keilor " Lily dale " I 16,. I HosPITAL DrsTRI.OTs-continued. Name of District and Institutlo!'· !>funiclpalltles to Contribu.te~ Rate of Contribution. I ']:.;;;; ! :;!(', )/·.; :t• >·'' .. Shire of Malvern , Merriang, I Melton I " Mornington ... " Moorabbin ... ,. " Nunawa ---·~--·------.. ScHEDULE .. No. 2. l3ENEVOLENt::ASYL:b)\f DISTRICTS. Name ol District nnd Instltution. Mun!clpo.l!tlcs to'Contrlbute. Unte of Contribution. City of Melbourne·: , CollingWQOd , Fitzroy , .l:'rahran ... ; ~ I • ' Town of Emerald Hill l ••• : .. ; :I~ .n: I • · ,j ').:. ,' , Hotham .. : 1 ;; • ~ ' • ' , nichmond ·.: .... Borough of Brighton ... ,, Brunswick ., l'Bsendon ... }'ootscray " Kew " Hawthorn St. Rilda ...... \Villiamstown .. • " Sale " ·17 BENEVOLENT ASYLUJII DISTRICTS-continued. Name of District and Institution, :?.!unic!pa.llties to Contribute. Rate of Contribution. Borough of Wood's Point ShireofBaechus Marsh Berwick I ", Boroondara Braybrook " Broadmeadows " Bulla ,, Caulfield Cranbourne " Coburg " Dandenong I " Dare bin . I " Bulleen Melbourne- 'f)1e contribution to be one halfpenny in the £, Melbourne Benevolent Asylum I " l~ltham and paid as under- Immigrants' Home •.• . .• Fliuders and Kangerong Melbourne Benevolent Asylum, sixteen- " Gisborne .•. ... fortieths. Home for lncurables ···1 " Heidelberg Catholic Refuge ••• ••• " The Irmnigrants' Home, sixteen-fortieths. . Protestant Refuge ... ••• ,, Jika ... The Asylum for lncurables, three-fortieths. Keilor The Homau Catholic Refuge, three-fortieths. Lilydale The Protestant Refuge, two-fortieths. " Malvern ", Merriang I Me !ton Moorabbin " Oakleigh " Phillip Island, &c. " Nuf1awading Rornsey I Mornington ", . Whittlcsea ,, Wyndham I , Alexandm Rroadford Kilmore I ", ·Goulburn Pyalong " Seymour I " Springfield Yea ... ", Newh:tm Alberton " l\VOII Bairnsoole I " Hosedale Maffra I Traralgon Buln Buln I i Narraean l " J Borough of Castlemaine I Chewton ... I 1\falmsbury JJaylesford I I Dunolly ... Carisbrook Castlemaine- , Majorca ... Castlemaine BeneYolcnt I , Maryborough I Asylum ... Shire of J\:lount Alexander ~One lwlfpcnny in the £ ... , ., Metcalfe Ryneton " lllount l;'ran klin I I Newstead Mal don G!enlyon I Bet Bet I l Tnllaroop ) I City of Sandhurst Borough of Echuca I Eaglch:twk I Heathcote j ,, Inglcwood I , Jbywocd ... , Tarnagulla ,, Gr:tytown I Bimdigo- I Shire of Echuca ... I Bendigo Benevolent Asylum .•• 1 , :lfaroug (One halfJJenny in the £. , Atmthfieldsaye , IIuntly I 'Varang:t East Loddon ... i " MciYor " Sw:tn Hill Korong I " I ll " Shepparton ) No.23. c 18 .BENEVOLENT ~SYLUM DISTRICT8-COntinued. Name of District and Institution. Munlclpalltles to Contribute. Rate of Contribution. ( Town of Geelong · ... Borough of West Geelong I Newtown & Chilwell , Queenscli:ffe Shire of Hampden 1 I Bellarine Geelong- " Colac .I Geelong Benevolent Asylum ... " Meredith " Corio ' r ScHEDULE No. 3. INSTITUTIONS TO RECEIVE £2 FOR EACH £1 COLLECTED. Asylum and School for the Blind. Melbourne Protestant Orphan Asylum. Deaf and Dnmh Institution. "Our Lady's" Geelong Orphan Asylum. Infnnt Asvlnm. I St. Angustine's Geelong Orphnn Asylnm. Ballar~tt. O~·phan Asylum. St. Vincent ae Paul's (Emerald Hill) Orpllan Geelong Protestcmt Orphan .Asylum. j Asylum. I' APPENDIX No. 2. COMPARATIVE STATEMENT of the Cost per Occupied Bed under various headings in Hospitals, Asylums, &c., for 1880. Salaries Printing, Xame of Institution. Average and Collection Provisions. Medical Comforts. ~Iedicines and Fuel, Light, and Bedding nnd Advertising, nnd Miscellaneous Repairs, Fittings, Total. No. Expenses. Appliances. Water. Drapery. Stationery. Expenses. and Furniture. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ 8. d. £ s. d. £ s. d. HosPITALs. Melbourne Hospital 349 21 3 6-l:J'h 17 15 -."!149noa 3 10 3 12 10~~ 3 12 4 10!! 4 17 64 9 7 7~9~ I 6 9 S:flg 3'19 4 4!¥~ 23-!~ 2 3 6Ai~ Alfred Hospital ... 96 26 6 IH 18 11 4fi 1 12 9t~ 4 7 8~ 4 17 6W 1 IO 7~~ 13 IOM 3 3 4-H 62 3 6 . Ballamt Hospital 98 23 15 S!lj 0~ 3 15 9 9B~ 1 7 J~g 7 16 7 4 15 43~ 3 2 St~ 14 Og8 2 15 0~~ 6 I IOh~ 66 17 8 Sandhurst Hospital 127 107 18 9 3f.l'l 12 14 31';'1 5 10r'if7 3 14 5f.JO., 4 3 7,'il., 2 6 101~7 .0 16 OH, 2 9 l'l'l 6 15 2fi1 52 7 5 Castlcmaine Hospital 77! I 7 7 '>12~ 10 6 !Of!:; 0 11 9:fy 2 9 3il 2 3 6-fts 011 0 16 8 12 9H 38 3 4 "''S5 5 3~¥ BH 2 3 9~ ts .Homreopathic Hospital . 14} 26 9 S~B 11 15 7H 2 lO 1~3 11 i 9Jr; 3 12 7M 9 5,b 7 I 4~fi 3 5 I q~ 5 17 3~~ 79 3 Il Inglewood Hospital 45! 6162 160 14 7 7fiy 1.3 3 2-flr 3 18 1St 2 5 sm 1 12 9ltJy 2 3 0 TST o 13 4fs\ 5 10 11m 2 9 7J'g", 46 4 10 Creswick Hospital 525 23! 26-k 20 8 94~ IS I5 4?9 ll '19 6 3 ll~~ 1 8 s7'h 1 1 '19 1 5 O~B 2 2 7~~ 3 15 3'1~ 56 12 4 . Daylesford Hospital 115 gr2o 31t 14 1 4m 12 18 9U'i 2 7 8;',"., 3 11 11¥,~ 2 4 101"5"7 1 9 4y'Yf 0 17 Ot;~ 0 6 li-f.r 2 8 15'1 40 6 0 Clunes Hospital ... 131 29! 16 13 5y';}g 14 18 6-fi"y 2 8 6Hi! 8 5 9y)~ 2 2 IN!! 2 17 2/,'b 3 11,',"9 4 li 7y·~'~~ I 12 7H9 54 I3 IO . Amhcrst Hospital 33 17 4 8:& 13 7 7fr 2 8 3~1 4 4 7f' 1 lO 0 I 5 4-d3 8 8 \ 2 3 5 11 2 lf3 44 14 ~ . f-L 1 1 33 c:o ~: Maryborough Hospital 50 I 7 4 Il! 15 18 3~8 1 8 9H 1 10 2!B 3 14 5! 1 18 lOf;; o 14 nl, 4 18 llg~ 47 8 11 1 Maldon Hospital 16f 12 a o 17 4 . 04oO 1 7 11.':; 2 12 11~ 3 2 7! l 19 lO,H 0 13 3~il 0 13 8H 2 15 7~0 42 13 1 Dunolly Hospital 34 I7 1711,\ I5 7 2r7 2 4 6} 4 2 8~~ 3 3 Jl61'1 0 14 9~~ 0 11 7l7 2 IS 9y'; 6 18 lly~ 53 19 8 2 • St. Arnaud Hospital 2Ib 32 17 9f2~ 20 I6 9yt'l 0 15 7r1o'7 2 16 5ih 2 2 4iY, 0 14 2-f.l'l I 15 2H~ 8 6 6-fu~ 3 0 5t\'1r 73 5 4 Kilmore Hospital 21 4 fl6 13~ 71~1 19 8 4HY o 11 51¥! 2 10 3y',\ 0 19 7N1 3 I I'll 2 li 4lfi 2 9 ON1 50 I 7 II Heathcote Hospital 11 111 10~ 29 6 1~ I5 5 926 2 14 50 4 6 4! 6 5"52 0 3 9~ 2 8 41<•2- 9 813 57 0 9 Ovens Hospital ... 65 . 25 11 4~ 18 11 11:. 3 12 3H 4 16 1M 4 0~! 2 12 5~! 2 I 6gg 3 2 6~~ 64 8 5 Mooroopna Hospital 12 30 6 5"12 9 18 3 0 17 6 8 "7:!- 2 2 0 I6 10! 3 8 5! 6 16 6~ 3 9-"-3 72 16 3 \V angaratta Hospital 2I 28 12 0~ 17 o 4H 6 1 11~ 8 19 1~ 2 11 0 11 1 9H 17 5Jt 4 19 IIH 2 6 7~ 83 10 4 ASYLUMS AND OTHER INSTITUTIONS. Victorian Blind Asylum ... 6122 8'·10 ...... 98! 15 9 l1V9 II 3 ly~g ... 0 Il 81~1 I I5 1If'9\ a 16 191 I 5 rn7 3 17 3y~~ ... 37 I9 4 Castlemaine Benevolent Asylum ... 97 4 3Mi 611 416 210 057 66~ 20 9 0 ... 8 97 8 7 97 0 13 7.0, 0 0 7M o 16 IOM 1 14 9'1 0 9 9'1 I 5 9'1 2 13 97 Ben_digo Benevolent Asylum_ _ 204 S14fl 0 513 6 41' 24 6 ...... 6 5 20'1 7 15 I02%\ 3 3'1 0 4 TO'l I 1 5fo'~ 4 5 96\ 0 7 5l'l 2 9 If 1 12 2r'ii'!! 5 Ov·ens Benevolent Asylum 63 10 18 ]26 30 Il Il ...... 5"7 IO I5 )Of~ 0 18 8~ 1 6 11~ 1 9 Oi!~ 1 18 4tB 0 13 B3 2 0 I,) 011 3H Ballarat Benevolent Asylum 240 217 9179 ...... 6 17 7~'b 7 7 lll:f0 0.16 5i\fa 0 11 1¥8 1 8 9"80 1 17 2ia 0 IS :rs 1 7 I! I 0 240 22 5 3 B[tlll_11;'l_1t Or]_Jhan_ 4sylum ·~·. 133 5 I9 510 060 1 9 20 15 3 -· - ··- IT'!f3 133. ... 0 0 7r':f, 1 3 3f':fu 3 _7 4H~ Oil IH3 2 I3 I Ot'Y3 8la2J Immigrants' Home ... 642 1 16 Ili!i~ 5 IO 11 o-4 I 1 61!-.1 1 2 2 20 0 7 0 5 lOb~~ 11 2 0 ... ·-... 63~ o. BM¥ ·7H¥ 2n 0· 9§:l~ .o l(J7 um Ballarat Refuge .•...... 7 9 IS 5q IO 9 9'7 - ...... 0 15 5+ 1 17 5q 1 1 6~ 314 8~7 1 0 5~ 28 17 11 APPENDIX No. 3. RETURN showing the Hates Paid during 1880 for the undermentioned Articles af tbe Institutions indicated. Wine Wine Wine Nameoi Institution. I Flour; ·I· Potaw•s, Br<>ml, Me ..t, Milk, c' Brandy, Wlllsky, 11 Gin, I (colonlal), (sherry), (imported), per ton. per ton. per lb. per lb. per quart. p per gallon. per gallon. I per gallon.! per gallon. per gallon. per gallon. £ s. d. I £ $, d. s. d. s. d. s. d. s. d. £ s. d. £ . s. d.! $, d. I £ s. d. HosPITAI,s. Melbourne Hospital 11 15 0 3 16 8 0 It 0 1£ 1 4 I o 3! 0 3} 0 8 I 4 6 I I 0 8 0 Alfred Hospital 12 17 7t 4 5 0 0 I;& 0 1:! 0 2 1 4 0 4! 0 3£ 0 8! I 5 0 6 4 0 IO 0 Ballarat Hospital 11 13 4 2 10 0 0 1 o ln 0 2 1 5! 0 4 0 9 0 10 3 0 0 I2 8 0 14 () Sandhurst Hospital 11 0 0 5 I2 6 o In 0 I~ 0 3~ I 6t 0 3y"& 0 8 2l 0 0 7 6 Castlemaine Hospital 1103!.350 0 Of~ 0 Ii 0 2! 1 8 0 SH 0 9! I 1 7 2 4 6 2 4 Homooopathic Hospital I6 6 8 5 5 0 0 0 2 0 2! 1 8;} I o . 3~ 0 3Jt 5 0 IO 6 Inglewood Hospital Creswick Hospital 10 18 . 4! ! 3 0 0 ! 0 Ifg 0 2£ 7~ 0 4fr 0 4 0 10 Oll l 4 0 10 0 Daylesford Hospital 17 6 8 2 5 0 0 I! 0 '"~4 0 2! 10£ o H 0 lit 21 1 0 0 5 6 0 18 0 Clunes Hospital 11 4 0 2 10 0 0 Jt 0 2 0 211; 11 0 4~ 0 9! 0 1 I! I. 6 IO 0 () I4 6 Amherst Hospital n 4 o 5 o o o In 0 0 3 5~ 0 4~9 0 11~ 1 2 2 0 6 3 .•. 9 ~ Maryborough Hospital 11 I3 4 . 3 9 2 0 It 0 2! 0 3 I 7£ 0 4t 0 9i 1 6 I 10 3 0 I6 0 0 I6 0 0 Maldon Hospital 10 12 9~ 4 0 0 0 I! 0 3 0 2~ 2 0 0 3£ 0 8 .1 6 0 I I3 0 Dunolly Hospital I2 6 41 3 I5 0 0 Ii 0 2~ 0 4 2 4! 0 4~ 0 ll! 0 11 4 3 St. Arnaud Hospital 10 0 0 3 0 0 0 It 0 2! 0 3 6 0 an 0 10 0 1 1 0 Kilmore Hospital 11 13 4 3 10 0 0 ljl 0 2 0 3 9 0 4 1 1 I 2 1 2 0 1 7 0 4 0 Heatbcote Hospital 14 0 0 . i 4 10 0 0 1~\ 0 2!. 0 4i 2 3 0 4t 0 10 0 9 13 0 4 0 I 4 0 Ovens Hospital ... 9 6 8 4 10 0 0 Ii 0 1f 0 li 8 o 4H 0 8 011 4 0 15 0 ! 0 li 0 Jfiooroopna Hospital I8 3 4 9 6 8 0 4 0 6 2 0 0 4t 1 0 I 0 10 0 i 10 0 IO 0 V)'angaratta Hospital 14 0 0 7 0 0 o H 0 2! 0 2~ 1 8 0 4! 0 9 0 !Oj 1 .9 6 I 2 6 I 2 6 .A.SYLUliS, ETC. Melbourne Benevolent Asylum 12 12 0 0 I 37 0 1{- I 3.!. 0 IO 1 2 0 6 0 I5 6 7 6 ... I I 2 16 81 0 O"'32 1lm 2 ... 3 Bendigo Benevolent Asylum ... 10 10 0 3 10 11-} 0 ldn 0 Iy\ 0 li~ 1 4~ ... 3~ 0 7-fn 19 0 0 15 0 l I5 0 I I~ Castlemaine Benevolent Asylum ... 10 I2 9~ 2 10 o 1 o OH 0 l-1! 0 3 l 6 ... '0 3~ 0 7 2 6 Ba.llarat Benevolent Asylum ... 12 1 6~~ 1 I7 6 I ... I! 0 3 I 2 ... 0 3 0 7! 1 3~ 1 0 0 5 7 9 I~ Ovens Benevolent Asylum ... 11 1 8 4 I3 4 0 It I~ If 0 4 I 5! ... 0 4! o n 0 IO 4 0 1 7 0 2 6 I 0 I8 0 M:elbourne Immigrants' Home ... I2 16 8 2 6 8 0 It 'o 2 0 2 I I! ... 0 2~ 0 11~ 1 3i 0 19 9 14 0 0 13 \) 4". Melbourne Blind Asylum ... 21 0 0 4 13 4 0 li 0 2! 0 2! 1 5'"4 0 0 0 9! 6 ·~ ~il Ball~>rat Orphan Asylum ... I2 6 4! 3 2 6 0 l~h 0 2yg I ... 1. 5, ... 0. st 0 9. 0 21 APPENDIX No. 4. STATEMENT of Revenue Public CharitieiReceived during the Year July 1880 to June 1881. Ave rage Re venue Institutions. No. Government Grants. Municipal Grants. from Total. ~nmates. Loeal Sources. .. i------£ s. d. £ s. d. £ 8. d. £ 8, d. Alexandra Hospital ...... 3 200 0 0 30 0 0 97 18 6 327 18 6 Amherst Hospital* ...... 37 I,335 0 0 40 5 0 427 11 6 1,802 16.. 6 Ararat Hospital* ...... 37 I,050 0 0 195 10 0 737 I7 11 1,978 ' 11 Ballarat Hospital ...... 99 1,900 0 0 258 15 0 2,350 12 7 4,509 7 7 Bendigo Hospital ...... 127 3,600 0 0 320 10 0 2,727 4 8 5,647 14 8 Castlemaine Hospital ...... 78, I,300 0 0 157 8 0 1,044 5 6 2,501 13 6 Clunes Hospital ...... 30 1,000 0 0 45 0 0 68I 8 8 1,726 8 8 Creswick Hospital ...... 23 800 0 0 55 0 0 708 I5 9 1,563 15 9 Daylesford Hospital"' ••• ...... 32 950 0 0 43 I8 0 296 11 3 1,290 9 3 Dunolly Hospital ...... 36 1,350 0 0 47 5 0 376 3 5 I,773 8 5 Geelong Hospital"' ...... 178 4,450 0 0 74 I8 0 1,456 16 7 5,98( 14 7 Gippsland Hospital ...... 21 465 0 0 64 0 0 698 13 11 1,227 13 11 Heathcote Hospital ...... 8 450 0 0 45 5 0 136 15 4 632 0 4 Hamilton Hospital* ...... 42 I,200 0 0 53 13 0 894 17 5 2,148 lO 5 Horshnm Hospital ...... 17 1,150 0 0 360 0 0 607 16 6 2,117 16 6 lnglewood Hospital ...... 44 1,500 0 0 45 15 0 685 2 1 2.230 17 1 Kilmore Hospitalt ...... I4 250 0 0 48 9 0 236 16 5 535 5 5 Kyneton Hospital ...... 45 600 0 0 106 0 0 796 ll I 1,502 11 1 Maldon Hospital* ...... 16 415 0 0 IO 10 0 I58 15 8 584 5 8 Mansfield Hospital ...... 7 ... 50 0 0 I06 15 3 156 15 3 Maryborough Hospital ...... 47 1,950 0 0 55 5 0 672 I8 11 2,678 3 11 Melbourne Hospital ...... 345 13,500 0 0 228 16 0 7,057 2 5 20,785 18 5 .. Alfred Hospital ...... 88 3,ooo 0 0 176 IO 0 2,466 16 11 5,643 611 Sick Children's Hospital ... 3I 750 0 0 172 I5 0 2,073 5 6 2,996 0 6 " Eye and Ear Hospital ... I3 800 0 0 256 9 0 730 I9 7 I,787 8 7 " Homreop!Lthic Hospital ... 14 700 0 0 59 18 3 709 8 2 1,469 6 5 " J,yiug-in Hospital ...... 51 1,450 0 0 I 59 1 0 2,674 19 3 4,284 0 3 " Mooroopna IIospital ...... 14 200 0 0 31; 13 0 440 8 2 679 1 2 Ovens Hospital ...... 73 2,850 0 0 317 I5 0 1,025 9 5 4,I93 4 5 Pleasant Creek Hospital ...... 37 I,OOO 0 0 20 0 0 666 12 9 I,686 I2 9 Portland Hospital* ...... 26 710 0 0 23 ll 0 288 4 8 I,021 15 8 St. Arnaud Hospital ...... 18 I,165 0 0 I 50 0 0 643 3 0 1,958 3 0 Swan Hill Hospital ...... I2 950 0 0 10 10 0 486 11 9 1,447 'I 9 Upper Goulburn Hospital ...... 13 800 0 0 5 5 0 262 17 7 I,068 2 7 Wangaratta Hospital ...... 19 750 0 0 2I5 5 0 518 18 5 1,484 3 5 Warrnarnbool Hospital ...... 3I 650 0 0 25 0 0 571 5 I 1,246 5 1 Belfast Benevolent Asylum"' ...... 17 450 0 0 33 3 0 225 8 8 708 ll 8 Ballarat Benevolent Asylum ...... 247 6,150 0 0 520 3 0 1,809 15 ll 8,479 18 I1 Bendigo Benevolent Asylum ...... ]98 3,200 0 0 322 15 0 2,258 0 2 5,780 15 2 Castlemaine Benevolent Asylum ... 97 1,650 0 0 159 8 0 727 18 2 2,537 6 2 Melbourne Benevolent Asylum ••• 623 5,400 0 0 126 11 0 2,819 4 2 8,345 15 2 ... I I. A. S. Benevolent Asylum ...... 6!0 5,950 0 0 34 13 0 2,264 17 ll 8,249 10 11 Ovens Benevolent Asylum ...... 63 1,l00 0 0 162 7 0 693 lO 2 1,955 17 2 Abbotsford Hefuge ...... 137 1,250 0 0 30 10 0 6,460 11 7 7,74I 1 7 Madeline-street Itefuge ...... 41 204 0 0 .. . 863 13 11 I,067 IS ll Ballarat Orphanage ...... I27 1,750 0 0 2I6 0 0 1,063 18 0 3,029 18 0 Geelong Protestant Orphanage ...... 77 1,450 0 0 9 19 6 400 7 3 1,860 6 9 ,. Roman Catholic Orphanage ... 105 1,000 0 0 I 6 3 266 15 5 I,268 1 8 Roman Catholic Orphanage ... 85 755 0 0 3 8 3 771 13 2 1,530 1 5 " Melbourne Orphanage .•• ...... 321 2,700 0 0 Ill I 0 2,476 I3 9 I 5,287 14 9 St. Vincent de Paul's Orphanage ... 324 1!,750 0 0 49 I 0 I,877 13 5 4,676 I4 5 Melbourne Infant Asylum ...... I3 300 0 0 ... 1,150 10 6 1,450 IO 6 Deaf and Dumb Asylum ... 80 1,600 0 0 ... 1,411 8 4 I 3,011 8 4 " Blind Asylum ...... 98 2,000 0 0 292 I9 0 2,699 14 0 4,992 I3 0 " 94,849 0 0 ---·6,039 I9 3 ----r---66;753 6 I I67,642 5 4 I " Hospitals and Dcncvolcnt Asylums. t Previous year's income taken no return for 1880...81 having been rendered. 22 APPENDIX No. 5. HE1:U1W showing the Average Number of Inmates in. the different Iustit.utiontl and the Cos-t Per Head for · the Year ended 30th June 1881, ns statell by the Managers. I Average ~-Average Institutions. Xo. Stntc -~--··~- d. Hospitals. .. £ s. d. Combined Hospitals and Asylums. £ s. Alexandra ...... 3;\- 106 18 0 Ararat ...... 37 39 17 6 Amherst ...... 37 34 7 0 Belfast· ...... 17 33 9 3 Ballarat ...... 99 48 4 3 Daylesford ...... 32 35 6 9 lsendigo ... ,. ·~ ... 127 46 7 9 Geelong ...... 178 24 ll 9 Castlemaine ...... 78 35 5 10 Hamilton ...... 42 • 10 13,. 3;. Clrines : .• ...... 30 52 9 ll ·Maldon ...... 16 37 0 0, Creswick ...... 24 42 17 11 Portland ...... 26 26 12 o' Dunolly ...... 36 44 0 3 Warrnambool ...... 31 32 15 - 1 Gippsland ...... 21 .58 6 1 Heathcote ...... 58 19 10 Benevolent Asylums. Hors ham ...... 17 70 9 9 Ballarat ...... 247 17 15 7 Jnglewood ...... 44 34 0 7 Bendigo ...... 198 20 13 3 Kyneton ...... 45 36 6 8 Castlemaine ...... 97 15 7 3 1\tansfield ...... i 66 6 3 Melbourne ...... 623 15 10 10 Maryborough ...... 47 46 4 9 Immigrants' Aid SoCiety ... 640 10 15 1 :Vlelbourne ... , ...... 345 58 10 7 Ovens ...... 63 29 15 7 Alfred ...... 88 53 9 2 Children's 31 01'phanages, 9'-c ...... 54 18 4 Ballarat 127 18. ·s .. 3 Eye and Ear .... 13 4 17 ll ...... Geelong Protestant ...... 77 21-ll 0 llomreopathic ~. 14 ...... 59 18 7 Geelong I{oman Catholic 105 Lyii1g-in · · ... . 57 53 19 3 ... 12 15 6 ... .. Geelong Roman Catholic ... 85 12 7 6 Moroopim , ...... 14 64 11 4 ; 7. Ovens Melbourne Protestant ... 821 16 5 ...... 73 53 14 6 41 Pleasant Creek ... 37 54 19 Melbourne Infant Asvlum ... 13 15 '0 : ...... 8 ' Deaf and Dumb Asylum 80 40 18 3 St. Arnaud 18_ 9 15 0 ...... Blind Asylum ...... 98 38 0 o· Swan Hill ...... 12 90 18 9 ; Upper Goulburn ... '•~. ... 13 77 9 5 Refuges. W angaratta ...... 19 77 0 0 Abbotsford ...... 192 19 0 0 Immore · ...... 14 48 2 0 Carlton ...... 41' 20 10 6 I I APPENDIX No. .6. MELBOURNE AND ALFRED HOSPITALS. ,. Inspector's Office, Treasury, ·· Sm, Melbourne, 11/12/80. · In presenting my first Report as Inspector of the Charities subsidized by the State, I beg to remark that I find most of those about Melbourne close their accounts and balance on the 31st December. I propose, therefore, postponing my e:?'ami na;tion of the accounts in detail until after the ensuing halance. My reports in the meantime will consequently relate to the .system of accounts, &c., at those institutions I may be able during this year to visit, instead of complete reports respecting the accounts themselves. The first will be THE MELBOtJRNE HosPITAL. In an institl.ttion such as tllis, where voluntary and pnid, professional and lay workers are engaged together, and where the requirements of the sick poor and the claims of medical science have alike to he attended to, there are necessarily involved many interests and numerous nice points of adjustment. It would be presumption for one unacquainted with all the details, and without the knowledge which a fuller acquaintance with the working of this and similar institutions ·will give, to present definite opinions at the outset respecting either management or outlay. _ I say this to · avoid being understood to advance definite opinions at this stage. I purpose speaking of four separate })Oints, viz., admissions, accounts, staff, and collections. 1. Admissions. ·whether imposition to any large extent exists or not, there can be no doubt that it is comparatively easy for persons to impose themselves on the charity who have no social right to adlllission or gratuitous treatn1.ent. A systelll of investigation " ~' : • ' : • '> • • •. I" • is followed by the Committee by 1vhich, apart from emergency cases, every applicant has to state his or her claims on presentation, tct a member, but the barriers to this inyestigation .being effective are so numerous and so obvious that it can scarcely be considered n)ore thari.' a matter of form. On one of the days of my visit several persons ·w~re passed whose statements and adornments did not appear consistent with· thti'·plea of poverty, but as they presented themselves they were to the hospital authorities simply persons unmistakably needing medical treatment and apparently poor, therefore fit subjects for relief. How to prevent. imposition is, no doubt, a difficult question to determine ; but apart altogether fmm the kindred question of " paying patients," the proposal of the Hospital Committee that power be· given to them and similar bodies to recover the cost of maintenance and treatment, at law, demands, !'think, grave consideration. The out-door patient system at such an institution as the Melbourne Hospital has evils connected with it requiring notice. One of these, the mixing of classes while waiting for treatment, is especially deserving of. attention. Prostitutes, factory girls, servant girls, &c., all meet and wait together. Evil consequences can scarcely fail to result. It appears to be a general opinion also that the bulk of the cases could be much more advantageously attended to in their own localities. It. seems, therefore, a pity that the establishment of local.dispensaries-which should be to as full·an extent as possible on the provident systeni-·has not been carried out, as suggested by the Commission of 1870. During the year ended 30th June 1880, 21,671 out-door cases were treated· ..at this hospital, the parties coming from all parts about the metropolis and its suburbs. It may, moreover, be noted that many out-patients become in-patients, who would, it treated locally, remain in their own homes. 2 . .Accounts. An elaborate system of accounts is kept at this institution, and the various checks which have been devised appear to be carefully looked after by the Finance Committee. But while this is the case, the whole seems to be based on the orders issued. by the Secretary, who, I· understand, acts entirely on his own judgment in ordering supplies. It is possible that this does not lead to extravagance, but it is calculated to do so. ·The Secretary, Mr. Williams, appears to discharge his difficult and responsible duties with much tact and judgment ; but where so large a sum of public money has to be disbursed, the Committee should, I think, carefully scrutinise proposed expenditure before liability is incurred. At the ~!\.lfred Hospital, the managers autho rise the purchase of supplies beforehand, except in the case of provisions, &c. ; and although this fact may not account for the difi'erence, it is worthy of note that in the flexible item of bedding, &c., which at the Melbourne Hospital cost £864, the rate per head was £2 10s. 6d. against £1 14s. 5d. at the Alfred. With so large a staff resident, there will necessarily be. many demands made of a debatable character. These should be decided by the Committee, instead of the responsibility resting with the Secretary. I may remark under this heading that medical comforts cost £3 Is. 3d. per head against £114s. 6d. at the Alfred Hospital, the cost per head for provisions being about the san1e at each institution. 3. The Staff. I append to this Report a return which I have obtained from the institution, showing the salaries and stated value of the allowances to the staff, as estimated by the authorities. It is exclusive of such items as fuel, light, attendance, and laundry vwrk. As I have before pointed out, it has to be borne in mind that the hospital is also a medical school. I therefore merely remark that the staff, exclusive of honorary medical officers, is at the rate of about 1 to every 3 patients, and that the cost per patient, not counting the items indicated above, is, under this head, £24 5s. The attendants at Yarra Bend cost £12 10s. 5d. per head for board, against £14 2s. 8d. here, and nearly £20 at the Alfred Hospital.· It .is almost impossible, however, to check these computations, as there is no scale for either officers' or servants' tables. 4. Collections. The sum of £708 8s. lld. was paid during the year ended 30/6/80 to the collectors. The Committee purpose adopting a plan to lessen the.· cost of coll~cting subscriptions, to which I ·will refer at the end of this H.epo~.:t · 24 THE ALFRED HosPITAL. 1. Admissions. The managers of this institution do not personally exercise superVision over the admissions, but the Hesident Medical Officer does not hesitate, apparently, to reject applicants on the grour1d of their ability "to pay for medical attendance.': This seems · to indicate that impositions are attempted. The mixing of classes, in regard to out patients, is, as may be supposed from the position of this hospital, less I;J.Oticeable than at the Melbourne. 2. Accounts. As before stated, the managers of this institution authorise the purchase of supplies (provisions excepted) before orders. are issued or purchases are made. There, however, supervision apparently ends, and no check is kept upon the disposal of the stores taken into the institution. The Matron has charge of all stores, provisions, and medical comforts. W11en she requires supplies; she forwards a.n unsigned list to the hall porter, who thereupon issues an order on the contractor. No account is kept of receipts, issues, or balances on hand. The Secretary, who also is Superintendent, has no cognizance of the orders issued on behalf of the Matron, and neither officer can say what the stock in store should be. The Superintendent himself orders verbally drapery, ironmongery, and such like articles. · Besides the Matron, the Head-nurse and one of the house· servants have occasional access to. the store. The system is, I think, faulty ; and the same remark appears to me to be applicable to the operations in connection with the banking account, cheques on which are required to be signed by the Treasurer only. I observed that a sum of £54 9s. 3d., an accumulation of small amounts lodged with the Secretary, by patients since deceased, has been passed during the year to the credit of the building fund. Unless there are bequests-which I understand there were· not in these. instances-it appears to me that, as a matter of principle, such sums should be passed to the maintenance account. . 3. The Staff. I appertd a list furnished me sho·wing the number of officers and servants, their S::J.laries and allowances. There is no scale at this institution for officers, their table being provided· according to the discretion of the Matron. Neither does a.ny scale appear to have been fixed by the managers for the serva_nt~, but the Matron is guided py an incomplete scale left 'vith her by her predecessor. The staff is in the proportio!l of rather more than 1 to every 3 patients, the rations for 26 servants being at the rate of nearly £20 per head 4~ Collections. The sum of £254 lls. 8d. was paid last year for collections. · Among the contributions on which the Collector has received commission during the current year are the following:- £ s. d. St. Vincent de Paul's Orphanage 20 0 0 Oakleigh Shire Council ... 10 0 0 Buln Buln do. 3 3 0 Caulfield do. 10 0 0 Malvern . do. 10 0 0 E. S. and A. C. Bank 5 5 0 Bank Victoria 10 10 0 Gas Company 15 0 0 Bank N. S. W. 10 10 0 L. C. Bank ... 10 10 0 Moorabbin Shire 5 5 0 Union Bank 10 10 0 Seamen's Union 25 0 0 Colonial Bank 5 5 0 Mornington Shire !) 0 0 National Bank 10 0 0 Shire of Wyndham 5 0 0 Dandenong Shire 8 0 0 Richmond Council 20 0 0 Oriental Batik 5 5 0 Railway Employes 26 16 0 25 £ s. d. Hotham Council 2 2 0 Cranbourne Shire 7 10 0 Bank of Australasia .. . 10 0 0 Brighton Council .. . 5 0 0 Phillip Island Shire .. ; 2 2 0 Emerald Hill Council ·30 0 0 Hawthorn do. 2 10 0 Several of the above were sent direct to the institution, but still commission is paid on them. The practice of paying commission on such collections as those cited also obtains at other institutions. GENERAL REMARKS. So large a sum of money is expended annually in connection with the sub sidized institutions and societies in and about Melbourne, on items which may be classed as incidental to management, but which may also be termed to a large extent non-essential, that I append hereto a return giving some particulars. A summary of that return shows the following expenditure:- £ s. d. Collecting expenses . . . 2,036 19 3 Printing, advertising, and stationery 1, 783 17 2 Bank interest 1,073 19 5 Total £4,894 15 10 The · Committee of the Melbourne Hospital are considering a new method . which they propose adopting for obtaining contributions. I venture to· suggest that a conference of managers of all the institutions be held, to see whether a plan cannot be devised for collecting the contributions of the benevolent more by voluntary than by paid agencies. . The proposal to erect two more hospitals in the vicinity of Melbourne, viz., the Homooopathic and that for incurable or chronic cases, makes the present a most fitting time for the whole question to come up for consideration. It is already the number of charities, rather than the relief they aftord, which is increasing the strain on the community to an extent that is ahnost beyond endurance, and this fact was pointed out by the Commission of 1870. lt has to he borne in mind that in providing the requisite accommodation in new institutions, the buildings for administrative purposes, and, in regard to the annual outlay, the administration or management, constitute a very large proportion of the cost. At the present time one new institu tion, viz., that for incurables, appears to be inevitable, as there are at the Benevolent Asylum and Immigrants' Home about 400 inmates who are probably more suited to such an institution. But it· is possible to make the new institution a very serious additional burden. The inmates of the Asylum and Home respectively cost £15 1s. 6d. and £11 9s. 5d. per head net. A reasonable allowance for those who work would make the cost of the others probably £20 per head. But the cost of the Alfred Hospital is at the rate of £60, and of the Melbourne £58 17s., so that it will easily be seen that, if the new hospital is to be maintained on the same scale as the two mentioned, the extra burden will he great. It is nevertheless very desirable, as I shall have to show in my report upon the Benevolent Asylum and Immigrants' Home, that action should speedily be taken to relieve those institutions. With respect to the proposed new Homooopathic Hospital, it is my duty to point out, without touching on the question involved in the fact that it is to be connected with a different school of medicine to the others, that the present institutions provide all the accommodation requisite for dealing with acute cases. The Commission of 1870 advised that all build.ing grants should cease. That recommendation should, I think, be now carried out, unless a case of a very exceptional nature should arise. In my letter of the 7th inst. I refened to a weak point in the management of the Melbourne Hospital, viz., the want of supervision over the young medical men on the staff'. This want not only interferes with efficiency, but I am inclined to think tends to increase the cost. . The resident staff remain attached to the institution, as a rule, only twelve months, and their object is understood to he simply to gain hospital experience and practice during that period. It is not probable that under such circumstances these young men take much interest in the economical administration of the institution,. and without the active assistance of tlte profes.sio:nal branch it is evidently almost impossible for the administrative branch to practise economy. . I desire only to add, at this stage, that a uniform system of accounts should be kept by the institutions subsidized by the State. Without this it will be difficult, if not impossible, to compare expenditure, so as to detect readily where economy may be exercised without injury to the well-being of institutions, while for statistical purposes the value of uniformity would be great. · I have the honor to be, Sir, Your most obedient servant, II. ·F. NEAL, Inspector Public Charities. The Honorable the Treasurer. STATEMENT of the OuTLAY of the METROPOLITAN CHARITIES for CollectiOJis, Printing, Advertising,. &c., and Bank Illterest, 1879-80. · Colle<:tor'sSalnry, I Printing, InsUtutlons. ' Commission, Advertising, and Bank Interest. Total. nnd :Kxpenses. Stationery. ------£ s. d. £ s. d. ·£ s. d. £ s. d. Melbourne Hospital 708 8 11 483 15 4 393 10 1 1,585 14 4 , Benevolent Asylum 206 (l 10 165 1 3 107 l 0 478 3 1 Alfred Hospital...... 