C O N T E N T S
Abstract ii Abbreviations iii
PREPARING THE WAY Chapter 1: Sydney's Response to Evangelicalism 1 Chapter 2: The Christian Social Union - The genesis of an idea 11
NURSING REFORM Chapter 3: The first District Nurse, and the Nightingale Influence: Liverpool, England, to Sydney 24
THE HISTORY Chapter 4: Beginning at 1900 - with One Nurse The structure, the executives, some personalities 31
Chapter 5: 1903 and on - Two Nurses, and the Fetes 39
Chapter 6: Localism and a permanent home 48
Chapter 7: 1906 and on - Some changes, some problems: The service grows, a reputation grows 59
Chapter 8: Fundraising - problems and successes: The women and the Branches 73
Chapter 9: The Nurses - Changes of role 81
Chapter 10: From the end of World War 1 - The end of independence, but not the end of the vision 90
Chapter 11: Recognition to incorporation 106
Chapter 12: The D.N.A. as a Network 111
Chapter 13: The D.N.A. and the Philanthropy of the Voluntary Citizens 116
Chapter 14: The D.N.A. as a Voluntary Organisation 120
Chapter 15: Tributes and Recognition - the Future 128
Notes 137 Appendix 1: 143 Appendix 2: 145 Appendix 3: 148 Appendix 4: 151 Bibliography 156
i THE_DISTRICT_NURSING_ASSOCIATION_--_SYDNEY,_!~QQ=!~ii
The aim of the paper is to examine the origins and develop ment of the District Nursing Association in Sydney. It is necessary to assess the wave of Evangelicalism and the revival of the Christian Social Union in the Church of England that helped to influence a re-evaluation of social attitudes by churchmen and lay men and women of the Angli can church. Of equal importance is the spreading ideology of Nightingale nursing, and the social attitudes towards philanthropy in Sydney as it affected women.
Beginning from a Christian Social Union formed at St. James Church, Sydney, the Association gained vice-regal patronage and the support of upper and middle-class women. It was maintained by personal service, philanthropic giving, bequests, charity functions and token government subsidies. Work was sourced from male medics, and men held some of the senior executive positions. Women were involved at executive and committee level, and formed the network of suburban branches; the only paid personnel were the trained nurses supplying medical treatment and personal comfort to the sick poor.
Women, paid and volunteers, made serving "The Sick Poor" in their own homes so much part of necessary social health care that philanthropy could no longer bear the cost. What began with one nurse, became a universal health-care service.
The District Nursing Association in Sydney in fulfilling the aims of its Evangelical and philanthropic origins, mirrored changes in social attitudes and expectations towards State responsibility for community health.
ii. ABBREVIATIONS
A.N.J. Australasian Nurses Journal
A.T.N.A. Australian Trained Nurses Association c.s.u. Christian Social Union
D.N.A. District Nursing Association
Q.V.J.D.N.A. Queen Victoria Jubilee District Nursing Association
R.A.C.H. Royal Alexandra Hospital for Children
R.P.A.H. Royal Prince Alfred Hospital s.c.E.G.G.S. Sydney Church of England Girls' Grammar School
iii CHAPTER ONE
SYDNEY'S RESPONSE TO EVANGELICALISM
1. On the 3rd September 1900 Nurse Amy Mann began her duties in Sydney as the first nurse for the newly formed District Nursing Association (D.N.A.) to minister to the Sick Poor in their own Homes. The concept began under the auspices of the Christian Social Union (C.S.U.), a movement born and fostered by the wave of Evangelicalism that had swept across England and was conveyed to the Australian colonies by Church of England clergy and those brought up in families embracing evangelical teachings. One aspect of this work will endorse Kathleen Heasman's statement that evangelicals can be "remembered for what they did rather than their theology"(!) and show that their influence on social reform outdistanced their original religious para meters. The influence of evangelical teachings helped to develop family structures whose active benevolence emphasised social work for families in need, and to be undertaken as a family.(2) The D.N.A. in Sydney became non-denominational but the strength of the evangelical social commitment carried them eventually beyond their ambitions as a voluntary group.
Sydney Anglicans first felt the influence of evangeli calism with Alfred Barry's appointment as Bishop of Sydney in 1884. He has been characterised as a scholarly leader with evangelical sympathies.(3) In 1890 he was succeeded by Wm. Saumarez Smith, a man who Cable referred to as showing the strength of the evangelicals and developing greater lay involvement in church matters. But, in 1899 Rev. W.R. Mounsey told a C.S.U. meeting in the Rectory Grounds of St. Johns, Glebe, that there was more to church work than attending Church meetings and early Communion, and distributing shirts to natives in the South Seas.
Where Cable found hesitancy and lack of cooperation and lack of social policy by Anglicans in their role of moral guides, a critical review of that work has argued that Sydney not only responded positively to the evangelical
2 • changes but became and remained strongly evangelical not only because of the determination and political organisa tion of its leading clergy but because of the significance of leading Anglicans who held high political office.(4) From this study, that signficance is extended to include the medical profession, female intelligentsia, and educa tionalists, and a leisured class of women, but also to note the drift from Church control as a specific course of social reform was pursued.
The new wave of gospel based Christianity was at its strongest within the Church of England, which represented the largest religious denomination in the colonies. The 1880s netted the largest increase of population through immigration for many decades, and the majority of those were Anglican, with actual church attendances recorded at 34% in 1886 rising to 45% of adherent adults by 1900. (5) At the turn of the century Bollen indicated that the suburbs of Sydney were strongholds of Protestantism, and with an Anglican denominational level of 43.5% in the City of Sydney, 48.8% in Alexandria(6), the potential for influence, and conversely the potential for working class poverty, was high.
Poverty, according to both Stannage and Fisher, has largely been a neglected theme in Australian historio graphy. A paradox of social and economic growth produced a "dispossessed" class the old, the sick, the disabled, nursing mothers and children. (8) Stannage wrote that by and large Australian history has been a history of progress, with historians reflecting the dominant values of Australian society. He categorised the "identifiable poor" - the aged, chronically ill, widows, and orphans and those in a "crisis poverty situation the injured, and the bereaved". To be poor in Sydney meant to be unable to afford fuel for either heating or cooking, to lack adequate clothing, shoes, food, and elementary education,
3 • and sometimes even basic shelter. With the deplorably bad working-class housing in Sydney, Stannage insists that much investigation is needed into slum landlordism in the 1890's and its social consequences. Charitable institutions of the day underestimated the extent of Sydney's poor, "the casualties of history", and their lives went unrecorded and undocumented.(9)
To some extent that has been redressed by Anne O'Brien's recent work. In recreating the way of life of Sydney's poor, she saw that the attitude that judged the sick and the poor as social misfits allowed their plight to continue.(10)
Massed urban living in Sydney from the 1880s had produced the effects of combined health and social problems that were beginning to alarm both political and community leaders. Sydney in the 1890s was a city suffering on many sides. The effect of the waterside strike, the economic recession, and what proved, by 1900, to be the longest drought then recorded, were taking their toll. With rural workers driven off the land to find work in the cities, existing unemployment among the unskilled worsened. The large pool of casual labour, the large number of women heading households with no male breadwinner, the women existing under conditions of sweating, women working at domestic or piece work for less than "living wage" rates, characterised the working-class areas of the inner city. All added to the problems of those already ageing districts.
The working-class areas, such as Lower George Street, The Rocks, and Waterloo, were described as crowded and squalid the result of bad drainage and a lack of basic sanitation. Slum clearances, coupled with demolition work involved in expanding the commercial sector, had been proceeding slowly since 1887, but districts that remained
4. were startlingly unwholesome. Sydney slums, according to Fisher, were even worse than those of London, and she laid as much blame on Sydney's economy as on the generally accepted factors of drink, landlords and careless, or as Mayne described them, powerless(ll), municipal councils.(12)
The Census data of 1911 revealed that, since the previous figures published in 1891, the percentage of tenanted to owner-occupied properties had risen considerably. Almost two-thirds of city housing was rented, with the most densely populated inner suburb areas of Chippendale/Surry Hills/Darlinghurst, Darlington/Balmain/Glebe to Redfern/ Newtown/Alexandria/Waterloo housing up to 56% of Sydney's total population. The closer to the city centre, the more densely it was developed. In 1901, tenanted housing in Paddington was 91% of the total, and in the Glebe and Redern areas it was estimated to be 77%.(13) This concentration of housing related to high land costs and high construction costs.
With a lack of restraining legislation, landlords effected cost savings in several ways. Houses were built adjoining three units on two blocks of land, or five units on three blocks, with common walls and common chimneys. It was not unusual when building on a main street to construct two rows of houses with the back row entered by a narrow lane that also housed a common privy, and was the dumping area for household refuse. Fisher cites an area in Clarence Street that consisisted of ten two-roomed, two-storeyed terraces on an allotment 34 ft. deep. Room size was reduced often to as small as 6 x 4 ft., windows were fixed letting in light but no flow of air, and when completed cellars built for storage were let as dwellings. Landlords ignored their responsibilities to correct faulty water connections, leaving properties without water supplies until authorities caught up with them. Municipal
5 • indifference to adequate drainage meant the localised filth and sewage flowed down streets and lanes. Without separately zoned areas, factory construction mixed with housing, was little better built, and was often hardly more than a backyard shed.(14) 5 • The recorded patterns of epidemic diseases typhoid and cholera and endemic diseases such as scarlet fever, diptheria, and gastrointestinal infections, together with a "catastrophic" death rate among children, especially those under five, combined to create community alarm.(15)
The children of the poor survived, or failed to survive, on what has been described as "nutritionally inadequate substitutes for breast milk"; farinacous, dehydrated or condensed milk, substituted for costly fresh milk, were the subject of medical reports and complaints in the medical gazettes.(16) Ignorance, poverty, and inadequate sanitation, coupled with a declining birthrate, added prominence to the deathrate among the children of the poor and the potential effect on natural population growth.
The sick poor of Sydney were the victims of inexperienced and unwilling efforts by successive colonial governments. In spite of the 1873 Royal Commission under Windeyer and the Reports issued condemning the prevailing hospital system, few changes were effected then. The increasing arrival of British trained doctors and nurses, and the return of doctors after study in Gt. Britain, bringing new new knowledge and techniques(17) ensured the inevitability of change. Between 1875 and 1900 hospitals gradually changed from institutions of charity for the poor to "public" hospitals. The consequence of the shift in responsibility and acceptance of the provision of services had a further effect on care for the sick poor. Bed usage doubled and put a further strain on existing facilities.(18)
6 • In 1882 Prince Alfred Hospital was opened and in 1894 the new Sydney Hospital was added, and historians draw attention to the improvement especially for women and babies. Dickey noted that there was a "deliberate aim of associating medical care with social and spiritual regeneration".(19)
The 1890's became a period of new direction for a combina tion of politics and church towards social reform.
The belief that the churches had been in alliance with Capital during the Great Strike of 1890, and the subse- quent depression, had forced a questioning of those principles guiding the church and this too led to an "anxious re-appraisal of social duty". The result was a new sensitivity to issues affecting the working class and the distressed poor. The new Labor movement, looking for working-class allegiance and support, was a further factor that led to a revision of the churches' social duty.(20)
Protestants imbued with the spirit of the new evangelical interpretation of the gospel as the means of achieving social justice looked to the church as guide and motiva tor, and to political power as the agent for action. Bollen stated "Protestant philanthropic agencies and campaigns for moral reform brought home the interdepen dence of material and spiritual welfare and promoted a realisation that both might be served by the powers of the State" and continued that "this process of adjustment coincided with a Protestant involvement in the politics of reform •••• "(21)
That combination of religious ideals and politics repre sents a factor of social change that resulted in the founding of the D.N.A. by a mix of clergy and church laity, and politicians.
7 • Since the time of Bishop Barker, the Church of England in Sydney had maintained a strong theme of Evangelicalism that spawned the development and growth of Christian Socialism. In February and March 1890 Alfred Barry delivered a series of six lectures to clergy at the Lambeth Conference.(22) He covered the socialising forces of the cooperation between the Law and Public Spirit, The Housing of the Poor, the Standard of Working-class Wages, the Position of Women, in the context of Christianity and Humanity discussed the socialising forces of Communi cation, Education and Moral Duty - with Christianity as a Spiritual Fire. He stressed the church's mission to mould the modern development of society by the inspiring and controlling influence of the Gospel. His successor as Bishop of Sydney, Wm. Saumarez Smith, may well have been a member of Barry's audience before taking up his position in Sydney. It is at this point of 1890 that Bollen points to the church's determination of their reappraisal of social duty.
In the Protestant Hall in Castlereagh Street, Sydney, the Rev. Philip Moses, who was said to have brought a Gospel of democracy to Sydney, spoke of Christian Socialism as a solution to the world's great social problems. He voiced criticism of the extremes of wealth and poverty, depressed wages for women, the lack of woman suffrage, and the anomalies of commercial interests engaged in sweating and philanthropists giving liberally to charities to alleviate the distresses of poverty.(23) While individual churchmen were exciting their listeners with opportunities for Christian service rather than direct attempts at social reform, in 1891 Bishop Saumarez Smith was urging that the occasional public protest against injustices should be the extent of church involvement. But by 1894 Smith addressed Sydney Synod exhorting clergy and laity "not to separate religion from any function of our common life ••• God's Philanthropy in Christ should be their guide". In the same
8. year, the Anglican Congress focussed on "The Church and Social Questions" and it was proposed that a branch of the Christian Social Union, founded in England some five years earlier, be established in Sydney.(24)
The hesitancy and ambivalence of the clergy can be seen to exist, but the determination and commitment of the laity beyond liturgical observance changed Sydney's response to growing social problems.
A motion was placed before Synod in 1897 that "This Synod sympathises with many of the efforts to ameliorate existing social conditions" and that "discussion should take place on the church's duty in regard to the social problems of the day". (25) Matters were left in abeyance pending the return to Sydney of Bishop Smith, then in England. On his return, he instigated a committee which comprised the Reverends w. I. Carr Smith of St. James in King Street, F.B. Boyce of st. Pauls in Redfern, W.G. Taylor of St. Philips of York Street, and H. Walker, and laity Messrs. J.T.S. McGowen, a Labour parliamentarian and Sunday School Supervisor for over 20 years, J. Barre Johnson and John See M.L.A., known to be sympathetic to the cause of women's suffrage and to the abolition of the abuses of sweated labour. A subsequent conference was held in the Chapter House on 24th October 1898. Before a large audience from all classes of society, papers were read on such social topics as "Living Wages and Hours of Labour", "The Drink Traffic and Social Conditions", and "Industrial Cooperation". Rev. Boyce delivered a paper on Old Age Pensions.
It was at this Conference that Archbishop Smith formally recommended the formation of the Christian Social Union in Sydney. While as yet the group would have no fixed program, Smith said it was to be the means of collecting information and preparing the way for a fellowship of
9. Capital, labor and ability, with Christianity at the base of its work.(26)
Interested people met two weeks later at the Y.M.C.A. Hall, and a further meeting was held another two weeks later at Quong Tart's Rooms in King Street.(27)
That meeting resulted in the election of Wm. Saumarez Smith as President, and an Executive Council comprising Archdeacon Langley, Reverends Boyce, Tovey, Carr Smith, Dr. Rundle, Robert Mounsey, and four lay churchmen and four lay churchwomen Mrs. Neville Griffiths, Mrs. Courtney Smith, Miss Flower, and Miss Carter.(28)
The executive resolved to send a deputation to the Chief Minister of the Government of New South Wales to urge the views of the C.S.U. concerning the Bill for Early Closing of Shops then before the House. The deputation comprised five clergy and laymen, and one woman - Mrs. G. Neville Griffiths, who was the President of The Womanhood Suffrage League of N.S.W. and friend of Miss Rose Scott.(29) The Minister explained the Bill which he indicated was to be passed in the current session, thanked the C.S.U. for their support and approval of the measure: "and the deputation withdrew".(30)
The C.S.U. through its representatives had established a "presence" and demonstrated their social concern.
10. CHAPTER TVO
THE CHRISTIAN SOCIAL UNION - GENESIS OF AN IDEA
11. Robert Mounsey had come from England at the invitation of the Rector, Rev. W.I. Carr Smith, to take the position of Curate at St. James Church. Innovative ideas of social reform were transmitted by English trained clergy, such as Robert Mounsey, Rev. E.S. Wilkinson of St. Thomas' Enfield, and Rev. S. Tovey of St. Johns Glebe Pt., who had all arrived in Sydney around 1896. As Secretary of the Sth. Staffordshire Branch of the C.S.U., Mounsey had become interested in social problems and conditions of industrial life. In Sydney he preached on the rediscovery of Christian social duty, and the C.S.U. gave the Church of England congregations their first opportunity for continuing study of the existing social problems in their own city, their first opportunity to mobilise support for social reform and reformulated the responsibilities of church membership.(!)
The first volume of the C.S.U. monthly journal f!.~.S.!.~~~' dated 1 June 1899, set out its governing principles:
I. To claim for Christian law the ultimate right to rule social practices. II. To study in common how to apply the moral truths and principles of Christianity to the social and economic difficulties of the present time. III. To present Christ in practical life as the living master and King, the enemy of wrong and selfish ness, the power of righteousness and love.
Mounsey said that the great work for the C.S.U. for the present was to be investigation of faith and of the causes and effects of industrial and social difficulties. Investigation and discussion alone were however not enough and must lead to formation of character, the improvement of environment, and the amelioration of suffering. Prayer, meetings, lectures and sermons would be designed to stir the consciences of churchmen and women.(2)
1 2 • Bollen stated that C.S.U. "membership was never large nor its influence extensive"(3) but, though short lived, "something of its spirit was absorbed by Australian Anglicanism".(4) He was partly right, but the influence of the C.S.U. as a group was far greater than realised in fact, in spite of itself. As spokesman, Mounsey had said the C.S.U. had no program and would avoid putting forward "anything cut and dried". He may have been speaking from his own clergy-base, but non-clergy consciences were moved beyond just investigation, and beyond the limitations of clergy direction. Something Bollen failed to note was the involvement of women as members and as contributors to p a p e r s r ea d an d a r t i c 1 e s p u b 1 i s h e d i n f.!.£.&!.~~~ , and t ha t the initial move to establish district nursing was made by a woman. Bollen prefaced his work with his contention that Evangelicalism came to terms with the new social ideals, with the Protestant churches supporting reform, and that what many preached some worked for "often adventurously and to good effect".(5) He determined that there were groups and institutions which, working through their ideals, affected the climate of public opinion and influenced the colony's actions towards understanding and overcoming its problems.(6)
The District Nursing Association is the epitome of that statement. The D.N.A. in Sydney, which 35 years later Lady Game was to call the "Cinderella of Good Causes" was the outcome of social change resulting from the Evangelical redirection of clergy and laity originating from the Church of England. Importantly, it was a social innovation in Sydney that grew, survived, and became indispensable, at the community level on the talents of women.
During its very brief period of publication, f.!.£.&!.~~~ printed a wide variety of articles on current social topics. Reinforcement of the call to social duty was not lacking. In the issue of February 1899 an article by Miss
13. E.A. Badham dealt with a comparison of c.s.u. and Socialist Ideals.
The point of agreement between Socialists and the c.s.u. was the disproportion in wealth, wealth produced from sweating and its inevitability in a Capital society, and their innappropriate acceptance in a society calling itself Christian. Socialists she saw as comprised of two extremes the one consisting of distinguished people advocating the reconstruction of society on a slow and gradual basis. The other was the element addressing crowds in parks or halls with inflammatory messages delivered by paid agitators or "the natural but unreasoned outpourings of those suffering intolerable wrong". Neither of these elements had a program of action; and she agreed that neither did the C.S.U. put forward a theory of government or solutions to social issues. In spite of its apparent vagueness she asserted that the difference with the C.S.U. was not in sermons and formal churchgoing but in individual example of the Law of Christ, to train its own members, and through them society at large. Members of the C.S.U. were not required to believe in a necessary levelling of society, but that wealth and leisure offered "opportunities of usefulness". Theories and cut-and-dry schemes regulated and inhibited. Miss Badham's answer was with the individual, with the Gospel as guide -
"To whom much is given, of him much is required." (7)
Unconsciously, the way was being prepared for the specific outcome of the C.S.U. in Sydney: an association with the life and vitality of many, the force of single wills moving towards help in social distress.
That February issue carried the first of a two part article on The Economic Independence of Women. The editorial of the issue of the 28 July 1899, No. 7, was
14. entitled "The Sphere of Women" and maintained that the central point for a woman was her home but whether in public life or private, the character of a true woman's nature was "gentleness of spirit", with suitable types of employment as women's work being horticulture, agricul ture, dairy and cheese forming - all obviously allied to nature and hence one presumes suitable for the nurturing care of a woman. But, more importantly, it was written by a woman, unnamed in the manner of an editorial.
"The sphere of women's influence, and then as to the public life of women: we must come to our public duties whenever we may be permitted to fulfil them ••• determined to fulfil them excellently well" ••• "public spirit in one shape (is) called patriotism and in another philanthropy. And so we find that women are bringing their influence to bear in the fields of philanthropy, education, medicine, in nursing the sick, manual labour, and among the workers in factories and shops. We may read in the Annual Reports of the Conferences of the National Union of Women Workers in England how women are increasingly spreading their labours over these wide areas of work. And there are those who cannot help actively, who are at least interested in them ••• and so help to reform that strong body of public opinion which gives strength to those who are working and without which their efforts are unavailing."(8)
The women members and speakers of the C. S. U. and the articles published illustrate a paradox that can be seen running through the levels of Sydney society. Miss Edith Badham was a highly educated, independent woman. After arriving in Sydney from her education in Europe, she maintained rooms in the city and taught English literature, Latin, Greek and Church History. The daughter of the first Professor of Classics at Sydney University,
1 5 • she was active in women's causes, women's sport, and was a member of the Women's Literature Society. She was selected by Archbishop Smith as a member of the committee, to set up a Church High School for girls. The school became the Sydney Church of England Girls Grammar School, later known simply as S.C.E.G.G.S., with Miss Edith Badham as the first Lady Principal. (9) Both the School committee and membership of the C.S.U. were made up equally of men and women.
Though of independent nature, Miss Badham maintained the primacy of teaching within a framework of femininity. The article on the Economic Independence of Women counter balances the sentiments of the female sphere. Another member of the C.S.U. was Miss McGahey, the second Matron of the Prince Alfred Hospital, was a career nurse in a position of management, with a degree of power, and considerable influence. Her teaching principles were devotion to duty and medical service, well laced with housekeeping skills, for women who were to be trained to observe, interpret and transmit essential, often life saving data. The women all had to maintain an internalised bipartite value system: retain femininity in accordance with social ethos, and reach out towards the early interpretation of feminism, independence and autonomy.
Nurses and nursing services began to be a major topic of discussion among those attending C.S.U. meetings. In Issue No. 4 a letter appeared (see page 17) signed with the cognomen "MAC". As Miss M.A. Carter was the Hon. Secretary, and in light of subsequent developments, it would not seem too unrealistic to assume that it was from Miss Carter.
The next edition carried a reply from Miss Kendal Davies, Matron of the Nurses Home at 140 Philip Street. It is interesting to note that Kendal Davies assumed "MAC" was male. (See page 18) 16. 7G PHOGRESS. May 81, 1899. ·------~------~ ---- ' who feel the urgency of the need and are interested eorrespondenee. in the scheme to help it by promises of sub scriptioLlS and suggestions. The ''Jubilee " and district nurses are doing [The EditorA decline all responsibility for letter, appearing a great work throughout the United Kingdom, in this column. Al' letters mmt be accompanied by and also in America ; and we in Sydney ·would be names anti addre8so• of the se!lders, a• a guarantee of glad to emulate them, and provide our sick poor good faith, but not necessarily for publication.] with loving help and sympathy in their great need. The objects of our Union make it very plain that it is CHRIST in practical life, whom we, by To THE EDr-roRs oF PROGRESS. imitation and reflection, are to present as the only Power which can touch the hearts of our people, Srns,-There is a great need in Sydney for and bring about true social reform. nurses who will tend the sick poor in their own This, then, surely is one way in which we may homes. practically introduce this Power into the homes of There are already a few women devoted to , our suffering brothers and sisters, and by loving this work. The Philip-street Home supplies one tact, and contact, sbow that we are the " enemies nurse; there are two working in one of the of wrong and selfishness."-Yours, etc., suburbs, and doubtless others scattered about the MAC city of whom we do not know. But the s~pply is wholly unequal to the demand, and the numbers might with advantage be multiplied by 100. -THE- Many of the clergy, doctors, and those who visit the sick in poor districts would be thankful to have the services of efficient nurses for the CHRISTIAN SOCIAL UNION. many cases they meet needing daily care and attention, and to know of some central place to PRESIDENT- which they could apply for their help. HIS GR!CE THE ARCHBISHOP OF SYDNEY. I therefore propose that the C.S.U. should VICE•PRESIDENTB: take up this work, and endonvor by all the means in its power to forward some such scheme as THE BISHOP OF NEWCASTLE. the following:- Dn. G. E. RUNDLE. REv. W. R. MOUN8EY. A Central Home for Nurses in Sydney, from tJfoN S&c.: which they could be sent to surrounding districts Holl. TnEAS: Mn. COURTNEY 8MITH. to tend chronic cases, and those unsuitable for HIS Union consists of Members of the Church uf hospital treatment. T England who have the following objects at heart:- The nurses to be paid a fixed salary, exclusive 1. To chim for the Christian Law the ultimate of board and lodging. All such workers should authority to rule social practice. not only be skilled nurses, but that they should 2. To study in c-0mmon bow to apply the moral truths have some practical knowledge of district work, and principles of Cbristia?ity to the Social and economic and be endowed with a true missionary spirit and difficulties of the present time. lovt'J for humanity to carry them through the 3. To present Christ in practical life as the living difficulties of such a life. Master and King, the Enemy of wrong and selfishnes;, the It is also hopt>d that such a Home would form Power of righteousness and love. the nucleus of a \\'oman's Settlement, from which Member:l are expected to pray for the well-being of in time other work could be carried on-e.g., pro the Union at Holy Communion, more particularly on or viding a shelter for factory girls and others, who about the following days:- work at some distance from their own homes, and The F'ea.st of the Epiph1ny. are unemployed sometimes for two or three hours The Feast of the Ascension. in the ruiddle of the day, they need some place The FeR.St of St. Michael and All Angels. which shall give them rest, refreshment, and Any Chri8t.ian may become an .Ai!sooiate-member on amusement. payment of subscription. We appeal, then, to the members of theC.S.U. Minimum subscription, 2s. 6l. per annum, and readers of :PROGRESS to turn this vision of All enquiries to be addressed : what might be, into o. present reality. It is proposed to start a '' ProgreBBive N u.rsing THE HON. SEC., C.SX., Fund" (the name is suggestive), and we ask all 221 Macquarie Street, Sydney-
1 7 • " DISTRICT NURSING To the Editors of Progress
Sirs,
The letter on the above subject signed "MAC" which appeared in your last issue is open to reply in several ways. It is quite apparent that your correspondent's knowledge of the requirements in the direction indicated, and especially of the work actually being done, might be improved. Does he not admit (after specifying several district nurses) that there are "doubtless others scattered about the city of whom we do not know?". In view of this admission it would be interesting to learn "MAC's" authority for the statement that the supply is wholly unequal to the demand and the numbers might with advantage be multiplied by 100.
