H—3l

These figures show an improvement on the previous year both in regard to the proportion of nurses to patients and registered nurses to pupils :

For several years the Department has been basing the requirements for staffing in the proportion of 1 nurse to I*s occupied beds and 1 registered nurse to 2 pupil-nurses. These requirements were based on a forty-four to forty-eight-hour week. It has become evident that in the large base hospitals where there are several theatres, special clinics and departments, and a large number of supervising staff this basis is inadequate and that an average of 1 to 1-25 will be required, or a fresh basis of assessment considered. If a staff of 1 to 1-25 is required for a forty-four to forty-eight-hour week, in those hospitals where a-forty-hour week is to be worked a staff of at least an additional onesixth will be required—i.e., approximately 1 nurse to 1 occupied bed. No hospital has a staff of anything like this proportion, although a few of the base hospitals are now finding it necessary, in order to provide a proper service, to have 1 nurse to 1-3 patients. This basis of staffing is quoted in the British Working Party's report as being already in existence in some English hospitals where a forty-eight-hour week is worked but where they are many special services. An alternative method is to calculate staff requirements on a ward basis and add to this for special wards or for special departments—i.e., in several international studies the number of nurses required for a 30-bed medical and surgical ward on a forty-eight-hour week was shown as 12 —3 registered, 6 for day duty, 2 night duty, and 1 reliever—but this number was increased by 1 registered nurse and 2 pupil-nurses in a children's ward of the same size. Obstetrical Hospitals Which Are Training-schools A few of the country hospitals have had a difficult period, but on the whole, in spite of the increased number of births, the staffing position has not only been maintained,, but slightly improved.

The increased beds are due to the public hospital system having to be responsible for more beds, due to the closing of private hospitals.

38

— 1946. 1947 1948. 1949. Total number of nurses to patients 1 to 1-9 1 to 1-77 •1 to 1-68 1 to 1-4 Total number of registered nurses to pupils 1 to 2-4 1 to 1-3 1 to 2-5 1 to 2-4

— 1947. 1948. 1949. Total number of beds 759 863 940 Daily average occupied beds 613-9 702-3 780-5 Total number of confinements 15,217 16,628 18,813 Total number of registered nurses— Midwives 138 138 187 Maternity nurses 91 73 137 Total number of midwifery trainees 49 48 39 Total number of maternity trainees— Registered nurses 218 193 215 Eighteen months' trainees 170 214 235