NURSING HOMES IN DOMINION

Southland Times, Issue 25746, 9 August 1945, Page 3

NURSING HOMES IN DOMINION

Maternity Training Discussed

INVERCARGILL CENTRE TO BE CLOSED (P.A.) WELLINGTON, August 8. Continuing the debate on the Nurses and Midwives’ Bill when the House of Representatives resumed this evening, Mr W. T. Anderton (Lab., Eden) stated that private nursing homes were charging from £2 to £6 above what was paid from the Social Security Fund and doctors were charging up to £lO above what was allowed from the fund. There was no necessity for these extra charges, he said, and the Government should do away with them by providing expert services at all the main centres within the Social Security Scheme. The people contributed enough to receive the best and the State should see that they received it without paying additional. In reply to an interjection, he said he would close all private maternity homes and give a full service. That was his personal view and not a statement of policy. Mi- M. H. Oram (Nat., Manawatu) asked if Mr Anderton advocated closing private maternity homes because they competed too successfully with those of the State or because he opposed private enterprise of any kind. If the latter were the case, would he advocate closing down private dispensaries, herbalists and chemists and the substitution of a State pharmaceutical service. Mr Anderton: Yes.

Mr Oram said Mr Nordmeyer’s outline of nurses’ salaries had been misleading. He drew attention to what he considered anomalies in the remuneration of dietary sisters and tutor sisters. He also declared that Mr Nordmeyer had cast an unwarranted slur on hospital sisters when he declared that one reason for staff difficulties was the tyrannical attitude of some sisters towards the nurses under them. Mr Oram said some girls resented the discipline which was rigidly imposed in hospitals, but which had built up a wonderful tradition and an efficient nursing service. There might be isolated instances of tyrannical conduct, but they were soon dealt with by the hospital matron. Mr Oram said hospitalization had run riot in the Dominion. Two contributing factors were the disinclination of people to look after chronic cases in their own homes and the actions of some doctors in getting rid of cases by sending them into hospital for treatment.

HOKIANGA SCHEME Mr W. M. C. Denham (Lab., Invercargill) dealt in detail with the Hokianga scheme, under which the hospital board and Social Security Department had made arrangement for the care of the population at the rate ot £1 a head on a population basis. The scheme, he said, worked well, because much of .the work done by doctors in other areas was handled by district nurses and the doctors were not overworked, and neither were the nurses. The same applied to pharmaceutical workers. Mr Denham added that in his opinion a proper service on the same basis would do away with a great deal of the charges against the Social Security Fund. Tons of medicine were prescribed today, although it was not necessaiy. An Opposition member: Why are they prescribed then? Mr Denham said the doctors prescribed medicine because they knew that patients believed that medicine of a pleasant colour would cure them. In his opinion most of the medicine was not worth a “tin of fish.” Mrs Hilda Ross (Nat., Waikato) said there was need for more training facilities for midwives. At present only about 60 midwives were trained annually in four centres, Auckland, Wellington, Christchurch and Invercargill. There had even been some suggestion that the Auckland training centre might be closed, whereas the need was for an expansion of training facilities. Mrs Ross said the private maternity homes did excellent work. She thought women did not bother about whether a maternity home was private or Stateowned if it gave first-class treatment. Mrs Ross added that she hoped the Minister would give more attention to war neurosis cases and their treatment. She was constantly receiving letters from people who were concerned about war neurosis in returned men. There had recently been several accidents which might have been prevented had these men been able to enter some institution—not a mental hospital—where they could receive the necessary treatment. A suitable institution should be built. Mr J. T. Watts (Nat., Riccarton) said he was very interested in the advertisements on health matters which the Health Department had published from time to time.

These advertisements, said Mr Watts, were of great assistance to the public, particularly to young parents. There were, however, some matters which should be gone into much more fully. One advertisement had dealt with criminal abortion, which was a very serious problem in this country. Something like 10,000 to 20,000 unnatural abortions occurred each year in the Dominion, causing a great loss of potential population and a serious lowering of the health of the potential mothers. Its incidence was perhaps as high in this country as anywhere in the world. He thought the Health Department’s advertisement dealing with this question should be used more widely and the dangers of criminal abortion should be brought home to both married and single people. Mr Watts asked what plan the Government had for dealing with the everincreasing demands upon hospital accommodation by people, not all of whom, according to the Minister of Health, ought to be admitted to hospitals.

