Contents -

Editorial
Around the Hospital
The 'Lunatic' Look
In the Group
Round the N.H.S.
Nursing News

Editorial

A national newspaper recently carried a crumb of comfort for the rank and file of the N.H.S. Under the heading 'Discontent in the Health Service' Senior Administrators complained, for example, about shortlists drawn up for the new area health authorities. One group secretary spoke of 'Roman gods playing sick jokes on us. And the senior tutor in Health Care Administration at the University of Manchester said of the Staff commission responsible, 'Overwhelmed . . to such an extent that rationality has been utterly discarded.' It must be really tough at the top.

We are glad to learn that Miss Pauline Radcliffe has taken up a part-time appointment in the General Office. A much increased work-load there has been responsible for our delayed appearance on several occasions.

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Around the Hospital

The League of Friends of Winwick Hospital are holding a Dance in the Recreation Hall on Friday, October 26th, 8.00 p.m. - 1.00 a.m.
Harry Jarman and his orchestra plus Disco.
Licensed Bars - Tickets £1.00 (including refreshments)
Tickets Available From:

Mr. B. Naylor
Mrs, J. Woods, Art Room
League of Friends Committee Members.

Donations suitable for Raffle Prizes will be gratefully accepted.

J. Thomasson,
Secretary of the League of Friends.

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FOR SALE

Honda 90 Motorcycle - 1968 - Taxed and Tested for 10 months. Excellent bike, no reasonable offer refused. Box No. 3.

Lady wishes to sell 1966 Morris 1100 - Taxed and M.O.T.'d till February - radials and other extras. Brake discs and bodywork require attention. £100 cash. Box No. 4.

Medium pram - detachable body.- Sun canopy - Navy Blue carry-cot. Push chair. Baby Bouncer. £20. Box No. 5.

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LETTERS TO THE EDITORS

We have received a very nice letter from Student Nurse A. Fedyk, thanking everyone for their friendship and help during her duty on Ward 23.

James Stewart, who was a temporary Nursing Assistant on this ward, has now gone on to University.

We would like to take this opportunity of wishing then both well.

P.C.

Mrs. Beatrice Powell has asked us to convey her thanks to her colleagues and friends in various Departments of the hospital, for their kind wishes and beautiful presents given to her on the occasion of her retirement.

P.C.

Mr. J. Bainbridge has asked us to print the following:-

I would like to express my sincere thank for all the cards, presents and flowers received on the occasion of my retirement. May I say I have been happy over the past years. I will miss you all very much.

Kitty Rogers.

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THE 'LUNATIC' LOOK

One of the more obvious changes in the economy of working class households occurring between the era of the thirties and the present day has been the gradual decrease in the need for second-hand clothing, hand-me-downs and patched backsides.

Those of us whose childhood spanned the 'hungry' thirties have memories - of mother tiredly burning the midnight oil every Saturday in a pathetic attempt to reduce our Sunday shabbiness.

Such memories, I think, have enhanced our appreciation of the psychological importance of decent clothing. In this respect later generations have become accustomed to take basic necessities of self-respect and respectability too much for granted.

The sociological changes brought about by organised and dedicated social activists in outside society have been parallelled during the same period by similar, though smaller and slower, improvements in the psychiatric hospital field.

The 'Sunday best' suit, for example, of our male patient is made of 55% terylene, which is the quality of material of the latest male nursing staff uniforms.

But nurses,. it seems to me, must avoid the complacency which often follows minor improvements in a deprived situation. The quality and cut of patients' clothing may have lost the 'lunatic' look, but even good clothing becomes second-hand clothing in a very short space of time unless its issue is organised on an individual basis.

From a therapeutic standpoint the individual issue of clothing is important because of certain rather abstract, though very human, considerations. The human spirit is a very fragile 'plant'. Its survival depends, in many particular circumstances, on the preservation of the human dignity of the individual human being, which in turn depends on the preservation of the basic rights of the individual.

The first time a nurse offers a patient a pair of laundered underpants which were worn by someone else the previous week, that nurse has set in motion a process the final outcome of which must be the erosion of the human dignity of the patient. I would justify this line of reasoning on the premise that the exclusite ownership and use of one's own drawers, or any other item of underclothing, is a basic, inalienable human right.

Deprive a man of this right and you make an assault on his dignity as a human being. Make this, or similar assaults, often enough over a prolonged period and you will eventually annihilate his human spirit. Such an annihilation, whether it takes place deliberately in a Siberian prison or inadvertently in a British psychiatric hospital, must be regarded as the most tragic of all possible human calamities.

