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of Broadmoor make imperative. This deterioration in supervision will increase if steps are not taken to remedy these deficiencies. The present staff is 19 below 8) and there appears little likelihood under
reaged the 3 future. in 25
prese complemen sufficient staff being
21. We have found it impossible accurately to assess the number of staff required for the efficient running of the Institution but we are ied that because of a number of factors (changes in hours of work, more treat- ment, &c.) the deficiency is greater than that indicated in the preceding paragraph. Moreover we have referred (paragraph 8) to the fact that it has been necessary to retain the services of 14 members of the male nursing staff who are over 60 years of age.
22. We have been told that the staffing problem is one that is common to all mental hospitals and is due to conditions in the labour market. It is not our concern to judge of the urgency of the problem as regards mental hospitals, but we are convinced of the urgency of the problem as regards Broadmoor. The relative financial attraction that Broadmoor offered to recruits before the war as compared with the financial attraction of other occupations should be restored. It may be that this can be done by increasing the "lead" in pay of Broadmoor nurses over those employed in ordinary mental hospitals. The existing "lead" of £40 (paragraph 10) is no longer effective by itself. We therefore recommend that sufficient increases in salaries should be made to attract suitable applicants for training as student nurses at Broadmoor.
23. The special conditions prevailing at Broadmoor lend force to the argument that the pay and conditions of service of the nursing staff should be determined independently and should not be automatically linked with those of the National Health Service. We recommend accordingly.
Rules of Conduct of the Institution
24. The rules for the guidance of staff in a Broadmoor Institution must of necessity be numerous, detailed and strict. We understand that the rules were last printed in 1908 and are now out of print. We think it important that the task of bringing them up to date should be expedited and that not only should every officer be in possession of a copy of these rules but that junior officers especially should be regularly reminded of the importance of the security rules. We therefore recommend that every member of the staff should have a copy of the Security Rules.
25. We have found evidence of misunderstanding on the part of the staff of the policy and intention of the Board of Control. We recommend that the Board should consider how it can secure a better understanding of its policy on the part of the staff.
26. Under the Lunacy Act, 1890, every patient in a mental hospital has the right to communicate direct with the Minister of Health and the Board of Control among others. Criminal lunatics did not have this right, but they had the right of communicating direct with the Council of Super- vision. This was a local body and in practice these communications were opened by the Council of Supervision in the presence of the Medical Superintendent. By the Broadmoor Institutions Rules, 1952 (S.I. 1952, No. 366), made by the Board of Control with the approval of the Minister of Health, Broadmoor patients are entitled to communicate direct with the Minister or the Board of Control or any Commissioner of the Board. An ordinary prisoner cannot communicate with the Home Secretary except with the knowledge of the Prison Governor and we think that there is substance