NURSING SERVICE IN COUNTRY

Shannon News, 12 November 1928, Page 1

NURSING SERVICE IN COUNTRY

BOARD TO CONSIDER PROPOSALS

A comprehensive survey of the Diar triet Nursing question in the Palmers* ton North Hospital Board’s district, was submitted to Thursday’s meeting of the Board by the Secretary Mr A. J. Phillips. "Hospital Boards,” he stated, "have the power to spend money in making provision for the treatment and medicul and nursing attendance for sick or infirm persons who are not inmates of any institution. This on Boards power to employ District Nur ses. I feel that there is some mis* conception ih the minds of Board members regarding what might be described to be the Board’s duty under the Act in this matter. The Act in effect provides that a Hospital Board in addition to establishing institutions, may maintain outdoor medical activities or nursing services in its district. In the ordinary course this work is Work which is entitled to no ,more subsidy than any other general purpose of the Board. If this Board undertook the Ovstablishment of a district nurse in any one locality, and the nurse cost, say, £4OO, we would receive, firstly, approximately anything from £IOO to £l5O in fees, leaving a balance of, say, £275 to be found through other sources. Of this amount, in the ordinary course, the Government would find 15-35ths., as maintenance subsidy, and the local, bodies 20-35t;hs as levy, the respective amounts being, local bodies £159, Government £ll6. Thus £159 would b 8 the cost of each district nurse to thi» Board, if no voluntary contribution* were received towards her work. If the Board desired to finance district nursing largely through voluntary contributions, there are two well defined methods of pi’oeedure.

One is to have a committee who would undertake to find the funds in the district to provide for locomotion and travelling expenses for, the nurse. This would Be approximately £2OO. Then against the actual summary of £2OO, the fees would be offsets and the balance found partly by levy and partly by subsidy. In this case, again approximately £125 would be the revenue from fees. Of the £75, £32 would be found by the Government and £43 by the local bodiea This would be a very satisfactory method of financing district nurses. The second method is to require the local residents to raise a certain sum each year by wav of voluntary contributions towards the cost of the nurse The trouble with this method is that this siirn can cany Government subsidy only if it is given unconditionally, i.e, that those who contribute to the funds do not reap any benefit from their subscription, i.e., subscribers to the fund who may use the services of the nurse would still be required to pay the usual fee.

As regards district nursing, in this district, I am of the opinion that it can he made a means of reducing hospital expenditure as well as a means of giving relief and assistance in the country districts. A good district nurse can do a lot to relieve the hospital as regards her particular district.

Consequently ,from my Knowledge o i tho district, in suggesting places die trict nurses might be stationed with • advantage to the Board, I would place the towns requiring district nurses ii the following order: —Levin, Shannon, Foxton, Palmerston North (a second nurse), a nurse with headquarters at Ashhurst to work the Pohangina Valley, a nurse to work Waikanae and the southernmost parts of the district, a nurse with headquarters at Kimbolton to work the Kiwi tea county, a nurse with headquarters at Rongotea. in suggesting the foregoing, regard lias been taken to tho distribution of the Board’-s district, and also to the fact that there is a maternity hospital being opened shortly at Otaki. At the same time when our by-laws were framed,-I had in mind that the Board would eventually have a comprehcnliive district nursing scheme, and incorporated in our by-laws are rules for the administration of district nursing j services. These w-e taken from the '‘model” by-laws with some amendments to suit local conditions. -The scale of fees set out in it are as follows: —A single visit 2s 6d, dressing ! wound, etc., for doctor 2s 6d, supplying 1 dressings Gd, occasional visits to waiting midwifery case (doctor engaged): ris or ,10s according to number sitting up for night with patient 10s 6d. for entire term with one patient per week £2 2s, if midwiferv case with delivery extra £ls ]s, daily visits with nursing once a day (per week) 10s 6d, daily visits with nursing twice a day (per week) £1 Is, daily visits, midwifery case, delivery and puerperium £1 10s. I would suggest that whatever sehemo the Board decides-to adopt, be brought into force as from the Ist April next. It was suggested that v.-e should ap proach the Government for further subsidy in this connection. I would point out, however, that to get any further subsidy for district nursing work requires amendment of the Hospital Act, and I think that there is no reason why this work should carry.any

greater subsidy than does, say, tho maintenance of the maternity home, or any other similar work. If the Board decides to press for such subsidy for district nursing work, I would suggest that the better method is to bring the matter before " the next- Hospital Boards’ Conference.” , The chairman (Sir J. G. Wilson} i* asking that members of the Board con* aider the question preparatory to a dls*. eussion at the next meeting of the Board, remarked that the adoption of i a comprehensive district nursing scheme was likely to increase the Board's expenditure but the question would have to be faced. The demands of the public warranted the Board taking some, steps in .the matter.