A little experience will sometimes do wonders in modifying one's opinions and it may be therefore surprise your correspondent to hear that the one District Nurse attached to the Philip-street Nurses Home could attend to far more cases than are brought under her notice, and this notwithstanding that intimations have been sent to many doctors, clergymen and others that such a nurse is available. Further, it should not be forgotten that some years ago there were three District Nurses attached to the above institution, but it was difficult to find sufficient for them ••••••••••• [n.b. corner of page is missing] ••••••• (an important item) funds were not always available to keep them going.
"MAC" is to be commended for his desire to see an important branch of Christian fellowship effectively carried out, but with all respect let me point out that there is a danger of over-organisation. This was made clear in the recent Report of the Commissioners who inquired into the administration of the various public charitable institutions. The philanthropic spirit is at the present time so active that care needs to be exercised before organisations with a tendency to unweildiness are exploited. Funds may be used less effectively than they need be, and useful energy may be wasted. Let us rather conserve our energy.
Much can be written on this subject but I fear to trespass on your space. My final word therefore is: Use the means at your disposal and if necessary augment such means before suggesting a multiplication of organisations.
Yours, etc. M. Kendal Davies, Matron, Nurses Horne, Philip-street. II
1 8 • In voicing her opposition, Kendal Davies may have been expressing a widely held fear then of yet another charity.
Between 1873 and 1890 five separate enquiries had been established in New South Wales and Victoria to examine the operation of voluntary welfare groups. Problems brought to light had been those of incompetent management, sub-standard care, lack of accountability of funds, waste, and duplication. As a result of the 1897 Royal Commission in N.S.W. on public charities, government aid was suspended to 14 charitable institutions. With bad publicity and a poor image, voluntary charities suffered considerable embarrassment.(10) All of that could have weighed heavily against another philanthropic effort on behalf of the poor.
But there were other factors that Miss Kendal Davies could not account for. The doctor members of the C.S.U. were as well as medical professionals, health-care specialists. They were men with management skills, in private practice, as well as being Hospital Board members, members of Company Boards, and both Drs. Graham and Wilkinson were M.P.s. They worked and taught extensively at the Prince Alfred Hospital and would have been aware of the calibre of nurses being trained there, and thus a talent bank to be tapped for a nursing service. If, as Kendal Davies stated, her nurses were under-used, the answer may have lain with the skill and competence available; and the vital spark of evangelical zeal may have been missing.
The debate and the ideas continued.
I n I s s u e N o . 7 o f f.!.£.&!.~!! , d a t e d 3 1 A u g u s t 1 8 9 9 , i t w a s reported that Dr. James Graham had indicated that a movement should be started for the formation of a Association or Union where medical and surgical nurses could be brought together for the interchange of views and
1 9 • experience. In recognition of the spirit of devotion and self-sacrifice of nurses, he proposed there should be a form of Sick Pay and Pension Fund. James Graham was suggesting reforms to an area of women's work known for its hardships, discipline, and poor rate of pay. At that time, Graham was a lecturer to nurses at the Prince Alfred Hospital, lectured at Sydney University, and as well as being the State member for Belmore, he was a city Alderman. He was an all-round committed medico and a responsibly citizen.
An editorial in September 1899 contained all the basic elements of the move towards action rather than discussion. The plan laid out almost exactly that which was to eventuate (see page 21).
Two months later there was a letter in the Correspondence columns, headed "District Nurses":
"Sirs, I seem to gather from conversations with fellow members ••• that Miss Carter's scheme is not one that can be rightly undertaken by the C. S. U. it is outside our province ••• we must give ourselves to study and investigation •••• This scheme will provide a very excellent means through which we may combine useful investigation and practical work. The scheme is not an ambitious one. The C.S.U. ought to give it hearty support. I hope that at the next meeting a really practical beginning will be made with it.
'LUGU' II ( 1 2 )
Those involved were aware of the needs of the community, and the direction of discussions was leading to a decision to act. Issue No. 10 of 23 December 1899 quietly carried the news of the most important decision the C.S.U. would make.(13) It reported that, at the meeting held in St.
20. 182 PROGRESS. September 29, 18B~. ------scheme is proposed by the C.S.U. to ensure the carrying out of their good intentions, and how the money will be used. In the first place, as nothing in this world, from the distribution of Id. buns to the choice of a Federal capita.I, can possibly be managed with out a committee, such a body will be nominated by the members, and would consist of one or more of the clergy, doctors, and lay members who have some pra!!tical knowledge of such work. Progress £s Secondly, it will he the duty of that committee to The Zall· of Lifi•• secure the serviees of· one who is not only a Man is not man as yet. skilled nurse, but who has the very necessary -BROWNING. qualities of love for her work, love of humanity, and who is cheerfully content to be the SYDNEY, SEPTEMBER 29, 1899. "Cinderella" of the poor. Thirdly, to place such a person in some central place where she will be within reach of those parishes most need Nurses. ing her services. The money will be spent in District nurses' salaries, their board and lodging, surgical The Christian Social Union undoubtedly and medical requirements, and occasionally suit exis~ among other. things for the purpose of able food for the patients. holdmg out a helpmg hand to all in trouble, It may be asked, and indeed has been asked, poverty, sickMss, whether of mind or body-to why not incrense the staff of an already existing comfort the weary and the sad by the bright organization for such work, rather than start a optimism of its faith, as well as to "stre1cgthen new one? The answer is (I) that by the Matron's such as do stand" by its principle of universal own acknowlodgment in her letter in PROGRESS of brotherhood under the one Almighty Father. June 30 their work does not seem to be quite And all this in the name of the Christian's Master attaining the object in view, and (2) the C.t:l.U. and King, because it is the enemv of wrong and would be glad of some centre-some rest for the selfishness, the power of righteousness and love. sole of their feet, so to speak-from which in time It tries to go to the root of all social reform by other br!lnches of work might be carried on. acknowledging as its guide that law which in all ,It is thought, too, that members might often its points "makes for righteousness," and which be able to spend a few days with the nurse, followed out in its integrity must change the taking interest in special cases, and helping in character of the individual and consequently of various,ways to raise those with whom they come the whole community. into touch Loth socially and morally. Care at It seems-at least from the point of view of anyrate would be taken that the spheres of work a looker-on who proverbially has the clearest of any two such organizations should not overlap, vision-that the C.S.U. during the past year has and there is ample scope in Sydney and the worked bravely for the objects it has at heart suburbs for a large force of such workers as this and in many practical ways has endeavored t~ Union hopes to obtain. help "_the oppresse~, 11 e.g., urging improved It can be seen that such a scheme has possi legislahon on the subJect of early closing of shops bilities of good, and the appeal is made to all and fair conditions iu all Church printing matters'. those who read this paper to turn them into a I~ i~ now seeking to extend its usefulness by pro- reality by their generous support. Promises of vidmg nurses to tend the sick poor in their owu annual 11ubscriptions to the Christian Social Union homes, and thus come into more personal contact Nursing Fund will be gladly rec11ived by the Hon. with some of the social miseries of this city and Secretary of C.S.U., or Miss M. A. Cart11r, 28i endeavor to relieve them. Canterbury-road, Petersharu (member of Execu- To start this work a yearly income of from tive Council, C.S. U. ). £80 to £100 is needed. Doubtless this could I easily be given and no~ missed by many wealthy -=-======-= members_ of the "umve~sal brotherhood," and Single copies of PROGRESS can be obtained perhaps if we plead sufficiently the urgency of the from the Book Dep6t, 17G Pitt-street; the N.S.W. nee~, s:ii,ch a fund may be forthcoming b_efore ~he Bookstall Company; or from any reputable news begmnmg of a_ new century. ~ut these mtendmg : agent. If. you have any difficulty in getting a benefactors will naturally wish to know what i copy, write to the Publisher.
21. James Hall on 25 November 1899, with Archbishop Smith presiding, Miss Carter outlined her proposal for a district nursing scheme for Sydney. The doctors spoke in support of the motion and stressed that the need for such work was very urgent. A Resolution was passed and a Committee convened to formulate a definite scheme. Its members were Dr. Rundle, Drs. Camac Wilkinson, Maynard Pain, Rev. Robert Mounsey, and Mrs. Graham (wife of Dr. J. Graham, and herself a former nurse), Miss S.B. Mc Ga hey, Miss Badham, Miss Carter, and a S. JA'.'111:< ULD H ..\LI •. Miss Agnes Dove of Ashfield.
The scheme was launched under the auspices of the C.S.U., but the C.S.U. specifically indicated that it was in no way pledged to any financial support of the scheme. The positive move had come from the lay members of a group that had nominally denied a commitment to action.
In January 1900 fE£~E~~~ reported that the nursing service should be in practical operation by the end of the year and that patient, perservering effort would achieve the many things that could be done to assist the aged and the poor. The final edition of Progress carried an article on Christianity and Sanitation, and an article on The Education of Women by Lady Mary Lygon who was to become the first Patroness of the District Nursing Association. She stressed the importance of the vote for women to realise their responsibilities. It would help them to use their place in society as a power for good in the world. Women needed to keep pace with the great improvements going on. Again there is that bipartite image of women incorporating the prevailing cultural femininity with feminist drive and goals. 2 2. The D.N.A. was the "fruit of the Spirit" generated within the C.S.U. 's membership. The technical and practical, personal services were to be the domain of trained nurses supported by a network of women who mobilised themselves to raise funds to support the service. For 35 years the service grew almost entirely on money given and money raised by the personal efforts of women, women from families who promoted church-based education, who had strong parish ties, women whose class committed them to upholding the dominant faith, and which gave them the time to undertake roles of philanthropy in the community.
23. CHAPTER THREE
DISTRICT NURSING AND THE NIGHTINGALE INFLUENCE
24. Some of the social reforms taking place in the late nineteenth century related to women. Nursing had undergone dramatic reform because of Florence Nightingale. Now nursing services with ancillary support began to change the lives of the women as well as social welfare care in Sydney. A network of women grew up through philanthropic endeavours and through professional service reached out to "ameliorate suffering": practical work, on both levels.
The new era in nursing owes a tribute to the three months that Florence Nightingale spent at Pastor Theodore Fliedner's Protestant Institute of Deaconesses at Kaiser- werth in Germany, in 1851. Though she received no nursing instruction and was highly critical of the standards of hygiene, she was impressed by the "high tone" and "pure devotion" exhibited by the staff of deaconesses.(1)
The spirit of dedicated service is the most lasting memorial of Kaiserwerth to nursing, and combined with Florence Nightingale's social and medical reforms produced a nursing service that had the qualities to meet the ideals of philanthropists.
Herself the daughter of an Evangelical Minister, Florence Nightingale nevertheless maintained that there should be a separation of the care of the soul from the care of the body. Her influence surfaced at the point in history when social change began to take place in attitudes to medical care, when curative and rehabilative medicine began to take shape.(2) Whilst the starting point was the religious principles of humane care, Nightingale principles of nursing were imposed on medical help and personal example. without intrusion into beliefs or moral standards. Health and living standards were their province.
Under the Nightingale system a better class of woman was sought as nurse trainees. A high standard of personal
2 5. discipline and moral tone were paramount qualities. To be able to read medical books and take notes imposed a further limit on those girls and women eligible for entry to the Nightingale training school at St. Thomas' Hospital in London. (3) The insistence on moral protection for the women ensured a respectability and social status that nursing had not previously known. Abel-Smith refers to Florence Nightingale's Lady Pupils as her missionaries in the nursing reform movement.(4)
The union of District Nursing and Philanthropy began in Liverpool, England. Wealthy philanthropist and businessman William Rathbone already had first-hand knowledge of conditions in the Brownlow Hill Workhouse in Liverpool. Son of Wm. Rathbone (1787-1868), philanthropist and Mayor of Liverpool, the Rathbones were members of the Unitarian congregation and were considered to be men of influence. The mix of philanthropy and Gospel-inspired social conscience brought about the formation of the first of the Mission Churches established by a Protestant congregation in Liverpool.(5)
During the long and final illness of his wife in 1859, Mr. Rathbone engaged Mrs. Mary Robinson as a live-in nurse. His appreciation of the kindness and comfort that Mrs. Robinson brought to his dying wife so touched him that he turned his thoughts to those in similar situations, who were too poor to be able to afford even the most basic nursing care. He requested Mrs. Robinson to act on his behalf to give nursing help to the sick poor. He provided her with medical necessities and food supplies and bound her with the responsibility to help the families raise their standard of living.
After only one month of the experimental term of three months, Mrs. Robinson asked to be relieved of her duties in despair at the privations she had observed. She con-
26. tinued with Mr. Rathbone's encouragement and support.(6)
Convinced of the value and the need for his system of District Nursing, the savings in cost and the emotional benefits of being nursed amongst their own families, in 1862 Wm. Rathbone consulted Florence Nightingale on his ideas about the need for the development of District Nursing among the poor. The outcome was a training school for nurses established at the Liverpool Royal Infirmary. Wm. Rathbone built a home there for the nurses, presented it to the hospital. A program to train nurses for the hospital itself and to provide nurses for private and District Nursing was begun. The pilot nursing scheme at Liverpool was described as a spectacular success.(7)
Rathbone's beliefs and suggestions, his insistence on tact and kindness were embodied in his book, "Social Organisation of Effort in Works of Benevolence and Public Charity by a Man of Business".(8) From the beginning, commerce was to be a major means of support for social reform.
Social change and Philanthropy determined a practical way of direct help to those economically unable to provide for themselves in sickness, and extended the opportunities for women to enter paid employment, gaining for themselves social and professional status, and economic independence.
Sydney first experienced the influence of Nightingale nursing reform through the medium of Henry Parkes. Alfred (later Sir Alfred) Roberts visited the Florence Nightingale Training School during a visit to London in 1860 and again in 1873 to discuss plans for a modern hospital and nursing school in Sydney. But the first positive step was taken by Henry Parkes as Colonial Secretary in 1866. He wrote to Florence Nightingale asking her to select four nurses to be sent to Sydney.
2 7. "Ma darn, The Government of this Colony is desirous of engaging the services of four ladies who have received an efficient training as nurses in some well-managed English Hospital. These trained nurses are required for the Sydney Infirmary where proper apartments will be provided for them by the time of their arrival in the Colony, but it is desired that in the performance of their duties in this Institution they shall become the hospital instructors of such other female attendants as may from time to time be placed under their superintendence. In other words it is hoped that a nursery for hospital attendants will be thus established from which similar charitable institutions in the country districts may be supplied. As the minister under whom such public charities are placed I do myself the honour of applying to you to ask your benevolent assistance in the selection of these nurses."(1)
To lead that group of pioneer women, Miss Nightingale's choice was Lucy Osburn, the daughter of a distinguished scholar and strong Evangelical Christian.(2) She had begun her career as a paying trainee, or "special probationer", at the Nightingale Training School. With her sound Church principles, and an excellent moral education, Florence Nightingale considered her eminently suitable for the position of Lady Superintendent. Her instructions stipulated that Lucy Osburn was to be recognised as "Superintendent and Chief Female Officer of the Hospital". Five nurses were chosen to accompany her arriving in Sydney in March 1868.(3)
In spite of the opposition, conflict, prejudice and lack of cooperation that she initially encountered, following the 1873 Commission Report Henry Parkes reported to Florence Nightingale that Lucy Osborn's achievements had
28. been a complete success. Altogether, she remained in Sydney for 18 years. After her return to London she was one of the earliest nurses to join the Queen's Institute' of District Nursing formed in 1887, and continued working until 1891 as a Superintendent.(4)
Following the 1873 Commission Report, Lucy Osburn wrote to Florence Nightingale that she then had 18 qualified nurses and a further six probationers. The Resident Medical Officers trusted her nurses, she wrote, with a great deal of responsibility and they displayed that sense of devotion and discipline that Florence Nightingale defined as so important.
"· •• the house doctors have only to give orders. We set the fractures and put on extensions. They never touch a starch bandage or put in sutures or anything of that kind."(5)
The nurses were building confidence in their skill and expertise. Praise of the nursing reform that had taken place was the notable exception to the condemnation of the prevailing hospital system revealed in the Windeyer 1873 Report. The sick poor of Sydney were the victims of inexperienced and unwilling efforts by successive colonial governments, and despite the 1873 Report few changes were effected. Change, however, was inevitable as doctors arrived from Gt. Britain, or returned after study there, bringing new knowledge and techniques; coupled with this, there were more British trained nurses arriving in the colony.
The new Prince Alfred Hospital opened in 1882 also had the "Nightingale Connection". The first Matron appointed was Miss E.L. Murray and it was reported in 1884 that the calibre of women applying for nurse training was vastly upgraded. By 1886 a parchment Certificate of Competency
29. was being issued after examination, and the curriculum included invalid cooking. The issue of a certificate was a departure from the principles of Florence Nightingale who was steadfastly opposed to granting certificates.(6) In Sydney it represents an advance in the recognition of nursing professionalism that reflected the local climate of social progress. Even more stringent selection of applicants followed, laying emphasis on character, education and disposition. By 1889 the course had been extended to three years. ( 7) Dr. James Graham lectured in Obstetrics and Midwifery at both the Prince Alfred Hospital and at Sydney University. Surgeon Dr. Percy Charles Clubbe, son of the Rev. Charles Clubbe of Buckinghamshire, also lectured to nurses and medical students and was Hon. Surgeon from 1884 to 1918 at the Royal Alexandra Hospital for Children where a number of the District Nurses received their training.
Miss Murray was followed in 1891 by Miss S.B. McGahey, from London, and under her offices nurse training entered an era of still greater proficiency and expansion.(8)
30. CHAPTER FOUR
BEGINNING AT 1900 - WITH ONE NURSE
31. With the combination of the inspiration of evangelicalism and medical personnel pointing to the area where help could have its most practical application, church members took up the challenge and Sydney's philanthropy addressed itself to a problem particular to the city.
The resolution passed at the C.S.U. meeting in December 1899 called for the setting up of a Committee of Management to arrange to commence work as soon as possible. On 22 November 1900 the First Report of Work was published and it advised that in the months following the resolution a Constitution and Rules had been put together and collections begun. The Patroness, Lady Mary Lygon, sister of the Governor, the Earl of Beauchamp, had held an At Horne at Government House on 1 September 1900 to celebrate the inauguration of the "Church of England District Nursing Association". As constituted the D.N.A. did not seek political reform, but aimed at direct, practical day-to-day help. They particularly did not impose judgrnents on lifestyle or seek to impose religious beliefs or observances on those they visited. Their stated reasons for entering the field of work was that it was the Church's social duty to help the Sick Poor, to gain knowledge of life among the poor, and to represent Christ in practical life what today is called "reaching out". They took as their motto "Christo in Pauperibus" and undertook to supply a trained nurse free of charge to the Sick Poor in their own Hornes.
In spite of the difficulty caused by pressure on the benevolent for funds for charities such as the Patriotic Fund, and the Army Medical Mission, the Report said that by August their funds amounted to /:,75 and permitted the appointment of one nurse. Nr. Amy Mann was selected from 19 applicants.
Amy Mann was then possibly in her early twenties as she
3 2. had only completed her three-year training at R.A.H.C. in March 1900. She spent the following months private nursing u n t i 1 h e r s e 1 e c t i o n f o r t h e D • N • A • Th e i s s u e o f f !.£.8.!.~!! of 29 July 1899 had specified that the person required as the district nurse should be
"one who is not only a skilled nurse but who has the very necessary quality of love and who is cheerfully content to be the Cinderella of the poor."(!)
"MAC" had also included "the true missionary spirit ••• to carry them through the difficulties of such a life". Nr. Mann was the first of those women and in a little over two months, she had attended 23 cases and made 437 visits in the first areas where the work was undertaken Redfern and Alexandria; and the Archbishop was quoted as saying the cases tended were those "which could in no other way be relieved than by these daily home visits of a skilled nurse". Doctors promised plenty of work and applauded the benefits that the nurse was producing. Expenses other than salary soon became obvious. There were now the costs of drugs, dressings, medical comforts and invalid food. Flannel, linen, and magazines were much needed. Grateful thanks were expressed towards the Drug Companies, Elliott Bros. and Burroughs Wellcome & Co. for supplying dressings, tablets, disinfectant and similar items, as well as medicinal port, and to chemists - one, A.E. Durno, for dispensary services and for the hire of a wheel chair.
Mrs. Boyce, wife of Rev. Boyce, was appointed as District Representative to service the applications for the nurse's visits and so to relieve her of routine paperwork.
At this point while it was possible to support only one nurse, it is interesting to note the size and structure that was set up.
33. Patroness President Vice Presidents - 4 Executive Committee - minimum 8 (Chairman, always to be a Doctor) General Committee - minimum 26
That first group of office bearers was made up of Lady Mary Lygon, who as well being Patroness of the D.N.A. was also Patroness of the A.T.N.A., Lady Darley as President, and the four women Vice Presidents: Lady Lyne wife of the Premier, Lady Harris, Mrs. Gould wife of The Hon. Albright J. Gould M.L.C., and Miss Snowden-Smith sister of the Archbishop. The General Committee comprised 7 clergy including Archdeacon Langley, Rev. F.B. Boyce and Robert Mounsey, and 4 male doctors one of whom was Dr. Steer Bowker M.L.C., plus Drs. Mary Booth and Agnes Bennett. The Committee was completed with Justice Stephen of the Supreme Court, and the Hon. Mr. W.R. Campbell, and then a 11 women (8 married and 3 single women). Of those 26 members, the male and female components were equal.
The first Hon.Treasurer of the D.N.A. was Dr. G.E. Rundle, and the Hon.Secretary was Miss M.A. Carter, whose address was given then as 287 Old Canterbury Road, Petersham.
The Executive Committee, again equally made up of men and women, consisted of Drs. Clubbe (Chairman), a Councillor of the A.T.N.A., and Blackburn, an A.M.A. Councillor and Hon. Pathologist at R.A.H.C., and Drs. Camac Wilkinson and Cyril Corlette.
Corlette had been a Resident Medical Officer at Sydney Hospital, and was a lecturer on Food and Diet, particularly in the care of invalids. In his private life, he was a Sidesman and a member of the Men's League at St. James Church.(2)
34. The women of the Executive Committee were Miss E.A. Badham, Mrs. Boyce, Mrs. Sinclair Gillies, wife of Dr. Sinclair Gillies of Macquarie Street and Committee member of the A.T.N.A., and Lady Graham.
Fanny (Frances) Graham was the daughter of Rev. H.S. Millard who came from England in the 1860s to be headmaster of Newcastle Grammar School, and the sister of Dr. R.J. Millard who served the D.N.A. as Hon.Treasurer from 1933 to 1944. She did her nurse training at Prince Alfred Hospital and became a Ward Sister, marrying James Graham, then the Medical Superintendent of R.P.A.H., in 1889.(3) Lady Graham, along with Mrs. Neville Griffiths and Mrs. Deas Thomson, was a member of the Ladies Commit tee of St. James Church, and in the St. James' church records both she and Miss Badham were listed as Ward Visitors at Sydney Hospital.(4)
Dr. Graham himself did not take an active role in the D.N.A., but the Nurses' log books show him among the referring doctors. Considering his other community roles his formal absence is not to be wondered at. James Graham came from Edinburgh, did extensive further training in Europe, and after his marriage to Fanny Millard practiced from their home in Liverpool Street. He is named as the Founder of the Women's Hospital in Crown Street, was a Councillor of the A.T.N.A., served two terms in the State Parliament of N.S.W., and received his knighthood in 1901 when Mayor of Sydney during the visit of the Duke, the future King George V. In 1900, at the time of the beginnings of the D.N.A., he was President of the City's Vigilance Committee during the plague scare.
Stuart, the only son of Fanny and James Graham, while still a medical student, was also organist and choirmaster at St. James Church. After graduation he served during War World I in France, where he died of wounds.(5)
3 5. The Millards and Grahams exemplify the long association of Church and community service, and their interlinking between community and family networks.
Among the women of the General Committee were Miss McGahey, also serving as Hon.Secretary of the A.T.N.A., and Mrs. John See, wife John See, then M.L.A. for Grafton. In 1900 he was a director on the Board of Sydney Hospital, a director of W.H. Soul Pattinson, and in 1901 became Col. Secretary and Premier, and was knighted. His wife would be a woman of position and community standing on the first General Committee. Others on that first committee were Mrs. Neville Griffiths, Mrs. Moseley, Mrs. C.B. Docker, and Miss Mary Iceley whose family was closely related to Lawson of the Blaxland, Lawson & Wentworth team, and who also counted a country doctor among their number.
The women Committee members of the D.N.A. represented a variety of interest groups. Women like Lady Graham and Mrs. A.J. Gould, and Mrs. John See had leisure, status, and the financial support of their husbands. Lady Mary Lygon and Miss Badham represented the female intelligentsia, women of independence and education. Together they represented all the changes taking place in society for women and also the stand some of those women were taking against prejudice, repression and inequality.
Of the women doctors on the executive, Mary Booth was a graduate of the College of Medicine for Women, Edinburgh, and returned to Sydney in 1900. She held strong feminist views and was a founder of a women's club in 1901, and was also a Vice President of the National Council of Women. In 1904 she became a lecturer in hygiene for the Dept. of Public Instruction.(6)
Agnes Bennett, a Science graduate from Sydney University in 1894, had taken her medical degree in Edinburgh and
3 6. returned to Sydney, and briefly to private practice, in 1900. Prejudice from male doctors forced her to give up her practice and she took a position as Junior Medical Officer at Callan Park. According to biographers, Agnes Bennett was a constant defender of women's right to higher education.(7) It speaks volumes for double standards that it was possible for doctors to force Agnes Bennett out of private practice and yet promote and praise the work of the skilled nurse.
Church, medical and women's groups became part of an interconnecting network of influence. But it was the voluntary work of the leisured women that supported the nursing service. Mrs. John See provided the first cards for collecting subscriptions. Amounts from 6d. per month were requested and the first Annual Reports list the names of 60 women collectors for the General Fund (see page 38). The year's report noted a philanthropic gesture by Mrs. G.E. Faithfull: she provided the fare for a 'poor woman, a patient of Nr.Mann to return to her relatives in England'.
To this point there was only the Central organisation.
