PLUNKET NURSES

Dominion, Volume 10, Issue 3011, 23 February 1917, Page 6

PLUNKET NURSES

AND GOVERNMENT SUBSIDIES

MINISTER STATES HIS VIEWS As may have appeared from reports published of the proceedings of the Conference of the Plunket Society now sitting in Wellington, there are some differences of opinion between the leaders of. the society and the Minister of Public Health (the Hon. G. W. Enssell) regarding the organisation of the society and its possible future development. The following letter; setting forth tho Minister's views, has been sent by Mr. Russell to Mrs. A. Carr, president of the Central Council of the society:— .

_ "In view of the fact that your society is meeting in conference, I desire to bring before you certain matters dealing with the relation of the society to the Government.

"I find that for the present financial year the following eums have been or will be paid over:—

Subsidy on nurses £2900 Subsidy for Karitane'Hospital £750 Travelling expenses" of nurses

(for half-year only) £184 In addition to the above the society's literature, printed at the Government Printing Office, costs a very considerable sum.

"I fully recognise that much valuable work has been done by the society, and trust it will continue to be successful in assisting in the saving of child life and the building up of a strong and healthy nation. It is a matter of .thankfulness that our Dominion takes so low a place in the matter of the infantile death-rate. For the year 1915 the deaths of infants ■under one year of age to every 1000 births were as follow: —New South Wales, 68.13; Victoria, 68.84'; South Australia, 67.30; Queensland, 63.97; Australian Commonwealth, 67.52; New Zealand, 50.05. This is.a most satisfactory record, and is the result of our healthy climate, the suppression of the 'baby farmer,' our good drainage and water systems, our system of trained midwives, tho close inspection through our receiving homesjand 1 the!licensing of foster parents and guardians, the vigorous inspection of food, and last but not least' the beneficial work of your society. In this connection it will bo of interest to note the infantile mortality rates of our four chief cities for tho last seven years, compared with New Zealand as a whole: —

Bates of Infantile Mortality in New Steffiland and Pour Chief Centres (Deaths trader 1 year of age per 151)0 births), each year 1909-15. ■ .

Auck- Welling-Christ-Dune-Yoar. K.Z. land. ton. church, din. 1909 : 61.60 61.85 84.21 62.78 48.52 1910 67.73 79.02 84.59 - 69.40 79.08 19U 66.31 63.02'. 73.36" 62.90 43.42 1912 51.22 56.95 61.32' 60.03 38.11 1913 69.17 80.81 60.23 63.49 73.42 1914 ....... 51.38 57.62 82.57 68.15 64.28 1915 50.05 . 71.67 57.17 54.24 ■ 72.26 It will be seen that in, most cases the city figures show a higher death-rate than the average for New Zealand, and this fact must lead us to see in what directions improvements can be made. "This conference has arisen over certain suggestions I ventured to make, which were, 1 thought, calculated to extend the scope and influence of tho society's operations. From the papers before mo I find that on September 30, 1916, there were twenty-nine nurees working in twenty-one different centres of the Dominion, after nine or ten years' work. I am satisfied that this rate of progress is not commensurate with the work to be done, seeing there are some 28,000 births in the Dominion per year. There are also 98 boroughs of .over i 1000 population, without considering the rural districts. What is to bo done for the 77 boroughs still beyond the scope of your.society's operations? This brings me to one of the main points' I desire to draw your attention to, namely, on examining the accounts I find that your 22 branches, whose accounts are before me, had-on April 1, 1916, credit balances amounting to £2158,' and that these had increased in six months ended September- 30, 1916, to no less than £3784 cash in bank, without considering other liquid assets. I also find, from the annual report .presented at Dunedin in May, 1916, that the society had credits at Dunedin of £3222, against which there were liabilities; amounting to £185, leaving a credit balance of £3036. '.'The Public Health Department is preparing a new form of.balance-sheet for the branch accounts, for the head office accounts, and for the Karitane Hospital accounts, which will be uniform, and will provide, necessary information. These when completed for the financial year ended March 31, 1917, will provide all the data necessary for consideration as to the bases upon which, subsidies will in future years be granted to the society for its work. Ido not desire to criticise in detail the credit balances on half the year's work, as the second half-year may materially alter the position, hut speaking generally I may say the Government's policy is to assist and subsidise in all cases according to the necessities of the work, .and that where a branch's accounts show that it does not need Government assistance, the subsidy should go elsewhere, where it can be of direct and _immediate service. This policy is .invariably carried out in connection with all hospital subsidies, and grants on bequests and gifts. Quite recently, subsidies were refused on gifts for charitable institutions in two different parts of New Zealand, because it was found .on examination of the accounts that they were not in need of the money. Therefore, in future a , subsidy of £100. per nurse will be paid ,to a branch only if that sum is needed to carry on the work, and the society will te expected to spend the money tlius saved in establishing nurses in new districts, where the branch is prepared to guarantee to raise a reasonable sum. Thus the strong branches will be_ able to assist the weaker-ones by practically handing over a portion of the Government subsidy, or, in the large centres may determine to employ more nurses. My desire is to see the infant population reared successfully, and it is with that view alone I have written to you. i ' "One" subject which is directly connected with tho matter is the work of organisation—that is, how the extension of the work to new centres is to be brought about. Among the towns where nurses are required I venture to mention the following:—Blenheim," Brunner, Campbelltown (Bluff), Feilding, Foxton, Greymouth, Lyttelton, Masterton, Milton, Mosgiel, Motueka, New Plymouth, Ohakune, Onehunga, Palmerston North, Pahiatua, Port Chalmers. Ruananga, Stratford, Hokitika, Kaiapoi, Now Brighton, Kaitangata, Rangiora, Lower Hutt,. Taumaranui, Te Kuiti, Taurariga Te Awamutu, Temuka, Thames, Waihi, Huntly, Waitara, Whangarei. Woodville, Woolstou, Rotorua. This is a long list and opens up a wide vista of work. "But how are the new branches to be organised'and set to work? .Where arc the nurses to he obtained? If 1 am not mistaken, the work-of extending the society has up to the present largely fallen upon the shoulders of Dr. King. Considering the responsible nature of his duties as Medical Superintendent of Seaclift' Mental Hospital, it is not possible for him to devoto the time necessary to this society's 'vork if it is to grow as it should. T therefore suggest io the, conference that it should consuW some scheme for opening new branches, . .