254 11 8 150 16 11 405 8 7 Immigrants' Aid Society 93 13 2 50 6 9 119 13 0 263 12 11 Protestant Orphanage 191 18 0 155 8 10 17 8 3 364 15 1 Refuge ••• . •. 40 0 0 11 17 10 0 7 2 52 5 0 'Deaf and Dumb Institution 6 1 0 89 1 5 95 2 5 Infant Asylum ••• 20 17 Il 20 17 11 .Blind Asylum ; .. 126 IS 7 170 10 10 297 4 5 . Lying-in Hospital • 203 11 '11 42 12 6 246 4 5 Sick Children's Hospital ... 187 16 9 84 5 9 255' 15 4 527 17 10 Melbourne Ladies' Benevolent Society 103 I8 9 39 4 5 143 3 2 Abbotsford Refuge 52 1 IO 52 1 10 St. Vincent de' Paul's Schools 92 ·2 8 92 2 8 Homroopathic Hospital .•. ... Hi I '6 2 8 19 3 160 5 5 ·Eye arid Ear Institution .•• 50 2 9 0 14 6 50 17 '3 Jewish Philanthropic Society 40 I8 3 18 I 3 ... 58 ~9 . 6 ------2,036 19 3 1,783 17 2 1,073 19 5 4,894 15 10 H. F. NEAL, 11/12/80. MELBOURNE HosPITAL STAFF.-lst July 1879 to .30th June 1880. Allo:wanc.es. No. Particulars. !Salary. .! Uemarks. Particulars. Value. ------£ s. d. £ s. d. 5 Medical officers 500 0 0 Teu officers ... 456 5 10 The ltpproximate cost is £45 12s. id. . I Demonstrator of Morbid 150 0 0 each ; the Demonstrator of Morbid Anatomy Anatomy does uot reside in the Dispenser 300 0 0 hospital, but occasionally messes 2 Assistant ditto 200 0 0 with the officers when his duties 1 Secretary 500 0 0 necessitate his presence in the in- l Matron .·.. ' 150 0 0 stitution. . 1 Male ... 11i 0 0 One hundred nurses and 1,413 6 8 The approximate cost is .£14 '2s. 8d. 3 £104 312 0 0 other members of the each. · ' . I " 91 0 0 staff I " .78 0 0 ---- In all cases fuel and light is allowed ; 5 " £65 325 0 0 1,869 12 6 the cost of this is a charge on the 1 60 0 0 ---- establishment. It is impossible to 1 59 0 0 give an approximate estimate of the 2. " £58 116 0 0 cost, the times and conditions dur- 12 i " £:32 624 0 0 ing which the consumption takes 51 12 0 place being varied and·\lllcertain. 1 16 I .." ...... £45 lOa. 728 0 0 2 , ••• £26 5:.! 0 0 a ·Female £53 159 0 0 I 49 0 0 .2 " £47 94 0 0 27 £4() 1,080 0 0 1 34 0 0 Salaries 6,429 12 0 20 " £30 600 0 0 Allowances ... 1,869 12 6 --, " ------m. I 6,429 12 0 8,299 4 6 J. WILLIAMS, Secretary: 13/12/80. 27 THE ALFR!i:D IloSPITAL.-lst July 1879 to 30th June 1880. Allow·mccs .. Amounts of ------·~ -- No, l'nrttcutnrs. Salaries. Hema.rks. i D:\!ly. ..A..unuall5. -- . . £ s . d. £ 8, d. GO 0 In lieu of residence. I Secretary and Superintendent ...... 275 0 0 0 I { I pcrs~~ at 4~·d. 6 16 !Ol For lunch daily. 1 Doctor ...... 250 0 0 1 Dispenser ...... 104 0 0 } 3 at Is. llid.... 108 7 2! 1 Matron ...... 104 0 0 1 Collector ...... 100 0 0 ...... , ...... 10 per cent. commission on subscriptions as explained verbally to Inspector. I2 Nurses-One at £50, six at £40, four at 439 0 0 £30, one at £34 2 Cooks-£52 and £30 ...... 90 0 0 ll 2 Housemaids-£30 and £26 ...... 56 0 0 2 Laundresses.:....£40 and £30 ...... 70 0 0 l Engineer ...... 84 0 0 ~26 at Is. ld.... 5I4 0 IO 1 Gardener ...... 52 0 0 2 Porters-£65 ...... 130 0 0 2 Porters-£78 and £60 ...... 138 0 0 I Yardsman, "W. ()." ...... 48 0 0 l Messenger Boy ...... }5 0 0 £689 4 IO! Secretary. APPENDIX No. 7. BENEVOLENT ASYLUM AND IMMIGRANTS' HOME. Inspector's Office, Treasury, SIR, ·. . 22nd December 1880. Continuing my remarks upon the Charities as visited, I have the honor now to report on THE BENEVOLENT AsYLL"M. I found this institution over-crowded, dirty, and untidy. The accommodation, according to the superintendent, is sufficient for 400, and there are 600 inmates. I examined many of the beds in several of the wards, and found a nm,nber of them infested with vermin. The superintendent stated. that he had been endeavoring to get the wards cleansed by degrees, but it will, I imagine, require very active measures to cope with the evil. A considerable proportion of the bed-clothing was very dirty. About many of the beds old clothes and rubbish were hid. I was informed that it is a common tendency of the inmates to adopt the practice of hiding ; but the general prevalence of the habit shows that Bye-law No. 3, which applies thereto, is not enforced. In several rooms various receptacles were filled with dirt and rubbish. The food supplied to the inmates for dinner was good, but the meat was served out from the kitchen in a very repulsive manner. Two large heaps, cut into slices, were on a table or counter, and two attendants took the slices of meat in their hands and transferred them to the tin plates. ·The contrast in this matter, as well as in other ·respects, between this institution and the home of the Immigrants' Aid Society is very marked. The institution contains both sexes, which has resulted in cases of immorality in the past, and is now the cause of much anxiety. In case of fire, the means of escll.pe are altogether inadequate, besides which, the situation of the asylum involves an evil requiring notice. In addition to the risk of an epidemic through so many ailing persons being crowded together within a confined space in the midst of a densely .populated district, there is the fact that all the drainage of the asylum flows through the. open street channels of Hothan1. Thus, while the management of the asylum appears faulty and wanting, especially in female influence and active oversight, the graver point for 1. Admissions. . The Committee exercise apparently careful oversight over the admission of inmates, so far as to their physical condition rendering them fit subjects for the asylum; but the question of their being able to maintain, or . partly to maintain, themselves, or of their having friends who should care for them, seems to be dependent for its answer upon the statements of the subscribers recommending and of the appli cants seeking admission. As this is a matter which will come under review in connection with legislation on the subject, it is enough here to record what appears to be the practice. . 2. Accounts. Under this heading there comes up necessarily in connection with this institu tion enquiry into a matter which does not pertain to the medical charities, viz., the employment of the inmates at remunerative labor. There was, however, no account by which I could ascertain the profit or loss on the work done. Of the extent to which inmates are employed I shall have to speak hereafter. The account books are written up by five different persons-the superintendent, the accountant, the store keeper, the dispenser, and an inmate clerk-and appear, as a consequence, to be complicated and somewhat unreliable. This is especially the case with regard to the wines and spirits, the account of which is kept by the dispenser. The orders are supposed to emanate in all cases from the medical officer, but many of them; although prepared by the inmate clerk, were unsigned, and several had been acted upon by the dispenser simply by the date being altered by this clerk. A book is supposed to be kept up, and to be laid before the Committee monthly, called the Abstract Book, showing all the issues; but this has not been entered up since January last. An abstract of the issues to officers, on the other hand, was duly posted, and is, I under stand, laid before the Committee regularly, constituting, no doubt, in the absence of a scale, a fair check upon extravagance. As stated in my former report, a uniform system of accounts at the charities subsidized by the State is evidently very desirable. 3. The Stajj: I append a statement supplied to me by the superintendent, showing the number on the staff, and the estimated value of the allowances as well as the salaries · ·paid. There are 33 persons employed, and their salaries and allowances are put down at £2,952. This sum, amongst 624 inmates (the average number for the year ended 30/6/80) shows the cost for supervision and management alone to have been £4 14s. 7d. per head. In New South Wales, at the Liverpool Asylum, with 629 inmates, 200 of whom are returned· as chronic and incurable, the only paid officers are stated to be the surgeon-superintendent and the matron. At the Paramatta Asylum, with 265 inmates, the master and matron, and at the Hyde Park Asylum the matron and a laundress, are the only paid officers. Small allowances (probably in the same manner as at our Immigrants' Home) are said to be given to such of the inmates as are employed. 4. Collections. The sum of £206 Os. lOd. was paid during the year ended 30/6/80 for collections. Commission is not paid on sums sent to the asylhm, but the collector is allowed in some cases to receive the contributions of local bodies, and when he does so he draws commission thereon. 5. Employment qf Inrnates. . This appears to be the exception rather than the rule, and it is scarcely possible for the visitor to avoid the conclusion that many of those inmates who are moving listlessly about could assist in household duties, or engage in some light work, with . benefit to themselves and profit to the funds of the institution. Oakum picking and hair teasing are the principal, if not exclusive, sources of revenue. A return has been furnished me which shows that a profit of £122 12s. 7d. was made on the former, between January 1st and November 30th of this year, while hair picking, &c., realized during the same period £5 3s. 1Od. · The superintendent is of opinion that, were the buildings arranged on the cottag~ instead of on ~he barrttek sys~em! he. coul~ utilize the services of the inmates sufficiently to enable htm to work the mstitut10n With one- 29 half his present staff It is beyond a doubt the fact that the buildings are inconvenient for the purpose to which they are applied ; but, making every allowance for this, and for such difference as exists between the inmates of this institution and those of the Immigrants' Home; the difference in the cost of the two shows that there is ample scope for economy at the asylum. THE IMMIGRANTS' HOME, or, as it should be called, the "Home for the Destitute," presents in its internal arrangements a marked contrast to the Benevolent Asylum, and the management is evidently of a higher order. The wards, dining rooms, utensils, beds, bedding, &c., both in the male and female divisions, and even in the casual ward, were clean and tidy. The accommodation is insufficient for the demands made upon the society, and the locale of the female section, which is close upon Government Domain, is very unsuitable. There are in all 619 .inmates. 1. Admissions. It is stated that full enquiry, either through the agency of the police, by letter, or otherwise, is made respecting the antecedents and connections of ne1v and unknown candidates for admission. The bulk of the applicants are described as of the " ne'er do-well" class, broken in health, and penniless, except in the female section, where immorality is evidently too often the cause of distress. The· Committee see personally every applicant for admission as an inmate, each one remaining as a " casual " until this ordeal has been passed. One recent case may be cited here to show the want of power to deal effectively with ·a class of persons frequently referred to in the press. A woman with three children obtained admission, and said that her husband, a farmer in a distant part of the colony, had turned her adrift, or rather had forced her to leave his home by ill-treatment. By some means, money had been obtained to enable her to come to the metropolis, and she had been persuaded not to take proceedings against her husband. Her story may be untrue, but it shows that necessity exists for prompt official enquiry in such cases, backed with power to take. action and force payment from the husband, if circumstances render· that course desirable. 2. Accounts. The account oooks, store books, &c., are all in good order, and kept pretty nearly posted up.. The same practice, however, obtains here as at the asylum, of issuing wines and spirits on the doctors' unsigned orders. Rations are issued by scale, and altl10ugh there is a disturbing element in the " casuals " (who receive sometimes only one meal), this enables the managing body, apparently, to exercise a check upon the issues. The purchase of supplies has to be authorized by the Committee before hand, and the like authority is necessary for most issues. It is worthy of note that but little new clothing is given to the inmates, the donations of second-hand clothing by the public assisting materially to keep down the amount of the clothing account. 3. Tlte Staif: As in the other cases, I append a return showing the cost of the staff. There . are on pay 33 in all, the same number as at the asylum, but of this ml.mber 29 are inmates, the total of whose salaries amounts only to £388 14s. per annum. The entire staff costs £1,526 14s. I may here remark that the cost .per head is less than at the Sydney institutions referred to above. 4. Collections. The collector receives 15 per cent. commission, but no salary. The snm paid under this head last year was £96 12s. 8d. The same practice obtains as at the other · institutions, of paying on some of the contributions of local bodies. I 30 5. Employment. • All inmates not exempted by medical order are required to work, and .. a considerable sum is received annually on account of their labor. The ~ant in t~is respect appears to be the power to enforce a labor test. :·. - • ~. :·1 ~ .. ' ; ~ 6. The Female Section: The foregoing remarks apply generally to this part of the institution, as well as to .that devoted to the males. There are, however, some special f~tures requiring notice.. There are in this section 181 females and 109 children, representing many phases of vice and poverty. It is the practice of the Committee, I was informed, to refuse admission to women who are, beyond question, "profligates ; " but cases· ~rise in which this refusal cannot be persisted in, as, failing this refuge, the only pla.;e available is the gaol. Without going into particulars with regard to· various poin_ts that arise, it is enough to &'ty here that by some means the Committee should be placed in possession of accommodation to enable the inmates to· be Classified and dealt with according to their speeial requirements, &c. It appears to me a grave question whether the children should be kept in the institution, at any rate to the extent they are. They are undoubtedly maintained at a low·cost, and there is very much to be said in favor of keeping them with'their mothers. But if the superintendent's opinion ·is correct, that !'a larger number of persons with a syphilitic taint apply than formerly," it would seem to be most desirable that children ·should be as speedily as possible removed. Besides this reason, there can be no'question that the companionship is most unsuitable for them, and especially for the young girls, of whom there are 14 over nine years of age. Several of the children appear to be orphans. There are several boys above nine years of age, but boys and girls :mix together at school, meals, and play. A teacher is employed to instruct the children, but the school is not under the inspection of the Education Department. GENERAL REMARKS •. . While it is evidently . necessary that steps should be taken to classify the ·various kinds of inmates of our two institutions for the destitute, it Vlrill, I .v~nture to think, be unfortunate for the community if the question is not now treated as a whole, . instead of being dealt with in separate sections. It may be necessary, on medical f' grounds, to separate the cases of chronic ailments, or, as they are termed, incurables, from the remaining destitute, but it ·must be obvious that the result will be ·a large increase of cost, as all specialties are costly; and, in this matter, little services are now rendered by inmates who are not disabled that would have to be·p·erformed . . by paid labor. _ . · One great want in regard to the metropolitan charities .seems to be a central _ power vested with sufficient authority to enable it to veto extravagance; and offer advice in matters of management, that, without necessarily becoming dictation, would. carry weight. Several of the reforms requisite can· only be attained by means of legislation; but this I may submit might be attained by, say, a Council for Charities, with the Inspector of Charities as chairman, being appointed by the Govemor in Council, and the grants in aid being made conditional on the reGOmmendation of this body. Such a body would probably say to the Hospital and Benevolent Asylum managers that, Vlrithout a reduction was made in the cost of management, and necessary · reforms effected, a grant would not be recommended ; ·and it woUld, moreover, be able to advise the Government whether new institutions should be subsidized or not. Acting with such a council for the metropolis, the Inspector. would have greater power to deal with abuses in country districts, and the Treasurer would probah,ly be strengthened by its advice in demanding that the charities subsidized by the State should exercise economy. · · · . . · There can, I think, be no doubt that the practice of supplying offic~rs' t:'tbles and rationing servants without the check which a scale creates is conducive of extra . vagance. I judge from the enquiries I made on the subject that no difficulty exists in the. way of rationing by scale; and therefore consider that the charities might be required to adopt that system. · The payment of commission on subscriptions sent to the institutions should be stopped, and lo?al bodies should be asked to send their contributions direct, to avoid their being subject to this charge. It is said that collectors must be paid by salary if not by commission, but I may point out that, even under the present system, the charities could, by joint action in this matter, do with a much smaller number of collectors, and yet make the work rell)unerative for those they employ. l have the honor to be, Sir, Your most obedient servant, H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. MELBOURNE BENEVOLENT ASYLUM.-lst July 1879 to 30th June 1880. ! AllowancM. No. Particulars of Officers Salaries. and servants. -- Particulars. Value. 1-· 1- £ s. d. £ s. d. 1 Superintendent ... 350 0 0 ...... 2 Resident Medical Officer 300 0 0 Board, &c...... 70 0 0 3 .Accountant ...... 150 0 0 Ditto· ...... 35 0 0 Dispenser and · .Accountant board together in one room 4 Matron ...... 75 0 0 Ditto ...... 55 0 0 5 Dispenser ...... 80 0 0 Ditto ...... 35 0 0 6 Plumber and Fitter ... 150 0 0 Nil. '' 7 Two Wardsmen £52 104 0 0 Board, &c...... 40 0 0 At £20 each 8 Two .Assistant do. £35 70 0 0 Ditto ...... 40 0 0 Ditto 9 Four Nurses £40 160 0 0 Ditto ...... 80 0 0 Ditto 10 Three .Assistant do. £30 90 0 0 Ditto ...... 60 0 0 Ditto l1 Five Housemaids £30 150 0 0 Ditto ...... 100 0 0 Ditto 12 Three Laundresses £35 105 0 0 Ditto ...... 60 0 0 Ditto 13 Two Cooks, £70 and £58 128 0 0 Ditto ...... 40 0 0 Ditto 14 One Kitchenman ... 40 o· 0 Ditto ...... 20 0 0 Ditto 15 Man for Men'sDining Hall 35 0 0 Ditto ...... 20 0 0 Ditto 16 Night Wardsman ... 45 0 0 Ditto ...... 20 0 0 Ditto 17 Gardener ...... 80 0 0 Ditto ...... 20 0 0 18 Carter ...... 60 0 0 Ditto ...... 20 0 0 19 Storeman ...... 45 0 0 Ditto ...... 20 0 0 £ .9 d. Salaries 2,217 0 0 .Allowances 735 0 0 2,952 0 0 IMMIGRANTs' Am SoCIETY.-July 1879 to June 30th 1880. Allowances. I Particulars of Officers and . No. Servant.. Salaries. Remark. £ s. d. £ s. d.' Officers' Salaries 700 0 0 .Allowances 90 0 0 " 790 0 0 Inmates' Pay nnd·Board 736 14 0 1,526 14 0 J. S. GRErG, _Res~ Se~. and Supt.. $CFIEDUI,E of }>ETTY O:n'ICERS and SEUVA~TS employed from among the Inmates of the Immigrants' Aid Society's Home. Allowances. No. Weekly Particulars of Servants. Wages. : Remark8 .. l'<>rtlculars. Annual Vnluc. ~ £ d. £ s. d. I Chief Wardsman ... 0 15"· 0 2 Dispenser. and Store- 0 17 6 "'d ~ .~ keeper 2w-5 3 Assistant Clerk 0 10 00.. .E ..d ... 0 .,~ ..... 4 Messenger ...... 0 8 0 ~ ~-·~ 5 Schoolmistress and As- 0 8 0 §:fh sistant Matron •.-1 ,.."'d Cl)"' .... 6 Boiler-man-Laundry ... 0 8 0 .. ,J. S. GREIG, Res. Sec. and Supt. 8/12/80. ·APPENDIX No. 8. MELBOURNE HOMffiOPATHIC HOSPITAL. ( l.'Yt.r;pected 20th, 21st, 22nd, and 31st Janumy 1881.) ·lnmates.-4 males, 11 females. f-Va.rds.-4, containing 17 beds, with an average space of 676 cubic feet each bed. Sta.ff.-·-N on-resident secretary, resident matron, 2 nurses, and 2 servants ; medical officers are all honorary and non-resident. Salaries (not including collectors' · commission), £342. Jlfa.nagement if House.-Good. Matron apparently in sole and responsible charge. Building, however, but ill-suited to the purposes of a hospital. . Dieting.-The medical men are supposed to or STATEllmNT showing the Cost of In and Out Patients in the Homreopathic Hospital for the Year 1880, as estimated by the Committee. Out. In. Total. £ s. d. £ s. d. £ s. d. Rent •.. . .. 100 0 0 lOO 0 0 200 0 0 Salaries and Wages ... 100 0 0 !182 9 3 382 9 3 Dt:ngs and Dispensing .•. 140 7 5 15 10 0 155 17 5 Advertising, Postage, &c. 11 17 8 ll 0 0 22 17 8 Sundries · ...... 10 15 3 10 15 3 Printing and Stationery .. . 64 5 0 15 7 2 79 12 2 Furnishing ...... 7 10 0 7 10 0 Petty Cash ...... 10 10 0 10 ln 0 21 0 0 Fuel and Gas ...... 10 0 0 42 13 0 52 13 0 Provisions ...... 257 16 6 257 16 6 Guarantee .Premiums ... 1 12 0 1 12 () Surgical Instruments ... 4 18 0 4 18 0 Ironmongery .• . ... 12 18 ll 12 18 11 Repairs ...... 36 19 2 36 19 I 73 18 3 Interest ... ••• 1 11 4 I ll 5 3 2 9 Bedding and Drapery ... 2I 6 7 21 6 7 Wines, Spirits, and Lemonade 36 6 9 36 6 9 Crockery ...... 3 13 0 3 I3 0 475 10 7 872 I6 11 I,348 7 6 number of in-patients, 14~ .; £60 4s. per a unum cost of each in-patient. .A. H. P .ADLEY, Melbourne, 8th March 1881. Secretary. No. 23, D ;34 APPENDIX No. :9. INGLEWOOD HOSPITAL. (Visited 6th and 7th January 1881.) In.mates.-27 males, 7 females, 1 child. Wards.-3, containing 40 'beds, with average space of 960 cubic feet per bed. Male ward unsuitable for so many beds. · 'JJtianagement o/ House.-Fair. Matron in charge of all except the principal male ward, ";hich is in charge of dispenser, who is also wardsman. Staff:-Doctor and secretary, non-resident. Matron, dispenser, and 5 nurses and servants, resident. Dieting.-Staff at matron's discretion. Patients are said to be rationed in accordance with the medical officer's directions, but neither the diet cards nor ration orders were written or signed by him. Some of the diet cards were dated as far back as 1877, and some were not dated at all, but were evidently old. No record of receipts or issues kept. · Medical Oomforts.-Ordered in same manner ·as ,ordjnary diet. Brandy had heen issued up to the ·day of my visit in four cases '011 orders bearing the following dates-1/2/79, 1/2/78, 1/2/78, 27/12/J7. Directly the laxity .of the system in regard to the diet cards was pointed out to the medical officer he promised to have it corrected, and to have the diet cards re-written. It is .a matter, however, calling for the active supervision of the Committee. No record is .kept by which receipts and issues can be checked. Stores.-No account is kept of receipts .or issues, and balances cannot consequently be checked. All the stores, groceiies, &c., included, are in the charge of the matron, who presents to the Comnrittee a monthly list of -the medical comforts in hand. I checked the last of these lists by the one preceding, the receipts for the month, and the authorized issues, and found in the item brandy a surplus of 35 oz. in store. According to the accounts this should have accrued during the month, in which case the patients could not have had the quantities ordered for them. It is more probable, I think, that the accounts were incorrect, and, as they do not appear to be at any time checked, the error has probably gone on for some time. Last stock-taking, 187'6. Collections.-By a collector, who receives, in addition to his salary·as secretary, a salary of £30 per annum, and 15 per cent. on all coHections other than those for fetes, &c. This salary and commission compute to nearly 40 per cent. of the receipts that are.bondjide private subscriptions, viz., £135 16s. 7d. The system with respect to receipts is very loose. The receipt books are unnumbered and are entirely at the disposal of the collector. I found three receipt hooks in use, two by the collector and one by the treasurer. For several sums brought to account in the cash book no receipts appear to have been given. Two, £7 4s. and £1 12~. 6d., are in the receipt book and not in the cash· book. Accounts.-Four accounts-viz.: Marryatt, for race wheel, .£4; Williams, sundries, £10 5s. 7d.; Horn blower, advertising, 12s. 6d. and £1 Ss. 6d. ; and Tatcheil, hire of hall. and piano, £2 2s.-which are charged to the maintenance account, should have been made a set-off to the proceeds of fetes and entertainments. Several accounts were receipted by the matron ·instead of by the claimants ; some bore no receipt, and several were unstamped. Books.-.Subject to foregoing remarks, correctly entered up to date ; hut the practice of entering the gross amount of cheques dmwn on the bank monthly in the ca,sh colunm of the cash book, and the cheques in detail on the opposite side, is an awkward system, and is I think, calculated to lead to nristakes. REMARKS. A sounder system with respect to collections and receipts should be adopted, the issue of rations should be. by scale, and the receipt and issue 0f stores .should be systematically recorded. Nearly every one of the out-patients I saw could, it appeared to me, contribute something towards the relief they were obtaining. H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. 24/1/81. APPENDIX No. 10. CRESWICK HOSPITAL. (Visited 12th and 13th January 1881.) Inmates.-18 male, 4 female. 1/Vards.-4, coutainiilg 33 beds, with average space of 1,541 cubic feet per bed. illanalfement if House.-Efficient. House clean and in good order. Resident medical officer in responsible charge. Staff.-Resident surgeon and 5 nurses, &c.; secretary and collector, non resident. Salaries, £534. Dieting.-Of patients by scale. Staff without .scale, but 'under supervision of medical officer. All issues are entered by the medical officer in a daily consumption book. If the staff were rationed by scale, and the receipts as well as issues were entered, the system would be efficient, and a proper check could be applied. Medical Com:forts.-Careful supervision appears to be exerci~ed by the medical officer over the issues, but the same remark with respect to entering receipts applies 'as in the case of dieting. · Stores.-Limited in quantity, and obta.ined only upon the authority of the Committee. Stock frequently taken under the supervision of the medical officer, ·but no account of receipts and issues is kept. Collections, goc.-Collector, who is also secretary, is paid by .salary only. Contributions are received by treasurer as well as collector, and 'in many cases moneys have been received without receipts being given. No check appears to be exercised ,ov;er the use of receipt books by collector. This system requires amendment. Receipt books should be under proper control, and receipts should be given in every case. · Accounts.-The account furnished to the Treasury for the year ended June 30th 1880 is not correct, according to the books of the institution. It should 'have 'been .as under:-- · £ s. d. Private subscriptions ",•. 336 10 0 Entertainments 184 13 4 Medical officer (provisions to family) 50 0 0 Municipal donations ... 60 0 0 Out-patients for drugs 7.2 12 11 Paying patients 27 10 0 £731 6 3 and this, moreover, ought, I consider, to have been further reduced by a sum of £4 15s., paid on .account of. entertainments, and charged to the mainteu.ance account. ·The audited balance-sheet for the year ended 30th December 1880 was incorrect to the extent of £4 .15s. ld., the difference between the sum received for drugs and the D2 36 amount brought to account. From the manner in which this mistake occurred, no blame can attach to the auditors. · · · Books.-Well kept; but the system of entering some receipts in a subordinate boo~ kept by the treasurer and some in the institution cash book should give place to a umform and more regular system. · REMARKS. Every ,out~ patient at this institution is expected to pay 6d. to the funds of the institution on 1getting medicine, unless they are too poor even to pay this. The result has been an addition dming 15 months of £134 10s. 6d. to the funds, about one-half of those in attendance paying the amount on getting the medicine. · Staff should be rationed by scale, and a record of all receipts and issues should be kept. The accounts could then be efficientlv checked, and, no doubt, economy would be the result. " · · The cost per head was £54 3s., omitting expenditure on building. . Deducting the medical officer's refund for prov-isions supplied to his family, and tl1e cost is £50 Vs. per head. There should, however, be a deduction for out-patients. H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. 24/1/81. APPENDIX No. 11. DAYLESFORD HOSPITAL AND BENEVOLENT ASYLUM. (Visited January 14th and 15th 1881.) Inmates.-Hospital: 19 males, - females. Benevolent Asylum: 5 males, 4 females. Wcu·ds.-4, containing 36 beds, with average space of 1,166 cubic feet per bed. Management qf House.-Very inefficient. The whole place very dirty and · untidy, vermin in beds, and rubbish about the wards. Surgeon supposed to be responsible, but he is non-resident, and his oversight in regard to this matter is evidently nominal. Stajf.-Doctor and secretary, non-resident. Wardsman and · two female servants, resident. Salaries, £420. · Dieting.-Of staff without scale. fnmates are supposed to be rationed by scale, and according to the doctor's orders on the diet cards, but on checking the ]atter by the ration sheet for the day, they did 11ot tally. Making such allowance as the wardsman claimed for the staff, the quantities received were in excess of the diet sheet (presuming the entry of receipts to be correct). For the day of examination the allowance of bread was about 29 lbs., whereas 64 lbs. had been obtained, and during the month up to that date, for an allownnce of about 404 lbs., 504 had been drawn. The wardsman is required to· keep a daily record of the quantities received in a book. To this I w":ill refer again under the head of accounts. · Med'icnl Com:forts.