37. Cards for the purpose of collecting small 1ubacriptions• from 6d. per month, can be obtained from Mrs. John See, "Urara," Handwick, or from the Hon. S1-c. We shall be very grateful to any who will take these cards; the money can go to the Geueral Fund, or to the Nourishment Fund, according to the wish of the subscrihers. The latter fund is to supply milk and necesHary invalid food for the patient.a. The following are already collectors by means of these cards:- 1 Mrs. Vickers, Randwick 32 Mrs. Richard Bioharda, R'wk
2 Mrs. Waltou, Coogee 1 33 Mrs. Cook Adams, :Randwiok a Mrs. Humphries, Randwick 3i Mrs. Kenna ,. 4 Mrs. Percival, 35 Mra. T. H. Barlow ,. 6 Mrs. Talbot 86 Alisa Marteyn ,. G Mre. Christian 87 Mrs. Norton ,. 7 Mrs. Cook, Coogee 38 Miss Agnee DoYe, .A.ahfleld 8 Mlle. Wood, Re.ndwick 39 .Mrs. Ralph Robinaon, Wat- 9 Mrs. J. A. Peters ., son's Hay 10 Mrs. :Sinclair Gillies, Eliza.- 40 Mrs. Gregory Walker Leth-street 41 Mrs. Rid~e 11 Mrs. Graham, Waverley 42 Mrs. Wallaat 12 MN. Lowe, Re.ndwick 43 Mrs. &nken 18 Miss Lon• ,, Taken at Mrs. Prank Broughton.'• H, Mrs. Jenkins, Moore Park I Drawing-room Meeting. 16 Mrs. Pewmell, Re.ndwick 44 Mrs. Ludlow 16 Mrs. He.rrison 45 Mrs. Gowing 17 Mrs. Trotter 46 Mrs. McRae 18 Mrs. Francis ., 47 Mrs. Nicollea 19 Mrs. Raymond Jones, R'wick 48 Mrs. Griffith 20 Mrs. Hodgson, Randwick 49 Mrs. Kellick 21 Mrs. Forbes 60 Mrs. Lewia 12 Miss Ash 61 Mr11. Donon,n 211 Miss Schultz 62 Mrs. Craig J!4, Mn. Dawson 63 Mrs. Frank Walker 15 Mrs. Hinton 64 Mrs. A. C. Goddard 16 MiBB Ridd 65 Mrs. Owen Friend 17 Miss J. Napper " li6 Mrs. Lealle 18 Miss A. Napper 67 Jrlra. Goldie 19 Mias Denning .. 68 Mn. Vansetti I() MiH T. Denning 69 lfra. l'rank Jhouchton 11 Miu Hewart 00 lln.:a..bbek
3 8. CHAPTER FIVE
1903 AND ON - TWO NURSES
39. The second nurse was appointed in 1903. Nurse Pilkington served the districts of the parishes of St. Philips, St. Lukes, and Holy Trinity in Lower George Street and The Rocks area. Applications for her services were received at the Rectory of St. Philips. That year the Annual Report advised that a uniform had been decided upon and would be worn by the nurses in the future. No details of design, style or colour were given, and as no costs for uniforms ever appeared in the financial records it must be assumed that the costs were borne by the nurses. "Buckles" are, however, an item that appeared in the expenses from time to time; so as, some nurses, depending on qualifications, wore heavy silver waist buckles, the Association apparently provided these. It is possible that the buckles may have carried D.N.A. lettering or symbol.
The following year there was mention of providing bicycles as a means of increasing visits. Again no cost appeared in the Balance Sheet so as "fares" were listed annually it seems most likely that the idea did not proceed.
A minimum annual subscription of 5/ secured membership, and members of the Association were urged to accompany nurse one morning or afternoon to see for themselves the value of the help and the power for good, but the proposition did not come up formally until 1904. Those founding members never saw themselves as remote from the service they instigated. Their philanthropy was based on investigation, personal attention, and practical assistance. Their aim at that point was to increase tenfold in the coming year, expanding towards the poor parts of Paddington and Waverley. That ideal was not reached but the D.N.A. continued to consolidate as it met the need to which it addressed itself.
The service soon developed a name and a presence in Sydney. From the beginning the Press attended and reported
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42. t he Ann u a 1 Me e t i n g s • I n 1 9 0 3 t he Q!!..!..!r_!~.!~.&!.!!.E.~ p r i n t e d an article commending the work of the district nurse, "the daily round, the common task", and recommended the charity from personal experience. The article was signed "UNA", which was the name of the magazine of the Victorian District Nursing Association which had been in operation in Melbourne already for some fifteen years.
The article was reprinted by request in 1905 in the Sydney womens' magazine ~!_g£~~- Amongst the sentiment,
"To the casual passer-by she was only a little woman, wearing a long brown cloak and a floating veil, and carrying a basket on her arm" and the beaming smiles, the old ladies' glistening eyes, the gleeful children, and the kindly nurse, are the hard facts:
"She is a member of the District Nursing Association which exists for the purpose of providing trained nurses for the sick poor in their own homes •••• The work of washing, dressing, changing linen had to be proceeded with slowly and cautiously, for the poor misshapen body ••• (it takes one hour and a half to wash one patient who is crippled with rheumatism.) Sores must be dressed - poultices made and applied • • • • on one point Nurse is inexorable cleanliness. her horror at the sign of an insufficiently washed bandage all this forms an education in itself."(1)
Money came from donors large and small: the Chippendale Boot Factory collected 10/3d. Until 1903 the Association's only fundraising occasions were private entertainments held in members' own homes or in the St.James Hall. Concerts, plays, games or musical evenings were the most
43. favoured. The Australasian Nurses Journal (A.N.J.) expressed a regret that Sydney should be so far behind Melbourne and Adelaide in the development of "so valuable a philanthropic work".(2) The Association recognised the need for more public awareness of their cause, and the women swung into action.
The outstanding events of the periods 1903-4 and 1904-5 were two Fetes held in the grounds of State Government House. The typed draft for the first of the two functions reads:
GARDEN FETE IN AID OF DISTRICT NURSING ASSOCIATION Held in the Grounds of State Government House by Kind Permission of His Excellency the Governor and Lady Rawson on Friday and Saturday, 4th and 5th September from 2 to 6
The Patroness was Lady Rawson, with Lady See the President, and among the Vice Presidents were Lady Fanshawe, Miss Snowden-Smith, the Lady Mayoress Lady Graham, Mrs. Walter Hall, and Lady Innes. Mrs. Neville Griffiths, Mrs. Sinclair Gillies, and Dr. Camac Wilkinson formed part of the Executive Committee. Lady Fairfax headed the Flower Stall, Lady See and the ladies of Randwick were in charge of the "Fancy Stall", Lady Barton and the ladies of North Shore presented the stall "North Shore Dolls and Childrens Clothing". Dr. Agnes Bennett and Miss Carter were among those ladies in charge of the "Alice in Wonderland" Side Show exhibit, and the Misses Iceley were in charge of "Cushions and Pincushions".(3)
The success of the Fete held over the two days Friday and Saturday would have relied heavily on the availability of the leisured and middle-class women with the time for both organisation and as the participating and spending public.
44. Lady Suttor was President of the Fete Committee, the second year, and the Annual Report recorded that the Patroness Lady Northcote visited every stall and "each had profitted by her generosity".
The "untiring energy" and fundraising abilities of the women put the D.N.A. on a sound financial footing; the Treasurer and committee men with financial expertise saw to their task of stewardship of the funds in their keeping. From 1905 to 1907, the Treasurer was Mr. W.C. Gaden, Manager of the Commercial Bank, Haymarket. He was then succeeded by Miss Gaden who filled the position until 1913.
Miss Carter retired as Hon. Secretary in 1903. She moved first to Shell Cove Road, Neutral Bay, and later became Principal of "Killarney" Church of England Boarding and Day School in Spit Road, Mosman.(4) After Dr. Rundle, the position of Secretary was always held by a woman.
By 1904 two more nurses had been appointed: Edith Somerville and Hester Maclean, both of whom had trained at R.P.A.H.
The Annual Report referred to district nursing as "essentially a woman's work", and in Judith Godden's terms(5), district nursing was a woman's sphere. The women themselves were quite clear in their delineation of what work was a woman's sphere and their efforts fulfilled both the actual fact of their place in society and their moves within a current of change. The nurses with technical and skilled labour were women working towards economic independence and professional status, and within the D.N.A. their work was made possible by women's charitable labour, of necessity directed by male doctors, with token women doctors appearing on the periphery.
45. The district nursing service was still seen then by many in its religious context. The Australasian Nurses Journal of 1905 reported on the work of District Nursing growing in strength and influence and described it as a new form of charity. The nurse herself given an aura of religious zeal: the nurse healer followed in the steps of Christ:
"District Nursing gives expression to the idea that the service of man is the truest service of God"(6)
The writings of Dr. Camac Wilkinson, and the editors of the Australasian Nurses Journal are paternal, laudatory, idealistic and inspirational in tone. The Journal made a direct appeal to nurses to spend at least two years nursing the sick poor: they would find the "compensations great" in a "most highminded field of work".
In 1901 an editorial in the Australian Medical Gazette referred to the nurse working outside the hospital system as a "loyal and valuable asset", her work that of "silent unsung heroism". It continued, "the medical profession must sing their praises and see they get due rest and rewards, and support schemes to give independence in old age".(7)
The health and welfare of the district nurses was a matter of prime consideration. Their working day was eight hours, and in 1904 the Executive Council considered that there was a serious need for a Central Home for the nurses. It would save valuable time in travelling to and from their starting points and would reduce fatigue. To begin with, the Nurses Home in Philip Street was used and the D.N.A. saw to providing a telephone at the Home so that doctors could call on the district nurse in an emergency. At 140 Philip Street, the number allocated was 140.
This Home closed some short time later, and the first
46. house rented by the Association for their nurses was at 33 Upper William Street, with Hester Maclean as Sister-in-Charge. The next move was to 112 Surrey Street, Darlinghurst. That year four nurses' salaries had totalled to ,l,438/15/4 and board and rent came to i270/7/4. A permanent home was now an obvious need.
Lady Fanshawe, dedicated supporter of the principles of district nursing, followed her success in organising the Fetes with two further proposals "Local ism" and a permanent home.
47. CHAPTER SIX
LOCALISM AND A PERMANENT HOME
48. By the end of 1905 the Association reported the proposal for a new arrangement for securing a stable income to further their aims. The Annual Report stated that at a meeting at Admiralty House the previous December Lady Fanshawe had expounded a scheme for collecting money for the work by dividing the city into five districts, each with its own sub-committee, collecting subscriptions and donations, and with each one supporting one nurse by their efforts. A system of 'local ism' was to be encouraged. With personal support for a nurse, each district would have greater interest and motivation. It was reported that the scheme had already begun and that in only eight months had already proved itself successful. Three meetings were held at Waverley, two in Potts Point, three in Woollahra, and two in Summer Hill, and Lady Fanshawe spoke at all of them.
The original districts proposed were North Sydney, East Sydney, Darlinghurst, Waverley, and Woollahra, with additional branch committees proposed for Summer Hill, and Surry Hills.
The Presidents and Honorary Secretaries were:
North Sydney: Mrs. Hodges, and Mrs. Moseley Darlinghurst: Mrs. Hayes, and Miss Ruth Dangar Waverley: Lady McMillan, and Mrs. R.J.H.Jenkins Woollahra: Lady Suttor, and Miss Marjory Knox
In their first Branch reports, Surry Hills reported that Mrs. Manning "by her energy and tact has brought about a federation of the various church centres in the district with the object of providing a trained nurse in the hour of sickness". Nr. Titcombe was their first nurse. This federation of effort, the report continued, in the case of charity was in the best religious ideals.
49. Taking what Richard Kennedy described as an early definition of "charity" as being "christian love"(l), the organisation was true to its purpose of supplying a skilled nursing representative of "Christ's love", supported by philanthropic endeavours.
The Central Executive stipulated that it would retain control, which would eliminate overlapping, unwieldiness of organisation or competitiveness between Branches - the concern that had emerged from the over-abundance of charitable bodies in earlier decades. The central aim and objectives would be primary. They would arrange the work and the allocation of nursing services, the new district system providing funds. The Report commented: "This is the best form of charity".
By the time of the Annual General Meeting, the North Sydney Branch had already provided 120 plus a large sum for the Comforts Fund that supplied day-to-day medical and personal needs for patients.
North Sydney reported that in the first five months of their operation they had held 14 Drawing Room Meetings to promote their efforts to support the work of Nr. Edith Somerville. In addition they were personally supplying her with 1 to provide any necessity for her patients as she saw the need. In 1906 they reported that 28 women of their 36 membershsip had collected contributions of ~350/15/10. Of the nett amount transferred to Head Office, 1(.180 was needed annually to support their nurse and continue the Comforts Fund.
In their first annual report, Waverley Branch encouraged their members: "Be not wary in well-doing".
Twice more in 1905 the D.N.A. received attention in At Home. In May "The Round World of Women" column, by-lined
50. "Portia"(3), reported on the Drawing Room Meeting being held to invite those present to become regular subscribers to the D.N.A. to ensure an annual income rather than the bazaar method where results were often not commensurate with the time and energy expended. Portia explained that the D.N.A. was "the philanthropic society which should appeal most readily to the heart": kindly ministrations to those "laid low by physical suffering". Into the slums the nurse went to the sick who lay unwashed, uncared for, unvisited. Nurse was, in Portia's view, the means of not only medical relief but a means of education "in general sanitary matters". With financial aid to the society itself, the community at large had everything to gain, and the ladies raising the income for the D.N.A. deserved the thanks of the community.
Several issues later Lady Fanshawe herself was interviewed. Bazaars were suited to specific purposes such as the provision of a Nurses Home, she stated, but sound rather than chance support was her aim. Brushing aside the question of her time and effort, she said
"The rising tide of the association's success was due to the activities of one woman ••• her memory will be cherished in the streets of this southern city by many a bedridden woman, and crippled man, and suffering child, to whom she has brought the best of all comforts in sickness the ministrations of a skilled nurse."(3)
The next issue again carried an article recommending the work: directly religious work, but not of the "preaching kind".(4)
There was a new view to Christianity that brought relief to suffering humanity. It was an economy to government
51. expenditure by reducing the cost of hospital Outpatient Departments, patriotic in ensuring the health of the working-class at the level of the home.
Women writing about women, for women readers, appealed to those spheres of women's influence where they immediately identified: nurture, comfort to the ailing, cleanliness, the power of motherhood, economy, and an ideal to work for. There were those to lead, and they appealed to many to follow and support.
With "Localism" firmly established, Lady Fanshawe turned her attention to the need for a permanent Nurses Home, and in proposing that the D.N.A. should now buy a house, she made the initial donation of £,50 towards the scheme.
Judith Godden defined the meaning of Philanthropy as the giving of money(5), and that principle relates directly to the D.N.A. and Lady Fanshawe's philanthropic gesture towards buying Darlinghurst house. With other donations and an overdraft secured with Mr. W.C.Gaden, Dr. Camac Wilkinson, and Mr.W.P. Faithful!, as guarantors, the house, including furnishings, was bought for 4,1485/19/9. It was officially opened on 6 November 1906, and Governor Sir Harry Rawson paid tribute to the organising genius and earnest personal appeals made by Lady Fanshawe. By October 1907 almost half the money for the house had been provided.
The Home was placed in the charge of Sr. Anna Garden, another nurse trained at R.P.A.H., and she remained as Sister-in-Charge for almost three years. She was succeeded by R.P.A.H. trained Sarah Breden who had been a district nurse during 1904 and 1905, and again in 1907. Anna Garden herself returned again in 1911.
The A.N.J. reported on the "homelike" atmosphere created
52. Fro nt View. D . N . A . Home .
Baek V i e vv, D "'-: . A. . H n rne- . 53 . ,.. ----·...--. -~r,,p~
~ . .. . •.
-1 Lt11 l ~I ! { 0 ,,1,1 :1 1 · ! le D. ~ . A H o rn e .
at the Darlinghurst home with a bush house, aviary, and pleasant rooms, but it was not until the Association published a Souvenir Booklet as a means of increasing regular subscriptions that we are able to see the home as it was. Some of its benefactors were business houses such as Wm. Farmer & Co. Ltd., David Jones Limited, churches, the Branches, and even a Football Club.
The Souvenir is a quality booklet((o), undated, probably published and distributed early in 1907. It featured formal studies of the uniformed Sir Harry and Lady Rawson, Lady Darley and the young Lady Fanshawe. Advertisers included the department stores of Marcus Clark & Co. and Anthony Horderns, the A.M.P. Society, a whiskey company, and the Singer Sewing Machine Co. The booklet included a Subscribers Form to be signed pledging support by means of an annual subscription. A minimum gift of 5/- per year secured for the donor voting rights at the Annual General Meeting. One such annual subscriber with voting rights was Miss Rose Scott.
54. Cr ;, ·1 \,';,,/ios, /'l1ot1•. H 1~ Excel l ency Admir al 5-ir HARH Y k A W::;'..)N , G.C: B., Guve r11 ur vl New S 0 u: h ':\it1 !e~ .
5 5. Her Exce tlenc y The L Pat r o ne~s of Athe DY D NORTH. N . A. COTE ,
5 6 • - ML
Patro11u1-LADY RAWSON Pruident-LADY DAR Hon. Trcasurer-C. W. GADEN, ESQ., Commercial Bank, Haymarket. Ho11. Secretary-MISS FARRAN," Hilton," Lower Forth Street, Woollahra.
THE DISTRICT NURSING ASSOCIATION exists forth~ purpose of providing Trained Nurses for the Sick Poor in their own Homes. In England, the Queen Victoria Jubilee Nurses, to the number of 600, arc daily engaged in this work. In Liverpool alone, there arc ~7 Nurses and 6 Matrons: in Leeds, 20 Nurses and 2 Matrons so engaged. F.vcry Nurse works under the supervision of a Medical man. They attend Chronic cases, and those suffering from variou:i diseases, wro cannot be taken into the General Hospitals, or cannot afford the time or the money to seek relief at the Hospital Outpatients' Department. Chronic cases, such as Chronic Rheuma tism, various forms of Paralysis, Chronic Ulcers, and hopeless cases of Cancer, Consumption, and other diseases, are beyond the reach of Hospitals, and sadly need the services of the Trained Nurse rather than of the Doctor. Undoubtedly the \VOrk of the Association relieves to some eJ:tent the strain upon the General Hospitals; and besides being beyond the possibility of abuse, it is essentially' economical, because there is no further cost than the cost of the Nurses' services. The Nurse is· also an invaluable factor in the prevention of disease. Society pays a heavy toll for its eJ:istence in populous cities, especially in the fearful sacrifice of the infants and children of the poor hi consequence of overcrowding, neglect, and ignorance. In no better way than by the practical lessons given day by day by the Trained Nurse in the homes of the poor can this blight upon the future generation be mitigated, and in part removed. Habits of order and cleanliness can only be gradu ally taught by constant iteration and reiteration of the lessons. Thus the Trained Nurse becomes a powerful factor in improving the environment, and thereby the physical and moral standard of the less fortunate units of Society. At present 5 of our Nurses are working in the poorer districts of Sydney, Redfern, Alexandria, Chippendale, Waterloo, Ultimo, Woolloomooloo, Sorry Hills, Miller's Point, Glebe, and Newtown. The Nurses from the Phillip Street Home ceased their work in 1903, and our Association continues their work. in the~ districts. At present our funds arc not equal to this demand. We must have regular annual subscriptions in order to place the funds of the Association on such a sound financial basis that we can not only continue the work hitherto done, but employ Nurses on a similar errand in every one of the
. __p~r _dTisthri~ts ~{~h:s ~~lt· 1:-· - .. ··1 ~. ,._h:. ~ . •. • • I. d I - . 11- ·f ...._- -b - ·H. · - • Eiecutive w1sn especial y to emp as1ze· the direct arid pract1ca a v ce given to II · b ·... y 1s Excellency Sir Harry Rawson, who,at..ihe opening of the fetc last year, urged the supporters of this work among the poor to realise that, notwithstanding the slrcfess of the--!P..tr, Jhc best and most satisfactory, because the most ~conomical, way of supporting the District Nursing Association was by. rtguiar ·a,.~,,~-.;.' :JJ,1,rip tions. Already Lady Fanshawe, President of the North Shore branch, bad urged this very important point upon the attention of the EJ:ecutivc, and it is to be hoped that some practical means will be initiated for increasing the number of annual subscribers. -_ .. ,., To one and all who thus devote themselves to the cause of the Sick Poor of Sydney, there must be at least great satisfaction in knowing that, by their efforts, it will be possible to engage Trained Nurses who, throughout this year, shal! be constantly going in and out of the homes of the poor, belpin,r and comforting and tending the afflicted ones on \heir bed of sickness. It may be said that 10,000 visits of mercy were provided for last year-surely a matter for great thankfulnCAs. Evc{Y one who has helped at all, even to the extent of a shilling, pays a vicarious visit to the siclt through the Trained Nurse, and helps the poor sick one in this way even nore than by a pcrsonalvisit. Six Hundtcd Pounds a year is required merely to continue the work already being done by 5 Nurses. Sydney should be equal to the task of providing at least One Thousand Pounds a year to be spent in this splendid work. We appeal to you to become Annual Subscribcts of from Five Shillings upwards. Annual Subscribers of Five Shillings become members of the Association, and are entitled to vote at the Annual Meeth1g. u__ If you intcrd to become a Subscriber, will you kindly fill in the slip attached, and forward it to the 17V7'Secretary, -NO-fl;.Hip 6tseet, S1duc1, 01 to the. Hon. TH&111rer Mp C, W Gmn Cemn1e1cial Bank IIa,ma,m-11~,,arr ~-~-13eL&..v-..:....NcJU, ' ·
·------~------·------~·-·
I intend to become an Annual Subscrih~r to the D.N.A.
Sum ...... _...... - ......
Name...... _ ...... Address ...... - ...... _ ... _...... 5 7. The reason for the appeal was only too clear. Regular annual subscribers had been falling off and funds were tight. The Association criticised itself. Inspite of the fact that of the 36 women on committees 28 were collec tors, they felt their shortcomings deeply. With barely enough funds to support four nurses, they compared themselves unfavourably with Adelaide (12 nurses) and Melbourne (between 10 and 11 nurses). With a comparable population, overseas cities, they reported, had as many as 20 nurses in the field. Sydney at the time had only one nurse per 50,000 population. So dire was their need, the Annual Report said they might have to approach the Government for funding.
The N.S.W. government offered a subsidy but the Executive decided for a time at least to appeal to the charitable instincts of the community rather than "manifest too great a readiness to accept the Government dole". The offer by the government was seen by the Association as a sure guarantee that the work they were doing was worthy of sympathy and support. If a direct appeal to the public on the merits of the service could not be sustained, they felt confident the government would not turn a "deaf ear" to their need. The Association was, however, made up of citizens committed to a particular, perceived purpose of their own. By retaining independence, their ideal and their appeal as a charity remained intact.
Between them, five nurses had made 22,839 visits and for the first time the cover of the Annual Report carried the message "For Nursing the Sick Poor in Their Own Homes", and with the Report came the first major changes.
58. CHAPTER SEVEN
1906 AND ON - CHANGES AND PROBLEMS
5 9. A change in direction appeared.
In 1904 in stressing the overall benefit of the nursing service to community health, the Annual Report had added: "The work is entirely non-sectarian". While the Association had its origins in Anglicanism and was predominately Anglican through the executive and at the branch levels, the nursing service itself was not denied on the basis of faith.
A formal change of policy had first been proposed at a meeting held in St. James Crypt shortly after the first Fete, but did not find acceptance with members. In 1906 the Constitution and Rules of the Association were altered so that members of all religious bodies might work together. The change diverted the purely Anglican control to a policy of "Interdenominationalism" "in the cause of the sick and suffering poor of our great city", but it was emphasised that the essential religious basis of the Association would remain unaltered. This move to non-sectarianism has been described as a distinguishing aspect that the twentieth-century Australian community had of itself(!), and the change then forms part of the particularly local direction.
The following year the Annual Meeting was held one day later than scheduled in the Y.M.C.A. Hall with Governor Sir Harry Rawson presiding. To be non-sectarian, he had refused to chair the meeting set down for the Chapter House. He said that it was the district nursing service he was interested in, and as the Association was now not restricted to Anglicans it was inappropriate for one religion to take precedence over any other. Attitudes were changing, as and bishops, clergy and others saw the need to pull together, those were the lines on which he said he himself was giving his help. The only real change was that the network for executive and auxiliary involvement could be spread wider. 60. That meeting was also significant for another policy statement. Lady Poore proposed that a system of contribution by patients be instituted for service. The proposal reflected the system prevailing in England where user paid - either joined and paid an annual fee or paid for the service when used. She observed that she saw the same names on subscriptions lists year after year as the only supporters of the system never the patients. In this, she said, the system did not appeal to her; though she did add that she knew conditions were different in Australia.
Replying to her proposal Dr. Camac Wilkinson, Chairman of the Executive Committee, said the suggestion was not appropriate at that time. The Association was begun for those unable to give even 5/- per year. What had worked best for the Association was the system of direct giving and had found its fulfillment in the scheme of Localism laid down by Lady Fanshawe.
Sir Harry Rawson thanked Lady Poore for her help, adding that the Sydney community had come to expect that the wives of British Admirals would do their duty, but summed up the Australian view of assistance to the poor:
"The welfare of every class rested on the health of the mass of the people, and every class should support that health."
From 1908 to 1911, the Patroness was the Countess of Dudley, with Lady Chelmsford as President; and of the six Vice Presidents, five had the title "Lady". In 1909 daily vists by the nurses had increased to 24,779, and the following year the Association had six working Branches supporting seven nurses. Surry Hills Branch, supporting Nr. Ellen Spencer, noted that "Nobody but the little woman herself knows just the full amount of what she has been
61. enable to do for our sick poor as some of the cases have been very dreadful".
Some of the treatments in the Surry Hills area included an 88 year old woman suffering senility, bed sores of a 30 year old woman bedridden for five years with a fractured spine, Annie 0'Callaghan, aged 60, bedridden for 15 years with osteo-arthritis, Mary Rowan, aged 38, husband missing, recently discharged from Sydney Hospital and supporting five children, and Valerie Dawes, aged 72, with gangrenous diabetes.(2)
Every subscription and donation was welcome and put to the best use. The Hospital Saturday Fund had made several small gifts from 1905 but in 1910 they contributed oi,60. The amount varied from year to year, reaching "150 in 1918-19 and ;1262 in 1924-25. The N.S.W. Government gave their first subsidy of ci250 in 1911 and repeated the amount until 1914. Throughout the war years they made only two gifts of ~99/19/10 each. By 1913 subscriptions alone brought in an income of ~1762/6/9, and to that was added i350, the first of the annual bequests from the Walter & Eliza Hall Fund. But in the two years 1912 to 1914, expenses had risen from J959 to .,11,159.