Being a charge nurse of a 70-bedded male ward with a very modest staff/patient ratio, I am fully aware of the problems involved in the issue of individually marked clothing - particularly in respect of underwear and shirts. The difficulties in supplying 70 patients with a twice-weekly change of personal linen, often with only one nurse available to do it, are of a manifold and perennial nature. Each major problem. encountered, if I may be allowed a home-made metaphor, has a thousand minor wheels of difficulty within it. Coping with these seemingly inherent problems requires single-minded tenacity, improvisation of a high order and, above all, total staff commitment.

. For some charge nurses working in high-dependency areas the question of a personal issue of clothing has assumed the proportions of an agonising ethical dilemma. Should you, they protest, sacrifice basic nursing imperatives for the sake of the luxury of individual clothing? As it is, they plead, either option will stretch their existing meagre resources almost to breaking point - if one objective is aimed at, the other has to be abandonned.

During a visit to a high-dependency ward recently, I intruded on the three nurses on duty busily sewing identification tapes on patients' garments. In this situation, where many of the patients suffer from double-incontinence, the number of garments requiring these tapes must be astronomical.

You need no work-study qualifications to see that if an individual clothing policy is to be implemented in these circumstances the nurse will be spending more time in sewing than in nursing.

In some wards the difficulties are compounded by the fact that the patient names have to be laboriously handwritten on the tapes, which then have to be heated by ironing to ensure indelibility. The ironing operation, by the way, is seldom effective enough to survive weekly laundering.

The best word to describe these problems from the worm's eye point of view is 'sisyphean'. The eternal punishment of Sisyphus was to roll a large stone up a mountain. When he reached the top the stone rolled down. The eagle's eye viewpoint I cannot describe because I have never heard it. Has anybody?

This is the question with which I'll conclude this present exercise. I hope I have said enough to show the importance of finding answers to the clothing problem. Some of the.answers I feel sure maybe provided.from sources to be found within the readership of this journal.

C. Breslin.

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IN THE GROUP

OPEN DAY

The Maternity Department at the General will be holding its first Open Day on October 17th, Invitations have been circulated to our ward staff.

P.C.

CASH FOR CASUALTY DEPARTMENT

Liverpool Regional Hospital Board has approved the spending of an extra £20,000 - making a total £63,010 - on improvements to the Casualty Department of the Infirmary.

P.C.

IMPROVEMENTS AT GENERAL

If approval is given to increasing the estimated cost by £8.546, the Liverpool R.H.B. are to accept the £21,396 tender for provision of staff recreation and general purposes accommodation, and the replacement and re-siting of the physiotherapy department's gymnasium at Warrington General Hospital. A £6,798 tender is also to be accepted for the replacement of the stores building at the hospital. Improvement to the hospital entrance in Lovely Lane are also to be carried out at a cost of £5,090.

INFIRMARY NURSES' HOME

Liverpool R.H.B. are to provide £18,000 for electrical installations at Bewsey.Road Nurses' Home.

D.O.H.S.S. OBSERVATIONS SOUGHT

Liverpool R.H.B. are to ask the Departnent.of. Health to give early observations on the lowest tender which has been received for the first phase of the redevelopment of Warrington General.

P.C.

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ROUND THE N.H.S.

NEW POST FOR G.A. ROYLE

Mr. G. A. Royle, Director of Social Services at Warrington since March 1971, has been appointed Director-designate of Social Services with Knowsley Metropolitan District Council with effect from November 30th.

Originally a Manchester man, Mr. Royle was for a number of years Lancashire County Welfare Organiser.

CHESHIRE AREA HEALTH AUTHORITY APPOINTMENTS

Appointments have now been made to the new Cheshire Area Health Authority. The A.H.A., which is composed of a committee of 18, will be responsible for administering the health services in the new Cheshire County from April 1974. Cheshire will come under the Mersey Regional Health Authority, the chief executive of which is Mr. Eric William Driver, formerly I.C.I. Mond Division Chief Civil Engineer, who lives at Chapel House, Crowley, Northwich.

The Secretary of State for Social Services, Sir Keith Joseph, has recently appointed the chairman of the Cheshire Area Health Authority. He is Mr. C.C.B. Stevens of Warley House, Park Lane, Congleton who for more than 20 years has been on the staff of I.C.I. Pharmaceutical Division at Alderley Park.

Amongst the 13 members appointed to the Cheshire Area Committee of 18 by the Mersey Regional Health Authority is Mr. P. Ditchburn, our Chief Nursing Officer. Other local members are Dr. H. Allison of Crewe, Mr. M.I. De Koyzer, Northwich, Mrs. E. Henshall, Sandbach, Dr. A. H. Luscombe, Wilmslow, Mr. J. Perry, Crewe and Mr. F.W. Cureton, Crewe. Those appointees all serve until March 1977.