-So fa~ as it was possible to check the medical comforts account, the issues had been con·ect, but a satisfactory check was impracticable. Some of the diet cards ordering medical .comforts dated as far back as December 1877, December 1878, and there were several dated 1879. Stores.-Limited in quantity, and obtained only on the authority of the Committee, lmt no record of issues is kept. Stock is taken by the wardsman (who has charge) annually. Collection:;.-. By collector, who is paid a commission of 10 per cent. in addition to his salary as secretary. His receipts were duly brought to account, but the practice of ~iving receipts for paying patients, sale of refuse, &c., without specifYing particulars, should be remedied. · 37 Accounts.-The annual account rendered to the Government for 1879-80 was incorrect. It should have been_;_ £ s. d. Contributions 223 14 4 Municipal Grants 48 18 0 Entertainments 59 9 8 Sale of Refuse 3 0 0 The accounts themselves were correct, so far as having been passed by Committee, but they are not properly checked. Under the heading" Dieting," I referred to the fact that the wardsman was required to keep a book, showing the quantities delivered by the tradesmen. I checked several accounts by this book, and found discrepancies in each, every Cftse hut one being against the institution. It. appears to me that the Committee should at once req nire the accoun~ to be efficiently checked before being passed for payment, nnd also see that only the quantities authorized are received and paid for. Three accounts due ·to the late medical officer were signed for by the treasurer (who is also bank manager) without, I was informed, any order having been given by the proper claimant. This should be put right. . The sum passed to the credit of the lwspital nccount in the books for hospital fete, for the past year is £54 10s. Sd., but on examining the accounts of the Ladies' Benevolent Society I found that they received £75 5s., which was supposed to be one-half the amount 1:!-llotted to the hospital. In the minute book of the institution the receipt of £150 10s. 8d. was acknowledged. An explanation should be given of the balance, which does not appear in the cash account, bank pass book, nor balance sheet for the year. I presume there is an endowment fimd, but the ·books contain no account thereof~ and the acting secretary could give me no information respecting it. Books.-Those kept by the secretary are well kept. REMARKS. A radi~al change is needed in the management of this. institution, and, if the grant is to be continued, should be insisted upon. The building requires a thorous-h repair and cleansing. '.!,'he staff as well as the inmates should be rationed by s·cale, and a proper record of receipts and issues should be kept. . · I saw some of the out-patients, a portion of whom, I do not doubt, could pay tor their medicines. · H. F. NEAL, Inspector Puqlic Charities. The Honorahle the Treasurer. 24/1/81. APPENDIX No. 12. CLUN.ES HOSPITAL. ( "Vis'ited lOth and 11th Januar.y 1881.) .lnmates.-20 male, 8 female, 1 child. Wm·ds.-8, containing 35 beds, with an average space of between 1,500 and 1,600 feet per bed. . Management of House.-Pretty good. House clean and in fair order. Resident medical officer in responsible charge. Staif:-Resident doctor, 5 nurses, &c.; secretary (non-resident). Annual salaries, £483. Dieting.-The medical officer orders what he pleases for his own table, and the head wardsman what he pleases for himself and the rest of the staff. Inmates are dieted presumably according to the medical officer1s directions, but the diet column in the ward cards was not filled in in any case, and the daily- diet sheet is in the 38 wardsman's handwriting, t1nsigned by the doctor: The receipt and issue of provisions cannot be checked, as no account is kept by either doctor or wardsman. There is no· regular dietary scale, but the doctor . is guided in his orders by a memorandum of quantities he has prepared. . · Medical Gomforts.-Received, kept in charge of, and issued by the doctor. No record kept. · · · · Stores.-A small stock only is kept, but there is no record to enable either issues or balances to be checked. The grocery store is in charge of the wardsman. Some time since there seems to have been a doubt as to the reliability of the wardsman (who has since left), and the remedy ·applied was to give the cook a duplicate key of the store. This she had when I visited, and the present wards man, who is held responsible, naturalJy averred that he could not, under the circumstances, be answerable for the stores. In the linen store I endeavored to test the balances, but they did not tally with what the nurse in charge said. her stock should he. There is no regular stock taking, but the secretary informed me that he took stock. roughly about two years ago. System very ba.d. Gollections.-By collector (who is also secretary), and is paid a fixed salary only. Receipt books are kept at the bank as a safeguard against their improper use; but as they are quite at the collector's disposal the check is not efficient. Accounts.-Apparently conect, but several of them could not be checked on account of the bills of particulars not having been preserved. Abstracts of the accounts are prepared monthly, and a receipt thereon taken. The secretary has. agreed to keer all the bills hereafter for reference. A number of items of expenditure are placed to wrong headings, as for instance-material for dressings to drapery ; surgical instruments, tin ware, copying press, &c., to provisions. An account of £1 4s. 10d., repairing a marquee, l1as been charged to maintenance, instead of being made a set-off to proce~ds of fetes. £35 paid for purchase of land is also charged to the maintenance account. Books.-Well kept, and balanced to end of year. REMARKS. The adoption of dietary scales, and a proper record of and check upon the receipt and issue of stores would, there is little doubt, lead to much economy. Several of the out-patients I saw, and of whom I made enquiries as to their circumstances, could, it appears to me, at least p~ty for their medicine. Some who attended are members of benefit societies, who should scarcely be out-patients of a hospital. This institution has an endowment fund of £400, made up of a· bequest of £75 and two donations from the Hospital Fete Committee. The sum is continuously on loan to the maintenance account without interest. H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. 24/1/81. ----···················--·----- APPENDIX No. 13. AMHERST HOSPITAL. (Visited 31st llfarch and 1st April 1881.) Inmates.-.28 males, 11 females, 1 child. Wards.-9 wards, containing 46 beds, with an average cubic space per bed of 1,178 feet. Staft:-Doctor, non-resident. Secretary and collector, non-resident. Warder, superintendent and 4 servants, resident. Salaries, £505 per annum. 39 Management qf House.-Good, the wards and all the surroundings being very clean and in good order. The medical officer is nominally in responsible charge, but being non-resident the responsibility rests practically on the superintendent, who deserves credit for the condition of the institution. Dieting.-This is supposed to be by scale for the patients, but it is evidently, both for patients and staff, almost entirely in accordance with the discretion of the superintendent, subject of course to the doctor's directions. No ration books are kept nor any record by means of which an effective check can be applied. Medical E.~·tms.-Issued in accordance with medical orders by superintendent, who has wines, spirits; &c., as well as all other stores under his charge. The issues are recorded, but not the receipts and 'balances. The superintendent had no stock list given to him when he joined three months since, so that the only test which could be applied was the month's issues with the month's receipts, assuming that at the beginning of the month there were no balances on hand. I applied this test and found a deficiency of 35 oz. (nearly two pints) of brandy, as well as a small quantity of wine and ale. Stores.-All stores are in charge of the superintendent. They are kept in very good order and are limited in quantity. The" Visiting Committee," with the surgeon, order all stores other than those under the head of provisions, wines, &c. No record is· kept of either receipts or issues. Collections.-By collector, who receives as secretary a salary of £100 per annum, and on collections a. commission of 5, 10; or 20 per cent., according to the nature of the collections and the distance from the hospital of the contributor. The receipt books are stamped, but this is no safeguard on account of books and stamp being in possession of the collector. · Accounts.-There is not an efficient check kept by the Committee over the accounts. The superintendent certifies to them, and all that is done beyond that is to ascertain that the rates and additions are correct. The receipted accounts· in many cases contain no particulars other than the entry " To Goods," the invoices proper not being kept.. Even the drug account, which is very heavy for so small an institution, is passed on the superintendent's certificate, and this officer is not a chemist. The drugs are obtained locally. The wines and spirits account is also exceptionally high for such an institution as this, being at the rate of £2 ·Ss. 3d. per head. Three accounts for fetes, &c., were paid out of the institution funds instead of out of the proceeds of these affairs. The sums, however, were not large. Books.-:_.Fair1y kept, but they are in themselves imperfect, and proper store and provision books should be insisted upon if this hospital is maintained. The Honorable the Treasurer. 40 APPENDIX No. 14. IVIARYBOROUGH HOSPITAL. (Visited March 29th and 30th 1881.) Inmate;;·.-37 males, 3 females, 8 children. Wards.-10, containing 103 beds, with an average cubic space per bed of. Stajj:-Surgeon, matron, and 9 nurses and servants, resident; secretary and collector, non-resident. Salaries, £859 per annum. Management of' House.-. Fair. Medical officer in responsible charge, having also charge of the drugs, wines, spirits, &c. The matron has charge of stores. One result of this hospital being not nearly full is the use of several wards as lumber rooms, a practice calculated to have a bad effect on the wardsmen and nurses in regard to cleanliness. A '' House Committee" appear to pay pretty fi·equent Visits to the institution. · · Dieting.-Of patients by sc.:'l.le, but of the staff according to the matron's judgment. No book is kept for entering receipts and issues. This, with the fact that there is no scale for the staff, made it impracticable to apply any cheek. · Medir:al Extra8.-Under the supervision and by the direction of the medical officer. No record is kept of receipts and issues. The expenditure is not extravagant under this head, having been £1 5s. 6d. for 1878, 14s. 9d. for 1879, and £1 8s. 2d. for 1880. · Stores.-Obtained by contract. Limited in quantity, but no record is kept by which the moderateness. of the issues or the accuracy of the balances can be tested. The Committee will now, however, they informed me, adopt a better system regarding stores~ &c. Collections.-By collector, who is also secretary, receiving for the latter office £150 per annum, and as collector 12~ per cent. on all collections other than those from councils, Hospital Sunday, and the annual hospital ball. The system to ensure the accurate bringing to account of collections at this institution is very complete, and the honorary treasurer appears to exercise a very vigilant supervision over the use of receipt books. The collections, inste~td of being brought to account in ~tn ordinary cash book, are entered in a book rnJed accorchng to the general heads of revenue. The result is that receipts under each head can be speedily and accurately ascertained and checked. The Teceipt blocks from July to September 1879 were mislaid, but the entries having been checked by the treasurer, at his monthly examinations, I had no hesitation in accepting them. Subject to this, I found that all the collections had been properly and 'lvith due regularity brought to account. · . Accountb'.-,-The building and maintenance accounts are somewhat mixed, thr.ough loan from one to the other and repayments on account. As a consequence, in one or two cases accounts have only been entered in part. The auditors properly took exception to this system, and desired its alteration, and it is, I understand, to be changed. In other respects the accounts were correct. Boriks.-Finance books are especially good, and are well kept. Provision and store books are requisite. Indeed, it seems strange that a committee and officers who have evidently taJren much pains to ensure a. good system in regard to finance should have left these important lJranches entirely without any record by means of 1vhich expen~iture can be checked. This '\\rill, however, I believe, b_e now remedied. REMARKS •. The cost per head, £4 7 8s. 11d., ·is high by comparison with the neigh boring institution, Castlemaine, which is £10 less. 'l'he Committee might, I think, endeavor to make the' two more neady approximate. This .hospital pays the local council £10 annually for water rates, a charge the council has, I understand, no legal right to make. Probably the council claims grant upon this sum•. _ 41 A more active check upon the admission of patients, and the treatment gratuitously of out-patients should he instituted. I examined a number of the latter . class, and with a few exceptions all could, I think, have paid for their medicines. . H. F. NEA~ Inspector Public Charities. The Honorabe the Treasurer. 7/4/81. · APPENDIX No. 15. l\fALDON HOSPITAL AND BENEVOLENT ASYLUM. (Visited 14th and 15th Feb?'Ua1'!J 1881.) lnmates.-3 hospital cases, males ; and 12 benevolent asylum cases, VIZ., 8 males and 4 females. Wards.-· 3 in main building, containing 22 beds, with an average space of 1,157 cubic feet .. An outer building used for some of the benevolent cases is utterly unfit for the purpose, being old and dilapidated. Staff-Superintendent and wife, resident; medical officer and secret..'lry, non resident ; 1 servant, resident. Salaries, £202. J.lfanagement of Honse.-The. wards in the main buildin~ are kept in pretty good order, but they are not free from vermin. . The outer building, used for some of the benevolent cases, was in a terrible condition when l inspected, the vermin literally swarming ·about the beds. The principal rooms in the main or central part of this institution are occupied apparently by the staff. Dieting.-.Of patients by scale,. I checked the accounts for three months by the scale and found the issues were much under the allowance (after adding reason able quantities for the staff) in everything but milk, but the supply of this article to the staff' appears to be very large. · Medical Extras.-These are supposed to be issued by doctor's order. It is not at all clear that they are so issued in all cases, hut the. doctor periodically initials the entry of issues. There is no record that can he relied on for testing the balances on · . hand, and these, so far a.s I was able to check them, were not quite correct. Two books are kept to show the issues, but they did not agree with each other. Stores.-Limited in quantity ; but no record is kept by which receipts, issues, and balances can be checked. I endeavored to test the balances assumed to be on hand in the linen store, hut the discrepancy was enough to show that nny test which might be applied would be of but little value. The Committee do not t.: 42 RE:ri:I:ARKS. The cost per head is put down at £35. By my calculations it is' somewhat more, as I do not make all the deductions claimed. But tailing it at that rate, the cost is. high, considering the large proportion of benevolent cases. The out-door relief is small, the destitute being relieved by the ladies' society. H. F. NEAL, · The Honorable the Treasurer. Inspector Public Charities. ' AnENDIX No. 16. DUNOLLY HOSPITAL. ( Vis·ited 11th and 12th April188l.) lnmates.-31 males, 7 females, 2 children. Wards.-6, two of which, capable of accommodating 12 patients, are unfumished and out of use. In the other 4 wards there are 42 beds, with an average space of 926 cubic feet per bed. Staff-Medical officer, resident and in responsible charge ; dispenser (who acts also as superiutendent under the doctor}, a wardsman, laundress, nurse, and cook, all resident. Salaries, £495 per annum, to which must be added 25s. weekly paid the doctor in lieu of board, and the salaries of secretary and collector, £145, making a total of £705 per annum. Management ofHouse.-Jndifferent, but the great want of ordinary conveniences in and about the wards will account, to some extent, for various things with which fault could be found. Thus, the fireplaces and corners of the wards are receptacles for brooms, buckets, dirty clothes, &c., and the beds for the patients' clothes.. The closet arrangements are very defective, both inside and outside. The inmates ( 15) ot one large ward have only one night commode within the ward it'lE>If for use at night or when confined to the ward. In the female ward, which is upstairs, the patients are also dependent upon a commode, and the contents of this have to be carried down stairs through the main building. Outside the closets for males and females are in one block, and very impe1fectly separated. The rules prohibit smok.i'ng in the wards, but I saw it, and also spitting on the floor, which is also prohibited. The laundl·y arrangements are defective, and no precautions are taken to disinfect the clothes of diseased patients. None of the ground about the institution is cultivated for the purpose of producing vegetables, but a portion has been put under crop by the doctor for his own use. The land is stated to be too poor and hard for the convalescent and "benevolent" inmates to work On the whole I formed the opinion that the Committee of this hospital are not exe~rcising as active a supervision as. is necessary. The hospital, moreover, is· unfortunate in having but a limited supply of water. Dieting.-The Committee have framed a dietary scale for patients and staff, but it is not followed, a~thou~h the form is $.o:r~e through. of is~uing a ': daily diet sheet" to the cook. It IS evident that the dietmg of patients IS accordmg to the dispenser's j:uclgment, subject to the doctor's directions, and of the staff entirely at the dispenser's discretion. The ward cards have been prepared by the Committee, so as to show the "diet" of each patient, but they are not filled in. No record is kept of the issues of pr:ovisions, or of the balances in store, although the rules· specify that the dispenser shall" enter the amount consumed regularly in a book to be kept for that pui·pose." Consequently no really serviceal)le test could be applied. With the . exception ofmilk, the consumption, however, tested by the scale, was not excessive. lJfedical Extms.-There is no record kept by which the correctness of the stock can be tested, not even the issues being entered in any book. The cost for last year was £2 4s. 6d. per head, against £1 8s·. 2d. at the neighboring (Maryborough) institution, and about 10s. at Castlemaine. To speak of nothing else, the careless manner in which issues appear to be made would tend to increase the cost. 43 Stm·es.-The same want of system is also noticeable here. No record of receipts and issues is kept, although the rules require it to be done. The store, which is just off the kitchen, is, I was informed, kept open. The stock is not large. The nurse in charge of the linen store keeps a rough list of her :receipts and stock, but it was not accurate when tested. The bad practice of committeemen being contractors obtains here. Collections.-By collector, who receives as salary £35 per annum for six months' special work in connection with fetes, &c., and in addition a commission of 5, 10, and 20 per cent., according to distance, on all private contributions. The system adopted under this head is very objectionable. The collector receives money in many cases without giving receipts, although the rules say "he shall give a receipt for every sum he receives," and in the aggregate a considerable sum is thus taken by him without such acknowledgment. In some cases a considerable time had elapsed before receipts were brought to account, and I was infonned that these matters are not checked by either finance committee or treasurer. At the annual balance on December 1879 a sum appeared to have been on hand ( £5 15s. ), which did not reach the bank till February through the collector not paying in regularly. Accounts.-These appear to be properly checked by the secretary, but the practice of permitting the dispenser to give an acquittance for the servants is objection able; There are four banking accounts kept by this institution; hut with the one hank. The first is a loan account showing a debit of £900, which the Hospital Committee are under a· pledge to repay by annual instalments of £150 ; 2nd, the cmrent account, which is at present in credit about £300 ; 3rd, the building account, with a balance of £11 18s. 6d., which is about to be closed; and 4th, an endowment ac.c~unt, with a deposit on interest of £100, the result of special donations by a mmmg company. Books.-The finance books kept by the secretary are in good order, but the system could be simplified with advantage. The store books want altogether re modelling. RE1l1ARKS. I saw a considerable number of out-patients, most of whom could, I think, pay for their medicines. The recommendations on which patients are admitted contain no record of poverty, and I could not learn of any check exercised by the Committee to prevent imposition. Circumstances of patients are not recorded in the admission book. A change should at once be made in the system of de::tling with collections, and rule 44 respecting this matter and the periodical paying in of moneys received should be strictly enforced. The rules generally are stated to be unworkable. If so, they should be revised and enforced. Cost per head, £49 13s., or, allowing one-third of doctm:'s salary and medicines for qut-patients, £45 14s. H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. 25/4/81. APPENDIX No. 17. ST. ARNAUD HOSPITAL. (Visited 13th and 14th Ap1·ill88l.) lnrnates.-20 males, 3 females, 2 children. PVards.-4, containing 33 beds, with an average cubic space per bed of Statf.-Medical officer (non-resident) in responsible charge. House steward, nurse, and cook, resident. Honorary secretary and paid collector, non-resident. Salaries for 1880,.£624 10s. 5d., but now reduced to the rate of £450 per annum. 44 111anagement qf House.-Fair. S9me very good rules have been framed hy the medical officer, which would, if carried out, tend much to improve the management. The inside closet arrangements are defective, as is also the method adopted in removing and disposing of the excreta. The clothing of patients suffering from contagious disease and the bed linen they use should he disinfected, either in or before reaching the laundry. At present it is simply placed to soak in cold water, which is then run off through an open drain to a portion of the hospital reserve, which I found saturated. In some recent diphtheria cases the same practice had been followed: Dieting.-No scale for either patients or staff. The former are understood to be dieted according to the doctor's orders, but these are not recorded, although the bed cards provided by the Committee ·contain tt place for the entry. . The house steward said that he had to remember what the orders were. The issues are supposed to be entered daily in a book provided for the purpose, but I found the same quantities entered when 23 as when 30 and 33 were rationed; and the house steward was not able to give any explanation of the matter. A monthly list qf the provisions consumed is sent to the Committee, but as it does not show the numbers rationed it is all but valueless. Medical Extms.-No record by which the issues can be checked or the balances. tested. Last year the expenditure was small-about £1 1s. per head. StoTes.--No record is kept, ai1d there are no means of checking issues or balances. ·with the exception of medical comforts, all are kept in an unlocked room. Collections.-By collector, who receives £100 per annum salary, and 15 per cent. on all collections except Government grant and municipal donations. The block receipt books are kept by the secretary, but the receipts are not all exhausted before new books are t.:'l.ken into use, and those remaining ·were not all cancelled. A cumbrous system, and one calculated to lead to inaccuracies (of which there were several), is in force in bringing collections to accconnt in the cash book. From the receipts the collector enters into a book of his own. A copy of these entries he then writes on loose sheets, by way of reports to the Committee. From these the treasurer enters into a book which he keeps, and from this book the secretary takes his cash book entries. The payments into bank are also very irregular, sometimes too much and sometimes too little being paid in. Thus the collect()r's list for the three half years ended December .1880 showed £987 17s. 6d., against £991 12s. 6d. as entered to him in the cn,sh book, while several receipts, particulars of which lleft with the secretary, were brought to account for lesser amounts than receipts were apparently given for. In one .case a receipt did not appear to have been brought to account at all. The cash hook contains many items for which no receipts were given, the amounts having probably been received by the treasurer direct. . Accounts.-! was unable to reconcile the account rendered to the Treasury for 1879-80 with the cash book. The discrepancy, however, was hut small, and the receipts not being classified prevented an effectual check. In the accounts for 1880, a nmnber, amounting in the aggregate to £31 6s. 5d., are on account of entertainments, the proceeds of which are entered in the receipts. For two accounts acquittances were missing. Eighty-five duty stamps were deficient. Books.-Both finance and store books very imperfect. The members of Committee whom I sa\v and the secretary expressed a desi_re of putting their system of accounts on a better footing. REMARKS. The Committee appear to be eru~nestly desirous of checking imposition, and make it a pa'rt of the collector's duty to enquire into the circumstances of the patients on admission. The doctor, who has private practice, has the power to refuse admission in other than emergency cases. The cost per head is very high, being about £67 per head, after allowing for out-patients. H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. 29/4/81. 45 APPENDIX No. 18. KILMORE HOSPITAL. (Inspected 25th Janumy 1881.) Inmates.-Males, 14; no females. Wm·ds.-7, containing 34 beds, with average space of 1,351 cubic feet per bed. Sta:fj:-Non-resident, medical officer and secretary ; resident, house steward, laundress, cook, and gardener. Salaries, £269 . .lWanagement cif House.-Good. House steward in responsible ch~trge. Con sidering the b1oderate staff ·and the size of the institution, the wards and building generally are inyery good order. · · Dieting.~By scale, and in accordance with doctor's orders on the diet cards. The latter, however, are unsigned. The receipts and issues are entered in daily diet sheets. I checked a number of the entries by the scale and found them within the allowance. I was unable, however, to check the accounts paid in the same manner, as the vouchers for 1880 could not be produced, the secretary having mislaid them. Medical E:l'lms.--The issues of these are in accordance with the ·entries on the diet cards, and a record of receipts and issues is kept in the same way as provisions. By this and the cards I checked the stock on hand and found it correct. Stores.-These are limited in quantity, but they were not in very good order. The balances on hand are shown on the daily list before referred to, as ·well as the receipts, and were pretty accurate. Stock is taken by the Committee about once a year. Collections.-By voluntary collectors in different parts of district. Collecting forms are issued to residents, who return them with the sums collected. No check is kept upon the issue and return of these forms. No receipts are given, although contributions are received by secretary, treasurer, and occasionalJy by members of Committee. · Accounts.-The Government return contained some inaccuracies, but not of any importance. The audited balance-sheet contains a singular inaccuracy. Following the cash-book account, it shows total receipts to the nmount of £883 18s. 2d. The credit side shows an expenditure, &c., of £885 Ss. 6d. Instead, however, of ascer taining the cause of the discrepancy, a balance has been obt.'tined by entering on the debit side, "Cash in treasurer's hands, £1 !Os. 4d." Of course, if the. treasurer actually held this money, it should he paid into the hank account, which would then show a correspondingly greater balance, and the discrepancy would be doubled. The manner in which receipts are brought to account and the absence of the treasurer, who alone apparently understands the accounts, prevented my discovering the cause of the error. ( )n comparing the batik and cash books, however, the discrepancy appeared to be £1 12s. 4d. instead of £1 10s. 4d. As all the vouchers for the year had been mislaid by the secretary, I was not able to complete. my examination on the spot, a.nd the requisite documents ·were consequently sent to me in town. A considerable number of accounts required stamps, which have been since affixed. · · Books.-In fair order ; but the method of entering receipts in three books, viz., cash book, treasurer's book, and ledg0r, is cumbrous and cnlculated to lead to such mistakes as that already referred to. Block receipt hooks should he introduced, receipts should be given therefrom in all cases, and the cash-book entries should tally with the blocks. It would he an improvement if a book were provided for entering therein the receipt and issue of stores instead of the sheets at present in use. REMARKS. The system of collecting by means of voluntary collectors could be placed on a sounder footing by a check being kept on the issue and return of the collecting listS. 