Non-sectarian support had by then come from the Jewish community. In moving the adoption of the 1911 Annnual Report, Rabbi Cohen stated that that the Association must aim to extend not just maintain. And the many gifts of goods included garments from the Jewish Women's Needlework group and the Sydney Hebrew Ladies Society. The North Shore Needlework Guild gave flannel shirts, pyjamas, rugs and underclothing. The Sydney Needlework Guild gave 90 articles of clothing and linen. "Mrs. E." gave boxes of eggs, "A Friend" gave air cushions and hot water bags, another "Friend" gave 5 lb. of Tea, Mrs. Hope Faithful! gave 16 woollen garments, and the gifts continued by the
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G1lbra1 .Finnie, .Finnie, t lloldsworth, lloldsworth, Parran, Parran, Gordon Obds l!an 'Fraze :Kno Rod ~ pnes, pnes, : ~am, ~am, .· .· -fA.de , 'Fairfax, 'Fairfax, 1!a ,, ,, } -f -f _ .: .: $, $, { t , ,. ~ / ~ - ( t >1fl >1fl '.1 '.1 .• .• ~~ ~ ir t._ ~[ ~ , , 1 1 i i , ' - · · f , l _.i' _.i' ~. ~. t"' . ~ _ : : --~ --~ ·{ 1 1 i i ! , · ! 1 - : \ \ .? .? :_ d d ]-!!. . ···, ···, ., ., .: ~ ""] ryJ \5ill_[ i':-;. .I': .I': ~ . . -~: "~{ "{ "{ «' \_f, --~: --~: . !i ;,- ,~,; . . ·; ~,, ~,, --'lf _-! f ·-;:~ eL,~ . . 1 d 1 · · ~ , , k Ho Ho . . £7 £7 food, food, . . , , men men s' s' medid hlank t 1 etc. etc. clfern clfern e ats, ats, e , , ic , , Id Id , , . . co .) .) H tr e rn. rn. clothing shawls s f, f, s i tti e , , llllt Nurs 1 nts . . . . 1 e e e o d i s , , e ca for for 1:1i1ts etc. etc. p clothing, clothing, g ti · · _ _ q . . es, es, , &c rni,. rni,. a cas n n . . 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District. er er e c1 linen, linen, blan~et t b for for oo sp g dow1i- mouth mouth e sandwiches. sandwiches. su a linen linen, linen, case, case, Glebe p lids' lids' w air air r r for for r r cial cial rn s r r R w a linen, linen, g g · e e old old for for 8 8 fo r r t t linen, linen, d d p fo for for . . and and - 11s, 11s, o pairs pairs cial cial o sp e - / im s, s, 1 g . . rs rs o e l 1 1 h patient. patient. thin hing, hing, etc. etc. t1. t1. r r 10 10 Redfern Redfern . . eries eries 2 2 o eggs, eggs, n. n. / hi e sp c linen. linen. £ _clothes, _clothes, for for ot s fo e 11, 11, y. y. £20 £20 £ £ cl thin g. g. for for f f knitt cakes, cakes, ro e o l111 - for for linen o 0 0 - , , o ss ss shaw lillen. lillen. for for lin e Cu A.-5 A.-5 1 P.-Old P.-Old G linen e hi rt--10 s._ s._ B.-Old B.-Old p s e 2s 2s e 6 6 k f. thin E.- o ge- Clothlllg Clothlllg line:i, line:i, / s I I a Kendal-Food Kendal-Food R.-£1 R.-£1 -Old -Old o Ohl Ohl A.-16 y~_ a . . J. J. n1 llen llen W. W. D. D. 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Burg , , . : : Co Cbarlt C C Cav Christian Co Ch Di Crou Cutler, Cutler, Dallgar, Dallgar, Jl Campbe Di ~ope, ~ope, r- Ila\'i Dollalds Carter, Carter, Fan , L l l l•a1thtull. l•a1thtull. h ~ ~ ~ page in the Annual Reports each year (see page 63 for the list of gifts printed with the 1905 Report): macintosh sheeting, brandy, dressing jackets, fruit cakes, and 10 women provided 12 months' library subscriptions for the nurses. Lady Graham gave Port for special cases. That same 1905 Report made mention of an appeal by Miss Carter through the press for contributions of groceries and invalid comforts for the corning Christmas. Fifteen people, including Lady Fanshawe, gave money; and 45 people, including Mrs. and Miss Corlette, Mrs. Neville Griffiths, Mrs. Ashburton Thompson, gave gifts in kind. Miss Badharn provided Christmas Stockings and toys, and the Glebe Dorcas Society held a Tea and Christmas Tree with gifts for thirty children. In spite of all the gifts, a district nurse put her plea for help into verse and it was published in the Nurses Journal in 1907(3): "THE CRY OF THE DISTRICT NURSE. 'Sister Have You Got----? This is the cry I hear all day: 'Sister! have you a chair, I say? For poor old Taylor's got the gout; I want to have wheeled about.' 'Sister! I want some boots for Dan; Please let me have them, if you can.' 'Sister! have you a little brandy? I want some if you've got it handy.' 'Sister! I want some pants for Paul; The little lad has none at all.' 'Sister! Are there any eggs for me? And may I have a little tea?' 'Sister! Poor grannie's back is bad; Is there a cushion to be had?' 64. I bid them all hush up their cry, And to my stores away I hie. Alas! like poor old Mother Hubbard, I look into an empty cupboard. The clothes and stores that should be there Are gone, and I am in despair." Bollen commented that by 1910 the Protestant churches were losing their drive and proved unable to maintain their social ministry as they saw it embodied in the Gospel. Lay initiative increasingly became the answer to the problems addressed by raised Christian consciousness.(4) With lessened church and clergy control, it was the continued lay dedication and commitment on which the Association grew - with money given and gifts in kind. But this was not without its problems. In 1912 the Balmain Branch closed. It was said that this was not through lack of interest by the Branch, or lack of poverty or suitable cases in the district, but lack of cooperation from doctors and clergy. So, in spite of women's fundraising, enthusiasm and Committee work, male input was vital. Following the Dail~_Teleara£h report of the Annual General Meeting in 1913, an attempt was made to restart the Balmain Branch. The government recognised the value of the service and offered to meet half the cost of a nurse's salary and provide the nurse with accommodation in the Balmain Hospital but lack of local support again prevented acceptance. Overall the work was growing and the service had, in the meantime, been extended to Kogarah. Smallpox in 1913, the high incidence of pulmonary tubercu losis, and epidemic outbreaks of diptheria, scarlet fever 65. and measles, over the next two or three years meant over crowding in hospitals.(5) After-care was the District Nurse's field and seven nurses were also making around 24,000 visits per year. The war years were difficult ones, and many social pressures affected the D.N.A. Public and private purses were strained. Association and hospital nurses left for active service with the forces, amongst them Nellie Worrall and Ellen Connolly. It was a time of stress, continual change, despair and anxiety. While clergy tried to maintain a stable and ordered church life, there were fewer lay readers and assistants, and church groups were disbanded. At a Parish in Balmain, five sons of the Rector were serving, and three were killed. Parishioners were economically hit with the breadwinner away at the front. Of Australia's 4\M. population, 7%, 330,000, were on Active Service and almost half of that number returned wounded.(6) This, in turn, would affect the future need for care by the district nurse. Sydney Hospital was forced to close one ward, with a loss of 50 beds, adding yet a further burden for the district nurse. Wi t h Wa r a p p e a 1 s f o rem o s t , t he S x_ d n ex__ Mo r n i n _g__ H e r a 1 d o f the 20 October 1914 stressed that private benevolence must not forget those at home - as equally deserving. An appeal went out to the "daughters of the leisured class to accompany nurse as a form of voluntary aid". But there were fewer voluntary workers, fewer women for visiting. Patriotic funds, such as the Red Cross and the Belgian Relief Fund, made demands for more and more voluntary women workers; and it has been observed that instead of visiting, many women simply stayed at home knitting for the troops.(7) Eight nurses then were covering 20 districts, and in 1915-16 they made 25,410 calls. The D.N.A. declared there 66. should be 80 not 8 nurses in the field, though this may have been natural enthusiasm rather than an assessment of actual need. The same year a major outbreak of gastro-enteritis among babies and young children caused considerable alarm. The deaths of young children in hospital was said to have demoralised nursing staff, and a conference between the Royal Alexandra Hospital for Children, the D.N.A. and the Sydney Day Nursery Association was held. The R.A.H.C. voted 100 to be provided as compensation for loss of pay to assist working mothers to stay at home to nurse sick babies. The District Nurses maintained that sick children recovered quicker at home because of "mothering" and reduced risk of cross-infection so prevalent in the ward. Home care under supervision proved more satisfactory than hospital treatment, and the Association reported only 5 deaths among the 169 babies the nurses attended. Even that figure by today's standards must be judged a sad commentary on the living conditions among the poor of Sydney. The District Nurse, the Association reported, was able to provide useful hints on home management as she tended the sick. It was noted too that demolition of slums in two districts the nurses served had already had a beneficial effect on the poorer classes. By 1914 three-quarters of Sydney's slums were said to have disappeared. A large area in Chippendale had been resumed and some 500 houses pulled down. The occupants of the dwellings moved to other suburbs where a healthier life style was to result from healthier living conditions. Working people were not able to move far, however; they established themselves on the fringe of the next closest suburbs, keeping as close as possible to factories and work sites. Between 1914-1018 little more resumption and reconstruction took place - house sharing and overcrowding continued.(8) 67. The nursing service was again reported as being cost efficient to the government. After three years of operation in Kogarah, the cost to the St. George Cottage Hospital was estimated to be .(160 but the cost per patient would have been six time greater if hospital accommodation were to have been provided. The possibility of amalgamation with the Alice Rawson School for Mothers was briefly mooted by the Minister for Public Health, Mr. Fred Flowers. Even withthe promise of a government subsidy if the work load increased, the D.N.A. still decided to continue as usual, as an independent, voluntary body. The year 1917 was a low point. Summer gastro claimed three babies of the 194 tended by the Association's nurses. There were fewer nurses available with so many still on Active Service. Nr. Lillie Morris, the Kogarah nurse, resigned to open her private hospital, and now with no home care available, the St. George Cottage Hospital suffered even greater overcrowding. Home visits dropped to 22,993. Wages rose to ,649/8/10 with only J481/18/6 contributed by the Branches. Home maintenance had risen to {260/14/- and, but for a gift of 160 from the Hospital Saturday Fund, the Association deficit would have been quite large. The Executive urged subscribers to induce 10 friends each to give One Guinea. Speaking at the Annual General Meeting, the Acting Minister of Health, Mr. David Storey, said that the district nurse was rendering a service money could not repay, adding that despite the tight financial position of the government the claims of the D.N.A. to government support would be considered when funds were allocated. The meeting was also told that insufficient support was coming 68. from business houses and that an appeal should be made by circular. In 1918 the Association applied for and was given a government subsidy of t100. The Hospital Saturday Fund gave t150, the Walter & Eliza Hall Bequest provided A300, and the women of the Branches raised J496/12/- plus the Comforts Fund money which was used for medical supplies, medicines, and other personal comforts. As well, patients who could afford it now contributed small amounts, and a donation of ,14/2/- came from the Police & Fireman's Carnival. The voluntary work of the women and private benevolence, however, still provided the greatest proportion of financial support, though with only seven nurses visits had dropped to 16,403. The St. Johns Ambulance gave assistance to three of the nurses; gastro cases were fewer; and a new Branch was formed in Redfern. The following year saw another Branch open at Darling Point; "to provide a nurse for one of the industrial districts". This year it was the influenza epidemic that hit Sydney and the nurses reported attending 353 cases. Three adults died, but no children, with some of the most serious cases transferred to hospitals. The end of the year seemed to indicate a new era ahead. Mr. Innes Noad, President of the Royal Society for the Welfare of Mothers and Babies chaired the Annual General Meeting. He said the Association was on a stronger footing than ever before. In his view, no government service, no matter how well it did its work, could give the same spirit of service, and he hoped the Association would continue to extend its activities. Dr. F. Guy Griffiths spoke of the number of doctors in all districts who would be glad to use the service if it were made known to them. Canon Charlton spoke and emphasised the themes on which the service had begun: raised moral tone in the areas where the district nurse went, and the influence her presence had through instruction on sanitary home conditions. 69. Recognition by government and civic leaders was not enough to maintain the service. Gastro struck again: 165 patients were attended but there were no deaths. Costs continued to rise, receipts fell short of expenses. It was necessary to build up funds. A major public appeal taking three forms: a direct "Special Appeal", a Fete, and a Children's Ball, realised ,i741/5/9. That, together with regular subscribers and donors still far outweighed money received from other sources. The "Voluntary Citizen", and the army of women working from the Branches remained backbone of financial and kindred support - a network of elite and middleclass women skilled as organisers and entrepreneurs. The tone of recognition of the nurse and the service she gave was changing. From the beginning, the work and value of the district nurse had always been highly regarded, evoking statements that ranged from sentimentalism to appreciative recognition from doctors, from their own Australasian Nurses Journal, and the public press. The editorial of the Australasian Medical Gazette of 1901 spoke of "silent unsung heroism" of the nurse working outside hospitals, a loyal and valuable assistant to the medical profession (9) - which it must be remembered was by intent mostly male. A hospital nurse, also in 1901, wrote of the arduous but honourable work giving dignity and status an occupation that fulfilled the ideals of womanliness. But she did perceive the duality of the role of nurse. An ideal of womanliness, soothing fevered brows, the lure of the uniform that identified the wearer's qualities, were sacrificed to the tyranny of housework under the guise of nursing, and a duty day of 11\ hours. However: "To another class of women the work appeals differently. It gives them a status independently of the men of the family. To the woman who feels she has a dignity and a worth of her own, any profession is warmly 70. welcomed that gives her this independence of male relatives, and a career of her own."(10) Camac Wilkinson, always eloquent on the nurses' behalf, wrote: "In all modern hospitals the trained nurse has earned her right to be called the invaluable and indispensable handmaiden of the up-to-date surgeon and physician - the nurse is the essential factor in success. The next step in the natural order of things is to bring within the reach of the sick poor who cannot afford them all these means for the relief of suffering and the prevention and cure of disease •••• The district nurse (is a) 'splendid missionary in the gospel of health 1 ••• improve physical, social and moral well-being of the community."(11) The Press too reported appreciatively, but less lavishly and without the religious fervour: "· •• the work of the Nurse as a citizen has been overlooked yet she was working for healthy conditions of the city, and no class of labour was more likely to develop a civic conscience •••• Teaching people to help themselves contributed to the real citizenship of the nurse."(12) Here we can perhaps see the real philanthropist. The nurse was paid, but she gave far more than she was paid for. Stripped of literary sentiment, the nurse was the individual example that Miss Badham wrote of, the power for good that the C.S.U. had proposed. The N.S.W. government, however, recognised the individual nurse less than the service. The Minister for Health and Motherhood, Mr. McGirr, speaking at the Annual General 71. Meeting in 1920 said the voluntary assistance of the D.N.A. was saving the government huge sums in an area where costs had risen from 500,000 to 1,200,000 in less than five years. Financial savings were as yet more important in the government arena than community benefit, so the responsibility for the financial support of the health care of the poor remained in the hands of volunteers. 7 2 • CHAPTER EIGHT FUNDRAISING - THE WOMEN AND THE BRANCHES 73. Fundraising for the Branches had its problems. Some experienced difficulties and regretted not always being able to meet their commitment to support their nurse. In 1919-20 the Darlinghurst Branch reported a drop in subscriptions and donations as many people had left the district - a drift to the newer suburbs. Prior to W.W.I, the city of Sydney housed one-third of Sydney's total population, but the decade of the twenties witnessed a land boom that moved a significant part of Sydney's growing population to such suburbs as Coogee, Clovelly and Maroubra, and into the "multi-storied flats" being built in Bronte, Bondi and Waverley, south to Rockdale, and to the Sutherland Shire as tram and train systems were extended.(1) Darlinghurst held a Bridge Party at the Waratah Rooms, Darling Point held a Fete in the grounds of Ascham School to augment funds and advertise the Branch. The following year they again reported falling short of the amount needed to maintain their nurse. By means of Bridge Parties and Tennis Parties, a "Special Appeal" was made. Funds for the Manly Branch came largely from a fixed percentage from the yield of the annual Manly Venetian Carnival. That was, at first, the only fundraising event for the women of the Manly Branch, raising amounts varying between i2so and ,300. The Summer of 1926-27 they reported that bad weather had affected the success of the Carnival and their quota of the proceeds was consequently less. The vagaries of the weather rather than the purse were at fault. The North Sydney Branch did not seem to experience problems to the same extent as some of the other Branches. The list of women collectors was long and detailed, and read somewhat like a who's-who of prominent commercial and 74. (J 6 6 0 0 6 6 0 6 f, o 0 ft 6 6 O 0 (, r. 6 rl. 6 (J (, 6 6 6 6 0 6 6 6 0 6 I> s. 5 0 (i 6 6 (> 6 7 (> 6 {, (, 6 (, 6 6 6 6 !i 17 n 6 10 6 10 6 6 6 10 10 13 £ Cr.-rd. 1 (l 0 6 tJ O 0 6 6 0 0 O 6 6 O 6 6 O 0 O O 0 Ra/dick, O 6 O 6 0 0 O O 6 O 7 O 0 (I O O 6 6 O O 7 0 () O O 0 2 I O O II 0 0 (I Syd11,·.1·. £21 ---- £12 .lf. ,\·. Cn·J1111n1,·. iss } . Snr. It- .ll .. . . S,·11r. .lfr.<. !lame·, Huck Su·,·,·/. Str,-,·/. I•.\' !Jnchr ;-.-loon· .. (;elclc1· Herry Clark dick I{. I•\' Hucls1111 (;eorg,• Hucl,1111. E. L. vo Baker '.\I. .inklatn T"m Black.. Dcwn Phillips Bryant Bal Bohart Hicks (;each I Ewing [ning Pownall A. Brookl' J. Esclaik. l. A. ~wan I Van Dneshury G. Catchln,·c· Took Nathan \Iorrice Hohhes Thomson St. \\"oocl Thorpe Rohl'rts \\"illiams Blackett Crt·ecl f,'nsali11,i rs. rs. rs. r,. .1!11rdo,-;, rs. rs. iss rs. rs. ollat.-d rs. iss rs. rs. rs. rs. rs. r. '.\frs. ( '.\I '.\I '.\I ).! l\1 Mrs. :\I Mrs. Mn. :\,\ Mrs. :\fr,. 1\1 Mrs. Mrs. :\i Mrs. ;o.lrs. l\!r-,. /II :\lrs. .\I :\lrs. .:Vlrs. Mrs. :\1 l\-lrs. :\lrs. 1\1 :\-1 Mrs. :\1 11 '1-- Col/rct<'d Dr. \lr. Mr. ' 77 :t-1 i : l)(JNA'l'ION8-Co.1ti11111·d. 1 1 •).lrs. , I I 19 I I 1' . · ! > ) ' () 0 I. 0 0 O 1 1 f, O r, t1 'I f, 1 () (, O (i ~ / i' /i cl. / ; ( i,: ~ :' () O 6 0 (, 0 (, 6 O 6, I> O O 0 () rlis. s. 6 / 1, (, (, (, AND 6 6 (i 0 5 6 6 10 10 10 10 10 1 () I (, ' 10 6 6 10 10 10 5 ,) 10 10 10 10 10 10 10 10 10 10 10 10 ffo £ I 0 () () 0 I) 0 0 t) 0 0 (} 0 0 0 0 (I (I O I 0 0 (I (I 1 1 (} 0 u (I () o U 0 () () I 0 0 () 0 1 0 0 I. (I (I .. .. .. .. .. I·.-.· ·,,11.<1,111N1:,,j 11 ('21) lands .. .. .. rs. .. .. .. ·1-:,,,. Russ<"ll ·1iatl'au- Fsq. .11 ( Deck Hipsley Ne,, Ha,li, Shirley uil'ff :,.,:ewlands .. 1· \\';.ky Crean·s A. Enemark St·arl J Sharpe \\'nod Bligh ck Halbl'rg Elliott fl';,,,d. Humphrl'y lngra111 Stoho B. D;tw,011 Kl'lvnack Hole Tavlor A. IJa F. Suttor ~UBRCHIPTlO:-S Ll'e. Paig,· A. Skinner Ingram Nc,H·II \Villian,, Helicar \Va~lmrtn11 H. Hiag-h F. K. A. H. T. Baylis. llayli,. Hat,·111an 1\1. Humphrey F. \V. Caml'ron Boyd F. E. D. E. Peacock f. E. G. S. W. flaring Alex. \V. F. ·H. R. G. P. M. ~. T. E. G. J. Hey Walker H. H. F. R. (;, Phil R. J. \V. A. C. rs. iss rs. h,,urg r,. rs. Cnl/Nt,·,1-h;.- Mrs. Mrs. Mrs. Shirlry F. ).frs. F. 11 1l Miss :\,j l\lrs. ~lrs. Mrs. ~I Miss Miss Mr. ~frs. '.\!rs. 1frs. ~!rs. ~1r. Mrs. Mrs. :\1rs. Mrs. Mrs. Mrs. Mrs. Mrs. Mrs. Mrs. Mrs. :\I Mrs. l\trs. Mrs. ~frs. Mrs. !.liss ~lrs. Mrs. Mr$. Mrs. .. 6 6 6- 0 0- 0 O· 6- d a in at of all the she s. 1 6 6 one cost U 15 been '.\lrs. their posi loyal same more. resig years. in 1 0 1 £ 0 tJ 0 O 5 donors 0 6 with receive Stmldy gratui tl'stify. making the and manner, financial satisfac meetings £10 the has her for high for names giving ten to one a rs. the herl'lofore. as to discussed skill Secretary. tln1s ior '.\f and 2.617. starts to ask the Prl'sidl'nt. for increase occasionally only continued effort ~,·cn·tary. resign direct eA-ici,·11t ~Oas and £~0. sickness. report a, ,,·hen still ancl Hon. a11 o\\'ing- to CREED. year £1 :\uditors that Allen patients ,·isits. thankful h<·r hi-ml)nthly nett rq!;rl't. thl'ir lwr Hn11. ti111e can weliarc of usual l">. ior ,u innal oi nmd1 Larkin pnsition Sver ~pecial ill-h<·,dth; her it lin,·11. iaithful. \\'ould Min Hon. Proctor Carter and R. fnr Dang-ar her to upk<'l'Jl. familiar coming by much their add l\'o alwav, Donations. that hl'en old suhscrihers' in rs. a11d NESSlE issl'S rs. work. thl' instead comp,.>lled succl'ed is to g<·neral Branch oi an 11umber '.\1 Mrs. Mr.,. :\I '.\I '.\fisses Mrs. the ni est,·,·m,·d by acco111pa11y re111ai11 has to i quite 18 and t11 with owing Committl'C thl' Braneh. ssihll'. eels nursl''s f, 0 () 0 () fl' \\'Ork £200 1l1t• thl' i d. .. hut gin· gin· and a late p are still REJ'Ol{T. the alsu s. :\11r"' 2 2 6 (1 maintained. as gratdul. "S.-l- · to lU 1(1 ,uhsniher,. her attl'ndccl. There with occ11pying: Central du<". forward y<'ar i, our E,plin. 1 0 0 Short· £ 2 this \\'hn ll U () 0 2 met. sell'Ct<'d especially received that iumls, well thl' · thl' rt'g-ards ti111e. are the Committ,·c· towards S1'd11,·1·. Johnston gi,-c11: day. after .·lll,·11. Co. touch c"11dition and also. the irom oi cll'ciderl hce11 made as was To looked of for Subacriptions North & meeting. been continu<'s husy the Com:-nitt<·<· services. in ar<' £50 thanks was Harre plcasur<' .1/iss in their .\'urt/i Committee of the have hoth satisfactorily has .. .. hl'ing Hry of cl"ctors request kl'<'P l'l'purt-'.\lrs. unanimously h· Hacon our of augmrut clothing. the a and Preside11t. with thanks Pe11fold Mrs. \\'ilshin·. contrihution halance. Proctor to ,·n·nt llll'lllhers to tu the been the year, of resignation is Hav Peninlcl Fussell as Gunther Pratt ,·isits bi-monthly been had contrihutinn living--it legacy these /,011n1,·.'' It Interest At l\'urse Membns To rs. i,~e, rs. iss rs. tory have position A ·ul!t·(f(d ,upport. Her ma(k crrrlit of the her Some obligations tously, has has James nation tion hrig-ht "rder l~)llg--continued the reason patients annual giits of '.\lessrs. :\I '.\I ).! \I :l.I Lach· ....., V, professional people (see page 75). Though more collectors were needed, they reported "The objects of the Association are being carried out by our Committee to the best of our ability". They were able to meet their obligations through the direct giving of their supporters. Only twice over the years were small fundraising events used, a Bridge Party, and a "Sale of Goods" on Neutral Bay Wharf. North Sydney held regular Drawing Room Meetings and always maintained a close relationship with their nurse. They knew each nurse and visited with her, and saw at first hand the nurse/patient relationship. From as early as 1910, President Lady King Hall visited with Nr. Conry, who had done her training in Liverpool, England, in the city and North Sydney areas •• Nr. Macrae succeeded Conry, and again North Sydney Branch reported their nurse was "most capable and very successful with her patients". Nr. Agnes Bacon had trained in Rockhampton, Queensland, and after a stint at the Sydney Quarantine Station, nursed privately for eleven years. She was with the North Sydney Branch for thirteen years. Committee members visited with her every month, and frequently she was driven by the ladies "to cases at long distances thus enabling her to do more work with less fatigue". They reported receiving letters of gratitude from her patients that gave "testimony to her efficient and kindly method of dealing with her patients". The Branch noted their regret that restrictions had prevented them accompanying her during the flu epidemic of 1918-19. In over 2,000 visits a year, Nr. Bacon attended surgical, malignant, gangrenous and terminal patients. No distinctions were made when nursing help was needed. Those who had the means made donations, and those who had none were treated with the same skills. In 1927 Agnes Bacon tended an invalid pensioner in Mosman - in a family 76. of four whose only income was i1 per week Invalid Pension. A woman of 52 with cirrhosis of the liver, supported by her husband earning is per week, was treated for bedsores. Nr. Bacon made three visits and they made a donation of 10/-. Ellen Blandford, aged 87, an Old Age Pensioner on i1 per week also gave 10/-; the records showed that Nr. Bacon nursed Ellen Blandford for her last three days. When Agnes Bacon resigned, Nr. Slocum took her place. She had her own car and the Committee reported she remained fresher and more able to attend her duties. In 1927 North Sydney Branch reported a new departure for them. Their nurse then was Nr. Mills and they asked her to attend their meetings when she was able to do so. The descriptions of the cases she attended "brought home to all of us the good work that is being carried out by the nurses of the Association and it filled us with regret that this work is not more widely known". Magazine articles spoke of the district nurse easing those final days for her patient. No nurse was exempt from these stresses. The nurses' register showed that Nr. Mills attended a 19 year old who died of sarcoma of hip, and four months later a woman of 62 died of breast cancer. Her rounds also included two mental patients in Paddington, and, on the lighter side, taking care of minor ailments at the local kindergarten. The problem of public knowledge and awareness of the work was recurring, but increased costs and the effects of the Depression caught up even with the North Sydney Branch. In 1928-29 they reported for the first time being unable to meet their responsibilities. Woollahra founded in 1906 with Lady Suttor as President and Lady Fairfax as Vice President, boasted 200 donors and 7 7. subscribers, among them the Horderns, Lloyd Jones, the Iceley family, Wentworths, Lady Stephen and Lady Denison. Another successful long-term Branch was Waverley, also founded in 1906, with Lady McMillan as President until 1911 when Mrs. Macarthur 0nslow took the reins. Up until 1915-16, their subscription list raised more than enough, as they put it, to support their district nurse, Mary Kelly from Adelaide. In 1916 she made 1,117 visits. At that time, the Waverley Branch began an annual fundraising event. The first was a Picture Evening. Next came a Euchre Party. No entertainment was organised during 1918-19 due to the severity of the Flu Epidemic. The first of the combined Annual Dance and Card Party functions began in 1920-21. Mrs. Sands, still drawing on the family commercial interests, provided the tickets. A major charity function was held in 1920-21 at the Sydney Town Hall, with several of the Branches taking part. Waverley's stall yielded ;/.88/17/-. The Darling Point ladies ran a "Refreshment Room" and earned '188/9/-. Woollahra ran a Sweets Stall, and the Surry Hills ladies had a "Sale of Works". Picture Evenings or Matinees at King Cross Theatre were sometimes shared by the Darlinghurst and Darling Point Branches, whilst Bridge, Golf and Tennis functions were more usual in the Newtown/Enmore/Stanmore and Strathfield Branches. Childrens Balls, Cabarets, Fancy Dress Balls, and Christmas Parties were favourites in all Branches. Despite the times, in 1928 the Branches alone contributed J1606/14/- towards the running of the Association from collections and entertainments. At "Killarney", Miss Carter's Christmas Party for the children of the poor continued until she left for Queensland in 1921. This was not a Branch fundraising event, but her own philanthropic contribution. 