H—3l

The General Hospital Service Last year I remarked that the occupied-bed rate of our hospitals used as trainingschools was still increasing and that there was a decrease in our nursing staff which I hoped was a temporary condition. The following table shows that for the first time since 1944 there has been a decrease in hospital occupancy. This is partly due to deliberate closing of wards owing to shortage of staff and partly due to the decreased demands of service patients :

The return shows the greatest decrease is amongst registered nurses, the reason for which I have already explained. The present figures give a total nursing staff of 4,402 for 7,812 occupied beds, which is 1 nurse to 1*77 occupied beds. This percentage of nurses to patients is slightly better than last year (1 to I*9) because of the occupied-bed rate having decreased by approximately 700 beds. The proportion of registered nurses to pupils, 3tol, is too low. For satisfactory staffing, the proportion of nurses to patients should be 1 to I*s and 2 pupil-nurses to 1 registered nurse. It is important that every effort should be made to build up staffs to this ratio if possible, otherwise conditions within the hospital become difficult and detract from recruitment. Registered Staff. —Points which will have to be considered in retaining registered staff will be not only reasonable salaries and hours, but also conditions of service so that young registered nurses are given responsibility according to their ability. This means adequate staff education, careful selection of nurses for the various types of duty according to aptitude, and encouragement of development, together with a happy atmosphere of pooled experience of the whole registered nursing staff. Some hospitals have made use of the married registered nurse, who may be only able to work a few hours of the day, by paying her on an hourly rate, and have found this worker of great assistance over busy periods of the day for routine nursing duties. This system might be much more widely used than it is. Student Nurses.—All employing authorities have now realized that the reservoir of potential young woman-power is limited owing to the drop in birth-rate between 1926-33, therefore every effort needs to be made to recruit carefully and make the conditions for student nurses those which are really for students and not just employees. At the recent Hospital Boards' Conference it was decided to set up a Joint Recruiting Board of the Hospital Boards and the Department, to which the Boards would subscribe as well as the Government, to carry out a more extensive recruiting scheme and to prevent if possible, some of the overlapping which had taken place when the Boards were carrying out extensive individual schemes.

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— 1941. 1942. 1943. 1944. 1945. 1946. 1947. Number of occupied beds 6,040-0 6,285-7 6,808-5 7,603-2 8,493 8,550-05 7,812-1 in training schools Number of registered 922 984 1,172 1,366 1,500 1,347 1,199 nurses Number of pupil-nurses .. 1,575 2,798 2,974 3,124 3,390 3,280 3,203