HISTORY New Zealand Dietetic Association Inc. I\ nz i NZDA AWARDOF EXCELLENCE ANDHONORARY LIFE MEMBERS RECIPIENTS

( acknowledged on the occasion of the Association's 60th AnniversaryConference August 2003)

NZDA AWARD OF EXCELLENCE 1999 Gillian Tustin Outstanding Achievement in Dietetics Kerry Mcllroy 2003 Outstanding Contribution to Clinical Dietetics Contribution to NZDA: Area Representation and Nutrition Care Submissions Subcommittee and Rules Taskforce Convenor, Community Dietitians Contribution to NZDA: member of inaugural Special Interim Group Convenor, Vice- Journal Editorial Board and peer reviewer, President, Preside member of member of Clinical Handbook editorial team, Publications and Awar Subcommittees, member of conference organising committees member of Journal Editor Board, Jubilee including Pacific Partners in Nutrition held in Conference 1993 History publication. Auckland since 1983, first Auckland Branch 1996 Mary Johnston President, continuing education programme Outstanding Performance in Food Service organiser and speaker. Administration 2002 Lyn Gillanders Outstanding Achievement in Dietetics, and Contribution to NZDA: Area Representative, Vice President, President, member of Outstanding Contribution to Clinical Dietetics Salaries Subcommittee, instigated and Nutritional Care Position Paper Subcommittee. Contribution to NZDA: Area Representative, 1994 Hikihiki Pihema member of Continuing Education, Rules Revision, Excellence in Provision of Nutritional Code of Ethics and Salaries Subcommittees, Education member of Journal Editorial Board and peer reviewer, Programme Convenor for NZDA Contribution to NZDA: nominee to Nutrition conferences in Auckland, nominee to Dietitians Taskforce, Te Hotu Manawa Maori, Food and Board and Chairperson,editor of Clinical Handbook, Nutrition Advisory Committee, Agencies for co-author of Position Paper 'Prevention of Obesity'. Nutrition Action, Vice-President, President. Cheree Mellow 2001 1993 Janelle Wallace Outstanding Achievement in Dietetics Outstanding Achievement in Dietetics, and Outstanding Contribution to Clinical Dietetic Contribution to NZDA: President of Auckland Branch, member of Auckland Branch Professional and Nutritional Care Development Committee. Contribution to NZDA: member of Salarie Subcommittee, Area Representative, Vice 2001 Janice Bremer Outstanding Achievement in Dietetics President, President, Awards Subcommittees Convenor, co-editor of Clinical Handbook Contribution to NZDA: co-author of Position nominee to Dietitians Board, Deputy Chair and Paper 'Diet and Prevention of Cardiovascular Chairperson, co-ordinator of Continuing Disease', NZDA conference speaker, Media Competence project, member of the Panel of Spokesperson, local and regional dietetic Expert Advisors, Health and Disability continuing education programmes. Commission. Moira Styles 2000 1993 Pamela Williams MNZM Outstanding Achievement in Dietetics Outstanding Achievement in Dietetics Contribution to NZDA: Area Representative, Contribution to NZDA: Area Representative, member of Employment Advisory Group and Secretary-Treasurer, Vice-President, President, Position Papers Subcommittees, Awards nominee to Royal Society of New Zealand and Subcommittee Convenor, Programme Convenor related scientific organisations, member of for NZDA conferences in Dunedin, Diabetes Dietitians Boards including first Dietitian Special Interest Group Co-convenor, Community Chairperson, inaugurated Corporate Dietitians Special Interest Group Convenor, Membership. member of Southern Districts Branch Committee.

April 2004 Page 21 Journal of chc New Zealand Diccccic Assoc..:iacion OF EXCELLENCE ·NZDAAWARD (Continued) 1992 Julian Jensen Outstanding Achievement in Dietetics Contribution to NZDA: Younger Members and Area Representative, Vice-President, President, Chairperson of the Working Party on the Report on the Dietetic Profession, nominee to Dietitians Board, Journal Editor, member of Journal Editorial Board and Professional Development Sub­ committee, representative on Otago University Working Party for Post-Graduate Diploma in Dietetics, Conference Proceedings Editor, held various offices in Christchurch Branch. 1990 Bernice Kelly Outstanding Achievement in Dietetics Contribution to NZDA: Area Representative, Executive Committee: ex officioAdvisory Dietitian, Finance Subcommittee, Secretary, Archivist.

HONORARY LIFE MEMBERS

2002 Bernice Kelly 1992 Jocelyn Hampton Meritorious Service Meritorious Service (refer to Award of Excellence citation) Contributions to NZDA: member since 1956, 2001 Sadie Andrews Treasurer, Area Representative, Vice-President, Meritorious Service President, nominee to Dietitians Board, nominee to Dietitians Salaries Grading Committee, Dietetic Contribution to NZDA: Area Representative, Training and Curriculum Working Parties, Southern Branch Committee member and Submissions Subcommittee Convenor. Secretary,Journal Subcommittee and Advertising Manager, Organising Committee member for 1988 Patricia Coleman conferences in Dunedin, Community Access Lady Sayers CBE Radio Organiser and Co-ordinator for Nutrition Advancement of the Interests of the Programme. Profession of Dietetics 1999 Pamela Williams Contribution to NZDA: ex officio member Meritorious Service Executive Committee, first Constance Shearer (refer to Award of Excellence citation) lecturer. 1994 Donald Beaven 1984 Shirley Thompson For contributions to the Knowledge of Meritorious Service Dietetics and Nutrition, and the Contribution to NZDA: Area Representative, Advancement of the Interests of the President, Subcommittee on Report of Board of Profession of Dietetics Health Committee on the Dietetic Profession, Contributions to NZDA: Affiliate member, regular nominee to Salaries Grading Committee. contribution to NZDA conference programmes 1983 Flora Davidson and Christchurch Branch activities. (deceased September 2003) Clifford Tasman-Jones Meritorious Service 1993 For contributions to the Knowledge of Contribution to NZDA: Secretary, President, Dietetics and Nutrition, and the Journal Editor. Advancement of the Interests of the Patricia Williamson Profession of Dietetics 1983 Meritorious Service Contributions to NZDA: undergraduate bedside and seminar teaching of dietetic students, giving Contribution to NZDA: member since mid- formal lectures to graduate dietetians, 194Os, Treasurer, Journal Advertising Manager, incorporating dietit_ians in ward rounds for sound ex officio member Executive Committee. practical comment and advice, incorporating dietitians in formal lectures and seminars as part of undergraduate medical student teaching, incorporating dietitians in a research team.

V1>I 58 Number l Journal of chc New Zealand Diecccic.: Ass(>c.:iacion Page 22 A History

New Zealand Dietetic Association (Inc) and Dietetics in NewZealand

by Dion Crooks

New Zealand Dietetic Assocation Wellington 1993 New Zealand Dietetic Association P.O. Box 5065 Wellington

© NZDA 1993 First published 1993

ISBN 0-473-02150-1

Printed by Broderick Printing & Design Ltd P.O. Box 100191 North Shore Mail Centre Auckland 10

Typeset by ProType Graphics Ltd P.O. Box 31-063 Milford Auckland CONTENTS

Acknowledgements

Foreword

The Early Years 1

Formation of NZ Dietetic Association 7

The Early Leaders 8

First Decade from1943 12

Second Decade from1953 19

A Dietitian's Day 27

Third Decade from 1963 34

International Connections 48

Fourth Decade from 1973 52

Fifth Decade from 1983 68

The Association in 1993 82

Appendix

Honorary LifeMembers 83

Presidents 86

Secretaries and Treasurers 87

Journal Editors 88

OverseasAcademic Qualifications 89 ACKNOWLEDGEMENTS

I would like to acknowledge the following forinput into this book:

Bernice Kelly - through her encyclopedic knowledge of the dietetic profession,dietitians, legislation and significantevents, and her help and support in providing filesand resource material.

Dorothy Moir - through her invaluable reference, Dietetics in New Zealand: A History, which she compiled in 1968.

NZDA Journal editors - Thelma Simons, Dora Campbell, Una Martin, Joyce Martin, Connie Shearer, Winifred Goddard, Flora Davidson, Julian Jensen and Pip Duncan -through the material they have published over 47 years.

Sue Hooker - through the historical interviews she has taped with early dietitians.

The willing co-operation of dietitians to share their.knowledge and thoughts.

Dion Crooks June 1993

Authors Note: The interviews with certain dietitians in this book are not intended to indicate that any dietitian has been or is of greater or lesser importance in the profession than another. Subjects for interviews were chosen forreasons of geography, age, background, professionalexperiences - and logistics - in an attempt to illustrate a broad cross-section of roles, activities and themes within New Zealand dietetics.

Throughout the text given names and current married names have been used.

NZDA Acknowledgement NZDAacknowledges the invaluable assistance Pip Duncan has so willingly given to the production and printing of this book. Grateful thanks too, to Bernice Kelly, Pamela Williams, Margaret Till and Gillian Tustin. FOREWORD

It is very appropriate that in this Centennial year of women's suffrage in New Zealand that New Zealand Dietetic Association is celebrating its 50th Jubilee.

The history of dietetics in New Zealand makes fascinating reading. No one could failto be impressed by the vision, determination and dedication of so many women to improve the standing of foodservice and nutrition in hospitals and then in the wider community.

Recorded in this book are the names of many women whose work should not be forgotten. I hope all of us will reflect upon their contributions and continue to honour their achievements. Of course it is impossible to record all the events that have been important to individual members of the Association. I hope this history may prompt dietitians to forward their own memories for future publication.

The affairsof New Zealand Dietetic Association have always been recorded-in minutes, annual reports, News & Views and the Journal of New Zealand Dietetic Association. However the Executive of NZDAagreed that a book describing the social, political and historical context of these events would be valuable.

I am delighted that we now have an historical reference book celebrating the first 50 years of New Zealand Dietetic Association from 1943. It makes nostalgic and enjoyable reading for older dietitians. But more importantly, it gives younger people studying the dietetic profession in New Zealand a glimpse of the struggles and achievement of those who have been in the profession before them.

We are humble and grateful to them all.

Gillian L Tustin NZDA President. THE EARLYYEARS

There is no doubt dietetics in New ½ oz tea, 2oz sugar, 4oz new milk, ½ the 81b of vegetables he mentioned on Zealand had its birth in the hospitals. oz salt, 8 lb mixed vegetables; spoon his diet sheet. But exactly when or how is unclear. diet - lib bread 4oz rice, ½ oz tea, 2oz. Details of where dietetics fitted into sugar, 4oz new milk, 81b mixed He was also an enthusiast for thefoodequationinearly New Zealand vegetables; milk diet - lib bread, 4oz "cordials" - in 1883, his last year in hospitals are very sketchy. rice, 2oz. sugar, 2 pints new milk, 81b office,80 patients received as medicine mixed vegetables. during June 76 bottles of wine, 46 The first known diet sheet in quarts of gin, 11 bottles of brandy and Auckland Hospital - and probably in It author, Dr Philson, was 219 pints of port. New Zealand-was circulated in 1866. physician, surgeon and administrator An offshootfrom army rations, it spelt of the hospital from 1859 to 1883. Patients' diet was included in the out four daily diets: full diet - 12oz. And, of necessity, he was dietitian. terms of reference of a Royal meat, lib bread, lib 8oz. potatoes, ½ Philson "fed fevers" and kept the Commission, inquiring into the oz. tea, 2oz. sugar, 4oz. new milk, ½ mortality rate of his typhoid patients management of Auckland Hospital, oz. salt, 81b mixed vegetables; half­ down to 10% by prescribing a low in 1904. The quality of the meals and diet-8oz meat, lib bread, lib potatoes, residue diet-presumably by omitting food did not fare well in a patient survey. Nearly every patient complained about the fish; eggs, � ,,.1--d@�,<>J,._ cabbage, soup and porridge were 2'.!" frequently criticised; milk never and

D;,,ue. Symitnlils• &'c, bread only once. Said one woman: "If I had depended on hospital food, I should have starved. I could not eat the food; my friends and children u-176"''.7'-?�,/ �/;&a-�� � brought me food." Of the fish, she ,t,-,,,.,__ said: "I could smell it beforeit came into the ward." Of the eggs: "they ;tJ&-,,/ j.4_£d� 11--�lvludA-<£:1. were hard-boiled, like cricket balls. 6l_l#IMl$1� Not fit for patients." The cabbage: � /� c "You wanted glasses to look at it. It "It �a- ...... , / was full of snails." And the soup: //,.,///···/ / wascolouredwithvegetables."Acook, /4 ...... / ,f / in hospital with throat trouble, ... '. , 4 I ,,. I -4 complained that the porridge was -�-- lumpy, the fish so rotten no one would l/4;� ...... , fr ..",. +. , .. ,. . touch it, there was not enough sugar and although the quality of the eggs •" • •. , I ,., I 21 ,., I ..t £ � was good, the quantity was ,,,. I 41 .. -I 4 -4 insufficient. His verdict on the cabbage: "It seemed to be all outside � I ,., I leavesandnotwellcooked."Themeat: "It was of good quality but it was spoilt in the cooking." And the soup:" It was

���-��/�a/ generally of one kind and so greasy I k p__L,,����---­ could not touch it."

• ��/� a/ 7,,_£,KOU.:..,.��� At that time, the matron was �'1/�'�/�� J�� responsible for food in the nurses home but the manager and house steward were entrusted with the "'·'-'�.a-,C,&, � A «:t F�, /4: patients' food. In reality, it was �� �,rf--��,"-'ffe- �4%-� . , probably the cook who said what left w./��n��-�- the kitchen for the wards. The commission noted: ".. .it appears to us ./lt;(o. to be much more the province of a ��-- woman than a man. to superintend AUCKLAND HOSPITAL DIET SHEET 1866 A copy of the first known diet sheet in Auckland Hospital. the distribution of foodto patients."

1 WhangareiHospital be too large else it will accumulate controlled by a certificated dietitian things that have no business in the with the status of a sister, who is Hospital dietetics at Whangarei kitchen -which is a place to cook food responsible forher department to the Hospital was discussed in an article in in. Along one side of the room stand matron just as a ward sister is the New Zealand Nursing Journal Kai the cooking appliances -steam ovens, responsible forher ward." Tiaki, in October 1919: kettle and stock-pot and a gas range and the near the exit door the steam­ The article outlines nurses "The problem of hospital dietetics jacketed plate warmer. In the centre training in diet - "the subject is dealt has been coming under review more of the room should be the cooking with in the pupil nurse's first year and and more during the past decade. To table, with pan shelves next to the all lectures and demonstrations are the average patient of our public range etc. and on the other side, the given in the hospital kitchen" where hospitals, the disturbing anticipation bins forflour, oatmeal, sugar etc. and nurses had to spend a month, learning is mainly one regarding food. His (sic) drawers forknives, spoons and small "the ordinary cooking and preparation medical and nursing treatment he articles. Overhead, a rack with hooks of hospital meals." takes forg ranted, but his feeding he forsmall culinary articles that hang. regards with misgiving. Close by open the pantry and larder. "The main difficulty in a general This arrangement saves a great deal adoption by hospitals of such a "The restrictions of diet are of walking. scheme," says the article," is the possibly sometimes a necessary part scarcityof trained dietitians. We were of the treatment but sometimes "The ideal wall is tiles, but a exceptionally fortunatein being able possibly the result of economical plastered wall covered with washable to initiate it through the goodwill of a tendencies of those boards who paint is a good and less expensive lady who had had a three years emphasise the 'charitable aid' part of substitute. A 'fama' or similar domestic science course at London, their administration of our hospitals." composition is an easy floorto clean England and was exceptionally but lacks the resiliency of a good qualified by training and teaching The article says that as this view of linoleum and is tiring forstanding. experience forthe position and who hospitals is gradually being replaced secured a formerpupil to continue it by another view which sees hospitals "The preparation of potatoes by forus. as state or community institutions to mechanical means is found to be provide medical and nursing services satisfactory, saving both time and "Such a teacher, however, is not that cannot be conveniently obtained waste of potatoes. Vegetables are still commonly to be found and a at home, the public is demanding prepared by the hands. The greatest knowledge of food values and mere something more than a "charity" source of waste is bread and meat and theoretical training are not sufficient standard - and "the cooking and no real solution of its reduction has forthe purpose, because the ordinary serving of an improved dietary is an yet been found. course of domestic science suitable essential improvement required." forthe making of a technical school "This is a source of great concern teacher is not altogether such as would Kai Tiaki says that complaints because the abundance of supplies in make a hospital dietitian. from patients and doctors that a hospital and the difficultyof tracing nurses doing private nursing had the delinquent has a tendency to make "Perhaps if sufficient hospitals very little knowledge of "cooking nurses form habits that constitute would take up the idea, the schools of arrangements" led some years ago the main complaint lateron of private domestic science might make a special to the addition of a course in invalid employers, who say nurses are course forhospital work and include cooking to the nurses' curriculum. extravagant and lack regard for the a practical class under a lady who had resources of families of moderate had experience of hospital "But patients do not subsist long means. requirements." on purely invalid diet and the whole question of the scientific preparation "Only the plates are washed in the These views of hospitals using a and economical distribution of food scullery and afterwarming, are taken dietitian to improve their efficiency has· come so specially under back in the foodtrolley at meal time. in treating patients were reinforced consideration during war conditions Cups and bowls are washed and stored by ProfessorHelen Rawson, Dean of that an efforthas been made by this in the ward kitchens." the Home Science School at the hospital (Whangarei) to make a start University of Otago, writing in the NZ in facing theproblem. Kai Tiaki saysindividual diets are Journal of Health and Hospitals in prescribed in the wards and October 1922 and reprinted in the "The firstessential is to provide a summaries made by the sister. The first bulletin of the Association of suitable kitchen. This must be very matron then makes up a meal Otago University Home Science airy and well-lighted but should not provision for thekitchen, "which is Alumnae in 1922.

2 "The doctors and nurses formthe appearing in American hospitals". for some years." A graduate of strong links in the chain and if they Rose Pybus herself was entrusted with Columbia University, Wells resigned alone were concerned, no doubt the the firsthospital dietary department in 1927, returned to the USA and was hospitals would be eminently in Britain, at the Royal Infirmary, not replaced. During her time in satisfactory,"she said. "But a patient Edinburgh in 1924. Even then, her Dunedin, she ran practical classes for cannot recover or feel at one with his appointmentwas not confirmeduntil nurses in the foods laboratory. (sic) surroundings if he has nothing aftera six-month trial period. by physic and good nursing... the food Edith Reid's experience provided preparation and other household A further report on hospital a further salutary example of the activities have been controlled by services in New Zealand in 1924 problems. When she returned to New officerswith no special training.. some recommended that a dietitian be Zealand, she was appointed to with native intelligence have been appointed to each of the fourmain Christchurch Hospital in February wonderfully successful, but it is no hospitals and in the large provincial 1926, working under the control of exaggeration to saythatin the majority centres. The report also the matron; but the nurses were of hospitals where lack of harmony recommended the appointment of reluctant to yield control of food prevails among the patients, the root an organising and consultant service and her status in the hospital cause lies in the preparation and dietitian to the Department of hierachy was never resolved. When , service of the food and in general Health. The report outlined the in 1928, she was appointed to housekeeping. status and function of dietitians as Wellington Hospital, she was given "the head of the dietary department the status of a house surgeon, directly 'We need a person trained in the and responsible to the medical responsible to the medical principles of management with a superintendent for food service to superintendent. This in turn, fuelled sound knowledge of dietetics and with patients and staff." dissatisfaction among nursing sufficientskill in household arts to be authority over the channel of capable of training subordinates in That was the theory. But the battle responsibility. right methods.. and trained thus, with for dietetic authority had to be won university status, the dietitian will on the hospital floor. While health take her stand as a professional authorities were clearly showing On her appointment to woman." interest in introducing dietitians into Wellington, Edith Reid had been the hospital service, jobs were still assured by the medical Another hospital comm1ss10n, scarce and there was plenty of superintendent she could use home which inquired into the �rganisation opposition from hospital staff science graduates to help. But w,ith a of hospitals in the early 1920s, responsible forfood service to patients change in medical superintendent, recommended that dietitians should and staff. the Wellington Hospital Board refused be trained and established in hospitals. to agree to assistants, paid or unpaid. Helen Rawson noted that training Sir Charles Burns, a physician and Not surprisingly, when she was offered would soon be available at the Otago health administrator, told the New a senior staffposition atJohns Hopkins University Home Science School. Zealand Dietetic Association Hospital 1n Baltimore, she resigned However, she added, if the dietitian conference in 1968 how when he from Wellington at the end of 1929 were to accept full responsibility, "she became a house surgeon at Dunedin and returned to the USA. She came should also spend three to six months Hospital in 1923, "there was talk, back to New Zealand in the early '30s as a pupil dietitian under an expert." always met by black looks from the to take charge of the university ward sisters, that the Otago Hospital extension service. Edith Reid pioneered the way to Board was thinking of employing a the USA in 1924 when she completed trained dietitian." That came to pass The real thrust fordietetic training her dietetic training atJohns Hopkins in 1925 when an American dietitian, came when Professor Ann Strong Hospital in Baltimore in 1924. She Eleanor Wells, was appointed. Burns became Dean of the Home Science then went to England in search of remembers her as "of somewhat Faculty in 1923. She began pushing further experience in London but forbiddingexter ior, which indeed she for training in New Zealand and seems to have arrived just a few needed, but one forwhose fortitude, encouraged graduates to go overseas months too early. In a quote from sense of duty and determination to for training. During the late 1920s Rose Pybus recorded in the History of see that her orders were carried in the and 1930s, over 30 home science the British Dietetic Association 1936- wards, however trying the conditions graduates headed forthe USA, Britain 1961, " ... at that time (1920), my might be." Which was just as well and later, Australia to study dietetic or nursing colleagues and I repudiated because, he said, "had this experiment institutional -training. Most had to the idea of anything so new fangledas failed, the introduction of a trained finance themselves as bursaries were a hospital dietitian, though these dietitian into the then only teaching scarce··and tuition fees and uniforms disturbing women were rapidly hospital maywell have been delayed were usually students' responsibilities.

3 These pathfinderswere Edith Reid, Winifred Stenhouse and Mary Mandeno to Johns Hopkins Hospital in Baltimore USA; Erena D'Auvergne and Airini Pope to Montreal Hospital in Canada; Nora Copsey, Joyce Godfrey,Ethel Pearce and Anne (Eta) Stubbs to Toronto General Hospital in Canada; Ruby Anderson to UniversityHospital in San Francisco USA; Isabel Crowe and Barbara Sleddon to Michael Reese Hospital in Chicago USA; Margaret (Peg) Brown to Presbyterian Hospital in New York USA; Adele Seay and Ellie Wright to Fifth Avenue Hospital in New York USA; Dorothy Davies, Anne Hill and Mary Steele to the Royal Infirmary In Edinburgh, England; Elfreda (Freda) Fraser, Helen Jeans, Mollie Marshall, Thelma Simons and Koa Tompkins to University College Hospital in London, England; Eleanor Couston, Monica McKenzie and Imelda Meadows to Royal Northern Hospital in London, England; Dorothy Bell, Georgina Boyd, Jessie Morgan and Ida (Kitty) Tyson to Alfred Hospital in MelbourneAustralia; Alison Morrison to Royal Prince Alfred Hospital in Dietitians at Wellington Hospital 1941 Sydney, Australia; Catherine Back row from left: MacGibbon to University of Chicago Mollie Priestly,Monica McKenzie,Evelyn Waddell. in Chicago, Evelyn Waddell to Frontfrom left: Universityof Washington in Seattle Catherine McFarlane,Barbara Dempsey. and Patricia Martin and Ellen Naylor to University of Iowa in Iowas City, Winifred Irving, Honor Pledger, Dora the university had no special USA. Campbell and Jean Bell were among equipment or kitchens, the home the first-trained as nurses as a path to science faculty worked closely with These North American dietary work. Studholme House. One experiment connections were to have a strong with 'culled' fowls, which were to be influenceon the later development of Diet assistants worked long hours sent to a country women's group, New Zealand dietetic training which - 6am to 1pm and 4pm to 6pm, with ended up with a crate of live fowls followed the American rather than one day offa week; they were paid £1 arriving on the Dunedin doorstep - the British example - seeking to a week. Many of them trained overseas much to the surprise of the erstwhile produce a generalist rather than a during the 1930s or in New Zealand experimenters. specialist, a person responsible for when local training became available the entire hospital food service and in the 1940s. The 10-year drought of dietitians not just treating those needing in hospitals ended in 1937 when therapeutic dietary advice. Meanwhile, Professor Strong had Eleanor Couston was appointed been visiting home economics dietitian at Lewisham (later Calvary As the depression of the late '20s departments in American universities and now Southern Cross) Hospital in and early '30s took hold, hospital and and began a new course at Otago Christchurch. In March that year, teaching jobs became even scarcer. allowing third-year students Mary Steele was appointed assistant Hospital foodservice remained firmly interested in dietetics and institutional dietitian to the diet sister at Wellington in the grip of diet sisters but some management to do specialist work. Hospital; she was a home science opportunities did develop for the The foods class dealt with catering graduate trained in dietetics at the employment of graduates as diet and quantity cookery and included Royal Infirmary in Edinburgh. assistants. Others - Annie Hill, some experimental work; and because

4 In November 1938, Monica Superintendent, Christchurch Catherine MacGibbon, from the McKenzie was appointed assistant Hospital; Miss A. Ross, diet sister, Home Science School, on large-scale dietitian at Wellington Hospital and Auckland Hospital; Dr A.R. Thorne, catering and institutional when the diet sister retired the Medical Superintendent, Wellington management and Eleanor Couston followingJune,shebecamethesenior Hospital; Miss Monica McKenzie, on diet therapy. Miss Tomlinson, the dietitian. She was later joined by others Dietitian, Wellington Hospital; Miss matron of Dunedin Hospital, Miss with overseas qualifications - Mollie Lambie, Miss E. T.Briggs and Miss J. Widdowson and Miss Ross were also Priestley, Evelyn Waddell and Eleanor Moore,Nursing Division, Department involved. Couston. of Health. During 1941, Catherine By 1939, several home science There was copious discussion (the MacGibbon and Maureen Frengley graduates were working in hospital verbatim report runs to 23 pages) on who was to join the Department of diet departments but their positions training responsibilities of hospitals Health as a dietitian the following were insecure and there was little and universities, the responsibilities year, surveyed dietary departments of scope for advancement. When Miss of a dietitian, status, salary and so on. the training hospital to assess their Mary Lambie, the director of the The result was that Professor Strong facilities.The syllabus was to remain Department of Health's Division of and Dr Gregory were asked to outline the core of the training until the Nursing, visited Wellington a curriculum for the prerequisite major revision of the mid-1980s. Hospital's diet department (where training at the School of Home two home science graduates, Nancy Science. The hospital boards of the An examination was mooted as a Appleton and Barbara Widdop),were proposed training hospitals were to joint undertaking by the working in March 1939, she wrote be approached to provide staff Department of Health and the to Professor Strong anxious that a (including medical lecturers) and University of Otago, with a definite curriculum should be facilities. It was also proposed there certificate in proficiency in hospital planned for these students with a should be a course for registered dietetics to be granted by the certificate to be granted on nurses wanting to become dietitians. department under the authority of completion and that the whole be the Minister of Health. However, "put on a proper basis." The University of Otago's Home the department eventually took full Science Faculty was to provide the responsibility for an examination During an overseas visit in 1937, students, the Department of Health in two sections - a paper in normal Mary Lambiehad been impressed with would provide the machinery for the nutrition and diet therapy; and two the work she had seen being done in introduction and regulation of papers, one in administrative hospital diet departments and realised training and hospital boards would be dietetics and one in quantity food more needed to be done in New asked to provide facilitiesand stafffor service. Zealand to improve these services. A theoretical and practical aspects. more scientific approach was needed Students were to be chosen on the to whatwasaveryimportantaspectof For more than twoyears, letters recommendation of the Dean of the hospital care, she argued. flowed back and forth, punctuated by Home Science Faculty, who would occasional meetings to thrash out havegained knowledge of prospective She discussed her thoughts with syllabus content, responsibility for students' character, academic ability, the acting Director-General of Health, examination procedures, payment of personality and fitness for further Dr R. A. Shore and suggested that if a students and agreement by boards for training during their home science round table conference could be held participation of the training schools. years. with Professor Strong, Dr Elizabeth Early in 1941, the Auckland Hospital Gregory, Dr Muriel Bell and Board said it had no staffavailable for Training was decided at a meeting Wellington Hospital officers, the teaching and could not provide of the planning group inAugust 1941 Department of Health would adequate facilities; Dunedin was under the chairmanship of the undertake to set up similar courses at prepared to accept nurses for dietetic Director-General of Health.A directive the hospitals where graduates were training but was not prepared to pay was sent to boards setting out reasons working. them. Both these decisions were fordecisions and the two courses - a eventually reversed. one-year (itwas revised to 15 months) That meeting was held on June course forhome science graduates or 29, 1939, with a much wider Drafting the syllabus was largely diploma holders, combining theory representation than first suggested. done by Dr Gregory (who succeeded and practical experience - at Present were: Dr Shore (chairman): ProfessorStrong as Dean of the Home Wellington, Auckland and Professor Strong; Dr Gregory,lecturer Science Faculty in 1941), Dr Bell, Christchurch hospitals; and a two­ in nutrition, University ofOtago; Miss Mary Lambie and Monica McKenzie, year course for registered nurses who Grace Widdowson, Lady with considerable assistance from had matriculated, consisting of two

5 academic periods of theoretical intake of students accepted under ,December 1942: May Abraham, instruction at the Home Science the new training scheme trained Ella Bath, May Baker, Alison Bell, School and twofive-month periods of through 1942 and sat the exam in Nancy Borrie, Flora Davidson, June practical experience at Dunedin December that year. Egglestone, Tessa Hill, Joan Hospital. Hollobon, Betsy Holmes, Joan Those whose names appeared on Jacobs, Josephine King, Dorothy The first qualifyingexamination the firsttwo examinations were: Kidson, Gwen Neale, Una Martin, was set for June 1942, with students Mary Moody, Eve Puttick, Helen who had been working in a hospital June 1942: Jean Bell, Dora Scott and Margaret Taylor. Eve dietary department for at least a Campbell, Betty Gentles, Winifred Puttick and Tessa Hill were the first year since or before fanuary 1941 Irving, Helen Luke, Catherine nurses to qualify as dietitians in and had requisite experience in Macfarlane, Clarice Stobo, Audrey New Zealand. hospital food service and diet Trengrove, Esme Ussher, Cynthia therapy to be eligible. The first Wadmore and Barbara Widdop.

Thefirst dietitians and student dietitians Christchurch Hospital 1942 Front row seated from left: Jean Williams(Bell) [Head Dietitian}, Dr AD Nelson [Medical Superintendent}, Miss Grace Widdowson [Lady Superintendent}, Mr Alex Prentice[Secretary North Canterbury Hospital Board},Audrey Rees (Trengrove) [First AssistantDietitian}. Middle row from left: Peggy Taylor,Esme Ussher [2ndAssistant}, June Egglestone, Mary Gardiner, Joan Jacobs, Dorothy Kidson. Back row from left: Gwen Neale, Betsy Holmes,Nancy Barrie, Joan Holobon, Cynthia Wadmore, Una Martin.

6 THE FORMATIONOF THE NEW ZEALANDDIETETIC ASSOCIATION The seeds of the New Zealand Stenhouse, Ann Strong. nutrition throughout New Zealand; Dietetic Association were sown at a meeting of the Home Science Eligible through British Dietetic * To raise the standards of dietary Alumnae in 1934 when it was Association: Ethel Grice (born work; suggested a branch be formed of Pearce), Joyce Godfrey, Evelyn qualified dietitians. However, as the Waddell, Jessie Aplin (born Morgan), * To provide facilities for those fewwhowere qualifiedwere scattered Koa Huenerbein (born Tompkins), interested to meet fordiscussion of all around New Zealand and were not matters pertaining to nutrition. working as dietitians, the idea lapsed. Eligible through American DieteticAssociation: DorisAllen(born Subscriptions for life members Itwas reconsidered in 1937 and an Francis), Maureen Frengley, Elizabeth were set at 8 guineas ($17.60), the effort made to decide what McLaughlin (born Wilson). annual subscription at 10/-($1) a year qualification would be necessary of for active members and 5/ -(50 cents) this professional group. The aim With dietetic training about to for associate members. The first would be to establish a membership begin in New Zealand, there was an executive committee elected was: standard that would be recognised urgent need forthe new association President, Monica McKenzie; vice­ internationally. to become active. With two groups of president, Audrey Rees; secretary, students due to qualifyduring 1942, Eleanor Couston; Auckland member, Application forms were sent out planning began for an inaugural Mollie Priestley; Wellington member, in 1939 to those who might be general meeting and conference in Helen Luke; Christchurch member, considered foreligibility. Mary Lambie 1943. Monica McKenzie, Elizabeth Esme Ussher; Dunedin member, was asked to distribute the forms to Couston and Elizabeth Gregory set Catherine MacGibbon, Dean, Home diet sisters who might wish to be about moulding the objects, rules Science School (ex officio),Elizabeth considered for associate membership. and regulations for the new Gregory. Thirty-three applications were association, working with the received; 11 ofthem were members of American Dietetic Association and Thestatusandsalariesof dietitians the American Dietetic Association or New Zealand Home Science Alumnae employed by hospital boards were the British Dietetic Association, were so that membership of the New discussed and sketches of badge automatically eligible formembership Zealand Dietetic Association would designs for student and qualified and were accepted immediately. Bess have international acceptance. dietitians were shown. A proposal to Wilson, fromthe University of Otago open a Post Office Savings Bank More than 50 delegates - and Medical School, acted as protem account was carried and a secretary and in 1941, circulated a list remember this was mid-war, came to recommendation that one annual the inaugural conference in of proposed original members. A examination a year be held for Wellington on May 16-18, 1943. The postal ballot among the 11 resulted in dietitians was passed. the election of Monica McKenzie as wide-ranging programme included president and Eleanor Couston as addresses on professional subjects, The NZDA began with 47 active secretary. Information on visits to hospitals and the ratification members. In addition, the association qualifications for membership of of the association's rules, objects and elected five associate members - Diet others was sought from the British constitution. The proposed version Sisters A. Dickinson (Auckland and American Dietetic Associations was accepted with minor Hospital), C. Henderson (Waikato and further applications for active amendments, perhaps because Hospital), I.A. McLean (Wellington and associate membership were delegates were warned that "owing to Hospital), J. Randall (Christchurch accepted. Some who were eligible did the paper shortage prevalent at Hospital) and T. Ross (Palmerston not, in fact,seek membership. present, members are requested to North Hospital) - in recognition of note changes as new copies of the their long service to their dietary This group, which formed the constitution cannot be supplied." Dr departments and four honorary life nucleus of the New Zealand Dietetic John Mercer pledged "full support members, C.R. Burns, senior Association, contained: and recognition" from the New physician at Wellington Hospital; Zealand Medical Association and Muriel Bell, nutritionist to the "Original" ... Eleanor Couston, offeredthe NZDAspace inthe Medical Department of Health; R. A. Shore, Freda Cox (born Fraser), Elizabeth Journal. the DeputyDirector General of Health; Gregory, Ida (Kitty) Kain (bornTy son), The objects of the association were Mary Lambie, Director of the Catherine MacGibbon, Monica confirmed as: Department of Health's Division of McKenzie, Mollie Priestley (born Nursing. By the end of 1943, 56 Marshall), Thelma Simons, Winifred * To further the knowledge of dietitians had become members.

7 THE EARLY LEADERS

The establishment of New indispensable the dietary back Professor Strong, " we don't Zealand's dietetic profession, dietetic department is," Mollie Priestley, who want any dirt in our kitchens!" training and the New Zealand Dietetic studied under Professor Strong, Association was largely the work of a remembers her saying. Mollie There was also the occasion when group of highly accomplished and Priestley recalls she was a big, tall the University of Otago hosted the US effective women. They would have woman who was always noticed Navy at a supper function organised been remarkable people today; given when she entered a room. When by Professor Strong. In her eyes, the .role widely expected of women moves were made to cut out entertaining the navy top brass was SO-odd years ago, they must have bursaries (which paid students' comparable to entertaining royalty. appeared something quite board), Strong went to town, bought She planned a stand-around supper, extraordinary. Who were these a new hat and headed forWellington. American style. But to her students, women? Exactly what she did or said, no one who were roped in to produce various knows, but she arrived back in items, it was all new. Mollie Priestley ProfessorAnn Strong Dunedin beaming with delight, the and another student made about 700 bursaries preserved. Parkerhouse rolls ("I have not made a yeast bread roll since!") The entire Having come from well-equipped meal was served on one plate - a kitchens in the USA, Ann Strong was curled lettuce leaf filled with some very conscious of the lack of facilities protein mixture (probably chicken), in Dunedin. She did the rounds of the the bread roll, a pastry case filled with shops and persuaded various firms to creme of oysters, a gelatin pudding lend her items to try outat Studholme turned out of a mould, two after­ House - a gleaming, white Hobart dinner mints and a cup of coffee. mixer was treated like gold. Then she With just a fork for the salad! Mollie extended these loans to testing all Priestley says it was fun watching the sorts of equipment and models; if it locals all looking fora ledge fora bit of won her seal of approval, "as used in leverage. Professor Strong also invited the home science department" was some of her students - those the only advertising necessary. And if guaranteed to behave properly and they got the OK from the Prof., many make intelligent conversation. of these items seemed to remain with her! Winifred Goddard (born Professor Strong Stenhouse), who studied under Mollie Priestley also tells how Professor Strong and latertaughtwith 1936 Dunedin Professor Strong got her students her at the school, describes her as "an involved in some extra-curricular amazing woman with an enormous An American who came to the activities. At the time of the South amount of energy and a forceful University of Otago's School of Seas Exhibition (which fell in January personality. She was able to get people Home Science as professor of and February), the old Studholme moving through her enthusiasm. She household arts in 1921, Ann Strong was turned into a "first-class hotel" was a widely-experienced person, had initiated the formation of the and students recruited to cook, wait a lively mind and was fullof ideas. And Association of Home Science attableandlookafterbedrooms.Neige she was a superb cook; her parties Alumnae of New Zealand. She To dhunter, employed by Flemings to were something." strongly believed that home science organise and advertise their products graduates should be able to fill every at the exhibition, made up all sorts of Although she retired in 1940, niche their training fitted them for oat biscuits and put them out for Professor Strong had been involved - including management of hospital sampling. ProfessorStrong organised in discussions and planning for dietary departments. Not only did what she thought was the perfect dietetic training in New Zealand. Her she encourage graduates to go kitchen - bench levels right and all vision became reality within a couple overseas to study dietetics, she equipment in the right order to avoid of years and she frequently expressed began pushing and promoting the unnecessary footsteps.Aspeople hung her satisfaction with the outcome idea of training dietitians in New around, fascinated by her patter, she and further development of the Zealand. was quick to pick up any remark from profession. She was elected an her audience."Nogood havingawhite, honorary life member of the New "You must get into those painted kitchen, shows all the dirt," Zealand Dietetic Association in 1945. hospitals and show them how called out one man, "Exactly," came 8 ProfessorElizabeth One of them, Professor Marion MonicaMcKenzie Gregoey Robinson, remembers Professor Strong and Dr Gregory visited her high school in Wellington in 1938 while travelling around the country "selling" home science and seeking funds for student accommodation. Her "lively and direct answering of schoolgirls' questions" left quite an impression. The Strong-Gregory combination culminated in the opening of Studholme Hall in 1961.

