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90
month, or nearly more than 11 per day. I mention this figure specially, as it is desirable that it
should be borne in mind when you are considering the question of the medical and nursing staff and
the work they perform. In an ordinary fever hospital where it can be said the nursing and medical
staff are considerably higher than here, a fair average number of operations is about 5 or 6 per month,
or practically one-tenth the number of this hospital in the same time. Further, you will remember
that not only do operations take up a large amount of time and quite half of the number mentioned
are performed by your resident medical officers, but they also entail subsequently a great deal of
responsible and often tedious after treatment.
Duration of Stay in Hospital.
No patient is discharged until he or she is fit enough to return safely home. At the same
time some of them do return at an earlier date than would be the case if the wards were less full
or if there was a convalescent home attached to the hospital as was the case 10 years ago, when*
Kingsbury Hospital was in use. Nothing is to be gained by keeping a patient convalescent after a
serious illness in a ward full of patients in the acute stages of their attacks. It is much better to
send them to their homes, though it would be better still if they were sent to a convalescent home,
there to reap the full benefit of the treatment which they receive whilst under the Council's care in
this hospital.
The figures below give the duration of the stay in hospital of all the cases treated, infectious
and non-infectious alike.

Visiting Medical Staff.
No change has taken place in the number of Visiting Surgeons attached to the hospital. Each
of the first three Surgeons on the subjoined list attends on one morning a week, and Mr. Oliver
attends once a month for operations on patients he has previously selected when attending the
Clinics.
The names of the Visiting Surgeons are :—
A. H. Bourne, F.R.C.S.
R. H. Campbell, F.R.C.S.
J. F. O'Malley, F.R.C.S.
M. W. B. Oliver, F.R.C.S.
Sick Staff.
I have to report an even greater amount of sickness during this year than ever. It is doubly
unfortunate too that it should occur at a time when the hospital was so severely taxed with work.
There were no less than 283 occasions on which members of the staff reported sick, and out
of that number there were 85 who were off duty for more than 24 hours at one time. The aggregate
number of days these 85 people were off duty was 986 days, as compared with 922 days a year ago.
Amongst the 85, 55 were nurses, and these were off duty for a total of 730 days, or the equivalent of
two nurses practically, throughout the year. In 1920, 44 nurses were off duty for a total of 414
days only. There would therefore seem to be a direct connection between the amount of work and
the amount of sickness amongst the nursing staff. As the hospital admissions increase, the proportion
of nurses remaining at the low figure of 50, so the amount of sickness amongst them becomes
more frequent. This lack of staff through illness is a very urgent matter, and it is one which calls
for your very early attention. There can be no doubt that if you have not a sufficient number of
nurses, the treatment of patients must suffer.
The same degree of sickness did not occur amongst the Domestic Staff; these members of the
staff work much shorter hours, besides they do not come into such close contact with the patients
as nurses do.
Hospital Accommodation.
A better heading would perhaps be "Lack of accommodation." In various parts of the
-report I have indicated the directions in which accommodation is wanting or is insufficient. In
my opinion more large wards are wanted so as to bring the number of infectious beds at any rate
up to 170 at least; that is, 1 bed for every 1,000 of the population, a standard number this hospital