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long periods, the Council will in future itself supply all equipment to patients suffering
from tuberculosis, and large articles to all patients. The type of equipment supplied
ranges from special bedsteads and Dunlopillo mattresses to hot water bottles, and a
deposit and a small charge varying from 3d. to 1s. a week are required from those who
can afford to pay.
Training
Training of district nurses in London is undertaken by the Ranyard Nurses and by
certain district nursing associations approved for this purpose by the Queen's Institute
of District Nursing. Not all the students trained subsequently work in London, but the
Council nevertheless recognises for grant purposes all expenditure incurred by the home
nursing organisations in connection with the training schemes, including the payment of
a fee of £6 to the Queen's Institute of District Nursing in respect of each student district
nurse trained under their auspices, this fee representing an agreed contribution toward
the overhead costs of the Queen's Institute scheme. The Council also pays for the hire
of a hall used by the Queen's Institute for lectures to student district nurses. The training
offered by the Ranyard Nurses covers much the same ground as that of the Queen's
Institute, but the approach is necessarily different, since the Queen's Institute system of
district nursing is based on a number of group nurses' homes each in charge of a
superintendent, whereas the Ranyard system is based on individual nurses each living in
her own home and subject to supervision by peripatetic district superintendents. Both
types of training overlap to some extent the syllabus of instruction for the health visitor
certificate in their approach to the social side of nursing and both will undoubtedly be
affected, both in length and content, by the experiments now being planned by area
nurse training committees following the publication by the General Nursing Council
of the revised syllabus of general nursing training which will be compulsory from
1st January, 1954. In this connection, it is of interest that state enrolled assistant nurses
employed in the home nursing service are generally given one month's introduction to
home nursing and then succeed very well under supervision.
The Queen's Institute of District Nursing have been pressing for some time for the
statutory recognition of district nursing training, and their initial approach to the problem
seemed to indicate a desire that their own particular method of training, backed as it
was by many years of experience, should be recognised for the award of a national
certificate. Local health authorities generally, however, have felt that in view of the
great changes impending in nurse training schemes it would not be advisable at this
stage to interfere with existing arrangements. It is clear that whilst the Council is using
as its agents differing types of voluntary bodies employing nurses trained by different
methods, it cannot well support the claims of any of them against the others.
Post-certificate training for district nurses is also organised by the Queen's Institute
of District Nursing on a national basis, and London associations send members of their
staff on some courses. Where a course is regarded as necessary for the improvement of
the service to the people of London, the Council approves, for grant purposes, the
expenditure incurred in sending the nurse to it. Instances have occurred, however, of
nursing staff being sent to courses designed to enable them to acquire certificates which
are neither required nor recognised for district nurses by the Whitley Council, and in
these cases the organisation has itself paid the cost out of its own resources. It is rare for
post-certificate courses to be held in London, but it is hoped that London nurses may
eventually be able to get refresher courses nearer home.
Inspection
Inspection of most district nurses and district nursing homes in London is undertaken
by the Queen's Institute of District Nursing and by the district superintendents of the
Ranyard Nurses. The cost to the Queen's Institute is covered by the payment by the
district nursing associations inspected of an 'affiliation fee' of £315s. 15s. annually in respect
of each Queen's Nurse employed on duties under section 25 of the National Health
Service Act, 1946. These payments are approved by the Council for grant purposes.
Three of the district nursing associations and the two religious organisations, however,
are not affiliated to the Queen's Institute and their work is not inspected professionally
although their voluntary committees keep in close touch with the daily work of the