46 The account of the institution at the bank was in funds from July 1879 to December 1880 ·with the exception of two very brief periods, and at times the credits were large. Should this state of things continue, I would suggest that an attempt should be made to arra~1ge \Yith the bank either to allow interest, or not to charge on the temporary overdraft. The check on imposition is ineffective. Patients are admitted from considerable distances, and the subscriber's ticket, which does not even specify that the person recommended is in poverty, is the passport for admission. There is no endowment fund. The cost per head is £50 5s. lld. H. F. NEAL, The Honorable the Treasurer. Inspector Public Charities. APPENDIX No. 19. • HEATHCOTE HOSPITAL. (Inspected 26th and 27th January 1881.) Inmates.-9 males, 3 females, 1 child. Wards:-3, containing 15 beds, with average space o.f 792 cubic feet per bed. · Stqff.-Non~resident, doctor nnd secretary; resident, wnrdsman (who is also dispenser), matron, and 1 servant. Salaries, £276. Manage1nent cif House.-Good. The w:trdsman~di,spenser in responsible charge. Dieting of pntients and staff at the discretion of the wardsman. In some cases the doctor, it was stated, had ordered special diet ; hut, although the diet cards provided hy the Committee have a place for such orders to be entered therein, no entries had been made. The ·doctor subsequently stated to me that he gave his orders on the subject verbally, and had no doubt as to their being carried out. Medical Con~forts.-In three cases spirits were continuously issued, hut the cards showed no. orders. A case hook, kept principally by the wards man, contained orders in some cases, hut it is evidently not considered the rule to enter them therein. No record is kept of issues. Stm·es.-Limited in quantity. No record of any kind is kept beyond the pass books, in which the tradesmen enter as they deliver. Stock is not taken in the institution at any time by or on behalf of the Conuuittee. Provisions are obtained by contract ; general stores are purchased by the wardsman, under the authority of the ·Committee. . Wines and spirits are purchased at retail rates from the nearest hotel. The system is, all through, very bad. Collections.-There is no paid collector. Voluntary collectors in different parts are appointed and are supplied with printed receipt books·. The honorary treasurer receives all payments, and keeps the institution cash book, &c. At the commencement the voluni:.:'try .system seems to have worked well, but it is now stated to be somewhat languishing·. The receipt books (treasurer's) from l5/lf80 to 23/6/80 could not be produced either to me or to the auditors. Account.'i.-Correct. and correctly -entered. The practice of allowing the wardsman to give a receipt for all the employes is one that should be changed. Books.-Such as are kept are in good order and accurate. REMARKS. It is impossible to doubt that this hospital is much imposed upon. The wn.rdsman told me that he considered many could pay at least something ; and the .doctor and secretary thought that nearly all could pa,y for their medicine who came as out-patients. Of the 12·adults who were inmates -on the day of my visit, 3 should only 47 have been in as payin.g patients, and 3 others were simply benevolent asylum ,cases. In the case ,of eme of the former £10 10s. had been paid an outside surgeon to perform an operation, and yet no payment was exacted. A or~ceptio~ lJook is kept., bu! it contains no record of the circumstances of patients, nor IS enqmry made on this pom~. Cost per head for the year about £62. The balance-sheet shows a credit balance for 31/12/80 of £212. H. F. NEAL, The Honorable the Treasurer. Inspector Public Chadties. APPENDIX No. 20. BENDIGO HOSPITAL. (Visited 18th, 19th, 20th, and 21st May 1881.) Inmates.-Males, 75 ; females, 35 ; children, 20 . . Wards.-21, providing 176 beds, with an average space of 1,090 cubic feet per bed. The whole of the wards were not in occupation on the day of my visit. . Stq:ff.-Resident: surgeon in responsible charge, one assistant surg·eou, house steward, dispenser, matron, and 22 ward attendants, servants, &c. Salades, inclusive of a small sum for occasional assistance, and the collector's salary, &c., at last year's payment, £.2,240 18s. 10d. Management qf House, <$"c.-Good. 'Vards, lavatories, &c., clean, and, on the whole, tidy; but supervision of the male wards by the matron would, I think, be .an advantage. The wards in the more recently ·Constructed part of the building are well ventilated, and supplied with suitable closet accomn1odntion. In the older portion some of the wards are not so well ventilated, and tbe closet arrangements are defective. There is a want of proper wards for isolating contagious and infectious cases. The laundry arrangements .as applied to the clothing of such cases are also bad, and, from the absence of any process for disinfecting, risk is run of sending disease germs (assuming the accuracy of the germ theory) into the city with the off-flow of the laundry. In nearly a-ll .cases straw beds are used, by choice, the medical officer informed me. Dieting.-Ofpatients, by scale. Of staff, by the judgment of the house steward. On :tttempting to check the issues, &c., I was surprised to learn that the daily record is not kept and that the monthly entry in a " Stock and Maintenance Report Book," under the head of '" consumption,'' instC<:'td of being the actual issues as shown by the daily record, is merely the representation of what is deficient at the end of the month. The account is consequently uncheckable and valueless. Medical Extras.-These are said to be issued according to the doctor's orders as a rule, but issues are made on his verbal order, and also in emergency cases, without being brought to account. The same bad method of entering consumption obtains as in the case of provisions. Sto1·es.-These appear to be well kept, especially the linen store in the matron's charge. No proper record is kept of the general stores, hut the matron keeps an account of those in her charge, and takes stock periodically. Gollections.-Tbe honorary treasurer, collector, assistant secretary (or house steward) receive money, but the collector is the only one who gives receipts from block books. These books are kept by the treasurer. The collector receives £26 per annum salary, £26 per annum forage allowance, and 20 per cent. commission on sums collected by himself. One or two small discrepancies appeared to exist between the amounts actually rec~ived and those paid into the bank, resulting on the whole in 48 an apparm1t overpayment, and caused probably by the method of bringing to account. The honorary treasurer and the house steward should, I think, give receipts. for the moneys they receive from block books. ·Accounts.-Correct and well kept.. My examination of the accounts, however, led me to the conclusion that it is most desirable there should be a scale for the staff . as well as for the patient'>, and that the issues to both classes should be systematically entered, so that a fuller check upon the accounts might he maintained. There are 3 bank accounts-1st, a loan account, based originally upon an overdraft of £2,450, which the hank insisted should he reduced at the rate of £50 each month, and which has been brought down to £1:300 ; 2nd, the current or general account, which at the · close of the yearshowed a credit balance of £643 17s. 2d. ; and, 3wl, a trust :1ccount, which, originating with a conditional bequest by the Avondale Mining Company, has since been used as a sort of accommodation account bv the treasurer. This account has become complicated through the deposits to credit not been clearly identifiable \vith the payments in each case. . It should not, I consider, be necessary to operate upon this account for any other purpose than th:1.t for which it was created, .but if it is so operated upon the transactions pro and con should be clearly identifiable. 'I'he · Endowment Fund now am omits to £5,5 98 19s. 7cl., being the result of bequests. £3,000, Mr. Lansell's gift, is on deposit according to the stipulation of that gentleman. The i·emaimler, with the exception of a small balance, is in Govermnent debentures. Books.-Finance books are rather complicated, but are well kept. Store hooks are inadequate, and the one book intended to show the receipts, issues, and balances, is not properly kept. . The books showing particulars respecting the inmates do not . give their circumstances, otherwise they are suitable. REMARKS. The system that has grown up in regard to admissions to this institution is but ill-calculated to prevent imposition. Subscribers are entitled to recommend in the ordinary manner, and the form they have to sign contains a declaration of poverty. Bnt no such declaration is required. from ministers of religion, who fi·equently send patients with simply a note. This is not in harmony with the rules, which provide (Rule 37) that "cases of disease, where combined with destitution, when recom mendations from contributors cannot be obtained, may be admitted on written reports of the circumstances from the officer in charge of the police, countersigned by a member of the Board, and by ministers of religwn, or the mayors of Sandhurst and Eaglehawk." This vei·y salutary provision is not carried out, I understand, in the case either of ministers or mayors. · The honorary secretary, however, was unaware of its having been departed from. After admission a personal enquiry is made of the patient, but nothing further appears to be done. The1'e seems, moreover, to be an exceedingly liberal view entertained as to the class who may receive gra.tuitous relief: A very small sum, £66 12s., was received last year fi·om patients. Out-patients do not contribute anything towards the cost of the relief they obtain. Out of 68 out-· patients I saw, I judge that at least one-half could pay for their medicine, and some of them more tharl that. · The system of book-keeping, in relation to the rationing and issue of medical extras, requires improvement, and the Committee are, I understand, only awaiting recommendations as to the best form to make a change. No change, however, will be really effective that does not involve rationing the resident staff by scale. The stafF appears to me to be a large and costly one for the number of patients; the average of the latter for last year having heen 127. The cost pm· head, however; is not very high for a well-managed hospital. The rate last year, allowing for out-door relief, and deducting· repairs, was £42 12s. H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. 31/5f81. ArPE:NDIX No. 21. CASTLEMAINE HOSPITAL. ( Visited 15th,, 16th, and 17th March, 1881.) Inmates.-Males, 63 ; females, 20 ; children, 2. Wa1·ds.-lO, containing 83 beds, with an average ·cubic space of 1,008 feet. There are also 5 lunacy wards or cells, in ·which beds are made up as required. Statf:-Medical officer at present non-resident, hut is shortly to occupy premises just completed. House steivard, matron, and 10 nurses and servants, resident. Collector, non-resident, is salaried. The secretary and treasurer are honorary officers. Total salaries, £1,239 per annum. Mana,qement if House.-Good. . House steward responsible (subject to the directions of the medical officer) for the general condition of the male section, and the matron· for the female portion, but the medi~al officer is held responsible by the Committee for the whole of the institution. Dieting.-Of patients at the discretion of the medical officer, and the staff at that of the house steward. There is no dietary scale. A diet list is kept showing the issues to patients, but there is no record of the issues to the staff; nor in the absence of a scale can a· check he applied. Medical E.rtras.-These are issued according to the directions of the doctor, and the issues appear to be very moderate, the expenditure on wines and spirits being under 10s. per head per annum. This hospital, however, has one advantage in this respect, in the fact that grapes are grown in the grounds, from which colonial wine is made, and this is used to a considerable extent in place of purchased liquors. No record is kept of the receipts, issues, or balances, so that they could not be checked. Provision is made in the store book for these items, and the house stewaJ::d told me that he would henceforth. keep them entered up. Stor·es.-All stores are obtained by contract, and are received and issued hy the steward. They are limited in quantity. · I checked the balances of· a few items, such as tea and sugar, and found them very nearly correct in each case. The store book, which is, p1·operly speaking, a provision receipt and issue book, would be suitable and of vahw if entered up at the time, and if balances were shown in it. No record is kept of general stores, bedding, linen, &c. The latter are under the matron's charge, who informed me that losses have taken place, but the extent thereof is not ascertainable, in consequence of no account being kept. Colleci'ions.-By paid ,collector, who receives a salary of £100 per annum, and 10 per cent. on all collections under £10. Contributions above that amount do not car1:y commission. The collector, however, receives commission on the payments by patients and the proceeds of sales of pigs and refuse. Receipts are given from block books, but these do not bear printed numbers. The stock of hooks is kept by the collector. An abstract of the receipts is prepared monthly by the collector for the treasurer, and the auditors, instead of veri(ying the recorded receipts by an examination of the pass books as they should do: accept this abstract. Accounts.-Correct, and in good order. A good many duty stamps were deficient, which the treasurer has since caused to be affixed. The practice which obtains of drawing a cheque for the gross amount of the month's accoimt, and paying the sum to the credit of a separate account, which is again operated upon by cheques for the accounts in detaH, is, I think, open to objection. . Books.-The system of book-keeping, relating to the financial transactions, is very good, and embraces nearly all that I provided for in the forms submitted 'With my letter of 28th January last. That which it lacks the treasurer purposes introducing. As I pointed out in that letter, the ledger account for such items. as constitute the cash account are rendered unnecessary. In fact, at Castlemaine the system is made to do duty for ~oth cas~ book and led~er, and 'there is c~nse.quently~~ very grea;tsaying of lahor, besides wh1ch the whole of the year's finanmal transactwns can be, seen at a No, 23. E 50 glance. · The treasurer of this institution has evidently taken very great pains, and spent much time, in placing before his committee comprehensive statements of accounts. I append a printed statement showing the last 9 years' transactions. The books relating to the receipt and issue of provisions and medical extras need improvement, and. a stock or store book is necessary. REMARKS. I judge this institution to be well, as it undoubtedly is economically, managed. The female portion, however, needs better ventilation and · closet accommodation. Provision should be made for removing the soil-pans in the male wards in some other way than by carrying them through the wards ; and more suitable arrangements should be made for cleansing and disinfecting infected clothing. · I questioned 35 out-patients who attended the day I commenced my inspection. Of these, 17 might be classed as destitute, 8 as apparently poor, and 8 ·as douhtful ; but who, I should think, were at least able to pay for their medicine. The remaining · 2 were refused treatment, not having orders from subscribers. Iu some cases, the doctor marks the prescription with sums the persons treated are to pay, but the practice is not so general as I think it might be. In some cases, the doctor rejects by the authority of the Committee admission cards bearing no certificate of poverty. . The cost per head is £38 (about), inclusive of repairs; exclusive thereof, about £37. · H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. 4/4/81. APPENDIX No. 22. OVENS DISTRICT HOSPITAl... ( Visited lOt!~, Iltl~ and 13th 1l1ay 1881.) Inmates.-· 61 males, 11 females, 3 children. Wa1·ds.-IO, containing 88 beds, with an average space of 1,050 cubic feet per bed. Sta.if:-Resident : Surgeon, dispenser, and 12 ward attendants, &c., male and female. Non-resident: Secretary (who is also house steward) and collector. Total salaries, £1,731 10s. per annum. Management Q{ House. -On the whole good, and with one or two exceptions, the arrangements of the hospital are satisfactory. Closet accommodation for the older wards defective. The ward for Chinese is unsuitable, and may well be the cause· of anxiety to the doctor. It is in the very heart of the building, arid while the general average of space per bed is 1,050 cubic feet, the average in this ward is only 768 feet. Besides accident and ordinary cases there are two or three cases of phthisis in the ward, and there have been cases of cancer, syphilis, &c. The hospital is deficient of proper isolating wards. The grounds are in good order. The piggery, if retained at all, should, as well as the manure heap, be renioved to a greater distance. The burial of the night-soil should also be under closer supervision. Dieting.-According to medical officer's orders. There is a diet~ng scale but it is not followed. The system of recording the dieting issue is vei·y cumbrous, and is valueless as a check. Medical Extras.-These are in charge of the house. steward. The record kept of receipts, issues, &c., is not . an effective one. There were sn1~ll · discrepancies between the orders and the recorded issues, and between the balances m store and the account, which indicated an inaccuracy. The only discrepancy of any extent, however, showed an excess.·. The expenditure under this head is high, amounting forth~ past year to £3 12s. 3d. pjjr head. Stores.~Limited in quantity, and balances are apparently correct, but a sufficient record is not kept to enable a satisfactory check to be applied. A quarterly inventory is supposed to be taken, but the last is dated April 1879. Members of · Committee may be tenderers and contractors, but they do. no,t sit in the Committee at the time their tenders are under consideration. Collection.r;.-By collector, who receives a salary of £200 per annum, and commission at the rate of 10 per cent. on all private subscriptions. These are entered as £837 18s. 5d., and the payment to the collector was £331 3s., or nearly 40 p.er cent. The collections were brought to account and paid into the bank with noticeable regularity. · ,· · Accounts.-These had not been preserved, so that I was unable _to investigate the details of expenditure. I notice, however, that a payment of ;f..tH 16s. ld. was made to the council for water rates, from which, I understand, charitable institutions are exempt. The sum of £387 10s. 9d. was passed to the building account during the year, but the balance-sheet shows a debit balance on ~he maintenance account of £324 2s. 7 d. The Endowment .Fund at the end of thC:Yyear (June 30/80) amounted to £435 8s. lOd. /' Books.-Finance books are well kept and are in good order, but· the system could be, with advantage and economy of labor, simplified. There are virtually no store books, and the sheets on which record is made should give place to proper books. REMARKS. Considerable pains appear to be taken by the Committee and staff to check imposition. During the year £82 .2s. 8d. was collected from patients, chiefly the result of the assessment made by the Committee. The cost of this institution is very high. Apart from the difference in the rates of certain articles which may exist, it may not unfairly be compared with Castlemaine. The. result it will be seen is very unfavorable to this institution, as a few items will show:- : Castlemaine. Beechworth. No. 85. No. 75. Salaries ... £1,239 0 0 £1,731 10 0 Medical extras per head 0 10 0 3 12 3 Cost per head ... 37 0 0 53 5 10 Paid collectors 199 . 4 6 331 3 0 The attention of the Committee may reasonably be drawn to these figures. An arrangement with the Committee of the local Benevolent Asyhun, might it appears to me, result in a lessening of the cost of collecting to both institutions. H. F. NEAL, Inspector Public Charities. 17/5/81. The Honorable the Treasurer. APPENDIX No. 23. BALLARAT HOSPITAL, (Visited 14th and 15th June 1881.) Inrnates.-67 males, 22 females, 14 children. WaTds.-10, containing 160 beds, with an average cubic space per bed of close upon 1,400 feet. Staff:-Resident surgeon in responsible charge. Secretary and collector, dispenser, matron, galvanist, and 22 wardsmen, nurses, and servants resident ; clerk, engineer, and gardener non-resident. Total salaries, exclusive of rations, &c., £2,166. . . E 2 , , -~, :._ -.. . ·_ 52 Management cif House, ~·c.-Very good. Everything about this hospital was, on the days of my visit, beautifully clean and in excellent order. The wards are well supplied with requisite conveniences, and the ventilation is good. There are two capacious infectious dise.ases wards, and a room fitted with the necessary apparatus for disinfecting bedding, clothing, &c. Altogether the institution is a credit· to. th·e management. . Dieting.-Patients by scale, staff at the discretion of the matron. The ~tter arrangement prevents the application of any satisfacto~·y test as t9 the accuracy of'th~ issues. A very suitable store book is used for recording the issues, and I was ~nforrhed that the House Committee periodically examine the diet issues. With an mcomplete.scale, however, these examinations cannot be very effective . .il1edi:cal,Extras.-These are in charge of the dispenser, who is provided witl{ very suitable booksJor bringing receipts and issues to account, and who is supposed t~ issue only on the doQt_or's order. On examining these books and comparing with. the doctor~ . orders, I found ·that there was a discrepancy caused by e~cessive entries. ------!h~ dispenser e~plained t~is ·hy~ating that it was. for the purpose of covering. spe.eial Issues to the patients at mght, to tlw,matron for cooking purposes, and also to. cover loss by evaporation, &c. The practice is·-lnanifestly so bad that it only needs to be pointed out, I imagine, to be remedied. · --~- ...... ' . . Stores.-These are under the charge of the matron. They are in good.m:der.: A rather large stock is kept on hand. The store book before referred to serves [lS the record for provisions received and issued, but no· account whatever is kept respecting the stores in general use. Stock is taken by the officers in responsible charge. Oollections.-By collector, who acts also as secretary and receives a salary o£ £17 5 for the joint offices and a commission of 5 per cent. on priva;te contributions .. The check maintained upon the issue and use of receipt books and accounting for collections appears to be good and effective. The receipts were all accurately brought to account, but the practice of entering payments by patients, when the latter are unable to pay the 10s. per diem fixed for "payi'ng patients," as private subscriptions is objectionabl~ and should be discontinued. · Accounts.-Correct and kept in excellent order, but many items were suggestive of very libeml views on the part of the management. 135 duty stamps w~re deficient. ~h,e endcrwment account, which is the result of special gifts and beq~ests, now amounts· to £4,461 18s: 7d. · It is in trust and invested in public debentures, the in~erest being periodically added to the principal. Books.-·The fi~ance books of this institution are very good and are well kept. The patients' bed cards, with a list he::tded "Daily Stores," which is prepared for each. ward and checked daily, constitute a fair substitute for a diet book; and the book showing . the "Daily Consumption of Articles" is a suitable store book, capable, howe\Ter,. of slight. improvement. I \ '.. GENERAL REMARKS. This is undo1~btedly a very well managed institution, and the inhabitants of the city are not without justification for the pride they are said to take in it, and the local support is on a liberal scale. These facts probably acco1mt in a great measure for the liberal feelings which appear to prevail generally with regard to the administration of relief. I had opportunities of conversing with several active members of committees of local institutions, and there appeared to me to be generally the existence rather of a desire to administer relief with a generous hand than to check the growth of a spirit of pauperism. I inquired into the circumstances of between 50 and 60 out-patients, and very few of them appeared to be destitute, while a considerable proportion appeared to me to be able to pay for the advice they required. The secretary informed me that there are occasional investigations by a sub-committee, which results in parties being made to pay. . . . The cost per head, allowing one-third of the medical salaries and drugs for out-door relief, is £62 9s., a very high rate indeed. It is claimed that a larger allownnce should be made for exceptionally large out-door relief: But the proper course, I think, w<;mld be to take st~ps to lessen the e:;dent of .such gratuitous assistance. H. F. NEAL, . Inspector Pu bJic Ch~rities.~~ The Honorable the Treasurer. . . 4/7/81. APPENDIX No. 24. MOOROOPNA HOSPITAL. ( Pi,sited April 26th and 27th 1881.) Inmates.-9 males, 2 females, 1 child. Wards.-4, containing 20 beds, with an average cubic space of 967 feet. Staff.-Medical officer (non-resident), house steward and wife (who is matron, laundress, cook and nurse), in responsible charge, and resident, wardsman (resident), secretary and collector (non-reside1~t). Salaries, £341 per annum. . Management qf House.-Fair. This institution is young, and may not in justice ·be compared with older hospitals in more advanced districts. . I therefore merely remark that more attention should be given to clQanliness' as regards floors and bed linen, and to tidiness a.bout the hospital .surroundings.· But even in saying this I must add that the three persons who constitute the resident staff evidently have their hands very full of work, while the matron has more than should be imposed upon one female to attend to. Although nearly all the patieJ?.ts, on the days of my visits, were ·convalescents, very few of them were rendering any help, and it was said that patients generally objected to engage in the duties of the place. The ventilation of the wards requires improvement. A thin ~traw mattress on an ordinary iron bedstead should-at least for patients who have to remain in bed be replaced by a more comfortable kind of mattress, with a palliasse underneath. Excreta should be more effectually buried than it is ; but in view of the very small block of land constituting the hospital site it would be better for it to be taken away altogether. The clothes of patients suffering from contagious disease should be disinfected before passing through the ordinary washing process. Dieting.-Of patients, by scale;. of staff, at the discretion of tl1e l10use steward. A daily record is kept of the number of the scale under which each patient is dieted, and by this, making a reasonable allowance for the staff, I checked one month's issues of bread, meat, &c., and found them pretty accurate. No record is kept of balances on hand, so that on this account, and fi·om the absence of a scale for the staff, the issue of groceries could not be satisfactorily tested. Medical Com.forts.-These are issued in accordance with the written directions of tl1e medical officer. A very good record is kept, which is periodically checked by the secretary .. The cost for last year was low under this heading, being at the rate of 17s. 1d. per head. Stores.-A very small stock kept. Supplies are obtained by contract. Members of committee are not permitted to be contractors. There is no record of issues or balances, but the steward is about ta~ing stock, and commencing a record. Collections.-The collector, who is also secretary, receives 10 per cent. commission on all receipts except Government grant, in addition to a salary of £52 per annum. Receipts are given apparently in nearly all cases fi·om a block receipt book.. The stock of receipt books is kept by the collector, but he informed me that he was about transferring the charge .to the treasurer, a change that is to be commended. A few of the receipts for July 1879 were lost or mislaid. A few entries represented moneypaid to the treasurer, for which receipts were not given. With these exceptions, and three seeming inaccuracies, the receipts were correctly brought to account in the cash book and balance-sheet, but in some cases there was an undue delay in their being so brought to account. The inaccuracies are No. 195, £1 ls. brought to account as £1 ; 248, £8 13s. 8d .. as £8 13s. 4d. ; and 266, £2 as £1 ; a deficiency of £1 1s. 4d. . · Accounts-With two exceptions these were. correct, and correctly entered. The exceptions were· apparent over-payments amounting to 2s. 6d., which, with the mistakes in. eutering collections, makes the balance-sheet £1 3s. 10d. out, unless an explanation can be given. Two vouchers for £12. lls. Sd. and £3 10s. 5d. respec tively were missing. Thirty-two accounts were minus duty stamps. '54 . Books.