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From the health administrator's point of view a general nursing scheme
which does not include preventive educational measures is incomplete.
A nurse in the course of attending a sick patient renders direct technical
service, and is very favourably placed for giving simple lessons in hygiene.
It is agreed that the primary duty of a nurse is the bedside care of the sick,
but at the same time there is no reason why the teaching of hygiene to those individuals
to whom she gives nursing care, and also to the rest of the family, should
not be included in her duties. In these days of preventive medicine any means of
disseminating information as to the cause and prevention of illness should be seized.
It is only by education that the individual can be made to take an interest in and
to look after his health. The nurse by reason of her intimacy with the family
meets the individual in the most receptive mood for knowledge on health principles.
A combined service of teaching and nursing, provided that an adequate
number of nurses per unit of the population are supplied, will, in my opinion, give
the best results, and duplication of effort will be prevented from occurring.
There is not much possibility of the voluntary associations expanding to
embrace a scheme which would provide visiting nurses for everyone in the Borough
desiring their services, and resident nurses in the homes of the sick for any length
of time. The tightness of money is more and more felt, and is reflected in the
amount of donations and voluntary contributions to associations, and consequently
they are compelled to rely on subsidies from the local authorities and other public
bodies in aid of their work. Under these circumstances a comprehensive scheme
to cover the requirements abovementioned could only be furnished by the local
authority.
The necessary staff required for giving effect to a scheme of this description
need not necessarily be expensive to the local authority where a hospital exists
adjacent to or lies within the administrative area of the Authority. The services
of the nursing staff could, by arrangement, be employed for this purpose, which
would greatly diminish the cost of the scheme. Further, whatever money was
expended could be recovered by a system of payments by patients, in accordance
with their ability to pay.
Camberwell is fortunate in possessing a training centre for nurses in the St.
Giles' Hospital (late Camberwell Infirmary), and should the recommendations
contained in this report be adopted I am of the opinion that 10 nurses would be
required to commence with, the number to be increased as practice may prove
necessary.
It is possible that the Camberwell Board of Guardians may be able to supply
the necessary staff. The nurses when not attending patients under this scheme
could perform all such duties as may be required of them by the authorities
controlling the hospital.
The law as it stands at present does not allow any Authority to incur expenditure
on the provision of a nursing scheme such as is outlined, and it would be
necessary, therefore, for legislation to be promoted to enable a local authority
to proceed with a scheme beyond that provided by the Maternity and Child Welfare
Act, 1918, and the Public Health (Pneumonia, Malaria, Dysentery, etc.) Regulations
1919.
I understand that certain Approved Societies pay nursing associations for
the treatment of insured persons, and this would open up the question as to how
far a scheme of this nature could be applied to include all National Health Insurance
patients requiring nursing services.
In conclusion, if the Council are desirous of promoting a scheme on these
lines I would recommend that representations be made to each of the Metropolitan
City and Borough Councils, with a view of inviting their support to the proposals.
Nursing.
During the year the Council agreed to pay the Rotherhithe
District Nursing Association at the rate of one shilling for each visit
made by their nurses to notified cases under the Public Health