In a tribute written on Elizabeth Gregory's death in 1984, Professor Patricia Coleman, who succeeded her as home science dean, described her as "a special person regarded Monica McKenzie with warmth and affection." She was positive, efficient and concise, Undoubtedly Monica McKenzie Dr Elizabeth Gregory traits sometimes suggesting had the greatest influence of any brusqueness. In the habit of making person on the formation and The successor to Professor Ann quick but well considered decisions, development of dietetics in New Strong as Dean of the Home Science she expected the same of others. Zealand. She initiated or influenced Faculty in 1940, Elizabeth Gregory Those of us who were on the staffof almost all the functions of the graduated from the school with a the school recall very clearly the profession. After graduating with a bachelor's degree in 1924, then gained times when we were asked for Bachelor of Home Science in 1926, a master's degree in nutrition in 1929 decisions and told: "There is no she taught at Wanganui Girls' College and a doctorate at the University of hurry. Take your time, just have it for several years before going to London in 1932, returning to Otago on my desk by 9am tomorrow." London to train as a dietitian at the as a lecturer in chemistry. Beneath this direct manner was a Royal Northern Hospital. Back in New person of warm understanding and Zealand in 1938, she was appointed Winifred Goddard, who knew her unobtrusive kindness who would assistant dietitian and then senior from childhood, describes her as "a give clear responses, sympathetic dietitian at Wellington Hospital. Early very intelligent person with plenty of advice,support and encouragement, in World War II, she was approached drive who set objectives and attained to help with adapting British Army whichever was needed. She was them." "Although she did not have rations to New Zealand soldiers and particularly renowned for her quite as much charisma as Professor to advise on menus in camps. "She unfailing sense of fairness and for Strong, she was highly thought of, had lots of common sense and was the fact that regardless of the especially in the academic world- she most helpful," commented the pressures upon her, she would was more acceptable then Professor Director-General ofMedical Services, always find time for the problems of Strong to the bulk of university Brigadier Fred Bowerbank. She was others." academia. She was also very prepared later called on to discuss suitable diets to help those prepared to put the work for the tropics and then again, to in." Elizabeth McLaughlin, another discuss ration scales for troop ships whose connections went back to and troops in Egypt. ShewasamemberoftheDietitians childhood, recalled her use of the Committee from 1948 to 1950, the signature, "E. Gregory", sometimes She was part of the group which Dietitians Board from 1950 to 1961 shortened to "E.G." or simply "E". developed the syllabus for dietetic and an ex officoNew Zealand Dietetic When Elizabeth Gregory applied to training in New Zealand, created the Association executive member from work in the lab ofDr Jack Drummond machinery forthe introduction and its foundation in 1943 to her while studying forher PhD in London, regulation of the training, defined retirement in 1961. Her professional she did not know Drummond had responsibility for the qualifying colleagues admired her dedication, banished women fromhis lab. But all examination, payment of students and drive and energy which allowed her to her correspondence had been signed other details. When the New Zealand carry a very heavy teaching load while "E. Gregory" and she managed to Dietetic Association was formed in administering the nutrition survive once she confronted a 1943, she was its first president - department and faculty as a whole. surprised Drummond. "Monica McKenzie was the

9 association," said one ofher associates to dietetics in this country is at the time. immeasurable; her qualities ofdignity, tact and modesty, her patience, As inspecting dietitian with the understanding and wonderful sense Department ofHealth in 1947 until of humour will not be forgotten. She her retirement in 1963, she saw the will long be remembered with deep Dietitians Act, Dietitians affection."But beneath these qualities, Regulations and the salaries there was steel, a determination and advisory and grading committees drive to get where she wanted to go. come into being. During her early She was skilled in using her tact and years in the department, she defined charm to sway various authorities standards for food service in round to her way of thinking. Her hospitals - menu patterns, portion close association with the nursing sizes, distribution systems, staff in the Department of Health allocation of space for kitchen and helped oil many wheels of hospital dining rooms. Dietitians were food service. generally young and inexperienced and MonicaMcKenzie became a sort In the mid-1950s, when a DrMuriel Bell of"mother confessor", encouraging considerable amount of hospital and knew how to use it. and supporting them in setting up construction was being planned, she departments through visits and obtained a WorldHealth Organisation Her contributions to NZDA letters. "No matter how tough or fellowship to study food service conferences - especially her pet desperate things got, you could planning and design and observe themes of fluoride and teeth, animal always ask Miss McKenzie what to development in equipment in Britain, fatsand coronaries and corpulence do." Scandinavia and the USA. She was and calories - were particularly convinced stainless steel was the most memorable as she leavened her Jocelyn Hampton (born Watson) appropriate material and even scientific information with her sense and Patricia Donnelly recall her brought home 12in x 20in counter of humour and played down her hospital visits. JocelynHampton: "She pans in her luggage. She was involved own contribution through her would ask about something (she in writing manuals on planning meals humility. She was also adviser to already knew the answer), listen for the elderly and maternitypatients dietitians and the NZDA on a wide intently to your explanation, then and planning kitchens and dining variety of issues. look into your eyes with a twinkle and rooms, which were published by the say, 'But you do that so well'. You'd department. When meals-on-wheels On a national scale, she promoted grow on the spot." Patricia Donnelly: started in 1956, she recommended the use of rosehip syrup as a source of "She was calm and gracious. We that hospital boards be responsible vitamin C for infants when other looked forward to her visits because for the cooking and service. sources were short during wartime; we could pour out all our problems. shepleadedacasefortheintroduction She was our saviour." She also recognised the need for of the 78% extraction rate of flour continuing education among which makes the New Zealand white One word keeps recurring when dietitians. The first refresher course bread loaf nutritionally sound; she those who knew and worked with took place in 1958 in the form of a was a protagonist for the milk-in­ her are asked what she was like . workshop - a new experience for schools scheme; she devoted herself Lady. dietitians then - concentrating on to fluoridation of water supplies; she administrative dietetics. supported the original "Daily Diet They speak of her ability to gain Pattern" for New Zealanders; she loyaltyand affectionfrom associates; DrMuriel Bell wrote the text, Normal Nutrition her modesty; her dignity, her Notes for Nurses; she was largely diplomacy and tact, her honesty an Afterplaying a prominent part in responsible for the initial production understanding, her ability to gain the drawing up the syllabus for the of the booklet, Dietitian Tells Diabetic, respect and co-operation of ancillary foundation training course, Muriel which was sponsored by the New staff, her capacity to listen, consider Bell was a member of the Dietitians Zealand Dietetic Association. and then give sound advice. In their Committee from 1948 to 1951 and tribute on her death in 1988, Flora then the Dietitians Board from 1951 When she died in 1974, an obituary Davidson, Bernice Kelly and Patricia until she retired in 1963. As in the NZDA Journal termed her Williamson (born Walton) (all former Nutritionist to the Department of contribution to dietetics as associates at the Department of Health and Director of Nutrition "immeasurable" and described her as Health) wrote: "The debt we owe to Research, she had to make sure "the greatest of New Zealand's women MonicaMcKenzie forher contribution dietitians had the latest information scientists."

10 MaryLambie MaureenBarker Eleanor Couston

The first dietitian in the The first secretary of the New Department of Health in 1942, Zealand Dietetic Association, Eleanor Maureen Barker (born Frengley) CoustonobtainedaDiplomaofHome graduated from the University of Science fromthe University ofOtago, Otago with a home science degree in then trained as a dietitian at the Royal 1923 and MHSc in 1931 and lectured Northern Hospital and St. in nutrition at the Universityin 1930- Bartholomew Hospital in London. After a period on the staff at Royal Northern, she returned to New Zealand in 1937 to become the first dietitian at Lewisham Hospital (later Calvary and now Southern Cross) in Christchurch.

She was later therapeutic dietitian at Hutt Hospital and a dietitian at MaryIsabel Lambie, C.B.E. Wellington Hospital.After a short spell at the School of Home Science, she As Director of the Department of Health's Nursing Division, Mary Lambie had the job of providing liaison between the department and hospitals. She advised and counselled from 1939 to 1941, formative years for dietetic training MaureenBarker and the New Zealand Dietetic Association. Her handling of many 31. For most of the 1930s she was problems which arose between the senior science mistress at the All India department, the UniversityofOtago Training College for Home Science and the hospital boards was a major Teachers in Delhi and was appointed force in reaching the final decision to the department job on Mary for training to proceed. Lambie's suggestion.

She was a member of the Dietitians Her role was to co-ordinate Committee from 1948 to 1950 and nutrition teaching in the different then the Dietitians Board until 1953. sections - nursing, dental and health Eleanor Couston She was one of the first- group of education. To do this, of course, meant honorary members of the new NZDA pioneering the development of joined the Department of Agriculture in 1943. nutrition publicity in New Zealand in 1952 as a rural sociologist, and the ability to reach widely different remaining as its senior home science groups-theveryyoungand the elderly, advisor until her retirement in 1968. academics and non-academics. Most knew her as Twink- a reference to the inevitable twinkle in her eye, During the organisationof dietetic hervibrantand vital personality, sense training in New Zealand, she and of humour and fun and enthusiasm Catherine Hunter (born MacGibbon) rather than any adherence to the more investigated facilitiesfor training and modern corrective fluid. the proposed training hospitals.

She remained with the department until 1946. An original member of the NZDA through her American DieteticAssociation membership and nutrition teaching experience, she was made an honorary lifemember of the NZDA in 1947.

11 THE FIRST DECADE - from 1943

Registration of dietitians - caterers, though proven and normal nutrition and diet therapy; designed to give dietetics a permanent members of kitchen staff using every available person with professional standing which would should be trained and encouraged to catering experience, male or female, be guarded by legislation - was the take more responsibility, or relieving to take over catering jobs under the critical achievement of the first 10 the dietitian of many routine jobs. dietitian's supervision; using more years. housekeeping sisters in nurses homes. * Male dietitians should not be Working dietitians themselves trained, but if they were, the standard Ministerial approval was given provided an indicator as early as 1946 of education and training should be to the formation of a Dietitians that they would like to see some the same as for femaledietitians. (A Committee in July 1948 as a formalization and legislation of the distinction was made between male controlling board fordietitians in professionand training. Responding dietitians and male catering officers New Zealand, with its authority to a New Zealand Dietetic Association who did not necessarily require any vested in the DepartmentofHealth. questionnaire dealing with the specialised training.) Membership of the committee, continuing shortage of dietitians, 45 which met for the first time in were unanimous that "any drastic * Traineddiet cooks could be used August 1948, was : the Director­ reduction in the standard of training to greater advantage arid,particularly General of Health, Chairman (Dr would be most unwise", although in small and medium-sized hospitals, T. H. Ritchie), the Dean of the some suggested time in training could freedietitians formore essential Universityof Otago'sHome Science schools could be reduced during "the work. Faculty (Dr Elizabeth Gregory), the present acute shortage." Department of Health Nutritionist * More use could be made of (Dr Muriel Bell), the Department They also agreed that since married dietitians in a part-time of Health Inspecting Dietitian ( dietitians were firmlyestablished in capacity, particularly in teaching and Monica McKenzie), a New Zealand hospitals and the term, dietitian, had therapeutic work. DieteticAssociation representative been accepted as a person qualified to (Winifred Goddard), the undertake general catering and special Suggestions for increasing the Department ofHealth's Director of diet work, "it would be a retrograde number of dietitians included wider the Nursing Division (Mary Lambie). step to employ unqualified persons to advertising of the training course, do the work of a dietitian -it would be overseas advertising fordietitians and The committee's functions were: damaging to the status of the qualified exchange system with overseas dietitians and damaging to the dietitians, the omission of subjects * Determination of training recruitment of persons for_training." such as clothing from the home courses for candidates for the science course, appointing staff Department of Health certificate However, they urged that "every dietitians to assistant positions of proficiencyin hospital dietetics. effort" bemade to enlist and encourage immediately after qualification, * Approval of hospitals or other the services of people with catering reducing the length of training or institutions where all or any part of experience to work, in close co­ considering a diet therapy the training could be given. opera ti on with and under the qualification, higher salaries, a supervision of a dietitian, as "food practical 12-18 month course for * Conducting examinations, supervisors" in kitchens and nurses caterers at the Home Science School, appointment of examiners and homes. training as housekeepers those whose issue of certificates. education qualificationswere not high * Receipt of applications for Other majority decisions fromthe enough for dietetic training. registration and authorisation of questionnaire were: registrati@n in a register to be kept Respondents came up with seven by the Department of Health. * Dietitians should not be ways of using dietitians to better employed solely forspecial diets and advantage - making greater use of * Conduct of registered teaching, as it would lower the diet cooks; training kitchen staff to dietitians. standard of general food service; in take greater responsibility; making fact, many preferred to reduce diet more use of food prepared in the main Of 121 people contacted for therapy work and build up food kitchen forspecial diets; making more possible inclusion on a preliminary service. use of local schools for teaching and register, 91 had trained in New Zealand practical cookery to preliminary since 1941. The remainder had been * Control of the main kitchen nurses; getting more help from tutor trained in England, Scotland, should not revert to cooks and sisters and their staff in teaching Australia, Canada or the USA.

12 The Dietitians Committee - new board assumed authority forthe WinifredGoddard, then president of described by Monica McKenzie as "a registration of dietitians from the the association said of the Dietitians great step forwardfor the profession Department of Health. Act. "This news should make every of dietetics" - functioned for three dietitian in New Zealand feel that years, until it was reconstituted as the "An importantmilestonehas been such an important step forward will Dietitians Board under the Dietitians reached in the history of the New do much towards firmlyestablishing Act which was passed in 1950. The Zealand Dietetic Association," the profession of dietetics."

The Parliamentary debate on the are given in schools is another good value to the community to have Dietitians Bill was a classic example training ground. If the meals are people telling the cooks how to cook of the irrelevancies which seem planned by a trained dietitian, the the cabbage and the peas, that is all endemic among politicians and children become used to eating right; give them a badge, give them indicative of some male attitudes certain foodsand grow to like them... a uniform and give them a flag to towards women at that time. If trained dietitians can be used wave if you like. wherever mass meals are served, we It began promisingly enough. In will gradually educate our people to "If we want to develop a race ofhe introducing the bill for the second eat the right sort of food. men and she women, let us start in time, the Minister of Health, Jack the schools. We should start by Watts, said its general purp_qsewas "I hope that as a result of giving teaching the girls how to cook a "to further the advancement of the proper recognition to dietitians, many decent meal. All this tiddliwinking knowledge of nutrition and dietetics more young girls will take up the stuff in the bill is simply to gratify and to make provision for the work. I hope that men too will enter certain people by making them look training and registration of this sphere... because they make just a little special and something dietitians. The direct aim of the bill as good dietitians as women. It is different from the common-or­ is to provide sufficientdietitians to work however which has a particular garden cook in an institution." staff our hospitals and to raise the attraction forwomen. They are natural standard of feeding for hospital mothers and housekeepers." Describing the bill as "a waste of patients and staff." In noting that time, Mr. Anderton said he believed the bill had the full support of the Miss Howard traversed her support in dietetics and that people should 100-strong NZDA, he expressed the for skim-milk in schools and her have correct nutrition but that "this hope that "more girls and young childhood hatred of brown bread, then sort of thing will do nothing in that women will take up a career in described an experiment with the direction." 'What we must d9 is dietetics". "Pay and conditions of digestion of fried eggs and her teach the children in the schools the work are good and dietitians obtain declaration she had not eaten, nor food values - and that is not difficult a knowledge which will be of great given a visitor a friedegg since. Which -and then teach them how to cook... use to them in future life if they prompted Ronald Algie ( A cabinet The bill simply glorifies afew people marry and if they do not marry, they minister and later speaker of who may be described as expertcooks will have a useful and worthwhile Parliament) to comment: "The and does not touch real dietitians at career." honourable lady is going to destroy all - the people who prescribe diets the Empire if she cuts out bacon and forpeople requiring them." Mabel Howard, the Labour eggs." member forSydenham, weighed in with her supportforthe bill: "Despite And Mr Anderton (MP for MrSim:"Itdoesnotsay anything the factnowadays there is plenty of Auckland Central):"I do not intend to about friedeggs." money about and nobody is poor, oppose this bill but, on the other our children are still sufferingfrom hand, I do not intend to go into Anderton: "No. Nevertheless, malnutrition and it all arises because raptures in support of it. If it satisfies England was built on roast beef and their parents have no knowledge of thewhim of the Department of Health beer and friedeggs and bacon and a dietetics and nutritional values of to register another section of the jolly finelot of people_ have lived in certain foods.We cannot stress too community, to regiment people into the British Isles and have done an strongly the importance of dietetics little groups and put badges on them, excellent job. We must not get too and knowledge of foodvalues ... then let the department do it. fastidiousabout our food. That will not do much good. We must be "There is a demand in industry " ...The only thing the bill does is to plain, sensible, matter of fact and for trained dietitians and that segregate another little section of the realise we have to see that education demand will increase. Wherever community, making a lot of glorified is imparted in the right direction - people gather together for meals, cooks who will do nothing else but that the girls in the schools, who are there is the opportunity to train stand over the real cooks and give to marry and become mothers, them in foodvalues, where meals instructions. If we believe it will be of should know how to cook food.

13 "If we cannot achieve that in fortunatein having reached this stage for the conduct of the syllabus and our homes, we shall never have it so early in our history and while examinations, for the registration in our institutions. People cannot rejoicing in the knowledge that such procedure and for appeals against afford to employ dietitians. They an important milestone has been Dietitians Board decisions. The cannot even manage to engage a negotiated successfully, we are not certificateof proficiency in hospitals maid to help scrub the floors or unconscious that it carries with it dietetics was replaced by a certificate giveanysortofhelp. Obviously, the added responsibility that we as of registration. aimshouldbetoimpartknowledge dietitians must accept.As professional in the right quarter and that is in women, it behoves us to prove by our State registration of dietitians the schools among the young seriousness of purpose, by our was not achieved in Britain until people." integrity and by our standard of 1960 and in the USA regulation of attainment in service to the the profession which began in 197 4, Rev Clyde Carr, the MP for community that we are worthy of is now in effect in 29 states. Timaru, added his bit: "lam inclined such recognition." to agree that so long as one has a DEPARTMENTOF happy and contented mind, it does The act outlined membership of I HEALTH not matter what one eats -the state the board. When it met forthe first of mind is everything." However, time in August 1951 its members The Department of Health was he went on to support the role of were: Director-General of Health - very much the vehicle on which New dietitians and praised their work in Registrar and Chairman (Dr John Zealand's dietetic professionand the hospitals (''Where dietitians have Cairney, represented by Dr H. B. New Zealand DieteticAssociation rode been employed in public hospitals, Turbott); Dean of the University of during their early days. Departmental the dietary has improved and it has Otago's Home Science Faculty (Dr staff and resources, much officially been good for the patients.") Elizabeth Gregory); Department of designated and a fair bit siphoned This led to discussion on food Health's Director of Nursing (Flora through unofficially, were critical in fads and cranks and the value of Cameron); Department of Health the successful establishment of diplomas, until Mr Watts managed Nutritionist (Dr Muriel Bell); dietetics. to sum up: '.'Wecan overdo it. We Department of Health Inspecting can get fads about our food by Dietitian (Monica McKenzie): two That major role and influence was reading advertisements and dietitians nominated by the New to continue for almost another 50 listening to talks. One of the things Zealand Dietetic Association (Joyce years, until the swing to devolution in a dietitian will encounter will be Martin and Winifred Goddard); the 1980s. For much of that time, the the type of person who gets a bee in Minister of Health appointee (Mary department had a structure which his bonnet and imagines he can Lambie). stood behind dietitians out in the cure all ills and evils by eating a field. certain type of food. We have to The board's first job was to make strike a balance. The purpose of the recommendations forthe regulations Maureen Barker was appointed bill is to train dietitians who can which would allow the act to work. Its Nutritionist in 1943 to coordinate produce suitable diets for sick continuing function is to enforce nutrition teaching and develop people. Not only in hospitals but standards of training through nutrition publicity. She also took any sick people requiring special professional examinations and its responsibility for advising the types of diet." registration authority and admit to Department on matters relating to the profession only those who can the training and employment of And so the DietitiansAct, which satisfy its requirements. The dietitians and the fledgling dietetic took effectfrom January 1, 1951, professional status of dietitians is profession. In 1947, Monica McKenzie was passed. protected by the act - anyone not was appointed Inspecting (later registered under the act is liable to a Advisory) Dietitian. Her task was to New Zealand was one of the first fine if he or she "describes himself or improve the standard of hospital food countries to give state registration to otherwise holds himself out as a service. Vital to achieving this dietitians, further reinforcing their dietitian, or uses the word, 'dietitian', objective was the training and international professional standing. in connection with his occupation." employment of dietitians which then "The importance of this cannot be became her responsibility. over-estimated," said Winifred The Dietitians Regulations, Goddard, "especially aswe realise that gazetted in 1953, provided the On the resignation of Maureen so far, similar powers have been machinery to put the act into practice. Barker in 1947, May Dale (born granted to one other group of The regulations made provision for Abraham) was appointed. Flora professionaldietitians in an English­ people intending to apply for Davidson took up the position of speaking country... We are singularly registration to take training courses, Nutrition Officerin 1950, a position

14 she held until1985. She broughtwhat demise in 1990 when the The position was held by Patricia other dietitians have described as "a Department's role changed due to Williamson, Elizabeth Murray (born balanced, common sense approach" restructuring. Gilmour), Joanne Swan, Mary Louise to the job. "It has been her sensible Hannah and Megan Grant (born approach to food and nutrition which The nutrition officer was Palmer). has guided the Department of Health responsible for all nutrition in its advice to other departments and pamphlets, booklets and publicity The public health dietitian's role organisations and to the public during material and for teaching to such initially was to provide on-the-spot times of fadsand extreme views." groups as post-graduate nurses, assistance by telephone or in the field health education officers, trainee to the general public, speak to and By1957 threedietitians, known as health inspectors, dental nurses, advise community groups on advisory dietitian, the nutrition officer kindergarten and teacher trainees. nutrition, prepare newspaper and and the administrative assistant The aim was to provide sound magazine articles, help people with dietitian, worked fromhead officein scientific background knowledge so diets recommended by doctors, work Wellington and a public health that all these groups spoke with one with public health nurses and with dietitian was attached to Dunedin public voice. While Flora Davidson local budgeting counsellors to help district health office. was Nutrition Officer she undertook individual families. Over the years, research among Maori and Pacific the needs of the local communities The advisory dietitian, also Island groups, the elderly and have dictated the emphasis and registrar of the Dietitians Board, was children. specificroles of these dietitians. probably best known forregular visits to hospitals. Usually, these were Mary Louise Hannah (born Dora Campbell became New welcome, often looked forward to. Longbottom) succeeded Flora Zealand's first district-based public Her role was primarily as adviser to Davidson in1985 and ElizabethAitken health dietitian when she was the Department on the training and filled the position from 1988 -1990. appointed to the Dunedin office in employment of dietitians and auxiliary When the Department of Health 1957, a position she held until 1963. staffin hospitals; on all aspects of food restructured, Elizabeth Aitken took a Other appointments were Dorothy service management; on planning and new position, as Senior Advisor Moir, Auckland 1963 -1970, Patricia equipping foodservice facilities.While (Nutrition). Mathews (born Clifford), all this may sound forbidding, many Christchurch 1969-1979 and Gillian older dietitians will tell you how glad The administrative assistant Tustin, Auckland 1973 - 1989 when they were to have a backstop to call dietitian worked in the advisory field area health boards came into on. with maternity hospitals, old people's existence. and children's homes, school and Four women have shared the university hostels, health camps, role of advisory dietitian: Monica industrial and commercial cafeterias. Dietetic Practice: McKenzie from194 7 -1963, Patricia She also assistedthe advisory dietitian PublicHealth Williamson from 1963 - 1965, in planning and training food Connie Shearer 1965 - 1968, and supervisors employed in hospitals, Since 1948 "Health" magazine Bernice Kelly from 1970 until its hostels and residential homes. has been the voice of the Department of Health onpreventive medicine and health promotion. In the 40th anniversary issue, Flora Davidson noted that the emphasis of dietary advice in the 1940s had been on optimum nutrition, promoting foods to increase the consumption of animal protein, calcium and vitamins. She said that as knowledge on nutritional requirements had expanded, these recommendations had been modified. The rather authoritarian advice of 40 years ago, which specified kinds and quantities of food to be eaten daily, had been replaced by a trend towards a more general informationservice to keep the public in touch with current Dora Campbeli, public health dietitian 1957 views on foodand nutrition. Dunedin Distric Office, Departmentof Health

15 Salaries refer to theNZDAexecutive if they got regulations fordietitians and student no joy. It was noted that if dietitians dietitians under the Hospital Salaries have been part of New did not apply for positions where Employment Regulations Zealand Dietetic Association life from conditions and salaries were not Amendment No 4 in 1948. the beginning. A proposal to set a satisfactory, the position would right minimum salary of £210 , plus living itself over time. Dietitians remained Three salary issues emerged (equivalenttoadietsister)forqualified their own advocates, although the among NZDA members: dietitians was raised at the NZDAwroteto themsetting outduties * Dietitians in charge of smaller association's first general meeting in and responsibilities which would be hospitals were not sufficiently well 1943.Amemorandumwassenttothe expected of them. Department of Health and the paid. executive directed to draw up a In 1947, theNZDAsetupasalaries * Years of experience should be suggested scale of salaries depending sub-committee - Winifred Goddard, considered in the computation of on the size of the hospital. Joyce Martin, Esme Ussher and Dora salary rates. Campbell (the foursenior dietitians However, many discrepancies from the training hospitals) - to * Staff and student dietitians' continued to exist and in 1946, discuss proposals with the salaries should be raised to the dietitians who felt their salaries should Department of Health and the equivalent of those received by home be adjusted were asked to discuss the Minister of Health. This led to the science teachers with equal years of matter with their hospital boards and establishment of a salary scale and service.

The Association and South Island representatives Subscriptions were increased to from outside the main centres and 10 guineas for life members, £1 a The NZDA held conferences to have a separate secretary and year for members, 10 shillings a every second year until 1949 when, treasurer. This inflated the executive year for associate and affiliate on the proposal of Monica to 13 members. members; a levy was suggested on McKenzie, the association became recently received back pay. This an incorporated society and was The first balance sheet in 1945 - extra revenue put the association's obliged to hold an annual meeting. a simple statement - showed a bank foundations on a sound basis with The original eight-member balance of £86 and total working a bank balance of £350 .and assets executive was increased to nine capital for the period of £130. In of £526 . Three years later, from 1945 to accommodate the 1950, affiliate membership was subscriptions took another hike past-president, then to 10 in 1947 opened to those holding scientific to £15 for life membership and £2 when the Department of Health's qualifications in nutrition, holding a year for members, with associate inspecting dietitian was included a prominent position in work related and affiliate membership as an ex officiomember. In 1949, a to dietetics, or advancing nutrition remaining at 10 shillings a year. decision was made to include North work through research.

Delegatesto NZ Dietetic ksn Conference WellingtonHospital 29 August 1950 Front row seated from left: Evelyn Waddell Barbara Smeeton, Connie Shearer,Maureen Barker, Eleanor Gray, Esme Ussher, Winifred Goddard, Dr Muriel Bell, Dr Elizabeth Gregory, Betty Gentles,Flora Davidson,May Abraham, Edna Geddes. Standing from left: �; u,i Mt JC�._,;1:i e.-- Margot Barnard, R Barlee, Sister Pole, Kay Cammie, SusanHolmes, Eva Puttick,M Leahy, Marie Thomas, Clarice Fleming, Grace Smith, Eleanor Couston,Alma Quinsy, E Jackson,E Moore, Sister McStay, Miriam Cox, Margaret Bannerman,Audrey Rees, Kit Moody.

16 Uniform Bulletin Dietitians wore nurses uniform fromthe beginning. Many dietitians, In 1946, the NZDA published forthe best part of 30 years, still recall itsfirstbulletin-a45-pagefoolscap, pushing their arms into freshly cyclostyled production put starched sleeves, to a crunch-crunch together by Thelma Simons. She accompaniment. had to delay publication and reported "a poor response The NZDA delivered an edict in forthcoming"from her request for 1945, telling dietitians that cardigans contributions: she must have been similar to those supplied by the North a persuasive person, however, as Canterbury Hospital Board were now the firstissue contained 20 articles, manufacturedfor the association: "It 13 of them written by members. is intended that these cardigans be Most of the articles dealt with Student dietitians regarded as working uniformand be professional nutritional matters Christchurch Hospital 1950 purchased at the dietitian's own and there were some items of news expense." and NZDA activities. Left to right: Margaret Meehan, LesleyBurnett, Although selection of uniform Three further bulletins were Marie Thomas(born Sare), Ivy actually remained a matter for produced - by Dunedin members Fraser,Jocelyn Shaun. individual boards, the NZDA was in 1947; by Una Martin and Gay undeterred. It proposed that the Brett, in Christchurch, in 1949 (its revised salary scale would include cover featureda freehanddrawing regulations governing the provision of the NZDA badge); and a 1950 by boards for"a cape or cardigan" as issue, edited by Joyce Martin, in part of the uniform and it told its Auckland, reduced to quarto size AucklandBranch members: "Since the NZDA resolved and containing two The New Zealand Dietetic that the cape or cardigan should be advertisements. In 1951, there was Association's first unofficial branch green, the onus is therefore on the a major revamp -a change of name was formedon January 20, 1948. The to Journal of New Zealand Dietetic practising dietitians themselves to Auckland branch had nine members, endeavour to arrange with their own Association ( on Dr Gregory's with Desley Zebhlik (born Collinge) hospital boards that the cape provided suggestion because, she argued, as president and Anne Ting (born should be green." scientific publications of any Wong), secretary. The programme was standing were called "journals"), a largely social, with speakers on various Badge change of formatto a small A5 size topics, not necessarily dietetic. The and twice-yearly publication (June branch folded in 1956 and was and December). reformedin 1973.

In 1945, the Department of Health issued its first badge to qualified New Zealand-trained dietitians. The oval badge carried the New Zealand coat of arms on a gilt centre with a blue enamel surround and bore the words, "Department of Health, New Zealand Dietitian". Name and number signifyingthe position on the register was stencilled on the reverse. With the passing of the Dietitians Act and provision for compulsory registration, the Department of Health badge could no longer be used. The Dietitians Board asked for suggestions for Stirring the Soup the design of a new badge. Main Kitchen, WellingtonHospital Some of the Aids and Cooks 1951

17 Wmifred------Goddard ---- In 1943, she applied for and was With Winifred Goddard as chief appointed chief dietitian at Auckland dietitian and Connie Shearer as her Hospital but was "manpowered" and firstassistant, Wellington had a high spent four years with the reputation among New Zealand Commonwealth Department of hospitals. Health in Canberra, not as a dietitian but as a home science and nutrition Even so, Winifred is somewhat adviser on food rationing (this was reserved about their achievements: wartime). "I think, though I'm not certain, that w� improved the quality of the "Education propaganda menu. (nutrition education) on food preparation and diet and a guide to ''When I started, it was like the eating during a time of severe good old British hospital menu - rationing" is how she remembers it. porridge forbreakfast, meat and two She was also involved in planning veg with some sort of pudding midday the details and training field officers and a light evening meal. Winifred Goddard received an OBE for the 1944 Australian dietary in 1981 for services to the dietetic survey and edited Food and 'We tried to give everyone a cooked profession. Nutrition Notes and Reviews issued breakfast and a more substantial and from the Austalian Institute of better type of evening meal. We also Working as a dietitian was the last Anatomy, Commonwealth tried to take account of individual thing on Winifred Goddard's mind Department of Health. differences. For instance, the men's when she set offto the USA to do her orthopaedic wards were mainly dietetic training in 1933. This delayed her return to New occupied by young, active males who She went to Johns Hopkins Zealand by four years and when she were used to large meals." Hospital in Baltimore, Maryland did come back, it was as chief dietitian during 1933-34 on study leave to at Wellington Hospital where she Her wartime experiences in complete dietetic training because remained until she retired and Australia had convinced Winifred of she saw it as a useful adjunct to her married in 1956. the need fora good breakfast. teaching career. She became heavily involved in ''You must have some breakfast Since completing home science New Zealand Dietetic Association but better still a cooked breakfast. in 1926, she had been on the staff of affairs- president from 1949 to 1952, Otherwise, you find people flaking the food department at the editor of the Journal from 1955 to out before lunch. They used to have University of Otago - assistant in 1961, a member of the finance sub­ soup at llam at Wellington but we 1927, assistant lecturer in 1929, committee from 1958 to 1976, found thatwith a better breakfast, we head of department in 1930. honorary life membership in 1971. were able to transfer the soup to the After her training, she visited She was also a member of the first evening meal ... soup and savoury." Britain and Scandinavia to observe Dietitians Board from 1951 to 1954. the teaching of cooking and home She thinks that 11am soup was management and took a course in The attraction to dietetics? -"I was probably a hangover from the days of haute cuisine in London. interested in both administration and sea travel when soup on the deck was teaching and dietetics seemed to the traditional "elevenses". Aftera couple of years back at the combine my need to teach and to be Home Science School, she went to an administrator. In 1990, when in Wellington Sydney as principal (and domestic Hospital as a patient, she was science teacher) of the. Memorial "I also like people and like to work disappointed to find the cooked College of Household Arts and with them - it's lots of fun. I didn't breakfasts had disappeared and a hot Science, a post-secondary private want to sit in an officeand tell them drink came between 9am and 10am fininshing school. what to do. I believe that to encourage instead of with breakfast and the same Aftera brief time in the commercial others, you have to be out amongst system in the evening - hot beverage field at Beath's Restaurant in them." later after the meal. Christchurch, she returned to Sydney in 1939 for four years as the bursar­ In her new role, she assumed Disappointed? "Yes," Winifred dietitian of a women's college at control over both food service and confides, "because I still have Sydney University. special diets. something cooked for breakfast." 18 THE SECOND DECADE - from 1953

Budgets and costs are often resolve to examine and improve in "There is a very real need in hospitals claimed to be the phenomena of the every possible way the standards in to survey the duties of dietitians and 1980s and 1990s. But in 1954, the dietary department in our hospitals." wherever possible, to delegate to both New Zealand Dietetic Association clerical and household staffas many conferencediscussed a remit calling Many feltdietitians were not being as possible of those duties which do for hospital boards to provide daily used to their best advantage in not require the dietitian's specialist per capita foodcosts each week as the hospitals - too much time spent on knowledge. The small number of only criterion forensuring foodcosts routine, practical work rather than dietitians can themselves then carry are controlled by the dietitian teaching and supervising staff and out more efficiently their primary responsible for food service. It was creating time to consider the broader duties which they and only they, can decided to send a copy of the remit to issues. The idea of two or three do. dietitians working together between the Hospital Boards' Association "to "It prove that dietitians were aware of all two or three smaller hospitals was is, of course, forthe hospitals foodcosts." floated. employing dietitians to set the lead by making sure the duties they are asked An editorial in the NZDA Journal The association initiated a move to do as routine are not the duties of of 1954 took up the point: 'We must for the Department of Education to a less highly trained person. The prepare ourselves to handle the establish a training course forcooks. delegation of the dietitian's duties problem of foodcost control. We must It received support fromthe Auckland brings us to the very important part demand the information we need so Hospital Board's Superintendent-In­ which the household staff play in that we can see where the money is Chief, Selwyn Kenrick, who said food hospital work. It will not be possible being spent... We, as dietitians, must for patients and staff at Auckland to delegate duties unless there are anticipate the future if we are to hospitals was the second largest facilitiesfor training staffand giving maintain efficient food service and budgetitem-10.8% of total spending. them their rightful status in the begin now on food cost control. We hospital. We must also be able to give mustnotbeafraidtouseourinitiative, Flora Davidson, the president of the worthy ones promotion within we must insist that accurate figures the day, also picked up on the theme: their own ranks. be supplied. Weekly costs should be made available to the dietitian so that each dietitian is able to show the daily cost, quality and nutritive value of the food used in the menu plan. From these figures, it will be possible to evaluate results and make any adjustments necessary." Standardisation of menus and equipment also aroused plenty of discussion. NZDA president Esme Ussher told the 1954 conference it would be profitable if dietitians noted the reports on standardisation of menus as practised in some places overseas. She referred to the many administrative problems facing dietitians and emphasised the importance of economical practices in trying to eliminate waste. She urged all dietitians to "critically evaluate the standard we maintain .. Let us survey our equipment - its design and finish and the maintenance it receives; our food preparation and food handling techniques; the standards of personal EXPERTS IN DIET: Dr E. Gregory (left), dean of the School hygiene we expect among our staff; of Home Science, Otago University, Miss J. Martin, immediate the general standards of cleanliness past president, and Miss F. Davidson, the new president, at the conference of the New Zealand Dietetic Association which maintained in our kitchens. Let us opened in Auckland yesterday.

