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190. There were no additions to hospital buildings and the only major alteration and improvement was effected by the enclosure of a large verandah at the end of one of the wards to provide a lecture room for the nurses training school. This room was well equipped and it considerably added to training facilities.

St. John Hospital, Cheung Chas,

101. This hospital is owned by the St. John Ambulance Association, but is at present administered and operated by Government under a 5 year agreement, which terminates at the end of 1954. It is one of two hospitals in the New Territories, and is situated on the Island of Cheung Chau, an important fishing centre which lies to the west of Hong Kong Island and on the southern side of Lantao Island. Of Its 102 beds, 42 are allocated for the treatment of minimal or convalescent tuber- culosis cases,

192. Until June 1953 only one medical officer was stationed at Cheung Chau and, as he was called upon to pay visits to centres in neighbouring islands, there were occasions when no doctor was, in fact, available at the hospital, This unsatis-

factory state of affairs was rectified in June 1953 by the posting of an additional medical officer to the hospital. This has enabled the work in the outlying centres to be improved and extended, yet permitting the full time availability of a medical officer in the hospital itself.

193. During 1953 there was a small decrease in admissions, the number being 1,589 as compared with 1,683 in the previous year. However, there was a substantial increase in out-patient attendances, new cases rising from 16,830 in 1952 to 22,299 in 1963.

194. An important addition to the work of the hospital was the initiation of eye clinica by the Government Ophthalmologist. It had been intended to hold such clinics once each month but the response of the people was an prompt and attendances so great that since October 1953 clinics have been held once a fortnight.

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Tama Yuk Hospital.

195. This institution with only 85 beds is the largest maternity hospital in the Colony. It is accommodated in an old outmoded building situated in a highly congested area of the western district of Victoria. Although the institution is administered by the Medical Department and the Medical Superintendent, nurses and midwives are Government officers, responsibility for the clinical work in the institution lies with the Professor of Obstetrics and Gynaecology of the University and his staff.

196. The hospital is the main centre at which training of midwives is undertaken and it is the only centre in the Colony at which medical students are taught obstetrics. All these students, in small groups at a time, receive resident training in the hospital for a month as part of the University curriculum, Inspite of the unsatisfactory building a great deal of work of a high order was accomplished and busy though the hospital was in previous years there was a still further small increase in the work carried out. The total number of admissions was 7,221 and there were 6,817 deliveries. The corresponding figures in the previous year were 7,216 admissions and 6,737 deliveries. The average length of stay in hospital was $-4 days, a situation, which had to be accepted, inspite of its dis- advantages because of the enormous demand for hospital beds. In the case of normal deliveries many patients were returned to their homes as early as the first or second day after delivery to tree beds for others in need. Such patients at home were supervised during the puerperium by visiting midwives. This arrangement, the best which could be adopted in the circum- stances, is an unsatisfactory one and not merely from the point of view of the patients. Early discharge from hospital does not permit of the proper training of medical students or midwives in the supervision of the puerperal period and it is thus not easy to train these personnel as satisfactorily as is necessary.

197. In spite of adverse circumstances results achieved were very satisfactory and a high standard of care was maintained, Maternal deaths during the year numbered 4, giving a maternal mortality rate of 0.58 per thousand and there were no cases of

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