The four members appointed by the New Cheshire County Council are Mrs. M. E. Melrose, Alderly Edge, Mr. J. Millett, Wilmslow, Mr. M.E. Oakes, Widnes, and Dr. J.K. Walley, Knutsford. The County has to decide for how long these members will serve,

Reports from the Joint Liaison Committee which has been sitting for some months show that in Warrington the District Management Team will be housed in the new Group Headquarters of Warrington H.M.C. and the Divisonal Health Offices at Winwick, with a local office to deal with enquiries, possible in the offices of the existing Executive Council.

The new health service will combine all facets of the existing N.H.S. and County Council health and Welfare duties. Larger towns in each district are to have enquiry offices which will deal with a vast range of queries concerning such matters as district nurses, midwives and home helps. A school medical service is envisaged and there is pressure on the Government to provide more health centres.

P.C.

Rent Paid

Warrington Rural Council agreed to make a grant of £67.40 to Winwick Old People's Welfare and Over-Sixties Friendship Club, to cover the cost of renting Winwick Leisure Centre for 1973.

PC

Survey Shock

The plight of 90,000 pensioners in Sheffield highlighted in a report has shocked the city council and a complete overhaul of the city's social services may be ordered. The report said that 17,000 aged people hardly ever go outside their homes.

PC

Hospital Need at Skem.

Skelmersdale, one of Britain's fastest-growing new towns, is facing a hospital crisis. The town is expected to double its population to 60,000 by 1980, but it could be 1985 before a hospital is built to serve the town's needs.

Because of the re-organisation of local goverment boundaries, Liverpool RHB will be handing this area over to a new health authority, and a hospital plan for the town, due to begin in 1975, has been deferred 10 years.

At present the town is served by Ormskirk General Hospital, but the number of beds per 1,000 population has already fallen below the national average.

PC

St. Helens Appeal

A campaign to raise £3,500 for a kidney machine for St, Helens Hospital is under way. Over £1,000 has already bean raised since the appeal was launched in May by the Friends of St. Helens Hospital.

PC

NHS Facing Staff Crisis, Say Unions

The Ancillary Staffs Council has submitted a document to the Pay Board in which they warn that, unless a substantial improvement in wage rates is achieved, the hospital service will face growing discontent and will be unable to attract and retain staff.

The unions represented on the ASC - the National Union of Public Employees, the Transport and General Workers' Union, the General and Municipal Workers' Union and the Confederation of Health Service Employees - point out that ancillary workers are badly paid in relation to a minimum economic income, in relation to the service they give, and in relation to other workers. They claim that the gap between the national average earnings is now about £6 per week, and will be £9 per week by the time the next ancillary staff pay settlement is due in mid-December.

The union submission also claims that ancillary workers have to put in more overtime than the average worker to make up a living wage. It points out that the basic wage is £19.48 with a top wage of £23.32. After deductions, an ancillary worker has less cash in hand than an average married man with two children who is unemployed and claims National Insurance benefits.

PC

More 1974 Appointments

Dr. P. O'Brien of Warrington has been appointed to the new Mersey Regional Health Authority, and Mrs. A.C. Boddington, a housewife and member of the Manchester RHB, has been appointed a member for the North-Western Regional Health Authority.

PC

Criticism of Bed Ratios in Warrington Area

At a Meeting of Warrington Health Executive Council held on October 5th, Dr. Frederick Deakin criticised the disparity in bed ratios in the Liverpool region. In the past, said Dr. Deakin, there had been far too many hospital beds for a declining population in the centre of Liverpool and too little provision on the periphery, including Warrington. Quoting from a new report, he said that at present there were 490 acute beds in Warrington. The estimated provision in 1981 amounted to a net drop of eight beds.

The Executive Council was considering a letter from the Regional Board which said that no more comments could be offered on bed ratios.

At a previous meeting, the Council had decided to make representation for the new bed ratios. Members felt that a provision based on population was not adequate because of the number of patients from outside the area who were treated after being involved in road accidents.

Mr. Eric Driver, chairman of the new Mersey Regional Health Authority, told the council that in many regional board discussions it had been said that Warrington was not getting a fair share of the 'cake'. It had something to do with the fact that Liverpool was a teaching centre, and teaching centres had an undue proportion of beds.

The region had more beds per head of population than almost any other. This had been a good thing, but could now prejudice new capital allocations. The Council agreed to leave the matter on the agenda for discussion at a later date.

PC

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NURSING NEWS

Technical Nursing Library

New books available on loan -

'Patient-Nurse Interaction' - A.T. Altschul
'Pathology' - C. P. Mayers
'Notes on Medical Nursing.' - W. C. Fream
'Introduction to Occupational Therapy' - S.W. Mountford.

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