78. Some women worked and served as collectors, on committees and as Secretaries and Treasurers for long periods. Mrs. Whyte of Surry Hills Branch resigned in 1923 after 20 years, and in 1928 Mrs. R.J.H. Jenkins of the Waverley/Bondi/Randwick Branch retired after 22 years as Secretary and/or Treasurer. When Miss Carter left the North Sydney Branch in 1921, she had been involved since c.s.u. days in 1899. Mrs. Barre-Johnston had begun her work with the Association as Vice President of the North Sydney Branch in 1907. She served as a District Representative with the Central body from 1909 and served as a Councillor from 1916 to 1921. At the Branch level she served variously as either President or Vice President from 1920. Her death was reported in 1928 "one of those who started th district nursing and was always a staunch friend and supporter". Her husband James Barre-Johnston was one of those chosen by Archbishop Smith in 1899 for the committee convened to assess the Church's duty to social problems, from which flowed the es tb 1 ishment of the C. S. U. Parish papers show that James Barre-Johnston was an active member of the parish of St. Clement's Church of England, Mosman. In 1910 he was a Parochial Representative and Synod Representative. From 1916 to 1925 he served as Trustee. He and his wife demonstrate action as distinct from good intentions, based on their religious beliefs. While the husband cannot be seen to have taken an active role in the D.N.A., Mrs. Barre-Johnston took her place amongst the energy force of women supporters. Mrs.F.G.Sargood was made a Life Governor in 1925 and this may have been because of a long-term service to the Central Association not at first apparent. Mrs.E.A.Antill served as Hon.Secretary from 1915 to 1919, Mrs.F.G.Sargood 79. C.B.E. became Hon. Treasurer in 1920 and held that position until 1923. No connection between the two names was mentioned in the Association reports, nor was there any reason to expect there might be. Lily Christian was a S.C.E.G.G.S. pupil (1895-8) inspired by Miss Badham. Lily's mother was a member of the General Committee of the D.N.A. and of the Waverley Branch from 1911. After leaving school Lily lead the carefree life of an affluent young lady, and married Major Edward Antil in 1902. Widowed in 1905, with her small son she returned to live with her parents at Elizabeth Bay until she remarried in 1919 to Mr. F.G. Sargood. Mrs. Antill resigned in 1918-19 to travel to England for a year: 1920, enter Mrs. F.G.Sargood C.B.E. as Hon.Treasurer. For her services at "The War Chest" she was awarded the C.B.E. and Bar, and the Croix de Guerre (Belgian).(3) S.C.E.G.G.S. revered the memory of Mrs. Christian by naming a "House" after her, and Lillian, who served for many years as President of the Old Girls' Union, left them the Lillian Sargood Bursary. (4) The influence of those women, from Miss Badham on, lives in the Church school they supported and attended, in their philanthropic service to the community, and as the church-inspired response to social duty. Beginning with Miss Carter, the Hon.Secretary of the Association was always a woman. Several men filled the position of Hon.Treasurer until 1908 when Miss Gaden took over from Mr.C.W.Gaden. The position then remained in female hands until 1933 when it passed to Dr.R.J.Millard, brother of Fanny, Lady Graham. He remained Hon.Treasurer until shortly before his death in 1944. His son, Dr.P.T. Millard, wrote that his father often drove Lady Game, wife of Governor, Sir Phillip Game, back to Government House after meetings and she chatted to him about visiting during the day with a district nurse.(5) 80. CHAPTER NINE THE NURSES - CHANGES OF ROLE 81. Whilst doctors had one view of the nurses as loyal and obedient handmaidens, and the press saw them as the symbol of civic conscience, their perception of themselves, for some at least, was towards the highest management levels attainable by women in their field. Working within acceptable areas for women, they were not lacking in ambition and drive for personal achievement. The concept nevertheless had some ambivalence. In September 1908 before a large audience of nurses, Rose Scott, delivered a lecture she titled "The Cultivation of Sympathy". Speaking of Florence Nightingale, she told her audience "To me she has always been one of the great women of the world - an inspiration and an example - a woman who dared to be herself, and dared to follow the dictates of her own spirit in scorn of the opinion of the world, with its smug conventialities and unwritten law with regard to the sphere of women, especially that of unmarried women, so that it was considered a shocking thing for our heroine to act as she did. The world is wider now •••• "(1) She began her conclusion with "So my plan is, seeing that all recognise the importance of physical and mental training should we not also ••• recognise that it is of the utmost importance to train and cultivate the heart and its channels of sympathy in order that we may direct it wisely and well for the benefit of our fellow creatures and for the betterment of our work in connection with humanity •••• " and she continued "Sound observation, study of character are of the 82. utmost importance, and the nurse who (armed with this knowledge) can also through sympathy enter into the patient's very soul, has a healing power which nothing can gainsay. Her magnetism is felt ••• scientific training update always must have its limitations. There is a world beyond that has not yet been explored •••• you will perhaps ask me - Why do you speak to us of sympathy, the very name of "nurse" indicates sympathy."(2) Rose Scott admired the woman who led a major social change, yet urged nurses to continue the concept of woman's intuition, "natural intuitive sympathy", "so long as the trainers of nurses look only to smartness and quick mental application and ignore the teachings of the heart, we shall never have perfect training for nurses •••• "(3) She had simply reinforced the refinement of social feminity on women who were the product of a reform movement begun and carried forward by nurse educators. Almost at the end of her presentation she urged the nurses to do battle for an eight-hour day: "the working man employs physical and mental force, and you employ these, sometimes other forces also. Therefore, you need far more than he does the eight-hours' day." But in the end, to Rose Scott, they were still only women and culturally approved feminine qualities were still paramount: "Therefore I would appeal to you, an army of women engaged in the service of humanity, to remember that 83. the spiritual forces you possess are greater far than all your mental and physical training ••• for the woman is above the nurse •••• "(4) In writing up the success of the presentation and spirited discussion afterwards, the A.N.J. also reported opposition by the nurses themselves against the proposition for a shorter working day. Their view was that the hospital and nursing regimen could not function on that principle.(5) Anne Summers argued that the explanation of this attitude that relies on acceptance and compliance with conditions involving self-denial to the point of exhaustion is that the dimension of their prospects as nurses was never lost on them. Nurses were not only retained but acted upon their personal view that nursing provided them with "aspirations to personal freedom and independence which outran by far the expectations of most of their contemporaries. It might be argued that a minority's chances in new and larger arenas helped to maintain the consent which only the sturdiest of women could hope to survive •••• 11 (6) As a District Nurse a woman was involved in a considerable change in role. She went from the position of service, total obedience and strict daily timetabling during her training to one of increasing autonomy. The one fits the symbolic feminine sphere and the other the move towards individual responsibility in the community. In the hospital system where she trained, the nurse worked in a strict hierarchical structure - she carried out the orders of doctors, matron, and sisters-in-charge. There was at all times a professional on hand with more technical or simply 'years of' experience. Her role then was not where the final responsibility for a life stopped. To leave the safety and support of the medical institution meant assuming greater personal responsibility for patient care. 84. Private nursing involved responsibility and accountability beyond any previous level. For the professional nurse the emphasis moved from technical care of the sick to the promotion and maintenance of health. The sick person needed to be able to rely on the carer for strength and comfort and often for training in managing ongoing treatment and perhaps adjusting to a changed lifestyle. The doctors needed to trust the nurse's capacity for observation and diagnosis. Her role would then change from subordination to responsibility in discerning a problem and initiating appropriate action. Amongst the city's poor, the lone nurse had to be prepared for conditions far removed from the spacious, and now hygienic conditions in which she trained. Both medical and domestic facilities would be almost non-existent. In hospital conditions the strictest adherence to cleanliness and hygiene guaranteed suppression of infection. During her training much of her training had been more concerned with scrubbing than direct patient care. Strength of character was a major requisite of the District Nursing Association. The District Nurse might even be viewed as a forerunner to the suburban General Practitioner, calling on her patient according to her assessment of the patient's need. She would set the pattern of visiting, building rapport and patient/carer bond. Ample evidence in D.N.A. records, the A.N.J., and press and magazine articles supports her acceptance. Professional nursing advances depended on recognition of the increased training and skill of nurses and the conse quent rise in social status of nursing, as much as the private nurses' perception of their ability to secure economic and professional independence, and the power inherent in positions of control. Compared, however, with the overall numbers within the field of nursing, those women were few in number. 8 5. After her four-years of training, as a nurse the woman had a profession and, as one wrote, they registered, then "in most cases passed out for private practice, the world before her". For some there was advancement to the title of Sister and, "for a few Matron"(7). The life of a nurse offered the scope of private or hospital work; in Australia there was Bush Nursing or District Nursing; the Red Cross; and war service; but, as the Depression showed, not a guarantee against unemployment. Two of the early Sydney district nurses saw service in the South African War. Sr. Anna Garden served as a military nurse from 1900 to 1902. After her military service, Lillie Morris remained in South Africa as a private nurse until 1904. She followed that with two years experience in London at the British Lying-In Hospital before returning to N.S.W. and becoming the district nurse at Kogarah in 1911. After six years there, she and her husband opened a private hospital. From 1906-7 the records of the A.T.N.A. Register of Nurses begin to show their global movement. Nr. Conry was the first nurse from overseas to join the Australian women of the D.N.A. Both she and Lydia Dunbar (1908) trained in Liverpool, England. Conry was Matron of the Society for Prevention of Cruelty to Children, and did private nursing before coming to district nursing in Sydney in 1907. After completing her training, Nr. Dunbar was a District Nurse with the Queen Victoria Jubilee District Nursing Association (Q.V.J.D.N.A.) for 2~ years before coming to Sydney in 1908. The Sydney nurse Elizabeth Andrews trained at Cairns, Queensland, and went to England in 1906 where she spent two years with the Q.V.J.D.N.A., returning to Sydney and the D.N.A. in 1908. She left again for England and private nursing in 1911. Janet Bloomfield trained at Sydney 86. Hospital and then served two years there as a Ward Sister. She travelled to England where she took the position of Staff Sister at the East End Mothers' Home for a year. From there she went to Florence for private nursing, returning to Sydney and the D.N.A. in 1909. Perhaps the most travelled was Ethel Blair. Certificated at the Buckinghamshire General Hospital in 1896, she spent three years with the Q.V.J. district nurses, and then another three years from 1910-1913. In the interim, Nr. Blair spent eight years in the Argentine first, as a private nurse, and later as Matron of a surgical hospital. In 1914 she arrived in Sydney, registered with the A.T.N.A. and joined the D.N.A. in November 1914. At least four of the Sydney district nurses served during World War I. Nellie Worrall and Daisy Wearne, who trained at Parramatta Hospital, s.erved in Egypt; and Ellen Connelly who had been nursing privately in London from 1910. Hester Maclean saw her military service as Matron In Charge, N.Z. Army Nursing Service.(8) Apart from "The Cry of the District Nurse", very little seems to have been written by the district nurses themselves, but many spoke or wrote about them. In October 1913 the Dail1__Tele~ra;e_h report of the Annual Meeting included the comments made by a Miss Bloomfield: "The work of the nurse as a citizen had been overlooked, yet she was working for healthy conditions in the city ••• teaching people to help themselves contributed to the real citizenship of the nurse." Over the years the image was built up of women who were efficient, gentle, patient, ever cheerful, resourceful, who despaired at the death of children and comforted the 87. dying and the newly bereaved. Doctors had spoken of unsung heroism, the nurse's loyalty and value as assistants. To inspire other women, women wrote for the press, magazines, and in the Branch Reports of the district nurse's loving tenderness and war against disease and dirt. The A.N.J. published articles for nurse readers that emphasised the principle of district nursing, the promotion of a higher standard of health, and emphasised the difficulties of working among "the less well-to-do where even the common necessaries of life are wanting".(9) 0 n t he Women ' s Pa g e o f t h e S x_ d n ex__ Mo r n i n _g__ H e r a 1 d , u n de r the heading DISTRICT NURSING ASSOCIATION'S AID TO THE SICK POOR IN CITY AND SUBURBS appeared the story of a recent call by the district nurse who "arrived to find no means of boiling water". In a house almost bare of furniture, the nurse was to attend a patient with wounds to be dressed. There was no gas, no spirit stove and no fuel for the kitchen stove, and not a basin or towel clean enough to be used. The writer commented that a nurse aware of nothing but nursing could be excused for not knowing how or where to begin. The Association nurse, however, chosen for her special qualities, went to the nearest Wood & Coal Yard, purchased 6d. of coal, carried it back to the house, and "before long had enough hot water to sterilise a bowl and a towel, take care of the wound, give the patient a warm wash, and make him a cup of tea".(10) Her response, though, changed from passive pleasantry to declaration of duty. In 1905 the journalist for~!-~£~~ wrote: 88. "'How tired you must get!" for the daylight had faded. 'You have been on your feet for hours.' 'Oh, lam not tired one bit! It is such delightful work ••• ! really love it • I and a glance at nurse's honest eyes showed she meant what she said." ( 11) "A Grateful Patient" wrote to the S1_dne1,_Mornin_&_Herald in 1932 of the care she had received whilst bedridden for twelve months. With a husband out of work for three years, the nurse had brought "nourishing food and fruit which we could not afford" on her daily visits, and the patient added "I was never made to feel my position". A nurse responded to that letter that "we have a higher sense of duty to humanity".(12) That sense of duty to Ethel McGregor included the nurses in her charge. After training at Sydney Hospital, she became Matron at R.A.H.C. in 1910, and served there until 1924 when she joined the D.N.A. During those years she took a "motherly interest" in her trainee nurses and pressed for many improvements in their lot increases in pay, recognition of seniority, better meals and living conditions, and employment of a seamstress to relieve the nurses of sewing and mending chores they did in the Ward. She was described as a "kind, concerned, religious woman", and soon after resigning from R.A.H.C. She became Matron at the Association's Nurses Home for approximately ten years.(13) On the written evidence of others, not the district nurse herself, she was a woman undaunted by whatever task or medical situation came her way. Her "one besetting sin, [was] that of covetousness. She covets and desires other men's goods! ••• for her poor patients".(14) The district nurse continued to build a service that became a catalyst to a change in attitude to community needs. 89. CHAPTER TEN FROM THE END OF WORLD WAR I 90. From the end of the war years, the D.N.A. received more public attention and attention from government ministers, t he j u d i c i a r y , and op i n i on 1 ea de r s • I n 1 9 2 0 , t he Q!.!.!z their notice of the Annual General Meeting "Value Recognised by Minister"; the following year the Szdnez._Mo rn i n_g__He ra 1 d, under the tit 1 e "Work Amongst the Poor", reported that the D.N.A. was a valuable organization but that the financial outlook was "disquieting". As Chairman of the meeting, Mr. Justice Street asked the members "Is that sufficient for the magnitude of the work you set out to do?". With nine nurses now, and two of them being boarded out, again money was given l:741/5/9, to enlarge the Nurses Home. Subscribers then included many business houses: the A.G.L., Daily Telegraph, Dalgetys, Anthony Horderns, Tooths, W.D. & H.O. Wills. Donors included the A.J.C., Bellambi Coal, S.C.E.G.G.S., and the Totalisator Board contributed unclaimed dividends. The Association rejoiced whichever way their finances swung. If they were short, they measured the comfort to the suffering against the expenses; and made plans to expand when funds outweighed expenses. The Government measured the cost in other ways. The D.N.A. represented an economy to the community because it restored people to normal health and work at minimum expense. Private philanthropy was an economy to the taxpayer. The service was growing and needed space to house the extra nurses. In his address at the Annual Meeting in 1921, Mr. Justice Street had said "This Association could not stand still: it must go forward." In paying tribute to "the devoted women of this association ••• (making) ••• a dozen visits a day and on foot ••• ", Dr. Mosely suggested that a home should be built for the nurses away from the centre of the 91. city. The proposal was seconded by Miss Williams, President of the Women's College of Sydney University who was a visitant with the nurses on their rounds. In 1922, still with nine nurses, the Association reported that there had been a number of changes in nursing staff; some nurses were resigning after only two to five years due to ill-health and pressure of work. By the end of 1924, the Executive Committee, who now included Dr. Kate Knowles recently arrived from Bermondsey, England, announced that they had met at extra sittings during the year to consider the purchase of larger quarters. At a cost of ./.4694/18/7, the home "Montana" in Boyce Street, Glebe, was bought, close to the tram, only 20 minutes from the G.P.O., large and capable of further enlargement. With Mr. Justice Harvey presiding at the 1924 Annual Meeting, the Chief Secretary, Mr. Oakes, presented a gift of ,1000 from the Treasury for the Building Fund, saying that the district nurse by treating the sick in their own homes was saving the government a great deal of expenditure. A similar gift of cilOOO was given by Mr. F.G. Sargood, husband of the Hon.Treasurer. He added a further ;/250 to the Furnishing Fund. By the end of 1925 the Association had ten nurses, had increased their salaries from L90 to il04 year, and with the aid of more gifts the mortgage on "Montana" was paid off, and the house completely furnished. The sale of the Darlinghurst property realised 1952. With "Montana", the Association then had assets of over ~5000, plus another ,13500 in deposits and stocks and bonds. By the end of 1926 those assets had increased to over ~9000, and Dr. Dick, Director General of Public Health, spoke of the benefits of the Association. Sydney Hospital costs per 9 2. bed per year were ~220, whereas the cost per patient to the Association was 26/- per year. Business house subscribers then included companies such as Hardy Bros., Kodak, Larke Hoskins, Nock & Kirby, Palings, C.S.R. and several Banks. A gesture from the Municipality of Glebe was to waive the Rates on "Montana". On occasions Pitt Son & Badgery had lent their Board Room for Annual Meetings, but now "Montana" was used for the Annual Meeting, and also as the venue for concerts and plays, and musical evenings often arranged by the Matron. Another two years, and another two nurses were employed. Mrs. Philip Street presided at the Annual General Meeting and, in moving the adoption of the Minutes, Dr. (now Sir Charles) Clubbe said that good work had been done over the past year but could it be better? the Association then was only a little larger than at the beginning of the Century but Sydney's population had doubled. So while the Association was making maximum use of their resources, the service was not expanding at a rate consistent with population growth, and fundraising was not keeping pace with costs. Nurses' salaries had risen to ~120 per year, fares for the year were up to A249/13/1, and the car allowance for the Manly nurse was then ~127 per year, and two Branches had been dissolved. The Association began to struggle against rising costs. In 1923 Mr. Bruntnell, Minister for Education, had spoken of the self-reliant nature of the Association which depended little on the government for support; but with salaries each year often running at over ~1000, and using at times half the money corning in, fares rising, and the cost of maintenance at "Montana", cash assets suffered. 93. In their financial dealings, the responsible members of the D.N.A. exercised their stewardship zealously. The Association changed their Bankers. They transferred their funds from the Commercial Banking Co. of Sydney to the N.S.W. Government Savings Bank which agreed to provide special concessions. The printer advised that he did not wish to send in accounts for less than three year periods. By 1929, with only sufficient funds in hand for four months operation, the Association appointed Mrs. Burley Griffin as Organising Secretary, and entertainment functions were run by the central body. She organised a motor picnic at Castlecrag, a Ball at The Ambassadors in June, and a Ball on the visiting s.s. Kitano Maru. But the Association still found itself in a serious financial position. The following table will give some idea of expenditures: Year Comforts Maintenance Fares Salaries I.: '- ~ ~ 1926 152.18. 7 789. 9. 9 214. 2.11 1154. 5 • 0 * 1927 232. 5 • 4 862.11. 6 199.17.11 1182. 4. 0 * 1928 312. 4. 9 1045.10. 9 249.13. 1 1223. 4. 8 * 1929 280. 8.11 983. 3 . 3 184. 5.10 1204.14. 0 * 1930 236. 3. 1 913.19. 6 175. 4. 9 963.13. 5 1931 237.15. 9 749.14. 3 180. 1. 8 890.15. 3 1932 209. 2 • 6 1026. o. 3 175. 6 • 2 1231. 5. 2 1933 197.19. 6 681. 12. 1 160. 2 • O# 1236.14. 2 1934 189. 9 • 0 594.14. 1 161. 3. 1# 1144.18. 0 1935 166.11.10 699. 1.10 209. 7 • 9 1116.15. 5 * The cost of the Manly nurse, varying betweenJ250 and 320 per year was additional to this figure, plus the cost of the car allowance. The records also show that during gastro epidemics, an extra nurse was employed on a temporary basis. # A drop in the cost of fares in these two years may be attributable to 28 women volunteers using their own cars to drive the nurses for 2-2\ days per week. 94. There had also been a serious drop in gifts in kind; from 1919 to 1929 the number of donors had halved, and the Association no longer described the gifts or quantity given. (See page 96). In 1929 the name of Miss Kendal Davies, who in 1899 had doubted the wisdom of starting a nursing service as yet another citizens' charitable activity, appeared as a Councillor of the Association. Her name was not noted as a member of any branches during the years so it may be that she was then herself retired from nursing and was able to devote time to the D.N.A. She was active in its works until her death in March 1935 when Council advised the loss of a "staunch supporter ••• (and) an invaluable member of Council". A car donated by the Australian Association of British Manufacturers in 1928 had meant that calls previously refused because of distance could be attended. It was sold because of lack of funds in 1930, and the city office of the Organising Secretary went too. Committee ladies now drove the nurses in their own cars two mornings per week. Those drivers reflected the commercial background of Sydney's leisured ladies Mrs. Klippel (wife of a manufacturer of menswear), Mrs. Perdriau (Dunlop Perdriau, manufacturers of rubber products and tennis balls), and mother and daughter Mrs. Teece (wife of Clive Teece a co mm it tee member since 1 9 1 0) and Miss Teece , and Miss Doreen Hordern. In 1930 with a cash deficit of J800 the Association was forced to dip into its reserves. Ever optimistic, the Association's organising Secretary, then Mrs. Jenner, approached both Blacktown and Bankstown Councils with a proposition for providing a district nurse in both municipalities. When she was asked if the Councils would be expected to pledge funds, she told them that while any money given would be welcome, the Association was not looking for any subsidy to the work.(1) 95. Our thanks are due to the following ladiP, and gentle men for rlonations in kind:-- .\lrs. Antill :\liHH Ma<'intrn,h .Mrs. Ash l\liss Mann Anonymous Mrs. Mccallum 1919 Mrs. Brady The Misses McCabe l\Irs. Rickerton Blackburn l\1rs. H. H. Meares Mrs. Baxter Bruce Mm. J. K. McKay Miss Bedford Miss Newnham Miss R. Bundock Sonny ()',Neill Mrs. O"Brien :\lrs. I<'. Norrie ,lliss Ruth Bedford J\lrs. Sydney Phillips .Mi~~ S. J. Campbell Mrn. A. K Philli·ps l\lrs. Clayton :\lr,. Plomley Miss ( 'hristian l\liss K Hankin Mrs. Conly :\1rs. !lice !llrs. Crowley :\liss Hiley l\liss Croaker '.\liss Hyrie Dr. Corlette The !loyal Yacht Club Chrlstorlelphlan Dorcas :\I rn. Steele Society :\In,. Su!'kllr1g Mrs. Dixon :\In;. 1Stanley Russell Mrs. W. P. Dixon Syrlney Needlework Guild Miss llodd :'11rn. W. D. Targall MlsH Dun Mm. Ninian Thompson .'lliss Faithfull M rn. Thompson Miss 1',arran ( Tea Party) J\lrn. U. H. 1',itzhardinge \Voollahra Annual Meet- Mrs. \\'. Freeman Ing MrR. Sinclair Gillies '.vliss Walshaw Mrs. Uoldsmlth .c\ligH Warburton Mrs. E. S. Hayman War Chest Hefreshment J\liss Hayman Stall (Town Hall) Mr,. Hemsley War C'hest Depot Mm. Lytton Hitchens illrs. Grandison Watson Mrs. Jcely l\1rs. l\iack Walker Mrs. lvory '.\Tr~. W. Walker Miss Irving \\'uverley, Bondi, and Miss J,,_ Clark Irving Han(! wick Branch Mrs. Jales .