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APPENDIX B
THE HOME NURSING SERVICE IN LONDON
Introduction—It is exactly thirty years since Dr. Margaret Hogarth produced her comprehensive
report on home nursing in London*—thirty years which have seen far-reaching
advances in the practice of medicine, a shift in the age distribution of the population and
vast improvements in the living and working conditions of the people. Another major
change has been the development of the personal health services as well as the availability
of free medical and nursing service to all, with specialist consultation when necessary.
These changes have completely altered the pattern of district nursing.
When the National Health Service Act, 1946 came into force the structure of the home
nursing service in London remained the same and in 1961 the service was still provided
by voluntary associations. The work of these associations is co-ordinated by the Central
Council for District Nursing in London, which was set up in 1914 for this purpose. From
1948, when the Council became responsible for the service, the Central Council has acted
as the Council's intermediary with the associations. Except in the case of the Catholic
Nursing Institute, the Council since 1948 has paid an increasing proportion of the approved
expenditure of the district nursing associations; since 1954 this has amounted to 93 per cent.
The total grant disbursed through the Central Council for District Nursing in 1960/61 was
£531,786; in addition the Council made a deficiency grant of £7,000 to the associations.
The home nursing service in London is provided by 25 district nursing associations,
which in the main still base their work on residential staff homes; 20 are affiliated to the
Queen's Institute of District Nursing. The Ranyard Nurses, together with an affiliated
association (Norwood) cover a large part of London and have traditionally employed
nurses working from their own homes in the areas of practice. Two other associations
not affiliated to the Queen's Institute are the Nursing Sisters of St. John the Divine, who
work in the areas of Poplar and Deptford, and the Catholic Nursing Institute in Southwark,
which receives from the Council an ad hoc grant of £900 a year. Both these associations
work from residential homes. A further independent association, Stoke Newington, is
non-residential. A detailed list of the associations will be found at the end of this article.
Staff-

Since the National Health Service Act, 1946 came into force, one of the changes in
staffing has been the entry into the domiciliary nursing field of the male nurse and the
state-enrolled nurse, both of whom are now well established as highly valued members of
the staff. The Council's view is that the ratio of one state-enrolled nurse to five stateregistered
nurses might ultimately be reached—the present ratio is one to 14.
*Survey of District Nursing in the Administrative County of London.
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