-Indifferent, and indifferently kept, the cash book containing several erasures and interlineations. The store books, as well as the finance books are incomplete. . RE~IARKS. This hospital, owing largely to the very small number of inmates, is maintained at a very heavy cost per head (over £70,. allowing the ·amount which the out-patients are stated to have cost), and it seems not at all certain that the population will ultimately enable an institution to be efficiently maintained. Assuming, howeyer, that M:ooroopna will be permanently the locality for a district hospital, additional land should be secured before . any more buildings are erected on the present site. A building scheme is at present under consideration, and for the purpose a grant has been obtained. It is proposed to build 'Offices, and so free the rooms now used for the purpose for patients' use. But the whole of the existing premises being attached, and of wood, I am very strongly of opinion that whatever money is s t should be to provide an isolated contagious diseases ward, and this, I consider, sh uld be impressed on the Committee in connection with the· payment of the grant. But it is my duty to draw attention to another aspect of the case. The maintenance account has an overdraft of £302 16s. lld., increased during the past year from £244 9s. lld. The hospital can now accommodate 20 patients, while the average for last year was only twelve. I question therefore whether the Committee are justified in spending money on building until they have made some provision for meeting their liabilities. There was also an overdraft on the building account of £53 18s. at the close of last year. There are but few patients who pay received. In one case the Committee would take proceedings if they had the power. I have the same impression 1\:ith regard to the out-patients attending this hospital as with regard to those obtaining relief at others, that they could pay in nearly every case at least for their medicines, and that it is better to lead them to do so than to permit them to drift into the position of paupers by obtaining entirely gra~uitous relief. H. F. NE.AL, Inspector Public Charities. The Honorable the Treasurer.' 28/4/81. APPENDIX No. 25. WANGARATTA HOSPITAL. (Visited 4th and 5th May 1881.) lnmates.-9 males, 3 females, 1 child. Wards.-3, containing 27 beds, 1\:ith an average space per bed of 1,397 cubic feet. Staff.-·Non--resident, medical officer and secretary ; resident, house steward, matron, wardsman, and laundress. Salaries (which have been lately reduced), £428 per annum. Management qf House.-Fair, but circ~mstances having just necessitated. an entire change of officers, and a local. doctor havmg temporary mediCal charge pendmg the appointment of a successor to the former medical officer, it would not be J:1st ~o criticise the management. It should, however, be noted that closet accommodatiOn IS defective. The wards, which are on the pavilion principle, are lofty and well ventilated. The Committee of this hospital are giving apparently more attention than is shown in some other institutions reported upon, to the comfort of patieuts confined to their beds. Dieting.-A dietary scale is in force for patients, but whether it is as yet followed by the new staff; is I think doubtful. · There is no scale for the staff. Consequently the Committee have no means of checking the issues. An examination of the accounts for the past year, show~d a very liberal consumption of luxuries, w~ile the requii·ements even extended to scent at 3s. per bottle. · 1lfedical Extras.-The consumption of wines and spirits has been most extr:wagant, the cost per head for the past three years having been-1878, £5 6s. 4d.; 1879, £5 Os. 7d.; and 1880, £6 ls. lOd. per head. An account of receipts and issues is now kept. It is, however, 'not correct, even for the one week that the new steward has had charge, the stock in hand being, in the item b11andy, 13 oz. in excess of the account. I was informed that the Committee are now giving attention to the consumption· of these extras.. It is certainly time that they did interfere to stop such extravagance. Stores.-No books have hitherto been kept, nor has any check apparently been applied to the receipts and issues. The Committee, I was informed, are in this matter also about introducing reforms. The stock of stores, which is in charge of the matron, although required by the rules to be under the care of the house steward, is limited. Collections.-By collector, who, in addition to his salary as secretary (which office he also fills), receives 20 per cent. commission on private subscriptions only. Receipts are said to be given in all cases; but, as all the butts of the receipt books up to December 18 7 9 were destroyed, I had no means of verifying this or testing the accuracy of the entries. The stock of receipt books is kept by the collector, apparently without any check by the Committee. There is no finance committee. Gre.at laxity has been shown in paying receipts into the bank, sums varying in amount, but sometimes large, having been held, even at the time of paying in. Thus, June 1880 closed with a balance in hand of £98. The first payment into the bank in July was £15 12s. 8d. On the 13th, a second payment was made of £53 2s., but this apparently included a cheque of £50 received from the. council on that date. The Committee have this year required the collector to pay in, by the time of the monthly meeting, the full sum received. But they should go further, and require that the fortnightly payments, which he is directed by rule 52 to make, shall (as is evidently the intention of that rule) cover the total receipts to date. Another very bad practice has been in force. At the end of the year the collector has entered in the cash book as received subscriptions which he expected to obtain, and this inaccurate statement of accounts has heen put before the subscribers at their meetings as correct. At the last annual meeting, however, the subscribers very properly refused to allow the practice to continue, and caused the balance-sheet to be put right. The cash-book receipts for the year ended June 30th 1880 were £463 18s. 9d. The sum of £536 8s. 5d. was rendered in the return to the Treasury as the amount, the difference being caused by the inclusion of subscriptions received in the following month, July. A ccounts.-These showed some minor discrepancies in payment of' salaries imd wages, which, though not much in themselves, should not be continued. The sum paid as. commission was in excess of the proper percentage on the amount collected during the year. · This was explained by the statement that the account included commission paid at the beginning of the year on moneys received during the former year. Making the proposed deduction, however, did not make the accounts tally. It would be well, as I suggested ·to the collector, to let each year's commission appear in its proper balance-sheet, so as to bear its due relation to the sum collected. · Seven duty stamps were short. J!ooks:-The financial books as kept are more complicated than is necessary for hospital accounts. There are, as before stated, no store books, but the Committee are about having them instituted. · REMARKS. I would suggest to the Committee of this hospital to at once appoint a finance committee, charged with the duty of ensuring proper regularity with the accounts, and bringing pressure to bear on the staff to exercise proper economy. The Committee endeavour to make in-patients pay, by assessing them at a monthly meeting, according to what they consider each one can afford, but the plan, the secretary informed me, has met with indifferent success, not more than one-tenth paying. · 56 . The cost per head, allowing one-third of the doctor's salary, and the cost .of drugs for out~patients, .was last year £66 3s. H. F. NEAL, Inspector Public Chruities. The Honorable the Treasurer. 9/5/81. APPENDix No. 26. BENDIGO BENEVOLENT ASYLUM. (Visited 25th, 26th, 27th, and 28th May 1881.) 1mnate.r;.-Males, 105 ; females, 19. Wm·ds._:_12, containing 138 beds ; average cubic space per bed, 547 feet. Staft.-Superintendent, matron, clerk, laundress, cook, 2 wardsmen, nurse, and servant, resident. Gardener and collector, non-resident. The visiting medical officer is counted on the Industrial School staff, which is not included in the above. Salaries, £911 10s. per annum. Management cif House, g-c.-Very good. The wards, beds, and bedding t;Jlean and in good order. The almost entire absence of patients' clothes and of rubbish about the beds indicates carefhl supervision by the matron. Ventilation generally good, and the balconies with which the.institution is provided enable a number of the ·inmates to get out into the air who would not otherwise be able to do so. The available ~pace for sleeping accommodation is, however, inadequate for the number of heels provided, so far as regards the sick ward, which contains 15 heels, and giv.es only . 481 cubic feet p~r bed. The beds, one ward excepted, are of fibre, with a ·straw palliasse underneath, and contrast favorably in this respect with some other institu tions, and even with the local ·hospitaL· Laundry arrangements .good except in the matter of disinfecting, which should be attended to in the. event of any infectious qisea~?e.·being present in either the asylum or the schooL . Dieting.-Of inmates and staff according to the superintendent's judgment. There is a scale, but it is not followed. A most elaborate system, running through several .books, and culminating in a formidable monthly stH.tement to the Committee, is in force for recording the ration issue~, but in no part of the system are receipts and balances shown, . so that it provides· no means whereby an e.ffective check· can be applied, nor, according to my information, is it ever checked. Medical Ea:tras.-Of these no account whatever is kept, and issues . are made · independently of the medical officer, as well as by his directions. · Stores.-A considerable stock is kept on hand. Sitpplies are, _with few exceptions,· obtained by contract, and Committee-men are not permitted to be contractors. Of the artiCles under the heading "Drapery and Clothing," a Dr. and Cr. account is kept. I checked the accounts of three of the principal items, and tested the stock 'i.n the store, but there were considerable discrepancies, two showing a large surplus,· and the third a deficiency. The book is not kept properly posted up. Collections.-The honorary treasurer, the superintendent, and tpe collector receive money. The collector receives 12~ per cent. on all private subscriptions, whether paid to himself or sent to the institution. His actual collections last year were £219 16s., and his salary and commission were £71 8s. 5d., or about 33 per cent. upon his own collections. . A very bad p1;actice prevails with regard to institution receipts and those by the treasurer. To provide tor the former class of payments a num her of blank forms are signed by the honorary treasurer. But when a treasurer leaves office his successor is requested to continue the practice in a new book, the result being that at the time of my visit there were a number of blank receipt slips bearing the signatures of three different treasurers. At my request all those signed by ex-treasurers were destroyed. The moneys received by the treasurer he pays into the bank (without giving the donors a receipt), ~nd sends the bank slip to the institution 57 for the receipt to be forwarded. There is, consequently, an ~ntire absence of check upon any oversight or omission by the treasurer. The collector pays his own collections into the bank. The result of this system has been considerable delay in bringing several of the sums received to account. · The sy::.;tem should be entirely changed. Each person authorized to receive money should he provided with a proper receipt book ; a receipt should be given for every payment at the time it is made, as far as practicable, and the receipts should be brought to account and checked periodically by the block-books and the hank account. · · It "ill be convenient to treat here of the Endowment Fund. This now amounts to £10,826 17s. 1d. It has been accumulating since 1871, but no less than £7,224 is the result of Easter Fairs and Hospital Sunday collections, which in other districts have gone towards the maintenance account. The ordinary contributions to the asylum being very small, it would seem that the institution has been maintained by an undue proportion of the Government grant. The disposition of so l::trge a sum of money is manifestly a matter of serious consideration, and some local feeling, I am informed, has been manifested respecting it. It is a noticeable fact that the annual statement or report and balance-sheet give the subscribers no information on the subject. The money is placed as follows :- £ 8. d. On deposit in Commercial Bank 6,926 17 1ill , Bendigo Building Society . . . 2,500 0 0 , Union Bank 1,000 0 0 , National Bank . .. · 300 0 0 . One Government 6 per cent. debenture ... 100 0 0 The banks a1Jow 3 per cent interest, and the building society 6 per cent. The interest is now placed to the credit of the maintenance account. A kind of subsidiary endowment fund has just been created, by placing donations of £20 and upwards to a separate account, dmwing the interest thereon for the maintenanc~ account during the life of the donors, the capital to fall into the maintenance account.at their death. The Government return is incoiTect in the following particulars :- Private contributions, £700 7 1, should be £395 17 1 Interest 726 12 9, should be 1,040 2 9 Sale of refuse 35 1 9, should be 26 1 9 The inaccuracy, it will be seen, is principally caused by the transfer of a sum of £313 10s: from interest to the two other items.· But this requires further explanation, as, although entered in the books and balance-sheet as " interest, &c.," it is in reality the amount received in 1877 from Hospital Sunday collections, and it \\rill serve to show what a,faulty system of book-keeping obtains at this institution to state that, although this sum was received in 1877 and banked by the then treasurer in the bank of which he is manaO'er, there was no entry made of its receipt in the books, and there is no minute by the CJommittee directing its disposal. The same bad principle has been adopted with regard to the subsidiary endowment fimd, £20 10s. of this not having passed into the cash book. Accounts.-·These yvere all correct, and in good order, but they contain items which seem to me to indicate the possibility of economy. £23 was paid for re-making mattressf's, and £41 10s. for lime-washing. In other institutions such work would be done by the inmates, who are certainly not too much occupied here. Again, brandy is bol.lght by the case at 70s., 72s., and 78s.; port wine at 66s. and 70s., and sherry at 55s., to say nothing of a number of itel'ns which indicate the desirability of rationing the staff by scale. Books.-An unusually large number of books is kept, and the .system of book keeping is at once complicated and incomplete. The store hooks need altering, so as to show periodically the receipts and balances as well as the issues. REMARKS. The admission of imnates and the administration of out-door relief appear to be under vigilant supervision, hut I am inclined to think that the latter can never be so satisfactorily performed by a paid officer as by voluntary committees. The officer is • Against this there is an overdraft of £4,603 5s. lOd. . more lik~ly t~·.be imposed upon, and much more liable to be blamed for partiality. The number relieved. shows that, if the cases we1·e all. deserving, stringent economy is exercised in this branch of the institution's work. I think, moreover, that its operations should not extend to localities where there are ladies' benevolent societies, as I found that recipients of relief from the Ladies' Society of Eaglehawk also obtained aid from the asylum. · Visitors to inmates are not seen or questioned lJy any officer or member of Committee. It is held to be practically useless to check their ·visits. A recent case, however, illustrates the value of inquiry. . A woman was recently admitted on a dergyman's recommendation, in apparently destitute circumstances. By .the agency of a visitor, however, it was ascertained that her .husband is a farmer, able to maintain his wife. Again, the daughter of an inmate lately deceased :visited at her mother's death, and paid for an expensive funeral. I have little doubt myseif that, if a systematic check was mnintained upon visiting, and the healthy moral influence of pu hlic .opinion brought to bear upon such cases. as these, there would he far less imposition upon our public charities. . Religious services appear to he well and systematically maintained. There is a small library at the disposal of the inmates, and gifts of books are occasionally, but not frequently, made~ · ) The funerals of inmates are not under sufficient control. It would be well for the conditions of contract to be made the same as those fixed by the Government. I have before referred to the fact that such work as lime-washin~ and mattress making is paid for. It should be added here that no work from outside is obtained for the inmates, the superintendent stating that he had tried but failed to obtain any. It is difficult to arrive at the cost per head of the inmates, because the accounts for the industrial school are not kept separate from those for the asylum. Taking all together, the cost per head (after deducting building, out-door relief, and certain expenditure daimed to have been special) was, for lnst year, £22 4s. 4d. Assuming that the school children were maintained at the rate paid by the Government (and, although the Committee say they cost more, it is not an unreasonable check to apply), the. cost of the asylum inmates .wa.s £27 18s. 6d. In any view of the case, the institution is maintained at an extravagant rate, and the Gov~rnment grant is larger. than it is legitimately entitled to. For instance, the grant for 1880-81 is £3,500. Allowing out of this three-fourths of the sum 1vhich out-door relief costs, and it leaves £2,060 for the asylum, or at the rate of £1'7 per head paid by the State for each inmate. I see no ground on which such a grant can be justified. H. F. NEAL, Inspector Public Charities. 1/6/81.. The Honorable the Treasurer. APPENDIX No. 27. CASTLEMAINE BENEVOLENT ASYLUM. ( Vi~ited 17 tl;, and 18th Mm·ch 1881.) lnmates.-Males, ~n ; females, 14; children, 2. Wa,rds.-10, containing 106 beds, with an average cubic space of about 800 · feet per l)ed. · Stafi:-Superintendent, matron, and 5 warders and servants, resident. Medical officer, non-resident. Total salaries, £318 per annum. ]J1.anagement ~~ House.-On tl1e whole good. · '\Vards, bedding, &c., clean, but not fi:ee from vermin. The dining-room arrangements are susceptible of much improvement. The matron (an officer upon whom so much necessarily rests in a benevolent asylum) had, when I visited, l)ut recently entered upon her duties, and 59 seemed quite alive to the necessity of a change in some matters which came under observation. The superintendent is in responsible charge . .Dieting.-Of inmates and staff entirely at the discretion of the superintendent. The Committee prepared some time since a dietary list, but did not specify thereon any quantities. The daily issues are entered into a book prepared for the purpose, and fi·om this book the total of the issues for the month are supposed to be posted into a book sho·wing the monthly receipts, issues, and balances. I endeavored to test the issues as thus brought to account with the view of testing the dieting, but the discrepancies were so great as to show that the record is valueless, as the following will show, the month taken being January, the last for which the books were posted:- 1'ea. Sugar. Bread. lbs. lbs. lbs. Issues as per issue book 69 493 907 As summarized in receipt and issue book 110 793 1,403 The balances are carried forward in the last-mentioned book. Medical E.1:tras.--The system in dealing with the issue of wines flnd spirits is as faulty as is that in regard to provisions. The account kept showed more than double the quantity issued that there had been to issue from-balance on hand and receipts included. Stores.-All stores are in charge of the superintendent, with the exception of the lh1en, &c., which are under the control of the matron. No records are kept. The stores are very limited, considering the size of the institution, and all goods are obtained by contract. Collections.-By collector, who receives 20 per cent. on private contributions, and a salary of ten shillings per week. Receipts are given from block books, but the singular practice has obtained of only partially using up these books, so that I found · a number containing blank forms, although the books were out of use. On my pointing out to the honorary treasurer the danger of this system, he cancelled the forms remaining in the old books, and took the stock of books into his own possession to ensure proper issue and systematic use. The auditors do not check the collector's receipt books, which is uridoubtedly a great oversight. Accounts.-There is an absence of system in dealing with accounts. Money has to be paid away both for out-door and in-door relief, and wardsmen's accounts are received for both. For the latter, receipts are taken on a pay-sheet, and this is verified by Committee and auditors. But for the former (although an expenditure was made last year of £550 ), the superintendent's receipt is taken. In some other cases, also, his signature is taken as an acquittance. In two instances, I found that accounts had been paid out of the institution funds which should have been debited to the affairs (sports and raffle) with which they had been connected. The proceeds of these 1 affairs consequently appear in the re.turn in excess of what they should be. The sums ; were small, but the practice should be prohibited. . Books.-These are neither very suitable, nor are they very well kept. Provision books need improvement, a store book should be kept, the receipt and issue of medical extras should be brought to account, and the cash book should be balanced at the end of the year's transactions, and its accuracy certified to by the auditors. REI't:I.ARKS. It appears to me that a more stringent check upon admissions should be instituted. The admission book should contain a record of the circlJmstances of all , relatives, and visitors to the inmates should not be admitted unquestio;;_ed as they now 1 are. One case was brought under my notice which illustrates the necessity of 1 vigilance. An inmate has three sons, all of whom are in business as publicans. Only one, however, makes a payment on account of his father's maintenance, and his contribution amounts to about £10 per annum, while the cost of maintenance is £17 17s~ 3d. I am strongly of opinion that all benevolent asylums should be required to keep a record of the relationship and circumstances of visitors to inmates. . Visitors to the institution appear to be but few. The absence of flowers and illustrated papers suggested that a ladies' mission would be able to do much for the advantage of the inmates. .60 . There is also a want with regard toreligious ministrations. !'understand tha;t nearly all the denominations are represented in Castlemaine, but the Episcopalians and the Christian Brethren, are, I was informed, the only ones who conduct services. The Committee might, I think, reasonably ask the different bodies to unite in remedying this. The building is very badly provided for in case of fire, a tact to which the superintendent is keenly alive, and which should also receive the earnest attention of the Committee at once. . The inmates are employed only . on institution work, and . evidently are not occupied to the extent they might be, if other work were available. In a large place like Cast]emaine some light work suitable for inmates should be procurable. . The out-door relief, to which reference has been made above, is managed altogether by a lndies' committee, on pretty much the same principle that lndies' benevolent societies are worked, except that in this case the collections made by the ladies pass into the funds of the asylum, and the accounts are paid as before indicated. In the nnnual report for the past year the cost per head is stated to have been £14 18s. 5d. This appears, however, to be a mistake, as £17 17 s. 3d. was the actual . cost, out-door relief and repairs being excluded. The grant tor the current year is, I observe, £1,600. The aventge number of inmates is 97, so that it is actually proposed that the St APPENDIX No. 28. BALLARAT BENEVOLENT ASYLUM AND LYING-IN-HOSPITAL. ( Visited 16th and 17th June 1881.) Inm,ates.-Asy1um.-Mn1es, 207 ; females, 39. Lying-in-Hospital.-F~males, · 7 ; children, 3. . Wards.-Asylum.-23, containing 251 beds, with an average c~lbic space of about 710 feet per bed. Lying-in-Hospital.-9 wards, containing 18 beds, with an average cubic space of 1,079 feet per bed. · . Staff.-M~ster, matron, and 15 male and female servants, resident, inclusive of · 3 inmates .to whom small money allowances are given. Non-resident-secretary and ' collector, surgeon, assistant secretary, gardener, and baker. Total salaries, exclusive ·of rations, &c., £1,614 14s. 111anagernent cif House, 9·c.-Good on the whole. Straw beds alone are used throughout the institution. They were well filled, and consequently less uncomfortable than I have seen them at other places. vVith one or two exceptions the ventilation of . the wards is good, and the average cubic space, ns shown aboye, is good. But several of the ·wards nre below the average, and, in some cases, below the I allowance for; English workhouses. Thus, 1 with 10 beds gives only 448 feet ; \ another with 10 beds, 509 feet; two others with 14 .each, 518 feet; and 1 with 7 b~ds, 466 feet; while another, termed the '' Convnlescent Room,)) which gives an nverage of 682 feet to 14 inmates, in·gently calls for change. At the time of my visit the atmosphere iu this vmrd was so foul as to make breathing difficult on first entering. · The female portion of the institution wns in admirable condition. . The closets, recreation grounds, &c., for the females are quite apart from those provided for the males. Although there is evidently a considemble surplus of lahor, for which it would be well to find employment of a suitable nature from O"!J,tside, the master of the 61 institution seems to be doinfl' his best to get the work of the place performed by the inmates. All the mattresse~ are made on the premises, the tinware is mended, ward boxes and stools are made, and locks, &c., are repaired, and nearly all the clothes are made. Some of the inmates are employed in the garden, kitchen, laundry, and dairy, attending to cows, and cutting wood for the recipients of out-door relief. Dieting.-Inmates are rationed by scale, staff according to the judgment of the matron. I endeavored to check some of the issues as recorded in the master's monthly statement by the scale, allowing what that officer considered reasonable for the staff, but they were considerably in excess of the scale in each case. They do not appea~ to be ever checked, and no books are kept. Medical Ea:tms.-I~sued, it is said, on doctor's order only, but no records are l~ept. It,i~ worthy of note, as a contrast to the rates paid at the Sandhurst asylum, that here colonial gin and ·wine (except beer, the only stimulants used) are obtained for 9s. I td. and 5s. 3d. respectively per gallon. Nevertheless, the expenditure is . sho·wn by the balance-sheet to have been at the rate of 12s. 8d. for each inmate, which is more than the rate at the Castlemaine Hospital. Stores.-No books are kept, and consequently, although the transactions in regard to in-door and out-door relief are very numerous, and represent under this head an expenditure altogether of over £~,500 per annum, no check whatever is maintained. Except for a hook showing the material received in any one year, the same remark applies to the entire clothing account of the institution. Stock is not periodically taken. · Collections.-By collector only, who is paid by' salary ( £350 per annum) and receives no commission. The issue of receipt books is a.pparently under a fair check. The receipts were duly brought to account. There was a slight inaccuracy in the return to the Treasury-contributions, entertainments, and church collections, which by the books were £1,550 4s. 7 d., being returned as £1,569 9s. 3d., the difference being caused by the inclusion of (1st) a sum of £15 15s. received on account of an inmate from the Pleasant Creek Hospital and (2nd) £3 19s. 6d. from sale of refuse. Accounts.-Conect and kept in good order. 100 duty stamps were deficient. An endowment account amounting to £70, which is invested in Colonial Bank shares, produces a small sum, which goes to the current account. Books.-Finance books are good and are well kept, but the entire absence of suitable store bo~ks (already refened to) is almost inexplicable with a Committee of business men such as have the management of this institution. The oversight should,· at any rate, be remedied. GENERAL REMARKS. . The comfort and well-being of the inilJ.ate~ of this institution appear to have received careful attention at the hands of the management, and I gather that the inhabitants of the city are not slow. to assistJ )_Vhile they are certainly liberal in their support. But I am compelled to express the same opinion with regard to the administratio~ of relief by this institution that I did with respect to the sister charity, that the desire to be g~~erous has ?versha~lowe~ ti:e necessity. of ~ndeavoring to check the growth of a spmt of paupensm. :Nor, v~ewmg the spec1al crrcumstances of Ballarat, is t.t~is to be wondere~ .at. '~ ork in the mines ~as produc.ed so many prematurely disabled men, and mmmg acc1dents have resulted m there bemo· so many wi~ows and fathe:lAss children, th~t a. lavish charity is not surprising nor ~ithout its claims upon puhhc sympathy. Still It appears to me to be an evil that should not pass unnoticed. The Lying-in Hospital appears to afford entirely gratuitous relief, although it seems to be well understood that in 111.. APPENDIX No. 29. OVENS BENEVOLENT ASYLUM. (Visited 11th and 12th May 1881.) I Inmates.-57 males, 9 females. ·Wards.-9, containing 73 beds, with an average space of 756 cubic feet per bed. . Staff. Superintendent and matron (husband and Vlrife ), with senior and assistant wardsmen, cook, and gardener ( 6 in all), resident ; laundress attending three davs a week. Salaries, £418 per annum, in addition to the collector's ·pay, which is £2oo per annum and 10 per cent. on collections . .i.Wanagement qf House.-. Fair. The wards and the bedding were fairly clean and in good order, but the absence of provision for the inmates' clothing, &c., has led to the common but objectionable practice of keeping rubbish about the beds in some cases. With one or two exceptions the beds even in the sick ward are straw mattresses, without palliasses, on the ordinary iron bedsteads.