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The education of the individual in personal hygiene, in the way of bringing
influence to bear so that there is an alteration in the daily habits of the people,
plays a great part in solving health problems.
Past experience has shown that it is only by direct personal contact with the
life of the individual can success be assured. As the result of this knowledge we
have seen local authorities, encouraged by the State, appointing health visitors
for the dissemination of knowledge on maternity and infant welfare work ; tuberculosis visitors for educating the individual tuberculous case how to live and not
to be a source of danger to the rest of the community.
The officials appointed by the local authority for these purposes confine themselves
solely to the teaching of hygiene on these questions, and take no part in the
nursing of diseases.
It has been the practice to leave the bedside care of the sick to the voluntary
nursing associations.
A brief recital of the position of the undermentioned associations operating
in Camberwell would be useful at this juncture :—
The Camberwell District Nursing Association.
Ranyard Nursing Association.
Rotherhithe District Nursing Association.
East Dulwich and Dulwich Village District Nursing Association, and
Nurse Wright, 35, Addington Square, Camberwell.
The associations in question employ 17 fully qualified nurses between them for
service in the Borough —The Ranyard 9 ; the Camberwell District 5 : and one each
the remainder.
Their activities and modus operandi are practically similar—patients are
received from hospitals, private medical practitioners, London County Council
Care Committees, the Clergy, Relieving Officers and others, and general nursing
treatment is given for both medical and surgical cases, with the exception of certain
notifiable infectious diseases, such as erysipelas, scarlet fever and diphtheria.
During the year 1923 about 4,000 visits were made by them.
The cost of a visit to the associations varies from 1s. 1d. to Is. 4d., and is
borne by donations, subsidies and patients' payments. Much of the work is done
gratuitously.
With regard to the two first named associations this Council has an arrangement
for the nursing of approved cases under the Maternity and Child Welfare Act, 1918,
and the Public Health (Pneumonia, Malaria, Dysentery, etc.) Regulations, 1919,
for which payment is made at the flat rate of 1s. per visit, estimated to cost the
Council £200 annually.
The above-mentioned voluntary associations have in the past made little,
if any provision for that section of the community who may be described as
possessing moderate means. Further, no effort is made by these nursing associations
to meet a long felt want in the supply of resident nurses.
It is a well-known fact that families of moderate incomes suffer great hardships
and financial strain during illness, especially if that illness is of long duration,
necessitating the services of a fully trained nurse in the home.
The rôle of the hospital is essentially for the treatment of acute illnesses. There
is an increasing demand on the hospitals for the treatment of surgical cases, and
there is no doubt that if reasonable nursing facilities were available the after-care
of surgical patients could be undertaken by private doctors, and patients could be
discharged from the hospitals at an earlier date than at present.
This would result in a lessened expense for the paying patient, and, tar
more important, a greater number of cases could be dealt with by the hospitals per
Many cases other than surgical find their way into hospital who could easily
be treated at their own homes, provided the services of a skilled nurse were easily
forthcoming.
It cannot be pointed out too strongly that these nursing associations do not
include hygienic education in their activities.