By Rosemary Collins


[Figure 1] ‘Staff on the picket line at the Queen’s Medical Centre, Nottingham’, with kind permission from the Nottingham Post. Photo by Marie Wilson, 20 December 2022, Nottinghamshire Live at

Strikes by nurses dominated the news in the early months of 2023; the Royal College of Nursing supported strike action for the first time. This ‘work in progress’ report explores a nurses’ strike which took place in April 1922 at Nottinghamshire County Mental Hospital. It stands out as an early example of female nurses initiating industrial action and not being afraid to challenge the authorities. The underlying causes of the 1922 strike were pay and working conditions, as in recent strikes. The action was led by female nurses who locked themselves in their wards with their patients in response to management proposals to increase hours and reduce wages. The strike lasted two days and ended when the nurses were forcibly evicted and sacked.

Female mental nurses had justifiable grievances after the First World War. However, grievances over pay and status were not confined to mental nursing. Thousands of women had entered the workplace during the war, many for the first time. The limitations of their employment rights soon became apparent; there were several strikes by women during the war years over issues of pay, employment conditions and unfair treatment. Although the number of women in the workforce declined as returning servicemen reclaimed jobs, women continued their struggle over employment rights. In 1920, for instance, the National Federation of Women Workers demonstrated against the Unemployment Insurance Act which brought in dole payments. The Act provided unemployment benefits for fifteen weeks at a rate of fifteen shillings (75p) for men and twelve shillings (60p) for women. Benefits for women were denied if they refused to take jobs in domestic service.[1]

Nottinghamshire County Asylum opened in 1902 twenty years before the strike and was renamed Nottinghamshire County Mental hospital in 1919. It was located on a large site in countryside close to Radcliffe on Trent. It had wards for around 450 patients and was invariably overcrowded, even when more accommodation was added over the years.[2]

[Figure 2] Entrance to Nottinghamshire County Asylum, from the postcard collection of Radcliffe on Trent Local History Society.

Governance of the hospital came under the remit of Nottinghamshire County Council. The Home Office had overall control of public asylums until 1919 and was then replaced by the Ministry of Health. The National Commission in Lunacy, renamed the Board of Control in 1913, inspected institutions regularly then reported back to local committees and the Home Office/Ministry of Health. Local committees were attached to each asylum, comprising a sub-group of county councillors who were known as the Committee of Visitors. In Nottinghamshire the committee comprised around twenty men who were prominent in local politics and voluntary organisations. Nationally, local control of mental hospitals remained in the hands of Committees of Visitors until 1948. Among other things, they were responsible for employing staff. On a day-to-day basis the medical superintendent was a powerful figure who managed individual institutions, assisted by his senior officers such as the matron and clerk.[3]

[Figure 3] Ellen Lever, Matron, Nottinghamshire County Asylum/Mental Hospital 1902–1925. Photo donated by relatives to Radcliffe on Trent Local History Society.

No previous training or experience was necessary for those seeking employment as mental hospital nurses in the early twentieth century. Female nurses had often worked previously as servants and factory workers or been helping their mothers at home.[4]  Male nurses were commonly ex-military men or unskilled manual workers. Few held the ‘Certificate of Proficiency in Nursing the Insane’ introduced in 1891 by the Medico-Psychological Association (MPA) and awarded to those who completed their two-year training programme and passed the requisite exams. Only twenty-one nurses at Nottinghamshire County Asylum/Mental Hospital qualified between 1902 and 1921.[5]

Working conditions in mental hospitals were arduous. Overcrowding and a high staff turnover were common problems in institutions across the UK at this time.[6]  Gender inequalities were blatant.[7]  Female nurses were more restricted socially than their male counterparts and were paid less. Where staff cottages were available, as at Nottinghamshire County Mental Hospital, they were allocated to male employees. But both male and female nurses were vulnerable; they could suffer instant dismissal and had no legal rights of appeal.

A radicalised female labour force in mental hospitals began to appear towards the end of the First World War, in line with emerging industrial action by women in other workplaces. The suffrage movement had shown women that changes in the status quo could be achieved through ’deeds not words’. Eleanor Rathbone pointed out that women’s war experiences gave them ‘greater confidence in themselves and a taste for the satisfaction that is to be found in skilled, responsible, well-paid work’.[8]  Female membership of trade unions rose from 183,000 in 1910 to over a million by the end of the war. By 1920, 25 percent of the total female workforce held trade union membership.[9]  Only a minority of general nurses belonged to trade unions but female mental hospital nurses were strongly represented. Membership of the National Asylum Workers Union (NAWU), which was set up in 1910, rose to 14,229 in 1919; almost half its members were women. Communism was rising in popularity too in the UK, especially among men.[10]

A number of strikes by mental hospital nurses took place at this time, including one at Monaghan Asylum in Ireland, which declared itself a soviet in February 1919.

