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Ordered, by The House of Commons, to be Printed,

6th July, 1926.

LONDON:
PRINTED & PUBLISHED BY HIS MAJESTY'S STATIONERY OFFICE.
To be purchased directly from H. M. STATIONERY OFFICE at the following addresses
Adastral House, Kingsway, London, W.C.2; 28, Abingdon Street, London, S.W..;
York Street, Manchester; 1, St. Andrew's Crescent, Cardiff ;

120, George Street, Edinburgh,
or through any Bookseller.

1926

or

Price 9s. net,

ORDER OF REFERENCE.

[Tuesday, 2nd March, 1926] :-Nursing Homes (Registra-
tion),Ordered, That a Select Committee be appointed to con-
sider and inquire into the question of the inspection and super-
vision of Nursing Homes and to report what legislation, if any,
is necessary or desirable for this purpose.

Sir ('yril ('obb, Dr. Vernon Davies, Captain Ernest Evans,
Sir Leolin Forestier-Walker, Mr. Hurst, General Sir Richard
Luce, Mrs. Philipson, Major Price, Dr. Salter, Miss Wilkinson,
and Mr. Cecil Wilson nominated Members of the Committee.

Ordered, That the ('ommittee have power to send for persons,
papers, and records.

Ordered, That Three be the quorum.-- (Colonel Gibbs.)

[Friday, 12th March, 1926] :- Nursing Homes (Registration),-Ordered. That Dr. Salter be discharged from the Select ('ommittee on Nursing Homes (Registration).

Ordered. That Dr. Shiels be added to the Committee.(Colonel Gibbs.)

[Friday, 26th March, 1926] :-Nursing Homes (Registration), -Ordered, That Sir Leolin Forestier-Walker be discharged from the Select Committee on Nursing Homes (Registration).

Ordered, That' Mr. Haslam be added to the Committee.(Colonel Gibbs.)

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The cost of preparing for publication the shorthand Minutes of the evidence taken before the Committee was £92 Os. 2d.

The cost of printing and publishing this Report is estimated by the Stationery Office at £266 98. 6d.

Witnesses' expenses amounted to £1 6s. 8d,

REPORT.

THE SELECT COMMITTEE appointed to consider and inquire into

the question of the inspection and supervision of Nursing Homes and to report what legislation, if any, is necessary or desirable for this purpose, have agreed to the following REPORT :

1. Your Committee have held 14 meetings and examined 36 witnesses, among whom are included representatives from the Ministry of Health and the following Associations :

The College of Nursing ;
The British Medical Association ;
The Society of Medical Officers of Health ;
The Royal British Nurses Association;

The Association of Municipal Corporations. Your Committee have also heard evidence from persons engaged in the administration of matters relating to public health in both urban and rural districts; medical practitioners; matrons or proprietors of nursing homes; nurses and men bers of the general public, who have had direct personal experience of nursing homes, either as patients or visitors; and a representative of the Christian Science Organisation. Your Committee examined one witness in private, who, for professional reasons, which your Committee felt not to be unjustified, did not desire that her evidence be reported. In certain other cases, for the same reasons, the names of witnesses have not been given.

2. Your Committee interpret their Order of Reference to cover two questions, the second being contingent upon the answer given to the first,

(i) Whether the general conditions under which nursing homes are conducted render it advisable or necessary, in the public interest, that these institutions should be liable in some degree to the supervision of a public body.

(ii) If the need for some form of supervision be shown to exist, then to what degree and in what manner should this be provided in order to be most effectively exercised.

3. The somewhat vague term “ nursing home” is commonly used to cover a variety of institutions differing greatly in character and type. It is clear that any institution that may

properly be called a nursing home must habitually cater for
patients, who, in some degree, are incapable of looking after
themselves, and consequently require more

or less

constant attention, and from the nature of their complaints may be unable to leave the home. Broadly speaking, a nursing home

differs from a hospital in that it is carried on for purposes of profit. Qs. 111, 112

It has been suggested to your Committee that a definition should be so framed as to include any premises used, or intended to be used, for the reception of persons suffering from any sickness, injury, or bodily or mental infirmity for the purpose of providing such persons with nursing, where any payment or reward is made, or promised by, or on behalf of any person so received. Such a definition would include both the paying wards of a hospital and any private dwelling-house so used by whomsoever owned, irrespective of the number of patients accommodated. As framed it would apparently cover homes providing for every type of mental infirmity whether certifiable or otherwise, but would exclude those premises or parts of premises used for the reception of women in childbirth.

This definition is one which must be weighed in connection with the further considerations which have been stated in paragraphs 20 and 35 below, but subject to these considerations your Committee have used it' as a working basis for their inquiry.

4. The various types of institutions which normally fall within
the meaning of the words“ nursing homes” may be classified
in many different ways in accordance with the point of view taken
up. If their general functions be classified, they fall roughly
into five categories, namely, the provision of accommodation
for :-

(i) Medical and/or surgical cases.
(ii) Maternity cases.
(iii) Cases requiring special observation and treatment.
(iv) Senile and other chronic cases.

(v) Convalescent cases.
The functions falling into the first two categories are similar
to those exercised by a hospital, but the demand for nursing
homes in these cases arises from those patients who can afford
to pay for their treatment and desire both greater privacy and
more home-like conditions than can be obtained in a public ward
of a hospital, or whose means render them ineligible for certain
general hospitals. The third category provides for a class of
patient whose requirements are not fully met by any other
institution. The fourth category provides mainly for that class
of persons who do not desire to incur the stigma of a Poor Law

institution. The title of the fifth category is self-explanatory.
Qs. 2397, 5. Although it is possible to classify the functions which
2822, 3630. nursing homes generally fulfil it is not nearly so simple a matter
Cf. App. II.

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