\I l'H. Whit lielcl Miss Jones :\liH>< Wllhwn Miss Kilday :'llif GIFTS. l\[rs. Adams. l\1 iss Mills. /1.rwnymous. Mrs. Morehead. Miss J. S. Barnes. !\I rs. l\[artin. Mrs. W. Burfitt. l\l rs. 1[addcn. 1929 Mrs. lloeheme. ).liss l\laxkerning. Mr. T. M. Burke. 1!iss Parkes. .r,t iss Harber. l\l isscs Reilly . Miss Halkcr. Red Cross Society (Rose Miss Ruth Conway. Hall). :Mrs. Christian. Sydney Needlework Guild. Dr. Chisholm. l\Iiss Stephens. Mrs. E. M. Cox. :Mrs. Colin Stephens. Misses Dove. Mrs. Reginald Sullivan. D.N.A. Auxiliary, North 'l'h~osophical Order of Ser- Sydney. vice. Mrs. Davidson. \Vee Service Band. Miss J. G. F1tzharding. l\ I rs. Yeoman. J\[rs. Jenkins. N9rth Shore High School Mrs. John Finlay. Old Girls' Union. Mrs. H. B. Greene. l\[rs. Harold Richards. :Mr~. Garnet Halloran. l\lr. \V. Knowles. l\lr. Hogg. l\[iss 1\1. Callaghan. Mrs. Edward Knox. l\l rs. G. Davidson. l\1 r,. :\IcGarity. 96. The Manly Branch was disbanded when the new hospital at Manly was able to meet the need supplied by the district nurse. North Sydney Branch was still expanding, but Waverley and Surry Hills combined, and Redfern took some of the extra work. Woollahra reported that the district nurse was much needed while there was so much poverty and distress. Throughout 1930 the Nurses Register increasingly recorded "unemployed". For the children treated at R.A.H.C. the notation "father not working" was more usual than not. In 1931 the records for Glebe and the City area recorded the entry "Dole" with increasing frequency. Leading members of the community and the Association spoke out. In 1929 Dr. Kate Knowles, who frequently referred patients from her Surry Hills practice, had said there should be a nurse for every poor suburb, Dr. Sydney Morris added that the D.N.A. was not a charity but should be regarded as preventative work. Dr. Guy Griffiths said it would be a serious loss to the community if through lack of funds the Association was forced to curtail its services instead of increasing. Dr. Love, Chairman of the Hospital Commission, went on record, somewhat propheticly, saying that the Hospitals should contribute to the upkeep of the Association. Over the Summer of 1928-29 gastro had raged across Sydney again. The Nurses' Register of Cases records that Nurse Savage in December attended eight children aged from one month to two years, ten children in January from five months to three years, and as it waned seven in February from three months to 18 months, down to five children in March. In the same month Nr. Slocum attended two cases in Manly - a boy of sixteen and his father, and a 40 year old dressmaker - for whom she she recorded "very little work", and "Does not get much work: in very poor circumstances". Under "Occupation", the Nurses' Register included a wide 97. range of jobs. Male jobs included a Park Ranger, ,/5 p.w., a labourer 14, tram guard .j.5/10/-, a toolmaker '/.-3/6/-, a window cleaner J4/10/-, painters, packers, a policeman on JS/10/-, and "Odd man in a Circus" (with burns). The women were laundresses, a chocolate dipper, waitress, a housemaid with burnt hands, "referred by Mistress", receiving free treatment for five days, and a dressmaker earning j3/10/- per week. Increasingly through those years the entry more often was "Out of work". There was a growing number of trained nurses out of work and a nurse wrote to the S.M.H. of the distressing problems facing the unemployed nurses. "In these stressful times few can afford ••• the fee of a private nurse." She described a case she knew of where, because of lack of money, a man nursed his wife during the last weeks of her terminal illness as well as looking after the home duties. With "public hospitals full to the last bed" and only able to employ a limited number of nursing staff, she proposed a scheme of temporarily reduced pay to home-nurse those in need - "Numbers of fine women would respond to the call". "Desperate times demand desperate remedies" the nurse said.(2) This and other cases of nursing need were situations where the Association could have stepped in, given the ability to raise and provide the funds to employ more nurses. The Hospitals not only acknowledged their need, but became a major competitor for public benevolence. During December 1930 full page advertisements appeared in the ~l~~~l Mornin~_Herald in a public appeal for funds - CHURCH AND STATE GREAT HOSPITAL APPEAL The appeal, signed by the Premier John Lang, told of curtailment of services, inability to pay tradesmen, and 9 8. suppliers of food and medical requisites. Through lack of funds the hospitals were said to be refusing admission to thousands to undernourished children needing the care and attention given by hospitals. In the spirit of Christmas giving, the people of Sydney were asked to respond.(3) Against such a highly visible appeal, the D.N.A. would have been hard pressed to compete for increased funding from the benevolent - at a time when the press were also reporting the subdued and sober air of the Christmas shopper with a "limited purse". (4) The times were such that the overcrowded public hospitals could not provide for those unable to pay for private care, there were unemployed nurses available, a widespread need for home care, yet the D.N.A. with the willingness and the experience could not expand - through a lack of funds. The expansion of the D.N.A. would have relieved the hospital overload, and taken up some of the slack in nurse employ ment; the poor and the unemployed would have benefited, but the opportunity and the funding was yet to be realised. Though the district nurses reported little general increase in medical calls due to the Depression, they were constantly asked for extra food and clothing which they were sometimes unable to supply. They were able, however, to direct the needy to the right channels for assistance. The one exception to medical needs was Newtown. The nurse there recorded making 2,250 visits during 1930-31, and still most frequently she recorded "Really needed financial help". As the Depression deepened, suffering and economic distress were reported by the Association as acute in the poorer suburbs. Gastro raged again in the December and the Darlinghurst Branch closed down in 1932. Nurse seniority 99. rates increased salary expenses, and the Trustees were forced to redeem i 1,000 on deposit with the warehouse company, Sargood Gardiner, before maturity date. In moving for adoption of the Annual Report, Mr. T.R. Bavin M.L.A. said that government relief work was no substitute for voluntary help. But voluntary help during economic crisis could not maintain the level of funds necessary to substi tute for a State health program, and Professor Sutton emphasised that hospital treatment was not the sole way of caring for the sick that the D.N.A. was an essential auxiliary to hospital treatment. There can be no doubt of the attention that district nursing received. The S1dne1_Mornin~_Herald gave space to their plight in October 1934, and under "District Nursing" published statements made by Sutton: "It is better and cheaper to keep the chronic sick alive in their own homes than to have them in hospitals." It was not only the chronic and the senile who needed the nurses' care. Two nurses responded to the publication of Sutton's comments by writing to the S1dne1_Mornin~_Herald. "That there is less sickness is one of the obscure blessings of bad times ••• " but the hospitals had long waiting lists and "the harassed husband with a sick wife and children to care for" could not afford either the costs of a private hospital or a private nurse. The nurse asked "what are the poor people doing?" presumably, this nurse said, relying on untrained neighbours, friends and relatives. A great many nurses, she too added, were unemployed - they were trained women for whom "unemployment relief undertakings are inapplicable". They were hard times for the nursing 100. profession, yet the D.N.A. as a voluntary body were unable extend the service to meet the needs of the poor. Nr. Pauli attended a women and her three children aged from 10 months to 4 years for pneumonia. Her records show the husband was in Newcastle Prison, and that the family had no means. Referred by the Police, Nr. Pauli attended Rita Broderick for post-natal debility. Nr. Dixon attended a 23 year old woman for 3 days following an abortion. The husband was out of work an emotional crisis wrought by economic distress: Nr. Dixon's record showed "needed help" financial help would perhaps have averted the need for medical help. Cystitis, ovarian cysts, miscarriages were common among the 20 to 40 age group. Length of time on the books for some of the older women was as long as 15 years. Nr. White recorded 200 visits to one female patient. Nurse dressed not only breast cancers and breast amputations, she cut nails and treated corns. In the most personal of female matters, the district nurse gave practical skilled care to women who could not otherwise have received professional treatment. This was essential individual social health care for poor women, and not an objectified transfer of class-structured benevolence. Dr. Sweet, in charge of Dispensaries at Ultimo and Christ Church St. Laurence, was quoted as saying: " ••• instead of 640 new cases, they should have been able to help 6,000. Lack of financial support hindered them and this should be rectified by assistance from the Municipality and the Health Department ••• attention to the sick in their own homes is a legitimate hospital expense for Government • ••• in 34 years a remarkable difference has been made •••• Money is the greatest need, but also loving service and determination." 101. It had already been shown, in treating sick children at home, that the benefits of efficient, trained and personal kindly care in familiar surroundings outweighed institutionalisation. Referred by Dr. Hislop, Nr. Blaxland attended a baby with an arm fracture. Over 53 days, she made 14 visits to the baby in her Waverley home. As the community suffered economically, so too did the D.N.A. Only once in the years from 1928 to the end of the financial year 1934-35 did its finances end in credit, 1232/19/3 in 1930-31, on the year's work. Cash reserves in 1926-27 had amounted to almost L5500; at the worst point at the end of 1932-33 those resources had been reduced by recurring deficits of l 700-850 per year. The cost of "Comforts", drugs, dressings, and often food, had risen considerably. A major increase in subscriptions in 1933 meant a deficit of only £38/15/-. The W. & E. Hall Fund donation wa~ increased to "300, an obvious recognition of the service in its need. And in 1935 at the point of incorporation into the State health service, the government gave l 700, still far outweighed by private benevolence. From ~1199/2/3 subscribed in 1930-31, subscriptions and donations together rose to ~2113/6/9 in 1934. Gifts in kind had increased again, even beyond the 1919 level, and the Association went back to describing each gift. (See page 103) During these years further changes had been effected to the Association as a legal body. The Council now included only one member of the Church of England clergy, Archdeacon Charlton, and only one doctor, Dr. F. Guy Griffiths. The remaining fourteen members were women. The Constitution had been altered so that the Executive Committee should now be composed of three delegates from each Branch, with an additional six members to be elected by the Committee if necessary. 102. Sundry Gifts during the year. AdnmR, MrA. Lii]('n nnd Cloth Fnirfax, :'lfiR8 1\f.-Linen. 1934 ing, making of lnoRe coverA Fairfax, Ladv-01<1 Lim•n. for "l\1011tann," J>nperR and J<'raAt•r-, 1\1iRR.:_Cloth ing. '.\[11gnzi11eA. Friend, '.\liRR A.-Old Lim•n. Allen, l\frA.-Knith'd 1\-litt,•nR. Andl'rRon, l\lr. Alnn-Ell'dri<• Gillies, l\lrA. Ri,wlair-Old Iron. Linl'n. Galloway & RtPphl'n, thl' ;\fiRHes Baxtn Bml'e, l\lrn.-LinPn. -Clothinj?. RoPhml', '.\1rA.--Clothing. Hudson. l\lrs.-Li11Pn. Bundock, Mrs. Clothing. Hook, l\liRR-Clothing. HerRhnrg, Mrs,-Rnrgirnl Ap- C'homlPV, Mrs.-0\d Lil]('n. plin1we,1. ( 'hriRti~n, MiR1t-Clothing. Haley, the l\liRAl'R-£1 for win Cox, MiRR l\Jndgl'-Portahle tPr romfortR. Bnth. Horrlnn, Larly-Tl'u, sugar, DavirlAon, MTR. A.--LiJwn nnd l'llkl' and hiR<·uits. Clothing nnd ,Jam. J-::ing. Misio Olin>---Clothing Dovl', the MiRRPR--Clothing. and applinnres. J)oui?lnR. MrR.-R1trgk11I A p Knox. Mrs. Edwanl--Linl'n plinnC'eR. nnrl Clothing. DibhR, l\liRR--LooRe-co,·er ;\TosPl<'Y, J\lrs.-C'lothin/!'. mntl'rial for "l\Iontnnn" Ait ::\lnrsh: Miss--Clothing nnri ting-room. ShoeR. Eton, MrA.-Clothing. ::'lfarshnll, 1\fiAR--Linc•n. MnRon, l\lisR--\Vnter-colour :Fairfax, 1\frA.-Linen and painting. Clothing. l\for<'hend, MisA---Clothing. McC , 1\!r. -:\!t•n's \ 'loth- \\'<'11t worth. 1\liss--ll 11g. ing. "'atHon, Miss :\.--Clothin,z. Wilson, ~fisR A.--Suit,·ns<', l'hillips, '.\I iHs--1.in.-n 1111itto. H11rgirnl ApplinnrPs. Tiu• S\'1l11,•v !\l,.r,11.-,n,rk <:uilri Rund I!', 1\!r,.-1,irH'n ,111rl !H; ( :a'rnwnt~. t'lothing. Th,• I 'nit Pd KnittPrR, per ~lrs. It. i--:ty--11 Bugs. 2-milh, :\!iss---( 'lothing. Tl1<• Th,•osnph i,·a I Ho,•iul HPr Staines, :\!r~. !lall---Clhl UnPn. ' i,·,•. l"'r ~I >s. ,knk ins Stuart, i\lrH.--Li11e11. K nitt.-,1 <:arments. Thi' f!Psl<'rton Grang<' Hewing Tooth, :\!rs. Douglas I 'hil,li-Pn's ( 'in·lr. prr ~Im. D11n,•11n-• Cloth in~. K11ittrd Garnwnts. Christmas Presents. 1.ady UnmP--Frnit. ~lrs. Hun 103. The wife of the Governor was to take the position of Patroness instead of President, with a working President elected by the delegates. Lady Street served in the position for two years, and then Lady Fairfax for the following two years. All the "perennials", as the Australian Womens Weekly listed them in 1933, had added enormously to the funds of the D.N.A. over the years but according to the writer of the article Fetes, Card Parties, and Dances had been "sucked dry". The state did not provide, and the charitable were criticised for their methods. They noted too that "The well of charitable impulse is bottomless"(5) and the D.N.A. had cause to thank Lady Game for her "charitable impulses". A Flower Show at the Sydney Town Hall organised by her netted J323, The Governor's Ball in April 1934 brought in nearly ,100, and her two final gestures before returning to England were the proceeds from her book of poems, "Barging Days - A Farewell to New South Wales", and a Garden Party at Government House with the proceeds shared between the D.N.A. (i943) and the Bush Nursing Association. The first public fundraising events were the two Fetes held in Government House grounds, and the final major public event for the D.N.A. as a voluntary organisation was Lady Game's Farewell Garden Party at Government House on 11 January 1935. A 42-page glossy Souvenir Program (6) was sold for 6d. Under cover of her regal photo in Court Dress, tiara, and feather fan, Lady Game's message read: "The District Nursing Association is still the Cinderella of Good Causes. But her star is rising There is still much to be done, but we feel confident that you will do it and that you will not rest until you have a District Nursing Association worthy of this city." 104. She had some criticism and some praise. Nine nurses now were coping with the sick poor in a city whose population numbered 1\ million, Melbourne had 18 nurses, and, with a fifth of Sydney's population, Adelaide had 17. The service in Sydney always compared poorly with other cities - but only in terms of the number of nurses in the field. But, of the nurses, Lady Game said "It is a thrilling if poignant experience to go on a round of visits with the district nurse ••• there is no one who can take her place •••• " (She had expressed these same sentiments to the Associ ation Treasurer, Dr. Millard, when he drove her "home" after D.N.A. meetings. But Lady Game's vision reached out: "It is not realized that the Association is, in fact, but a nucleus of what it should be - a good one it is true, but only a nucleus". 105. CHAPTER. ELEVEN RECOGNITION TO INCORPORATION 106. That nucleus had over the years been praised and commended by government Ministers and officials; though, in over 30 years the State had contributed only 2500 towards the cost of the service. Its economy to the community in the form of savings in government expenditure was frequently outlined. The Director General of Public Health, Dr. Dick Otton, spoke of the benefits of the Association in 1926 when he compared the cost per hospital bed to the D.N.A. cost per patient in their own home. In 1930 Dr. Elma Sanford Morgan moved the adoption of the Annual Report. She was then the Assistant to the Director of the Head of the Division of Maternal & Baby Welfare, and under that division, Dr. Sanford Morgan was in charge of "Supervisory Nurses". On the 21 October 1930 the Sydney Morning Herald reported Dr. Sanford Morgan's message: "No Association had a wider appeal that the D.N.A. In her medical opinion she found that the services it gave to the sick poor were invaluable. The Hospitals should realize to what an enormous extent the Association relieved them in caring for chronic cases of illness ••• who otherwise occupy hospital beds. It filled the gap in the hospital system." To the Association the value and need for the service had never been in doubt, and now it was being seen as complementary ancillary service for the public hospital system. The nurses were praised for dedication, efficiency, and above all skill. The hundreds of women in the financial support structure worked with enthusiasm and entrepreneurial flair "chasing the charity pound". The medical services of nine nurses by the end of 1934 rested on the philanthropic services of a network of women. Lady Game's Farewell Garden Party was a farewell to independence for the D.N.A. The service had proved itself necessary to the health and wellbeing of the socially 106i. disadvantaged of the city. Lack of funds was the impediment to growth, and that was about to change. On the 6 December 1934 the Hon. H.M. Hawkins,Col. Secretary spoke at a sitting of the Legislative Council on the Public Hospitals (Further Amendment) Bill: "The bill contains a provision for the assumption of control of district nursing services by the boards of hospitals, it being thought advisable that these activities should be co-related. Existing services will not be linked-up except with the consent of those concerned. Doubtless many of these institutions will be glad of the opportunity to make comprehensive provision for the sick, injured and others who require their services ••• and to cover payment to them of subsidies from the Hospital Fund. This is being done with a twofold objective, to enable those auxiliary services to receive the support to which they are entitled •••• They are all part of one great plan to ease the sufferings of those who have fallen by the wayside so far as health is concerned. The more the fact that those services should be linked together is appreciated, the greater will be the result."(1) On 11 December 1934, after the Second Reading, the Bill was adopted and the legal means were in place for the government to add the existing district nursing service (and the Bush Nursing and aerial medical services) to its existing health system. It now needed the concurrence of the D.N.A. to do so. At the Annual Meeting held on 4 October 1935, with the Minister for Health, Mr. H.P. Fitzsimmons presiding, members were informed that 107. "In view of the passing of the Public Hospitals (Further Amendment) Act last December, which extended the provisions of the Public Hospitals Act to a District Nursing Association on application by such Association, the Council decided to recommend such application." A General Meeting held in July had recommended that the Association should apply to have the its name included in the Second Schedule of the Public Hospitals Act, to alter the name to "Sydney District Nursing Association". The Hosp it a 1 s Co mm is s ion in turn recommended to the Minister that the Association's application be accepted, and the addition of the District Nursing Association to the Second Schedule of the Act was duly gazetted. The Executive Co mm it tee reported "It is hoped that under this arrange - rnent the usefulness of the Association will be greatly extended, and the hospitals of the Metropolis greatly assisted". Dr. R.B. Wade addressed the Meeting and outlined plans for using the district nurses to reduce the number of patients attending Outpatients Departments. With Honorary Doctors trying to attend to as many as 60 persons in an afternoon, ward care of serious cases was suffering. Horne treatment by district nurses would assist in decreasing those corning to Outpatients Departments, thus too reducing the need for the sick and injured to travel to a hospital for treatment. The necessary government funds would be provided as the work progressed, and he emphasised that the Association would be working under the advice of the Commission rather than its control. The key to the changeover, as the Szdnez_Mornin~_Herald, of 5 October 1935 described it, was that "a comprehensive scheme of cooperation was necessary". The State needed the nursing service and the Association needed the funding. Legal form had to be observed and the Association had to 108. be willing to surrender their totally voluntary status to allow their original aim to continue. With the addition of State funds it would not only be the poor who would benefit, but any citizen in need of nursing aid. Dr. H.H. Schlink, Chairman of the Board of R.P.A.H., also addressed the 1935 Meeting. He told members that during his time as Medical Superintendent of R.P.A.H. he had had much experience of the work done by the district nurses in supervising home treatment for patients discharged from hospital, and there was then a new and serious medical problem where the skill of the district nurse would be needed. Since 1934 deaths from cancer had become second on the list of killing diseases. Government health officials were baffled at the heavy toll - as high as 52.7% in Newtown, 56.67% in Darlington, and 46.63% in Redern of all deaths.(2) For some years R.P.A.H. had been treating cancer patients with the new radium procedure, reporting considerable success. But the high incidence of advanced cancer meant incurable patients were unable to remain in hospital. These were people with a desperate need for dressings and nursing attention, and he added that the value of the district nurse must be realised in carrying out hospital instructions for discharged cancer patients, and in guiding their care at home. As Schlink knew, many of the district nurses had trained at R.P.A.H. and had developed there both confidence and skill in dressing cancerous growths(3), and his opinion was that instructions for home treatment would be more difficult without the guiding hands of Sydney's district nurses. The essential personal service of nurse to patient was going to continue as an integral support to the hospital system, but also it was to remain what it had always been: skilled nursing aid to people in need, in their own 109. homes. Only the superstructure had changed. The D.N.A. was no longer a wholly voluntary organisation; and the burden of cost and responsibility was to be spread across the resources of the State. Changes in social attitudes to poverty and community health had caught up with the vision of Sydney's pioneer nursing service for which, in spite of their energies, the women fundraisers had not been able to keep pace with the need. 110. CHAPTER TWELVE THE D.N.A. AS A NETWORK 111. After an historical review of the D.N.A., there is a basic question that should be asked: Is it likely that such a nursing service could have survived and grown without the particular organization that started it, controlled it, and supported it. There already was a nursing service operating from the Nurses Home in Phillip Street, and although they requested that the area of Lower George Street be left to them, the Home and the service closed down only a few years after the D.N.A. got under way. The D.N.A. was a citizens' voluntary organization founded on philanthropic ideals that produced an extended community network of committed supporters. An analysis of the theory of the three concepts can be related to the D.N.A. A theory of Community Involvement put forward by Sower, Holland, Tiedke & Freeman stipulated that any problem introduced into a community has its own natural history, with a flow of action devolving from an idea, proceeding continuously until rejection, successful completion, or failure short of its stated goal. They further stated that though people do act continually upon the problem, there does not have to be uniform action through the total community upon the 'crisis' and that the problem does not have to be one that is necessarily the concern of the major portion of a community.(1) The idea for the district nursing service came from a small intellectual and professional elite group. Their basic objectives and aims were specific in terms but vague in intended application. The evangelical thrust towards social reform produced a convergence of interest by clergy and church members, and, with legitimation and sponsorship provided by the Archbishop, 'the initiating set' was begun. They produced their "execution set" and mobilised their micro-community resources by producing their journal 112. f .!.£.&.!.~2.2. • The i r cha r t e r , how eve r , w a s on 1 y p a r t 1 y fulfilled. The stated goals held within themselves the reason for rejection, and non-continuance. They said they had no program and would avoid putting forward anything cut and dried. They allowed themselves no form of growth other than philosophical study and representation. Within that group, however, were people actively involved in the social processes of the community, and it was they who produced the idea, introduced the 'crisis' that most concerned their particular merging of interests. The problem produced discussion, conflict, and resolution, which in turn influenced the action that has been shown to have its own natural history. What occurred was a specific sequence of events which brought it to a point of acceptance within a major social process: government incorporation, a universal welfare application and shared community responsibility. The D.N.A. exhibited social convergence of interest, with concrete steps taken to fulfill their purpose. With a common goa 1 they established their charter, and a group identity. Group rationale for their purpose was never, from sources available, at risk from individual deviance of interests. The D.N.A., as successor to the C.S.U. ideals, because of its secular and political community involvement was able to influence in turn Vice-Regal and titled upper-class people, and members of the professions, decision-makers, and opinion leaders to their support. The prestige and attention that accrued at both the central and branch levels flowed in a circular motion to further strengthen involvement. The role of a neutral group became that of the Church. The clergy served on committees, permitted the use of church 113. halls for women's Branch meetings and to provide storage space. Their influence diminished to a nominal presence after the decision to become non-sectarian. The "opposition" that is put forward is that in spite of being active and organised, legitmation does not include "equivalent access to the recognised instruments of community authority"(2). The D.N.A. remained for 35 years an independent philanthropic body, without access to regular government funding. They existed almost entirely on private donations, bequests, subscriptions, private fundraising and an occasional government grant. They did not look for or need government authority or recognition to establish their worth in the community. It is possible that in the beginning their work progressed further because it did not represent official action within the home and family unit. The initiating set of the D.N.A. was able to act effect ively because of their prior cross-linking channels of community involvement. They were influential within their own spheres and were able to influence other overlapping political, commercial and professional spheres. The members had social status, prestige and mutual goodwill and, notwithstanding individual directions, all were in t.he stream of social reform and environmental reform. By reason of their work and interests, many were already within "friendship cliques" and so responsive to requests for assistance(3). Many were linked by marriage and kinship. With their execution set established, the D.N.A. were in a position to mobilise management and professional personnel to implement their goal of nurses in the field. Expert assistance was always readily available from members of the finance and business sectors. Because of the support of doctors, technical assistance from dispensaries, 114. medical supply and drug companies was readily made available, as were ambulance services when needed. The most important factor is that the executive superstructure depended on the network of women doing what they knew best, and where society most commended their presence and efforts: fundraising and providing goods. The women's substructure held their meetings, and supported and sponsored the nurses. They were the active majority on which the vital personal service to the individual patient rested. The visiting district nurse was the outward symbol and the raison d'etre of the association and she existed and the service expanded because of the inspirational appeal and sentiments for the value of their work that developed between the nurse and the women at the Branch level. The executive organisation of the D.N.A. fulfilled their charter to the Sick Poor in their own Homes, and community awareness validated the need for the service. Appeals from high profile men and women attracted the attention, sympathy and financial support that was needed to maintain and expand. Though the problem did not concern a major portion of the community as supporters, it concerned a major portion of a disadvantaged sector of the whole community, and proceeded to successful goal achievement. Structurally the Association was designed to extract maximum benefit from individual talents, and fluid enough to allow the Branches an autonomy of operation that strengthened the central body and the overall image and achievement of their objectives. As an organisation, the network of the D.N.A. was its fundamental strength. 