[Figure 4] Aerial view of St. Davnet’s, Monaghan asylum, archived at the Irish Qualitative Data Archive, World Within Walls image collection.

The strike was led by Donegal union organiser and IRA commander Peadar O’Donnell. Nurses and patients barricaded themselves in the hospital for twelve days. A red flag was hoisted onto the roof and the authorities were forced to negotiate a fifty-six-hour week (previously ninety-three hours) and a pay rise. The strike ended in a victory dance and the strikers were not victimized.[11]

For a short time it seemed that strike actions had achieved changes. A Joint Conciliation Committee (JCC) was set up in 1920 with a newly formed Mental Hospitals Association (MHA) representing employers and the National Asylum Workers Union representing workers. Better working conditions were introduced, pay was increased and hours reduced to sixty per week. The Committee of Visitors at Nottinghamshire County Mental Hospital became members of the MHA and upheld the JCC’s agreement regarding pay and hours. However, the agreement broke down in 1922, partly because of the difficult economic situation the country was facing. In February 1922 the Nottinghamshire Committee proposed a 10 percent pay cut for the Nottinghamshire County Mental Hospital nurses and an increase in their working week to sixty-six hours.  Longer hours would be achieved by cutting leave from two days a week to three days a fortnight. Notices informing staff of the changes were posted in the hospital, sparking weeks of unrest.[12]

[Figure 5] National Asylum Workers Union magazine cover 11 (1912), i-x.

The NAWU soon became involved; the pay cut and increased hours went against the agreement made with the JCC. The Nottinghamshire Committee of Visitors insisted they were only subscribing members of the MHA and did not have to abide by their decisions. NAWU officials George Gibson and Herbert Shaw held a meeting with their members on 3 March and called on the nurses ‘to resist in the interests of asylum workers generally’.[13]  The nurses agreed to accept the wage cuts but not the increase in hours. On Sunday 5 March the matron put a non-unionist female nurse on night duty, possibly to discover any plans for industrial action.[14] The other female night staff refused to go off duty and went on strike for four days; the nurses locked themselves in their wards with their patients, allowing the matron and doctors to do their rounds.[15] A truce was arranged between the Committee of Visitors and the Union, pending a special meeting to reconsider working conditions. Subsequently, the committee maintained its stance regarding the new contracts and served a month’s notice on all the hospital’s nursing staff on 27 March. Those wishing to continue their employment had to reapply on a new contract of reduced wages and increased hours, to be signed by 5 April. The forty-two female nurses were relatively new to the hospital. Half had less than two years’ service and only five had worked there for more than three years. All except four refused to sign but around half the male nurses did so, notably those studying for their MPA qualification and living in hospital cottages. The Committee of Visitors then suspended five of the staff, including the union branch secretary, for trivial reasons.[16]

[Figure 6] Nottinghamshire County Mental Hospital staff cottages, Henson Lane. Photo © Alan Murray-Rust (cc-by-sa/2.0) –

On 6 April  the Committee advertised for female nurses, with or without experience, based on the new contracts of reduced wages and increased hours. On 10 April the union officials held another meeting where it was decided the female nurses would go on strike the next day. It remains unclear whether the NAWU was amplifying the nurses’ discontent so that the hospital could become a test case for preserving the gains made by the Joint Conciliation Committee.[17]

[Figure 7] One of the former hospital wards where the 1922 strike took place. Photo by author Rosemary Collins, 2023.

The strike began on 11 April 1922 at 7am. Thirty-eight  nurses and nine house staff barricaded themselves into wards with their patients. The patients were well cared for and the day passed peacefully. That evening around half the male nurses decided to join the strike. The next day, 12 April, began with the female nurses still locked in their wards and thirteen male nurses plus a hall porter now locked in three of the men’s wards. The men managed to hold back the strike breaking force temporarily but the doors were soon smashed down and they were evicted. Meanwhile the Committee of Visitors announced they had sacked all the strikers, plus the five people already suspended, bringing the total number of dismissals to sixty-six. Female blacklegs were bussed in, ready to take over nursing duties once the authorities had gained control.[18]

[Figure 8] ‘A battle of a new kind’ by Achille Beltrame, Italian painter. From La Domenica del Corriere, 30th April 1922, Italy.

A strike breaking force of seventeen policemen, together with fifteen others, including ground staff and hospital officials, forced their way in to the female wards; forty-six policemen were on standby outside.[19] The physical attack on women by a large group of men armed with hammers and crowbars was a blatant exercise of male power, authorised and encouraged by the Committee of Visitors. The nurses and house staff fought back, turning water hoses on their attackers. Windows were smashed, legs torn off chairs and there was general chaos.[20]  After four hours, the strikers were overwhelmed and evicted. Union officials provided charabancs to transport them to Radcliffe on Trent, where they were met by a large crowd of supportive residents. There were demands for a public enquiry but it never took place.