19 "As dietitians, we know we cannot practising members from 19 - 22 [ Recruitment function without our household staff, August 1958. The theme "Planning but we must go furtherthan this and for the Future" which covered topics Dietitians gave plenty of attention encourage our staffto work with us as such as streamlining dietary to addressing shortages of dietitians a team. We must build up the spirit of departments, organisation as a tool of and how to recruit trainees. The NZDA a team responsible for the very management, selection and use of took up a Christchurch Hospital important task of providing an physical plant and equipment, suggestion to approach the Dietitians efficientfood service to both patients training of dietitians and supervision Board about producing "some and staff." was dealt with through a mix of propaganda pamphlet" advertising lecturers, panel and general dietetics as a profession or · how to The Department of Education did discussions and reports on specific become a dietitian foruse in schools call a meeting in 1956 to discuss the studies. and vocational guidance centres as a suggestion but decided there was means of sparking more widespread nothingitcoulddo. Therewassupport knowledge and interest in the however for importing trained or [ Code of Ethics profession. This eventually took form partially trained cooks fromoverseas. in a leaflet, ''What Does A Dietitian The adoption of a code of ethics Do?" Dr Gregory expressed her concern had been proposed by Christchurch about the lack of teaching facilities members at the 1953 annual Analysis of the professional forpractical training in institutional meeting. They envisaged it should strength of the profession showed management at the School of Home define principles of professional that of 166 dietitians trained since Science and sought NZDA support in ethics appropriate forNew Zealand. 1941, 80 were married, 51 were pressuring the University of Otago to The proposal was approved, a draft employed in hospitals, seven in other take action. This was taken up by the circulated to members for fields (two as dietitians and five in University Grants Committee and comments and suggestions (Esme allied professions), 20 were overseas improved training facilities were Ussher deplored the apparent lack and eight were not practising. 57 provided in 1957. ofinterestshown) and the following dietitians - six of them overseas­ year, the code was adopted: trained, were working in New Zealand [ RefresherCourses hospitals. "The aims of the dietetic Continuing education, in the form profession are primarily concerned By the end of 1963, NZDA of a refresher course for dietitians, with the improvement and was raised at the 1956 conference and membership stood at 138 - 58 life maintenance of national health. members, 24 full members, 42 the new executive was given the job of Each member is held personally investigating time, place and subject. associate members, three associate responsible for supporting the life members, five honorary life The matter was discussed thoroughly association in pursuit of these aims again the following year, with the members and six affiliate members. by rendering service of the highest But of 226 who had qualified to outcome that a four to five day quality in the community, no refresher course should be held in practise in New Zealand, 147 were matter what branch of the married, 18 were overseas, 13 were Wellington in place of the 1958 profession she follows, regardless conference. At the request of the working in other fields - and just 48 of personal gain or monetary (10 of them married) were practising Association, Dr Elizabeth Gregory reward. was instrumental in making in hospitals. arrangements forProfessor Evelyn "Each member of the Smith, a former professor of Several factorsinfluenced the high association should act on the rate of dietitian fall-out - hospitals institutional management at the principle that on the conduct of University of Illinois, USA to visit New often had a policy not to employ the individual depends the married women; pay rates which did Zealand under the Fulbright research reputationofthewholegroup. She programme. not compare well with the alternative should thereforeset beforeherself professionsof teaching and nursing; the highest standard of personal While here Professor Smith the social more of the time that when integrity and professional a woman married, she stopped studied hospital dietary departments efficiency, combined with the and student dietitian training working in paid employment; and the sound judgement, human number ofyoungwomen who headed throughout the country. With this understanding and tact essential background she was the leading overseas in search of adventure soon to the successful accomplishment after qualifying. participant in the refresher course of her duties as a member of the attended by dietitians from26 hospital New Zealand Dietetic Association Back in 1951 this had prompted boards, Department of Health, School Incorporated." of Home Science and by several non- a warning from the NZDA's then

20 president, Winifred Goddard. Boards' Association, two from the "Experience gained in other I Salariesc!!lJi Grading NZDA, plus the two independent countries is most valuable and The contentious prospect of a appointees. should be sought after, but it is grading committee to determine most important that a dietitian where dietitians should sit on the The committee attracted plenty should be well established in her salary scale came to a head at the offlakfromdietitians, oftenreceiving profession before she contemplates 1955 conference. The suggestion the blame forthe outcome of salary leaving the country to take a position that dietitians be graded according negotiations. But it did not have a overseas. The reasons are obvious - to responsibility, experience and part in setting salaries; its job was to a dietitian who has just qualified is seniority was eventually endorsed grade dietitians on a scale of grades ill-equipped to gain the most from and a request made to the and steps according to job any experience and if she is at all Department of Health forthe system responsibility, experience, serious in her purpose, she should to be set up. qualifications, proven ability and realise she must give as wel 1 as take. hours of duty.Problems oftenarose Maturity is also an essential quality This resulted in NZDA where a dietitian in a position of for the sound judgement necessary recommending a grading scale responsibility moved to another to assess the value of a piece of work starting at student dietitians (£.500a centre and ended up taking a less observed or shared. Moreover, a year) and staffdietitians (£675-725 a highly graded position because it young inexperienced dietitian is not year), then progressing fromgrade was the only one available. Dietitians necessarily a good advertisement one (£675-775 a year) to grade five often complained about being for the training and standards of (£1175-1325 a year). What was "derated" in such circumstances; hospital dietetics as practised in New gazetted in the 1957 Hospital the grading committee was adamant Zealand." Employment (Dietitians) they had been "regraded." Regulations was: student dietitians I Objects (£.515-560); staff dietitians (£640- There was also the problem of 695); grade one (£695-780); grade relativity between positions in Revised rules, adopted for NZDA two (£780-900); grade three (£950- differenthospitals. The committee in 1955, included a restatement of its 1150). did eventually attack this in 1979, objects as: establishing relativities between The grading committee was to positions and setting maximum * To further and advance the consist of the Department ofHealth's gradings forthem, basing its re\,liew knowledge of nutrition and dietetics Director of Hospitals, as chairman; a on the principle of "broadbanding" - throughout New Zealand. Department of Health officer, the grading for each· position appointed by the Minister of Health; spanned two, sometimes three * To raise the standard of nutrition two hospital board members grades. But despite these changes and dietetics in New Zealand and to appointed by the minister; two others and the introduction of an annual support and protect the character, (not dietitians) employed in hospitals review of salaries grading, many status and interest of those persons and appointed by the minister after dietitians remained unconvinced practising in New Zealand. in the consultation with the NZDA. This about the system when the grading professionof dietetics. committee was separate from the committee went out of existence in salaries adv'isory committee 1984, because of a change in * To promote the knowledge of (dietitians) which contained two legislation. nutrition and dietetics by lectures, dietitians nominated by the NZDA. discussions, the provision oflibraries, During 1957, the NZDA took its correspondence with government The grading committee came firstsmall steps into formalisedpay departments, public bodies, societies into being in 1957. Dr Elizabeth negotiations when it took up an (whe_ther in New Zealand or Gregory and Winifred Goddard(who invitation fromthe Council forEqual elsewhere) and individuals interested had retired as Senior Dietitian at Pay & Opportunityto send observers in or concerned with the study of Wellington Hospital) were the two to its meeting. This investment nutrition and dietetics in all its appointees. Dietitians were not yielded a dividend when the branches or otherwise. happy about the absence of a hospital GovernmentalService Equal Pay Act dietitian on the committee and in of 1960 made provision for the Further revision of the rules 1969, the composition of the elimination in three annual stages, appointed the Journal editor an ex committee was changed - an starting on April 1, 1961, of officio member of the executive in independent chairman, one government employees' wage or 1961. The executive was also give the representative from each of the salary scale differentiations based power to co-opt two active members Department of Health and Hospital on sex. for any purpose.

21 Terminology The Association Publications In 1958, it was decided to base the An advertising manager, In 1959, the NZDA came up treasurer in Wellington to ease the PatriciaWilliamson, was appointed with recommendations on collection of subscriptions and to the Journalin 1958 and by 1962, terminology for use when handling of money. the publication was self­ advertising fordietary department supporting. However, increasing staff: These were early days for printing and postage costs and sponsorship-the term itself was rarely mergers between individual * Dietitian - a person registered used. But during 1959, the NZDA advertisers made that situation accepted an offerfrom an Australian hard to maintain. Production of undertheDietitiansActl950 (New the Journal has been a continuing Zealand). firm, Fawns & McAllan Pty Ltd, to fund£300of printing costs for10,000 balancing act between restricting diabetic food tables and booklets in costs, while maintaining a * Dietetic auxiliary- a person return for acknowledgement and an professional "shop window" - both who is a member of the British advertisement. But various hiccups in looks and content - for the dietetic profession. Dietetic Association or of the and the emergence of new national dietetic associations of information delayed the booklet so Anewpublicationwaslaunched countries within the British long the offer eventually lapsed. in 1962, on the initiative of Frances Commonwealth but who is Berry. News and Views was ineligible for registration as a produced quarterly to report on dietitian in New Zealand. research, new dietetic practices, Badge new products and equipment, availability of foods and products * Food supervisor - a person A new badge was finalised in 1954 for use in restricted therapeutic who holds a diploma in institution when authority forregistration passed diets, employment information, management following a to the Dietitians Board. Lozenge­ course, seminar and meeting recognised training course butwho shaped, it has a silver centre embossed notices and topical issues. does not hold a diploma in dietetics. with the wheat and barley sheaf and Responsibility forcollecting and the serpents of Aesculapius entwined. distributing material moved from hospital to hospital, until an editor * Dietary assistant - all persons Green enamel surrounds the words, "New Zealand registered dietitian." was appointed. The original who up to the present, have been cyclostyled format has changed employed as kitchen supervisors, Only dietitians who qualified and several times and more NZDAnews dining room supervisors and trained in New Zealand were eligible has been filtered in, but essentially dietitians' assistants. to wear the new badge. the original concept remains.

NZ Dietetic Association Conference 1960, Palmerston North

22 DieteticPractice: pattern". Over the next 30 years this FloraDavidson Publichealth was revised many times in the light of new nutritional knowledge. It Flora Davidson - 43 years a Many New Zealanders received acquired a new name, "Food for dietitian - maintains she wasn't their nutrition advice froma variety health", in the late 1960s and its 1987 looking for a vocation when she of pamphlets produced by the version was a colourfulposter with a entered the profession. Department of Health, the most photograph of the many foods that And Flora - 33 years in the familiar being the "Daily dietary comprise a mixed diet. Department of Health - is equally NEW ZEALAND'S adamant she had no idea of a career � in public health. "I just wanted to make a living . 'D�� and dietetics was a lesser evil than A GUIDE TO HEALTHY EATING teaching. I didn't even know what 'Daitr public health was." MILK: Pre-school children I¼- I¾ pints; school child· ren and adolescents not less than I¾ pints, (including school milk); adults not less than I pint. (Drink it After qualifying at Wellington cold-use it in hot drinks, soups, sauces and puddings). Hospital in 1942, she worked there EGGS: One a day when possible. At least 3- 5 per as a dietitian for fouryears. week (including those used in cooking). Preserve eggs in the flush season for use in the winter. "But you've got to be the sort of CHEESE: A small cube every day. Use on bread and butter, in sandwiches, in salads, and as savoury person who likes to wear a uniform dishes. to work in a hospital. I liked the MEAT: A serving once a day. Serve LIVER patients and the work but not the at least once a week and FISH, when possible, hospital set-up - I didn't like once a week. uniforms.

POTATOES: She escaped on a fellowshipto England where she split her time between "observing" and working VEGETABLES: Green vegetables, cauliflower, in school meals service. or swede every day, and one other vegetable at any of the three meals of the day. Serve She returned to New Zealand raw in salads often. and joined the Health Department

FRUIT: in 1950, taking over the Nutrition education position from May One RAW fruit in Abraham in 1951 when May leftfor whatever is used, the USA. Flora stayed with the or dried, department until she retired in 1985, becoming known particularly forher international activities and involvement in other BUTTER and FAT: The full ration of butter used on the table or in sandwiches; and lard, mar• cultures. �- garine or dripping in cooking. -�-� -��� 2, BREAD: At least half the day's At that time, her part in the � supply should be wholemeal. ·•-w· . department scheme of things was CEREALS: Unrefined porridge meals such as to help develop food service in oatmeal, rolled oats, or ground whole whe,t, smaller institutions, such as IODISED SALT: � COD-LIVER OIL : � children's homes, boarding (or substitute) schools, even prisons, helpingwith IO ED f, Should be used for One teasl?oon daily for pre• "'DIS �t· school children and expect- food, menus and sometimes . �ALT � '"'- . all purposes, in a'!t and nursin1;mothers. (ln _ � _ �- winter and spring months 1t kitchen planning. f �-- cooking, as well is advisable to include this UfjJ ""' in the dietary of older I " as on t h e tabl e. children. In 1955, she attended a World Eat any other foods to satisfy hungry appetites, but try to get these into Health Organisation seminar in the day's meals. Manila, Philippines on nutrition 'fo«ADietl and health education. Yo-u� B� Dr Harold Turbott (director of Issued by the Department of Health. 16..48 the Health Department's public An early version of the daily dietarypattern.

23 health division), wbo had organised for Monica McKenzie's appointment Flora has also seen many May Abraham's US study, was keen as inspecting dietitian. "She will get turnarounds in ideas fordiets, in the forFlora to do likewise. But instead, on well with the matrons," it said.And early days, there were diets for peptic she was granted leave to work with she did - "the matrons were and duodenal ulcers ("which haven't the UNESCO as a home economics intimidating and they were very been used foryears and years"), low specialist in the Korean National important. Food services had been in fat diets for liver disease ("which Fundamental Education and their control for decades and before haven't been used for years and Research Centre. The aim was to Monica came on the scene, there were years") and diabetes ("now train graduates to instruct villagers times when they had been reluctant completely different - from low in nutrition. to hand over the reins to non-nursing carbohydrate/high fatto very high staff." carbohydrate/low fat"). On her return, she was involved with Dr Ian Prior's epidemiology "Monica had a wicked sense of Her involvement in dietetics has unit and his work on Maori health. humour," says Flora. "I remember extended beyond her professional She was part of the team which her returning froma visit to a small work- secretary of the New Zealand surveyed the dietary habits of the South Island hospital where the Dietetic Association (1949-52), Maori population in Ruatahuna and matron had served 14 differentthings president (1955-56), Journal editor on the East Coast. forafternoon tea -Monica had counted (1962-79), member of the Dietitians them. And a surgeon at another Board, member of the Nutrition Thisworkextended to the Pacific. hospital told her · he had 'a very Society of New Zealand. Flora visited Rarotonga and important matter' to discuss with her Pukapuka in the Cook Islands and - it turned out to be the sandwich While she says she was invariably made three trips to Tokelau as the fillings." lategettingtheJournalto the printer, diet and nutrition expert in Prior's the April 1968 edition made it in unit. The change from the labour­ rather dramatic circumstances. intensive food service of the 1940s to Flora was due to leave for the "Harold Turbott was very the computerised menus and ordering Tokelaus the day after the Wahine interested in Maori health and gave of the 1990s has been the greatest storm but hadn't finished the me licence to go and work in these advance in dietetics, says Flora. Journal. She rang Elizabeth schemes. He had quite an influence Gilmour, who also worked in the on my career. "At Wellington, we had a butcher Department of Health and was in shop, a bakery, had peas (in pods) · Flora says she has oftendwelt on Christchurch for a meeting, once a year at Christmas, one woman suggesting she take the boat because the circumstances which brought spent all her time squeezing oranges Monica McKenzie and Mary Lambie the airports would almost certainly because there was no commercial be closed. together. source of fruit juice and the bread had to be sliced and buttered. And there "Elizabeth ended up in the "It was quite remarkable that was always a shortage of staff." they should come together at that harbour but survived and the last thing I did before leaving the next time. The Home Science School had Free medical treatment led to an day was to have someone drive me to been talking about dietetic training enormous amount of hospital the printer with the Journal." for 20 years but these two were a building during the 1950sand 1960s. wonderful pair of organisers; they knew what they wanted . and they "Although she had a hard time She was editor when advertising knew how to get on with people. It's convincing the Ministry of Works was introduced to the Journal and hard to imagine what would have engineers, Monica McKenzie and her saw commercial input continue to happened without them. dietetic contemporaries were the only develop: "It's a different sortof world people who had knowledge about now. I still remember the day "Mary Lambie·had been to the kitchen equipment and planning on a Elizabeth Gregory told me how USA and been impressed with what large scale. 'absolutely horrified' she was to learn she had seen dietitians doing there. that the Journal was funded by When she returned and found "There were a lot of young newly­ advertising." Monica McKenzie, it must have qualifieddietitians, many in theirmid- seemed like a gift from the gods. 20s, in very big jobs running vast food During her time as president, They set up the training course in service departments, with no one to NZDA issues included training for two years during wartime. turn to but the Health Department food supervisors, auxiliary staff, Something would have happened· dietitians." salaries - and hospital china. some time but it would have taken much longer without them." She has a photograph from an She says she didn'tseekavocation NZDA conference in 1950 in which in dietetics or public health; but in Flora says she sighted Maureen "everyone looks so young - the oldest retirement, she says she enjoyed it Barker's letter of recommendation is Dr Muriel Bell who was 52." and has no regrets.

24 I PatriciaWilliamson Wellington, graduating in 1945, then handing over to Bernice Kelly in 1970. worked at Hutt Hospital, Cornwall Patricia Williamson brought a Geriatric Hospital and National The senior advisory dietitian broad perspective on foodservice to Women's and Auckland Hospital visited and advised the major hospitals the Health Department. before goingoverseas. on food service management, menus, special diets, planning for new She went to Home Science School In London, her experience kitchens and equipment.As Registrar in 1938 not sure where she was headed: included catering officerfor Kodak's of the Dietitians Board she was "The hospital interested me but I'd cafeterias, school meals and special involved in the training of dietitians. never heard of dietetics as a career; I diets at King's College Hospital. In was interested in home science and Canada, she was in charge of meal She earned a reputation for maybe teaching - that's what most services at the University of Manitoba moving easily in professional circles, people who took home science did." in Winnipeg. for friendly rapport with colleagues and students, for maintaining close She did institutional management Back in New Zealand in 1957, she personal contact with hospital and decided dietetics sounded "very joined Monica McKenzie and Flora dietitians and for warm interesting - I'd decided I didn't want Davidson in the Health Department encouragement and support for to teach." forsix years: "I was the third dietitian dietitians in the field. in the department and was assistant But she had to wait two years after to both of them. My job involved From 1958 to 1965, Patricia was completing home science before visiting and advising old people's business manager of the New doing her dietetic training because homes, boarding schools, psychiatric Zealand Dietetic Association fewer interns were accepted for hospitals and producing material to Journal, her mission to increase the Wellington where she wanted to train. help them." level of advertising. During this Instead, Patricia got herself a job with time, the Journal actually ran at a the Standards Institute, working on When Monica McKenzie retired profit for a few years until in the clothing and food standards needed in 1963, Patricia was appointed mid-1960s, printing costs rose. She forwar -time austerity conditions. advisory dietitian until 1965. She was the NZDA's treasurer from 1961 returned to the position part-time to 1963. She eventually trained in when Connie Shearer died in 1968,

ShirleyThompsori 'lwelve years later, there was a organised in Tauranga when she sense of deja vu when she began met Margaret Cameron, dietitian­ Shirley Thompson (born lecturing in institutional in-charge at Dunedin Hospital, at Johnson) made something ofa habit management at the Home Science the Dunedin railway station. of successfully taking on teaching School. Margaret was going overseas and jobs she wasn't sure she should be asked Shirley to apply forher job. doing. "I felt it was a big responsibility at first. But I just tackled it day by day It was the beginning of what she In her firstyear out of training at and the responsibility didn't seem so terms "six golden years" from 1959 Christchurch Hospital in 1952, she great, even if at times, I did get the to 1964. During this time, Shirley was tutor dietitian to nurses at heebie jeebies and wonder what I'd was an NZDA executive member, Dunedin Hospital. taught them." president in 1965-66 and was elected a lifemember in 1984. She has also "I thought I was too young but I During the intervening years, she been on the executive of the Home got it." had three years running the food Science Alumnae. service at Dunedin Hospital's nurses' As it turned out, her youth was But it is her institutional home. an advantage because she was not management teaching role, as a too much older than the nurses. She lecturer and senior lecturer in food quickly realised the nurses didn't Then, during two years in England, servicemanagement from 1964 to much like nutrition and she needed she worked in a number of hospitals, her retirement in 1980, for which to make it interesting. including London Hospital which Shirley is best remembered. convinced her food service should be Her response was innovations under the control of a dietitian. "I was lucky to have ended up such as 'It's In The Bag' - type teaching students who were going competitions. Back in New Zealand, she had a job into dietetics, a profession I loved."

25 I Nellien McFarlane Her firstjob was commissioning thing that every happened to Cherry Wakari Hospital where getting kitchen Farm" - in terms of "wonderful "Asking too many questions" staff was the biggest problem. As a savings" and in the quality and variety launched Nellien Mcfarlane into hospital forthe acutely ill, Wakari had of the meals. Many patients dietetics. a high proportion, up to 70%, of commented on what a pleasure it was patients on diets. to have such nice meals. She had completed her nursing training at Waikato Hospital in 1952, Ward sisters and nurses served While she enjoyed management, but found her "fascination" and meals, which meant dietitians lost Nelli en says she never lost her interest interest in foodmeant she was always control of the foodonce it was in the in patients. She believes nurses who around the diet kitchen asking wards. became dietitians brought a different questions. approach with them through their Initially she had no intention of Marriage brought a temporary halt nursing instincts - "I enjoyed my becoming a dietitian, but working to her dietetic career but she returned contact with the patients." alongside thein as a nurse, she became toworkpart-timeinthenurses'home convinced that there was a future for at Dunedin Hospital in 1971, then 'We could also establish a better her in dietetics. became dietitian-in-charge at rapport with the nursing hierarchy Dunedin and in 1976, chief dietitian and had a greater understanding of Some of her nursing training was with the Otago Hospital Board. nursing practice. I always wore my cross-credited and she didn't have to nurse's badge at work." do basic clothing and design. But she As chief dietitian, one of her main had to cram three years of science roles was planning - for selective "I'd like to think the old image of into two and without any background menus and tray service in Dunedin in mother in the kitchen serving the in biochemistry, she foundnutrition the early '80s, then at Cherry Farm. meals has gone. But I'm not sure it a fairslog. These changes she says were "the best has completely."

MarjorieBloxam Pahiatua camp to Palmerston North, time dietitians and provided meals hospital staffhad the responsibilityof for the hospital, rehabilitation When Marjorie Bloxam retired feeding them. centre, psychiatric unit, radiology fromPalmerston North Hospital in department and staff.As well as the 1981, she had been there 28 years, They had been on meagre diets, new kitchens, Marjorie had commissioned three kitchens many of them were in poor physical commissioned a new staffcafeteria and been to almost all the condition and a number of them had at the hospital. internationalcongresses of dietetics. TB: "They needed a bit of special attentionaswellassomedecentfood." Apart from Amsterdam and She came to Palmerston North Washington, Marjorie Bloxamwent with a background of dietetic Keeping staffwas oftena problem. to every international congress of training in Auckland, two years as a Many dietitians saw Palmerston North dietetics. She foundthem valuable matron at the Plunket· Society's as a stepping stone; Marjorie Bloxam formeeting other dietitians and for Karitane Hospital and two years at a recalls two assistant dietitians who picking up ideas on foodservice and children's hospital in Southampton, "had a most marvellous time until the staffing. England, after two years in the hospital ball and then got married." Midlands and holiday - relieving in "They tended to get very big and Oxford and London hospitals. The business of feeding about 500 subdivided and after Canada, I people a day continued. At its peak, decided enough was enough." When a group of central the Palmerston North kitchen Europeans was transferred from a employed two full-timeand three part-

26 A DIETITIAN'S DAY

How has a dietitian's day changed who worked as volunteers. with those of contract prices for over 50 years? These excerpts from commercial products at Christchurch dietitians' writings help to give some Joan Brickell outlined January 18, Hospital. Costs fora 41b jar were: jam idea of the day-to-day routine and the 1945, when 10001b ofnectarines were - Cook 6d, Christchurch 10d; issues of their days. preserved, as a typical day. marmalade Cook 3.25d, Christchurch 10d, tomato puree - Dietetics in the 1940s 'Work started at 8am and the last Cook 7 d ( cost increased by addition of worker was offat 6pm. The working sugar and butter), Christchurch 6d; Dietetics in the 1940s was a lot of hours were approximately 40-46 pie fruit - Cook 8.5d (high cost of hard slog, according to Joan Brickell hours.To taljars, 386.Work was slowed preparation with pears and quinces (born Hollobon), who spoke to the up at times because the staff had raised costs), Christchurch 8d. first New Zealand DieteticAssociation other duties - the preparation of the conference about her experiences usual meals forthe dayforthepatients She quoted four major preserving fruit at Cook Hospital in and staff. disadvantages - strain on staff who Gisborne between January 1944 and had to do this extra work as well as May 1945. "The order of work was: their normal duties, other things were * Porter brought up the fruit and liable to be leftundone because of the Duringthattime, the hospital used immersed it in hot water. urgency of the preserving, a great 21,8961b (9-10 tonnes) offruit, either worry to the dietitian; complaints of grown in the hospital garden or * Domestics did the blanching monotony in the menu while bought locally. From that, the kitchen and cleaning. preserving wasbeing done; very little staffmade 11,7221b of jam and jelly * Porter did the stoning. saving in comparison with wholesale (including 50001b of marmalade), market prices. preserved 73321b of fruit and made * Dietitian did the packing. 1462lb of tomatopureeand 1380lb of Domestic cleaned jars. Her conclusion - although the relishes and pickles. * * Cook made syrup and did the result and satisfaction was excellent, There was quite a range - melon processing." the conditions under which staff and lemon, fig,rhubarb and orange, worked and the amount of labour plum, apricot, peach, plums, apricots, Losses occurred from breakages required in such a large-scale peaches, gooseberries, pears, quinces, and over-processed fruitbecause other preservation led her to advise against nectarines preserved; tomato relish, work was going on at the same time. such a scheme, except forpickles ;and green tomato pickles, home-made Joan Brickell compared Cook's costs relishes. Worcester sauce. When she started at Cook, the open-kettle method of preserving was used; the result - an inferior product and excessive overtime for_ staff.The cold pack method forstone and berry fruit provideda more pleasing taste and appearance and spread the preparation work more evenly. Processing was done in steam­ jacketed boilers fitted with racks; 30 half-gallon jars could be done at a time. The modus operandi was: the orchardist notifiedthe dietitian when the stone fruit was ready and all possible helpers were called to the kitchen as the fruit would not keep. The hospital menu was simplified during this time to allow kitchen workers to help with the fruit. The Dietitians at Dunedin Hospital1946 house steward lent a porter forheavy From left: lifting,the sub-matron lent domestic MollieStephens (born Houlber ), Joan staffand the matron provided nurses Brickell,Alison Perry.

27 The New ZealandDietetic those years of study and that one finds tell her that each new day on duty Association's 1950 McLester and Joslin knew their was differentand usually exciting? Bulletin business? 'Would you tell her that listening The New Zealand Dietetic "Would you tell her how your to patient's complaints got Association's 1950 Bulletin patience almost ebbed awayat the exasperating -or would you tell that contains some advice which also seemingly constant dumbness of fromalmost every complaint, there tells us something about a the new kitchen maid - or would is something new to be learned or a dietitian's lifeat that time. Headed you put a feather in your bonnet new suggestion of improvement to "If you were asked", it says: and tell her how you spent a half­ be made and after all, that is your hour of good down-to-earth job? "And you will be asked about a explaining? The results are amazing dietitian's lifeby many a high school - best maid in the place! "Remember that your answer girl and by many a college girl who to her questions is your own is teetering on the decision of a "Would you tell her that the personal vocational guidance choice of careers. Think about your student nurses' questions almost programme! Does your conscience answer! drove you crazy-orwould you tell her not prick a little and do you not some of your best friendswere student wonder if you have not sometimes 'Would you tell her that during nurses, admitting that nurses were a been careless in your "shop talk?" your training, your feet literally great help in keeping your patients' To be a "good" dietitian is to be a ached off (most of ours did) - or data up to date? "good" advertiser. would you tell her it was the nicest tired feeling,one of inner satisfaction 'Would you tell her that your first The other recollections were that in your small way, you were job was hard to learn - or would you published in the New Zealand contributing to the welfare of sick tell her that a new job holds a great Dietetic Association Journal (April people? thrill and anticipation that very 1986), an issue which focusedon seldom ends in anything but pleasant celebrating the 60th anniversary 'Would you tell her that you surprises? of the appointment of Edith were completely confusedabout diet Whitcombe (born Reid) to a therapy - or would you tell her 'Would you tell her that the days dietetic position at Christchurch training is the true application of got long and boresome-orwould you Hospital.

Dieteticsin 1946 science graduates as hospital accepted as a student). The person dietitians. who inspired my choice of career was Gay Brett, who trained in 1946- Professor Strong, then dean of the 4 7 and was later dietitian-in-charge "My education had been directed school, a gifted andfar -sighted woman at New Plymouth Hospital until she towards teaching Latin, French and who encouraged the concept that the resigned from hospital work in 1961: music and my progress through the dietitian in New Zealand hospitals School of Home Science was rather should be responsible for the total "The diary entry of January 22, erratic (nowadays I would not be foodservice, not just forthose patients 1946, reads, "Reported at 9am. Started duty as hospital kitchen supervisor student; good meals, Divided duty on this job: 6:50 - 1.30; 4.20 - 6.20.

"BytheendofJune 1947, the post­ graduate training period was over and the examination had been passed. I was very happy to have fulfilled a long-term ambition, the result of a session at the School of Home Science on a snowy Friday evening in 1938 when a group of Dunedin schoolgirls had been entertained and told, among A dietitian'sday: Christchurch Hospital 1950 other things, of the prospects of home From left: Cynthia Wadmore, Gay Brett, Marie Thomas.

28 requmng therapeutic dietary The diet kitchen supplied in bulk bottled pears and the dietitian's cream treatment. In the training, the three puree of vegetables and fruit, as of tomato soup. aspects -administration, diet therapy well as cream soup. However, many and teaching - were all covered, not meals were individually plated and "Dietitians were great preservers, only theoretically, but also as a sent out fromthe diet kitchen, such particularly of unsweetened fruitfor completely practical exercise, as the weighed diets for diabetic and diabetics and they also made jam. The surprising tooutsiders but very useful obese patients and other special most delicious aroma imaginable is a in an emergency. diets. cauldron of fresh raspberries boiling up for jam and it seemed to happen on "Many advances in technology are "It is the field of diet therapy now Boxing Day. I have a good marmalade now taken for granted, such as sliced that changes are most evident. One recipe based on a bushel of citrus fruit bread, not then a commercial of my first impressions of the diet and a 701b bag of sugar. proposition in New Zealand. In the kitchen was the large number of bread room, a guillotine-type machine small dishes of foods with hand­ "Teaching eventually was my was used and the loaves ofbread were written labels for the typhoid fever speciality in my training school. cut and buttered (table margarine patients who were to take at least Dietitians then taught nurses at three was illegal) for distribution to wards 4000kcals/day in low residue, two­ levels-cooking school for preliminary and departments. There were hourly feeds. It was a few years before nurses ( beef tea, egg nogs, invalid refrigerated coolrooms but no 'deep specific antibiotics made the job of cookery), basic nutrition during freezers.' Ice cream was a novelty preparing that diet redundant. The training and dietetics for finalists. requiring special handling and diabetic diets were meticulously There was a nutrition and diet therapy delivery from the supplier was weighed. Then there was nephritis paper to be passed in State arranged for a specified time in (Bright's disease) in three stages. In examination finals. Lectures were insulated bags. Vegetables were those children (stage one), nephritis often compulsory for nurses and were in season, or dried or canned. followed 'school sores' infection attended in uniformin off-dutytimes. before antibiotics were freely I gave duplicate lectures morning "The food, cooked by atmospheric available. and afternoon. The girls were often steam, coal gas or electricity, was tired but the discipline was fine - the conveyed to the wards in heated food "Rheumatic fever, also associated tutor sister sat at the back of the trolleys which were, in fact,portable with infection, led to cardiac disease room. In the lectures, whooping bains-marie into which boiling water in later life. In the 1940s, cholesterol cough and infantile paralysis was put before serving time. In the was of interest only academically in (poliomyelitis) were included,· both wards, the meals were served by the relation to gall-bladder disease. Its requiring special attention to food. ward sister with a team of nurses. significance in heart disease was yet Pernicious anaemia was taught as a Each plate of food was personalised; to be suggested. In fact,at least one deficiency disease. the sister knew her patients and gave egg a day was included in most cardiac each what she feltwas suitable. For diets. I recall also that there seemed "Being in complete control of loading the trolley, a dietitian had to be almost an epidemic of peptic food, dietitians were responsible for carved (on a Hobart-Berkelslicer), ulcers and that diet was an important the Nurses Home Kitchen (all the the main meat and another dietitian feature of the treatment ( in three nurses and most of the sisters lived had divided two steamed boiling fowls stages, of course). There was a period in) and for the executive-type dining into suitable portions, garnishing the when I felt sensitive about being rooms and tea trolleys for VIPs who steamed chicken orders with white labelled a 'white sauce queen' and the had their food free. At Christmas sauce and roast poultry with gravy. phrase, 'ulcer pudding', was not time, each ward and department The trolleys had been 'checked' by a intended to denote haute cuisine. received an iced fruit cake made dietitian (after various cooks and and decorated by the dietary kitchenmaids had made their "One of the scourges was department. Graduation functions contributions) using the ward sisters' tuberculosis. I spent some time as and conferences-_ of various requisitions as a basis. assistantto the dietitian at the local professionals were all catered for sanitorium where the patients were and dietitians usually played hostess "The variety of foods prepared handsome young people, many of (strictly in uniform). The diary entry daily, particularly for dinner, was whom as boys without immunity or of my last full day on duty in my considerable; soup, fish, chicken, the benefit of BCG, had been packed training school reads: 'February 15, meat, potatoes, a green and a root like sardines in naval vessels during 1951: 8-3, 10-12 midnight ( served vegetable, gravy and white sauce. the war (1939-1945). The treatment supper to BMA conference). For dessert there was a steamed or forpulmonary TB was rest, fresh air baked pudding, a milk pudding, and food.Te rminally ill patients were "It may be that all this sounds a bit stewed fruit, baked custard and jelly. allowed to request foods, usually physical, i.e. hard work. We did have

29 a five-and-half-day week and our carrot was a 10g portion. I can well training was held and, later in the lectures and study were in off-duty remember sieving (with a wooden year, students sat the examination time, but the derogatory phrase, 'work spoon through a metal strainer) after a 12-month training period. ethic', was yet to be formulated. chicken, meat and fishfor babies with Professionalism was a precious coeliac disease in the pre-gluten-free "The 1960s were optimistic years concept; the thought of house diet days. What an advance it was to in which to practise dietetics. The surgeons or school teachers going use Complan rather than mix eggs, hospital service was comparatively out on strike would have been quite cream, orange juice etc. to make a well funded and dietary departments ludicrous. The dietitians I worked tube feed." up and down the country were being with have been my friends for life. renovated and rebuilt. Given another chance, I'd go back [ Dietetics 1957-66 again; moving on was one of the "Senior dietitians travelled hardest thin�s I ever did. ElizabethMurraywas in the class extensively overseas seeking of 1957 and a former NZDA informationon foodservice systems, [_Dietetics 1950s president: equipment and management techniques which could be used in Dorothy Ritchie, a 1949 "Dietetics 1957-66: TheOptimistic New Zealand. The stainless steel graduate, worked at Auckland Years. Few of the group who entered industry boomed, producing benches Hospital and St. Bartholomew's in dietetic training in 1957 did so the to replace inferiorsurfaces. Dietitians London, before becoming charge expectationof embarking on a lifetime provided them with designs and dietitian at Northland Hospital in career. In the short term, dietetics specifications for the food trolleys, Whangarei in 1952, then dietitian­ appeared to be interesting, runabout trolleys and standard in-charge of Cook Hospital in 1955, stimulating and, at that time, well modular containers we now take for where she remained until she retired paid. However, a high proportion of granted. in 1982. She was the NZDA's that class and others of the mid-1950 president from 1969-71: era have spent their lives working as "Unemployment was virtually dietitians. non-existent. This made it easy for "Recollections of this time that dietitians to move about and to travel stand out are firstly of people. I "A 15-month training period was overseas. However, it made it very remember particularly Miss Joyce undertaken. Student dietitians no difficultto retain award staff. The pay Martin and Miss Monica McKenzie. longer had to work as diet cooks but was relatively low and new staffwould Joyce Martin was in charge at much time was spent in the diet work fora few days or weeks until they Auckland where I trained in what was kitchen writing tickets from the diet could find a better-paid job in a factory. at the time an exceptionally large boards and on the ritual of service of Few hospitals had a personnel class of eight.Miss McKenzie, advisory 'special diets'. Large numbers ofulcer department so interviewing staffwas dietitian, had the rare gift of being diets were served with various grades a consuming duty. Most hospitals had able to enthuse and inspire everyone of consistency. Diabetic diets were a stable core of experienced cooks. to bigger and brighter things. calculated to provide percentages of Establishing a new cook was not easy carbohydrate, protein and fat, as, in the absence of training schemes, "At this time, the training period 40,20,40, respectively. Meals for one had to teach them oneself. for most of us was two years - we diabetics were carefully weighed. This started in January, sat our exams the may or may not have benefited the "Few departments had their own followingMay and then were bonded recipients but left dietitians of that clerical staff so that even to get a to our hospitals until we had given era with food portioning skill of menu typed was a matter for two years service. By the 1940s, unerring accuracy. Complan was the negotiation with hospital marriage or travel loomed large for only commercial tube feedavailable. administrators. most of us. With long hours and lack of part-time work, most married "At the time, the main nutritional "Despite the difficulties and the dietitians left the profession; the concern was the diet/heart low stafflevels, the optimism and the number of dietitians was small and controversy. The public asked that if situation improved markedly over that travel was frowned upon although an the experts could not agree whether decade, through the energy and option still taken up by many. fat was harmful, why should they activity of several far-sighteddietitians change their diet? Fad diets for who pushed for change. Over the "Our therapeutic diets seem quite slimming were prolific. decade, more dietitians were trained restrictive now -ulcer diets 1,2 and 3; and appointed. Food supervismrs were very precisely weighed diabetic diets "A change in the length of dietetic appointed and efforts made to train with great decision-making on such training came in 1960; in May, the last them and to establish the training of burning issues whether 4oz or 6oz of studentexaminationforthe 15-month cooks."