"Tlio further question'to be considered is, wliere are thn nursos to bo obtained? This also will need to be gone into carefully, ami I suggest t$ the

conference to carefully consider IT nurses trained in Karitane Hospital are not, available, whether some subatitutionary method cannot be devised by which trained midwives or hospital nurses can be associated with expert l enced Plunkefc nurses for training, or special classes be esfcabilshed in the larger centres which could be conducted by medical experts. In all these cases an examination should, in my opinion, be conducted by the Public Health Department of the nurses before they were sent to work, on 'their; own responsibility. This is desirable in the interests' of both the nurses themselves and the people of - tho Dominion.

"Tho work of saving child life and! assisting to rear a healthy population;; is of suoh tremendous importance thafc- : I sincerely hope your conference willi be able to see its way to assure me ofi its ability to grapple with the question: as a national undertaking. Lath as Twould be to do anything that wouldi interfere .with the great work your ! society has selected as its special do- 1 main, I feel so impressed „. with its clamant importance that if the oannot soe Its way to extend its work}) other means of coping with the neces-*; sities of the situation must be found, and a system of trained nurses created? for all fields not covered by. your society. In view of'the. wastage oflife caused by the dreadful war through! what we are passing, our duty' as a; nation to child life is imminent. Equal-; ly is it the duty of the Government tdsee that every pound given- by that. State is devoted at once to the pur-/ pose in hand, and not employed to.: build up endowments and permanent* funds. ■ . •

"The £1400 balance of subsidy for the present year will be at once paid over, and, as* already stated, the whole, question of, the basis and amount or future subsidies to the.society will be carefully and fully considered when the final accounts of tho branches, the head office, and the Karitane Hospital are available after the close of th*. financial year on March 31, 1917. ' PLUNKET SOCIETY'S ATTITUDE REPLY TO THE MINIS'EER-'S LET- ■ . TER. . ' _/•■•- A report was placed before the conference of the' Society for the Protection of Women and Children last ev'.ening by a committee which had asked to deal with the Minister's let> ter. The draft reply etated that mostf -.of tho points rasieduyr.the Minister', had been covered by aHetter sent to( tho Minister on December 31 last bjf the Central Council. This letter an- v . swered almost all the points he ,wa3now raising, and had deserved the clos- , est attention. ,-As it had apparently; , not been read, \a duplicate copy was ■ now forwarded. The committee asked the Minister to explain bow thai work of the society could possibly be> i extended.if the branches of the society \ were not allowed to establish the. rieces-. sary financial position by. building.uj> their voluntary funds. The ' whole), amount of the Government subsidy for Plunket nurses had been promptly expended in all cases, in. addition to about an equal amount of voluntary . funds. The accumulated funds men-- - tioned by the Minister consisted entirely of money subscribed by private people, for special purposes, sometimes as) specified permanent endowments. Tha . letter points out that if the policy o£ diverting voluntary funds for. the purpose for which they had been, given; Vas persisted in, it would shatter public confidence, and stop all tendency to> further donations or bequests' in the Mure. "We can imagine no_ more di-_ sastrous policy than this drying_ up_ or the springs of voluntary humanitarian benificences—especially at the present national crisis. Most of the places mentioned by the Minister as requiring Plunket nurses were not capable- - of supporting them, or were already being ...visited by: .Plunket. nurses. Even some of the larger centres men- I ', tioned had been found by experience not to specially need Plunket. nurses* The society was at present training a; considerable number of nnrses and was proposing to' establish twelve additional Plunket nurses at the most suitable places. The committee hoped that the Government subsidies for these extra nurses would be forthcoming. ...

The conference went into commit tee to consider the committee's 'suggested reply. : . ' The draft reply was considered m committee, approved without, amendment, and subsequently confirmed in open conference. . A deputation from the conference will interview members of the Government to-day, wheh it is hoped that the Actine>Prime Minister (Sir Jas.: Allen), and the Hon. Messrs. G. Wi Russell, J. A. Hanan, and Vt. H. Hemes will all be present.