LARGER FAMILIES Mr Watts urged that in the next year or ‘two no private maternity home should be permitted to close down if it possessed the minimum requirements. He said several doctors had told him in recent months that there was an increasing willingness on the part of expectant and potential mothers to have larger families. Mr F. Hackett (Lab., Grey Lynn): Fear of starvation has been removed, that is why. , Mr Watts said fear of starvation had not been removed any more in the last few months than in the last 20 years, but whatever the reason was, if women were prepared to bear larger families they should be encouraged to do so and adequate facilities should be available to them. Mr T. H. McCombs (Lab., Lyttelton) said he had nothing to say about private maternity homes as far as their treatment of patients was concerned, but in some the charges were so much above the amount provided by the Social Security Fund that mothers were almost terrorized when they received their accounts on leaving the home. He had seen accounts running to £l5 and £lB above the Social Security refund. » The Minister of Health, Mr Nordmeyer, in reply, said we could not do without private maternity homes. He agreed that they did not need to take steps to prevent illness as well as attending to those who were ill, but that was the normal activity of the Health Department. All of its officers were engaged in maintaining hygienic standards and on a campaign for the immunization of the population. Last year 31,210 children had been immunized against

diphtheria and 1460 against whooping cough, and other statistics could be quoted to' show that steps were being taken to prevent the spread of disease. The Government since the outbreak of the war had taken steps to prevent the’ spread of venereal disease. That had succeeded to such an extent , that visitors from overseas had been amazed. At all times an active campaign against disease was being waged. The hospital population had been questioned, but the normal hospital population was only 6.2 per 1000, and including maternity cases, tuberculosis and old folk it was only 10 per 1000. In addition, it should be remembered that civilian hospitals were looking after the sick and wounded from Hie services and that had meant a great increase in the hospital population. In some districts the number of hospital beds occupied could be considerably diminished if the boards would provide a proper out-patient service, with diagnostic facilities, which would reduce the numbers of people needing to enter the hospitals. It had also to be remembered that much of the money spent on the work of doctors and on hospitals was actually preventive, not curative, medicine. TRAINING FACILITIES Discussing' the training facilities for midwives, the Minister said the Health Department had to maintain a balance between the training of midwives and of doctors. The Government was concerned to see another medical school made available for the purpose of training medical men, not merely undergraduates, but doctors who had been overseas and those in the country who wanted to undertake a refresher course. This new hospital would be established in Auckland. When it was opened it would not be possible to maintain dition to it St. Helens Hospital in Auckland. However, that would not mean any diminution in the number of midwives trained. The Invercargill training centre would also be closed, but the Wellington St. Helens Home would be enlarged to 100 beds and the Christchurch St. Helens to 50 beds. Those two centres would provide all the training facilities for midwives necessary in the Dominion. Mr Nordmeyer said Dunedin and Auckland would provide for the training of graduates and undergraduates in medicine, as Wellington and Christchurch would provide for the training of midwives. It must be realized, however, that in homes where midwives were being trained, it would not be possible for patients to have their own family doctors in attendance. The St. Helens Homes enjoyed the service# of some of the foremost obstretic specialists in the country and would be the best that the country could provide. Discussing war neurosis, Mr Nordmeyer said all the best medical advice was against treating such cases as problems and putting them in institutions. The matter had been considered fully early in the war and there had been a number of generous offers of private homes for the treatment of such war cases. However, psychiatric treatment, if required, could best be given at Hamner, and for other neurosis cases the medical authorities considered the best treatment was to get them back to their normal environment, work, home j and friends. He added that if any worthwhile body of medical opinion could be advanced to say the treatment of neurosis cases should be altered, the Government would give that opinion every consideration. Mr Nordmeyer said dramatic results could not be expected from the Health Department’s advertising campaign, but over a long period of years it should pay a good dividend. The Bill was read a second time and referred to the Public Health Committee.