30 � ]971 Student as me, we didn't think we knew it all hospital budgets, In some cases, but we didn't feel pressured to know this has meant compromises and Dr Heather Spence, a 1971 more. (It took the International an adjustment of standards which Congress of Dietetics in Sydney in would not have been acceptable in student, lecturer at the School of 1977 to put the bomb under me, previous years. Such adjustments WellingtonHome Science, Hospital chief dietitianand now at moving me from my comfortable have been necessary to maintain mana ging-director of a food service niche of five and a half years.)" basic services. management consultancy: [ Dietetics inthe 80s "The 'new breed' of dietitian may not be prepared to accept the stress of "Many of the problems that exist Kaye Dennison, formerly first some situations they face without thein d ie19tetics40s, astoday can werebe seen around in the in assistant dietitian at Christchurch adequate compensation in 1973 Board of Health Report on the Hospital and now working in Oman: remuneration and status. Some of Dietetic Profession. For example, these pressures on newly qualified a'insufficientvailable to meet number present of dietitianneeds' ...s "Some of the challenges constantly and inexperienced dietitians may be 'insufficient status and recognition facing this profession are new contributing to the turnover which is which training and responsibilities technologies, including the use of preventing the necessary should command', 'm edical computers, advanced management consolidation of experience essential and accounting techniques and recent to building the profession for the developments in clinical dietetics. future. Too often, we see the profession states that itis not always Some of the new skills required to enthusiastic dietitians who, through gexpectsetting ...the' wserviceere identified it needs and as cope with this growth exert additional seeing 1 imited progress, are frustrated problems of the time. This report pressures on practising dietitians to in achieving their goals. Monetary was one of the major events of the continually update their knowledge rewards and improved conditions of 1970s and its recommendations base. Unfortunately, these positive employment will do little to improve provided the impetus for effective challenges can be counterbalanced the present staffretention problem, if areas, but by the stress caused by disruptive dietitians who are struggling to change in some industrial relations activities and by maintain these basic services are not unfortunately not all. the interest being shown by given the administrative and clerical "In 1973, the National Heart commercial catering firmsin hospital support so essential to any major Foundation's Coronary Heart food service. This latter challenge business undertaking. Disease, a New Zealand Report had forces dietitians to justify their a great impact on the medical and professional actions, often to people "This decade has seen a return to dietetic professions but it took with little real understanding of our an emphasis on 'professionalism' ... Dietary Goals for New Zealanders to professional philosophies. The dietitians who worked so have any impact on hospital menus. enthusiastically 50 years ago to The National Heart Foundation "Stress is now an 'in-vogue' term establish dietetics as a career did so by began its contribution to dietetics but 10 years ago, it was given a low working together, solving mutual and nutrition education through profileduring dietetic training. Then, problems and communicating at all support of projects such as Dial-a­ food service was seen as an essential levels of the service. This cohesive Dieti tian, printed nutrition hospital service and incidents of approach helped them establish the education materials and the national industrial action were infrequent. The high standards we are so proud of. To diet survey. Dietary fibre was the knowledge 'it wouldn't happen to us' faceup to the continual challenges, it other big news of the early 1970s, gave security to hospital dietitians. is imperative dietitians recognise the with dietitians being converted in The industrial relations scene has . importance of collaboration within the time it took to read Painter's since become such it is necessary for the profession. The Importance of Dietary Fibre. dietitians to be skilled in The growing interest in nutrition communications with staff and "Dietitians must present a unified for sportspeople enable dietitians dealing with work-related problems front to all in the New Zealand Health to extend their nutrition education and this adds pressure which does not Service - we must pull together and activities into exercise and fitness help to improve the quality of working not become a fragmented group, all clubs and sports medicine. life. going in different directions. Any continuation of insular and isolated "A feature of the 1970s was the "Many dietitians, along with actions by dietitians will only prove drive forpost-graduate qualifications other allied health professionals, detrimental to the future growth of and continuing education that is so have learned to live with the effects the dietetic profession." evident today. If others felt the same of population-based funding on

31 Una Martin Una Martin was one of the first group of student dietitians in 1941. In the wartime, things were pretty grim - the hours were long and dietitians - a new breed of professionals -at that time were not fully accepted, either by nurses or medical staff.'We had come in and taken over from what they had done for years and we had to be very tactful and tread very delicately when we were in the wards."

Una stayed at Christchurch Hospital as assistant dietitian (therapeutics) and tutor dietitian and was closely involved with the training of dietitians and nurses - and took a significant role in the training of these professional groups.

She succeeded Audrey Rees as chief Una Martin and Audrey Rees dietitian of the North Canterbury Christchurch Hospital1944 HospitalBoard and held the position from 1970-1977. This was an era of change in Christchurch and throughout the country. in full swing during Una's time as Red Cross. Red Cross retained chief dietitian. Although she retired responsibility for the delivery of Nationwide was the amalgamation before commissioning, she was Meals-on-Wheels in Christchurch, of mental health organisations - responsible for the major decisions but the move of production enabled psychiatric and psychopaedic about installing_central tray service greater control of quality and food hospitals - with the public hospitals. - the first purpose built application safety. One of the major issues was that the of this technology in New Zealand psychiatric hospital cooks had a and centralising dining and When Una retired from the North differentgrading system and pay scale dishwashing facilities. She and the Canterbury Hospital Board, it was the from the public hospitals and this architect were sent to Australia to end of an era. She had started work caused some bitterness.Andthat there visit a number of kitchens and during the war and had seen the had never been dietitians in the cafeteria facilities - the beginning profession gain in standing and psychiatric service and it took more of a fairly cooperative liaison respect. Dietetic training was well persuasion to convince management between architect and dietitian. established and a tutor dietitian was and the food servicesupervisors that in place. Dietitians were responsible there was a role fordietitians in this Other initiatives in Canterbury to the medical superintendent-in­ environment. at this time were the appointment chief and were an established part of of a tutor dietitian for the dietetic the patient care team. Christchurch In Christchurch, planning for training programme and taking over was poised to absorb the new the new kitchen and cafeteria was Meals-on-Wheels production from technology of the day.

32 Audrey Rees tactfully. Dietitians were treated and her staff were told what rations with great suspicion by everyone, they had to manage. Sick patients Audrey Rees wasn't really particularly the nurses, who didn't and invalided soldiers were given 'trained' as a dietitian, but she was like seeing their control in the area special birthday trays -Audrey still in the first group examined in diminishing." has a letter of thanks from one of dietetics by the Department of these, written in 1943. Health, in 1942, along with Mary The first major battle was in Moodie, Esme Ussher, Cynthia 1940-41 when the details of dietetic Staffing in wartime came Wadmore and Jean Bell, all from training were being sorted out. Had through manpowering and included Christchurch. dietetics not escaped nursing the cream of Christchurch society. control and become responsible as Many of these were excellent Audrey had graduated in home a self-directed professional group workers, often catering for over 600 science in 1934 and then worked in to the medical superintendent in patients in conditions farfrom ideal. her father's hotel, where she got to chief, training school status is The problems arose if a manpowered grips with the basics of personnel unlikely to have been granted. staff member needed firing; you management -one of her strengths. couldn't discharge or sack a person She looked after the hotel household There was still the problem of without permission. staff, hiring, training and recognition. Kitchen work was very disciplining. unglamorous and maligned and that Audrey had a short break and new dietitians were aligned with then went to Burwood Hospital as She and her sister travelled this was a powerful weapon for those dietitian from 1947-1955. During overseas in 1938 and on her return, who felt threatened by this new this time, she had another working Professor Strong asked her to relief profession. The young dietitian holiday to England where the teach for a term at Napier Girls' really had to display competence highlight was an assignment in High School. She hated it. and professionalism in all activities. charge of the dietary department of Gradually the suspicions were the Country Branch of Great The war had just started and whittled away, as the new graduates Ormond Street Hospital at Tadworth Audrey wrote to various hospitals took on positions in hospitals in in Surrey. "It was a very exciting seeking employment. She was wartime. In Christchurch, Burwood time as we were doing some of the appointed as second assistant had the burns unit and the TB early experimentation on diets for dietitian at Christchurch Hospital, patients were housed at the coeliac disease, phenylketonuria responsible for the staff meal service. Sanatorium on the Hills. Audrey and fibrocystic disease," she says. She was interviewed forthis position says these positions were very by the second assistant matron who stressful for young graduates and In 1955, she was appointed chief was in charge of hospital food she is proud of their achievements. dietitian, North Canterbury services. In the early days, dietitians They had to manage the food service Hospital Board, a position she held were responsible, to the Matron. and provide the clinical or until her retirement in 1970. Since therapeutic dietetic service. she did her own exams in 1942, she Audrey was "almost saw 120 student dietitians through manpowered" into the position of Catering during the war years the course in Canterbury.A number chief dietitian from 1943-1946. was difficult because of rationing. of these are still working. "Each Patients brought their ration books person is different - an approach She emphasises the huge to hospitals and the coupons were that works well for one will not struggle early dietitians had to gain collected and tallied on a daily basis. necessarily work for another. We recognition. "I don't think those Diabetic patients were allocated must recognise and respect people's who followed us really understand extra rations for butter and cream individuality." 4ow very difficult it was - we had to to allow for the high fat, low play our cards persuasively and very carbohydrate diets of the day.Audrey

33 THE THIRD DECADE-from 1963

The appearance in 1964 of New employee groups to explore charade: "Union negotiators had an Zealand Dietetic Association attitudes to salary fixing machinery. audience and were expected to representatives before the Lythgoe perform. The most important committee, a special committee of In its submissions to the Cabinet negotiations were in the backroom," Cabinet, to discuss training of committee on July 31, the NZDA says Jocelyn Hampton. dietitians, their responsibilities and proposed an extended salary range - conditions of work heralded a new staff dietitians (£990-1070) and During 1965 and 1966, the NZDA phase in salary negotiations. It was to graded dietitians (£1020-2030). aligned itself with seven other be the start of a salary saga - ''We This, it argued, removed the worst hospital employee organisations to seemed to spend our lives feature of the previous scale and form a Combined Hospital negotiating," recalls Pat Donnelly, part was intended to cover all conditions Employee Organisations (CHEO) of the NZDA salaries sub-committee or work. committee to investigate the for what she says seemed 15 long machinery for conciliation and years. The outcome was increases in negotiation with the Minister of salary scales and an extra two days in Health. This led to the government Dietitians continued to align annual leave. It was the first salary approving the establishment of a themselves with home science increment fordietitians since 1957. Hospital Services Tr ibunal. As a teachers, who had similar member of CHEO, the New Zealand qualifications and training through None of the dietitians involved in Dietetic Association became a the Home Science School. The salary submissions and negotiations member of the Combined State dietitians stressed the importance of would ever claim to have enjoyed it. Services Organisation (CSSO) in a salary scale attractive enough to Pat Donnelly describes salary 1970. CHEO itself developed into attract a "fair share" of students to negotiations as "the worst days of my SHEO (Society of Hospital training schools and to satisfy life." Employee Organisations), meeting dietitians who spent their working for the first time on March 14, 1972. life in the hospital service. The ''We were babes in arms and we dietitians reported they felt rather had no skills in negotiation. The whole However, dietitians' place in the "pressurised" by the time factor- at thing was scandalous and totally growing number of industrial thefirstmeetingonJune 111964, the cynical. The government negotiators organisations was farfrom simple. All committee indicated it wanted the had a low opinion of dietetics; they health professions, except medical, NZDA's representative view on were not impressed with anything to were represented on SHEO. overtime, penal rates and a commuted do with it. They thought that anyone Membership was on an association annual. allowance byJuly 20. Executive could cook and had little regard for not an individual basis and the NZDA members and practising dietitians the science of nutrition." remained the professionalass ociation were circularised with 55 of 57 fordietitians, although it did receive replying. Jocelyn Hampton, who was help fromSHEO with preparing salary involved in negotiations during the claims. SHEO did not belong to the They were unanimous that the 1970s, concurs; "It was very Combined StateService Organisation salary scale should be sufficientto unpleasant. We were working against (CSSO), the negotiating body for state compensate for the demands and professional negotiators who service unions. Dietitians employed conditions of professional specialised in professional and by a hospital board for 12 months and standards." They felt overtime and individual character assassination. who were financial members of the penal rates were "inconsistent with They would pick on one thing NZDA were also eligible to join the professional standards" and would dietitians were not doing, not on what Public Service Investment Society create "obvious and complicated" dietitians were doing. The whole (PSIS), founded by Public Service problems. Most dietitians preferred system was unfair because the Association members as a co-operative to have their salaries aligned to chairman was not impartial but an venturewhichhadvariousadvantages professions outside the hospital advocate fromthe other side." formembers. service but with a similar academic background. The NZDA held Dietitians discovered that much Little progress was made on discussions with other hospital of the public faceof negotiation was a improving the salaries of food

34 supervisors, or on having them mechanism for all hospital especially nurses. He felt it was a included in the dietitian's salary scale. employees. A Royal Commission of mistake to make comparison with During 1967, a new scale of salaries Enquiry into Salary and Wage-fixing teachersbecausethegovernmenthad and new work conditions were Procedures recommended the State chosen to upset relativity by increasing introduced forfood supervisors, giving Services Co-ordinating Committee teaching salaries in the early 1960s. them overtime and penal rates as per be extended to include the Domestic Workers Award. The representatives of education, the * The number of vacancies for NZDA considered this "a services and health and that a hospital dietitians would need to be disappointing result after six years of conciliation committee be formed quoted as proof of the profession's strenuous efforts to have them of two representatives from the inability to recruit. The extended incorporated in the dietitians' salary Health Department and from each range at the top of the scale, as scales." In 1971, the NZDA looked to of the Hospital Boards' Association proposed in the NZDA's 1969 forming a special interest group for and the State Services Commission. submissions, was not acceptable. food supervisors and approached Dietitians should adhere to a hospital boards fornames. Eventually, The government pretty well pyramid structure which was in in May 1973, the Minister of Health accepted the recommendations as a favour at the time. The order of ruled the basic qualifications and job job lot. The idea of a Hospital Service grades should be reversed to content of dietitians and food Tribunal was shelved but grading coincide with government supervisors were "too widely" committees would continue to departments. differentiated" to have such a close function. Negotiation and wage professionalassociation. determination would be done through * The appointment of a male a Hospital Services Committee, advocate appeared essential in During 1966, Pat Donnelly noted comprising the Director-General of presenting futuresubmissions. that the NZDA's salaries sub­ Health, a Department of Health committee - Kay Cammie, Joyce representative, a hospital board * Kennedy did not seem adequately Martin, Gay Brett and Connie Shearer representative and a State Services informed on the job content and were the other members - had not Commission representative. Appeals responsibilities of dietitians' work. received any indications of against the committee's decisions Because of his opinion and that of the dissatisfaction from dietitians about could be made to a State Service interim consultative committ�e, it their salaries. Did this mean no Tribunal.An independent pay research was apparent dietitians must create a dissatisfaction exists - or were unit would review particular more professionalimage. dietitians diffidentabout writing? occupations. "While our two and a half hour A questionnaire circulated in A questionnaire among dietitians discussion was helpful and February 1967 offered a different revealed strong support fordropping provocative, it was very disturbing answer. More than half of the 50% the "staffdietitian" title for qualified in revealing his views on dietitians' ofNZDA members who replied were dietitians. There was also plenty of status and responsibilities in dissatisfied with the salary scale, support for dropping "student hospitals - his query as to whether most felt adjustments should be dietitian", although no clear patients would continue to be fed if confined to grades one and two and alternative was suggested. 'all dietitians transferred to teaching increases should be £25-50 a year tomorrow', or whether a person and most agreed there should be Five members of the NZDA's trained in management could do "sufficient difference" between salaries sub-committee - Monica our work and his observation of a degree and diploma holders at McKenzie, Pat Donnelly, Joanne senior dietitian pouring tea at a student and staffdietitian level. A Swan, Kay Cammie and Fleur Punnet function he attended", dismayed the major submission on salaries was (born Haley) -met the Department of salaries sub-committee which felt prepared in 1968, seeking a revised Health's chief executive officer, Mr. E. "the immediate need is to improve salary scale, with more graduations A. Kennedy on May 6, 1969 to seek our image before we can hope to in grades one and two. But it was advice on framingsalary submissions. improve our salary scale" and unsuccessful. They reported: suggested an examination of the role of the dietitian in hospitals. The Hospital Conditions of * Kennedy's view was that Employment Bill was proposed to dietitians must compare their jobs "It would appear insufficient of provide for a salary -fixing with those of other hospital staff,

35 her time is spent in the wards as she The committee also had a word NZDA had recruited almost all is not seen as having close contact on recruiting: "It has become practising dietitians to join, the with the patient. We should ask apparent in training hospitals that response fromnursing staffhad been ourselves such questions as: many students do not have a clear very poor. Nevertheless, she feltSHEO idea of the work of the dietitian and had potential and could look after "* Are we training and delegating are disturbed that practical work hospital groups' conditions of wherever possible so that full use is overshadows theory. Could it be employmentand salaries much better made of our special skills?" that the increase in the scientific than the Public Service Association content of the work at Home (PSA) where hospital-employee "* What service does the general Science School makes the practical groups were just one group among responsibilities of the hospital more many. public, including the patient, expect It fromdietitians?" difficult to accept? is essential that students should be well A meeting with SHEO's executive informed asto the value and content "* The routine management of officer, Jack Turnbull, told dietitians of the hospital year. Students it was difficult to establish relativity dining rooms, cafeterias and extra nowadays are very salary conscious catering needs to be delegated in all with another group and oftendifficult and, for this reason, the dietitian's hospitals to food supervisors. The to compare jobs, especially the role and image, future salary teaching profession, which had been demands made on the dietary submissions and recruiting of set apart politically. He felt the department in different hospitals students are very closely related." association needed to take a "tougher" would of course require to be approach from the start. considered individually and it is felt During late 1970 and early 1971, this should be general policy to release another salary submission was A letter from Margaret Till, one the dietitian for more specialised prepared. Penal rates remained a of those who met Turnbull, to the duties. sticking point - most dietitians did NZDA secretary, Pamela Williams not want them but there was growing (born Woodhams), tells more of "* The dietitian should at all times acceptance they were inevitable as dietitians' frustrations with the wage project the impression to patients, dietitians could not remain the only negotiation process. "I felt it a staffand the public that her specialised hospital profession(outside doctors) complete waste of time," she wrote, training is directed, firstly, towards without them. " the reason being Mr. Turnbull had patient care in the wards and, secondly, not done his homework. He knew to the executive management of her Dietitians were in fact the last nothing about dietitians' salaries, department. hospital group to accept penal rates. Many of the older dietitians considered job responsibilities etc, etc. And themselves "profes�ional", and felt it being in this position - completely "* The dietitian's role in ward food in the dark - he, at the start of the service could be visualised in future was unacceptable to accept trade union practices. meeting, said we must go back and as a ward or 'block' dietitian, to renegotiate. I felt this to be highly increased patient care, concentrating The claim was filed in 1972 and as irresponsible and can only think on the total food service in wards and with most documents, a lower scale that he wants to keep the pot boiling becoming more involved with the than proposed was eventually to justifyhis position." hospital 'team' as a whole. accepted. The government had since imposed its economic stabilisation The NZDA decided to reconvene "It is imperative that she has time regulations, which prevented further its salaries sub-committee and prepare to equip herself with the latest wage increases until 1974 and it was a new claim aimed at increasing the therapeutic trends, with special felt the NZDA should be ready to range at the top of the salaries scale, feedingproblems in the wards, with present new claims when these were investigating relativity with salaries new developments in · methods of lifted. paid to male hospital-employed food service, such as use of selective groups and keeping "a watchful brief" menus and convenience foods,with Pat Donnelly was disturbed that on dietitians' salaries and conditions the extension of out-patient services SHEO's overall membership was "far of employment. and with more intimate control of short" of what it needed to make it a expenditure." strong organisation. Whereas the

36 Publications of diet sheets had been sold. A second two revisions of the book; each time edition was produced in September , it seemingly became harder and Afterits seemingly interminable 1971 and a third edition renamed harder fordietitians to agree on the incubation period, Dietitian Tells "Food and Diabetes" in 1980. figures to be used to calculate the Diabetic was eventually published diabetic diets. in 1968. A handbook on dietary There was some concern among management for diabetics, it was dietitians about "forced" sales to Later renamed the nutrition edited by Dr Muriel Bell. Foods which hospital boards and patients-diabetics education and public relations fund, were readily available in New Zealand who had little option but to buy it. So the money was used to assist were divided into exchange lists and the profits, which in the end were communications within the there was a section given to recipes small, were invested as a special association, mainly forvisits by the and suggestions for varying the projects and communication fund for president to branches and groups of diabetic" diet. By May 1968, 3459 use in projects which would directly dietitians. It was put to public copies of the booklet and 692 copies benefit patients. The fund financed relations during the 1980s.

NZDA 25th Jubilee Conference, Christchurch 1968 Front rowseated fromleft: PhyllisJackson, Evelyn Waddell, Monica McKenzie, Una Martin(President), Pamela Williams, Susan Burs/em, Dorothy Ritchie, FloraDavidson. 2ndrow standing from left: Margaret Till,Elizabeth Fuller,Kay Cammie, Dorothy Moir, ShirleyThompson, BerniceKelly, MargaretBannennan, Clarice Dollimore,Mollie Stephens, Marjorie Bloxam, Patricia Mathews, Julian Jensen.

Association was established there. A milestone as first morning in the Home Science far as executive members were School. In 1965, on the initiative of Connie concerned occurred in 1972 when it Shearer, the association decided to was agreed that half of their travelling The executive looked at the combine the roles of the secretary expenses to meetings should be association's membership structure and treasurer and pay that officeran covered by the Association. during 1968 and decided the active honorarium. The first secretary life and associate life memberships treasurer was Enid Cooper who held By August 1965, the NZDA had should be deleted. More than half of this position for 18 months. She was 214 members - 68 active life, 12 the NZDA's 230 members fell into followedby Pamela Williams, who as associate life, six honorary life, seven these categories and were becoming secretary treasurer from 1967 until affiliate, 52 active and 49 associate. an increasing burden on the 1980, achieved the continuity. It was The annual conference that year was association which was also having to also decided this officershould be in a residential affair - living in at cope with rising costs. Wellington and a permanent address Studholme Hall in Dunedin, with the

37 DieteticPractice DieteticPractice: working party set up in 1970, looked FoodSemce at food processing and food service with particular reference to the use of NZDA president Joyce Martin At the time Joyce Martin made convenience foods and the foreshadowed the later these comments, the Auckland implications for planning and concentration on management Hospital Acute Block was under equipping food service facilities.The with her comments at the 1966 construction. This included a new challenge thrown to the Department's conference. She described kitchen and cafeteria to serve all dietitians was, "Can we reduce the management as "the art of co­ patients and staff on site. Here her kitchen areas by a third from the ordinating staff, materials and management philosophy and existing planning guidelines?" money to achievement of a management skills came to the fore. certain purpose." "Those who The result was the Kitchen Area master this art must be prepared The food service system for Allowances Graphs and Equipment to recognise and accept patients was based on a selective menu Schedules which became very familiar responsibilities for: organisation with the food delivered in specially to many dietitians involved in the and co-ordination; systems and designed trolleys to ward floor surge of hospital building in the 1970 methods; planning of work; kitchens serving about 100 meals; - 80s. Kitchen areas were reduced. patients selected their meals which induction; training; morale; were served by food service staffready Selective menus reflected wider discipline; delegation; public fordistribution by nursing staff.This choices of menu items suitable for relations." She emphasised that semi-centralised system, modified diet meals, saving on management was the means to commissioned in 1969, was the designated diet kitchen space; fewer an end, not the end in itself and forerunner of the centralised tray "from-scratch" fluid meals were she stressed the need for service systems adopted in other prepared with the introduction of continued learning about job hospitals fromthe mid-1970s. commercially-prepared formula skills and management. foods; preprepared vegetables and Towards the end of the 1960s, the other forms of convenience foods "The dietitian must be able to Department of Health undertook reduced the need forextensive storage inspire workers with the desire three studies which influenced its areas. to carry out the tasks she assigns policy and the design of foodservice them so as to bring about the facilities in hospitals. In 1967, the The other change was the achievement of the goal she has efficiency and quality of centralised recommendation a centralised tray set for herself and her tray service compared with two other service system be adopted where department. She must meal service systems was studied in practicable. This implied that the continually be learning about three wards at Hutt Hospital. A dietitian would be responsible for the such things as purchasing, comparative study of the use of food production and service system equipment handling, scheduling convenience foods was done at from the kitchen to the patient's of production, distribution of food RotoruaHospital in 1969and 1970.A bedside. and good planning forthe kitchen and its related services, a combination of skills that becomes daily more and more complicated.

"Those of us who take the trouble to learn management can look forward to rich rewards. A better food service to patients, prestige for the department and importance in status to the person who can not only produce the knowledge of how to feedbut can also learn how to feed economically with a minimum of effort and a minimum of cost." Nurses Dining Room, Hutt Hospital, 1964 Dietitian-in-Charge, Kay Cammie standing at left.

38 Waikato Hospital, with Jocelyn Constance ShearerLecture Hampton as director of dietetic services, led the way in 197 4 when its kitchen was remodelled to accommodate a centralised tray service and central dishwashing area. Responsibilityfor the entire system from the point at which the patient marked the selective menu form to the delivery of the meal tray to the bedside was transferred to dietetic staff.This meant dietitians were able to monitor more closely patient treatment and progress thus reinforcing the treatment aspect of foodservice.

The 197 4 NZDA conference held in Hamilton was devoted to a detailed study of Waikato's centralised tray service system after a year in operation. A seminar with architects, engineers and equipment suppliers was held in Connie Shearer 1966 conjunction with the conference. Connie Shearer, who died in New Zealand has not been easy and DieteticPractice: 1968, had been one of those the status now enjoyed has come PublicHealth instrumental in guiding dietetics through the ideals and courage of a through the 1950s and 1960s. Her few persons." 1962 ushered in a very busy contactwith dietetics spread over 22 period for the Department of Health of the first 28 years after training Her involvement with the New nutrition officer, Flora Davidson and began in New Zealand. A former Zealand Dietetic Association the Epidemiology Unit, Wellington teacher (three years at Wellington included roles as treasurer (1949- Hospital under Dr Ian Prior's Girls' College) who trained at 51), journal editor (1951-54), vice­ direction. The team carried out Wellington Hospital qualifying in president (1959-60), president surveys of Maori health in the rural 1948, she worked as a dietitian in the (1960-61), secretary (1963-64) and community of Ruatahuna in 1962 Wellington Hospital nurses home, delegate to the International Dietetic and of the eating habits of adult then as firstassistant dietitian at the Congress in London (1961). New Zealanders in Carterton in hospital. 1965. The first of the Tokelau Belinda McLean, twice a pupil of migration studies began in 1968. She spent nine months during Connie Shearer (as a schoolgirl at 1951 studying at the University of Wellington Girls' College and as a In between the latter two studies, Alabama, gaining a BSc in home student dietitian at Wellington a dietary survey of meals-on-wheels economics and studied foodservice Hospital), described her in this way recipients was done in Wellington. management in British and when giving a Constance Shearer Preschool children's health status Australian hospitals. She was lecture on communicating came under scrutiny ina longitudinal appointed senior dietitian to the dietitians' skills: study of Maori and European children Wellington Hospital Board in 1956, living in three differentcommunities a position she held until becoming "Constance Shearer was held in I from1969 - 1972. advisory dietitian to the Department awe by her staff and students, not of Health in 1965. She began her because she was a tough boss but paper to the International Congress because she was a powerhouse of in London in 1961 by saying: "the vitality, with that dual quality; the professional path of the dietitian in ability to attend to all the small

39 human details essential to the formedwithin broad parameters but foodpreparation and service, as the success of a service industry, at the focusing on continuing education standardshesetswillbethatfollowed same time infusingeverything she activities of dietitians. Income is used by the dietary department under her did with the visionary quality of her to fundthe Constance Shearer lecture direction. She must of course be ideas. on a subject related to and of interest responsible forthe most meticulous to the dietetic profession. Further standards of hygiene, so needs some "In this, Constance Shearer, money could be used for awards, knowledge of microbiology and its stood out from the hospital prizes, grants forpost-graduate study, application to practical health bureaucracy ... where formality gifts to libraries and the like. problems. She hires and fires staff ruled, she was informal. Where and deals with many staffing control was paramount, to her, The first Constance Shearer problems which human nature people were paramount... She was lecture was given by Professor brings to such a situation. She is one of the few, the pathfinders, Coleman, Dean of the Home Science very much a teacher - to domestic whose qualities inspired our Faculty at the Universityof Otago, at staff, nurses, patients, sometimes profession and whose values the NZDA conference in 1969. She dietitians in training and tactfullyto remain our values today. discussed her vision of the changing medical staff. Along with this, she Constance Shearer was a woman role of dietitians, the likely impact of endeavours to maintain a of deeds as well as words, but above technological advances and the harmonious relationship both all a communicator." direction of dietetic training. She too within her department and with had· some comment on the role and other departments in the hospital." Connie Shearer also achieved image of dietitians: mention in despatches in a book ProfessorColeman raised several by Carmen , a well known "When one reflects upon the issues about the future of dietetic transvestite on the Wellington present duties of a hospital dietitian, training - one preliminary course social scene during the '70s and the demands are staggering and, I instead of two ( degree and diploma '80s. Carmen refers to having believe, fartoo little recognised. Her in home science); the exploration of worked in the dietetic department principal concern in the hospital a national postgraduate training at Wellington Hospital as "a giddy organisation, like that of a doctor, school; a degree course leading girl/boy" in the '60s. When Carmen nurse and other medical staff, is for directly to dietetics; the return to was jailed for keeping a brothel, the patient. She too has the post-graduate training school Connie helped a lawyer lodge an responsibilities which extend around by dietitians in service for appeal. As it turned out, Carmen's the clock, the week and the year concentrated updating courses. three-month imprisonment was without respite. For this part of her doubled. Carmen - "When I was let job, she needs a thorough knowledge She urged the NZDA to form a out of jail, I went to Auckland, I of nutrition, which forher purposes special committee to review chose not to take up Matron must be soundly based upon the training of dietitians, including Shearer's kindly offerof returning sciences of chemistry, physiology and under-graduate and post-graduate to work at my old job ... But the biochemistry. stages. "In doing so, we may also knowledge my job had remained bring some clarification to the role open for me was a great comfort." "Then she is a manager of a vast of the dietitian to the hospital and kitchen. This means she must be an health services of the country." In Connie Shearer left£.500 to the organiser and administrator. She is fact, the Department of Health NZDA with no specific instructions responsible for the expenditure of a picked up this initiative and on its use. Several members very substantial foodbudget and plans requested the Board of Health to suggested the association establish menus and food orders for patient set up a committee to review the some formof memorial which would and staff. She needs to know about Dietetic Profession. This resulted perpetuate Connie Shearer's name. equipment, plans, layouts and general in the Report of the Committee of The New Zealand Dietetic work organisation for quantity food the Dietetic Profession 1974. Association Education Trust was service. She needs a knowledge of

40 Branches RefresherCourse

Dietitians in the Waikato area After a gap of 10 years it was applied for permission to set up an apparent changes in nutrition officialbranch of the organisation. knowledge, dietetic practice and in The executive advised them to meet employment meant dietitians needed informally - as Waikato members of to be brought up-to-date. In response the NZDA - while it navigated its to a request from the Association, a way through the cumbersome rule three-day refresher course was 12 concerning branches. The feeling organised by the Department of was that if branches were to be Health in place of the usual two-day established it should be with a annual conference. This was held in minimum of secretarial Wellington in August 1972. In broad responsibility on their part. Formal outline, the programme was: approval for the formation of the branch was given on October 29, First day: Food service 1970. During 1972, the branch management including trends in � produced a low calorie recipe book. health services, work of the design & Jocelyn Hampton, 1991 evaluation unit, financial planning Most of the members of the and control, delegation and In 1957, when it was accepted that Christchurch branch, formedin 1973, supervision. women would leave work as soon as were non-practising dietitians. Over they married, this was unusual and the next 10 years, a growing number Second day: Nutrition update she was asked by the medical of practising dietitians restored the including nutritional requirements, superintendent why she was not at balance as the branch concentrated the epidemics of the affluentsociety ­ home having babies. on an educational as well as a social diabetes, heart disease and obesity role and on taking dietetics to the Twelveyears on, now in Hamilton community and the media. Third day: Education, including and her familyall at school, she found nutrition forthe public and nurses, WaikatoHospitaldidnotemploypart­ The Auckland branch, which had training of foodservice personnel. originally formed in 1948 but folded time dietitians, but they relented and in 1956, was reformed on September invited her to work "school hours" as More than 90 dietitians, about 25 firstassistant dietitian. A year later, in 26, 1973, with 34 members (80 of whom were non-practising, NZDA members worked in the 1970, when the senior dietitian retired, attended. Auckland area) paying a $1 Jocelyn was appointed director of subscription. The foundation dietetic services with board-wide officers were: president, Gillian This format set the pattern for responsibility as an advisor for all Tustin; vice-president, Kerry Maher future refresher courses held at five foodservices in 24 hospitals. Included (born Cook); secretary-treasurer, yearly intervals. wastheprimaryroleasseniordietitian Penny King. The branch's first at Waikato Hospital. meeting took the form of an evening JocelynHampton to discuss counselling, with three At that time she was the first speakers and outpatient clinic Jocelyn Hampton believes she is dietitian with a husband and familyto dietitians taking part. A counselling one of the privileged dietitians who be appointed to such a senior position course of lectures with the Workers' were trained by both Winifred in a New Zealand hospital. She Education Association would start Goddard and Constance Shearer. considered this a breakthrough, in March 1974. A group of 10 "Their professionalism, their people because she was not seen as primarily dietitians was formed to speak to skills and their adherence to logically a career person. Married women were weight-watcher groups on subjects determined standards held us in awe expected to work part time and fill related to dietetics. Auckland had of them and has influenced us gaps. She hopes her example already been holding monthly throughout our working lives." In encouraged others to raise their goals. meetings as a means of continuing 1954 the excitement and enthusiasm education, with hospitals taking of the "pioneers" was infectious. With Waikato Hospital building a turns to arrange programmes. new ward block in 1972, Jocelyn Speakers had included medical staff After a year as senior clinical investigated food distribution in and dietitians. dietitian at Wellington Hospital, hospitals during a scholarship-funded Jocelyn's marriage meant a move to trip to Australia and returned with a Nelson and a year at Nelson Hospital. recommendation for a central tray

41 service system. The board acted Grading Committee. From 1973, she I MargaretMadill immediately and after two years of was a member of the NZDA working planning, negotiation and "dreaming party on dietetic training and later a The three "Ps"werewhatappealed up all the questions, so we could find member of the DACUM committee to a teenage Margaret Madill in the outtheanswers", the firstsuch system which was responsible for the mid-1930s. to be introduced to a major NZ public planning and implementation of the hospital was implemented at Waikato new curriculum for training Potential in a profession field. Hospital in 197 4. She says the success dietitians. She was convenor of the People thing. Practical application. of this project was a tribute to the submissions sub-committee and of loyalty and dedication of the total the planning committee for the Hersneakingdesiretobeadietitian foodservice staffat the hospital. The Jubilee Conference. had been whetted by a charming system attracted immense interest competent home science trained from all over the country. Jocelyn Her interest in education and teacher at her school and by Mary estimates that she or her staff training has not been restricted to Mandeno, an American-trained conducted "tour parties" of health dietetics. She was involved in dietitian who had stayed with the service staff around the system at establishing catering courses at Madill familyin Blenheim. least three times a week, for the next Waikato Polytechnic in 1973 and five years. Most hospitals in New was a member and then chairperson Completing home science training Zealand now have similar systems. of the Catering Advisory Committee in l 940with a teaching specialisation until her retirement, ensuring that Margaret chose teaching as her The advisory management courses appropriate to quantity essential wartime occupation with component of herwork forthe board­ catering became part of the appointments in home economics and wide hospital foodservices developed polytechnic. And at an age when general science at Newmarket, to such an extent that in 1986 the many people believe they are fully Helensville and Dargaville District position of charge dietitian at Waikato trained, Jocelyn resumed studies to High Schools, Normal Intermediate Hospital was established separately complete a Diploma in Health in Auckland. Teaching became and Jocelyn moved into the policy Administration. repetitive so she fulfilledher longheld and planning group forthe board. In ambition to complete dietetic training addition to her duties as director of With a real concern for fair in Auckland 1949. dietetic services, she was co-opted as treatment of her staff,Jocelyn became executive officer for the board an acknowledged expert on the Twoyears on the staffat Auckland committee which planned the interpretation of the NZ Hospital Hospital included lecturing to changes to area health board status in Domestic Workers Award. She was nurses ... vast classes of 50 plus 1989. Technical Advisor to the Employers nurses in an old lecture room ... Assessors at conciliation negotiations some slept after being on night duty With the development of the and consulted by both employers and or on their day off, some had no Health Goals in 1990, her the workers union on frequent interest ... it took 15 minutes just to establishment of five new positions occasions. call the roll. for community dietitians was a major achievement. On her Jocelyn has seen and initiated, While overseas in 1953-54, initiative and under her direction, many changes in practice over the Margaret worked as a dietitian for 6 the planning and design of the new years. Her reaction to those challenges months in the metabolic unit at the dietetic services building at Wai.kato has been a blend of competence, sound Royal InfirmaryEdinburgh under the Hospital was completed early in judgement and a clear, incisive grasp highly regarded Miss Buchan and as a 1992. Before her retirement she also of issues. Her readiness to share her locum dietitian in London. Back at ensured the formal adoption of a accumulated knowledge and Auckland, she became firstassistant comprehensive board policy for food experience with dietitians throughout to Joyce Martin. and nutrition services. New Zealand is acknowledged and appreciated by many. Her strong faith Joyce successfully pioneered and Jocelyn's contribution to the NZ in dietetics and those who practise it spearheaded establishment of dietary Dietetic Association has been has encouraged those who work with services and the training of dietitians significant. Afterrepresenting North her to performat levels beyond their in Auckland. She had five years of Island country areas on executive, own expectations. army experience, tremendous drive she was president in 1976-77. She and skill and got things done though served as Association nominee on the Jocelyn was honoured by honorary this sometimes meant everyone was Dietitians Board and was the first lifemembership of the Association in notherfriend.Valuable support came hospital employed dietitian to be 1992. from senior medical staffand notably appointed to the Dietitians Salaries senior administrative staff during