1 1 5 • CHAPTER THIRTEEN PHILANTHROPY AND THE VOLUNTARY CITIZENS 1 1 6 • In an analysis of philanthropy and charity in 1938, Constance Braithwaite used District Nursing as one of her themes. Braithwaite identified the emergence of a charitable activity before the State is able to act adequately. She developed the argument that certain types of voluntary and personal social services progress to the point where they are seen to merit public funding rather than depend on charitable funds. Sympathy, a sense of community, and an extension of Christian tradition, motivate a social service that acts as a brake on the waste of human resources.(!) By means of grants, the move to State financing is gradual and increases as the charity is recognised for its practi cability and desirability. Most usually it will be a "pioneer" form of service that gathers the weight of public opinion in its favour.(2) Two problems that Braithwaite detected in other charities were, in her opinion, not inherent in district nursing. As charitable relief was not given in money, no conflict would develop between the paid professional and the unpaid voluntary workers.(3) For the voluntary citizen the personal service was a sparetime activity with many advantages accruing. The number of people visited was few in relation to the number of workers and so a personal interest would be manifest. Valuable training was gained in citizenship and in specialized social problems, as well as in finance and administration. With widened social awareness and know ledge, the voluntary worker would be more likely to continue to use the expertise gained.(4) Braithwaite showed that it was possible for a voluntarily administered charity and State financial aid to blend, despite reluctance to surrender to State incorporation. The essential factor was that the citizen as philanthro- 1 1 7 • pist would have developed loyalty and obligation to the individual - the object of the organisation.(5) The D.N.A. followed the Braithwaite model as a typical philanthropic charity, illustrating work by elite and middle class volunteers with time and resources to devote to the relief of distress among the sick poor. The poten tial for conflict did not emerge as relief was given in medical care and personal comforts. There were, though, many instances where the nurse noted that financial help was seen to be as great a need as medical care that poverty induced or exacerbated illness. The paid profess ional was the trained, experienced nurse held in esteem by doctors and by the network of women auxiliary workers. This service built on nursing skill became a necessary adjunct to the State health system, and so not only became a legitimate claimant for State support but an obvious target for incorporation in its expanding health program. By 1930 the value of the service was undisputed. Twenty two doctors from Redfern to Glebe were referring patients. Amongst those doctors were Drs. Ludowici of Surry Hills, Fairfax of Leichhardt, Minnette of Manly, Armstrong, Lloyd Jones and Lucy Gullett of Redfern, Bullock, Isbister of North Sydney, Teece of Edgecliff, and Armstrong and George of Glebe. As well, there were the referrals from hospitals, chemists, clinic nurses, the Red Cross, and Public Health Inspectors. Women of the Branches referred those who came to their notice.(6) Personal recommen dations came from grateful patients who wrote to the newspapers and to the Branches. The concept of district nursing was already well estab- lished in both England and America and the Sydney Association was modelled on those overseas organisations but developed its own direction to meet the local needs. The status of most women working to fulfil the aims of the 118. D.N.A., was reflected from their husbands. Other women, such as Miss Badham, Miss Carter, Miss McGahey, Rose Scott and Mrs. Neville Griffiths had created their social space in their own right. They achieved, as Godden says, their "legitimacy and purpose" working within the sphere that pertained to women and their purpose with the D.N.A. created the "autonomous women's culture", the sub- structure, that made the achievements of the D.N.A. possible; but nor did they, as Godden points out, step outside their sphere of women's philanthropy. The drive towards and achievement of Woman Suffrage detracted from power within a separate women's sphere. "What survived was a women's sphere where women were subordinate to selected men. In many ways the group which took over this power in philanthropy ••• was ••• the physicians."(7) Godden also pointed to the gap in historiography - the underestimation of the influence of women in philanthropy and the influence of the church.(8) Once they were confident of their activities within their women's sphere, the philanthropy of the Sydney women of the D.N.A. accounted for both power and purpose. The long term aim had always been for expansion, but in spite of the "considerable energies of bourgeois women", their efforts were not able to keep up with the needs of an expanding population. In Braithwaite's view, the defect in charitable finances is not in what they do but in what they are unable to do. With the transfer of the D.N.A. to the Health Commission in 1935, the burden of cost was transferred to the whole community: to the government committed to "universal entitlement, or just proven need".(9) The D.N.A. began a service as a group of voluntary citizens in a colonial society. Population growth in a more industrialised society required a service as large as the founders envisaged but larger than a voluntary organisation could uphold. 1 1 9 • CHAPTER FOURTEEN THE D.N.A. AS A VOLUNTARY ORGANISATION 120. In evaluating the role of voluntary organisations, David Scott of the Brotherhood of St. Laurence based his analysis and critique on the existence of government services already in place in the community. He gave as "Reasons for the Importance of Voluntary Organisations" 1. Experimenters and Innovators regular welfare services are pioneered by voluntary groups and organisations. 2. Do humane things government welfare organisations cannot and do not do. 3. Voluntary organisations are the citizens' best guide to official services. 4. Effective, knowledgable and independent critics of official services. 5. Provide opportunities for self-realisation and fulfillment identity, purpose make "caring" effective and satisfying. ( 1) With hindsight, his factors of importance are relevant, and, with hindsight, they are interesting in evaluating the D.N.A. - and in assessing its historical progress and the role played in social change. As a voluntary organisation, the D.N.A. could make deci sions and adjust strategies as conditions determined. The service itself was not completely an innovation or an experiment. Similar services were operating in both England and the U.S.A., and were already in operation in Melbourne and Adelaide. It was not an entirely new field for a church organisation to undertake service among the poor. It was however an innovation for Sydney, an experi ment for an untried group, an experiment in attending the 121. sick poor in their own homes, and an experiment to begin with only one nurse - and she only recently qualified. They started a humane service, based on their Christian principles, a service that the State was then not able to provide, and neither saw as a current or a future priority for itself to provide. That response was a reflection of a prevailing unconscious denial of the existence of poverty. The plague scare of 1900 finally made it obvious that excuses could no longer be offered. Networks were already in place for localised help. Neigh bours were often alert to those in need, mission clergy and deaconesses made house visits, and police officers were on occasions the intermediaries to assist when a doctor was required. By 1906 the services of the D.N.A. were included in the Social Workers Handbook (see page 123), so by then it was included in a semiofficial guide to community aid and support systems. David Scott described a voluntary organisation as a body established and maintained by people making their own decisions and wholly supported by acts of giving, by persons not paid for their work and based on loving kindness towards others. The D.N.A. fills those criteria. It might be argued that fundraising events are not strictly acts of giving, but goods offered for sale in that way and the time given to organise are equally acts of giving as much as the "direct giving" of money. As a voluntary organisation, the D.N.A. for over 30 years made payments only to their nurses, the qualified personnel performing the service for which the body existed. Both the executive groups and the nursing staff were working within a voluntary organisation by choice, in a local and specific field. Scott discussed the twofold way in which the identity and 122. DISTRICT NURSING ASSOCIATION 112 Surroy-stroot, D:1rli11glmrnt, Sydney. Tel.: 197 William-stroet. Hon. Secretary: Mm. E. A. Antill, 8 011>1!0·,v Avenue, Elizalrntli Buy, Sydney. The Nursing Staff of tho District Nursing As~ociation consi~ti; of a Slstor-in-Chargo and 5 Nursoa. 'l'l,e ObJect of tlie Association is to ~u1,ply Train<'d X urn,.,. f.., tlio ~id, poor in t-hoir own homes nnd ot h,•r• wi8e to niiuistor to their llcc 1. 8t. :ll i,• hal'I ',i Ill-dory, :-.u rry II ills. ~. St. Barnabas' Hectory, Olchc. :~. ~!.. l'aul':; l(p1·tory1 H,•,1forn. Sud1 applieations cnn he mn,1o at any time (Stlltcln.y in !'ln,to Bmn<"hcs, with their own ComrnittcP,11 l1a vo be<'n forn,ccl in tho difi'crent ili8iricb for the puq,cso of c,il lecting funds, :i. ;·eprcsilffcativc from ci~h eommittee b,,ing- a member of the Centrnl Council. Milk Ordorn aro dispOT!!JCcl by thfl Nurneo to patfonte in neNl of milk, and nbnolntc>ly unable to meet the co;;t of procuring it for therni;e]V<'-~. Thorn is aLo a Comfo,·;; Fund conni,cied "·ith t.he As~o r.iation to supply the sick with nece8sary food :111,! elotMng-, etc. Excerpt from The Social Workers Guide. 1911.(pp.70-1). 123. status of an association worked.(3) The D.N.A. was established and supported by persons with community identity and social standing. They carried professional significance to the Councils and Committees, often from groups with similar interests, and membership of the D.N.A. as it gained public attention and support added to the prestige and respect of those involved. The position of Lady Fanshawe in Sydney society brought attention and support, and her continued media exposure because of that involvement returned her increasing respect and admiration for her generosity, innnovativeness, and support. In all, this parallels the network analysis. He also wrote of the importance of voluntary organisations as expressions of altruism, and altruism as an agent for change. Putting aside the negative response of escape from personal responsibility and conscience salve as a reason for participating, he nominated generosity as the key to true altruism. Collective action, the willingness to share and to make arrangements for redistribution are the measure of altruism that can develop into an agent for change: " ••• voluntary organisations are more direct expressions of altruism than government admini strations if their resources come from genuine voluntary giving and their staff are motivated by generally altruistic motives."(4) The D.N.A. was founded on voluntary giving, survived and grew almost entirely on voluntary giving, and there were no "staff" as we recognise the term. In the D.N.A. those who worked, worked with one purpose to ameliorate suffering; and to supply the means - the skilled nurse. When the D.N.A. began, hospitals were under-financed and overcrowded. There was no organised domiciliary care for 124. the aged, chronic, and the long-term ill, and in times of plague and epidemic, the hospital system was unable to cope. Experiments with nursing sick children at home had proved more successful than wardcare. Daily visits by nurses trained to the importance of cleanliness, hygiene and sanitation in the preservation of health served to emphasise the need for state and municipal planning and regulations for housing, and the provision of adequate drainage, sewerage and garbage disposal. The amount and extent of poverty-related sickness, highlighted the degree and trauma of unemployment and the plight of women bringing up children on their own. Medical advice and domestic instruction by the impartial skilled nurse, eliminated the fear of State intervention with regard to children, and allowed the space for rehabilitative care and advice. The D.N.A. began as a marginal voluntary organisation, to act as a remedial and preventative service in an area where there was no government provision or public expenditure: "Voluntary organisations are more sympathetic and flexible so it is more appropriate that they provide this gap-filling service •••• Many of the extensions of government services were made as a result of voluntary initiatives which directed attention to need and often demonstrated ways in which service could and should, be provided. Some of these innovations ••• led to government intervention •••• "(4) The paramedical health-care service demonstrated to the community and to the State a specific need which led to its incorporation in the government health service. As an organisation, the central group and the sub-groups of the D.N.A. were enthusiastic and dedicated - evidenced by the length of service of members at both executive and branch 125. levels. The dedication and interest of the women of the Association included involving the nurse in their meetings to hear about the people she attended, and in visiting patients with her. In that way their community service was educational, bringing them into personal contact with the sick poor for whom they worked. They learnt of their suffering and deprivation, and were made aware of the effort nurse put into her duties and the physical effects on the nurse herself. The number and the spread of the women across the suburbs of Sydney meant a considerable coverage of women talking in other friendship and recrea tional groups about their service with the D.N.A. In Scott's terms, generation of interest in social issues by community education and support makes change easier to achieve: proposals for change are thus likely to be more successful. However, working from the Annual Reports there is no evidence that the executive conducted any policital campaign either for direct State intervention by specific reform, or for State funding. They had stated they were confident the government would not turn a deaf ear if they applied for funds - but there is no evidence of any such request. The Association as a body was happy to serve, to adhere to and consolidate the principles on which it was founded. It could be asked whether there was a basic integrity in maintaining an independent voluntary status that would have been contrary to requesting direct State funding. The conscious action involving the D.N.A. that influenced social change was the public commendations they received in newspapers and magazines, and from public figures, government ministers and officials. Scott commented that "Change is continuous and produces unexpected results."(5) He wrote that where a voluntary organisation survives, it 126. is relevant to contemporary social needs and attitudes. The D.N.A. survived as an independent voluntary organisation for 35 years and at every crisis point, the necessary resources to keep going were always found, by gesture, work, or by falling back on reserves. In those terms, survival proved its continuing relevance to community health-care in the continually changing social and economic climate of Sydney through war, growth, Depression, and regeneration. The unexpected was the government intervention at the end of 1934. With State concern for health, and increasing expenditure on hospital services, government ministers and health officials took a gradually more visible role in the annual reporting of the D.N.A. and to that end Scott wrote: "If the government is seen as having to be responsible for the well-being of the community and the notion of participation is important, then a system that provides services that are funded by the government and provided by local government, or voluntary agencies, offers the best compromise."(7) The social change that is reflected in the incorporation of the D.N.A. into the State health service is just such a compromise. The service represented value for money, augmented an expanding State health-care system, retained its original specific objective and area of service, but gained the support of a benevolent government. Not only would public funds be added to a voluntary organisation, but there would be State funding for a proven health-care service still provided by private practitioners, and still with voluntary support. The D.N.A. as an voluntary organisation instituted a nursing service that became both a factor towards and an integral part of social change, with women as the major participants and agents for change. 127. CHAPTER FIFTEEN TRIBUTES AND RECOGNITION - THE FUTURE 12 8. A national tribute came in 1985. District Nursing in Australia had first begun in Melbourne in 18 8 5, and, as a result of representations by the national body, the Royal District Nursing Service, in 1985 Australia Post issued a centenary stamp and cover. The commission by Australia Post to Sydney designer, Wendy Tamlyn read: "Apart from celebrating the anniversary of an important national organization, this occasion recognises the services provided by women."(1) In her design she shared the design honours between Melbourne and Sydney. For her stamp design, she adapted a photograph of a Melbourne district nurse standing with her bicycle. For the pictorial cover, she used a photograph taken in 1900 of a Sydney street in The Rocks area; she then took artistic licence to emphasise poverty and its effect on women and children. Whilst the costume and bicycle of the nurse do not reflect the Sydney nurse, the two illustrations are the antithesis of each other in their presentation: the slum setting, and the modest wholesomeness in the cameo of the nurse. (See Appendix 4) 'G·1J1enarv of Di.'-lnrr N11rs{11g ~ St•n,irrs 191-i.1 '.:'t-F"~~:- !..... :_•: I , District nursing in Sydney was the agent and the product of social change. Community leaders were committed to the extension of hospital services and the State was committed 1 2 9 • to the hospital system but suffered a continual problem in providing sufficient finance. The gradual acknowledgment of community health as a national asset, the cost effect on the economy, environmental health factors, and a cyclical upsurge of response to Christian duty set the precedents for the move from philanthropic to State support. State-funded, the service could expand to fill the need. It was, however, still a health care service provided by the private sector, giving personal medical care on a one-to-one basis. District nursing was aimed at a different class from private nursing. The district nurse was involved in medical and social issues, a liaison between two fields developing the human support that became their special field. Historians generally acknowledge the existence of unknown or little known groups providing for the poor of Sydney's colonial society, and the actual under-estimation of the numbers living in poverty. Official figures published in 1913 recorded that private benevolence and response to special appeals and relief in kind was statistically impossible to record. The report specifically mentions the District Nursing Association of Sydney "no paid or house collectors. All collection is from within the network."(2) With their work aimed at ascertaining the causes of poverty, the report of D.N.A. work concluded that "Illness is a major cause of poverty". There was a vital need for a home nursing service in Sydney. Religious orders caring for the poor placed spiritual needs before physical relief and traditional charity was aimed at preventing actual physical starvation. By 1911 the numbers housed in asylums had increased dramatically; and many were people under 40 with 130. incurable conditions such as cancer, consumption and paralysis - removed from their homes and family.(3) It was exactly this need that the D.N.A. addressed. It was these people that the nurses and her women supporters worked for. It was just this service that became cost efficient to the State, and it was this work that has been overlooked in historical records so far. District nursing in Sydney is an unwritten history of women's work: unwritten because the women held no political or economic power. The Annual Reports of the D.N.A. included a report from each Branch. Those of the North Sydney Branch were consistently the most detailed and the most articulate concerning their endeavours, and from those records there is nothing to suggest the women responded to anything other than relief caring and healing. Nurses and supporters worked entirely within the "women's sphere"; as nurses they performed the work they trained for, and as branch members they performed the work expected of women of their class. Had they been diverted into political lobbying, their primary objective may have suffered. The D.N.A. as an organisation focussed on "needs", and made no long-term determination of respons ibility. Their vision and the work of the women supported and strengthened a service indispensable and integral to the changing social needs of Sydney. It was a personal charity and a personal service built on nursing skill supported by the philanthropic work of the women as organisers and entrepreneurs, and it developed devoid of political activity for reform. Formulated denying a program for social change, its foundation was nevertheless the result of a minority elitist group's new-found direction in social responsibility, based on trusted nursing skill that had resulted from changes in selection and training. The aggregation of these components into a society that 131. had available the talents of educated and leisured women to act as office bearers, committee-women and fundraisers allowed the scope and flexibility to adapt to financial fluctuations, growth, and accelerated demand during epidemics, and the fluctuations in Branch support. Between them, the nurses and the women supporters, developed a service with strong emotional and inspirational appeal. The need for the service never declined. With a growing population, the service expanded as finances permitted, measuring its success in terms of performance and achievements against its goals. The rate of growth in Sydney was compared to its disadvantage by the Association itself, and by others, to Adelaide and Melbourne, but there is evidence to suggest that, in fact, Sydney was not as economically robust. The rise in wealth-holders, like Samuel Hordern and W.R. Hall, during the early part of the century came to a halt during World War I and continued to decline into the Thirties. The War Census of 1915 showed that net wealth of high income earners in N.S.W. was marginally less than in Victoria and only about 60% of that held in South Australia. Commerce was the second largest source of wealth in N.S.W. but averaged only 25.8% of the total over the period 1900-39, with professions showing a mere 7.1% during that time. Reliant on the benevolence of urban wealth, district nursing in Sydney appears to have had a smaller and less wealthy class to call upon than the services in Adelaide and Melbourne.(4) Ultimately population growth may have been a major cause of the inability of the D.N.A. to grow as they had envisaged. The burgeoning working class of the 1920's became the victims of the Depression. The philanthropy of the middle- 132. class could no longer meet the demands of charity. According to Mendelsohn, the Depression ended forever the role of the voluntary society as the main source of social relief charity fell drasically short of need, and the philosophy of moral inability of the individual to cope was changed forever(5); and, as Bollen expressed it philanthropy was refined by justice.(6) Social change had overwhelmed the commitment and flair of the women fundraisers, but they had promoted a nursing service to a universal value in Sydney. Social change made it impossible for private philanthropy to carry the burden, and made it impossible for the State to evade collective responsibility. The value of the work could not be ignored or abandoned. Based on British precedent the service developed to suit Australian perspectives of social care. With the emergence of the concept of medical research into preventative measures, government and community attitudes to social welfare were reflected in the acceptance of the district nursing service as an essential extension to a program for future State health care. The continuing need was to expand, not just to maintain. Where previouly government health policies had developed on an ad hoe basis with little forward planning, the incorporation of the D.N.A. into State services would have provided access to a record of health data and statistics, and an overview of the working class ill-health. The nurse records would provide the means of assessing standards of health and provide a basis for planning extensions to State health-care services. In acquiring the D.N.A., the State gained an established and respected, well organized and well managed regional nursing service with the capacity and the willingness for immediate growth. What the State could give would be financial stability and 133. the ability to expand which had been the principal objective of the founders. Of welfare service, Mendelsohn wrote "· •• a developed society in which welfare services were not provided at all is inconceivable, ••• without health services ••• society would exist only at a primitive level. Welfare services are an essential part ••• of the socioeconomic structure of a modern society."