· Some of these mattresses were so · thin from wear as to be but little protection to the occupants of the beds, and the I sense of discomfort had evidently induced various devices to. be reso_rted to in order ) to lessen that discomfort. In the sick ward and the female ward at any rate this state of affairs should be remedied by the Committee providing suitable bedding. The closet accommodation for the females is very unsuitable, and the bathing accommoda tion is inadequate, there being but one bath for all the inmates. The former defect the Committee are about remedying. Dieting.-Of inmates and staff by scale. A very elaborate system was introduced to bring the expenditure under this head to account, but it proved too cumbrous, and was discontinued without· any other being substituted. There conse quently appears to be no periodical check upon the issues. I checked the stated issues for April by the dietary scale, and found them, with very trifling exceptions, within the allowance. Medical Extms.-These are, as a rule, issued only by the doctors' orders, but, as the medical men are honorary and not in daily attendance, issues have to be made in cases of emergency. The superintendent also issues brandy and wine to patients for special services. In two cases the doctors' orders da.ted back to Februa.ry and September respectively in 1880, and in another to 1873, vvithout renewal ; but the Committee, I was informed, have just requested the medical men to renew these orders periodically. I checked the stock in hand by the receipts and orders, and found a surplus of 102 ounces of brandy, 12 ounces of whiskey, and 4 ounces wine. The record, however, which is in much the same position as that relating to diets, will not permit of the check being regarded as satisf~tctory or complete. Stores.-Very well kept by the superintendent (who is also storekeeper), but the system of record needs improvement. The very bad practice obtains of members of Committee tendering, and even sitting at the board while their tenders are considered. One member only is at present a contractor. · Collections.-By collector, who, as before stated, receives a salary of £200 per · annum and a commission of 10 per cent. In the last balance-sheet the amount of private contributions is set down as £417 19s. 6d. for maintenance, and £67 lis. 6d. for building, while the collector was paid £251 7s. 7d., or more than 50 per cent. of the total receipts from this source. The collections have all been brought to account, so £'tr as receipts from the block-books are concerned ; but in a few cases money is received without receipts being given. ln the return to the Treasury for the year ended 30th June 1880, a sum of £12, collections of the next month (July), was included. A sum of £702 10s. 7d. has been transfeiTed from the maintenance to the building account, partly by "way of a loan." Accou.nts.-Correct and duly stamped. A payment of £22 3s. IOd. is made to the council for water rate. The year's account closed with a credit balance of £113 15s. 5d., notwithstanding the transfer to building account before refen·ed to. Books.-Finance hooks are well kept, but the store books, &c., are altogether inadequate. REMARKS. The cost per head at this institution is very high, amounting, exclusive of out door relief, expenditure on building, &c., to £30 lls. 7d. per head, or more than double the cost in either of the metropolitan institutions, and nearly double that of the Castlemaine. A few figures will serve to show the extent to which such institutions as this become a charge on the public revenue to an extent that cannot be justified. The vote for this asylum 1880-81 is £1,500, or at the rate ot £23 16s. per head for each inmate. If the Government relieved the district altogether from payment of the small sum it contributes towards the cost of its poor, and contracted with, say, the Immigrants' Aid Society for the entire maintenance of the inmates of this benevolent asylum, there would result a saving to the revenue of about one-half the vote, or £7 50 per annum, in maintenance alone, omitting from the calculation out-door relief, which for last year amoutecl to £397 lls. 5cl. T~e inmates of this institution do not earn anything. Eighteen months since the supermtendent proposed to the Committee to look for work for some of the inmates, b.ut the question was not entertained. Some of them are employed about the institu tiOn, but not apparently to any great extent. · A small profit ( £5 7s.) was made last year by the sale of pigs reared on. the place. I saw these fed ll'ith bread and meat, for which. many a poor family would have hee.n grateful, and was informed that it was customary to give them 'an· the meat from wluch beef-tea was made, and the table refuse, stews not being made. . Religious services are hut indifferently sustained at this asylum, only one of the local clergyme~, I was _i~formed, and the Chinese ~issionary ~Jeing in regular attend:'tnce. Uccaswnally VlSttors attend to read and smg to the mmates, and the ladies of the district are said to be very attentive to the female inmates. . The sick ward is too crowded. The average space per bed in the asylum when fully occupied is 756 cubic·feet, but the sick ward g~ves only 711 feet. H. F. NEAL, Inspector Public Charities. The Honorahle the Treasurer. 23/5/81. APPENDIX N 0. 30. ASYLUM AND SCHOOL FOR THE BLIND. (Visited 8t!t, 9th, 10tk, and 13th June 1881.) lnmates.-52 males arid. 45 fema:les ; total, 97 of all ages from 6 and 8 to 49, and even 62 years. Eleven are paying or are.paid for, at rates varying fi·om £5 per annum to £45 per annum, the latter being a payment by the New Zealand. Government. . Dorrnitories.-5, containing 104 beds, with an .average cubic space per bed of 756 feet. ' Staff-Superintendent, matron, clerk, music teacher, 2 assistant music teachers (who were pupils), school teacher, 3 assistant teachers (ex-pupils), basket making instructor, brush do. do., and .11 male and female members of the household staff; in all, 23 persons, with salru·ies amounting annually to £1,490 16s., in addition to quarters, rations, &c., for the entire· staff~ with the exception of the t"'o trade instruc~ors and the gardener. . · . · Management cif House.-. On tlie whole good. The dormitories were fairly clean, hut the b~?dding was scarcely so clean, nor were the beds so tidy as might:have been expected in view of the largene~s of the staff. I saw several indications of the existence of a genial family influence, and the imfortunate inmates appeared to be contented, happy, well cared for, and to be receiving good instruction. The hospital arrangAments are not suitable, and better accommodation for the sick is certainly desirable. This want seems to have occupied the attention of the authorities, but the absence of funds has prevented any practic:ll outcome. The ventilation generally anpearedto me not to be so good as is desirable. Admissions.-Non-paying inmates are only admitted on the application of parents, guardians, or near friends, and the application, ·which contains a statement as to circumstanc~s, has to he certified to by two persons of known repute. The same procedure is observed with regard to those who pay or are paid for, with the additimi of a statement as to the amount it is proposed to pay. The i)rOJWSed rate of payment is, I understand, nearly always accepted by the Committee,. and no after-inquiry appears to be made a.s to the ability of parties to pay an increased rate. Education and Training.-This institution being mainly educational, one principal featme is that the inmates are not supposed to remain any longer than is necessary to teach them to read and write, and to enable them to acquire a trade, or master music as a profession. The adoption of the Braille system has much facilitated the teaching of reading and writing, and both these branches of education have, as I was enabled to test, son;te well-advanced pupils. There is, under the Braille system, quite a variety of books available. :.\fusic is taught as a profession, and it is said that se\r~ral former inmates are eru·ning theirliving thereat. Tuning will also become one of the branches of industry in. which .inmates may become fi~ted to earn their owri 65 livelihood, and in connection with this it may be of interest to note, from the last report of the British and Foreign Blind Association, that " the Royal Normal College continues to train the blind to the profession of music with most satisfactory results ; " and that, "among trades for the blind, piano-tuning maintains its position as the most remunerative." It may therefore be hopeJ that the efforts in this direction which are put forth at 011-r own institution may lead to similar beneficial results. There is unfortunately no profit and loss account kept with the workshops, so that the actual result cannot accurately be ascertained. The balance-sheet, however, shows Expenditure, £516 4s. ; sales, £694 7s. 3d. ; leaving a balance of £178 3s. 3d. to go against the trade instructor's wages. The superintendent, who appeared to be most. desirous of having everything of the kind on a proper footing, intends commencing a profit and loss account. It may be remarked here that when an inmate has acquired sufficient proficiency in a trade, and an opening offers, he is provided with a set of tools and discharged. Dieting.-Of inmates and staff entirely l.)Y the direction of the superintendent and matron, there being no scale. I think the absence of a scale a noticeable omission in an institution such as this. Medical E.xtms.-Issued only by doctor's orders. No account is kept. The expenditure under this heading is said not to exceed £5 per annum, but it is included in the item "medicines." Stores.-The store's themselves were in good order, and the stock is limited ; but the transactions are not under proper check. With the exception of the provision account, no record is kept by which receipts, issues, and balances can be tested. The provision book is suitable, but is not properly written up. Collections.-These are entirely free from commission, all receipts going direct to the asylum. A considerable portion of the revenue is derived from concerts give1i by inmates, but there is no proper account kept iri connection with the institution books of the proceeds. The result of this was that last year the sum derived from two of the concerts ( £25 7s.) was not brought to account, while a sum of £21 os. 4d., paid into the bank, had no explanation as to tJ1e source whence it was derived. The balance-sheet for th~ last financial year consequently understates the collections by £4 Os. Sd. An explanation was given after investigation into the matter by the superintendent that the full sum had been paid into the bank, although not brought to account, inasmuch as, at the close of the previous half-yenr's account, he was debited in the balance-sheet with a sum of £19 13s. 3d., said to have been due the institution by his predecessor, of which he only received £14 15s. ,fd. Assuming this to be correct, there is 17s. 3d. due to the superintendent. It is not, however, a proper way to deal with the account, nnd I advised that the £4 Os. Sd. be paid into the asylum funds, and that a cheque be drawn for whatever may be clue the superintendent on the other account. On one of the accounts an under collection of 3s. 4d. had been made. . This also should be put right. . Under this heading I may nlso refer to the proceeds of sales, which are not under a good system. 8everal persons about the place sell things to visitors, but there is no check upon the bringing the money so received to :1ccount. This also is a matter which will no doubt novv be remedied, and a better system be adopted generally with regard to the manufacturing account. Accounts.-Correct, and in good orcler. · A few duty stamps were deficient. The expenses of two concerts and the annual demonstration ( £16 13s. and £36) are included in the general expenditure, while the gross proceeds ( £20 14s. and £1 L5) are shown in the receipts. The management think the latter item should be allowed, because it is the cost of the annual meeting which is common to all institutions. I think, however, that the proper course would be to keep a separate account for all these sources of revenue. and bring the net result only into the general account. Books.-Finance books suitable and well kept. Store books require more attention, and the system could probably be simplified to save clericallabor. A proper system of book-keeping for the industrial department is requisite. GENEHAL REMARKS. The circumstances of the relatives of inmates should, I think, be the stl.bject of closer and more frequent inquiry. . . No. 23. 66 The staff of this institu~ion, which comprises 23 persons, appears to me to be unduly large for the comparatively small number of inmates to be cared for, the average for last year having been 98-k ; and the cost per head is consequently high. Omitting the salaries paid the trade instructors and the school and music teachers,. the average cost last year Was over £32 r.er head. In view of the ages of the inmates, there appeared to me to be a dangerous freedom allowed the sexes in roaining and meeting about the premises. · H~ F. NEAL, Inspector Public Charities; The Honorable the Treasurer. 30/6/81. · APPENDIX No. 31. BALLARAT ORPHAN ASYLUM. (Visited 21st and 22nd June 1881.) .Jnmates.-78 boys and 53 girls. Dormitories.-11 in occupation, with 158 beds, and giving an average cubic space per bed of 67 6 feet. Staff-Superintendent, matron, sub-matron, cook, laundress, housemaid, nurse, and man-servant, resident; secretary and collector, and gardener, non-resident. Total salaries, exclusive of rations, &c., £925 per annum. · Management.-On the whole good ; but the bedding, in several cases, was less clean than could be desired. The boys' beds are much too close together ; a matter which, as there are several vacant dormitories, should be altered ; ·and, in view of the fact that there are boys and girls in this institlition 14 years of age, the aration of the sexes and the supervision at night are not sufficiently effective. The ning-room. arrangements, as regards the little children, could be changed with advantag~, and the elder girls might with profit to themselves be appointed to attend to the young .ones. Education.-The sehool is under the Education Department, and is dealt with . as an ordinary State school. Good progress is made vvith the education of the children, 27 having obtained certificates in 1879, and 13 during 1880. Religious Instruction.-The children, Protestants and Catholics, proceed to their respective places of worship every Sunday~ Sunday school is conducted by the different denominations separately on Sunday afternoons, and family worship of an undenominutional character is conducted by the superintendent daily. Industrial Training.-So far as the boys are concerned, this is confined. to gardening and milking, no tra.des being taught. The girls lea1•n the ordinary house hold duties, so far as these can he taught in an institution. Dieting.-Of children and staff according to the matron's judgment. There is a dietary scale specifying the kind of food the children are to have, but not the quantities. Medical Extms.-These are issued only on doctor's orde'r, and, with drugs, last year cost but £4 5s .. Stores.-Obtained by contract; and kept in cbarg·e of the superintendent ; they are brought to account in a very suitable book, but the entry. of consumption represents simply the result of deducting the balances in hand from the quantities received. It is consequently quite valueless as a. record of the transactions of the · institution. No clothing account is kept. Stock is taken annually, but only by the superintendent and matron, who are the officers responsible for the stores. Collections.-As a 1.'ule, hy collector, who, as secretary, is paid £300 per annum, and receives no commission. The receipt books are kept by the collector. The collections were duly brought to ::tccount. The Government return was incorrect, consequent upon the inclusion under the bend of privn.te. subscriptions of two stims; 67 • the one .£12, a payment made by the Education Department, and the other £24 Ss. 4d., a payment for board by apupil~teacher. · ·. · Accounts.-. Coi·rect, and representing apparently moderate expenditure ; 43 duty stamps were deficient . · · · The endowment account, made up of bequests and accrued interest· thereon, is invested chiefly in Government deb~ntures. It now amounts to about £1,200 ; the interest being periodically added to the capital sum. Books.-Finance books are good and well kept. The store book is suitable, but is not properly kept. A book showing the disposal of material in making or· repairing garments, &c., and the issue of clothing, should be kept. . GENERAL REMARKS. The children are kept in this institution longer than is necessary, 14 being the age fixed, even although they may have earlier obtained the certificate of education. I saw several strapping girls, each of whom had passed, and was quite' fitted for a situation. The point IS of the more importance in view of the mixing of the sexes here. A large proportion of the children are said to be claimed by their mothers when fit to leave. Two points are worthy of notice, having :regard to recent comments respecting the disposal of Industrial School children, viz. :-1st, the so-called license terms have, with slight alteration, been adopted, and higher rates, it is said, cannot be obtained ; 2nd, while the Committee are quite willing to allow children to be adopted, none have been so disposed of for some years, and very few altogether. The cost per head (deducting £109 15s. 9d. spent on buildings, two-thirds of the sum paid as interest, which belongs to the building account, £67 2s., and £71 Is. 3d. spent on the piggery, which is covered by a sum of £95 13s. realized by the sale of pigs) is £20 Is. 2d. per head. The Government grant is at the rate of about £12 per head per annum. · H. F. NEAL, Inspector Public CharitieR. The Honorable the Treasurer.. 6/7/81. APPENDIX . No. 32. BALLARAT REFUGE. ( Vzsited 22nd June 1881.) Inmates.-7, 4 of whom are between 15 and 18 years of age. They are required to remain 6 months in the institution at least, and, if then considered deserving, a place is found for them. If their conduct does not warrant their being recommended then, they are permitted to stay during a further period of probation. Ward.-There is but one sleeping room, the accommodation being somewhat limited in the building, which is a temporary one. Should the present structure be replaced, it "ill be desirable to provide separate sleeping rooms for the inmates. Staff:-Matron and sub-matron. Salaries, £60 16s., in addition to rations, &c. Management.-This appeared to me to be very good .. All the inmat~s were actively employed at useful occupations. Washing and sewing are done for the public. ' Dieting, Stores, g.c.-.These are entirely controlled by a committee of ladies. No accounts are kept. . · · . Collections.-. Made periodically by ladies. The pass books showing 'the sums · collected were not available ; but, assuming the accuracy of the advertised lists, they were all accurately brought to account, and the audited balance-sheet agreed with those lists. Accounts and Books.-These were correct, and the expenditure appeared to be modemte. The finance books in use are fairly kept. . . :F 2 68 GENERAl, REMAHKS. This is of course· quite an exceptional institution, and its transactions are li~1ited. In the very nature of the case payment or imposition can scarcely be a.. question. I inquired of various persons, including the city missionary, respecting the work done by this institution, and the general opinion appeared to be that it is, accomplishing much good. It may be worthy of note that public prostitution is said: to have been brought, hy the energetic action of the police, within a very small compass at Ballarat. But the fall from virtue of very young girls was a fact which could not escape notice either here or at the Lying-in Hospital. At the latter place, a child under 14 was an inmate. The local hospital, I may remark here, was said to be exceptionally free of cases of syphilitic disea~e. Cost per head, £28 17 s. 1 Od. H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. 6/7/81. . APPENDIX No. 33. FORMS OF BOOKS RECOMMENDED TO INSTITUTIONS. (A.) ______HosPITAL (or Benevolent Asylum, as the case may be). Receipts during the Month of _____l88 Not Bearing Commisslon. Bearing CommiS;Sion. Bnnkcd. .J 0. Grants I I Payments ~ule by-Munl· or I.eguclcs, Name. Residence. Govem~ Church by or on _clputitics Itcfuse Bequests, Prlvnte I Totnl. ~ ment Uollec. Account and Subscrlp· Date. Amount. ~ or other Interest, I 0 Grant. tion!3. of Public Proceeds &c. tlous. 0 l)atients. oli.nbol'. Z: Bodies. ______! __ · ----I~------:------! : I i I I ; . I [Headings can be varied or the number of columns increased to suit local requirements. The total cf each month's receipts 'under the respective headings to be carried into the Summary of Revenue Book (Sample B). · All receipts should be entered in this Book A. In printing the book a date column should be introduced before the column for name of contributors. The heading "Church Collections" might have added to it in this book "and Proceeds of Entertainments," as, the number of receipts being small as a rule, one column may suffice for all. But if preferred a separate column could be provided.] (B.) ______HosPrrAL (or.Asylum, as the case may be). Summary of Revenue for .the Year ____ Grants by · IPa.yments Sales of· Legooiea, Govern- Muni- Church by or on ltefuse Proceeds Private &quests, Interest ment cipalities Collec· . Account a.nd of l>'n· Contrihu· a.nd upon Total' Total. Grant. and tiona. of Proceeds terta.in· tions. Spcclul Invest... Banked. other Public Patients. ofLabor. menta. Donations. menta. . Bodies. - ·~ J:uly ... I August ... September I October ... November December ... January ... February ... .I March April ... May ... Jun~ ... - ---I- --- 1--·- Total :.; - -- --~-~ --- -- 69 FORMS OF BOOKS RECOMMENDED TO INSTITUTIONS-continued. (C.) ~-~-~---HOSPITAL (or Benevolent Asylum, as the case may be). Summary o£ Expenditure during the ,; 0 ...... '~'!.§ m "" "" • om..,m I ~~>." ~ tl '3 ~ ~.: ... ·;; -~ (5'§ ~ ~...z .;:;·- & "" :'2 ."le ·~ -.:: :; sa .; ~~ 00 ~ .!9 ~~!! -.., 0 HI ri~ 00 .::; ...... ;;l" ~o.::< 111 """ - ~ if 0"' E-< - iJ 1! u i--,----;--'---;-- July ...... August ... September ... I October ... November ... " December ... January ... February ... March ...... April ...... I May ...... ,June ...... 1 __1_____ ------'--1 "---'---'-Ill --'---'---'--1 11 r 111 111 111 : 11 '' 1 1 I 11 111 IJJIII 1 r o Avern.~es should be strack ns follows :-The number of days coon patient hll.S been In the lnst•·utlon during the month to be added together and the total for all the patients to he divided hy the number of days In the month. (D.) (or Asylu~i, as the case may.be). Salaries and Wages Account for the Month 1 Period. ! Rate. I Amount. Duty Rank. Name. Yearly or Signature of Payee. Stamp. Remarks. From 'l'o 1 Dally. ·--- :-· [This should be in a book.] (E.) (or Asylum, as the case may be). Building and Maintenance Accounts for the Month ______ Name. Amount. Name. Amount. Stamp. - 1- 1- The Treasurer is authorized to pay the above Accounts, amounting to £ : : _f!ha~rman of Cvmrnittee (or Finance Committee, tu the case 1'1'ta!J be.} . .. ~ .. -··· ~This may be either in book form (the binding being on the left-lmnd margin) or loose sheets. If the latter are use , they should, when completed at the end of each month, be gummed into a guard book. In printing this form, a column should be provided for Date of Payment, which will probably involve an increase in the size.] CLASSIFICATION LtST FOR TRI>ASURER, ~ Building .•• ...... Forward £ Repairs to Building ...... Provisions ...... Fittings and Furniture ...... ]'uel and Light ...... Funeral Expenses ...... ·Medical Comforts ...... Collectors' Commission ...... Medicines ...... Bedding, Clothing, and Drapery ... Printing, Advertising, Stationery, &c. Other Expenditure ...... Out-door Relief ...... Forward ...... I Total ... £ ; 70 Fomrs OF BOOI{S REccim.rENDED TO !NsTrruTIONS-contiuued~ (F.) ---~-----HOSPITAL (or Asylum as the case may be) . . llegistcr of Provisions, Medical Comforts, &c., Received and Issued dnring ______l88 :i ~ ":! .,; ~ ~ oi 0 ,.; ,.; .,; "'0 :i ~ ~ .,; ~ ~ ~ .; " 0 0 'i:l "" .g ~ ,;. .,; 0 ~ :!!! ::s ~ ~ "" ,.; 0 0 1:: .9 d ~.0 ~ );! " ~ ~ " ~ ~ 0 0 0 " ~ 1« !>< E<" m ~ ~" ~ !><" 0 < Total Issues ... ----~------ Balance forward to next} - -~------.------·------month ... Total I [Where a daily diet list or book is kept, the totals thereof for the week to be posted into this book as the issues· for the week, providing the issues to the staff are included therein. If such list or book is not kept, the daily issues to !Lll departments should be recorded in a book, and the weekly totals posted into this. A similar book should be kept for recording the receipt and issue of other stores, such as ironmongery, crockery ware, drapery, &e., and for surgical instruments and appliances.] · r .ADDITIONAL REPORTS. APPENDIX No. 34. '! •,\ THE DEAF AND DUMB INSTITUTION. (Visited 26th, 27th, 28th, and 29th July 1881.) Inmates.-38 males and 31 females, in addition to '7 private pupils, whose maintenance and tuition are paid for by their friends. Out of the 69, payment is made for 21. Two are paid for by the New Z~aland Government at the rate of £42 per annum each, and for the remaining 19 contribution is made at various rates from £4 to £13 per annum. The inmates vary in age from 7 years to 57 years, but the bulk are between 10 and 19 years, there being but one above the latter age. Dormitories.-4, containing 76 beds, 19 of which, for the younger children, are double, providing in all accommodation for 95 inmates, and giving an average cubic space per inmate of 7 90 feet. Staff.-Sul)erintendent an~ matron, who, in addition to furnished quarters, maintenance, &c., for themselves and family, receive a joint salary of £500 per annum. Teachingstaff .of 7 persons (including the visiting drawing master), 5 of whom are resident, and are paid at the rate of £687 6s. 8d. per annum. Tailoress, yardsman, nurse, housemaid, laundress, cook, and sculleryman, who are resident, and are paid at the rate of £302 per annum. There are also non~resident, the secretary, shoemaker, and gardener, whose salaries amount to £454 16s., making the cost of staff, exclusive of maintenance, &c., £1,944 2s. 8d. Management cif House; g.c.-Very good, the whole of the institution being very clean and in good order. The practice of permitting boys 11 years of age to sha:re the one bed is objectionable, and should be altered. A deficiency in the shape of swings foi· the girls and .gymnastic appliances for the boys is, I was informed, about to be supplied. The ·closets, lavatories, &c., appeared to be well attended to, but stricter attention to the disposal of the contents of closet pans is requisite. Teaching.- So far as I may venture to advance an opinion on this point, I may say that the Committee appear to be doing all that modern intelligence has suggested in regard to this branch of their work. The children and elder pupils alike seemed happy in school, and to be well cared for and kindly treated by officers and teachers generally. Religiotl.s instruction is given by the teachers daily, and family worship is conducted morning and evening. · · Industrial Training.-The boys are taught shoemaking, tailoring, and gardening, and the girls plain needlework and laundry work. The omission to teach the girls kitchen work should be remedied. · · . Dieting.-There is a dietary scale, but it is not adhered to, the rationing of inmates and staff being almost entirely according to the superintendent's judgment. The Committee, I was informed, do not exercise any check. . Medical Ea;tras.-These are very rarely used, and when required are issued ·solely on medical order, no stock being kept. Stores. -Groceries are obtained by contract, but ironmongery, crockery, bedding, &c., are Jmrchased by the superintendent after the Committee has authorized the requi1•ed articles being procured. Jn some cases! found that large orders were thus left to the superintendent, instead of being the su~ject of action on the part of the Committee, as I think they shonld be in all cases ·When tenders are not iftvi~d, 72 The system of issue within the institution is also lax, and, as described to me, is not checked systematically even by the superintendent. Stock is taken half-yearly, but only by the officer responsible for the stores. The Committee, I was informed, do not check the store accounts, nor test the accuracy of the stock on hand. The issues of material for manufacture to the employes is practically uncheck~d, and no record is kept to show that a proper account is rendered of the manufactures fi·om such issues. The whole of this branch of the institution's work appears to me to be loosely conducted. · Collections.-There is no paid collector. Receipts for ordinary contributions are si~ned by the treasurer, who sig·ns a number in. advance and leaves them with the supenntendent for use. This officer also issues receipts in many cases signed by himself. There are several receipt books in use. The system could be simplified with advantage. The receipts fi·om the shoemaker's shop not being represented by any receipt blocks, and there being no proper account kept of the manufacturing proceeds~ cannot he satisfactorily verified. I checked these· receipts, however, so far as the entries in a ledger dating from the 1st January 1880 represented the transactions, and found that they had been· duly brought to account. Accounts.-All the accounts were in good order, and prop.::;rly entered up. Three distinct cash books are kept for as many separate funds. These funds stood. as follows in June last:-. £ s. d.. £ s. d. Maintenance account, to credit 449 8 8 Less accounts dne 281 9 8 167 19 0 Building account, to credit 1,271 16 l Endowment account, do. . .. 447 4 10 Do. (in course of receipt) ... 250 0 0 ---- 697 4 10 £2,136 19 11 The endowment fund appears to be the result of bequestsl hut the building fund is the result of an appropriation for some years past of the municipal contributions, and apparently without the municipalities being made acquainted with the fact that their contributions have been so appropriated. In the last two years, £648 7s. has been thus diverted from the purpose for which there is little doubt it was given. Seeing that the building is ample for the limited number of inmates, and that this fund is now £1,271 in credit, the practice should be stopped. Books.