42 planning stages for the new acute As deputy for Joyce in the main Pamela Williams block at Auckland Hospital. kitchen, Margaret's duties still involved some supervision of the diet Pamela Williams (born Joyce Martin insisted on total kitchen and nurses home meals, Woodhams) has no doubt about patient care as it involved her weekly nurses lectures and some the basic requirement of a department, aware that many lecturing of student dietitians until dietitian. employees lacked experience of 1965 when Joyce moved to the patient treatment. She was assiduous Hospital Board office andMargaret "A dietitian has to appreciate in establishing consultation with gained promotion to dietitian in food preparation and appreciate medical staff andliaison with nursing charge. food presentation. In other words, personnel and handled sales a dietitian has to be a damn good representatives with consummate Her Edinburgh experience, with cook." skill. substantial in-put from Margaret And Pamela should have a fair Hankin, was tapped into design and idea after 36 years in dietetics - Margaret recalls the occasion operation of the new Metabolic Unit during which she has seen the when Monica McKenzie viewed the (with kitchen) under the direction of profession and the New Zealand "Dickensian situation" in the old Professor Derek North. Dietetic Association from most nurses home at Auckland Hospital. perspectives. Not then under dietitians' control, 1\viceMargaret went overseas on there were three kitchen cooks... study trips as an 'approved hospital Her viewpoint has been visitor' with the aim of up-dating moulded this way: One in her 50s - greasy hair, professional knowledge,to U.S.A. and vastly overweight. As meat cook, Canada in 1971 and in 1976 to Britain * 1957-58: Trained at she carved the meat by hand starting where children's hospitals were Wellington Hospital, under Connie with the joint on the table, finishing targeted. Shearer and Winifred Goddard: with it on her bosom... 'Winifredhad eyes in the back "Always one needed tolerance and of her head but she taught one the A second, tall, dark, immutable. a sense of humour - how else to cope importance of standards of work. She was sweets cook and made with a male pot-washer wearing a hat And it was Connie who encouraged sponges, scones etc. every day forthe and singing "I'm H.A.P.P.Y."when he me to go to the USA for post­ Matron's flat. was; the D.K. kitchenmaid who graduate study. "helped" the failingstudent make her The third, the soup and vegetable dieticecreamwitha 'never-fail'recipe "The hospital had its own bakery cook, very likeable but chain­ of whole cream and lots of sugar!; the and butchery. The menus would smoked while peering into her soup male sweets cook discovered behind use the whole carcase. We would cauldron. the frigwith a powerfulbrew of fruit come in at six in the morning to juice and raisins; the student dietitian slice the bread; we must have sliced On leaving Monica gravely late fora demonstration in the x-ray and buttered a hundred loaves each day. And there was special foodfor commented "This must be changed. department dark-room, finding I will do all I can at administrative herself facingthe door when the light the staff- the matron who lived in, level to help transfer responsibilityto came on?" always got two filletsteaks i� the the dietitian." weekend." Margaret says she always sought to achieve good patient care, good * 1958-59: Worked at Waikato The transferfollowed, the first two Hospital forsix months: "Even in meals in hospital and cafeteria - and left, ... Joyce kept the third and worked 1959, the student nurses and on the cigarettes. by extension in the community, good dietitians had to curtsey to the teamwork in the department "It matron if she was in the dining Joyce Martin helped design newly always seemed available ... positive room when they came in and again established household staff training inter-reaction with other personnel if they leftwhile she was there." courses and was instrumental in in the health service, especially nurses, hospital board approval for and continuity of performancefrom * 1960-61:StudiedforanMSin preparation ofMeals-on-Wheels from the staff, at the same time seeking to foodservicemanagementatKansas Auckland Hospitals in 1957. By 1977, instil these goals in the minds of State University: " Elizabeth 5000-6000 people in the area between students... who really make it all Gregory (Dean ofthe Home Science Warkworth and Waiuku were worthwhile forme." School) encouraged New Zealand delivered meals five days a week on dietitians to go overseas for post­ issue of a doctor's prescription. graduate study. She encouraged

43 students to reach out and extend Wellington helped me form wide system at Christchurch Hospital. I themselves to attain academic goals networks. It made me realise the was invited to give a paper on the only dreamt of. importance of networking. It was introduction of a computer extremely satisfyinggetting to know programme to assist food service "I studied under Bessie West, of a new president every two years; they management." West and Wood, which is still the each had different strengths and I institutional foodservice textbook. made valuable, lifetime professional * 1989-91: President, New The foodwas very highly rated." friendships." Zealand Dietetic Association: "The two years made me realise the * 1961: Worked at New York * Consumer representative, Metric professionhad a new face.We had General Hospital for six months: Advisory Board and member, Food become far more strategic in the "Connie Shearer came to New York Standards Committee: "New Zealand way we worked; we had learnt to be and encouraged me to go to the is one of the few countries with more subtle and cunning. In the International Congress of Dietetics dietitians on their food standards 1970s, we were isolationist as a in London:-we went to the Four authority. I was a member for nine profession and expected people to Seasons Restaurant, which was very years and Winsome Parnell and come to us. We were now asking new then and I remember her telling Rosemary Hewsen have also been on others to join us and working from me: 'Never forget, a dietitian must the council." within the system -with good results. have an excellent appreciation of food and must love food for more * 1979-90: Chief dietitian, North "I followed Wendy Webb who than just nutritional reasons'." Canterbury Hospital Board and had initiated the strategic planning dietitian-in-charge, Christchurch process during her two years. It had * 1961-66: Research home Hospital, responsible for all of the a significant impact on the economistatMeatResearchinstitute (MIRINZ), board's foodservices. association, not only in planning of New Zealand Hamilton, but in involving a lot more dietitians "One of the problems New Zealand working on research into the ageing than we had done before in future dietitians have had is the difference of New Zealand lamb to prevent it developments". toughening during freezing: "I was between what they did and how it was regarded as a bit of a heretic among perceived. I still don't think the * 1990-: Chief executive, dietitians. I gave a paper at the 1963 majority of senior health managers Canterbury/West Coast division, NZDA conference and I felt very appreciate the skills of food service Cancer Society, responsible for much a stranger -I had to make sure management." Pamela is an ;issociate administering the society's research, I did it very well. But Monica member of both the New· Zealand education and patient support McKenzie, Flora Davidson and Institute of Management and the New services: "I had been managing a Connie Shearer were all extremely Zealand Institute of Health health service at the hospital and supportive - they had all done other Management. I'm still managing a health service. thingsapartfromhospitaldietetics." In 1979, she had the role of It's not too different.I've been able to use my previous knowledge and Her time at MIRINZ also consolidating the new Christchurch Hospital foodservice department and networks to good effort for the convinced her of the importance of Society." nutrition in the production of food. introducing a computer programme She joined theNew Zealand Institute to help with foodservice management. Pamela believes the strength of of Food Science and Technology (and * 1981-90: Chairman, Dietitians dietetics and the New Zealand was admitted as a fellow in 1989), Board: "Previously, it had not been Dietetic Association is that women the Nutrition Foundation and the possible for a dietitian to chair the havebeenabletoflourishinapositive Nutrition Society ("dietitians have board. The director-general of health environment, with good feedback, played an important role in these who initiated the change to dietitian tremendous support and positive two organisations"). control always admired dietitians for relationships with significant people. * 1966: First part-time, married their professionalism. And because it is a small dietitian at Wellington Hospital: "But The development and trialling of profession, dietitians have had to I worked as a planning officernot a the new training curriculum was assume leadership roles and dietitian and was working two to extremely exacting. 'We were ahead professional responsibility while three days a week by the end." of ourselves as a profession-we looked young. The rule which allows the at where we were at and took action." association to co-opt a recently * 1967-80: Secretary/treasurer, graduated dietitian to the executive New Zealand Dietetic Association: "I * 1984: First New Zealand dietitian has paid dividends. enjoyedthe nuts and bolts, getting to give an invited paper at an things under way and doing things, International Congress of Dietetics: "There has always been a blend of meeting people. I got to know the "This followedthe visit by a Canadian youthful skills and enthusiasm, with Health Department people well and dietitian, Dr Elizabeth Upton who the wisdom and experience of older representing the NZDA in was very impressed with the computer dietitians."

44 PatriciaDonnelly

Patricia Donnelly had no doubts about why she wanted to be a dietitian.

'When I was at Home Science School in 1939-1941, dietetics was a new career. It sounded glamorous and exciting."

"A$soon as I got into my hospital training, I knew it was the right environment for me. I was doing usefulwork; dietetics gave me a feeling of service. And it was challenging and interesting.

"Right through my career, I felt I had spent my day usefully and to someone's benefit. If I was discouraged or problems seemed Patricia Donnelly enormous, I always felt better when Wellington Hospital I got to the kitchen where we were making nice, appetising meals for the patients." UK with the school meals service in New Zealand hospital management London - "we wore hats, gloves and 20 to 30 years later. Meals were important to supply high heels to work" ... we felt like good nutrition essential fortheir part human beings." "Because we were so cost­ in patient recovery. In addition to the conscious, I revised the existing physiological role of food,there were She returned to Cornwall cookery book on the basis of quantity the psychological aspects too. It was Hospital in 1950. In 1954 Pat went cookery". said long ago the two things patients to Australia where she worked as looked forwardto in the long hospital regional dietitian in the foodservice Pat returned to England in 1961 day in an alien and frightening section of the Federal Department for another three years, including a environment were visitors and meals. of Labour and the New South Wales year as a dietitian/caterer for the The dietitian was privileged to National Service. Lambeth Hospital Group. Some provided one of these comforters as months spent in a villa in the south part of her role in patient care. Her work in Australia involved of France were her "mid-career advising on foodservice management break." When Professor Ann Strong to government cafeterias, including came to New Plymouth in the late naval bases and dockyards. In both She returned to New Zealand at 1930s recruiting for the Home New South Wales and Victoria, her the same time Connie Shearer needed Science School, one of Pat's sisters responsibilities were state-wide. She a firstassistant at Wellington. When went to the lecture, returned home was seconded to work in foodservice Connie took the Department of Health and announced: "That's what Patty at the Olympic village in Melbourne job in 1965, Pat took over as chief is going to do." in 1956. dietitian.

Her first job was at Cornwall "Emphasis was on quality rather Once in the job (which she held Hospital, in Auckland, from 1945 to than the little emphasis put on until she retired in 1984) she found 1947, where the three kitchens in the financial aspects during our training she enjoyed lecturing and writing Greenlane/National Women's/ in my day, but there everything was and the challenge. Cornwall complex fed about 800 calculated on cost per serving." patients, 180 of them geriatrics in Pat's rapport with her staff and Cornwall. It was something of a shock but colleagues was always special. She prepared her well for the financial was especially respected for her Pat spent from194 7 to 1950 in the "accountability" which was to beset professionalism.

45 MargaretTill Nightingales who just kept on working She commissioned two kitchens - dietitians were the last health group (one forpatients, one in the nurses Margaret Till has always been to negotiate penal rates"). home) at the new Princess Margaret keen to keep up with what's going Hospital in Christchurch in 1959. on overseas. The shortage was partly because New Zealand's firstpressuresteamer dietitians were expected to stop work fromthe USA was installed - "It had Her international connections go once they married and partly because to pass inspection by the Marine back to 1957-58, just a couple of New Zealanders were so keen to get Department; they put a massive years after she had qualified as a their famous "OE" (overseas metal strip around it because they dietitian, when she headed to Ohio experience)and jobs were easy to get didn't think it was strong enough State University in the USA on a both overseas and in New Zealand. even though it complied with Fulbright Scholarship to complete standards in the USA." a Master of Science in medical "In the 1960s, food service was dietetics. much more sophisticated in the USA It was traditional foodservice of than in New Zealand. They were into the time - patients fedin bulk from She continued to go back and cook freezein a big way, central tray heated wagons. forth to the States, working at New service and selective menus were the York Hospital ("those were the norm and food service was being Everyone got cooked breakfast golden days of the Metropolitan computerised. baked beans, liver, bacon, kidneys. Opera and Carnegie Hall") and The traditional cooked breakfast teaching dietetic interns at Ohio In between her excursions abroad, eventually disappeared from State University. Margaret was New Zealand Dietetic hospitals in the '70s as dietitians Association president in 1962 - 63, a adapted to people's changing eating At the Harvard School of Public member of the NZDA's salaries sub­ habits. Health, Boston 1964, she worked on committee for20years which involved a very early study on the effect of diet her in many wage negotiations and Dinners were meat, potato and on serum cholesterol and has was appointed to the Dietitians Board one vegetable. Frozen foodwas only observed the diet/heart hypothesis as a head of training school in 1989. just on the horizon in the 1950s; evolve over the years. peas were a special Christmas Day While Margaret is cagey (''we were treat - bought by the sack and She was a New Zealand Dietetic dedicated to the cause and just got in distributed in paper bags to the Association official delegate to and did it") about her reputation for patients who podded them. Most International Congresses ofDietetics working to manipulate opposing wage hospitals maintained vegetable in Stockholm, Sweden in 1965, negotiations, her colleagues are less gardens and Margaret remembers Washington, USA in 1969; and restrained. The most famousexample being confronted with "mountains Hanover, Germany in 1973. was during the NZDA'sbig salary win of runner beans." in 1985 when she discovered that the At Hanover, she negotiated with chairman presiding over the Wage Margaret was appointed dietitian­ Joan Woodhill from Australia, over Tribunal had had recent heart surgery. in-charge at Greenlane in 1966. In the 1977 congress in Sydney, She subtly (not too subtly, according 1982, she was appointed the agreeing that New Zealand should to some) reminded him he would be Auckland Hospital Board's chief host a pre-congress seminar in requiring dietitians' services in the dietitian and head of the training Auckland. future. The chairman awarded the school. highest wage increase he had given in She says she tried to implement his time in the Tribunal Court. When she retired in 1992, she what she had seen in the USA back in had completed centralisation of food New Zealand, but there were always Auckland dietitians also remember service at Green Lane Hospital "financial restraints". There was also her ability to manage hospital board providing all meals at National a lack of dietitians ("no one was bureaucrats, negotiate foodcontracts, Women's and Carrington Hospitals, applying forj obs") and there were keep them up to date with salary the Sutherland Unit and Mangere no penal rates (''we were Florence negotiations. Hospital.

46 Wmsome Parnell Davidson, from the Health her a cup of tea each morning, Department and in 1981 with explaining why feet had to be checked Winsome Parnell (born Harding) Catherine Russell. forcuts especially those fromcoral. has never been what you'd call a traditional dietitian. The visit was part of the "She was a great observer of epidemiology unit's study and she everything around and read a lot. She Now a senior lecturer in human worked with the medical team always said you had to take notice of nutrition at the University of Otago, among 500 people, 50-60 eating what was going on." she has spent her career in research groups, on the Fakaofo atoll. The and teaching. team had to work around local She also worked with Flora on the events, such as cricket and feast last two years of a five-year study "I never intended to be a hospital days. dietitian and I didn't intend to work in comparing dietary nutrition of Maori children from Porirua East, Maori the health system. I wouldn't get an 'We measured the foodintake of internship today! children from Ruatoria and Tiki Tiki all families and the range of foods on the East Coast and pakehachildren they ate - coconut was the staple in Wellington. "I was interested in nutrition so I which supplied about half of their decided to do home science and see energy, fish of all varieties and what happened. There were plenty of breadfruit. There was very little "Itwas aneducationforme. Some families were hunting ·for food, jobs about then." imported food- flour, rice and a little bit of taro (there was no soil to grow cooking on open fires andliving on But, she says, she is still a dietitian. it on the atoll). dirt floors. We stayed in the hotel, had She says she had combined the basic roast dinner every night, met local theory of nutrition with studying the "Nothing was hidden away in people and the people knew why we foodpeople actually eat. cupboards. There was no electricity had come". or running water." "I enjoy food and I enjoy working They found that although the with people across a very wide range. "Flora Davidson was marvellous Maori children had more anaemia I wanted to do my internship to to go with," says Winsome. "I had than pakehas, they ate,just as well as learn what happens in a hospital no experience of the Pacific but their pakeha counterparts, but had setting." Flora showed me how to shower in less variety in their diet. half a bucket of water, how to gut On completing her training at fresh fish and explained the cultural Aftercompleting a masters degree Wellington, Winsome worked for nuances - such as not showing your at Guelph University, Winsome seven years with Dr Ian Prior, an knees, wearing a hat to church; returnedto Massey University to teach epidemiologist, on nutrition research women sitting on one side at church nutrition to foodtechnology and other at Wellington Hospital. and men on the other. And she students on campus and extra-murally entertained me with experiences forseven years beforemoving to Otago Twice, she visited the Tokelau from previous visits." in 1989. Her special teaching area is Islands to study food and eating infantnutrition. habits - in 1976, with Flora Winsome recalls Flora bringing

47 . INTERNATIONALCONNECTIONS

InternationalCongress of inadequate food supplies must be In 1965, response to the overseas Dietetics given assistance... and the optimum conference fund exceeded utilisation of all available foodsupplies expectations and £175 was provided The NZDA established its first must be secured. Governments have forMargaret Till and£75 forMargaret formal international contacts when been encouraged to establish Cameron to attend the international Esme Ussher (who was in England at programmes for nutrition education. congress in Stockholm. The the time) was the Association's official conference theme-"New Horizons in delegate to the International Congress "The purpose of collaboration in Dietetics" -had been suggested by the of Dietetics organised by the Dutch the solution of the problem concerned NZDA and New Zealand was Dietetic Association in Amsterdam, with human diet has been one of slow represented on the interim committee Holland in 1952. Dr Muriel Bell and growth, accelerated fromtime to time planning for the next congress in Desley Zbehlik, a former executive by new and outstanding discoveries Washington in 1969. That created member, were also there as observers. in nutritional science, by dramatic some difficulties in finding a Esme Ussher, who received£15 from changes in national and international representative to attend meetings in the NZDA towards her expenses, spoke economics and by the intervention of London, because the Association on the training of dietitians in New individuals whose imagination and could not provide faresfor a delegate Zealand and the dietitian's role in zeal have stimulated their fellowmen to travel from New Zealand. This public health in New Zealand. Thirty to constructive action. problem was overcome by asking countries were represented by 600 Margaret Cameron to be the delegate delegates. "We must encourage young fora second term. students into the field, assist to make Enid Cooper represented the educational programmes effectiveto As a result of a request from the NZDA at the second International meet the needs of the world today. Stockholm Congress to the Congress of Dietetics in Rome, in This is the responsibilityof us all, to InternationalLabour Office in Geneva, September 1956. She was among ensure that the progress so far the professionof dietetics was included more than 650 dietitians, including achieved is maintained and in the International Standard delegates from the USSR, Egypt, increased." Classificationof Occupations. At the Japan, Brazil, New Guinea, Israel and same time the International Labour Puerto Rico. The association put up Having made itscommitment to Office adoptedthe spelling "dietitian". £25 towards her expenses. When the an international presence in 1961, third International Congress of the NZDA believed it was time to Joanne Swan and Margaret Till Dietetics came around in 1961, the move away from the financially were appointed delegates to the NZDA decided it "must" be convenient practice of choosing International Congress in represented. Connie Shearer, then delegates from members who were Washington in 1969, with $800 to be president of the NZDA, was nominated overseas at the time or were planning split equally between them fortravel. as the association's official delegate a trip that coincided with a congress. and presented a paper on "The During 1962, the NZDA set up a fund Margaret Till presented a paper Development of Dietetics in New to help finance delegates to future co-authored with Professor Cliff Zealand and the Administration of international congresses. All Tasman-Jones, ':4n assessment of the Hospital Dietary Department':a members were asked to donate 5/- to medium-chain triglyceride therapy topic requested by the congress the fund. The followingyear, that was in patients with pancreatic andsmall organisers in London. A raffle was increased to 10/- a member. bowel disorders". A feature of this run to help meet her travel expenses, Washington congress - still talked raising £200. The organisers later The NZDA's international about today by American dietitians - agreed the NZDA could send a second involvement moved to a further stage was the New Zealand barbecue hosted delegate and immediate past­ with an invitation to appoint a by Frank Comer, the New Zealand president, Margaret Cameron, who representative to attend an Ambassador. The international was then living in London, was International Committee of Dietetic delegates feastedon barbecued lamb nominated. Association's programme committee and pavlova garnished with the then meeting in London the followingyear. rare kiwifruit - all this in the parklike Connie Shearer reported that Margaret Cameron, whowasworking grounds of the Embassy. congress put dietetics and nutrition in London, was appointed as the NZDA into a wider perspective: "The scope representative to the committee Margaret Till and Marjorie Bloxam for international action is clearly which was planning for the next were New Zealand's delegates to the immense... the extent of under­ international congress in Stockholm, 1973 conferencein Hanover, Germany nutrition and over-nutrition must be Sweden in 1965. and $400 each was contributed for assessed... those countries which have their travel fromthe Congress Travel

48 fund. At this congress NZDA'sposter The seminar programme was "A There are many memories of .0n 'Work and Training of Dietitians Community Health Service-Patients Sydney -the chicken sandwiches and ,in NZ" produced by Belinda McLean's stay at home"- Dr John Lopdell, Joyce the purple carpet at the champagne husband, John Gillespie, was Martin, Joyce Attar, Kerry Maher; opening in the Opera House foyer, the favourablyreceived. "Tracing Trace Elements in New ballet performance also at the Opera Zealand" - Dr Marion Robinson; House and the air trafficcontrollers, The Hanover conference, based "Popo, Puha and Pavlova" - Flora strike which saw all delegates unable around the theme of dietetics and the Davidson. A dinner - featuring New to leave Australia.In desperation Clara environment, drew 1710 delegates Zealand tarakahi, roast lamb, kumara Zempel, executive director of the from 47 countries - compared with and kiwifruit and New Zealand wines American Dietetic Association 7300 from41 countries at Washington -was attended by 400. telephoned the US President in the three years before. There were eight hopes he would alleviate the plight of registrants from New Zealand. The Association wanted to the stranded Americans. encourage as many dietitians as At the Hanover congress, New possible to travel to Sydney. The Following the Sydney congress Zealand agreed to become a member decision was made to seek where Pamela Williams' presentation of the ICD planning committee for contributions to the congress travel to the delegates meeting had the 1977 Sydney Congress which fund from commercial firms - 22 emphasised the value of affiliation NZDA had agreed to co-host with replies were received from the 80 with a universally recognised scientific Australia. Pamela Williams, who was firmsapproached; eight declined and society (ie NZDA'smembership with the NZDA delegate, was joined by the other 14 contributed $725, with the Royal Society of New Zealand), an Margaret Till at the interim planning another$150promisedby 1976. These application was prepared by Dr Joan meeting in 1975 held in Sydney. contributions were also used to fund Woodhill of Australia and Miss the organisation of the Auckland Dorothy Hollingsworth of the United At the 1976 refreshercourse held seminar (dietitians still saw Kingdom on behalf of the at Victoria University, NZDA learned sponsorship as "unprofessional") and International Committee of Dietetic that as co-host the association was all New Zealand dietitians who went Associations for affiliation with the committing NZDA members to a to the Sydney congress received $35 International Union of Nutritional financial liability five years on, in assistance (half their registration Sciences with observer status. (Australian and New Zealand dietitians fee). were to be responsible for any loss Dr Woodhill represented the incurred from the congress). The three dietitians, Heather International Committee at the Members at the ACM decided Pamela Spence, Kerry Maher and Jocelyn General Assembly ofIUNS held on 29 Williams should go to the Australian Hampton, who presented papers in August 1977 and reported that this Planning Committee meeting in Sydney had their full registration fees application was passed unanimously. Sydney within the next two days. As a paid by the NZDA Education Trust. Observer status permits attendance result of this flying visit NZDA Julian Jensen (bornMorris), Christine at General Assemblies and withdrew as a co-host but offeredto Brown (born Lyon) and Marie Thomas participation in discussions but not support the Australian dietitians by (born Sare) prepared poster voting rights. providing a precongress programme presentations. More than 30 New in Auckland and hosting a formal Zealand dietitians were among the New Zealand can be proud of its reception for the officialdelegates in 1262 delegates, representing 33 contribution to this significant step Sydney. Encouraged by Professor countries at the Sydney congress. in international scientific recognition. Coleman, members at the Wellington Jocelyn Hampton and Julian Jensen ACM passed around the 'hat' to assist with Bernice Kelly as proxy were At Sydney, it was decided that with Pamela's expenses. NZDA's official delegates at the ICD congresses should be held every four meeting. years instead of three after the 1980 The first half of 1977 was the Congress in Brazil. Belinda McLean busiest in the history of NZDA as faras Ahighlightat the Sydney Congress and Diane Gane (born West) were the international activities were for New Zealand and the official New Zealand delegates in Sao Paulo, concerned. The precongress delegates was the formal reception Brazil. programme included a seminar and hosted by Joe Turnbull, the New trade display arranged in Auckland Zealand Trade Consul. As at the In 1984, the Canadians hosted the on 29 April. Much to the amazement Washington Congress the all-New 9th congress in Toronto. Penny King of the organising committee, there Zealand menu was received and Vivienne Mason, as the official were about 400 registrations enthusiastically. No one attending that delegates, ledapartyof16New Zealand including 240 Americans. Marilyn reception will forget Joe Turnbull dietitians. Waring, the then MP for Waipa, greeting each international guest in opened the seminar. their own language. Following a visit to New Zealand

49 in 1983, Elizabeth Upton of Guelph of the value of post graduate Dorothy Ritchie's guidance at Cook University was impressed by the qualificationswas Emeritus Professor Hospital, Gisborne. development of a food service Lucile Rust, Kansas State University, computer system at Christchurch who visited New Zealand in 1952 as a Overseas qualified Hospital. Subsequently Pamela FulbrightScholar. She made a study Dietitians contributionto Williams, then chief dietitian of home science education with the NewZealand Canterbury Hospital Board, was particular emphasis on the curricula profession invited to present a paper "The for teachers and dietitians. Following Introduction of a Computer Program this visit, she paved the way forNew Shortly after World War II overseas to assist the Managementof a New Zealand home science graduates and dietitians began seeking work Zealand Food Service".Bernice Kelly, diploma holders to undertake experience in New Zealand. The need as Registrar of the Dietitians Board, graduate study at Kansas State to establish the quality of these also presented a paper, "UsingDACUM University on the same footing as people's qualificationswas a factorin for Dietetic Curriculum Planning': American students. This association determining the functions of the Both of these papers demonstrated with Kansas State University over the Dietitians Board. Since the 1950s the considerable development of the past 40 years has been particularly dietitians fromBritain, Canada, the dietetic profession internationally. significant in the growth of the USA, The Netherlands, South Africa profession. and Australia have joined the Sue Pollard (born Frankham) and professionin New Zealand and shared Christine McDonald (born Dutton) Until 1971 any financial assistance were nominated as the NZDA'sofficial their knowledge and expertise with forNew Zealanders studying overseas delegates to the 10th International New Zealanders. Many settled here Congress of Dietitians in Paris in July had to be foundby the dietitian herself. permanently. 1988. With the establishment of the Home Science Alumnae Education Trust, [ Dr Neige Todhunter Gillian Tustin, Sue Pollard and an exchange scheme, firstat Kansas Pip Duncan, three of the 10 New State University and since 1984 at The NZDA lost one of its oldest Zealanders in Paris, presented papers. Iowa State University, six dietitians friendswith the death of Dr Neige have received assistance to study fora Todhunter in 1991. She was one of Four years on, in Jerusalem, Israel, masters degree. the home science graduates who Patricia McFadden and Jo Stewart headed overseas in the 1920s. were the New Zealand delegates. A Dietitians have also studied in However, she never returned notable development from this Canadaatthe University of Guelph, in permanently to New Zealand, Congress was the establishment of a England at the University of London instead staying in the USA where permanent secretariat within the and at other international universities. she became one the foremost offices of the Canadian Dietetic While some of these people have dietitians. Association. continued distinguished careers out of New Zealand, most have returned Born on her parents' dairy farm Graduatestudy and to practise here and the profession is near Christchurch during a snow experience indeed richer for their wider storm in 1902 (hence her unusual knowledge and experience. Christian name), she completed a The development of the dietetic master's degree in home science at profession in New Zealand has been I South PacificConnection I Otago then taught at a secondary enhanced by the contributions of school fornine years. She leftNew dietitians who have obtained post During the 1960s and '70s a Zealand in 1928 to study for a graduate qualificationsoverseas. Until number of students from Australia, doctorate at Columbia University the mid-80s, opportunities for such Malaysia, Fiji and Western Samoa in New York. study in New Zealand were limited, trained as dietitians in New Zealand. particularly in fields of interest to Some were sponsored by their own Her career included teaching dietitians. However, now there is a governments. and research assignments at variety of post graduate programmes Washington State College until offered in New Zealand and more Another connection was the six _1941, then an appointment at dietitians have undertaken post­ month post graduate training the University of Alabama where graduate study, forinstance, Diploma programme forFiji qualifieddietitians she set up a research laboratory in Science (Community Nutrition); set up by the Department of Health in l;J.umannutrition and became Diploma of Health Administration, and the Dietitians Board at the request head of the foods and nutrition or MasterofBusinessAdministration. of the South Pacific Health Board. department. She was Dean of the Between 1968 and 1975, at least six School of Home Economics from Prominent in the early recognition dietitians gained experience under 1953 until she retired in 1966.

50 The following year, she became recognition and appreciation of her Always direct in her approach, she wisiting professor of nutrition at contribution to nutrition as a educator was never afraid to speak out on Vanderbilt University in Nashville, scientist and historian. She was named issues that were important to her. Tennessee. Much of Vanderbilt's a fellow of the American Institute of She challenged as no other person !History of Nutrition collection is Nutrition in 1983. On her death, she I know but her standards of the result of her work and in 1987, left the NZDA a major bequest of scholarship, integrity in service to she donated her life-long collection $150,000 .. profession and community served of more than 1400 cookbooks to as models to all she came in contact Vanderbilt. Margaret Till recalls meetingNeige with. Todhunter for the first time at the President of the American American Dietetic Association "At many international Dietetic Association in 1957-58, the convention in Miami in 1957. congresses of dietetics and American year after she had been made Dietetic Association meetings, she honorary life member of the New "It was at this meeting she took was always in the middle of a group Zealand Dietetic Association, she co- office as president, but she found of young followers,listening and so authored a textbook, Food and time to meet and look after this easily discussing the topic of the day. People and Essays on History of young dietitian from Christchurch. Her tall stature, striking auburnhair Nutrition and Dietetics. In 1978, Over many years, it was my privilege and exceptional_i:ommandof words she was awarded a plaque fromthe to have known Dr Todhunter and to and phrases gave her the charisma Society of Nutrition Education in have listened to her philosophy. and respect she so deserved.

L,!t�aret Cameron Hygiene and Tropical Medicine's In 1969, Margaret succeeded (LSHTM) department of Human another New Zealander, Bee Nilson, After graduating from Home Nutrition. as principal lecturer at the Polytechnic Science School in 1943, Margaret of North London (PNL) and became Cameron was manpowered to the Among other projects, Margaret responsible for the 18 month post Wallaceville Agricultural Research became involved with teaching on a graduate dietetic diploma. During her Station near Upper Hutt to work on multi-disciplinary nutrition and food time there this course was replaced a mastitis programme during the science course, run jointly by the by a new four year degree course, war. LSHTM and the Universityoflbadan, giving eligibility forstate registration Nigeria for mature students from a as a dietitian. On the urging of some friends,she wide varietyof developing countries. eventually did her dietetic training at UNICEF, WHO and FAQ supported Afterthe PNL, Margaret continued Wellington Hospital under Monica the course, with students having the teaching at the TCHU and designed a McKenzie, lwinkCouston and Evelyn backing of their governments or course specially forPHC workers in Waddell. grants from agencies such as Save developing countries.It concentrated The Children Fund. on the role ofnutrition, not in isolation She made her first trip to England but along with all other factors from1949-1953 doing locums at the For fiveyears, the course was run associated with health and the Royal Edinburgh Infirmary, Leeds forfour months in London followed prevention of malnutrition, infections Infirmary, several London hospitals by fourmonths practical application and infestations. including the London Hospital in the in Nigeria. Students planned and heart of the East End, a wonderful conducted a comprehensive nutrition Early on in the course, nurses who mix of nationalities and cultures. survey, analysed the data and produced had been involved in feeding a report which they presented and programmes in refugee camps came Back in New Zealand, she had discussed. to join the primary health care seven years as Dietitian in Charge of workers. 'We wanted everyone to the Dunedin hospitals and dietetic Internationalcontacts made at this know how to make the best possible training school beforeleaving again time led to consultancy work in many meal for an infant or young child, for a 'year' in 1960. The year turned different countries and also to using the best mixture of low cost, into 28. teaching nutrition in relation to locally available foods. maternal and child nutrition to On this trip Margaret met paediatricians and primary health care "Teaching these mature students, Professor B. S. Platt, head ofthe MRC's workers (PHC) taking courses at the so keen to learn and with so much Human Nutrition Research Unit and Tropical Child Health Unit (THCU) in experience to share, gave much professor of the London School of the Institute of Child Health, London. satisfaction".

51 FOURTH DECADE - from 1973

The Report of the Board of Health Board; Bernice Kelly, advisory fully,used in the most effectiveway. Committee on the Dietetic Profession, dietitian to the Department of Health; released in 1974 , foreshadowed most Bill Murphy, director of the * Not enough dietitians are of what has happened in New Zealand Department of Health's division of available to meet national needs. dietetics since. public health; Gordon Nicholson, gastroenterologistwith theAuckland * Not enough recruits of the high Professor Patricia Coleman, dean Hospital Board; Phillip Rossell, calibre required are being attracted to of the Home Science School and a professor of management at the meet increasingly demanding future member of the Board of Health from University of Otago, Patricia needs. 1966 to 1983, floated the idea during Williamson, formeradvisory dietitian * Dietitians are not oftengiven the her Constans;e Shearer lecture in with the Department of Health. status and recognition their level of 1969. She initiated the report and training and responsibilities should The report was wide-ranging, chaired the committee. She says command. dietitians were "not entirely happy discussing the need fordietitians, the with their lot"; many felt they faced background of dietitians in New * The medical profession says it 'enormous demands' with their Zealand, the practice of dietetics, the does not always get the service it responsibility and management of role of the dietitian, the futurerole of needs and expects, especially in clinical staff, finance, therapeutic work, the dietetic profession, training of dietetics and research. patients and staff training. dietitians, salaries and conditions of employment, career prospects, * Recently qualifieddietitians are "There were too few dietitians and recruitment and public relations. expressing dissatisfaction with the a shortage of trained support staff nature of some aspects of their work (food supervisors). Morale was rather "We set out to be very and their status, salaries and career low; dietitians felt they did not receive comprehensive, to reassess the prospects. adequate recognition, especially from situation, discover what and where medical staff. Many doctors said the problems were and what might be * Qualified dietitians and students dietitians were not well enough done about them," says Professor are expressing dissatisfaction with prepared and lacked confidence. Coleman. "We clarified a lot of some aspects of training. problems and analysed them. The committee came up with a "There were also salary problems Submissions were requested from a number of recommendations: - teachers were better paid than wide range of health-related dietitians who had similar organisations; the response was quite qualificationsand had to work shifts good and we got a mixture of positive I The Recommendations and weekends. The conditions were and negative. not always attractive. Food service functions 'We didn't shake the earth, but we * Dietitians should remain in "It seemed a good time for a look gavethings a good shake-up". There overall control of food service in at the whole issue of dietetics, to was an immediate response from the New Zealand hospitals. assess the profession, where it was Health Department. Dietitians were able to look at themselves and see * Immediate attention should and where it was going." She got be given to training of food Health Department support to set up what others' reactions were to them. It was an overall picture, a base from supervisors and foodservice staff a committee and set out on "a labour for hospitals and institutions of love". which to look outwards; it was an influence on dietitians to see it was throughout New Zealand. The Committee not much good waiting forsomeone else to do something. They needed to * The training programme for food service staffshould lead to a Her colleagues on the committee analyse, see where they wanted to go and how they were going to get there. nationally recognised qualification. were: Don Beaven, professor of Technical institutes are seen as medicine at the Christchurch Clinical appropriate places forthis training School of the University of Otago; "Its objectivity helped sow seeds; it was a trigger." and dietitians should be involved Joan Benedict, senior lecturer in the in planning and teaching courses. Universityof Otago's fooddepartment; The report identified seven major . An employment structure to give Elsie Boyd, assistant director of problems in the profession: those who gain qualifications Department of Health's division of appropriate status and nursing; Patricia Donnelly, senior * The training and special remuneration is essential. dietitian with Wellington Hospital knowledge of dietitians is not being

52 * Dietitians must be prepared to in teaching and to assume the role of should be asked to provide staffing delegate responsibility and authority tutor dietitians in training hospitals. and facilities to establish a single for some food service management training school for dietitians, to tasks, while remaining in overall Public health dietitians become the "principal training control and safeguarding standards. * The number of established school". positions forpublic health dietitians * It is essential fordietitians to be should be steadily increased to make * Present training schools in supported by clerical assistance and dietetic educational, advisory and other centres should be asked to be by personnel or executive officers, counselling services available in all "associated training schools". particularly forstaff recruitment and regions of the country. departmental co-ordination. * As part of the reorganisation of * Every effort should be made to the one-year dietetic training, * Where sufficienttrained people recruit, train or re-train dietitians negotiations should be made with are available, itis desirable fordietary with suitable qualifications and medical clinical schools to increase staffto be responsible forfood all the experience forthese posts. the clinical experience in the training way from kitchen to patient. period and the routine food service Advisoryservice tasks should be given less emphasis. * Use of a centralised foodservice * Services of dietitians should be system should be adopted in hospital widely used in a part-time or * Negotiations should begin planning. consultant capacity in an effort to immediately for the appointment of improve standards of foodservices in staffto organise and initiate both Specialisation institutions. training schemes and provide an * Three major areas of dietetics appropriate staff-to-student(one to should be developed-general dietetic Training six was recommended) ratio forthe practitioner: administer of dietary * For initial qualificationand entry clinical aspects of teaching. services; clinical (or community) into the profession, there should be dietitian. two alternative forms of training - a * Seminar and workshop-type four-year degree in dietetics, co­ courses should be planned * The initial dietetic qualification ordinating clinical studies with the immediately to help tutor dietitians should prepare a generalist who, academic pre-clinical component of overcome their lack of preparation with experience, can function the undergraduate course: a forthe teaching role. effectively as a general dietetic prerequisite qualification in home practitioner in a sole charge or science, followed by one year of * To meet the need forincreased smaller hospital. professional training based on a single depth in the basic and pre-clinical training school. sciences, the home science diploma * Post-graduate training should course should be gradually phased be introduced to allow specialisation * A curriculum planning team out as prerequisite qualification for in administrative or clinical aspects should be established to consider dietetics - 1980 was proposed as a of dietetics. details of the proposed degree course, cut-offdate but should be reviewable particularly the co-ordination of its depending on numbers available * Comparable recognition for academic and clinical aspects. fromthe degree courses. promotion and salary should be established within the career * The degree in dietetics should be Post-graduateand post-registration progression forboth administrative run by the University of Otago and training and clinical specialisation. include appropriate subjects fromthe * Immediate steps should be home science degree and other taken to develop training for post­ * Clinical dietitians should be subjects relevant to dietetic practice; registration study in specialised areas able to gain qualificationsin a special clinical practice should be gained by of dietetics to enable dietitians aspect of clinical dietetics by further spending part of the third and fourth already in the profession to increase training and experience, making years in training hospitals. their qualifications. them well prepared for work in special units such as those associated * Some modifications m the * A central body should control with paediatric, renal and metabolic present prerequisite home science the numbers and conditions for medicine. courses should be requested to meet acceptance of applications forpost­ some deficienciesin the preparation regis tra ti on courses, with * Able dietitians in all three of dietitians. consideration of the needs of specialisations should be encouraged hospitals and health services. A to take post-graduate qualifications * The Auckland Hospital Board "dietetic education committee"

53 should be formed with teaching hospitals, depending on the should deal with the lack of margin representation fromthe Department skills required. between grades and determine the of Health, university and teaching total salary range. This could be in hospitals and the New Zealand Libraryresources dorn(jointly by the profession and Dietetic Association. * Hospital boards should be the Department of Health. requested to review their library policy * Post-registration training fordietetic departments to ensure an Career path should be organised by the principal up-to-date collection of journals and * Hospital dietetic departments dietetic training school, with references is available to staff. should. be reorganised to give a requested co-operation ofthe clinical flattened organisational structure to departments of the Auckland School Relationship between nutritionists replace the pyramidal structure. of Medicine. and dietitians * An induction programme, * To meet longer term needs, * Graduate nutritionists wanting including planned rotational post-graduate facilities should be to undertake clinical responsibilities training and experience fora year, developed alongside the basic should be required to obtain should be required after entry to the trainingwith provision foruniversity registrationasadietitianbyfollowing profession. post-graduate diplomas an!:! a training based on that required for advanced degrees. a home science graduate or the final * Career planning and year of a degree course ( with development should be based on an * To assist in financingspecialist modifications in each case to allow assessment of performance and and post-graduate training, the forthe differing backgrounds of the aptitudes. equivalent of two staff dietitian courses). salaries should be available each year * Entry into both generalist and specialist fields of dietetics should to pay dietitianswhile taking courses. Regular assessment of training * Regular five-yearly assessment be accompanied by appropriate in­ * As soon as possible, post­ of all training schemes should be service training. graduate or specialist qualifications made by the Dietitians Board in in preparation for teaching should * A system of training for consultation with the University and increasing promotion should be become an expected prerequisite for the Department of Health. appointment of tutor dietitian planned and implemented. positions. Salary * A manpower plan should be * Two annual study awards, * Salaries must be sufficient to prepared, incorporating the needs including salary and travel attract talented people into the dietetic of hospitals, community and public assistance, should be made available, profession and keep them there by health services. tenable in New Zealand or overseas, rewarding them forchallenging work and responsibility. Recruitment to gain approved qualifications or * The New Zealand Dietetic experience. * Relativity is essential between Association should prepare material dietitians' salaries and those of other to help its members in an active Continuing education graduate hospital employees with recruitment programme, with the * Concentrated courses in similar educational background, cost to be shared by the Department specific areas of dietetic practice training and responsibilities. Unless of Health. should be organised by the principal this is achieved, the Hospital Services training school in collaboration with Committee will not do justice to the * A start should be made to universities and clinical school dietetic profession. combat the assumption dietetics is (appropriate financial provision solely a woman's occupation -more would be needed). * It is of vital importance to reward direct dietetic training and a better people for qualification and salary scale should make the * Dietitians should be given exceptional performance. Increments profession of more interest to men. encouragement and opportunity to should be based to a large extent on attend these courses, with salary performance appraisal. Public relations and travel assistance provided by * The New Zealand Dietetic their employers, * A thorough study of job Association executive should elect a classification and job evaluation public relations convener with the Retraining of dietitians should be made to determine the objective of setting up a public * Provisions should be made for correct salary levels for the profession relations working party to bring in retraining, based on training in relation to other comparable proposals for an initial and an programmes within existing professions and, within the profession, ongoing programme for the facilities, either in the university or for each grade of job. Evaluation association.

