Report of the Working Party on the Recruitment and Training of Nurses.

Date:
1947
Catalogue details

Licence: Public Domain Mark

Credit: Report of the Working Party on the Recruitment and Training of Nurses. Source: Wellcome Collection.

    10/132 (page 2)
    16. The total cost of sickness shortly before the war has been estimated at not less than £300 millions a year*. We may safely assume that the cost was no less in 1938, a year for which reliable estimates of the national income are available. © In 1938 the national income was about £4,600 million. Thus the cost of sickness- was about 7 per cent. Three main items were estimated as entering into the cost of sickness as follows :— Item £, millions 1. Value of work lost through sickness .. Re 100 2. Treatment and maintenance of the sick 7 185 3. Public preventive services Sy . Ss 13 17. The first two items suggest the question—what reduction of loss of work : through sickness might result from an increase in nursing strength? The answer to this question would give an indication of the optimal size of the nursing profession. z There remains the third of the items of sickness cost listed above, namely, the cost of the public services for the prevention of ill-health. At present this item may be estimated at not more than about 4 or 5 per cent. of the total cost of sickness. Here again the question arises how far the loss of production through sickness might be reduced by a given increase in the efforts devoted to the prevention of ill-health. 18. A considerable amount of disease and mortality is preventable. The infant mortality rate in England and Wales declined from 156 per 1,000 live births in 1896-1900 to 45 in 1944. Death rates from infective diseases in particular show a marked decline. . The death rate from diphtheria was reduced by 84 per cent. between 1871 and 1945. In the same period the death rate from respiratory tuberculosis declined by 75 per cent. The number of cases of scarlet fever was reduced by half in 1944 as compared with 1934. The Chief Medical Officer of the Ministry of Health writes of diphtheria: “ It is a sad reflection that in this country during the war far more children under 15 were killed by this preventable disease than by enemy bombs”.f In Canada the incidence of this disease in 1937 was less than 1 per 100,000 as compared with 149 in England and Wales. _ “The conclusion arrived at, therefore, is that diphtheria can be controlled by persistent and relentless effort’. Similar reductions in incidence are doubtless possible in the case of other disabilities of body and mind. 19. Clearly the problem of sickness can be attacked quite as much by reducing the number of patients as by increasing the number of nurses. A scientific study of the health needs of the community would enquire what is the greatest reduction in item 1 above above which could be brought about by increase in expenditure onitem3. The data have not been available to enable us to make these calculations. But the proper stage for the estimation of sick nursing requirements should be subsequent to the estimation of the optimal requirements of health nursing services. 20. Nor can the optimal nursing requirements of the community be properly assessed before first estimating what further contribution medical and allied research could make to the reduction of sickness. Before the war the annual cost * ** Report on the British Health Services.” Published by P.E.P. 1937. “On the state of the Public Health during six years of war.” Report of the Chief Medical Officer of the Ministry of Health. H.M. Stationery Office. 1946.