-Like the accounts, very well kept, but they could be simplified "rith advantage. There are no less than 10 different books for the financial transactions. Proper books should be commenced for the general stores .and the manufacturing work of the institution. REMARKS. As I have already said, this institution is very well managed internally, but I must add upon a very extravagant scale. The average number of inmates during the last financial year is said to have been 81. This included 3 who were simply taught as day boarders, and 6 whose clothing was provided by parents. Taking the number, however, as 81, and the cost per head computes to £40 17s. ld. Deducting the teaching staff, which may necessarily be exceptionally heavy here, and ·the cost was £32 12s .. ld. for maintenance and supervision alone. The staff salaries (riot including allowances and teaching) amount to no less than £15 10s. 3d., and· the Government grant for last year was at the rate of £19 J 5s., per head. There seems to me, therefore, to be room for a reduction of the grant, and for economy at the institution, and I would suggest to the Committee the appointment mthout delay of a finance committee, whose duty it should be to supervise the expenditure, check the accounts, and especially the rates of purchases, and also to see that the stores and manufacturing . branches are under proper check. H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. 2/8/81. 73 APPENDIX No. 35. VICTORIAN INFANT ASYLUM. (Visited Angust 5th and 8th 1,881.) Inmates.-13 mothers with their children, and 14 child1·en without their mothers ; in all 40, exclusive· of the children boarded out. Wards.-3, containing 40 beds, and having an average cubic space per bed of 460 feet. r Stqff.-· Lady superintendent in responsible charge, matron, and 1 general servant. Total salaries, £140 per annum. Management qf House, ~·c.-Good. The institution, however, is in an unsettled state at present, consequent upon the new buildings having only lately been taken into occupation, and the workmen being still about. The sleeping rooms appeared rather crowded, but this will probably be changed as things are put to rights. The room set apart for treating cases of infectious disease-.a necessary provision in such an institution-is not well suited for the purpose. Dieting.-Entirely by the superintendent's discretion. No'mtion book is kept, or account of the receipt and issue of provisions beyond the tradesmen's pass books. The superintendent is held responsible by the Ladies' Committee for the economical management of the institution in this respect. Medical Extras.-As a rule, none are required; when they are used, it is only O? doctor's order: No account is kept. Stm·es.--Monthly supplies only are kept. Contracts are taken for the principal articles. Bedding, ironmongery, &c., are purchnsed by the ladies themselves. No books are kept. Coltection.'!.-Entirely by ladies, so that there is no deduction for commission. The sum· shown in the last balance-sheet as •: Subscriptions and Donations" is £82116s. fid., a large sum considering there is no paid collector. Th~ collections were all 'accurately brought to account and hanked. There are two accounts-the building and maintenance. The former closed the year with a debit balance of £399 12s. 2d., after payment of nearly £3,000 on the new premises. The maintenance account closed with £434 19s. to credit. There is no endowment account. Accounts.-These were all correct with a few exceptions, which were put right before I closed my examination ; but no receipts are taken from the foster-mothers for the monthly payments made to them. This is an oversight that should he remedied. The expenditure generally appeared to be on a moderate scale. Books.-Finance books suitable and well kept. Store books should be commenced, and receipts, issues, and balances be recorded. GENERAL REMARKS. Admissions to this institution are necessarily of an exceptional character. The object beirig to prevent infanticide, a very rigid scrutiny into ·the circumstances of applicants is prohably not to be expected. But the superintendent informed me that the ladies do inquire into the past career and social position of the mothers who are admitted, hut in very few cases do their "friends" or relatives make any payment towards the1r maintennnce. I do not wish at the present time to raise a question as to the desirability of the State subsidizing institutions of the character of this one, but it should he pointed out that very gTeat care is necessary lest a serious social evil should be fostered by granting relief without instituting the thllest inquiry in each case. For this reason, while having every confidence in the management of the i:t:tstitution bv the ladies, and recognizing the high-toned philanthropy which prompts their efforts, f feel that a keener and fuller scrutiny is necessary in many of the cases than they or· their lady officers are able to exercise. Probably this fact will in course of time force itself upon their attention. Contributions towards the cost of maintaining the infants 1s 74 obtained from a considerable number ofthe niothers when they get to service. Last ye.ar they paid £233 lls. 3d., or about one-fifth the total outlay. The cost per head of inniates (taking simply the average number of mothers) \\'aS £45 4s., or, deducting rent and taxes, £36 lls. The expenses of the year were probably exceptionally heavy, consequent upon occupying and furnishing the new premises. The children boarded out and at wet-nurse averaged £38 58 .. as the cost per head. H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. 16/9/81. ·'"' APPENDIX No. 36 . . ' \ ·.··. MELBOURNE HOSPITAL. (Visited lOth to 12th and 15th to 19th August 1881, inclusive.) lnmates.-196 males, 119 females, and 25 children . . , . Wards.-.,22 in present use, cont..'tining 382 beds, giving an average space of ,1.. ,~65 c~bic feet per head, the minimum being 869 cubic feet. . . .: · · Sta_ff.-As per schedule attached. ·' .. Managenzent qf House, o/c.-On the whole good, but in two or three of the \vards there wa.s .a .tendency to allow·rags, used apparently for .household purposes, and· slops to remain about, which is objectionable in any hospital, and should not be pennitted ~n. this, which, as the central, .should be the pattern institution. Better provision is desirable for t~e disposing of the clothing of patients, as in several. cases they ~~~e · permitted to remain about and under the beds. The arrangements for washing_. ~p the utensils. used for meals are bad. The .sinks being in the lavatories, be::;ide the pith'd .ba~~ns, in ~~veral instances the latter were in ~ .greasy sta~e, and in one ~!U'e even. the bath was half-full of gre~sy water. Owmg to tlns arrangement, the lavatories generally were less clean than ·is desirable. Besides, washing-up mess utensils in such close contiguity to tl~e closets, baths, &c., appears to me to be in itself objectionable. Tlie wards themselves were clean, and on the whole in very fair order. The ward stock should be subject to some check. The kitchen and all the kitchen utensils were very dean and tidy. The laundry arrangements present the same oversight that I have referred to in other hospitals. There is no disinfecting chamber, and the clothes from diseased cases are placed in cold water to soak, and the water is allowed to run through the open channels of the streets of Melbourne. I do not go into the medical question of " disease germs," upon · which the doctors I have conversed with express very different opinions, lJut I understand that the Central Board of Health act upon the theory that these exist and that heat to a stated degree is requisite for their destruction. Writing, therefore, upon the assumption that the dictum of that body is accurate, it is my duty to .point out that the practice at this institution is highly calculated to spread disease through the city. It is, I think, not clear that the closet system does not do the same thing. Dietary.-Officers' tables are.. supplied under the matron's direction, to suit their respective tastes. N m·ses and servants under the direction of the same officer, but subject to the control of the secretary, and to a certain extent by a skeleton scale. There is a diet scale for inmates, but it also is simply a skeleton scale, manifestly designed to permit of the medical men ordering what food they choose for their respective patients, and an examination of the diet cards shows plainly that this is liberally done. There is perhaps no branch of hospital work more difficult to adjust than the dietary of the inmates, nor any in which there is so great a loophole for extravagance and waste'. It is difficult to tell the exact cost of provisions from the balance-sheet of this hospital, because the item " oilman's stores" is mixed up with groceries. Taking the cost, however, of the five items-1st, bread; 2nd, meat, fish, . and poultry; 3rd; groceries, eggs, and oilman's stores ; 4th, potatoes, vegetables, and fruit 7 ~th, milk; and the outlay per h~d for l880 was at the rate of £·17 15s. At the ' I ' I. ' .. , 75 C,4stlemaine Hospital ''provisions" cost £1 0 6s. At· the latter institution I~edi:cal comforts cost only about 12s. per head, so that 110 provision items :l.re there charged under that head. The comparison, therefore, will serve to show, whatever legitimate allowance may be made for oilman's stores at the Melbourne Hospital, that there is a lai'ge' difference of expenditure at the two institutions on an item where they should more nearly approximate. : A number of the diet cards prescribed a daily ration that would he counted liberal for persons in good health, and I cannot doubt, from what I saw 'and heard, that it frequently happens that ·the food ordered remains unconsumed. But it should, I think, be understood that tb'is is a matter in which the administrative staff is practically powerless. The medical men give the orders for their respective patients, and whether the food is to be eaten or rejected, it. must be supplied. ' And doubtless the medical answer to any complaint on the subject would be that the condition of patients must be studied in this respect. An elaborate system is ·in force 'to show the daily dietary of each inmate. I checked this by a number of diet cards taken· promiscuously from the different wards, and, with a few minor ~xceptions, found the entries correct. The precaution to ensure the food ordered by the niedica',l 'men reaching the kitchen, and· being duly brought to account, appears to be pi·etty complete ; bnt the only guarantee that it reaches the patient seems to be the possibUity of .an occasional inquiry by the medical officer in charge of the case, the general supervision of the matron, and the possible complaint by the patient, the ward nurses trusting apparently to memory to guide them in regard to the distribution of tp~ di~ts sent to their· respective wards. It is said, however, that in practice the system i:;;, w9rkgd with accuracy. But that it is possible for non-compliance with the ~edical . or.ders to take place was manifest from the fact that one of the inaccuracies wl;licll ; crone . under my notice was the omission for 7 days (assuming the accuracy of tp~ diet sheet) to supply a patient with an item of diet that· was ordered. · From the daily diqt sheet, the ration expenditure is passed through other forms till brought to account in the provision receipt and issue book. Stock is taken by the secretary ::tborit tWice a year, the actual weight and measure of the balances being ascertained. ~u,t ~s the secr~tary }s the resp9nsihle officer, although the issues are actually made by a subordinate officer, the stock-taking should be perfonued by some other p~rson. I compared the receipt and issue book with the last stock list, and, for such large tran~sactions.; the discrepancies were very slight. Medical Extras.-These are issued on ·medical order only. Each ward is supplied with a wine ticket, in which the name. of the medical officer ordering is inserted as well as the quantities of each article to be supplied. The orders are also iri the diet cards. A short time since, the visiting committee had stock taken and the balances checked, but this, I was informed, was an exceptional thing. I am of the same opinion with regard to this matter as to the groceries, &c., that stock should be periodically taken oy persons not concerned with the accuracy of the accounts. The expenditure last year was at the rate of £3 10s. 7d., wines, spirits, beer, lemonade, and ice being the only items included . . Stores.-:-Groceries, wines, spirits, and such like stores are obtained by contract; but furniture/ironmongery, crockeryware, &c., are purchased, Things in general use a1~e obtained by the' secretary as they are required. An efficient record is kept of 1·eceipts, issues, and balances of groceries, wines, and spirits, hut there is no account kept of the disbursement and of the balances of other stores, and the stock of the institution is evidently an unknown quantity~ The linen is under the charge of the matron, but, although the expenditure is necessarily considerable, there is not a satisfactory account kept by that officer of her receipts and issues. Stock was taken about 12 months since, but stock-taking is not systematic. I have before expressed the opinion that, in the store transactions of such institutions as mueh as in regard to the accounts, a })roper system of investigation and check is requisite, and the Committee of the Melbourne· Hospital should, I think, reorganize this branch of the institution under their direction. · , Collections.-Last ye!lr, by two collectors, who were paid at the rate of £100 per ailllum and 10 per cent. on all collections within 9 miles, and 12k for collections beyond that distance. One of the collectors is provided with a buggy, but has to find his own horse. In but rat'e cases, I was informed, does the collector receive commission on sums sent direct to the hospital. The check upon the use of receipt books and to ensure the collections being brought to account appears to be now effective, but. I ·16 found in some receipt books which were out ·of use a large number. of bl:tnk forms. These were destroyed in my presence; but I think in all such cases hereafter the forms should be destroyed in the presence of and the. butts be cancelled by the treasurer or .a member of the finance committee. I was informed that neither auditors nor finance committee check the entries in the subscription book by the blo~k receipts, which I take to· be an oversight. All contributions (those of municipalities included) which are over £20 are appropriated to the building fund by resolution of the Committee. Among the amounts entered as contributions from July 1880 to June 1881 were £68 5s. pupils' fees, £94 19s. donations from patients or friends of patients, and £25 from anatomical school; but I a~ informed that the contributions, without these .items, are more than sufficient to claim the amount voted by Parliament. If so, it will .not affect the return sent in to the Treasurv, but it would be better for such items· to be shown distinctly under the head of "other sources." Most of the contributions hy local hodies are collected by the collectors, who consequently receive commission thereon. There cannot be much doubt that all such contributions could be obtained direct. The collections are placed to four accounts-1st, maintenance ; 2nd, building ; 3rd, convalescent fund; 4th, endowment. The first is continuously in arrear from £1,000 to £R,OOO, the average being probably £5,000. The building fund, at the end of the year, was £950 in debt. The convalescent fund has a credit of £58, and the endowment fund no~r amounts to £10,456. The convalescent fund is only used to provide poor patients with trusses, &c., and as this is manifestly not what was intended, it would be better to extinguish the account altogether. The endowment fund has been legitimately made up of bequests. The sum to the credit of this fund is left in the bank without interest, on condition that the bank pennits the other accounts to be overdrawn to a similar amount without charging interest. This, however, is only another way of saying .that the institution draws on its own reserve fund, allowing the bank the gratuitous use of the difference between its current necessities and the sum of such reserve fund. In the past, when the endowment fund was less than it now is, the arrangement may have been a good one, but I should think a better one could now be made. As the Committee comprise good business men, ho~'ever, it is enough for me to suggest a revision. The funds in debt are charged regularly with interest, which is passed to the credit of the lending fund. Accounts.-Accurate, and apparently very well checked. The system of finance to secure accuracy of payment is very complete, and, I had reason to observe, is ·carefully watched by the honorary treasurer. Books.-These, although rather complicated and more numerous I .think than the actual requirements of the institution necessitate, are complete, so far as the finances are concerned, and are very well kept indeed. The store books should be supplemented by a book showing the receipt and issue of all stores, and another showing the state of the stock throughout the institution at each stock-taking. I have previously remarked that there are at this institution-on accQunt of its being both a medical school and the principal dty hospital-many nice points of adjustment; and it cannot he doubted that this fact makes the task of the Managing Committee a most difficult and onerous one, and adds materially to the cost of the institution. It is said, and I think with justice, that the value to the community of the practical education given to the medical students here cannot be gauged by its · money cost, and, as it is apparently a necessal'y accompaniment of the imparting of that education that the medical gentlemen shall be unrestricted in the orders they.give on behalf of their l)atients, it is doubtless very hard for the management to check extravagance. Comparison with other institutions. is also practically out of the ·question on this account, as well as from the fact-a fact which has come under my own observation while in the country-that this institution is resorted to by difficult cases from all parts. :Nevertheless, I think th~ Managing Committee should persistently continue the endeavours, which I find they have already made, to bring the medical . orders forspecia1 diet and extras within reasonable bourids. Hecognizing the causes which are in operation to make a difference between the cost of dietary and medical extras at the Castlemaine and Melbourne institutions, I still fail to see that that: difference is so great as to warrant an expenditure of about £21 per inmate at the latter against ab? ut£ 11 77 at the former. The matter is one. to which the special attention of the newly-appointed medical superintendent should be given. Probably a more complete dietary scale for the patients, and a definite scale for the staff, would go a long way towards effecting economy. So many of the admissions to this hospital are emergency cases, which may not be refused, that in the present state of the law-which it is presumed does not give hospital authorities power to recover for maintenance and treatment, although in one case I have brought under notice proceedings were Sllccessfully taken-the gratuitous treatment of persons able to pay cannot, it is said, be prevented. I think, however, it should be more a definite practice with the Committee than I judge it to he to investigate fully each case of doubt in this respect that a.rises, nnd demand payment from those whose social position warrants such a demand being made. The circumstances of inmates are not recorded in the admission book. I think this should be done. The proposed endeavour to change the practice with regard to out-door relief deserves warm commendation, but I think a mistake has been made in dispensing with the services of the inspector of imposition. Seventeen inmates are reported to be fit subjects for a benevolent asylum. · I am much inclined to think that the presence of so large a hospital in almost the very heart of the city is an evil that should not be tolerated, and one that will before long force itself upon pu hlic attention. The hospital by no means complies with modern requirements, nor is it, I imagine, practicable to fit the present buildings thereto. The Committee would therefore do well to take this matter into early consideration. The non-existence of a cont:'lgious disease hospital renders it of hut little use speaking of this subject in connection with the Melbourne Hospital. Nevertheless, wards for isolating scarlet fever and better provision for erysipelas cases are, I think, a necessity. The lock ward also would he better away from the main building. . Cost per head, £61 2s., allowing for out-door relief one-third of the medical salaries, the dispenser's and hall porter's salaries, and the cost of drugs. . All officers and staff, except demonstrator of anatomy and dispenser, reside in the place and are rationed. The officers at an average cost of £45 12s. 7d. per annum, and the staff at an average of £14 2s. 8d. approximately. They are also supplied with furnished quarters, fuel, light, washing, and attendance. H. F. NEAL, Inspector Public Charities. The Honorable the Treasurer. tl/9/81. STAFF. £ s. d. 1 Medical Superintendent, at per annum ... 450 0 0 6 Officers, at £51) each per annum 300 0 0 l Demonstrator" of Anatomy, at per annum 150 0 0 1 Dispenser, at per annum 300 0 0 1 Assistant Dispenser, at per annum 200 0 0 1 Secretary, at per annum 500 0 0 1 Matron, at per annum 150 0 0 1 Male Wardsman, at per annum 117 0 0 3 at £104 each per annum 312 0 0 1 " at per'annum 91 0 0 1 " at per annum 78 0 0 5 " at £65 each pm· annum 325 0 0 1 " at per annum 60 0 0 1 " at per annum . 59 0 0 2 " at £58 each per annum 116 0 0 12 " at £52 each per annum 624 0 0 1 " at per annum 51 12 0 16 " at £45 1 Os. each per annum 728 0 0 2 ",, at £26 each per annum 52 0 0 3 Female Nurses; at £53 each per annum 159 0 0 1 at per annum 49 0 0 2 " at £47 each per annum ... 94 0 0 27 " at £40 each per annum 1,080 0 0 1 " at per annum ... 34 0 0 20 " at £30 each per annum " 600 0 0 78 APPENDIX No. 37. IMMIGRANTS' HOME. (Visited Aup;ust 24th, 25th, 26th, and September 13th 1881.) Inmates.-351 males, 170 females, and 112 children. Wards.-There are 29 sleeping apartments, with a total cubic space of 292,728 feet. This space divided by the number of inmates gives 462 feet each. Stqfj:-As per schedule attached. . 1Wanagement of House, g.c.-Very good. The ordinary division for_males.1v~,ts, clean and in excellent order. The hospital division and the female section were as clean and tidy as the crowded st~te of the premises will probably permit of their· being kept. A new working shed for the females has lately been erected, and is a serviceable addition to the premises. · . . · . . · . ~ · Dieting.-Inmates by scale.· The excellent plan is adopted at this institution ofnot dieting the officers. I checked a number of the recorded issues, and found them to be in each case within the scale. · · . · lYiedical Extras.--Entirely by doctor's orders. When I last reported on this' institution, I drew attention to the fact of stimulants being issued on the doctor's unsigned orders. This has now 1Jeen stopped. . l checked the account by tl;le orders·; there was a considerable discrepancy, but it was subsequently explained, certain variations having been omitted by the clerk from the account. To improve this portion of the institution's system, it is requisite that the "list" be written up more frequently and that it be periodically checked by the medical orders. · ·· ' Stores.-All supplies under the head of provisions, ·&c., are ~btained by contract, but bedding, crockery ware, &c., are purchased as required. Stock is taken,· and the issues checked of each description of article when a fresh supply is required. As described to me, the check upon this part of the management is efficient, and the" moderate outlay indicates economy. Collections.-By a collector, who has no salary, but receives a commission of · 10 per cent. on all donations collected or influenced by him. His ·actual collections for 1880 amounted to £5461s. 7d., and his commission to £99 19s. lcl., or a little over 18 per cent. Receipts were duly brought to account in cash book and bank. As the subsidy to this institution is "unconditional, so far as regards private contributions," I did not check the return to the Treasury. The balance-sheet, however, was correct by the books. Accounts.-With the exception of a few duty stamps being deficient, which· were subsequently supplied, the accounts were moderate, and were accurately entered. · Books.-Suitable and well kept, with the exception of the medical comforts .book, to which, however, the superintendent has since given his attention. . GENERAL REMARKS. . It is a met:e act of justice to the superintendent of this institution-Mr. Greig to say that, in every branch, traces of his careful supervision are manifest. The fault, or weak point of this institution is one over which he has no control. It is a matter, however, to which I must, as in my last report, call attention. The available accommodation is quite inadequate to the demands made upon it. Even with the present number of inmates, which is said to be somewhat under the average, the cubic space available gives an ave:r:age only of 462 feet. The male hospital wards, which contain inmates with many varieties of disease, have an average space of 769. and 794 eubic feet for each, and the cancer ward gives but 531 feet. A report to the Poor Law Board of England some time back, dealing with "the requisite amount of space and other matters in relation to workhouses and workhouse infirmaries," advised that "there should he allotted to each sick inmate in metropolitan workhouses an air space of not less than 850 cubic feet on an average, and that in thost: cases where the height of the ward is more than 12 feet, such additional height should not b.e taken 79 into account in calculating the cubic space of 850 feet ; that there should be all?wed a clear space of 6 feet across each bed, and that no bed should be placed on the m1ddle; of the floor." Such conditions cannot be complied with at the Immigrants' Home, nor is the space ~vailable for inmates who are not confined to bed equal to the minimum required for the same class in English workhouses. The opening of the Hospital for lncurables will, it is hoped, relieve this institution's sick wards materially, but cannot do so sufficiently to make the accommodation suitable for the many old people who are here gathered together. . In the female division, the hospital ward, although giving an average cubic space of 939 feet, 4as the beds too close together for safety, while the wooden huts are utterly unfit for habitation. · · The inmates are welLand profitably employed. . . The cost per head for 1880 was £11 2s., but deducting the outlay on repairs· and the net proceeds of inmates' labor reduces it to £9 4s. 3d. This very low rate is a testimony to good management. H. :F'. NEAL, Inspector Public Charities. The Honorable the Treasurer. 17/9/81. IMMIGRANTs' HoME.-STAFF. £ s. d. 1 Secretary and Superintendent ... 350 0 O, quarters, fuel, and light. 1 Matron 100 0 0, " " 1 Clerk ... 100 0 0, quartm·s, rations, &c. 1 Medical officer ... 200 0 0, no allowance. · 1 Dispenser and Storekeeper . .. · b2 0 0, quarters, rations, &c. 29 Servants and Inmates receiving pay or gratuities at rates ranging from 15s. to 1s. per week, in addition to quarters, rations, &c., £6 13s. being the average weekly pay ... 345 16 0 34 1,147 16 0 H. F. NEAL. 17/9/81. APPENDIX No. 3B. l. . MELBOURNE BENEVOLENT ASYLUM. (Visited August 31st, Septembm· 1, 2, 5, 6, 8, and 15th 1881.) Inmates.-411 males and 211 females.-Total, 622. Wards.-59, containing 622 beds, with an average cubic space of 623 feet. ·The minimum space per bed in any ward is 224 feet, aud the maximum 892 feet. There . are 8 wards, with 43 inmates, having in each less than 300 cubic feet per inmate; 5 with 39 inmates, having from 300 to 400 feet ; and 5 with 52 inmates, having from 400 to 500 feet. · · Staff.-As per ·schedule attached. . . Management .qf House, &c.-There is a very marked improvement in .the· internal condition of the asylum since my last visit, thorough and periodical cleansmg of wards, lavatories, bedsteads, bedding, &c., having been made. .The old mattresses are being rapidly cleansed or replaced, the necessity of which is sufficiently manifested by a SL'Ltement mare to the superinten~ent by inmates that it l1ad not bt;en done .for years befoi·e. The f(mmle wai·ds, as at my last visit, presented the n:iost · noticeable evidence of untidy'ness; and, ori this occasioi1 1 seemed to he less clean than the othei·s. so. ' This is no doubt due, to a considerable extent, to there being so many females confined, to their rooms. I am not able to speak with definiteness respecting the cleanliness of the female portion, and this fiwt leads me once again to refer to the necessity whicli exists for ri ladies' committee to exercise oversight therein. It is impossible for· gentlemen, however good committeemen they may be, to look after this section of the institution as it requires ; but if there were, as there is at the Ballarat Asylum, a ladies' committee entrusted with the duty, I have no doubt a great improvement would soon be noticeable. · The kitchen arrangements were better than at iny last visit to the extent of foi·ks being used instead of the harids to place the cut-up meat in the -\rarious plates; but the servii1g-out arrangement is at best a clumsy one. The crowded state of the institution prevents the superintendent making those divisions into messes which do so much to make this part of the work at the Immigrants' Home show to advantage ; but, notwithst."tnding this, I think :i:nuch might be learnt in this respect from the latter institution. . · Of the closet accommodation I "\vill speak under the head of General Remarks,: but I may refer here to the practice which obt."tins of burying the closet refuse in the grounds. Considering the number of persons in the institution and the density of population in the neighborhood, this is o~jectionahle. . . /Jietin,q.