54 TrainingIssues in the in 1975 put an end to the White Paper "This committee is composed of 1970s capers. skilled negotiators whose sole job is to debate and demolish salary claims Later in 1974, the government Salaries with such groups as dietitians, released a White Paper on a Health laboratory technicians, Servicefor New Zealand, proposing A general wage order of 9% was to physiotherapists and others. Salary one employee organisation" to attend be the last for an indefinite period; negotiations are a good test of one's to the welfare of all health service cost-of-living orders replaced half­ adrenaline capacity and blood personnel". However, the NZDA yearly general wage orders. TheNZDA pressure control. At the end of the believed the opinion of non-hospital had the right to negotiate up to a day, you hope something has been employed members could affectNZDA 2.25% increase with the Hospital achieved but it is never totally decisions on salaries and conditions Services Committee; anything above satisfactory to all members of the of employment for dietitians. that had to go to State Services profession." Tribunal by proving serious As a result, the NZDA reaffirmed anomalies. The salaries sub­ Continuing Education its independence as a professional committee began investigating organisation; agreed it should retain relativity between the private and state Ninety dietitians attended a its independence as a negotiating body sectors. A wage freezeimposed by the refresher course at Victoria forho spital dietitians and, if possible, government until May 14, 1977 University in August 1976. Topics food supervisors; and sought legal stymied furtherattempts to seek salary included: management and advice on establishing an economic increases. budgeting; selective menus; welfare group within its existing training; nutrition education; diet framework as a negotiating body. SHEO advised NZDA to mount a sheets; presentation of information case forimproved dietitians' salaries to the public; paediatric nutrition; There was also concern about a as soon as possible. SHEO was dietary treatment of renal disease; proposal forconsensus management disbanded in 1983, the NZDA turned dietary fibre; positive incorporating a regional to the Combined State Unions (CSU), reinforcementfor patients. administrative officer, regional a voluntary federationof state unions community physician and regional covering about a third of New Dietitians around the country nursing officer. While dietitians Zealand's organized workforce,as its met regularly and were involved welcomed the opportunity to be part primary source of industrial support. in a number of community and of community health programmes continuing education activities and saw value in preventative work, A NZDA salary claim was settled with other professional groups. they also needed to be represented at on June 19, 1979-givingamovement The Waikato group got involved top management. Dietetic services to of about 5% in salaries. While in somethingjust a little different the community should be co­ disappointed with the final offer as this Waikato Times report, under the heading, "Ruakura's ordinated and delivered with a high (dietitians at the top scale got an degree of professionalism and big day for the whole family", increase of $700 a year instead of the explains: efficiency and in co-operation with $2000 a year which was sought), the other health services. salaries sub-committee felt it was "Go to a farmers'field day to get In its submission to the personnel "perhaps not too unreasonable" in a few tips on slimming, dieting and consultative group, the NZDA said: times of economic stringency. With meal planning - they just had to be only a week to decide whether or not joking! "The preservation of professional to accept the offer, even the four­ attitudes and standards is the strong committee was divided. "But they weren't. Dietitians responsibility of each professional on the Health Department association.The continued existence During the 1980s Margaret Till, demonstration point at the anddevelopment of these associations then chairing the salaries sub­ Ruakura fieldday dealt with a steady must be safeguarded. Only committee, wrote an article which stream of enquiries - mostly from professional organisations can described salary negotiations in this women but also a fairsprinkling of evaluate scientific and technological way: "The role of the salaries men who looked as though they developments and assess the need for subcommittee is to investigate and might have diet problems but their application to the hospital field. prepare salary claims on behalf of insisted they wanted pamphlets "for To this end, a professional association hospital-employed dietitians. Over the the wife". must retain control over the training years, we have agonised preparing a of new graduates and the continuing case, burnt the midnight oil doing the "The health demonstration was education of qualifiedstaff." homework required and girded our one of the features that typified the loins to face the Hospital Service way the field day's character has However, a change of government Committee. gradually developed and changed

55 since it was introduced just over a secretary-treasurer, Pamela Williams, there were no formal courses nor quarter of a century ago. These "the best public relations activity New education institutions to teach them. days, the organisers don't concern Zealand dietitians have ever Jn the case of training for hospital themselves exclusively with what undertaken". Other groups were cooks, the profession expressed its might be described as the basics of delighted and somewhat surprised to views through a submission by the farming.They cover a wide range learn of the contributions and indeed, Dietitians Board to a Department of of topics - and their message goes the high standard of papers presented Education committee in 1961. across the better for it. by dietitians," she told the national delegates' meeting at the International After on-again off-again "Every once in a while among Dietetic Congress in Sydney in 1977. discussions throughout the 1960s and the displays you'd expect at a She said from their experience, New following the establishment of the farmers'field day, something with Zealand dietitians would "thoroughly regional technical institutes, block a slightly off-beat character to it recommend that dietitians do not courses were begun at the Otago has been inserted. There was the Polytechnic in 1969. In 1972, remain an isolated group, relying only slimming, dieting and meal Wellington Polytechnic offereda 24- planning - officially,it was "Better on those brave outsiders who are week day-release course in quantity food for a healthier world" - of sufficiently interested in dietitians' cookery. This was followedby similar course. work to attend dietitians' meetings, courses at Christchurch Polytechnic but to get out and actively show what and Auckland and Waikato Technical The New Zealand Dietetic dietitians can contribute to the Institutes. Dietitian representatives Association combined with the scientific community as a whole". from the NZDA and the Department Institute of Food Science and of Health who served on the advisory Technology, the Nutrition Society Before membership was granted, committee for these early courses of New Zealand and the Society for the NZDA rules, New Zealand included Patricia Donnelly, Jocelyn the Study of Diabetes to stage dietitians' scientific and practical Hampton, Bernice Kelly, Margaret Nutritech '78 at Lincoln College in training and professional Madill and Patricia Matthews. 1978. And it worked with the responsibilities were scrutinised. Institute of Food Science and Eventually, in 1981, a National Technology and the Nutrition The only query was for a fuller Certificatein Quantity Cookery course Society in organising the food explanation of the NZDA's "trade began in a purpose-built teaching science and nutrition section of union" activities - its role in the kitchen at Waikato Polytechnic. the ANZAAS (Australia-New negotiation of salaries fordietitians. Zealand for the Advancement of The recognised starting point for Science) congress in Auckland in Other benefits included possible formal training for food service 1979 around the theme of financial support from the supervisors was a report from the "directions for the future". Dr government for local projects and University of Otago Department of Magnus Pyke was brought from national and international meetings University Extension in 1971, "An England as the keynote food and (the governmentrecognises the Royal Investigation into the Training of Food nutrition speaker; he also gave a Service Supervisors Employed in public lecture and attracted plenty Society as the spokes-organisation for scientists) and opportunity for Institutional Meal Service" (J. T. of media attention. Phillipps and E.E. Carpenter). Under joiningactivitiesandconferenceswith the leadership of Emily Carpenter, a The Health Department was fellowmember organisations. working party including NZDA asked to run a refreshercourse for members employed in several dietitians in Wellington in 1981. The Royal Society connection was organisations was set up by the further strengthened in 1977 when a Vocational Training Council (VfC). A workshop fortu tors and heads fire forced the NZDA to vacate its In tum, the working party became of dietetic training schools was held national office in Wellington ( a the Institutional Training Advisory in December 1980 at which the permanent officehad been set up in Committee (ITAC) under the vrc recommendation was made to April 1974); itacceptedaRoyalSociety umbrella in 1974 and in 1976, was review the dietetic curriculum. offerof an officeat its premises. granted associate member status on the Hotel & Catering Industry RoyalSociety of New FoodService Personnel Training Board (HCITB). Zealand 'Iraining The long term ideal of the NZDA - During 1975, the NZDA The value of proper training for recognised national training forfood "launched" itself into the New Zealand food service staff,particularly cooks service supervisors came to fruition scientific community by joining the and foodservice supervisors,had been in 1977 when the first post-entry Royal Society of New Zealand. It was, recognised by dietitians for many courses began at Waikato and Otago in the words of the association's years. Other than on-the-job training, Polytechnics. Department of Health

56 dietitians Patricia Matthews, Joanne is elected to make decisions. Although Swan and Gillian Tustin were key DietitiansBoard members are consulted on important contributors to the teaching issues; the NZDA should remain the Dr Ron Barker, the deputy programme. negotiating body for hospital Director General of Health who dietitians. NZDAwas represented on the ITAC chaired the Dietitians Board in the late 1970s, was of the opinion that by Kay Cammie, Vera Greiner (born Membership the profession had come of age and Marr) Ngaire Fox (born Morrison) Membership must remam should be in charge of their own and Helen Bell (born Reid) until its voluntary, although it was hoped affairs. demise in 1990. Patricia Donnelly practising dietitians would consider represented the Hospital Boards' membership and support of NZDA Association of New Zealand and Subsequently, an amendment activities as a professional Joanne Swan the Department of (taking effectfrom lJanuary 1980) responsibility; the NZDA has a Health during the 1970s and 1980s. to the Dietitians Act increased responsibility to members to membership of the Dietitians Board demonstrate all its activities in the from eight to 11, five of whom 7lial-a-Dietitian interests of dietetics and its members; would be dietitians nominated by associate membership should be In 1975 Auckland dietitians the New Zealand Dietetic encouraged for non-working floated the idea of establishing a Association. Othermemberswould dietitians who should pay about half dial-a-dietitian service and the beaheadofdietetictrainingschool, the active subscription but not have a servicebegan in 1977. People were a medical practitioner, the dean of vote; investigations should continue able to phone in to seek information the Home Science Faculty, a or talk about a problem with a into lifemembership. Department of Health dietitian. Callers could leave representative, the registrar (to be messages when the phone was Communications a registered dietitian employed in unattended. The followingyear, a The Journal should continue; the Department of Health) and one similar scheme was trialled in there was great enthusiasm for News other person nominated by the Christchurch for six months and and Views and it was planned to Board. The major impact of the act the branch then set it up on a publish three issues a year; the NZDA was to reduce Health Department permanent basis, answering should continue to organise an annual influence on the board and transfer around 400 calls a year. In both conference/seminar with the annual control to dietitians. Under the cities, the service was originally meeting, a national refreshercourse previous legislation, four of the fundedby the New Zealand Heart every four or fiveyears and take part board's eight members came from Foundation and the local branch. in joint meetings with related the Health Department. professions; the NZDAshould support l Publications international meetings within its Restructuring financial resources; the NZDAshould An initiative which originated co-ordinate the profession's affairsand in the Waikato was the Calorie The restructuring fashion hit the speak on dietitians' behalf and Counted Cookbook. Waikato New Zealand Dietetic Association promote dietitians in the community dietitians collected and tested during 1977, after discussion at the at a national level; the NZDA has a recipes butwere unable to complete annual meeting indicated five major responsibility to encourage the project. The NZDA executive areas of concern. Much comment and recruitment; branches and regions later approached Winifred Goddard discussion followed and the executive should run their own regular one-day to edit this book. Winifred Goddard came up with its "contemplated" and weekend seminars; individual retested the recipes and 5000 action: dietitians must accept responsibility Calorie Counted Cookbooks were for keeping up to date; executive published in 1976. This was sold Structure·and representation. minutes are available to any member out in nine months and a second The executive should remain at its requesting them; a fund is proposed run of 6000 was printed. Winifred present size and should meet at least to help finance communications Goddard gifted the royalties to twice, preferably three times, a year; between the executive and members. NZDA the system of area representation Christchurch dietitians spent should be maintained but area Education much of 1983 testing recipes in representatives must take more NZDA responsibilities to be revised preparation for the branch's fund­ responsibility for communication - for continuing education and its raising venture, the Triple Tested with members, notjustthe executive; role in registration, clarification of Cookbook, which was published it was too binding to write a two or standing of practising certificates the following year and eventually three-year term for executive were some areas specified. ran into a second printing. members into the rules; the executive

57 Administration they are employed; active life others from working. Lack of Central administration should members were asked to pay for their opportunity and unwillingness of remain and the workload shared more Journal. practitioners to employ dietitians widely-assistant secretary, delegation were the main reasons for most of routine jobs, help with preparation This led to a decision that existing working in a private capacity. Most of accounts foraudit. life members retain their life felt well equipped to deal with all membership but no furtheractive life dietary advice and were keen in Life membership memberships should be granted. A keeping their knowledge current. Life membership was becoming retired membership category was an increasing financial burden on introduced formembers reaching the Code of Ethics the association and the executive age of 60, who have been members of spent many hours discussing ways the association for20 years and have The emergence of this group led and means of achieving a fairer retired from professional NZDA to revise its rules and code of system.ln mid-1978, theNZDAhad employment. This left five ethics to fit the late 1970s and early 130 active life and 19 associate life membership classifications - active, 1980s. The new version of the Code of members among its 340 members. retired, associate, affiliate, honorary Ethics and guidelines for practice life. The new regime took effectfrom adopted in 1981 contained two Several schemes were tried to August 1981. encompassing clauses: ease the problem - all life members were asked to pay the active A number of dietitians sought *To further and advance the subscription to help with advice on working in private or knowledge of nutrition and dietetics administration costs; donations group practice. A questionnaire to throughout New Zealand. from members were sought on a determine interest in private voluntary basis; retired life members practice drew 17 replies, 16 of them * To raise the standard of nutrition were given the option of receiving interested in working in group and dietetics in New Zealand and to only one posting a year; practice and one in private support and protect the character, professionally employed dietitians employment. Ten of them were status and interest of those persons who were life members were asked currently employed, while family practising the profession of dietetics to pay an active subscription while commitments were preventing the in New Zealand.

Guidelinesfor practice adequate meals which are an essential product for personal gain or any were: part of the total treatment of each other reason. patient whether directly or indirectly * The dietitian must continually in her care. * Dietitians employed by the strive to improve her professional commercial sector must bear in knowledge and reassess present * The dietitian must operate mind their professional aims and dietetic practices in the light of within the constraints of safeguardtheir independence. current research. professional secrecy. She must not divulge confidential information * Dietitians may not accept * Adietitianmayprescribedietary about patients except to others commission fromcommercial firms. treatments to patients in involved in this treatment. Discretion is to be used in the consultation with a medical acceptance of small gifts. e.g. at practitioner and also as a member of * The dietitian has a Christmas. the patient care team. She may use responsibility to related professions her professional knowledge and to appreciate their aims and ideals * Dietitians should act against status to initiate treatment where to cooperate in working towards fraud and deceptive practices in their appropriate and in consultation with common goals. In order to maintain field. other team members. harmonious relations, the dietitian must assume proper responsibilities * Dietitians may use the media to * Dietitians must act impartially yet know how to collaborate with promote nutritional health and and give a uniformlyhigh standard other professions. education in the community though of treatment to all people regardless not to advertise either products or of sex, race, religion, politics, or * The dietitian has a responsibility their own services. socio-economic status. to interest herself in the welfare of people in the community and to * A dietitian may inform other * The dietitian must take full participate in activities where her professions personally that her responsibility for the hospital food specialist knowledge is valuable. services are available, or she may service. She has a responsibility to put a professionalnotice or card in all patients to provide nutritionally * Dietitians may not advertise any the press.

58 After questionnaires and dietitian's vocabulary in the '80s. These * Maintain and extend the discussion, the association terms are cost-effectivenessand cost­ fluoridation of water supplies. developed management guidelines benefi t. Cost-effectiveness can be for dietitians in private group defined as the best way of using This could be, summarised in practice, suggested conditions of resources to achieve a given objective simpler terms as: employment, clarification of and cost benefit as the choice of availability of their services, objectives." * Eat a varietyof foodseach day. continuing education and questions to ask beforethe clinic started. NubitionGuidelines * Don't eat more than you need.

Prophecy During 1981, the Nutrition * Eat less sugary food (simple Advisory Committee of the Board of carbohydrates) and more starchy In her address to the 1979 Health released its national foods(complex carbohydrates). conference, outgoing president nutritional goals for New Zealanders. Elizabeth Murray made some There were 12 goals: * Eat less fat,especially saturated prophetic comments: fat. * Education of the public in the "I predict the '80s will bring more importance of consuming a wide * Eat less animal protein. budget cuts, staff limitations and variety of foodsin the daily diet. plenty of nifty suggestions from * Use less salt. hospital boards of measures for * Limit total energy intake to curtailingthe expenditure of dietary balance energy expenditure - * Increase the amount of dietary departments. I am sure hospital increased exercise and reduced food fibre in your diet by eating more dietitians will quickly come to regard intake. cereals, fruits and vegetables. the '70s as the 'good old days' in terms of finance. If population growth and * Reduce intake of simple sugars, * Drink less alcohol. economic growth stay slow, the principally cane sugar and increase expenditure on health will remain intake of complex sugars, principally * Support the fluoridationof water static. starch. supplies.

"All of us are aware that as soon as * Reduce fat intake, especially Pamela Williams, then chief hospital budget cuts are proposed, saturated fats. dietitian for the North Canterbury one of the firstareas to come under Hospital Board, described the close scrutiny is the food service. * Reduce intake of animal protein guidelines as "part of a sensible Everybody is an expert on food waste and consume relatively more protein approach to advocate a moderate yet and quick to notice obvious waste in fromvegetable sources. enjoyable lifestyle", while noting they the hospital - laden pig tins or other were not the last word in nutrition. members of the staff having free * Reduce the amount of salt added She was concerned that the public rations. Dietitians must accept that to the diet. could be confused by the plethora of monetary constraints are here to stay nutritional information emanating and that the most efficientuse of the * Increase the intake of dietary fromapparently authoritative sources, hospital dollar is in everyone's interest fibreby greater emphasis on cereals, especially when dietitians and and for her own job security. Dollar­ fruits and vegetables. nutritionists changed their minds wise dietitians will certainly check frequently. the pig tins forwaste and take action * Reduce considerably the intake to deprive the pigs if they are faring of all alcoholic drinks. too well. At a more elevated level, she Branches will form long-term and short-term * Pay attention to the dietary habits Abranchwasformedin Wellington objectives and review them constantly. of pregnant women and nursing in 1981, with Carole Gibb (born mothers. Miranda) as president. Its programme "The dietitian will need to evaluate has been a mix of social and any proposed change in terms of hard * Promote breast feeding and educational activities. cash. Ifthe hospital board can see that better infant feeding practices and the dietary department is running provide sound nutritional advice to efficiently, it will be less likely to mothers who cannot breast feed. consider proposals from contract who catering firms are currently * Activelydiscourageyoungpeople beating at the doors of hospital boards. from starting smoking and urge those Economists use two terms of jargon already smoking to stop. that should become part of the

59 ProfessionalProfile on the Dietetic Profession (the dietitian," she said. "While a publicity committee identified "a lack of officer at national level can be How did others see dietitians? understanding of the role of the effective in some areas, I believe Even as far back as 1976, NZDA dietitian by the public and even by public relations can only be effective president Jocelyn Hampton put it people in other branches of the health ata local level; personal contact is an this way at the annual general services" and recommended the NZDA essential element. To be effective,a meeting. set up an ongoing public relations public relations person should enjoy "Physicians see us at our best as programme) - led the NZDA to the communicatingwith others and feel part of the medical team, able to decision in March 1976 to appoint a able to make personal contacts with advise, to discuss cases and to provide public relations officer. the various media, people in local them with the expertise so they can institutions and foodindustries etc. The association believed it should To be well established in the area is prescribe treatmentwith confidence. make "a determined endeavour to They say our knowledge of disease a definiteadvantage so that ongoing create a better informed public relationships can be built up. physiology is not deep enough. opinion concerning the role and "Management sees us as potential of its members." "I believe all dietitians are capable responsible fora substantial slice of Acknowledging its modest of expressing reasonable views on the financial cake, assisting their resources, the association determined matterswithintheirfieldofexpertise duties with expert control of to concentrate on national activities, and that to do so should be a natural performance and financial with follow-upat regional level-"every result of our training. Dietitians budgeting. They think our situation in which a dietitian is able to should try to shed their hesitation to knowledge of business management participate in the activities of other express their views on matters of is only superficial. national organisations and local importance,provided they have good reasons to back them up". "Planning departments see us as bodies will also assist by providing a advisers on kitchen architectural direct line of contact with dietitians She also felt NZDA statements development including the detailed and their work." should be a consensus between the analysis of working drawings. They Belinda McLean, a dietitian and president, secretary and publicity consider our knowledge of food writer, agreed to a 12-month officer.The result was that executive architecture is limited. trial period as publicity officer from members were nominated as local November that year. Her brief was to publicity officers and Belinda "Other hospital executive staff McLean reappointed as publicity see us as being responsible for a publicise NZDA activities and promulgate the value of good officer (she was also the editor of large department with many staff News and Views). When she resigned who, not being dedicated health nutrition to the community. Much of her work centred around answering in 1979, the year in which she also professionals, need firm discipline won an award forhealth journalism, for control. Our knowledge of enquiries from people interested in work or courses; answering queries the NZDA decided the outgoing personnel administration is barely president should be the publicity adequate. fromprospective dietitians; answering letters to the editor in newspapers; officer. However, after Elizabeth "Dietitians see themselves as all dealingwith the news media on behalf Murray had done one year, McLean these things and more. The training of the NZDA; initiating and agreed to resume the role. She saw of dietitians forregistration covers a encouraging the preparation of two roles forthe publicity officer - wide range of topics and in a articles fornewspapers and journals; publicising the profession and practicable course, can only cover establishing contact with media and educating the public about healthy them in outline, providing a foodcompanies; and a liaison role in eating. The outgoing president's idea foundationof knowledge on which health education. was resumed in 1982 with Jocelyn to build." Hampton's appointment as publicity A year into the role, she reported officer. She reinforced the need for she believed NZDA public relations. practising dietitians to be could be more effective if handled Jocelyn Hampton pinpointed "continuously adding to that locally by area representatives who some of the difficulties when she educational base line" ... to seize could respond to local issues so much relinquished the job two years later: opportunities with enthusiasm. faster. She recommended she be "There has never been an attempt to replaced by a publicity officer to act define the position and the post The whole question of image and and coordinate national activities obviously means differentthings to public relations-fuelled by feedback when necessary and provide back-up different people." Did it involve on how others viewed dietitians, advice and expertise forthe locals. publicising the activities of the especially when it came to salary association through press releases negotiations and the comments and "The ultimate success of public and interviews? Did it involve recommendations of the Committee relations depends on the individual providing informationto the media

60 about the activities of dietitians so responsibility to ensure all its control of the Department of Health, that the general public and members will be working towards to hospital boards. This move potential employers were more this quality of service." prompted Nelson Hospital Board to aware of what dietitians do and give Nelson Hospital's dietitian-in­ could do? Did it involve responding The 1982 annual meeting did charge, Mollie Stephens (born to media articles and statements however endorse a remit calling fora Houlker), the responsibility for the about nutrition, food practices, committee [Lyn Gillanders (born production of the meals forresidents dietetics and so on? Did it involve Goudie), Rhonda Akroyd (born and staff at Braemar Hospital from getting involved in controversy or Divers), Vivienne Mason and Sue 1971. She and Raewyn Penrose seeking to counter information Pollard were appointed] to investigate (born Rhodes), working with withwhichtheNZDAdidnotagree? the future of continuing education Braemar Hospital management and She urged the NZDA to set clear forNew Zealand dietitians and explore nursing., staff, paved the way for guidelines, with a job description means of establishing and promoting dietitians to work in psychiatric explaining the responsibilities and post-graduate education. A hospital food service. giving the appointee direction on questionnaire survey of dietitians to relationship with the president and ascertain their needs for continuing The first fulltime appointment of the executive. education revealed a preference for a dietitian afterthe amalgamation of short courses, workshops, study days the psychiatric hospitals into hospital I ContinuingEducation and meetings and a journal review boards was made by Wellington There had been discussions about service. Hospital Board in 1973. Dianne Boaden (born Barkley) was appointed formalising continuing education for Just over half the respondents dietitians formany years. There was as dietitian at Porirua Hospital where favoured a voluntary system with a she worked with the food service talkof appointing an education officer points system as a guide to desirable "to collect areas of knowledge supervisors who were responsible to levels. There was also strong support the hospital secretary and with requiring attention and to develop for a small base levy ($50-$100 a post-graduate courses" (it got as faras nursing staffto set up a simple cycle member) as a basis for education menu for meats, revise orders, a remit in 1982) and of compulsory activities. Lack of awareness by some organise modified diets and justify continuing education as a pre­ dietitians of the availability of costs. She also gave lectures to student requisite for registration. But continuing education was seen as an psychiatric nurses and talks to patient continuing education, in the formof important barrier, especially forthose groups. seminars, workshops and short geographically or professionally courses, was largely left to branches isolated. In 1974 Nelson Hospital Board and local areas, without any overall appointed Margaret Morales (born national coordination. The Auckland Dietitians were also asked to Kuhn) to Ngawhatu Hospitaland the and Christchurch branches have indicate their major areas of interest Waikato Hospital Board established a developed structured programmes, for continuing education in various position at Tokanui Hospital which both organising programmes on categories - clinical dietetics, was filledby Elizabeth Fitchett (born specific topics rather than just management, behavioural, social and Watson). arranginga speaker at the meeting. communicative sciences. Topics of major interest were: nutritional status By the end of the decade dietitians In proposing the appointment of assessment; current vitamin and had been appointed to most of the an education officerin 1982, Janene mineral research; new foodsand food psychiatric hospitals operated by the Eagleton (born Douglas) from the products;insulin-dependentdiabetes; eight boards providing that service. Auckland branch, said it was "essential oncology and nutrition; current The responsibility for food service, to the leadership and standing of the research on obesity; obesitytherapies; including clinical dietetics, had shifted dietetic professionthat dietitians stand gastrointestinal disease therapies; from the hospital secretary to the up and be counted as respected interviewing and counselling; dietitian-in-charge. Menus had profession" in health and business computer language and use. become more varied with the circles. "Society has an urgent need scrapping of the fixed ration scales for our profession and we have a DieteticPractice which had depended on the responsibility to ensure we translate PsychiatricHospital imagination and. skills of the villa correct, up-to-date informationinto Setvice cooks to create palatable meals from practice. Methods for quality the ingredients provided. Central assurance being provided by our Legislative changes proposed in kitchens were built into existing professionare clearly not present and 1970-71 foreshadowed transferring structures in several hospitals and if dietitians are going to practise their the responsibility of managing new ones built in others. It was a skills, I would strongly urge that the psychiatric and psychopaedic challenging time for dietitians who New Zealand dietetic professionhas a hospitals, then under the direct chose to work in psychiatric services.

61 GeneralHospital Food employment structure as a threat to Update '82, a combined conference of Service their security. The arrival of contract the NZDA and the Home Science foodservice companies in the market Alumnae, with Pamela Williams Many hospital boards embarked was a case in point. replying to the challenge. on refurbishing or replacement of old kitchens and dining rooms in the Contract food service DieteticPractice: 1970-80s. The food service jargon management was discussed in June Publichealth acquired a new vocabulary; conveyor 1978, when the secretary, Pamela belt, lowerator, trayline, portion pack, Williams, outlined recent interest in By the mid-decade, there was along with the tradenames New Zealand, with advertisements in considerable interest in the levels of 'Ganymede', 'Finessa', 'TempRite'. local papers and hospital journals pesticide residues and toxic elements offering to provide management in the New Zealand diet. Department When the North Canterbury services in small institutions. of Health staffincluding the dietitians Hospital Board came to Approaches were made to the NZDA and the Department of Scientificand commissioning its new foodservice aboutwhatroleNewZealanddietitians Industrial Research, planned the total building at Christchurch Hospital in might have in these organisations diet survey using a simulated diet and 1977-78,it agreed to the appointment and these companies were showing carried out the analysis during 197 4 - of a dietitiaI) to oversee the interest in having dietitians in advisory 1975. commissioning process. Kate Flood positions. The NZDA saw possibilities (born Penny), as commissioning for new avenues of employment as Work in other areas such as the dietitian, developed the timetable, the "no doubt, one or all of these assessment of plans for kitchens for operational plan and organised the companies will eventually operate in old people's homes continued apace staff training which ensured the New Zealand institutions and probably with the Government's policy of smooth transition from the bulk in hospitals." It was felt dietitians granting building subsidies to these trolley system to the centralised one. should work with rather than against institutions. Parallel to this, the public Other hospital boards followed this these schemes. The NZDA asked the health dietitians spent many hours idea to assist with the commissioning Hospital Boards Association to adopt advising on planning and foodservice of their new buildings. guidelines foremploying foodservice forthese homes. contract companies and to ensure The winds of change were any dietitian working for such a Responding to requests for beginning to blow in the dietetic company was registered in New nutrition information and updating world. Zealand. medical officers, public health nurses, dental nurses, health Some saw the dilution of the The manager of a contract education officers and the public hospital and government-dominated company was invited to speak to was a regular activity.

ProfessorColeman During the 1950s and '60s home executive and on the Dietitians science graduates were employed Board. As a member of the Board of New Zealand dietitians are a very mainly as either teachers or dietitians. Health from 1966 to 1983, she goodproduct,saysapersonwhowas From the 1960s onwards, initiated the Report into the Practice involved with their education at opportunities were much wider in of the Dietetic Profession whichwas universitylevel over a30yearperiod. industry - food science, product released in 1974. development and promotion, textiles "Dietitians as a professional and clothing, design and in a variety The report became the basis of group require scientificknowledge of governmentdepartments. self-examination by the NZDA of its and its application of clinical aspects training, practice and overall of dietetics", says Patricia Coleman, Dietitians'salaries were frequently professionalism. From the past lecturer in the School of Home below those of the other occupations decade onwards they have made Science 1956-62 and dean of the and they were required to work long giant steps forward and are to be Faculty from 1962 until her hours and weekend shifts.The tenacity warmly congratulated on their retirement in 1987. "In addition they of the dietitians emphasised their achievements. need management and commitment to their chosen entrepreneurial skills, with profession. Her contribution to dietetics was responsibility forlarge budgets plus recognised by her election as a personnel management. They have Patricia Coleman backed her high honorary lifemember of the NZDA not always been given the status and regardfordietitiansby25-yearperiods in 1988. recognition their demanding role of service as an ex officiomember of has deserved." the New Zealand Dietetic Association

62 BelindaMclean two years (1975-76) as a dietitian in MaryJohnston Wellington Hospital, a year (1977) Belinda McLean says she researching and writing nutrition Mary Johnston (born McKenzie) sometimes feels like a traitor. publications for the Department of was a married student dietitian in the Education and appointment to the late '50s. A trained dietitian and one of New Nutrition Advisory Committee and Zealand's pioneerwriters on nutrition, chairperson of the nutrition education Pregnancy cut short her training she does not always call herself a sub-committee. eight months into her 15-month term. dietitian - largely because she is now Mary promised herself: "One day, I'm fulltimein public relations work. In 1979, she went fulltime with going to finish my training." the National Business Review, "Nevertheless, I'm proud to have winning an award for health Meantime, she picked up part­ been writing as a dietitian. I felt no journalism. She switched to public time food supervisor work at one understood dietitians and what relations in 1980 with Network Studholme Hall, Dunedin Hospital's they do. Communications Ltd which was in staffcafeteria and the YWCA boarding the process of trying to build a client hostel in Dunedin. "Being a dietitian has been a huge base in the foodand nutrition area. advantage to me and I'm very grateful Eventually, that "one day" arrived. for my training. Home science Three years later, she returned to She applied to train at Christchurch graduates were so competent and have NBR as health, management and Hospital in 1977 and was accepted -a followedinteresting careers, whereas marketing journalist, while studying 40-year-old with three teenage people with other degrees often forher MBA at Victoria. In 1985, she children. floundered. helped set up a communications consultancy, Clarity; she has since Her schedule was horrendous as "Our management training meant returned to Network. she commuted between Dunedin and we knew how to organise. Home Christchurch for weekends off. Five science and dietetics, combined with hours on a bus to Dunedin, time out other qualifications, are a huge Between 1977 and 1981, she was benefit." publicity officerwith the New Zealand to switch from training to mother Dietetic Association and sought to and wife; then five hours back to Belinda has added an arts degree heighten the profile of the association Christchurch, time out to switch from from Victoria University, an editing and dietitians. She also edited News mother and wifeto training. course, some public relations papers and Views during that time and was a from MasseyUniversity and has started delegate to the 1980 International "But I loved that year as a student. a master in business administration. Congress of Dietetics in Sao Paulo in It was stimulating. I had to learn how Brazil. to learn and catch up in some areas." She got her start in nutrition Her practical work experience made writing followingher three-year stint While the association knew what food service "a breeze" but getting up (1968-70) as a dietitian in Wellington it wanted it achieve, it didn't have the to date in nutrition was "hard work". Hospital when Pat Donnelly (the chief resources to sustain the intensive, dietitian) referredher to Tui Flower, three-year campaign needed to From training, it was straight into food editor of the Auckland Star change public awareness and a job as staff dietitian at Dunedin newspaper who was seeking a attitudes, she says. Hospital, then six months to Wakari nutrition column. Hospital as charge dietitian. She Some NZDA members felt it was remained there until 1984. She had the right pedigree. Her ''waste of money" but Belinda says the mother was one of the first through younger members were generally When Heather Spence left Otago the University of Canterbury more switched on to the media and University's foods department Mary journalism course and an uncle, T.P. the community. was granted leave of absence fora year (Terry) McLean, is one of New to cover the food service lecturing Zealand's best known sportswriters. Nevertheless, she points to several vacancy: "It was a whole new world. I That wasaround 1970 and it led to achievements-some excellent display was paid to learn. I loved it; it was a regular columns on health, nutrition and promotional materials, moves to real update forme." andthe environment in the Auckland sponsorship and corporate Star, the Woman's Weekly and the membership, NZDAleaders becoming She was then asked to apply for National Business Review over the more astute in using the media and the permanent position on the next 10 years. dietitians became more aware of the condition she complete a masterate value of proactivity taking their and spent a year specialising in food This period was interspersed with message to the public. service fromthe University of Guelph the birth of two daughters, another in Canada.

63 In amongst all this, Mary was communication and rapport, Working in groups (teams) ofnine, president of the New Zealand Dietetic constructive support and tolerance; they organise three functions, with Association 1984-85. work procedures such as planning, students rotating around roles. 1\vo time management and technical functions are in student hostels, the Group dynamics is what a big part competence and performance. third a theme meal at the staff club, of practical foodservice training is all which they have to market by choosing about for University of Otago At the end of the year, the practical a saleable theme and "selling" to consumer and applied sciences countsfor60%,the examination40%. customers. The aim is to run at a (CAPS) students. profit.

Mary Johnston is assessing her 'We're assessing their behaviour, It all sounds like fun -and it is, says students on many levels - base attitudes and coping skills in a live Mary. knowledge, flexibility, adaptability, situation involving the nuts and bolts professionalism, teamwork (as a leader of foodmanagement (the Studholme But it's also very serious. With 60 and as a team member), constructive Hall Kitchen)." to 70 students chasing 20 dietetic effort and self-evaluation (ability to internships and probably needing a B learn frommistakes). In their second year, the students or B-plus pass, the pressure is on - have to apply what they have learnt both students and lecturer. She puts it another way by about planning and production by breaking it down into three areas - producing a meal for the hall's 120 Mary clearly establishes quite a personal qualities such as assurance, residents. And in their third year, they relationship with students, but has to responsibility, discretion and are responsible for a week of meals - remain totally objective and confidentiality, stress management; planning menus, ordering food, professional when it comes to group qualities such as leadership, supervising staff,starting to budget. assessments.

