Mr. FALASZ. Well, it so happens at this time, Senator, there are two separate units operating in our State. Senator ELLENDER. I know, but one is just-I would not know how to differentiate-but one is just hygiene and the other is industrial hygiene? Mr. FALASZ. They are both industrial hygiene units, Senator; one within the Public Health Department and one within the Department of Labor. Senator ELLENDER. I cannot help but contend that you are bound to have duplication. Senator WAGNER. Don't you think that your State is neglectful there in having the same activities in two different departments? There is bound to be overlapping. Mr. FALASZ. I know that Mr. Derkin has asked the consolidation of both of those units in order to expand the activities of the hygiene unit in the Department of Labor. Whatever rules there may be within the United States Public Health Service to prevent that I don't know. Nevertheless, it was necessary that they operate under the circumstances under which they are operating now. We have attempted to cooperate in the State, but because of the fact that they are located in two different places, several miles apart, and because we have no connection with them except perhaps by correspondence, we find very often, as I stated, that our paths would cross, and we find constant duplication of work which we hope we can eliminate if under this act any allocation of money is to be made to the Labor Department. Senator WAGNER. There is a large field of hygiene outside of industrial hygiene, isn't there? Mr. FALASZ. Oh, yes. Senator WAGNER. So that the hygiene work outside of industrial hygiene could very well be done through a health department? Mr. FALASZ. That is right. Senator WAGNER. It is the fact as the chairman suggested a moment ago that labor organizations have been interested in the question of industrial hygiene, the health of the worker, for a long time, haven't they? They are quite active in that? Mr. FALASZ. Yes. Senator WAGNER. I suppose that they have been in contact with your department in that regard? Mr. FALASZ. They have. Senator WAGNER. Interested in following your activities? Mr. FALASZ. In reporting to us conditions from time to time that they know to exist, and in calling our attention to them and sponsoring legislation and so on. Senator WAGNER. Mr. Woll said yesterday, and I know it is a matter of history myself, that labor organizations have interested themselves in industrial hygiene even before they did in industrial insurance. Senator ELLENDER. In reading title 6, section 601, if I am to interpret that correctly, the only hygiene activities that are recognized are industrial hygiene activities. Senator WAGNER. For Federal aid? Senator ELLENDER. Yes; Federal aid. That being true, then you would be doubly sure of getting any money that is allocated for that purpose, so I cannot see why you should worry about changing any phase of this act in order to assure it. Mr. FALASZ. What we had in mind in appearing here was to call the committee's attention to the condition that we have now, and, if possible, to see that we would not be confronted with a recurrence of the same situation that we have. It is quite clear, as I see it, and I am reading from lines 5 and 6, on page 17. I see that language. Senator WAGNER. Dr. Parrin made it clear a while ago that the language was much broader in this bill than it is under the present law, and, as I interpret that section, you folks would get all of the money that would be allocated to Illinois for industrial hygiene activities, and if a State plant is submitted asking for funds, it would have to be spent by the department established for that purpose in Illinois. Mr. FALASZ. Which we intend to do when that time comes. Mr. FALASZ. And I hope that the Senator is right in his interpretation, so that when our time comes to call for it that we won't be confronted with a refusal. Senator ELLENDER. You can cite our colloquy as authority. [Laughter.] Mr. FALASZ. I have practically covered the field as far as I intended to in view of the fact that Dr. Greenberg has spoken at great length and has covered practically all of the phases that we have in Illinois. Senator WAGNER. It is implicit in your language, but you did not specifically say whether you favored the enactment of the bill. Mr. FALASZ. We are in favor of the bill and hope that we can get it through in Illinois. We are in need of it as much there as any other State in the Union. Chicago, with its large metropolitan center, needs that care that is provided for in the bill. There is not any question about needing it and the benefits that the people will get in the matter of health as the result of it. Senator WAGNER. You are not afraid of any invasion of States rights? Mr. FALASZ. Well, not right now. Senator MURRAY. Thank you. The next witness is Mary Luciel McGorkey. STATEMENT OF MARY LUCIEL MCGORKEY, CHAIRMAN, HEALTH COMMITTEE, NEW YORK STATE INDUSTRIAL UNION COUNCIL OF THE CONGRESS OF INDUSTRIAL ORGANIZATIONS Miss McGORKEY. Gentlemen, the 700,000 members of the New York State Industrial Union Council eagerly await the passage of this bill. We are convinced that it will supply the large lack today in social security for the people. It seems reasonable of course to assume that the wealthy State of New York would necessarily have adequate hospital and