H.—7

4

"In 1890, when Sir Harry Atkinson was Premier, I made a strenuous effort to induce the Auckland Charitable Aid Board to admit to the Costley Home, then just opened with plenty accommodation, a number of chronic and harmless persons merely suffering from decaying faculties, and who had been sent to the Asylum because there was no other refuge for them. They were discharged with the hope of relieving tbe congestion of the Asylum. Thereupon there arose a great outcry from one end of the colony to the other against my inhumanity. The Auckland Charitable Aid Board declined all responsibility. The Government had not the courage to face the storm, and had to compromise the matter by paying the Salvation Army to take care of these poor people. That is an illustration of the struggle which is always going on to relieve local rates at the cost of the asylum vote. " The same thing would happen to-day if the Government were to attempt to confine our asylums to their proper functions —namely, the curative treatment of the patients who are curable, and the care of those who could not be managed outside of the asylums. As the law now stands it would be sufficient to remedy this state of things if it were only enforced, for it lays down the principle that 600 cubic feet is the minimum dormitory space for each patient. Yet a reference to the foregoing figures show that, making allowance for all the space available at present in all our asylums, we have 234 patients in excess of the legal limit. Even when all the works now in hand are ready for occupation we shall have an excess of 158; and that without making any allowance for the inevitable annual increase, which will be considerably over a hundred. " This being the condition of our asylums, it seems hopeless to induce medical men and the friends of patients who are showing symptoms of incipient mental disease to commit them to our care, when even with our present means much could be done in the way of prevention that is impossible without legal control in private houses. No man can exaggerate the terrible consequences to many unfortunate persons of the natural horror of committing dearly loved friends to institutions which are well known to be so overcrowded that their proper treatment cannot be hoped for. The early treatment of the mentally diseased in many cases offers the only chance of restoring sanity. Many for the want of this become hopeless dements for life." Any one who is curious for further exposition of the causes of the rapid increase of our insane I would refer to my Beport on Hospitals and Charitable Institutions for 1898, wherein for the first time in any British State the matter was dealt with without compromise. Subsequent to this report many writers have given utterance to the same ideas, -notably Mr. Arnold White. Many American writers have also taken up the same theme, as, for instance, Dr. McKee. I also frequently pointed out the great evils arising from the want of separate institutions for the following classes : Idiots and imbeciles, epileptics, persons that are not as yet certifiable for admission to asylums, and criminal lunatics. I point out that the effect of all this is to make our lunacy statistics entirely misleading, and to give our country a bad name for insanity which it does not deserve. lam glad to see that this year the public and the Parliament are rousing themselves to deal sincerely with this question. I think it necessary, in view of the universal change in the conditions of our labour-market, to raise the wages of our asylum attendants. Artisan and charge attendants ought to receive an increase of 25 per cent, and ordinary attendants 20 per cent. It will be necessary also, in my opinion, to increase the salaries of the assistant medical officer to £300 instead of £250, rising to £350 after five years' service, for I have found it impossible to get suitable applicants at the lower figure. As I have already pressed on your predecessor, the exhausting conditions under which our Medical Superintendents have to perform their arduous duties induce me to recommeud that Parliament should agree to give them, every sixth year, twelve months holiday on full pay. The frightful strain they have had to bear has all but broken down every one of them. During my visit Home I had the opportunity of discussing with many of the highest authorities the various aspects of insanity now occupying so much public attention in that country, as for instance the hospital treatment of the early stages of insanity with Drs. Clouston and Eobertson, the toxic theory of the causation of insanity, the new methods introduced for nursing at the Larbert Asylum, Stirling, the construction of cheap wood-and-iron buildings for the treatment of consumptives which is now being carried out in several of the Scotch asylums. All these matters are of secondary importance to us till such time as we can provide for the ordinary treatment of our patients and their classification with a view to rational treatment.