JulianJensen year of the new dietetic training more naive. There's more structure programme-at Christchurch in 1993. to the Association now and members Julian Jensen has a string of New want much more accountability for Zealand dietetic firsts to her name. "Just a case of being in the right their subscriptions." place at the right time," is how she * She introduced the first passes off this catalogue. "I've never Her appointment as chief selective menu to a Canterbury seen myself as being particularly dietitian at Christchurch in 1977 hospital - at Burwood in 1968. innovative, but just prepared to give plunged her into the planning and things a go." commissioning of the new food * She was the first exchange service department - "a huge job" of student between the Home Science Aftertraining at Christchurch, she combining five dining rooms and Alumnae and Kansas State was a staffdietitian at Burwood,then two kitchens and selecting and University - in 1971. became dietitian-in-charge in 1968 installing central tray service, a * She was the New Zealand and introduced the selective menu central staff cafeteria and central Dietetic Association's youngest and was involved in planning the new dishwashing. president - at 28 in 1973. kitchen at Burwood. The North Canterbury Health * She was the youngest chief In 1971, Julian went to Kansas in Board sent Julian to Switzerland to dietitian of a large hospital board - at August for a year to do her MS in food see the equipment first-hand before 32 forthe North Canterbury Hospital service management, studying under committing itself to buy. Board in 1977. Grace Shugart. She left in mid-1979 to have a * She was involved in planning Back home, she resumed her family but within a year, she had a forthe new kitchen at Christchurch position as firstassistant dietitian at new job-editor of the NZDAJ oumal, - the first in New Zealand designed Christchurch and became NZDA a position she retained until 1991. specifically to host central tray president in 1973-74. This was the service. time of the Report on the Dietetic While the position kept her in Profession and Government White touch with the Association and the * She was the first New Zealand Paper on Health, both of which profession, there was also a fair dietitian to go into private practice consumed a lot of NZDA Executive amount of work involved; "There as a food service management time. was never a backlog of articles and I consultant-in Christchurch in 1985. had to encourage people to publish." She believes life has become * She is one of the fivearea co­ tougher for a president: "The issues April 2, 1985, was a big day for ordinators appointed for the first were less crucial then and we were Julian -the day she started in private

64 "When I left dietetics in 1955 practice. There were the doubters everything used to be weighed for but she says she has "never not had diabetic diets, down to a fewounces - something to do." cut an inch offthe end of a banana - "I put a card in the paper and and food separated with greaseproof wrote to architects, rest homes, paper in aluminium containers." schools and local doctors." * The arrival of nutritional Her work has reflected that supplements. market - consultancy for rest "There had been nothing when I homes, private hospitals, schools, trained. If kids had an allergy to milk, area health boards, architects and we had to make a meat-milk mixture, designers, community talks and blending the meat with oil and lectures and some clinical work. vitamins. It was like mud, very thick She has also done some tutoring and the kids had to work hard to get it at Christchurch Polytechnic and it through the teat.'' was this which led her to combine with Pip Duncan in writing * Changes in uniform. 'ProfessionalFood Service.' Vera Greiner "As a student, I wore the same 1954 uniform as the nurses... hats, capes "We were both tutoring Student Dietitian, Auckland and starched uniforms.In 1975, hats quantity cookery at polytechnics were disposable, there were no capes and knew there was no New Zealand shift from Auckland to Levin where and uniforms were made of textbook. We wrote what we polycotton. At Porirua, the patients considered was a good practical there was no work opportunities for dietitians. didn't like uniforms,although we did tool to filla need and it has become wearuniformsforclinicsbecausethey the quantity cookery text in gave us authority." polytechnics." Her return was prompted by the opening of a geriatric unit at She has served the Association Paraparaumu. She enquired about Vera moved on to Kenepuru where at a national level continuously job possibilities but was asked instead she ran the food service foranother throughout her professional life, if she wanted to go to Porirua for 12 five years beforeshe took a relieving starting in 1967 as younger months. She ended up there forfive job at Wellington, in therapeutics. members' representative on years. executive to 1993 as Convenor of In 1986, she moved into the Accreditation Taskforce and a "I was diffidentabout coming back community dietetic work and member of Editorial Board. after such a gap. But 1 had what Pat completed a three-year diploma of Donnelly called 'life experience' and community nutrition from Otago Her standing in New Zealand she and the other dietitians were very University. dietetics was recognised in 1992 supportive, which helped give me when her peers acknowledged her confidence. Now, as the fulltime community contribution to the professionand health dietitian for the Wellington the Association through the NZDA's "I went to conferences and took as Area Health Board, she is involved in most prestigious award, the Award many continuing education community health, directed at of Excellence. opportunities as I could. And I found keeping people in their homes rather that having my own children, I could than in hospital or institutional care; talk with confidence and authority to promotion of nutrition and healthy VeraGreiner I mothers about their problems.'' eating and administration. VeraGreiner(bornMarr) has what Vera also recalls Flora Davidson 'We liaise a lot more with everyone is probably the most unusual telling her she was sure she would in the community. It's a multi­ curriculum vitae of any New Zealand disciplinary approach.'' dietitian. have some input into the community, that "you were never lost with dietetic training." Vera believes the work of It reads: community dietitians has helped 1954-55: Student dietitian, And what happened during her change the public perception of a Auckland Hospital. dietitian. 1955: Staffdietitian, 20-year absence? Auckland Hospital. * Great advances in technology, "People used to think a dietitian 1975-80: Dietitian-in-charge, especially the arrival of computers. was someone who made them lose Porirua Hospital. weight. Now, they are realising a The20-yeargapwasacombination * Therapeutic diets, especially for dietitian is someone who helps them of circumstances - marriage and a diabetes, weight reduction and ulcers. with feeding their family.''

65 GillianTustin Since 1989, her formerlyvast area changing and evolving population, to of responsibility (from Taupo to understanddifferent philosophies and Gillian Tustin is an example of a Kaitaia) has been consolidated into ljfestylesand to adapt and emphasise rare species - the last survivor in the central Auckland. She has instigated nutritional advice so that it is line of regional public health dietitians the appointment of four half-time appropriate and relevant. employed by Department of Health. communitydietitiansandapart-time nutrition goal co-ordinator. Gillian Tustin trained in Auckland She has seen the Wellington and in 1967, then spent three months at Christchurch positions disappear and One of the factors which Cornwall Hospital during 1968 before the advisory dietitians structure at facilitatedthese appointments was moving to Middlemore Hospital as head officedismantled. the release of the health charter by first assistant dietitian. a former Minister of Health, Helen But she has also seen the Clark. By nominating the promotion After time overseas, which gathering momentum of public of nutrition guidelines as one of included a three-month locum at health nutrition promotion and the New Zealand's health goals, the King's College Hospital, London, she establishment of community charter helped further focus public returned to New Zealand in 1971 and dietitians under area health board attention on food and eating habits. became first assistant dietitian at umbrellas. Gillian's role with Wellington Hospital. Auckland Area Health Board covers Essentially Gillian's role is to public health nutrition as well as promote the principles of healthy Gillian still recalls her interview planning and service delivery for eating and a healthy lifestyle to the forher Department of Health position, community dietetics in Auckland. many different groups that make up recounting a somewhat unusual communities in Auckland. method of impressing a prospective Much of her work is to update and employer: "After a long interview I influence others whose work in the "Unemployment, poor housing was asked why I wanted the position community has a nutrition and poverty stretchdietitians' ability and I flippantlyreplied: 'So that I can component - public health nurses, to help. Unless people have adequate work Monday to Friday and play golf dental nurses, teachers, home housing and money, we'rejustaband­ on Saturday'." economics teachers for instance. aid." These community workers can reach To which Auckland's Medical a far wider cross section of the She has also had to find ways to Officerof Health replied: "That's great community and can be very influential communicate with a wide range of - I've just taken up the game! What's in getting messages to the public. ethnic and religious groups, a your handicap?"

Sue Pollard at planning change and adapting to Hospital for one year and then new ways." worked in various other part time Dietitians are pivotal in the positions. "selling" of the modern hospital, Now, as hospitals seek to offer says Sue Pollard, manager of food quality at the best price, they are That was followed by six and a and nutrition servicesat North Shore recognising that people tend to judge half years splitting herworkingweek Hospital in Auckland. hospital service by things they know between the North Shore Extra­ about, such as food. Mural Hospital (meals on wheels, And, the emphasis on dietary counselling, home visits and management, quality and cost Sue, one of the dietitians involved some health promotion) and the containment has given dietitians the in the DACUM process which provided Diabetes Education and Advisory edge amongst health professionals the foundation forthe new training Service( a joint project between the in the hospital environment, she curriculum, quotes that as further Auckland Diabetes Society and the says. evidence of dietitians' willingness to Auckland Area Health Board). change - "It was quite revolutionary "Dietitians have always been in those days." She returned to Middlemore for trained in management and 18months as senior clinical dietitian organisation of foodservice and this Aftertraining atAuckland in 1964, beforemoving to her present job at has increased under the new she had three years at Middlemore North Shore in 1987. training. This has allowed them to Hospital, starting with clinical work easily adapt from the role of food then transferring to food service And what of the modern food service manager to general manager. management. While raising her family servicemanager? during the late 1960s and 1970s, she "They have shown they are good was tutor dietitian at Auckland "It's less of a hand-on role and

66 less time in the kitchen. A lot of families at the Child Development In 1983 she and Jocelyn time is now spent setting budgets Centre at Waikato Hospital. In 1978 Hampton established the first NZDA and planning. The food service is Janelle became the senior clinical Award - the Ecolab Award - and run as a business unit within the dietitian at Waikato Hospital and Janelle has convened the Awards hospital; in the old days, if you has continued to specialise in Sub-committee since. During this wanted more money, you asked for clinical dietetics. She is now Clinical time, the number and value of the it and it just came. Nutrition Manager at the hospital. Awards has increased.

"It's a differentapproach to work Janelle has developed policies Janelle was appointed to the - quality and price, quality at a and procedures for the clinical Dietitians Board in 1983, becoming cheaper price." dietetic management of patients. deputy chairperson in 1986. In 1989 She was instrumental in she was elected chairperson of the JanelleWallace establishing the NZDA Clinical Dietitians Board and has used this Handbook and co-edited its first position to represent dietitians' views publication. She was a leader in the throughout a period of major change development of quality assurance within the health sector. Under her for dietetic practice in 1983. Janelle leadership, the Board has sought is a strong advocate for clinical alternative proposals forthe training dietetics and has shared her of dietitians and worked to ensure the experience and knowledge with smooth transition of dietetic training colleagues and other health from the traditional hospital based professionals consistently. She training programme to the Otago supports and encourages young Universitybased training programme, dietitians working in clinical begun in 1993. practice and enjoys teaching. Janelle has also overseen the Much of her work has been with administrative changes in the patients making the transition from Dietitians Board froma Board fully - hospital to home. This has led her funded by the Department of Health, Janelle Wallace beyond the hospital into the to one where dietitians have had to community and given her a wide pay for the cost associated with the AftertrainingatAuckland Hospital knowledge ofh�alth care services and Board's functions. in 1964, Janelle Wallace (born Lomax) agencies. was staffdietitian at CornwallHospital, Janelle, with support from the then senior therapeutic dietitian at Janelle's contributions to the New Board and the profession, has taken Auckland Hospital. Joyce Martin, Zealand DieteticAssociation began in the initiative on issues such as dietitian-in-charge at Auckland, was 1969 when she, Jocelyn Hampton possible deregulation of the a major influence through her and Sue Campbell established the profession, an improved system for professionalism, assertiveness and Waikato Branch of NZDA - the first registration of overseas applicants willingness to teach. branch in New Zealand. In 1977 she and developing continuing was appointed to executive and the competency requirements for In 1967, Janelle became Salaries Advisory Sub-committee, practising certificates. dietitian-in-charge at Burwood becoming Vice-President in 1979. Hospital in Christchurch, moving It is important to her that the to Hamilton in 1968. While working Her time as President, in 1981- Board and the Dietetic Association part-time in the Dietetic Outpatient 1983, was marked by strong emphasis work closely so that neither Clinic at Waikato Hospital, she on the need for Executive members organisation is seen to be isolated broadened her experience by to communicate with their members, fromthe professionat large. working as dietitian at Tokanui so that dietitians would become fully Psychiatric Hospital two days a week involved with their professional and working with children and their Association.

67 THE FIFfHDECADE - from 1983 ProfessionalProfile specialises in dietetic and foodservice vThe pamphlet added further management. information on dietitians' roles: Dietitians have spent a lot of time and effortin the past 10 years looking "Dietitians have traditionally been * Clinical dietitians translate the at themselves and how others see found behind the walls of hospitals. treatment needs of the patient into them - and trying to influence these The public exposure of the dietitian nutritionally suitable food and perceptions. and her/his skills through private materials, consulting with other practice and community-based members of the treatment team and With the emergence of a group of appointments is an important advising the patient and his/her family close to 20who set up private practice marketing strategy forour profession. or caregivers. (work on producing guide-lines for Along with this shift outside the consultant and private practice hospital setting comes the emphasis * Management dietitians are dietitianshadbegunin1973)orjoined on 'prevention' rather than 'cure'. responsible for managing the hospital other health professionals in group Dietitians are gaining recognition as food service, including personnel practices, dietitians had begun to health professionals who have an management, financialmanagement, escape from the hospital confines important contribution to make in strategic planning, kitchen design and during the 1970s. But into the late the area of preventive health care". planning and menu planning. '70s and '80s, the scope of dietetic activity and the vision of many And as dietitians' horizons widened * Community dietitians use their dietitians widened by many beyond the hospital walls, so did their nutrition knowledge and foodservice dimensions - sports nutrition, need forprofessional recognition and management skills in the wider nutrition consultancy, contract food image. community, promoting healthy service, community nutrition and eating by working with local dietetics, health education, product Vocational Guidance Service communitygroups, residential homes development and promotion, careers informationprepared in 1973 and media. university and polytechnic teaching. said dietitians' training prepared them for positions of responsibility in * Dietitians are well qualified to This was a longwayfromadecision hospitals, public health services and undertake research; they participate at an executive meeting in August community nutrition education in in trials and surveys in clinical 1946whentheNZDAchosetoconsult New Zealand and the Pacific. nutrition research and foodnutrition the British and American dietetic consumer research. associations about the use of the term, ANew Zealand DieteticAssociation "dietitian", by people not employed in pamphlet of the late 1970s also * Private practice includes areas hospitals. Information was sought stressed the hospital. It puts the such as weight loss, sports nutrition, from these sister organisations on question, what does a dietitian do? It food allergy, children, diabetes, requirements fornon-hospital trained answers: "Most often, the dietitian referrals from doctors, writing for dietitians to become members. works in a hospital" ... as a manager magazines and newspapers, kitchen Registration ofNew Zealand dietitians planning, coordinating and planning and design and foodservice and the formation of the Dietitians administering the total foodservice, management. Board did, of course, solve the as a teacher instructing nurses and problem. hospital personnel in nutrition and * Food industry is an expanding diet therapy, as a therapist working in area, with increasing numbers of Heather Fear (born Macpherson) wards, outpatient clinics or patients dietitians employed by manufacturers who has variously been a private homes. The only non-hospital option in product development, consumer practitioner, a community dietitian mentioned was public health work, education, public relations and with Diabetes Education Centre in helping the general public understand nutrition policy development. Christchurch and then with the the function of food and its National Heart Foundation, put it contribution to health. By the fifthdecade, many of these this way: The 1980s have brought an perceptions were changing. added dimension to the dietetic By the 1990s, a NZDA pamphlet profession with the appointment of was describing a dietitian as "an expert An upsurge in public interest in community/extramural dietitians in the scientific study of food and food,nutrition, diet and health, partly working in areas of domiciliary care nutrition" who worked in three main flamed by alternativehealth medicine, or community health. Several areas - hospitals or crown health spawned a proliferationof "nutrition dietitians have also set up in private enterprises, private practice, or m experts" purporting miracle diets, practices in clinical dietetics and one industry. vitamin therapy and items "absolutely

68 essential" for people's well-being. dietitian and the association and Sponsorship Often, this focused attention on raising the profile of the dietitian and dietitians who were asked to comment the association as sources of The NZDAalso jumped aboard the on or discuss issues raised. authoritative and useful food and sponsorship roundabout, raising nutrition advice. around $6000 for the Journal, News By 1985 the NZDA had produced a and Views and position papers during job description fora publicity officer, Specific ideas included press 1986. The 1986-87 public relations whose aim was "to promote the releases (about once a month), a new budget of $12,400 was based around dietetic profession and to promote format for News and Views, editing $7,500 from sponsorship and $4,900 the registered dietitians as the position papers, communications in a public relations levy on members. provider of nutrition services in the seminars forNZDA members, opening The following year, that was up to community". Target groups were one day of refresher courses to the $21,240-$15,000 in sponsorship and identified as the general public, public, developing a list of speakers, $6,240 fromthe levy. national and local health policy publicity leaflets, letterheads and formulators, related professions, business cards, "foremothers" cards The NZDA involved the food employer and employee groups and with information on famous or industry in its affairsthrough a first the profession itself. The publicity foundingmembers of the profession, trade display at the 1974 conference. officer's primary responsibility was working with NZDA representatives Commercial interest in the NZDA "to issue press releases on topical on issues management. The cost was continued to grow -advertising in the nutritional matters, more especially expected to be around $400 a month. Journal, which had started in the responding to dubious claims by 1940s, sponsorship of seminars or nutrition 'experts' and supporting functions at conferences, trade sound nutrition information when PositionPapers displays at conferencesand seminars, and where appropriate." sponsorship of awards, sponsorship Following the lead of the of publications. Belinda McLean, meanwhile was American Dietetic Associationand thinkingalongthe lines of a marketing after many years discussion, a Awards plan for dietetics - a much broader Christchurch-based committee, compass than simply improving the headed by Gendy Brown (born Industry-based awards continue association's image and educating the Seay) established the protocol for to support dietitians in gaining public. This would mean the writing position papers. These are professionaladvancement by funding profession reappraising itself authoritative professional work or study projects or attendance (collectively and individually), statements on food,nutrition and at conferences in New Zealand or analysing itself, its market, its dietetic practice. overseas. immediate and long term objectives and the steps to achieve them. The first position paper, written In 1981, Jocelyn Hampton and by Marie Thomas (born Sare) and Janelle Wallace approached Ecolab Early in 1985, the NZDA Barbara Harris (bornGibson), dealt Ltd (then Economics Laboratories) approached a public relations firmfor with the nutritional management to sponsor an NZDA award to a one-year proposal to put dietitians of diabetes in New Zealand and was encourage professionaldevelopment on the "professionalmap", to give the published inApril 1989; the second, of dietitians. After consultation with profession a higher profile, to on the nutritional management of members of the Association, communicate the association's views food intolerance, followed in conditions and application formswere on nutritional and health issues and October that year. Its author was prepared and applications sought in to help dietitians communicate their Carol Wham with co-authors 1982. The firstawards were given in special knowledge and advice. The Penny King and Rhonda Akroyd. March 1983 and certificatespresented NZDA executive went along with the to successful applicants later that year proposal but delayed a start because The position paper sub­ at the 40th Jubilee Conference dinner the $6,500-plus required to fund it committeewas moved to Auckland in Hamilton. was not readily on hand. in 1989 and led by Barbara Cormack. Further position papers In 1989, Janelle Wallace negotiated Ayear later, the association sought have been published on nutrition with Douglas Pharmaceuticals and another proposal, this time from for physically active adults and Abbot Laboratories to sponsor awards Clarity,a public relations firmin which athletes in New Zealand by Ien and successful applicants received the Belinda McLean was involved. Its Hellemans (bornvan derTuin) and first awards in 1989 and 1990 proposal concentrated on obesity: treatment or prevention? respectively. The Abbot Award is for strengthening the self-image and by Lyn Gillanders and Gillian the same purpose as the Ecolab Award public professional image of the Tustin. and the Douglas Award provides

69 support forattendance by a paediatric the capital so that by 1988 the first Young Achievers Award was dietitian at the annual Australian award could be made fora continuing instigated by Gillian Tustin in 1992. Inborn Errors of Metabolism education project. This Award recognised dietitians Conference. who, within five years of NZDA under the guidance of registration, excel in an aspect of president, Pamela Williams has added In 1985, Susan Pollard, then dietetic practice in New Zealand. its own Award of Excellence - the president of NZDA, instigated The first award will be made during highest honour the Association can discussion on a possible Education the 50th Jubilee Conference. bestow on a member. The award Trust Award.This had its beginnings recognises outstanding contributions in 1968 after the death of Connie Honorary life membership has to the advancement of the profession Shearer, who left a legacy of $500 been awarded to people who have and can be made in any of four which started the Education Trust made a significant contribution to categories-dietetics; clinical dietetics fund. This was added to in the formof NZDA. Selection and nomination and nutritional care; food service memorial donations afterthe deaths criteria include involvement with the administration; nutrition education. of other dietitians - notably Kay Association, professional activities, 1\vo awards have been made - to Cammie, Patricia Mathews and specific contributions to NZDA or Bernice Kelly in 1990 and Julian Joanne Swan. Individual donations, dietetics and, in the case of non­ Jensen in 1992. plus those from branches and the members, promotion and support of Association general funds increased The NZDA/Nestle Foodservice dietitians or dietetics.

BerniceKelly __ structure of the profession; evaluation ... * Her thorough and unequalled When the New Zealand Dietetic understanding of legislation and "She contributes beyond formal Association decided to make its first regulations governing dietetic education and training by always Award of Excellence, it did not have practice and her ability to objectively showing an active interest in all to look farfor its first recipient. discuss and critically analyse it; dietitians (working, retired or Bernice Kelly, advisory dietitian * Her wide knowledge of dietetic temporarily out of the workforce), with the Department of Health since training; offering kindly encouragement or 1970, received the NZDA's premier * Her expertise in food service objective advice wherever necessary, award in 1990. planning and design; assisting dietitians by going straight * Her ability to predict changes in to the critical factors of a problem The award which recognises professional practice and prepare and offering simple, practical outstanding contributions by dietitians to cope with them; solutions." dietitians to the advancement of the * Her knowledge of the location of dietetic profession, is the highest resources and dietetics; She has contributed to NZDA honour the association can bestow * Her reputation for meticulous affairs in one way or another for 37 on a member. preparation and attention to detail; years - finance committee for 16 * Her report writing skills. years (1970-86), elected member Bernice received the award for of executive for four years and ex "In her position as advisory pioneer work and leadership in the officiomember for 21 years (1970- profession. dietitian, this knowledge and ability 91) and secretary since 1991. She has been applied in monitoring trends has also been a regular attender at Her citation said she had shown in dieteticworkforce development and conferences and refresher courses leadership by consistent making recommendations fordietetic professionalism, integrity and and worked with Dorothy Moir on workforce needs; advising on food the association's 25-year history. discretion; thoroughness and sound service and policy to programme judgement in professional matters; managers, boards and architects with contributing information and the Department of Health; and. On the wider front, she was a resources to help dietetic and other carrying out the many functions of member of the Board of Health professional groups function registrar of the Dietitians Board... Committee on the Dietetic effectively. Profession (1972-74), chairman and ".. .As registrar of the Dietitians member of the Institution of Her proposers said she was Board, she has been responsible for Training Advisory Committee (1981- recognised as an authority in organising dietetic training, 91), secretary of the New Zealand dietetics because of: examinations and registration. She Federation of University Women's * Her wide in-depth knowledge was a prime moving forcebehind the Wellington branch (1974-75, 1982- of dietetics, its philosophy and curriculum revision project, fromthe 83) and National Executive as practice; initial evaluation, through secretary-treasurerof the Fellowship * Her unique knowledge of the implementation and ongoing Trust Board (1988-91).

70 "Her contribution has been and Her first job was as a dietitian with refurbishment of food service is always made from outside the the Otago Hospital Board. She then facilities in most hospitals and in limelight. She is always there went to the University of Manitoba other institutions; working in the background, giving and Stratford General Hospital people information then stepping (Ontario) in Canada. * The improvement in food back to let them take the credit. service andin foodservice systems; Every dietitian in New Zealand has While she was in Canada, a benefited from Bernice Kelly's 34 message arrived from Elizabeth * The privilege of holding an ex years of dedication to the profession," Gregory, via Bernice's aunt: ''When's officio position on the NZDA concluded the citation. Bernice going to start her masters? executive. Tell her to write to K-State!" Two Bernice herself says she has years later, "after a lot of hard study She has no doubt the strength of always sought to do "a job well done and food service management the New Zealand dietetic profession forthe dietetic profession." experience", she emerged with an has been its generalist education MS from Kansas State University. and training. It's not surprising she should combine education anJ service. Back in New Zealand in 1967, she "This must continue if dietitians Education in its broadest sense was was quickly confronted by the reality are to be equipped with a good always a priority forher fatherand of hospital dietetics - re-establishing knowledge base, with a wide range public and community service for a dietetic service atNorthland Hospital of marketable skills to practise in her mother. Board which had gone a long time diverse settings. without a dietitian. When she arrived at Home Science School in 1952, Lucile Rust, "In New Zealand we cannot be Bernice became advisory dietitian lulled into the 'security' of narrow emeritus professor of home to the Department of Health in 1970. economics education at Kansas State areas of practice where dietitians Itw as the start of20 years service with end up in professional cul de sacs University was in residence as a the department. Fulbright scholar. with few or no opportunities for From that time, she picks four career advancement. Bernice says a combination of highlights: influence from Lucile Rust, "We have to constantly Elizabeth Gregory, Monica * The major revision of the dietetic remember that dietetics is the McKenzie and Patricia Williamson curriculum; application of the principles of "ensured I was launched on my nutrition to all people in health and dietetic career." * The replacement or disease, wherever they may be."

CorporateMembership of single training school based in committee to review the training Auckland - occupied much of the curriculum early in 1983, which had During 1990, a new corporate time of a working partyset up by the not been changed since its inception membership category was New Zealand Dietetic Association to 30 years previously. introduced to the Association at investigate some aspects of the $500ayear. By 1993, theNZDAhad Committee's report. This working The role of the dietitian was 23 corporate members who, in party included Jocelyn Hampton and changing as the national return fortheir support, get access Pamela Williams. But despite the time importance of nutritionally-related to specialist dietetic and nutrition and effortof many dietitians, despite disease became recognised, as information, joint ventures with proposal and counter-proposal, there budgetary controls became the NZDA, discounted rates for was nothing concrete to show for all commonplace, as increasingly Journaladvertising and conference the talk. sophisticated management skills trade displays and contact with became part of a dietitian's life. Association members. It was evident that prerequisite training for dietetics would remain The Board pointed to a need for 'Iraining university based and dietetic training detailed guidelines for training would remain with hospital boards. schools to help them achieve Ever since the Committee on the Polytechnics were not interested in consistent national standards. Three Dietetic Profession released its picking up the dietetic training which particular criticisms of the findings and recommendations in many dietitians thought was an curriculum attracted special mention 1974, there had been interest in the inappropriate training centre. - the inadequacy of a dietitian's future shape and direction of knowledge and confidence to lead in dietitians' training. Indeed, training - In October 1982, the Dietitians their field; lack of basic and applied especially the Committee's suggestion Board authorised the formation of a physiological knowledge among new

71 entrants to the profession; the services; demonstrate professionalism in 1989 asked the NZDA to "give importance of dietitians retaining in practice and ethics; apply principles consideration to the future of dietetic management of hospital foodservices. of nutrition in health and disease; training in New Zealand and give plan and administer foodproduction priority to a central training school". All this meant entry levels for and service; apply safety and food With the demise of area health boards dietitians, training programmes and hygiene standards; performoffice and imminent, training was under assessment procedures needed to be hospital administration; plan and financial threat and there was still a looked at again, said the Board. 1\vo design foodservice facilities. strong Auckland lobby to bring the aspects were of prime concern - the Committee on the Dietetic Profession . high expectations of new staff Basic to the exercise was the recommendation to fulfilment. dietitians and the entry-level skills of philosophy that foodservice should dietitians. remain the responsibility of people Professor Sir John Scott, fromthe with expertise in that area and trained Auckland Medical School, put up a Eight dietitians representing all to apply current nutritional principles proposal fora one-year post-graduate areas of practice and years of in health and disease - and that diploma of dietetics course training experience, fourdietitians specialising registered dietitians were the people centred on the medical school; in education, and a co-ordinator best trained forthis role. practical work would be done in (Graham Wagner, from the New Auckland hospitals and examinations Zealand Council for Educational A coordinator (dietitian) of student would remain under Dietitians Board Research) who made up the training was suggested and it was control. The suggested syllabus committee, used an approach known proposed that tutor dietitians should included four papers - clinical in the education world as DACUM - receive teacher training at local level. nutrition, community nutrition, food developing a curriculum. Or service management, a special topic translating from the jargon - locking A 12-month training year (March of the student's choice. themselves up in a room until they to March) was proposed, with a home came up with the answer! science degree or diploma as a pre­ During 1987, the School of Home requisite. At the end of their training Science was also subject to In this case, it took a week in year, students were to sit two papers - reorganisation. The diploma of home February 1983. Nutrition in Health and Disease and science was discontinued because it Food Service Management for the wasfeltitdidnothaveastrongenough The dietitians thrashed out what State Examination forDietitians. scientific base. In its place came CAPS they reckoned their job entailed and - consumer and applied science, a what skills an entry-level dietitian The new curriculum was piloted three year degree course. It was a needed. At this stage, DACUM went in Christchurch Hospital during 1986, move designed to make the course graphic, transcribing these skills on evaluated and reviewed by a Dietitians more attractive to a wider range of to a single sheet of paper. Board Committee during 1987 and students. The new undergraduate introduced in the Auckland and course was more appealing formen. The occupation was divided into Wellington training schools in 1988. However the number of male general areas of competence or activity All students sat the same papers in dietitians who have trained in New and each then analysed to identifythe 1989 and a further full review of the Zealand is still very low. Of the three skills it contained. Simple definitions curriculum was presented to the men who have trained in New Zealand, of these skills were arranged in small Dietitians Board in 1991. two are currently practising, as well blocks on the chart, providing a rating as one American trained male scale for evaluating the learning of Although the 1989-90 review dietitian. defined skills. Each skill was then involved course providers and further analysed into a skill employers in curriculum The University of Otago, which development profile (there were 125 development, dietitians remain had remodelled the old home science of these) which could be sequenced adamant the curriculum should degree and diploma into a bachelor of or broken down into teaching remain under Dietitians Board control consumer and applied sciences, modules to suit timetablesand needs and should not be hijacked by any responded by setting about developing of particular training schools. other organisation. its own proposition forthe training of dietitians. The upshot was a decision The nine areas of competence/ Meanwhile, however, it was back by the Dietitians Board on November activitywere: teaching skills to impart to the idea of a single training school 13, 1990 to call forsubmissions from information; communicate with in Auckland and a new debate over its tertiary education providers for individuals and groups; apply location. undergraduate and graduate training principles of financial personnel and programmes for dietitians. resource management to dietetic A remit from the Auckland branch

72 The Board noted that under the dietetics on a full or part-time basis. * business management - existing post-graduate internship The aim, said the Otago proposal, was principles and application of scheme, only 18 dietitians could be "to provide an accessible, management functions in finance, trained by the Auckland, Canterbury standardised, comprehensive personnel resources, industrial and Wellington area health boards training". Student dietitians are based relations, marketing, business policy; and said it wanted to explore other in five centres with a tutor in each training options. The government's training centre are linked by the * applied dietetics - practical intention to switch funding from the UniversityofOtago's distance teaching application of service management health vote to the education vote also network. This allows access to expert and normal and prescriptive nutrition forced dietitians towards moving from tutors from throughout the country. in community, preventive and a hospital-based intern programme Tutor dietitians are based in each institutional setting; introduction to to a university-led, post-graduate training centre - Auckland, research and research methodology; training in hospitals and community, Christchurch, Dunedin, Hamilton communication, counselling and serviced by distance learning. and Wellington. teaching skills; identification and development of resources; The Board identified public and Dietetic training followsa three­ private sector roles fordietitian s as: year Bachelor of Consumer Applied * dietetic practicum - work food service management in hospitals, Science course, is made up of 42 experience to integrate theory with" including an advisory and consultative weeks of professional education and on-the-job" practice. role in the community; clinical training and 12 weeks of practical dietetics in hospitals and the work m hospitals after the By initiating their own curriculum community; community nutrition examination. Students are based in review and moving towards programmes complementary to hospitals, receiving two half-days university-based training, dietitians nutrition education in hospitals; the (eight hours) a week of distance pre-empted what would have been food industry. It pointed out that teaching sessions and spending the forced on them anyway by the transfer future training may need to adapt to remaining 32 hours doing practical of funding for dietetic training from accommodate the widening of the work in the community, clinical or the health to the education vote. traditional role of dietitians and the management placements. recruitment of Maoris, Polynesians StrategicPlan and men needed to be encouraged. Students sit six papers * human nutrition - nutrition in The restructuring itch struck The Board also indicated there relation to health lifestyles and the NZDA in 1987, 10 years on from could be a need for "second level treatment of nutrition-related the review of its structure in 1977. Wendy Webb (born Smith), as support personnel" - dietetic diseases; nutritional needs of groups NZDA president, was largely technicians with a nationally and individuals within communities; responsible forthis initiative. She recognised qualification nutrition-related illness; was concernedabout fourissues. supplemented by on-the-job training. This could cover food service * community dietetics - nutrition * Where was the NZDA heading? management, clinical dietetics and and the social environment * What issues should take priority? nutrition education in the hospital community demographics and needs; * How was the NZDA performing? and the community. preventive nutrition and community * What progress had been made? health promotion; nutrition policy; Faced with having to decide food legislation food standards and Proponents for restructuring between the Auckland and Otago quality; focusedon foursigns -the difficulty options, the NZDA sent copies of both the Association was having keeping proposals and a questionnaire to its * food service management - within budget; executive meetings members, seeking response and operations management; menu which went over time and did not submissions. The result was responses planning; foodhygiene and foodsafety; deal with all business; the effectof from 25 groups and 200 individuals equipment and product evaluation; the changing industrial relations 20 groups to fivea nd 145 individuals new technologies; industrial and scene on salary negotiations and the need for the NZDA to decide to 55 favouringO tago. The proposals hospitality applications; cost were compared on delivery of training, where its future lay; the increasing management and control; process complexity of the organisation recruitment, outcome of training, analysis and process planning which now dealt with publicity, practical competency, involvement of organisation and methods; facilities annual wage rounds, new industrial dietitians and general comments. layout and design; production legislation, continual requests for planning and control; quality submissions from the government The preferred Otago proposal assurance; purchasing and supply and other organisations. involved a post-graduate diploma in management;

73 After discussion with area by many dietitians in the past in many ChangingHealth Sector representatives and consultation capacities but the demands today on Environment with members, the Association a profession, such as ours, make it decided to: investigate the cost of imperative that we take a high profile "I think the year 1990 will go fourexecutive committee and two in the political and professionalscene." down in the history of the dietetic full council meetings a year; As part of the organisation review, profession as the year in which investigate the cost implication of an executive officerNorma Goodman, everything that could happen did a dietitian assuming 20 hours of was appointed. happen!" said NZDA presidentPamela secretarial work; investigate what Williams. Not only was she referring financial and secretarial duties the Standards of Practice to changes within the Association but Royal Society could offer;set up a to the rampant restructuring in the quality assurance and a submission Standards of Practice was health industry. committee; set up an award of another project initiated by Wendy excellence; set and work towards a Webb in March 1990. long-term strategic plan; carry out "There have been new organisation a membership drive; review the The Association applied to the structures established in area health role of the Dean of the Home Health Workforce Development boards; new managers with little or Science School and the Fund fora $36,700 grant to finance no health experience having, what Department of Health advisory a 12-month project fora working seems, awesome authority; overnight dietitian on the executive. group of dietitians and consumer in the secrecy of the Budget and representatives to develop without consultation, the Dietitians The strategic plan was measurable standards for dietetic Board was required to become self formulated through a planning practitioners and dietetic services. workshop facilitated by a It funding; an Association delegation received $25,000. The standard was summoned to meet the working management consultant, Gordon of practice document was released Davidson, who had earlier in February 1992. Mary Louise party on occupational regulation and, consulted with many Association Hannah led the project. despite effortsto ensure the record of members aroundNew Zealand.The the meeting reported the dietitians' process involved defininga mission The group's aims were to stance accurately, we understand the statement for the Association, formulatestandards of practice for draft report has been written and setting broad strategies and New Zealand registered dietitians presented without our comment; new projects (five-year goals) to help and standard for dietetic service labour relations legislation has seen for New Zealand health care achieve the mission statement and It the Association required to become a setting objectives (how and when providers. set out to: establish performance criteria; help division of a union to maintain an the goals will be met). A review industrial voice for the majority of process ("inspect what you expect") individual dietitians evaluate their and accountability also had to be professionalperformance; provide members; and there isa vastly changed built into the plan. a measure for professional Department of Health which, in the competence; develop a means of process, shed one of the profession's Out of this came the 1989-90 evaluating overall dietetic services sheet anchors-the position of advisory strategic plan with the mission in health care; advise dietitians on dietitian. The Nutrition Section is no statement: how standards of practice will be more and no matter how progressive The New Zealand Dietetic implemented; advise area health one's thinking is, the apparent Association is a progressive and boards and health care providers of disregard fornutrition in the health dynamic organisation which the standards of practice. charter must be of considerable promotes a supportive concern to all dietitians... environment responsive to the SummitMeeting needs of members and committed "For the past 20 years, the to promoting high standards of The first dietetic summit knowledgethattheadvisorydietitian, nutrition and foodmanagement. meeting was held in Rotorua over Bernice Kelly, was just a phone call a weekend in March 1991. This was away to talk over a problem, to ask for Objectives initiated by Pamela Williams as an advice or to seek reassurance was a opportunity to discuss professional security blanket many of us never There is now a process of an annual issues especially the threat of strategic meeting to determine the truly acknowledged until the position, occupation deregulation. It also alongwith other professionaladvisory year's priorities. brought dietitians together to reinforce networks and support roles, was unceremoniously swept In March 1990, the NZDA decided away. During 47 years, Bernice Kelly to seek the services of an executive each other during a time of rapid officer, half-time on a 12-month change. Gillian Tustin, the current and her predecessors, Connie Shearer, contract. SaidNZDAPresidentPamela president, called the second Patricia Williamson and Monica Williams, herself a long-serving summit meeting in Picton, McKenzie, have made enormous secretary: ''We have been ably served February 1992. contributions to the profession and

74 we were saddened as we watched involve dietitians through one goal The July 1986 increases were the something called 'progress' bring in "to reduce the incidence of dietary­ most successful pay increases ever the new order. The challenge will be related health disorders by improving achieved by dietitians. The to ensure that in this new order, the nutrition." negotiations went to a Tribunal ideals, enthusiasm and courage of the Hearing with Judge Williamson past are not forgotten." In 1988, the Department of Health presiding. Dietitians from allaround established the Nutrition Taskforce the country came to Wellington to Devolution, a much-loved word of under the chairmanship of Professor support their colleagues who were governments in the late 1980s and Cliff Tasman-Jones. Among its giving evidence. Even the Judge early 1990s, enveloped the Dietitians objectives, the Taskforce was to commented it was the highest Board in 1990 when the government develop nutrition policy goals and percentage increase he had given in determined that occupational objectives for New Zealand, review any Tribunal case. Staff dietitians' registration boards should fundtheir the "Nutrition guidelines for New salaries went ahead of first year activities entirely from fees. The Zealanders", and explore the potential teachers. Department of Health had been a for a comprehensive food and major contributor to supporting and nutrition policy. NZDA became part of the Combined State Unions ( CSU) in 1986 servicingthe Board, along with other Megan Grant, Elizabeth Aitken, similar Boards. The Dietitians Board's and considered affiliation to the Isobel MacNeill and Jenny Reid acted registrar Bernice Kelly, forexample, Council of Trade Unions (CTU) in as technical advisors to the Taskforce was employed by the Department but 1987. When dietitians received a 7% at different times during its spent a third of her time on Board wage adjustment in 1987, Heather deliberations. The report of the Spence (the NZDA'srepresentative to work. The Board's secretary was Nutrition Taskforce, "Food for employed by the department which the CSU), described the result as "a Health", was published in 1991 and also funded two board meetings a good deal fordietitians and probably gave a comprehensive summary of year. more than we would have got had we nutrition in New Zealand. It continued with the usual salary claim recommended new foodand nutrition In the end, the government procedures". In fact,dietitians would guidelines which were published by probably have got 2.5% otherwise. decided to phase in full cost recovery Department of Health in 1991. Work over two years, although the Health on implementing other New government legislation, Department continued some support recommendations is continuing. through the Registration Boards through the Labour Relations Act in Secretariat which the Dietitians Board Branches 1987, forced many small health­ shares with nine other similar boards. related professions to look towards Two branches were formed in some form of amalgamation to meet The effectof full cost recovery was 1990s. Central Districts branch began the new 1000-strong minimum seen in the near four-foldrise in the meeting in October 1991 and was membership needed forregistration cost of individual dietitians' annual formally established in 1992, and as a union able to negotiate salaries practising certificates to $224 forthe Southern Districts branch was on behalf of members. The New 1993-94 year. established on May 2 1992 with 19 at Zealand Dietetic Association, the the foundationmeeting. second-smallest union in the state In a letter to dietitians, the sector, was one of the most severely secretariat said the fee hadbeen set to Salaries affected. cover the costs of registering applicants, approving training Salary negotiations were at a Members voted to give the NZDA programmes for registration, general standstill until 1985 because of the executive the go-ahead to start operating expenses and disciplinary government wage and price freeze. negotiations about joining the Public procedures. The letter said "attention However, early in 1985, the NZDA Service Association, a 69,000-strong has been paid to keeping cost as low as requested the Hospital Service amalgam of state employees which possible but the requirement to Personnel Committee to review had proven expertise in salary comply with legislation tends to add dietitians' gradings and a new salaries negotiation. Butwhile dietitians were to the cost of the Board work." sub-committee was assembled to keen to hook into these negotiating prepare for the September wage­ skills, they were reluctant to get into NumtionTaskforce round. With the restraints lifted, a situation where commitments to a dietitians received two increases, the wider group, such as the PSA, could A change of government in the first in dietitians' salaries since threaten food services in hospital 1980s and a change of health minister November 1981 - 8-10% in January through strike action. They therefore brought in a new health charter. It 1985 and a whopping 36-45% in July endorsed patient meal service as an was wider than just nutrition but did 1986. essential service in health care

75 institutions and written guidelines I Submissions * TaskForce to Review Hospitals forprofessional conduct when dealing and Related Services (which led to the with industrial action. And while The New Zealand Dietetic Gibbs report) 1987. negotiations with the PSA were in Association, anxious to take every train, they decided to continue looking opportunity to promote itself * Royal Commission on Social for alternatives. professionally and to the public at Policy 1987. One of these was Apex - a holding large, has been a conscientious union of allied professional health respondent to calls for submissions * State Sector Bill 1988. groups. NZDA hospital-employed on government proposals and members gave a clear cut 115 to 48 legislation, which became almost * Department of Commerce on vote in favourof APEX over PSA, with everyday event during the 1980s. occupational deregulation of an informal poll of those ineligible to professions1989. vote reinforcing the decision by a The first Submissions Sub­ further 25 to 10. APEX, in turn had committee was set up in 1987, based * Fluoridation 1990. links with PAIR (Professional in Auckland with Gillian Tustin as Association of Industrial Resources). convenor. Three years later it moved * Mutual recognition ofregulatory to Waikato with firstJocelynHampton The Employment Contracts Act, standards of occupation 1992. and later Sue Henderson as convenor. of course, turned much of this upside down in 1991. By March 1993, a lot of * Funding of clinical training of dietitians were still employed under Among submissions presented on health professionals1992. the Dietitians Award, some were on a variety of topics, were: individual contracts and one collective * Food standards. contract had been ratified with * Health Benefits Review another under negotiation. Committee 1987.

