9

H.—lB

only a presumption, but it is an eminently reasonable one, and requires to be met by specific proof, and not by empty declaration. It is to be noticed that, while one of the papers of charges alleges that the nurses in question were dismissed and only taken on again in consequence of public indignation, the framers of the other, knowing that no nurses except Nurse Cameron had been dismissed at all, assert only that it was sought to dismiss them, leaving it, I presume, to be implied that this would have been done but for the public indignation referred to in the other paper. But it has been shown that no intention to dismiss, without finding some other provision for the persons concerned, has been entertained. This question of getting rid of the older nurses really resolves itself into two heads, one of which relates to their capacity and efficiency, and the other to their alleged misconduct in forming or associating themselves into some sort of faction or cabal to thwart improvements and reforms in the organization of the nursing staff. The former branch of the subject needs no elaborate argument, and, indeed, it is really difficult to see what there is to discuss about it. The simple fact is that a new and greatly improved system of nursing has sprung up of late years, and is fast superseding the old system, which had grown up in times when it was not generally understood that nursing is a scientific art, and in a time when popular education had not become generally diffused, and the people had not learned to demand everything of the best quality in their public institutions. That in such a state of things there should be friction between the declining and the rising systems is, of course, inevitable, and that the former should manifest its inferiority when exhibited alongside of its newer rival is only in the nature of things. When, therefore, we are told by experts that what might have been expected by those who are not experts has actually happened when the matron and the House Surgeon say that the nurses who have inherited the older traditions only are inefficient when tested by the standard of modern requirements, and when this is confirmed by the Inspector-General, and by a lady so eminently qualified to judge as Mrs. Neill, it is reasonable to ask what there is to set against a case thus recommended by its own intrinsic probability, and proved by the evidence of responsible experts whose business it is to judge and to act ? The answer is that there is nothing to be said; and, accordingly, the opposition to the reforms takes the shape of appeals to compassion and assertions of the hardship to old and faithful servants who are to be displaced to make room for younger rivals. The benevolent people who use this argument must command the sympathy of right-thinking minds, and certainly the contemplated reform should not be effected in a harsh or hasty manner. On the contrary, the greatest consideration should be shown to these old servants, even at the cost of some present inconvenience and some delay in completing the necessary reforms. But what ought to be distinctly understood is that the reforms are necessary, and that they must take effect; that the delay is in itself an evil, and that it is only tolerable in connection with the real and practical intention to take the earliest opportunity that may offer of providing otherwise for those who, through no culpability of their own, have become obstacles to the march of progress. In these remarks I have particularised no names, nor do I think it necessary to do so, because I believe the professional and responsible heads of the nursing staff to be the only authority competent to pronounce upon the degree of efficiency or inefficiency displayed by this or that nurse. No doubt those who are yet capable of learning and improving ought to have every chance ; but I cannot doubt that the principles which I have above indicated must command the assent of all who are unbiassed, and I think that a Board which should hesitate to co-operate with its skilled officers and responsible advisers in giving effect to those principles would show a strange misunderstanding of its duty, or a strange indifference to its performance. Thus much of the necessary conflict between an old system and a new ; but it is alleged that the older nurses have conspired to frustrate reforms, and have introduced insubordination, and caused confusion in the administration of Hospital affairs, or, to use the words of the InspectorGeneral, they have formed " a cabal which paralysed the authority of the Eesident Surgeon and the matron, and the result was to cause such internal friction as to make the position intolerable." If it was natural and inevitable that the introduction of a new system should seem a grievance to those whose interests were bound up with the old, it was also natural, though not justifiable, that the feelings of jealousy so excited should find some mode of expression. Accordingly, we find some of the old. school indulging in sneers at the expense of the new, talking about " broken-down ladies," &c. There can be no doubt that this has happened, nor that it happened often enough, to make some of the probationers unhappy and depressed in spirits, a condition the most unsatisfactory for the performance of the duties of a nurse. There is no evidence that this was caused by any conduct on the part of the probationers—that they gave themselves airs, or did anything to provoke such manifestations of feeling. On the other hand, it is fair to say that these manifestations do not seem to have occurred —at all events, to any serious extent —until the suspension of Nurse Cameron created alarm, excitement, and animosity. How far the nurses who felt their position endangered allowed their alarm to carry them into improper speech or action is not very easy to determine. The apprehension of a common peril would naturally, and without pre-deter-mined arrangement, bring them frequently together in conference and counsel; and, if any persons outside the Hospital encouraged confidences, or held out the hope of aid, it is obvious that what might deserve the name of a fiction or cabal would insensibly spring up without any preconcerted design. From Dr. MacGregor's evidence, I gather that this is much what he meant when he spoke of " a cabal " in the passage above quoted. J3ut I think his language was rather unguarded, for the report certainly seems to imply that the " cabal " was the work of "the older members of the staff," and was confined to them, "and certain others whom they have influenced." There is no evidence to show that their disaffection led them to directly thwart the work of the Hospital, or that they ever failed to discharge their duties in the wards to the best of their ability. Indeed, it is difficult to see how they could have acted otherwise in these respects without at once giving a handle against themselves. In speaking of a " cabal," 2—H. 18.