health facilities, and it is true that New York undoubtedly-and I do not say this with any local pride-leads the Nation and perhaps the world in medical science, medical institutions, medical centers, and all the rest of it, and we in New York are very proud of the wonderful work that we have done. However, these very large institutions, the advances that have been made, have caused a great many people to say, "Well, since we are so very good, the facilities must necessarily be adequate and therefore New York needs nothing at all, and that to put through the Wagner health bill would be to tax New York for the people away out in the foreign parts of the country like the West, the South, and the North." We are not of this opinion, and we believe that if the people who think along those lines were to read the Fifty-seventh Annual Report of the New York State Department of Health, they would find that they were laboring under an illusion. Recently one of the opposition witnesses before your committee, a medical doctor, characterized the equalizing of health opportunities as a "seductive phrase." As a nurse, I am surprised by this diagnosis and can only infer that the good doctor has stepped outside of his specialty. For he ought to know that no one has ever been seduced by a phrase. I do not think that you gentlemen are interested in phrases. I do think that you might be interested in some of the facts regarding conditions in the hospitals in New York State. I realize that I am slightly at a disadvantage, because I am a nurse, and I have worked in many of these hospitals, and unfortunately there is quite a definite policy that a nurse who tells what actually happens within four hospital walls is pretty much in the same category as the gentleman who kisses and tells, and so it is with a bit of fear that I give you my experiences in some of the hospitals, and the opinions of the members of the nurses' union whom I visit daily. I visit many of the hospitals within a month. In the voluntary and the private-charitable institutions in New York it has been estimated by a survey of New York, that over $25.000.000 has been spent in construction, and that there has been no return in the form of services on this expenditure; that only 44 percent of the private beds were occupied in the year 1936; that only half of the semiprivate beds were occupied; and that the wards were almost always full-80 percent of the ward beds. There is no free care. The patients that are hospitalized in the private hospitals who cannot pay are paid for by the city of New York, or the local treasury, supplements the cost which, however, is not sufficient to cover the expense of caring for that patient, it is claimed. However, there are a great many beds, from 3,000 to 7,000 empty beds, in private and voluntary hospitals within Greater New York alone that are not used throughout the year, not because these hospitals are not equipped to take care of any kind of a physical ailment, because they are. But it will depend-if you break your leg and you had a compound fracture. they would have everything to take care of you providing your pocketbook did not have a compound fracture. If it did, the chances are that you would be sent elsewhere. I will cover that under another point. You probably will be sent to a city hospital, and under Mayor LaGuardia's administration within 6 years, we have had more hospitals, more clinics, more baby health stations, more nurses, a shortening of the working day, more soap, more bed clothing-not enough yet not nearly enough-in spite of the expenditures. There is great howling on the part of these people who feel that they are paying the bill. They usually could afford the best of care and found it none too good, and got the best because it is purchasable if you have the money. But, on 144809-39-pt. 1—18 the other hand, hospital wards remain overcrowded and the facilities and personnel are in many instances taxed beyond capacity. In city hospitals wards constructed to hold 30 patients are occupied by 60. This often necessitates placing the sick not on ward beds but on cots in corridors, drafty halls, in front of elevators, and treatment rooms. Beds are placed so close together as to make it impossible to maintain the most elementary sanitary conditions. We have patients, and cancer patients, too, who are housed in a hospital that is over 75 years old, with beds not more than a foot apart; we have old people housed in dilapidated wooden buildings-we have a new hospital under construction, which is not completed yet. We have wards, where beds-the foot of the beds in the old women's pavilion flush together this way [indicating] all the way down the ward, so that in order to get out of bed you crawl over the foot of it. That is not a new technique, and it is not recommended by anybody, but it is necessary, and so they do it in some of our city hospitals. It is considered wrong to tell our patients that they are not getting the right care. We are supposed to assume that they do not know it, when they are flat on their backs and they may not, but we know better than that. We have wards built to hold 28 beds that have 60 and 70 beds in them. You do not get a bed if you happen to be No. 32 or No. 50, but you get one of these cots that I just spoke about, and that is where you go no matter how sick