76 Journalof NewZealand had a keen eye and ear forappropriate cover design commissioned to fit DieteticAssociation topical and interesting papers. Flora with the new NZDAcorporate image Davidson and her research colleagues and colour scheme. The official publication of the often contributed to the Journal, New Zealand Dietetic Association reporting the research results of Advertising revenue had had its beginnings in 1946 as a dietary surveys in New Zealand and increased to about 30% of cyclostyled Bulletin. Four volumes the South Pacific. She began the publication costs by the end ofl991, of the Bulletin were produced by tradition of the table of contents on thanks to successive Journal 1950. the frontcover. business managers.

On the suggestion ofDr Gregory, In 1980, Journal editorship was In 1992 Pip Duncan took over as the Bulletin changed its name and taken over by Julian Jensen in editor, based in Auckland. She has formatand the first Journal of New Christchurch, workingwithaJournal established an Editorial Board with Zealand Dietetic Association was sub-committee. A diversity of papers membership drawn fromaround the published as Volume 5, Number 1 in continued to appear, ranging from country and from a diversity of 1951. The Journal was announced original research, presented papers, dietetic practice.The Editorial Board in the editorial notes of that issue as innovations in dietetic practice, book sets editorial policy and is working 'the official publication of the reviews and professional activities. to establish the Journal as a fully Association and will be published Julian Jensen introduced an editorial referredscientific Journal - a logical twice yearly'. column to encourage dietitians and progression in its growth. othernoteable contributors to present The new A5 format and style of a point of view. Pip Duncan negotiated with the 1951 was largely followed in New Zealand Sugar Company and a subsequent years, under the While the domestic column had Premier Paper Award has been editorship of Connie Shearer and long gone fromthe Journal, personal established. The inaugural award is later, WinifredGoddard.Advertising achievements of many dietitians were to be presented at the 50th Jubilee revenue was an important recorded as profiles of anew president, Conference in 1993. consideration in meeting costs of retirements of esteemed and long producing the Journal.In 1961 the servingdietitians, special awards and Each Journal editor has Journal recorded that the net cost of obituaries. responded to the changing publication of Volume 2 had been professional interests of members. £1/10/7 compared with £42/0/0 in The Journal cover was redesigned This has always ensured a very 1959. in 1983 tocarryalogo-areplicaofthe readable and informative Journal.It dietitian's badge in green and black has certainly succeeded in being the Flora Davidson edited theJournal on a white cover. In 1991, the format flagship publication of the for 17 years from 1962-1979. She was changed to an A4 size with a new Association.

News and Views hospital. The contributions dealt with new products, as well as the The Clinical Handbook In 1962, a remit put forward by availabilityof foodsand products Frances Berry proposed "that all suitable for restricted therapeutic The first Clinical Handbook research work and new practices diets. being instituted by dietitians should was published by New Zealand be reported in the Journalto prevent While the format has changed Dietetic Association in 1987 with repetitions by other dietitians." After overtheyears, theobjectivesofNews Lyn Lloyd, Lyn Gillanders and much discussion and general and Views haveremained the same. Janelle Wallace as editors. support from members, Connie It is the in-house newsletter for Corporate sponsorship covered Shearer at Wellington Hospital dietitians to share experiences and the printing costs. The Clinical offeredto undertake a trial period of ideas and to keep up-to-date with Handbook sub-committee, with distributing cyclostyled material new products, services and convenor Lyn Gillanders, has every three months. It was resources. overseen two reprints, in 1988 understood that all dietitians would and 1992. The Handbook is a contribute items of topical interest. Pamela Williams, Belinda widely used reference book McLean and later Judy Wood (born especially for clinical dietitians Initially, responsibility for Newton) were editors of News and collecting and distributing Views. Pip Duncan took over as editor throughout New Zealand. material moved from hospital to in 1991.

77 EvelynBoorer and now provide nutrition input for many When she went to South LizCutler of the polytechnics mainstream Canterbury Community College courses, including weekly lifestyle (parentofAorakiPolytechnic) in 1985, The Community Nutrition Centre, modules forAccess and TOPS courses. she tutored part-time in the hospitality based at the Aoraki Polytechnic course which was just starting. campus in Timaru, was the brainchild They inform, educate and help a of Liz Cutler (born Snograss) and varietyofcommunitygroups(schools, Liz Cutler has a less traditional Evelyn Boorer (born Scott). clubs and numerous organisations); background. After training as a have run nutrition update days for dietitian, she worked forNurse Maude When the two dietitians, who' Plunket, Karitane and Public Health Association in Christchurch looking trained together at Christchurch in nurses and pharmacists; been involved afterthe kitchen, implementing food 1973, found themselves together at in health promotion days and service at Averill House and visiting Aoraki, they started bouncing ideas, continuing education classes through discharged people. She then travelled gained from -post-graduate studies, the polytechnic; run education overseas. Liz had a year at Teachers offone another. sessions for polytechnic staff and College and then taught science at students. Pleasant Point before starting as a Their key aim was to project the part-time tutor atAoraki Polytechnic. importance of sound eating habits They are involved with other health She is interested in the application of into the community. professionals and liaise closely with nutrition to sport and outdoor national health bodies, such as the recreation. They also hoped to increase the National Heart Foundation and the profile of nutrition among Cancer Society. Both Evelyn and Liz graduated polytechnic staff and students, May 1993withDiplomaforGraduates increase the number of tutor hours Liz has developed a sports and Post-graduate Diploma in for student on nutrition-related nutrition module for the Hillary Community Nutrition. topics and offer a nutrition Commission diploma in sport and counselling service. recreation and Evelyn is responsible BarbaraCrooks for an 18 hour optional nutrition 'We were feeling acutely aware module forAoraki's fulltime certificate The wheel has turned full circle that orthodox nutritionists must seek in Tourism and HospitalityOperations forBarbara Crooks (born Heddell). strategies and develop modern public course. relations techniques to ensure When she became the first New dietitians are perceived as readily Both modules are being taught Zealand dietitian to work for a availableandaccessibletothepublic," this year and Evelyn and Liz have contract foodservice company in says Evelyn. found that chef tutors and student 1980, she was met with hostility chefs at the polytechnic have an and was ostracised by many They approached the polytechnic increased awareness of the dietitians, especially at conferences. administration with a proposal to importance of nutrition. promote the concept of healthy eating In 1993, she and Joanne Arthur, for healthy living in a professional There are some drawbacks another of the five dietitians setting. however: "We're well known in a Advanced Food Systems now small city. If you go to the fish and employs, have been asked to lecture 'We wanted to focus on offering chips shop, you can be sure someone student dietitians. opportunities to carry out practical will say "We know where you work!" activities relevant to day-to-day "Going to conferenceswas not implementation of the nutrition goals. Evelyn Boorer trained at a pleasurable thing to be doing," We also wanted to be available to talk Christchurch in 1973, was a staff says Barbara, even if there were a to groups out in the community or at dietitian there, then went to PMH on number of dietitians prepared to the centre. six weeks' trial in 1974 and stayed for accept her new role. "You never three years. knew who would give you a good "Our concern was that it is cost­ dig in the ribs or stab you in the effective to keep people healthy and She helped with Dial-a-Dietitian, back. well. We should be less concerned tutored food supervisors courses with the cost of preventative health and quantity cookery courses at "But the NZDA always took the and more concerned about the cost of Christchurch Polytechnic, taught a side of the hospital dietitians. When doing nothing." Women's Educational Association proposals by contractors for course in budgeting and job-shared hospital foodservice were raised at As a result of their efforts, they at Christchurch Hospital. executive meetings, the discussion

78 was always about how the NZDA others, to sharpen their costing and in 1988, she went fulltime and later should react." budgeting skills to extract the best that year, was appointed New Zealand value fromthe dollar. manager of the company-a role that She felt she and others from has taken her beyond the nutritional outside hospitals, were not getting "These were things few dietitians and dietetic function into support from the NZDA, although had ever worried about, but they are management and marketing. they were members. skills now sought in hospitals." She says it was not easy going Contractors, she says, were seen Barbara had come from a into a contract company where the as a threat to dietitians' jobs. traditional background of hospital dollars were always important: "I dietetics - trained at Christchurch was always balancing quality against (1967), staffdietitian at Palmerston Yet the company has always cost." employed two or three dietitians North (1968), dietitian at ("there would probably have been Christchurch (1969), overseas (1970- She has also pioneered a path for more in management positions in 71) including nine months at the women in the company and is one of hospitals had they applied") and only Royal Infirmary in Edinburgh and a the only two women in senior in the last two or three years has it locum at London Hospital, second management positions. A New been asked to quote on the large assistant, Christchurch (1972-73), Zealand Institute of Management hospitals. In its early days, the dietitian-in-charge, the Princess diploma of management in 1987 company only got into hospitals Margaret Hospital (1973-74), part­ strengthened her claims for which could not attract dietitians. time at Waikato (1975), some private promotion. practice (1976-79). "In the last couple of years, there The Advanced Food Systems "Dietitians are ahead of a lot of has been a real turnaround and I am position appealed because it was "a others in realising their now seen as someone quite nice little part-time job" that suited qualifications won't last a lifetime." respectable, someone to be listened her family situation at the time - she to, something of a guru. I've stuck could do a lot of the work at home. But despite those conference with it and weathered the storm." Her task was to set and maintain "blues", she has no regrets: "I've had nutritional and dietetic standards a far more interesting, rewarding Barbara puts the change down to within the company and its contracts. and challenging job than I would developments in the health system have had within the hospital system. which have forceddietitians, among The "part" continued to grow until I've been exposed to farmore."

[ PipDuncan Pip has published widely; papers Her work with producer boards in the New Zealand Dietetic and large multi-national companies Pip Duncan comes from a Association Journal since 1975; co­ ranges from product and recipe traditional dietetic background. After authoring Professional Food development, research and training at Wellington Hospital in Service, with Julian Jensen (1991), development and food photography, 1973, she worked there for two years Safe Food, with Liz Fitchett (1992) frequently carried out in "The beforegoing overseas where she spent and Nutrition forNew Zealanders, Nutrition Kitchen'. two years as senior clinical dietitian at with Anne Perera (1993); St. Mary's Hospital in London. coordinating 'In the Kitchen Pip tutored the "Quantity Cookery Back in New Zealand she was the Cupboard' (1991), 'Kitchen Sense' Course" at the Auckland Technical first assistant dietitian at Greenlane (1992), 'Cooking for One or Two' Institute of Technology forfive years. Hospital in Auckland from 1979 to (1993) and 'Cooking for Large 1986. Families' (1993) for the Auckland She has been editor of the Area Health Board. She also Association's News and Views since From 1986 to 1988, she was contributes regularly to foodservice 1991 and of the Journal since 1992. charge dietitian at Kingseat Hospital and quantity cooking columns in She is the convenor of the Publications in Auckland, also responsible for trade journals and popular Sub-committeewhichwassetupwith Raventhorpe Hospital until its magazines. the primary objective of assisting the closure in 1988. She then worked Journal to become a fully referred part time for six months at North In her consultancy business, Pip scientific journal. Shore Hospital while setting up her has concentrated on the foodservice own business. aspects of the role of a dietitian.

79 · Penny Field opened a staffcafeteria, reorganised the training programme More than staffinglevels, re-organised the food 100 differentpeople will contribute At the beginning of 1993, Penny service at nearby Lake Alice Hospital their expertise to the 1993 course. Field became the University of and appointed the country's first full Otago's first director of dietetic time community dietitian. Students do five papers - human training - the outcome of a move by nutrition; communitydietetics; food the Dietitians Board of New Zealand Penny sees her new role as that of service management; business to delegate the responsibility forthe a co-ordinator who teaches: "I am the management fordietitians; applied provision of dietetic training to Otago link betweenthe profession and the dietetics The course is completed University. The Post Graduate university dietetic training with a sixth paper, the 12 week Diploma in Dietetics was offeredfor programme." dietetic practicum which integrates the firsttime in 1993. recentleamingwith dietetic practise. Distance teaching has been chosen She, her team of tutors and 21 as the method of communicatingwith What the dietetic student of the student dietitians are at the eye of the 21 students and their tutors in the '90s needs, she says, is a mix of the profession'sfocus as they pioneer Auckland, Waikato, Wellington, academic ability, inter-personal a new-style training system. Christchurch and Dunedin training skills, career motivation and centres. willingness to explore the many Penny was the first dietitian in options now available. New Zealand to gain a masters degree Penny co-ordinates the national in business administration from programme. The tutors in each of It's these inter-personal skills, Otago and she established a these centres co-ordinate the weekly ability to question and the levels of reputation forinnovation during six 20 hours of practical experience self-confidence which have years as chief dietitian for the programme, assess, support and impressed her most about the first Wanganui Area Health Board. encourage the students. batch of students.

There she planned and She says distance learning allows "They know the job market is commissioned a $3.Sm kitchen, the contribution of nationally reasonably tough and they've got to introduced central tray service, recognised professional expertise to prove themselves."

Sue Henderson Sue says the community dietitians * Outpatient clinics in rural areas. workwithagroupofpeoplewithlittle * Counselling for rest homes and Sue Henderson (born knowledge about foodand nutrition. private organisations. Buckingham), senior community dietitian forthe Waikato Area Health "Children are taught a lot more Dietitians promote nutrition by Board, sums up what community about nutrition than previous mounting displays in public places dietetics is all about: generations and the elderly are quite and write regular newspaper articles clued up because they had to learn to to reinforcetheir message. Education 'We've gone right back to basics, survive in the Depression days. for other health care staff is also talking about what people eat, when provided. the eat and why they eat it ... about the "But there's a middle group who food pyramid, four foodgroups and lack even the most basic skills. Many Education can range from how much people should eat of each of them can't cook, can't even peel teaching people onan individual basis in a day." potatoes. to running large scale seminars and promotions. She says community dietitians are 'We've got to start teaching them dealing with many differentgroups of these things. It's no good encouraging 'We are inundated with requests people - from toddlers to the elderly, them to buy more fruit and vegetables for talks to community groups and the well and the sick and have a strong if they don't know what to do with enquiries about nutrition. We also belief that prevention is better than them." link with other health promotions cure. (run by the Heart Foundation, Cancer The communitydietetics positions Society, Nutrition Foundation) and "We are seen as part of the in the Waikato were set up as part of do some of our own, such as having a community,which adds value to what the Health Charter and the health stand at the National Fieldays to we do. We go out and meet people on goals. The services they provide promote healthy food." their terms, as equals. That changes include: the relationship fromwhen they come * Health promotion "We see ourselves as resource into a hospital." *Foodservice and clinical services. people and advisers, educating the

80 public health nurses and other health of a diabetes group at Ngaruawahia much into community work and professionals to help spread our where a dietitian has run six-session Cardiff places more emphasis on it message. It is essential we all give education courses. Local general than most other training institutions. consistent messages and respond practitioners have supported the quickly to nutritional issues. This can scheme by providing freeassessments In New Zealand, she worked at bedonebyhavingamulti-disciplinary and people have been phoning to join. Wellington Hospital forthree months, team approach to nutrition They have developed into support then had two years as a clinical promotion. One of the ideas of the groups which now meet on a regular dietitian at Tokanui Psychiatric community dietitian is in schools, basis. Hospital. She moved to her present where they encourage healthy foodin job in 1991, resuming her connection the cafeteriaand ensure foodpolicies Sue, who trained at Cardiff from with community dietetics, "my first are written and implemented." 1980 to 1984, comes fromthe British love." system which has no food service There has also been the formation element. Britain, she says, is very

I Penny King people management - she has a total provided a sound grounding in basic staff of around 180. dietetics and food service Penny King is very much your management, it concentrated on modern dietitian. She has a diploma in personnel manythingsdietitiansdidn'tdomuch management and industrial relations of any more instead of business Terms such as business and from Auckland University and has management, operations budgets, clients and customer service, completed the Hospital Boards' management, financial management quality and value for money trip Association management and personnel management." naturally offher tongue. programmes. She was one of the dietitians ''You've got to know exactly what After training at Wellington who went through DACUM, you've spent. You've got to be able to Hospital in 1968, she spent the next deciding what an entry-level juggle the dollars and work within two and half years in paediatric work dietitian should be capable of doing, budget," says the Auckland Area in Britain - at the Hospital for Sick defining dietitians' skills and putting Health Board's manager of Nutrition Children in London and in Glasgow. a priority on them. Services. Back in New Zealand in 1971, Penny believes one of the greatest She concedes there's a certain she continued in paediatrics at the benefits of the new training is that dichotomy between business and Princess Mary Children's Hospital "theory and practice go together". health, but says it's important to see inAuckland, until becoming charge She is also encouraged by the things from the client's point of view: dietitian at Auckland Hospital when competition and assessment under "They've got to perceive they're getting Margaret Madill retired in 1982. the new regime, remembering how quality service and food... value for she was accepted for training in money." She has been closely involved with Wellington without even having to the development of the new syllabus facean interview. Auckland's nutrition services and training formatfor dietitians. department, which provides food service to patients and staff,is part of She was a memberof the Dietitians "Now it's very competitive - there the hospital's business services. And Board which "saw the need for a are twoor three times more candidates the hospital cafeterias are now one of revision" to make training more than there are places. And we were the department's major sources of relevant to dietitians' roles in the never really assessed during our revenue. 1980s. training - now, there is more regular assessment and more feedback from She says much of her role is about "While the old curriculum students and tutors."

81 The Associationin 1993

From those few dietitians who was conscious of the need to keep of communication between members. formed the original membership in branch presidents well-informed of 1943, NZDA has grown substantially national activities and of the need for Awardsareimportantforproviding every decade so that by March 1993 branches to interact with e_ach other. recognition and financialbenefits for membership stood at 368 active, She has instituted regular telephone Association members. Corporate associate, intern and retired members meetings with branch presidents, sponsors are generous in providing and 23 corporate members. which have been successful in financial awards to NZDA members. improving the internal NZDA Education Trust supports Two area representatives from communication of the Association. dietitians in the pursuit of continuing Auckland and one from each of the education and NZDA Award of other NZDA areas provide the link Special interest groups are Excellence recognises outstanding between Executive and members. becoming increasingly important achievements in dietetics. Honorary They are also oftenthe link between as they provide the opportunity for lifemembership honours those who the executive and the executive sub- dietitians throughout the country have given outstanding service to committees where much of the work to network and liaise. Based on a NZDA and the professionof dietetics. of NZDA is achieved. In 1993 these core of seven in Christchurch, about Sub-committees are: 15 private practice dietitians set up Most recently, a bequest of over the first special interest group $150,000 from the estate of Dr Neige Awards within the NZDA in 1988. Further Todhunter has given the Association Clinical handbook special interest groups have followed a wonderful opportunity to provide - dietitians in industry in 1990, scholarship funds to assist with post- Continuing education community dietitians in 1991, graduate education fordietitians. Employment advisory diabetes in 1991, dietitians in management 1992 and paediatric Gillian Tustin, NZDA president Position papers group in 1993. commented, "The progress made Publications by NZDA since 1943 would make all Today, a Dial-a-Dietitian service those early pioneers very proud that Public relations continues in Auckland organised by their efforts have been so well Submissions NZDAAuckland Branch co-ordinator rewarded. Most of all, it is the Pip Duncan, with support from NZ strength, energy and vitality of our Where specificprojects have been Pork Industry Board and theAuckland professional Association that is required, taskforces have been set up. Area Health Board. In Christchurch impressive. It is by the collaborative Accreditation, Standards of Practice the service is operated by community efforts of many dietitians that this and Rules are examples of these health service dietitians working for has been achieved. projects. Canterbury Area Health Board. "The Association is now in a very With six branches formedby 1992, The Journal and News & Views sound position to pro-actively support Gillian Tustin, as national president both continue to be important means the development of the profession."

82 HonoraryLife Members

1943 Dr MurielBell C.B.E., MD, Hon.DSc., F.R.A.C.P., F.R.S.N.Z., F.N.Z.I.C.* Dr Bell was Nutritionist to the Department of Health. From the late 1930's until her retirement almost every event in human nutrition in New Zealand was initiated by Dr Bell. Her contribution to dietetics is immeasurable. She was a strong supporter of dietetic training and the formationof the NZ Dietetic Association. This was recognised with her election to honorary lifemembership at the inaugural meeting of NZ Dietetic Association. 1943 Sir Charles Bums K.B.E., M.D., F.R.C.P.* Sir Charles Burns, a physician, had a lifelong interest in diet and nutrition which is recorded in his many presentations at scientificmeetings and his writings in medical, nutrition and dietetic journals. He was always a strong supporter of the dietetic profession fromits very beginnings and this was recognised at the inaugural meeting of NZDA when he was elected an honorary lifemember. 1943 MaryLambie C.B.E. * While Director of the Division of Nursing, Miss Lambie played a key role in the introduction of the dietitian to the New Zealand hospital. She assisted in the establishment of dietetic training by liaising betweenthe Department of Health, University of Otagoand the Hospital Boards. This was recognised with her election to honorary life membership at the inaugural meeting of NZDA. 1943 Dr RAShore* Director General of Health at the time of introduction of training in New Zealand and the formationof the Association. He was elected honorary lifemember at the inaugural meeting of NZDA. 1945 ProfessorAnn Strong O.B.E. * A strong supporter of the role of the dietitian in hospitals and a member of the original Planning Committee forthe organisation of dietetic training in New Zealand.

194 7 MaureenBarker M.H.Sc * First dietitian to the Department of Health from1942 -1945. Developed much of the firstpublic health nutrition material including "Good eating all", a series of nutrition talks foruse by district nurses and school dental nurses. 1951 Rose Simmonds O.B.E.* First trained British dietitian to work in the United Kingdom. She was well known to many New Zealand dietitians who were privileged to know and work with her in London. 1956 Dr Neige TodhunterM.H.Sc., Ph.D.* Dr Todhunter was elected honorary lifemember in recognition of her outstanding contribution to the study of nutrition. Most of her working lifewas spent in United States of America where she was a member of American Dietetic Association. 1958 ProfessorEvelyn Smith* In 1957, followinga distinguished career as a dietitian, educator and foodservice management consultant in the United States, ProfessorSmith was granted a Fullbright Research Scholarship to work in New Zealand at the University of Otago, Victoria University and with the New Zealand Dietetic Association fora year to strengthen dietetic training instruction. Her contribution to the profession in New Zealand was recognised with her election to honorary lifemembership.

83 1971 Dr ElizabethGregory 0.8.E., M.H.Sc., Ph.D., Hon LLD*

Dean of Home Science Faculty 1940 - 1961. Dr Gregory strongly supported the establishment of dietetic training in New Zealand and contributed very significantlyto the recognition of dietetics as a profession. 1971 Monica McKenzieB.H.Sc. *

Founder President of New Zealand Dietetic Association; Inspecting Dietitian, Department of Health 1947-1963. Miss McKenzie was the key person in the establishment, recognition and support of the dietetic profession in New Zealand. Her contribution to dietetics and New Zealand Dietetic Association has been immense. 1971 WinifredG oddardO.B.E., Dip ff.Sc.*

PresidentofNew Zealand Dietetic Association 1949-1952; Senior Dietitian, Wellington Hospital 1947-1956. Mrs Goddard has had wide involvement in Association affairs and has been a great influence in building and maintaining the professionalstandards which the Association set out to establish. Received an OBE in 1981 for services to the dietetic profession. 1971 Eleanor Couston Dip ff.Sc.*

Foundation member of the New Zealand Dietetic Association and its first Secretary. Senior Home Science Advisor, Department of Agriculture 1952-1968. 1983 FloraD avidson B.H.Sc*

Nutrition Officer, Department of Health. Flora Davidson made a major contribution to the improvement of the health of the people of New Zealand and the South Pacific.She contributed significantlyto the development of New Zealand Dietetic Association and held offices including Secretary and President and was Editor of the Journal NZ Diet Assn from 1962-1979.

1983 DorothyMoir Dip ff.Sc* ' Public Health Dietitian, Auckland District officeof the Department of Health from 1963-1971. Miss Moir has been a constant suporter of NZDA and was President 1961-1962. She was instrumental in the compliation of the "History of the Dietetic Profession" which recorded the first twenty five years of the Association. 1983 PatriciaWtlliamson B.H.Sc.*

Dietitian to Department of Health 1957-1963 and Advisory Dietitian 1963-1965. Mrs Williamson's support and encouragement of dietitians enhanced their recognition and standing in New Zealand hospitals. She was Advertising Manager for the Journal 1958-1965 and Treasurer 1961-1963. 1984 ShirleyThompson B.H.Sc.

As Senior Lecturer in food service administration, University of Otago 1964-1983, Mrs Thompson had a major influence on students who would later be accepted into the dietetic training programme. She had been a willing contributor to New Zealand DieteticAssociation including being President 1964-1965 and a member of the Salaries Grading Committee for 6 years. 1987 DorothyRitchie Dip ff.Sc.*

As Charge Dietitian, Cook Hospital Board 1955-1982, Miss Ritchie was an innovative dietitian, introducing a six day a week meals on wheels service to Gisborne, a selective menu to Cook Hospital and provided practical experience for Fijian trained dietitians as well as New Zealand students. She was a loyal supporter of NZDA, being President 1969-1971. She was a member of the Dietitians Board for nine years and a state examiner for dietitians.

84 1988 Professor PatriciaColeman C.B.E., Dip.ff.Sc.,M.S.

Dean of Faculty of Home Science 1962-1987; member of Dietitians Board for2 5 years. Chaired the Board of Health Committee on the dietetic profession which culminated in the skill based curriculum for the training of dietitians. 1990 EmeritusProfessor Marion Robinson C.B.E., M.H.Sc., Ph.D.*

Personal chair in Nutrition, University of Otago 1980-1989. World leader in the field of nutrition, particularly in the research of selenium. Dr Robinson has had a major involvement in the training of students, including those accepted into the dietetic training programme. 1992 JocelynHampton B.H.Sc., D.H.A.

Director ofDietetics, Waikato Area Health Board 1969-1992. Mrs Hampton has had a long and active involvement in New Zealand Dietetic Association at local, national, and international level. She was President 1975-1977, a member of working party on dietetic training, member of DA CUM Committee, member of Salaries Grading Committee, Convenor Submissions Sub-committee 1990-1992 and Convenor, Planning of Jubilee Conference1993.

* deceased

NZDA HIS'IORY Erratum p 84 Honorary Life Member: Insert

1985 Patricia Donnelly Dip H.Sc* Senior Dietitian, Wellington Hospital Board 1966-1985. Longstanding service to NZDA as President 1966-1967, and member for 12 years of the Salaries Advisory Cornnittee responsible for suhnissions and negotiations. Strong advocate for high standards of professional practice and for trAining ofdietitians and food service staff.

85 NZDA Presidentsand ConferenceVenues

Year President Location Conference Date 1943-1944 Monica McKenzie Wellington Wellington 1943 1944-1945 Monica McKenzie Wellington Wellington 1945 1945-1947 Joan Jacobs Christchurch Christchurch 1947 1947-1949 Sue Campbell Auckland Auckland 1949 1949-1950 WinifredGoddard Wellington Wellington 1950 1950-1951 Winifred Goddard Wellington Wellington 1951 1951-1952 Winifred Goddard Wellington Dunedin 1952 1952-1953 Dora Campbell Dunedin Wellington 1953 1953-1954 Esme Ussher Christchurch Christchurch 1954 1954-1955 Joyce Martin Auckland Auckland 1955 1955-1956 Flora Davidson Wellington Wellington 1956 1956-1957 Audrey Rees Christchurch Christchurch 1957 1957-1958 Audrey Rees Christchurch Wellington 19581 1958-1959 Margaret Cameron Dunedin Dunedin 1959 1959-1960 Margaret Cameron Dunedin Palmerston North 1960 Connie Shearer - Acting Wellington 1960-1961 Connie Shearer Wellington Wellington 1961 1961-1962 Dorothy Moir Auckland Auckland 1962 1962-1963 Margaret Till Christchurch Christchurch 1963 1963-1964 KayGammie Lower Hutt Wellington 1964 1964-1965 Shirley Thompson Dunedin Dunedin 19652 1965-1966 Joyce Martin Auckland Auckland 1966 1966-1967 Patricia Donnelly Wellington Palmerston North 19672 1967-1968 Una Martin Christchurch Christchurch 1968 1968-1969 Una Martin Christchurch Dunedin 19692 1969-1970 Dorothy Ritchie Gisborne Wellington 19702 1970-1971 Dorothy Ritchie Gisborne Auckland 1971 1971-1972 Joanne Swan Wellington Wellington 19721 1972-1973 Joanne Swan Wellington Christchurch 1973 1973-1974 Julian Jensen Christchurch Hamilton 1974 1974-1975 Julian Jensen Christchurch Dunedin 19753 1 1975-1976 Jocelyn Hampton Hamilton Wellington 1976 1976-1977 Jocelyn Hampton Hamilton Wellington 1977 1977-1978 Elizabeth Murray Wellington Christchurch 19783 1978-1979 Elizabeth Murray Wellington Palmerston North 1979 1979-1980 Patricia Mathews Christchurch Auckland 1980 1980-1981 Patricia Mathews Christchurch Wellington 198!1 1981-1982 Janelle Wallace Hamilton Dunedin 19823 1982-1983 Janelle Wallace Hamilton Hamilton 1983 1983-1984 Mary Johnston Dunedin Christchurch 19843 1984-1985 Mary Johnston Dunedin Auckland 1985 1985-1986 Susan Pollard Auckland Wellington 19861 1986-1987 Susan Pollard Auckland Nelson 1987 1987-1988 Wendy Webb Gisbome Christchurch 1988 1988-1989 Wendy Webb Gisbome Auckland 1989 1989-1990 Pamela Williams Christchurch Dunedin 19902 1990-1991 Pamela Williams Christchurch Wellington 199!3 1991-1992 Gillian Tustin Auckland New Plymouth 1992 1992-1993 Gillian Tustin Auckland Auckland 1993 Key 1 refreshercourse 2 residential conference 3 combined meeting with other professional group(s)

86 NZDA Secretaries& 'Ireasurers Year Secretary Treasurer 1943-1945 Eleanor Couston Eleanor Couston 1945-1947 Una Martin Tessa Hamilton 1947-1949 Cynthia Wadmore Joyce Martin 1949-1950 Flora Davidson Connie Shearer 1950-1951 Flora Davidson Connie Shearer 1951-1952 Flora Davidson Alison McKegg 1952-1953 Catherine Macfarlane Patricia Mathews 1953-1954 Nancy Borrie Jocelyn Roberts 1954-1955 Margaret Madill Enid Cooper 1955-1956 Muriel Pringle Anne Morgan 1956-1957 Una Martin Jocelyn Hampton 1957-1958 Una Martin Enid Cooper 1958-1959 Dora Campbell Enid Cooper 1959-1960 Enid Cooper Enid Cooper 1960-1961 Enid Cooper Enid Cooper 1961-1962 Margaret Madill Patricia Williamson 1962-1963 Lynley Messervey Patricia Williamson 1963-1964 Connie Shearer Elizabeth Murray 1964-1965 Gillian Kingsbury Elizabeth Murray 1965-1966 Enid Cooper Enid Cooper 1966-1967 Pamela Williams Pamela Williams 1967-1968 Pamela Williams Pamela Williams 1968-1969 Pamela Williams Pamela Williams 1969-1970 Pamela Williams Pamela Williams 1970-1971 Pamela Williams Pamela Williams 1971-1972 Pamela Williams Pamela Williams 1972-1973 Pamela Williams Pamela Williams 1973-1974 Pamela Williams Pamela Williams 1974-1975 Pamela Williams Pamela Williams 1975-1976 Pamela Williams Pamela Williams 1976-1977 Pamela Williams Pamela Williams 1977-1978 Pamela Williams Pamela Williams 1978-1979 Pamela Williams Margaret Bennett Margaret Bennett Deidre Armstrong (Assistant Secretary) 1980-1981 Anne Fisher Deidre Armstrong 1981-1982 Anne Fisher Deidre Armstrong 1982-1983 Judy Wood Deidre Armstrong 1983-1984 Judy Wood Deidre Armstrong 1984-1985 Judy Wood Deidre Armstrong 1985-1986 Judy Wood Deidre Armstrong 1986-1987 Carole Gibb Rosemary Hewson 1987-1988 Carole Gibb Rosemary Hewson 1988-1989 Carole Gibb Susan Burslem 1989-1990 Carole Gibb Susan Burslem 1990-1991 vacant Susan Burslem 1991-1992 Bernice Kelly Susan Burslem 1992-1993 Bernice Kelly Susan Burslem

87 NZDA JournalEditors

1946 Bulletin Vol l Thelma Simons Wellington 1947 Bulletin Vol 2 Dora Campbell Dunedin 1949 Bulletin Vol 3 Una Martin & Gay Brett Christchurch 1950 Bulletin Vol 4 Joyce Martin Auckland 1951-1954 Journal Volumes 5-8 Connie Shearer Wellington 1955-1961 Journal Volumes 9-15 Winifred Goddard Wellington 1962-1979 Journal Volumes 16-33 Flora Davidson Wellington 1980-1991 Journal Volumes 34-45 Julian Jensen Christchurch 1992- Journal Volumes 46- Pip Duncan Auckland

88 AcademicQualifications obtained Overseas

Year Name Qualification University 1948 Honor Pledger MS Kansas State University USA 1950 Susan Parkinson (born Holmes) MS Cornell UniversityUSA 1951 May Dale (born Abraham) MS University of Michigan USA 1952 Judith Chambers (born King) MS Ohio State UniversityUSA 1953 Constance Shearer BS University of Alabama USA 1954 Grace Johnson (born Smith) MS Kansas State University USA 1955 Margaret Gillies (born Hankin) MS University of Alabama USA 1958 Margaret Till MS Ohio State University USA 1961 Pamela Williams MS Kansas StateUniversity USA 1966 Robin Fellers (born Brown) MS Kansas State University USA PhD University of Florida 1966 Bernice Kelly MS Kansas State University USA 1966 Mary Griffiths Dip Nutrition University of London UK 1969 Margaret Chan MS Texas Technological University USA 1972 Julian Jensen MS Kansas State University USA 1975 Diane Holdsworth PhD University of London UK 1976 Dianne Boaden MSc University of London UK 1978 Christine King (born Findlay) MSc University of London UK 1980 Barbara Smith (born Wright) MS Columbia University New York USA 1980 Winsome Parnell MSc Universityof Guelph Canada 1981 Heather Spence PhD Kansas State University USA 1983 Elizabeth Aitken MS Kansas State University USA 1984 Heather Benning MS Kansas State University USA 1985 Jennifer Pearce MS Iowa State University USA 1987 Helen Seagle (born McGlone) MS Kansas State University USA 1988 Mary Johnston MSc University of Guelph Canada

89