-This branch of the institution's work is loosely conducted. The scale for inmates simply specifies the quantities· of certain articles to he issued to the different sections of the institution, without reference to the number of persons. The issues are varied when a material change of numbers occurs-as at Christmas time hut not otherwise, although, of course~ the numbers on ordinary diet vary by reason both of changes and of doctor's orders. Testing the issues for one month by the strength showed the following as the average daily issue per inmate :-Tea, i oz. ; sugar, 2-! ozs. ; meat, 9 ozs., free from bone ; bread, 13 ozs.; potatoes, 10 ozs. ; oatmeal, It ozs. ; rice, ! oz. ; and milk, k of a pint. Many of the inmates are on special diet by order of the medical officer. These orders are recorded on the diet cards, and appear to vary fi·equently. Beef-tea is frequently ordered. · I tested that which was being served out on one of the days of my visit; It was wretchedly poor, although stated by the cook to he of the average quality that is prepared in the asylum. It does not appear that the medical officer has given any special direction respecting the quality of this article to he supplied to his patients, and the desire to economize has led apparently to its being made of shins of beef and other inferior parts of the meat purchased that is not easily served up for ordinary dinners. The matter is one which, 1 think, should receive attention from the doctor.· There is no diet scale for the staff. My suggestions under this heading are :-lst. That the Committee should formulate a proper dietary scale for both inmates and such of the stafF as ate rationed ; and 2nd, that a daily diet sheet be kept, somewhat similar to that in use at the Melbourne Hospital. The book provided for the purpose of bringing to account the diet issues is suitable, but it has not been well kept prior to the present accountant taking charge. In one item the issues are sho,vn to have been in excess of the receipts, and in another (the erro1· in this case appearing between .May and June last) a considerable discre pancy appearing between. the balance on hand at the end of one month and that carried forward to the next. I understand that the store and diet hooks are not systematically checked by the house committee, as I am of opinion they should be . .Medical E:~:tras.-The arrangement with regard to wines and spirits is also unsatisfactory. The general stock is in the charge of the superintendent, who issues to the dispenser in small quantities for issue upon the doctor's order. The issues by the dispenser are all supported, theref9re, by medical authority. But the superintendent makes very large issues ·On his own authority for services rendered by the inmates ; the number at the time of my inspection standing thus :-Ale, 20 persons ; brandy; 12; gin, 3 ; rum, 3 ; whisky, 5.-Total, 43 .. Under the English Poor Law system, the following rule obtains :-"The guardians may, witlwut any direction of the medical officer, make such allowance of food as may he necessary to inmates employed as nurses· or iri the household work ; but they shall not allow to such inmates any fermented or spirituous liquors on account of the performance of such work unless in pursuance of a written recommendation of the medical officer." The books relating to this branch of the work-fom· in all-are not ·well kept. The account for the bulk of the stpck has not been balanced since May 1880, and the entry forward on January 81 1st 1881 was simply the record of what was found in cellar at stock-ta~ing. ~ith such a system, all intermediate entries are valueless. As the suggestiOn whiCh I purpose making under the head of Stores will equally apply to this b:anc~1, I n~ed not record it here. I may remark, however, that the books could be snnphfied With advantage, and that the use of colonial spirit, as at the Ballarat Asyl~tm, in place of the dearer imported article, might be found practicable. . Sto1·es.-Grocedes and bread are obtained by contract. Meat is purchased by the superintendent in the market, and carted home at the expense of the institution. The impression is that a saving is effected by this plan, but I am inclined to th~nk that a loss results. During 1880 the price paid for meat at the Melbourne Hospital was l~d., but at the Benevolent Asylum nearly l.Hd., to which cart.'l..ge has to be added. To the system of purchase is due, in a measure, I think, the practice of using inferior parts of meat for making beef-tea. Wines and spirits are procured by contract, but eggs, butter, soft goods, crockeryware, ironmongery, &c., are purchased. The stock kept is not large of any of the articles, and stock is taken by the accountant in June and December. Reviewing the transactions of the asylum under this and the two preceding headings, a change in the system appears to me very essential. At present four persons are, independently of each other, concerned in the transactions and the record thereof, apart from the superintendent, viz., the accountant, dispenser, storeman, and an inmate clerk, neither of them having any practical responsibility in regard definitely to any one branch. The suggestion I would offer to remedy the state of things existing, and which, I think, is felt to be unsatisfactory all round, is that one officer-say the gentleman called the accountant-should be made responsible for and placed in charge of the entire of the stores, with a title, say, of house steward; and that the storeman and inmate clerk or clerks should work under his direction. At present the superintendent is held responsible for stores, but, with his varied duties, such a responsibility can only be nominal. Such a change would focus the accounts for provisions, medical extras, and general stores in the hands of one person, and enable the house committee to discharge what I conceive to be a duty of the first importance, viz., exercise a constant oversight of the receipt and issue of all stores. · .Collections and Revenue.-Collections by collector) who receives £5 per annum salary and 10 per cent. on all collections. The superintendent, and in special cases the Committee, receive contributions. On the latter the collector does not receive conmiission. He receives it, however, on the contributions of municipalities. A number of the block receipts in the superintendent's book were apparently duplicates of those in the collector's book. For a number of collections by the Committee receipts do not appear to have been given ; and in one or two cases there are blank butts, the receipts being away. A sum of £20, represented by one hutt, was not brought to account, but the explanation given was that it had been refunded to the donors (the Order of Druids), and that no contra receipt had been taken. This part of the institution business requires somewhat closer scrutiny by the finance committee, and the same remark applies to the oakum and hair teasing receipts. There is no record kept by which the accuracy of the charges made to customers can be tested, or as to the profit a.nd loss of. the transactions. The net result of this work last year was £98 Os. 5d. At the Immigrants' Home a sum of £393 2s. 7d. was realized for corresponding work. At the latter institution, the materittl (except spalls for stone breaking) is ·not purchased, the customers supplying their own ttnd paying for the labor. I think this is the more profitable method. Another bad practice in force at the asylum, and which should he changed, is to enter in the year's accounts the value of the sales effected, and not the actual receipts therefrom. There are two endowment funds, one of £3,190 Is. 6d. on deposit at 3 per cent. in tbe bank, and the other consisting of two amounts, viz., £763 in inscribed stock, and the other of £250 at deposit in the Savin~s B~nk. The interest on ~he £3,190 goes to ca.pital until the sum reaches £10,000 ; the mterest on the other IS passed to the mamtenance account. There appeared to ·be a small discrepancy between the cash account in the ledger and the balance-sheet, which the accountant has promised to investigate. Accounts.-If I am correctly informed, only· abstracts are checked by the finance committee. I think that, at least occasionally, the details should be investigated and checked. The receipts for salaries and wages should be taken in the salaries book instead of on loose slips. The accounts geuera.lly would be better kept if placed in a guard book, as at other institutions. No. 2:3. G : · Books.-These have been very indifferently kept in the past, but the present accountant is making strenuous efforts to· bring them into order. The system is, however, needlessly complicated, and I have no doubt that a change in this -respect and the abolition of about half the books now in use would .tend to much greater accuracy. GENERAL REMARKS. Understanding that the Committee are anxious to receive suggestions, I have made those above recorded, to which I may here add the erection of entirely separate ~losets for the females in some part of the grounds that will secure :to the women greater privacy in passing to and fro; and, secondly, provision to check a fire, should 'it occm· within: the establishment. At present there is an entire absence of any such provisiOn. At the least, a screw tap and small hose should be placed on each landing. , . But all the suggestions must be subject to the one main recommendation, that the institution be removed. The population of the neighborhood has increased too much for it to be a suitable locality, and the. number taken in has far exceeded the suitable accommodation of the asylum. Not to repeat the quotation from the recommendation by the Committee of the Privy Council in England, given in my last report on the Immigrants' Home, I may, in connection therewith, say that it is manifest that no London workhouse would be permitted to crowd inmates within so smaU a space as is allotted to a large proportion of those within this institution. . It is needless for me to enlarge on this point. The provision for our destitute,· aged, ·and infirm is altogether inadequate and~ ill-suited to the purpose. The Immigrants' Home, or Home for the Destitute, should, as well as the Benevolent Asylum, be removed, under an amalgamated management, o_ut of the city, with limited provision in the cjty for only the class termed· 4f casuals." If the institution thus united could be placed near the · Hospital for Irteurables, it would be an advantage. to -both· and 1 WQ~ld.result in each being managed a~ a reduced cost. . · · ' , •• . I know nothing in regard to either institution that so urgently calls. for attention· as this one point. I give below a statement sh STAFF JN SEPTEMBEH 1881. .. £ 8. d. 1 Superintendent 350 0 0 and quarters. 1 Medical Officer 300 0 0 quarters, rations, &c. 1 Matron 75 0 0 . 1 Dispenser 75 0 0 " " 1 Accountant ... 75 0 0 " " 2 Cooks, at £70 and £50 120 0 0 ,".. " 1· Gardener 60 0 0 and rations only." · 1 Carter 50 0 0 2 W ardsmen; at £52 104 0 0 quarters," rations, &c. . " 1 45 0 0 1 Storeman" 45 0 0 .," " 1 Sculleryman 40 0 0 " 2 Assistant Wt1rdsmen, at £35 70 0 0 " " 1 Manservant ... 26 0 0 " " 4 Nurses, at £35 140 0 0 " " .. 3 Laundresses, at £35 105 0 0 " " 3 Assistant Nurses, at £30 90 0 0 " " 4 Housemaids, at £30 ... 120 0 0 " " 1 Engineer 156 10 0, non-resident." " 3 Inmate Servants, at £12 36 0 0 quarters, rations, &c. 35 Total Salaries £2,082 10 0 DISEASES, ETC., OF l:NJIUTES, ·22ND SEPTEMBER 1881. , \' , ' , Bedridden from paralysis, or spinal disease .. . .;. · · .. . 42 Confined to wards from paralysis, chronic rheumatism, ulcers, &c. 60 Other incurable diseases 205 Blind ... .,. 105 412 O.ld age .and debility ,. ',••• 210 · .. (Signed) F. HO~LETT, Superintendent. 'I APPENDIX No. 39. .. ,, . ALFRED 'HOSPITAL. , j (ViSited 22nd, 23rd, and ~5th A,ugus(,1881.,) lnmates.-57 males, 30 females, and 9 children. Wards.-10, containing 107, ~ed~, and ~;:tvit;tg an average cubic space per bed 1 of 1,51~ feet. ·-· ' '"·'' ·'· • • Staif.-As per schedule attacheg .. Management.-Fair, but ·the pantries in· one ·or two· instance's and the closet arrangements generally require closer attention. In some cases there. was considerable laxity manifest with regard to the charge of medical extras by the wa1·dspeople. ·The kitchen arrangements are good, as also are those of the laundry, apart from the matt~r of disinfection. There is a very small disinfecting chamber, or rather oven, at the side of the boiler, but it is quite inadequate to the demaxtds .. of a .proper system of disinfection; and my enquiries leave little doubt on my mind that disinfecting is not the practice. · · · · · The system of training nurses has been commenced at this in$titution, and will, the management hope, produce good effects. ·Some care, however, is necessary i~ working the new system, as the practice of having young females 'in the male wards, should be under much closer supervision than it seemed to be. ' · · Dieting.-·The dieting of the staff is according, to the matr~:m's discretion~ For the patients a scale has been fixed by the managers, but the system for computing the daily diets is very incomplete, the plan adopted to record change being to score out the figure representing the diet or e4tra, so that the issues for past days cann9t be traced with anything approaching accuracy. I checked the orders which are supposed to be issued by this list, but there was ~ considerable discrepancy which coul~ not be explained. The system is altogether very lax, and no . rec9rd is kept of rece~~ts or issues to enable balances to be tested. Medical Extras.-These are issued on doctor~s· orders only. ·Issues are made by the matron, but, as with the provisions, no record of receipts and issues ·are kept. . . Stores.-The practice which was in existence when I last visited, of allowing store orders to be issued by the hall porter, has been stopped, and they are now issued in effect by the superintendent. The purchase of general' stores has to be .authorized by the house committee before being made. Stores are not extensive. Stock was taken in January last, but only by the persons in responsihle charge. No record i~ kept of receipts, issues, and balances. .. . 84 Collections.-" By collector, who is paid £100 per annum and 10 per cent. on all sums received by him, or, which he can satisfy the managers he has influenced the collection of. He. is also allowed an annual railway ticket to and from town, and expenses.when going into the country. The sum actually collected by him last year was £1,245, and the amout;J.t paid him was.£272, or at the rate of above 20 per cent. Commission was paid on the entire contributions made by municipalities, although nearly- all were sent direct to the institution. I checked the receipts from July 1st to 16th 1879, and from 2.8:7·9, on to June +881, and with two exceptions they were correctly brought to account. For the intervening dates the receipt blocks could not be found. The exceptions indicated were a contribution of £1 10s., which had been altogether omitted, and a payment of £1 ls. on account of "paying wards account," which has been purposely kept apart from the other accounts. It is desirable, I think, that the cash account should include all receipts and payments. There are two bank and cash accounts, viz., building and maintenance. The former has to its credit £2,715, which is on fixed deposit at the bank at 3 per cent. interest. The maintenance account at the end of 1880 was £1,000 to credit. The hank account is stiJI operated upon by the treasurer's signature only. Accounts.-These 'were correctly entered up, hut the practice of charging poultry and fish to the meat account is objectionable. For these two items (poultry and_ fish) the expenditure was very large last year, the account being £156 10s. 7d., or over £1 15s. per head. A practice prevails with regard to entering petty cash expenditure, which prevents the cash book agreeing with the balance-sheet (although the latter was correct), a difference of £3 6s. 8d. existing between the two. As there is !t simple remedy for this (which I suggested), it is' not likely again to arise . . Books.-Finance books on the · whole well kept. Store books are almost entirely wanting. GENERAL REMARKS; This hospital is fairly well managed on. the whole, but as it is not on the same footing (as a medical school) as the Melbourne Hospital, and as the salary of the one paid medical officer is low, the cost per head is very high. There is no reason, as far as I can judge, why the cost for provisions and medical extras should be much higher here than at Castlemaine, yet they stand thus- £ s. d. Alfred Hospital 19 '119 6 Castlemaine Hospital (under) . 11 0 0 or about £9 excess at the former institution. I have selected Castlemaine for comparison throughout, because it is the most economically worked of. any of the institutions I have visited. The whole cost stands thus- £ s. d. •: Alfred Hospital ... 56 9 11 Castlemaine Hospital (about) 37 0 0 There is clearly room for the exercise of economy. The arrangement of lavatories, &c., for some of the wards is defective, in two cases there being for each ward only a small space, 9 ft. 6 in. square, for baths, closets, lavatories, sink for washing up, &c. . It is desirable that a proper disinfecti.qg chamber should be erected. The closets should be more frequently cleansed. The bottles containing stimulants issued for patients should be labelled and kept under better supervision. · The wards for isolating cases of infectious disease are suitable. . At the time of my visit, there were said to be only two cases smted for a benevolent asylum in the hospital. H. F. NEAL, Inspector of Public Charities. The Honorable the Treasurer. 13/9/81. 85 ALFRED HosPITAL STAFF. £ 8. d. 1 Superintendent, at per annum ... 275 0 0 1 Medical Officer 250 0 0 1 Matron, at per annum 104 0 o· 1 Dispenser, at per annum 104 0 0 1 Hall Porter ... 65 0 0 1 Out-patient ditto, at per annum 60 0 0 1 Engineer, at per annum 84 0 0 1 Night Watchman, at per annum 65 0 0 1 Gardener, at per annum 63 0 0 1 Y ardsman, at per annum 50 0 0 1 Messenger, at per annum 16 4 0 1 Dispensing Porter, at per annum 60 0 0 1 Head Nurse, at per aunum 50 0 0 1 Assistant Nurse, at per annum 45 0 0 5 , , at £40 per annum 200 0 0 1 , , at per annum 34 0 0 3 , , at £30 per annum 90 0 0 2 Ward Servants, at £26 per annum 52 0 0 1 Cook, at per annum ... 52 0 0 1 Kitchenmaid,:at per annum 36 0 0 1 Laundress, at per annum 40 0 0 1 Assistant Laundress, at per annum 30 0 0 1 Housemaid .•. 30 0 0 1 Collector 100 0 0 £1,705 4 0 ------. The superintendent receives £60 in addition to his salary in lieu of residence .. The engineer receives his meals in addition to his salary. The collector besides his salary receives 10 per cent. on all sums collected by him, but no board allowance. All the other officers and servants have quarters and rations allowed them. H. F. NEAL. APPENDIX No. 40. HOSPITAL FOR SICK CHILDREN. (Visited September 5th, 6th, 7th, and 14th 1881.) Inmates.-43, including 3 orphans, 6 fatherless and 3 nurse children. Wards.-7, containing 53 beds, with an average space of 648 cubic feet per bed, the minimum being 587 feet. ·· · Staff.-Matron in charge, medical officer, head nurse, 7 nurses, gardener, cook laundress, housemaid and general servant, resident. Collector, dispenser, medical galvanist, and out-patients' nurse, non-resident. Total salaries, £947 6s. Management.-Very good. The whole of the institution is beautifully clean and in excellent order. The closet accommodation for convalescents is somewhat defective, but on the other hand it is said that there is but little use for the outside closets, as the children a.re discharged as soon as they are convalescent. Provision is made for isolating infectious cases, also for disinfecting the clothing. Dieting.-Of both inmates and staff at the matron's discretion, subject of course to the doctor's orders. There ·is a scale specifying articles for imnates, but not quantities. No account is kept of the dieting, or beyond the tradesmen's pass books of the receipt of provisions. Medical Extras.-These are issued by doctor's orders only, unless in emergency cases. A very suitable book is kept showing receipts, issues, and balances. This I checked by the orders and found to be correct. The cost under this head was about £1 Ss. 8d. per inmate, but that is for stimulants only. 86 Stores.-J:'he somewhat ·peculiar -p.ractice is adopted of having no contracts. Provisions :ire piirchased by the matron, and other supplies as. requ~red by the ladies of the Committee: No record of receipts and issues is 'kept: Stoclds taken annually by the matron. · · · Collections.-By collector, who receives a salary or' £100 per alinmn, and 10 per cent. on :~ll contributions collected or influenced by hirri,· also tr~velling. e~penses, the amount of the latter being hut small. , The total paid to him last year was £241· 7s. The check on the issue of receipt books is good. Receipts all duly brought to account and banked. The maintenance account closed at the ·end of last financial ·year (June 30/81) with a credit balance of £372 Os. lld., the convaleseent fund with £232 3s. lOd., and the building and endowment ftb1d with £447 ·. 13s. 3d. The balances in the two latter cases are partly on deposit in th~ bank arid piu·tly in colonial Government securities. Since the year closed the proceeds of the late bazaar, nearly £4,000, have also been paid in. The convalescent fund:is held to be a semi-private account, the contributions being made specially to provide extra comforts and indulgences for the children. 'Vhile agi·eeing ·with the plan which the_ pommittee contemp~ate of keeping a separate account for tbis fund,· I thin~· it vVill Jibe well to bring· the monthly totals, both of receipts and expel}diture, into the. ordinary cash account, so that they may be under periodical supervision and audit. · . Accounts.-These are very well kept,. and, with a few exceptions, regularly stamped, the omissions being subt:equently put right. I could not form a reliable opinion of the reasonableness of the household expenditure, because in the bulk of the cases abstracts only hav~ been kept. The matron. has, however, promised to keep invoices in future. Fish, poultry, ice, and jellies are charged to provisions instead of to medical . extras. . For. these item:s .. a very good book, showing .the expenditure classified, is kept and is examined monthly· by the Committee. · . · · . · . . Books.-The books m use. are-·ve~y well kept... Store and diet books are·, Uowever, 'requisite. l. · ,. · · · : • · ' · ._ · · · '· ~ '- GENERAL REMARKS. The little suffering inmates of. this institution are so excellently c~red for, and the institution presents such very strong claims to public sympathy, that it may seem ungracious to give expression to any kiq.d of ~ault finding. Nevertheless it appears to me that exception may reasonably 'be taken· to the cost of the institution, which, deducting interest on mortgage and cost_gf .r~p~irs, was £75 7s. Allovving, on account of out-patients, the usual one-third of medical salaries and drugs, with the total pay of the out-patients' nurse, _'fill r~Auce i~:.l&. £69 ,~bo11k Ser~rating the medical salar~es, drugs, &c., altogether from the. others, we have the following result :-Medical salanes, out-patients' nurse( d'r\tl31drugs, :;£22~·68; ;; 'keep;· supervision,:wand~-..:n:ursing, £53. The number of the. st~ff, exclu§,iv,e of honor!try medical officers,. co,lle.-;tor:, and out-patients' nurse, is }7~;./ I 'Flie average number of inmates last year was ·uhder~'32;··so that the staff was in the proportion of more than one to every two children. This, with the fact that there is no systematic check upon the dieting, and that contracts are not taken for provision.s, will dpubtless acco11nt in ~ome me~sure for the large cost. . _-: · · ... , . I w~~L enabled, _by the courtesy of· the Ladies' Committee, to .see. a number of the out-patient!'' parents and . relatives, and _to witness the iJ?.vestio-ation as .to circumsta!'-ces made )Jy the. Committee before .authorizing relief. I think the latter ~s s:iti!!Jfa~-~pry, but ~.also. think it quite v~a~ticable to obtain some payment from a fmr proportion of th~ relatives. . . . The outlay on d~ugs is high. H. F. NEAL, '.. Inspector Public 'Charities.···· The Honorable the .Treasurer. . 17/9/8~. '"' w ~ • • ' • • • ; ' •• ~: ' ' • ' .: . .. .,. '._. ·"' .· ,, ·' ... :) . f ,· •.; • I • ~ ,. '1. : '.'\. .. 87 APPENDIX No. 41. MELBOQRNE LYING-IN HOSPITAL,.. ETC. (Visited .August 30th, September 6th, 7th, 8th, and 12th 1881.) . . . Inmates.-· 46, of whom 23 were married and 23 single. ·· ' Wards.-20, compris~ng several small rooms, having'' 2 beds in each for accouchement cases. In all, the institution provides 66 beds, with an .average space per bed of 879 cubic feet. The mininmm. space per bed is 748 cubic' feet. .» · Staff._:_Matron,in responsible charge, resident surgeon, 9 nurses and servants, porter, cook, laundress, and housemaid. The collector is the only.paid officer who is non-resident. Total salaries, inclusive of collector'sl salar.y but exclusive of his commission, .£915. The finance books are kept, and the secretarial work is performed hy honorary officers: Management qf Hou.<;e.-Good. Additions to the building were in progress on the 4ays of niy visit. Nevertheless the whole of the institution was neat and clean. The arrangements seem to be as satisfactory as the nature of. the .l:milding will permit. I· scarcely feel justified in passing an opinion respecting its suitability for the special work for which it is in use, but I question its being well designed for the purpose. . Somewhat greater care should ·be taken in regard to the charge of dangerous medicines. Dieting.-The officers' table is provided according to the matron's discretion. The rest of the staff and the inmates are rationed by scale, subject, of course, to the doctor's orders in regard to extras. I checked the issues and found them in every case within the scale. The matron informed me that when the house was full she was able to effect a saving, but that when there were but few inmates the full allowance was requisite. The diet issues, as well as the medical extras, are entered daily in a suitable and well kept book. There is also a well kept provision register, showing receipts, issues, and balances. The latter the matron states are checked almost weekly. Medical Extras.-Issued, except in emergency cases, upon the doctor;s order only. All issues are entered as ordered on the diet cards, and signed for by the medical officer. The average cost per inmate was about £3 8s. for the year under this head. The receipts, issues, and balances are entered with the provision items. Stores.-Groceries, &c., are obtained under contract, but drapery, ironmongery, &c., are purchased as required. The stock of stores is small, and is well kept. No record, however, is kept of the receipts, &c., of items outside the provision account. There is an inventory book, but an inventory was last taken in December 1879. Collections.-By collector, who receives a salary of £100 per annum, and commission at the rate of 10 per cent. on all contributions, those by municipalities included, unless the donor in sending the subscription direct to the treasurer intimates that it is not to be subject to commission. The amount paid the collector last vear was £213 148. 5d.. The check upon the issue and use of receipt books, as described to me is satisfactory, but in the block receipts there were several alterations from, in nearly every case, larger to lesser sums. This is an objectionable practice, and I suggested to the treasurer to endeavor to check its recurrence, and, should it occur,. to require an explanation in each case an~ then initial the correction. Subject to the accuracy of these altered blocks the receipts were duly broug·ht to account and banked . .Accounts.-Correct. A good many duty stamps were short, but were subsequently affixed. The expenditure for drugs at this institution is exceptionally heavy, due it is said to the peculiar nature of the cases treated in the infirmary section. In the balance-sheet the words, "medical comforts," are in the line with " medicines," but, as a matter of fact, all medical comforts are charged to provisions. This is a mistake. Books.-Except for the fact that there is no record of general stores, the books. are pretty suitable and are very well kept. A proper store b?·ok ·should be instituted. 88 . GENERAL REMARKS. The special character of this institution renders it probably more than any other liable to be resorted to by 1)ersons not altogether linable to .make some payment for the relief afforded them. I judge from the enquiries I made that many persons well able to pay are treated, especjally as out-door patients of the infirmary department. I was informed that the- Committee make it· a practice to closely investigate each case admitted, and. the medical officer consid~rs. hims~lf Justified in refusing advice to out-patients able to pay. Under these circumstances it would be natural to· suppose that the income of ·the institution would include a fair sum from patie,nts. On examining the balance-sheets for the last six years, however, I find that the small sum of £111 12s. was all that was received fi·om this source. The doctor's reports for· the same period show 3,'141 accouchements within the institution, 77 at private residences ; 1,505 infirmary in-patients, and 5,312 infirmary out-patients, so that altogether:they did not· contribute at the rate of 3d. each person. I cannot doubt th~t.a little ·mo:re vigilance would prqduce much better results. The discontinuance 0£ ·the servi~es of the Inspector of Impositions is regretted by the manageinent. Cost' per head, making the usual aJlowance of one-third of doctor's salary, porter's salary and cost of dl·ugs, was for _1880, £57 14s. 6,d. . . H. F. 'NEAL, Inspector. Public Charities. T'4e Honorable the Treasurer. 16/9/81. . '. 9. By ~uthority: JonN_ FERRE's, Government Printer1Mclbourne ' "'~·•.,