you are if you happen to be one of the overflow and you find yourself in a city hospital today. True, this is not true of every division nor on every floor nor in every hospital, but these things are true in specific divisions of every hospital, not only in the city hospitals but in other hospitals as well. We have a situation where on night duty a nurse very frequently has 40 patients to take care of. And sometimes 80, and it has happened that we have had one nurse with 101 patients at night. Not all of them required care, but you know you only need one hemorrhage to require all of your time. So that means that if you are No. 101, and you have a hemorrhage, you are really in luck because you will have the attention of the nurse, but if you happen to be one of the other people who just need a glass of water or a treatment or a bedpan, you can wait. Organized nurses particularly today have awakened to the fact that we are not nursing patients, that we almost never have nursed patients. I had a nurse say to me the other day from the Postgraduate Hospital: "Luciel, I simply cannot go on, I cannot do it. I have had to forget everything that I was ever taught about nursing. I cannot give simple comforting care, I feel as though when I walk into a ward with a bottle of alcohol in one hand and a box of talcum in the other, all I can say is 'Hello, everybody, this is supposed to be an alcohol rub, and I hope that your back is more comfortable now."". There just is not time for any kind of real care in a hospital, and you feel that all of the forces of evil in the world are plotting to make you uncomfortable and unhappy in your work. In our State hospitals, we have a more serious situation. At the present time-I am not even anticipating what is going to happen when the new budget goes into effect-in the State hospitals a great many of our workers are attendants, some of them trained and some untrained. We have as many as 127 violent patients to one female attendant at night. In the daytime, the average case load is 1 to 20 or 30. The State regulation calls for 1 to 6. If you divide up those working in the kitchen and the man plowing in the field you find that you are probably within the regulation and you can somehow figure out 1 employee to every 6 patients, but on ward services the actual patient care is increased to a case load of anywhere from 20 to 127 patients. This exists today at Creedmoor State Hospital, and the Rockland County State Hospital. It is not strange, not a strange thing or a new thing. It is not because Commissioner Tiffany does not know his department or know how to run it, any more than the department of hospitals in New York is the result of inefficiency on the part of Commissioner Goldwater; in fact, he is one of the ablest men in the world in his field. But these things cannot be done without money, and the personnel constantly nurses a budget, forgetting the patient. We have to. If you don't have soap, if you don't have sheets, if you don't have bed jackets, and the like, you cannot possibly give a patient a bath and change his linen, and if you have 50 people crying for you all at once, you cannot give treatments and medications on time. In the State hospitals surgical dressings are done by people who have no training whatsoever. Is that because Commissioner Tiffany thinks that they are qualified to do it? Not at all; it is only because his budget won't permit him to employ trained people. The salaries of the attendants in the State hospitals are $54 a month. One of the regulations is that if a patient is in restraintsome call it a straitjacket, but I don't like that term-we do not use restraint with mental patients unless we have to, but if you are one attendant with 127 patients, if you have 20 suicidals, and anywhere from 15 to 20 homicidals, you would have to use quite a bit of restraint, and then disregard all the other varying needs for attention of all the other patients. These patients are supposed to be removed from restraint every 2 hours. I am not saying that they are not. I have done psychiatric work, and I know that they are not. I do not have to be in every State hospital to know that it is not done. I know that no one is going to take a violent patient out of restraint when they have 127 people for whom they are responsible and risk-well, the attendants at these hospitals have broken fingers and arms and gashed heads, and sometimes the patients, themselves beat up the other patients, so there is no care being given to the mental patients either. pa The cost to the State of New York per day for mental patients in State institutions is $1. The cost of a meal per mental patient is 6 cents. Commissioner Tiffany has estimated under the proposed budgetary cut, which is over $3,000,000 in his department, that it will be necessary to let 1,600 employees go; it will be necessary to decrease the food, the fuel, the clothing, and so forth; there will be no construction or repair work possible, and he is frankly, well, in a state about this, because he knows that this will mean more deaths in State hospitals; he knows for certain that it is not going to mean. increased research in mental diseases. Today the Psychiatric Institute where there is some money-not nearly enough-for research work into the cause and perhaps the cure for mental diseases. He |