(7) The work of the women of the D.N.A. in Sydney attracted public attention and educated public opinion, and influenced government action. Mr. D.K. Otton, Secretary and Superintent of Hospitals, as reported by the Daily Telegraph account of the Annual Meeting in October 1936, said that the D.N.A. had attended 50,000 patients for the year at a cost of 7/- per day. The number of visits had almost doubled in a year, and the savings to the hospital by using the district nursing service, he said, was in the order of ~ 9000. The government had already supplied two cars to the nurses and, with hopes of getting two more cars, the Association was assisting two nurses "to qualify as motor drivers". The Illawarra district nurse with her Austin car was able to travel to patients in Marrickville, Arncliffe, Hurstville, Bankstown and Croydon in a day without the time wasted in waiting for infrequent tram services. The Branches were now each registered under the Charitable Collections Act of N.S.W., and the decision was finally made after so many years to levy a charge to patients. The Hospital Commission suggested a charge of 6d. for each call from the district nurse, but the charge was subject to remission where necessary. The long-established policy of providing free nursing to the sick poor thus remained unchanged. 134. In her handbook written in 1965, Matron Drylie wrote that the district nurse had become a responsible member of a Health Team. She had been guided and directed into learning all the various services available to patients. It was her duty to utilise all the services for the welfare and progress of her patients.(8) Christian social duty had initiated a service to the sick poor that de v e 1 op e d to one recognized and v a 1 u e d by the co mm unity and government until the major cost burden was moved from the private citizen to be borne through State funding across the whole community, ceasing to be a class responsibility. The pity is that the role of the women has been overlooked. Many have addressed the political and economic changes, but little has been written of the women at work within the social changes. Of Miss M.A. Carter it was written in 1903 "for all time Miss Carter's name will be identified with the cause of District Nursing in Sydney". Yet it was not until the North Sydney Branch reported their sadness at her death in 1928 in New Zealand that she was spoken of as "Marion Carter." In over 20 years of work for the idea she introduced to Sydney, it was the first time she had been referred to so personally. She like all the other women Fanny Graham, Edith Badham, Lilly Christian Antill Sargood, and Amy Mann, and every nurse who followed her laboured for their cause, not for themselves. The growth of District Nursing in Sydney is a tribute to the philanthropic work of women for the sick poor during its period as a totally voluntary organisation. Social change overwhelmed the commitment and flair of the women fundraisers, but they promoted a nursing service with one nurse to a nursing service of universal value to the city of Sydney. 135. NOTES APPENDIX 1 APPENDIX 2 APPENDIX 3 APPENDIX 4 BIBLIOGRAPHY 136. N O T E S CHAPTER 1 1. Heasman, Kathleen. EVANGELICALS IN ACTION: An Appraisal of their Social Work in the Victorian Era. London Bles. 1962. p.15. 2. Ibid, pp.18-28. 3. Judd, Stephen & Cable, Kenneth. SYDNEY ANGLICANS. A History of of the Diocese. The Anglican Information Office, Sydney. 1987. pp.124-136. 4. Hogan, Michael. Book Review of Judd & Cable SYDNEY ANGLICANS, in JOURNAL OF THE ROYAL AUSTRALIAN HISTORICAL SOCIETY, Volume 74, Pt I, June 1988. pp.84-86. 5. Phillips, Walter. DEFENDING 'A CHRISTIAN COUNTRY'. Univ. of Q. Press, St. Lucia Qld. 1981. pp.378-400. 6. Bollen, J.D. PROTESTANTISM AND SOCIAL REFORM IN N.S.W. 1890-1910. Melb. Univ. Press. Aust. 1972. Appendix 2. 7. Fisher, S.H. 'An Accumulation of Misery' in LABOUR HISTORY, No.40, May 1981. pp.16-28. 8. Stannage, Dr.C.T. 'Uncovering Poverty' in EARLY DAYS, Journal of the Royal Western Australia Historical Society. 1976, pp.90-106. 9. O'Brien, Anne. POVERTY'S PRISON. The Poor in N.S.W. 1880-1918. Melb. Univ. Press, Carlton, Vic. 1988. pp.1-5. 10. Mayne, A.J.C. FEVER, SQUALOR AND VICE. Sanitation and Social Policy in Victorian Sydney. Univ. of Qld. Press, Qld. 1982. p.222. 11. Fisher, S.H. Op.cit. p.19. 12. Jackson, R.V. 'Owner-Occupation of Houses', in AUSTRALIAN ECONOMIC HISTORY REVIEW (10) 1970. pp.138-154. 13. Fisher, S.H. Op.cit. pp.139-153. 14. Mayne, A.J.C. 'The Question of the Poor in the Nineteenth-Century City' in HISTORICAL STUDIES, Vol.20, No. 81, Oct. 1983. p.559. 15. Lewis, Milton. "Obstetrics: Education and Practice in Sydney 1870-1939" in THE A.N.Z. JOURNAL OF OBSTETRICS & GYNAECOLOGY, Vol.18, No.3, August 1978. pp.68-69. 16. Dickey, Brian. 'The Sick Poor in N.S.W.', JOURNAL OF THE ROYAL AUSTRALIAN HISTORICAL SOCIETY, Vol.59, Pt. I, March 1973. pp.25-26. 17. Ibid, pp.36-40. 18. Dickey, Brian. 'Hospital Services in New South Wales 1875-1900, Questions of Provision, Entitlement and Responsibility'. JOURNAL OF THE ROYAL AUSTRALIAN HISTORICAL SOCIETY, Vol.62, Pt. I, June 1976. p.40. 19. Bollen, J.D. Op.cit. 1972. p.7. 20. Ibid. p.8. 21. 'Six Lectures by Bishop Barry', London 1890. M.L. 22. 'Christian Socialism No. 1'. M.L. 23. Bollen, J.D. Op.cit. 1972. pp.27-28. 137. 24. Records of the C.S.U. in fE£&E~!!, Vol.1, No.1, 1.1.1899. M.L. 25. Ibid. 26. Ibid. 27. Ibid. 28. Ibid. 29. Dolman, F. 'Miss Rose Scott' in Ladies_of_Sz.dnez., (Extract from The Woman At Home). p.437. M.L. 30. fE£&E~!!, Op.cit. Vol.1, No.1, 1.1.1899. CHAPTER 2 1. Bollen, J.D. Op.cit. pp.89-91. 2. fE£&E~!!, Vol.1, No.5, 30.6.1899. M.L. 3. Bollen, J.D. Op.cit. p.90. 4. Ibid, p.113. 5. Ibid, p.vii. 6. Ibid, p.3. 7. fE£&E~!!, Vol.1, No.2, 1.2.1899. M.L. 8. fE£&E~!!, Vol.1, No.6, 28.7.1899. M.L. 9. See letter and information supplied by Ms Mary Maltby, Archivist, s.c.E.G.G.S. - Appendix 1. 10. Jones, M.A. THE AUSTRALIAN WELFARE STATE. George Allen & Unwin. Sydney. 1979. pp.12-14. 11. fE£&E~!!, Vol.1, No.9, 11.11.1899. M.L. 12. fE£&E~!!, Vol.1, No.10, 23.12.1899,M.L. 13. fE£&E~!!, 23 December 1899. CHAPTER 3 1. Abel-Smith, Brian. A HISTORY OF THE NURSING PROFESSION. Wm. Heinemann Ltd., London. 1961. p.18. 2. Ibid, pp.18-20. 3. Ibid, p.22. 4. Ibid, p.24. 5. Walker, R.B. 'Religious Changes in Liverpool in the 19th Century" in JOURNAL OF ECCLESIASTICAL HISTORY, Vol.XIX, No.2, 1968. pp.195-211. 6. Dolan, Josephine A. HISTORY OF NURSING. W.B. Saunders co., u.s.A. 1968.p.274. 7. Abel-Smith, Brian. Op.cit. 1961. p.304. 8. Dolan, J.A. Op.cit. 1968. p.275. 9. Cope, Zachary. SIX DISCIPLES OF FLORENCE NIGHTINGALE. Pitman Medical Publishing Co. Ltd. London. 1961. p.11-12. 10. Ibid, p.10. 11. Ibid, p.12. 12. Ibid, p.23. 13. Ibid, p.20. 14. Cope, Zachary, FLORENCE NIGHTINGALE AND THE DOCTORS. Museum Press Ltd. G.B. 1958. 15. Doherty, M.K. 'The Nightingale Connection. Story of the R.P.A.H. School of Nursing. 1882-1942' in ~~f~~~ ~~&~~!~~' 1976, No.74 (Winter). pp.15-20. M.L. 138. CHAPTER 4 1. fE£&E~!!, Vol.1, No.6, 28.7.1899, M.L. 2. Australasian Nurses Journal, 15.3.1906, and St. James Church Year Book, Easter 1899. M.L. 3. See letters from Dr. P.T. Millard, Appendix 2. Dr. Millard answered a request that was published on my behalf by the Srdner_Mornin&_Herald seeking information from descendants of the early District Nurses. Dr. Millard's was the only response. Biographical information ready sighted for James Graham had shown "m. Fanny Millard" so I replied to Dr. Millard asking if Fanny Millard was his mother. Instead she was his aunt, and he supplied the rest of the family details. 4. St. James Church Year Book. Op.cit. 5. Refer to letters from Dr. P.T. Millard. Appendix 2. 6. Australian Dictionary of Biography. 7. Australian Dictionary of Biography. CHAPTER 5 1. At Home, Vol.1. No.5, September 1905, pp.11-12. M.L. 2. Australasian_Nurses_Journal, October 1903, p.97. 3. See Appendix 3. 4. This information about Miss M.A. Carter was obtained from the Street information, and from the Education listings of the Sands Directories, held on microfiche in the Mitchell Library, c.1903-5. 5. Godden, Judith. 'The Work For Them - The Glory for Us! Sydney Women's Philanthropy' in Richard Kennedy (ed.) AUSTRALIAN WELFARE HISTORY, Macmillan Co. of Aust. Melb. 1982. p.84. 6. Australasian Nurses Journal, October 1905, p.124. 7. Australasian_Medical_Gazette, 1901. p.79. CHAPTER 6 1. Kennedy, Richard (ed.) AUSTRALIAN WELFARE HISTORY. Macmillan Co. of Aust. Melb. 1982. p.3. 2. ~!_g£~~' Op.cit. Vol.1, No.1, 1905, p.7. 3. Ibid, Vol.1, No.4, 1905, p.3. 4. Ibid, Vol.1, No.5, 1905, p.4. 5. Godden, Judith in Richard Kennedy (ed.) 1982. Op.cit. p.85-99. 6. An original edition, under "Prospectus & Appeal, Sydney, 190 (?)", is held in Pamphlets File in the Mitchell Library. CHAPTER 7 1. Bollen, J.D. 1972. Op.cit. p.181ff. 2. Nurses Register of Cases. This material was placed at my disposal by Ms Regis McKenzie, Director of the 139. Sydney Home Nursing Service, at "Montana", Boyce St., Glebe. There are only three volumes now in existence. They are leather bound books, that have been printed especially for the nursing service, with columns pre-headed. They have apparently been written up by one person, in the one hand, from nurses' cards or notebooks. 3 . " C r y o f t h e Di s t r i c t Nu r s e " , ~~!E.!.!!!!.!.!~-!!~!.!~! Journal, 15.2.1907, p.40. 4. B~TT;~~ J.D., 1972, Op.cit. p.181. 5. Armstrong, Dorothy, THE FIRST FIFTY YEARS; A History of Nursing at the Royal Prince Alfred Hospital, Sydney. 1882-1932. Sydney, 1965. p.96. 6. Judd & Cable, 1987, Op.cit. pp.175-8. 7. Ibid. p.179. 8. Boyce, F.B. FOUR SCORE YEARS AND SEVEN. Angus & Robertson, Aust. 1934. pp. 86-98. 9. Australasian Medical Gazette, 20 May 1901. 10. 'Nursing as a Profession' by a Hospital Nurse, The_Woman's_S£here,_Februarz_1901, pp.48-9, in Kingston, Beverley,(ed.) THE WORLD MOVES SLOWLY, Cassell Aust. Ltd., N.S.W. 1977. 11. Australasian Nurses Journal, 16 October 1905, p.124. 12. 'The Daily Round' in Dailz_Tele&ra£h, 20 October 1913, reprinted in D.N.A. Annual Report. CHAPTER 8 1. Judd & Cable, 1987. Op.cit. pp.191-2. 2. "Church News", Parish paper of St. Clements Church of England, Mosman. No.58 (1 Jan.1910), Vol.6, No.10 (June 1916+ (some issues missing). M.L. 3. See correspondence from S.C.E.G.G.S. Archivist, Appendix 1. 4. S.C.E.G.G.S. History: 'Sydney Church of England Grammar School 1895-1970'. Princeton Press, Sydney. 1972. For the House Names, see Appendix 2, p.127. For the Old Girls' Union, see pp.117-9. 5. Refer to letters from Dr. P.T. Millard. Appendix 1. CHAPTER 9 1. Scott, Rose. 'The Cultivation of Sympathy' in A.N.J. (printed in two parts) 16 November 1908, pp.364-372 and 15 December 1908, pp.406-411. 2. Ibid, A.N.J. 15 December 1908, p.407. 3. Ibid, A.N.J. 15 December 1908, p.409. 4. Ibid, A.N.J. 15 December 1908, p.410. 5. Ibid, A.N.J. 16 November 1908, p.388. 6. Summers, Anne. 'Images of the 19th Century Nurse' in HISTORY TODAY. No. 34 (Dec.1984). p.42. 7. Szdnez_Mornin&_Herald, 20.12.1932, p.8. 8. Australasian Trained Nurses Association "Register of Nurses". My early enquiries for biographies of nurses was made to the N.S.W. Nurses Association, where 140. Ms. Wolstenholme made time available to assist with details from the Registers in her keeping. Subsequent information was obtained from the volumes held in the Mitchell Library. 9. Australasian Nurses Journal. 15 June 1910, pp.201-2. 10. Srdner_Mornin&_Herald, 21 March 1933. 11. At Home, Op cit. September 1905. p.12. 12. Syd~;y-Mornin&_Herald, 26 November 1932, p.17. 13. Hamilton, D.G. HAND IN HAND. The Story of the Royal Alexandra Hospital for Children. John Ferguson Pty. Ltd. Sydney 1979. pp.92-95, 111. 14. ~!_g£~~- Op.cit. 10 September 1905. p.12. CHAPTER 10 1. Nurses' Register of Cases. Op.cit. 2. Judd & Cable, 1987. Op.cit. pp. 191 ff. 3. Ibid, pp.202-3. 4. Ibid, p.201. 5. Kingston, Beverly. Op.cit. p.134. 6. An original of the Souvenir Program is held in Pam.File Q362G, M.L. CHAPTER 11 1. New South Wales Parliamentary Debates. Second Series • Volume 142. 30th Parliament. Fifth Session. 8 November 1934 to 5 February 1935. 2. Report of the Medical Officer of Health for the Year, Joint Volumes of Papers presented to the Legislative Council and Legislative Assembly, Volume III, Second Session of the 31st Parliament 1935-36. 3. Armstrong, Dorothy. 'The First Fifty Years: A History of Nursing at the Royal Prince Alfred Hospital, Sydney. 1882-1932'. Sydney. 1965. p.106. CHAPTER 12 1. Sower, Christopher, et al. 'Community Involvement: The Webs of Formal Ties that Make for Action". The Free Press, Glencoe, Ill. U.S.A. 1957. pp. 308 ff. 2. Ibid, p.311. 3. Ibid, p.312. CHAPTER 13 1. Braithwaite, Constance. 'The Voluntary Citizen'. London 1938. pp.1-9. 2. Ibid, p.25. 3. Ibid, p.199 ff. 4. Ibid, p.50 ff. 5. Ibid, p.50 ff. 141. 6. Godden, Judith. The Work for Them - the Glory for Us' IN Richard Kennedy (ed.) Australian Welfare History. Macmillan Co. of Australia. 1982. p. 84. 7. Ibid, p.96 8. Ibid, p.97 9. Ibid, p.91 10. Gandevia, Bryan. 'Occupation & Diseases in Australia since 1788'. The Annual Post Graduate Oration, delivered on 26 May 1971. Sydney 1971. 11. Dickey, Brian. 'No Charity There. A Short History of Social Welfare in Australia'. Thomas Nelson, Aust. 1980. pp.137-40. CHAPTER 14 1. Scott, David. 'Don't Mourn For Me - Organise. Social and Political Uses of Voluntary Organisations'. George Allen & Unwin Aust. Pty. Ltd. Sydney 1981. p.1, Introduction. 2. The Social Workers' Gu.ide. 1911. pp.70-1. M.L. 3. Scott, David. Op.cit. pp.12-13. 4. Ibid, p.14. 5. Ibid, p.23. 6. Ibid, p.108. 7. Ibid, p.155. CHAPTER 15 1. Australia Post supplied the home address of Wendy Tamlyn, and, following a phone conversation, a meeting was set up. She generously provided the original brief from Australia Post and an original of her first prototype of the stamp - See Appendix 4. The copy of the arrangement of stamp and First Day Cover came from Australia Posts philatelic magazine Stam£_Bulletin for the quarter January- March 1985. The copy of the photo of Cumberland Place, one of a series taken in 1900 after the outbreak of plague, was obtained from the Archives Authority of New South Wales. 2. 'Public Benevolence' in Official Year Book of the Commonwealth of Australia: Statistics for Period 1901-1912, No. 6, 1913. 3. O'Brien, Anne. 1988. Op.cit. p.54, p.225. 4. Rubinstein, W. C. 'Top Wealth-Holders of New South Wales - 1817-1939' in AUSTRALIAN ECONOMIC HISTORICAL REVIEW XX(2). 1980. pp.136-152. 5. Mendelsohn, Ronald. THE CONDITION OF THE PEOPLE. Social Welfare in Australia 1900-1975. Geo. All~n & Unwin, Sydney. 1979. p.125. 6. Bollen, J.D. 1972. Op.cit. p.133. 7. Mendelsohn, Ronald. 1979. Op.cit. p.18. 8. Drylie, Winifred (Matron). "Information and Instructions for District Nurses". 1965. Sydney. M.L. 142. APPENDIX 1 ~szbnee Q!4urr4 of ~nglanb C&irls' Cfirammar ~r4ool 215 ~orbes ~reet ~arling4urst 2010 N~· ~k 1/tv,~ b/fvll1'M7 l!SJ-/9,2n dar~ /} 0~ E#J Jftr)tJ f -1.u ~ "+__) ( /lnf ,J~ Cfu_i 1~4?~, 'H),-v ~d /89 _: v)tt/.J ulu-uAUf ;,.._ ~~; &~ ~ ~ /4J,~/ ~/ ~/ ~ v ~ ~ y ~n-- - /w~ /~~/.~ M;v~ ~~-~~__c-/, -U~.1-/~~ t~ A.- ~ - A/t'-1- ,~ - //e~u;;,l~ ~Si1- ICj /7. -14.20 , -/tw.~~~~ E,&v,-'rd ltjo6 -- ICJ7~ (#w,,,11~ /t/vdl~tt~ /q I/ -,91-6_, ( ~) ~ /.LJ_;; /&f /.)_ .--/ Cj I~ 143. \ , - I. ,,rd ' -- _it..Uf-//\(1_,,n_-t._ o/'-t' t:'l.,j ,/ ' 0 ' ~ C ( LIM u X Page Four ~ ~~ {k~ /4M...,C/f-1(.1sr1mv ~Sl;e-z,s_g IN LOVING MEMORY /li{S"-( ~c;&. MRS. SARGOOD Lilian Mary Sargood, known to S.C.E.G.G.S. as Lily Christian, was one of the early day pupils at "Chatsworth," Potts Point. She loved her School and Miss Badham who was her chief attraction. After leaving school she enjoyed a life of freedom and enjoyed her favourite sports, tennis, cricket and rowing. In June, 1902, she was married to Major E:Jward Antill, who died suddenly in 1905, at Queenscliff Battery, Victoria, leaving a small son, John Macquarie Christian Antill. Mrs. Antill and son returned to Sydney and lived with her parents at Elizabeth Bay until their death in 1918. In 1914 she organised and worked at "The War Chest" until the end_ of the war. For her services )'. she received the C.6.£. and Bar decoration and the Croix de Guerre (Belgian). In 1919 she married Mr. F. G. Sargood, who died in November, 1932, in England. Except for trips abroad, Mrs. Sargood lived at Bowral, where she died on 23rd I-" M av, 1945, after a long illness. Always interested .i:: .i::- . in the School and especially in Christian House. ~ she was President of the Old Girls' Union and Ex ./\.,.,"--> officio a member of Council. She gave us the "1;-1 --6<: . Lilian Sargood Bursary. ,,-,y./'-·\,E APPENDIX 2 DR. P. T. MILLARD 65 Ar.Ae~A 51R2Ei L6lll!!IUCO ILLE Qil6.6 MB., F.R.C.S E N.SW. TELEPHONE: ~7- 9)? '31..11 511 "BIRDWOOD" .2.: COLOOLI RCili> NARP,ABEEN 21;,1 'kc~ VJ.;_.Aa f~e , ;,t t .))_ N. /', . j Cc~~ f, S;~ 'i.~ Ml.'--C l... ~~ ~ul. (~ , \'Vll r~. A"K-J-Mtll_0-cd_ ~ ~-~.k~q dl ~ f>._/ · I q 3() ,_ · ~ £"'-> ~ ~ _t,{ 4 · -p-r 'lA/\C;{.,U.. ~ ½~CX-4? ~ ~- ·· ~JT ' 5;f (i' .e_~1 '4us. ~ ~ ~'"" tCf 4-·~. ~ iu"e<..---1 Qa~G, Jh.~ -lf~cvv.J2-v/+~e 1J2evvl . . , ~ ~Tol 1L ~ U.4 i N U,-r/4 l~ ~T ~ t.rt·R l,u~-i ( 145. ,- < -~~ tr~ ctl.,,~ ~ .t~ lM-,1:,-,.~~ A-tM.-ce ~ 1,1,LC-e. ~ h./41-'\ ~ 1'11\ . ~e (,l,y--R._ -~ --e.:. H-4 ult~r~ w,~ SL0-{ l>P7 ~ ~'½ t~\· ~~~ iA.-0 l,- ~ c~ ~, h ~ '"u~(eu~ 1-c ~p_,'f.A, ~; i ~--1·~ \;.,~~ ./4.~ pOJ:tKt.A.JCV( ~a. Tu_ J ~ /i.Q~ ~ ~ 1~~, ..& f- UU) ~t-i.J ' l.e.-. f ~ /J...,, fr-; '-f. MAA, i.,,_,·~ (,;_'/ ct /~ ~~--/ ~~(ull-1. ~~-... {.~. ,i,~ ~ ~~(~ Cl- it~ ,r{' ~,1-L-\loUv..._ t,evy'G, c.a..,\· qc-v~ ~ bu..r- fk~ \tA-CL.L-t ~-P ~ r -il-0 ~~ Nt~~~ ~~LA. 146. I i I Phone 982-3211 5 I I Co Loo~ i .. ,o.,d , •.• ~,{ Jl~;~i-- II,,): 210·1 Denr Mrs. r.1g-e, I ,,111 sorry not to hzve . ,nswerod your <7ueri es ( Your • letter of 28/6/88). I h,·ve been out of to·1ch for sorno wool<:s. 1. tiy :f;:-itlicr (n~lll) : nd his sister F',;nny C"r-.nces) were chi.Ldren of' Hev. 11. S. hil. L"rd (J.U'l' ·,1.G.) 1vho cwue from England in the 1860s to be he,1d111,1ster og Newc;istle Gr~,inrn,lr School where he died nbout 1895. 2. Jpmes Gr:1hrnn c,:mo from Jxlinl>urgl1 - onEi of' sever,11 doctors who fol lowed . nderson Steu:1rt, the foundor of the Sydney Hedic,'l School. !lo l;;·ught n:,to111y, becnmc Su:>er intendent o.f H..P •. ,.H. ,,nd than pr.,ctisecl :from his hor:1(J in i,iverpool. Street. He lectured in Obstetrics :from 1B97 to his de,ith in 1912. IIe w:,s :founder of' the ,/omens' llos1 1 it; .1., Crown Street, served two terms in 3t;,tc p,,rji;,ment ::nd ,.,, -s knighted when, :is 1,ord l·-I,,yor of' :-.,yclney, he entert,ti11ed the f'u t!ure :;ing George V in ·190 1. i le : md my : mn t E' nny h ,cl one chi\. d, Stu,:rt, who whi i. e :, i.1edi c,, L s tuclen t 1m s org:,ni s t , nd choirm:1 stor :, t ~]t. .Jn.mes, ·, ·ing :-; treat. '. [e gr, du,· ted i.n 1,edi cin I in time to serve in 1.v. if. 1 ~md c.lif-)d of' ,v0m1ds in :~'r;1nce. ,,, ,1 J/. 1,1y ,unt .L":rnlly tr, :Lned :md becrnne ,, w.,rd-sis-i.;or il 1 .:1t ~U>..'\.l-1 be.fo1--0 sl1e 1n:_l.rried J;.,1nl?S " c;rul1··1111. 11 ',I I c:m t tell you wh:·t t connection they m,1y 11,1 ve h: d ,:! with the :founda tiou of the SlJN but since he !>r:1cti sed on the 1~1 verge of Surry llii.ls and Dnr.Li.ng·hurst ,1nd w,1s closely ;,ssoci,1te{1 with Crown Street Ilospi tr1.L where much o:f the wori.;: then \I' s ,:: domici1L,ry, I feel sure tlrnt he ,,,ould h:ive been much concerned ::I and prob:'lb.ly ,-,lso Fnnny on the f'und-r,:ising auxi Linry side. '' ,, 4. J\Jv fnther h'ns never in priv:1.te pr,,ctico. !Ie w,1s ! a Public lie«lth Of'f'icer unti.L 1908 when he becrt;ue Superintenden1:: of' the Const Hospi tnl (remnmed Prince Henry) un tLL his retiremer' in 1933, the ye.1r tlrnt he bocr1rne JJ011. Tre,·surer of' the srn~ ·,. ': He w:,s :•tso on the Donrd ;md i.,1ter J'resident of' the N;:.,, Dush 'Ii Nursing .ssoc;h:ition c1nd did rnn.ny ·Long country tours visiting '\, their cen trcs. lle w,1 s ,: member of' the Nurses' Hegi str.. tion Bo·,rd. 1[e l1.1d :1 f',drly distinr,;uished record in H. J.1; J .fter ! servinc- 1vith ,, F'ield '\mbuLmce ,,t nznc he .Lntor bec:crnc ~:o:..one~ :1nd DDMS ,t ·,ustr,1linn lI<2 in i,011.don. He w:'s m,.r:,rded tlie ~LG :•nd CB.I!.;. 1,iy mlbther died in 192? but my eldest sister ,Joyce took some p:·rt in v:irious soci,11. events connGcted 1,ith tlle SUi, :1ncl Ul\ un ti L she moved to j;ho country in ·19 39. I expect th,,t much of this is not very re.l.ev,int to your project but I hope you wiLL ;.ot me know if' I c;,n help you :fm:xk±.1uc :further. ,,I, 147. APPENDIX 3 -, . . .., .. DI AID OF DISWCT _ llUPODiO ASSOCIATIOW. ' Held in the oro,mde ot Slate ~erm~?:t Troust'! l'y kind permt11·-1on ot HI8 EXCELLE'.NOT tht GOV'ERliOR 1-m4 LJJYY RA~~N i ~n ~i~ey anf! S11tui-tby, lhe 4 th and lt.h ~~eaber. fl-a .a to ,. The teto 13 to b. dtOlc;red epu by us F4ACF.LU:?;ey VICE >.w.IRAL SIR are af! follow•:- f1tronesa. L~,ty Rawson. V1oe PTe '.:1deata. 1b-e. l'!nshawe 9 ~U.a1 Snowdon S:d th, 1'!1e La.4J ~ore'-• Mrs. 1'1nn, ~'1y Innes, Krs. W'"'lt"'!' H~ll, ~:he M. 'R~rri!'I. · · · ---· Executive Kr• Wffille Oritf1th•, ~~f!. Sinclair 01111.ea, - . . litneia¥M, .111"•• - Wi.ee,. Dr. CEi..:l~C Y1lk1nson • Captain Ro'bertso11 Clark • . Hon. seoa. lire~- Do1igii.a lf.aincenzle, t-ll~!I r.onsett stel)hen, ' . 2 • n.s Nina Mylne • . Ion. Treas. !Ai.as D1bn,llr. H~es. ·- - . LIS! 01 3T,U.U, .A)if, :uni~ SP-OD. 1. TABLE ' DF.r,o.H.ATIOhSe M1sa Rs.Yaon. · · ¥.1ae sut tor • .2. '.:LOWER STALL Lady Fa1rtu:. Mr• Ewan huer. · .. 3. S1fti!ETS. Mrs. Chris. BeMett. 148. ;(. ·- ~··'. . . 1,.,... !f?'I • La.47 Se~ ma ladies ot Ra.n'1Yiak. a. iOR'lH SYDV!Y DOntS' AND ORILDRJ!l('S CLOTHDIG. Lady Barton and lru11ee ot )forth S7Ane1. ., . PO'iftRY • 111-a. 1f1ae. ~8. B. 0,,en. 8. OUBHIOMS .AND PI.NctJSRIONS. !he !fuse• IceJ.y. Visa Wataon. 9. i(ra. te Salia. >r 'r, '': :"tl 10. mNdES. 11. Mra. Y. Bro\i&hton. ·_·., r.. u. :.tra. Renn 1 t • lb"e 01111es. 'lrs Ju1eson. a.tra. Olubbe, 13. ;;..-. vra. Ho4a••• Miu Ra-n17 • ·111u Oater. 149. S:':,. _ .. :':'·· 11. OltILDBDJ' I COBD:R. ~•• C:1.sny Walker. l. Toy Stall. a. Dr1yi.ng tilrougn bottles. 3. Aunt s~lly. ·•· Shoot1Jig. 5. Pon7 rides. 6. !11h Pond. '1. ill"an P1e. 9. 'tlr• ~e1kla!lam. (conjurer) 11. 0omic Art Oe.llory. Ma:1a.ged by hli!ls l. Ori!fitlis. lo. ~1ss F.~~1th ~alk~r. ~1.rs. Art~•1u· Cox. 1. Living .ti.u?~t Sally, lllr.lll!!f&4 by .Blue Jaoketa of R.M.s. Royal Arthur. 2. Shooting Gall~ry. t,. Mutoscopo . .-andly lent by Mansttr of Mutoscope ~o., Sydney Arcade. 4. I.1ft1~ ·4aehinea 5. Ro~e uolt. G. Cocoanut 3~1os. at 3.~. - M1at1 Dorothy Dibbs '!lld Afisn N&pyer 0•e-re non. seo. f'c-r a Doll DrossinR oomJ)otition arran~od by ;,irs. 7s..'18ha.we 1n connection ~itJ1 the North Sydney Stall. Judges. Mr•. 'iDJ1shs·ye. !.b-a. Finn. APPENDIX 4 CENTENARY OF DISTRICT NURSING 1985 - BRIEFING NOTES FOR POSTAGE STAMP 1. · Extract from Commission Paper "Visiting nursing services in Australia were instituted in February 1885, with the founding of the Melbourne District Nursing Society 'for nursing the sick poor in their own homes'. Other home nursing services were formed in South Australia in 1892, Tasmania in 1896, NSW in 1900, Queensland in 1904, and Western Australia in 1905. Apart from celebrating the anniversary of an important national organisation, this occasion recognises services provided by women. Source: representations from the Royal District Nursing Service." 2. R~yal District Nursing Service Miss Norma Bryan, Director of Nursing, is the liaison officer for the stamp. (03266791). 0170 :2,bb On 17 February 1885 a meeting was held at the home of Mrs William Mcculloch in Spring Street, Melbourne, convened by Dr Charles Strong. Dr Strong was a well-known church leader, and the meeting was held to discuss the need for an organised system of nursing care for the sick poor in their own homes. The meeting was attended by 19 community-minded citizens, and its outcome was the formation of the Melbourne District Nursing Society. The Society's objects were: "Carrying the benefits of skilled nursing, medical treatment and comforts to the houses of the sick ppor of the city; To attend to chronic and septic cases which cannot be accepted by the general hospitals; To complete cures which exigencies of space necessitated leaving the hospital; To attend cases where the removal would entail the breaking up of the home. 111 Home nursing services were subsequently formed in other parts of Australia: The Royal District Nursing Society of South Australia in 1892. The Hobart 8istrict Nursing Service in 1896. The Sydney Home Nursing Service in 1900. St l.,uke 's District Nursing Service, Queensland in 1904. The Silver Chain in Weste~n Australia in 1905. ------ 1. Royal District Nursing S':!rvice. Annual report, 1978. Melbourne, 1978. 151. 2. Over the years, many areas of community health and welfare services have been pioneered by the voluntary home nursing organisations, attributed 'to the caring concern of the nurses and their first-hand knowledge of their patients. The Melbourne District Nursing Society established a home midwifery service in 1894, an After Care Home in 1925, the first Melbourne ante-natal clinic in 1931, and the Melbourne first family planning clinic (the Women's Welfare Clinic) in 1934. Specialised educational programmes have been developed by the voluntary home nursing services, to assist nurses to acquire the skills necessary for effective home nursing care. The (Victorian) Royal District Nursing Service, through State and federal grants, has established the largest home nursing education department in Australia. its programmes are available to, and attended by nurses throughout this country. In 1966 the long-standing contribution of the Melbourne District Nursing Society was recognised by the granting of a Royal Charter, and a change of name: the Royal District Nursing Service. A national co-ordinating body was formed in 1969. The Australian Council of Community Nursing was set up to enable closer consultation among home nursing services. Executive staff are elected from each of the State voluntary home nursing agencies. The first International Congress on Domiciliary Nursing was sponsored and conducted by the Royal District Nursing Service in 1970. The 400 participants from eleven countries included a senior official from the World Health Organisation. Another international Domiciliary Nursing Congress is planned for 1985, to be held in Melbourne. Voluntary home nursing services have developed from one nurse employed in Melbourne in 1885 to 1,927 nurses throughout Australia in 1982. In 1981 nearly 51/2 million home visits to patients were carried out. In Victoria, the Royal District Nursing Service employs 327 nurses, caring for 32,447 patients and families. 4. Pictorial material a. Illustrations in the history of the i'oyal District Nursing Service: Rosenthal, Newman. People - not cases. Melbourne, Nelson, 1974. b. Royal District Nursing Service crest. c. Photos of district nurses in 18$5, nurses on bicycles, first district nursing cars, etc. 5. Previous depiction of nurses on Australian stamps i. Australian imperial forces 1940: sailor, soldier, airmdn, with nurse's head. 15 2. 3. ii. Nursing profession and centenary of Florence Nightingale in Crimea, 1955. iii. Definitive stamp, 1958, depicting Australian War Memorial, Canberra. iv. 50th anniversary of Australian Inland Mission, 1962. 153. Centenary of District Nursing Services ]985 C..rn .... .,,..._ ,,. ·i.,r~, , '?"7-' ~ ' " '· I .. t.i1'. ; ' I . .\\it~ ,;,,l~ ~ l 5 4 • Place' 1 1 5 5 • BIBLIOGRAPHY DISTRICT NURSING ASSOCIATION: Annual Reports 1901-1936. Mitchell Library. Pamphlets - Prospectus & Appeal. Sydney. 190-(?). Mitchell Library Souvenir. Illustrated. Mitchell Library. Nurses' Register of Cases. (Held at Sydney Home Nursing Service offices at 'Montana', Boyce Street, Glebe. Correspondence from Ms Mary Maltby, S.C.E.G.G.S. Correspondence from Dr. P.T. Millard. CONTEMPORARY SOURCES: Australasian Medical Gazette. 1898-1901 Mitchell Library. Australasian Nurses Journal. 1903+ Mitchell Library Australasian Trained Nurses Association, Register of Members. Mitchell Library. At Home. Sydney 1905. Vol.1, Nos.1-7. Mitchell Library. Austrilian Biographical Dictionary. by Fred Johns. 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