[Figure 9] Evicted strikers outside the Black Lion pub, Radcliffe on Trent. National Asylum Workers Union magazine cover, 11 (1922).

The strike was reported extensively by local and national newspapers; coverage was broadly sympathetic.[21]  The response from public health organisations was mixed. The Royal College of Nursing regarded the strike as undignified and demeaning to the profession of nursing. The Nursing Times pointed out that ‘we cannot pretend our sympathies are with these “nurses” in these deplorable actions’.[22]  From the NAWU’s point of view, the main outcome was the total rejection of conciliation agreements by the Committee and ‘their determination to dismiss the whole staff, sacrifice the interests of the patients, and, if necessary, wreck the whole institution, in order to have their own autocratic way’.[23] The Union concluded that the Committee was ‘the vanguard in a general attack which is to be launched upon the standard of conditions of asylum workers; the objective being an early return to pre-war conditions of labour’.[24]  The NAWU was right. In June 1922 many councils demanded that the Joint Conciliation Committee increase hours and reduce wages and annual leave. Accordingly, as at Nottinghamshire County Mental Hospital, the working week was re-set at sixty-six hours and wages were reduced.[25]  It was not until 1934 that the union was able to negotiate a return to the sixty-hour week.

[Figure 10] Charles Vickerstaff, sacked striker, who was employed at Caterham Mental Hospital after he was dismissed from Nottinghamshire County Mental Hospital. From the Cutler Collection, Radcliffe on Trent Local History Society.

Around a quarter of the striking women obtained employment as nurses elsewhere. Five male strikers were given jobs in other mental hospitals; most moved on to different types of work. Four marriages took place between male and female strikers, underlying the existence of bonds and local connections among the nurses. The situation at the hospital remained unsettled with continuing problems of female staff retention and overcrowding. However, a trend towards the professionalisation of mental health nursing was becoming evident; training for the MPA qualification became a requirement for new staff at Nottinghamshire County Mental hospital following the strike. It was renamed Saxondale Hospital in 1947 and closed in 1988 in line with the move towards community care, as set out in the Mental Health Act 1959. The site was redeveloped for private accommodation.[26]

[Figure 11] A former ward at Nottinghamshire County Mental Hospital, now private housing. Photo by author Rosemary Collins, 2023.

Membership of the NAWU declined during the 1920s and it became a less powerful voice.[27] But the strike did not crush the Union. It continued for several years with George Gibson as General Secretary, merged with COHSE in 1946 and became part of UNISON in 1993. It is now the biggest trade union in the country and has been heavily involved in the nurses’ strikes of the 2020s.[28]

The 1922 strike was a fundamental challenge to an institution characterised by a hierarchical system of governance and dominant discourses concerning appropriate behaviour for women. It is a timely reminder of difficulties nurses experience today which include pay cuts, long hours, a soaring cost of living and finding ways of achieving satisfactory resolutions to disputes concerning wages and employment conditions.

[Figure 12] Staff on the picket line at the Queen’s Medical Centre, Nottingham, with kind permission from the Nottingham Post: photo by Marie Wilson, 20 December 2022. Nottinghamshire Live at



[1]  Keith Laybourn, ‘Waking up to the Fact that there are any Unemployed: Women, Unemployment and the Domestic Solution in Britain, 1918–1939’, History 88/4 number 292 (2003), 606-623.

[2]  Andrew Roberts, Saxondale, Index of English and Welsh Lunatic Asylums and mental Hospitals [n.d.].  Available at: [Accessed 4 December 2023].

[3]  Peter Nolan, A History of Mental Health Nursing (London: Chapman & Hall, 1993), 31–35.

[4]  Michael Arton, ‘The Professionalisation of Mental Nursing in Great Britain,1850–1950’ (unpublished PhD thesis, University College London, 1998), 32.

[5]  See Arton, ‘The Professionalisation of Mental Nursing’, 242, for numbers of UK mental health nurses with MPA qualifications. Information about MPA qualifications at Notts County Asylum was received by the author from Dr David Stewart, following enquiries he made at the Royal College of Psychiatrists, February 2022.

[6]  Peter Nolan, A History of Mental Health Nursing (London: Chapman & Hall, 1993), 72.

[7]  Louise Hide, Gender and Class in English Asylums,1890–1914 (London: Palgrave Macmillan UK, 2014), 67.

[8]   Eleanor Rathbone, ‘The Renumeration of Women’s Services’, Economic Journal, (March 1917), reproduced in Population and Development Review 25/1 (1999), 145–158.

[9]  TUC History online [n.d.], The Union Makes Us Strong. Available at: http;// [Accessed 1 December 2023].

[10]   Andrew Thorpe, ‘The Membership of the Communist Party of Great Britain, 1920–1945’, The Historical Journal, 43/3 (2000), 777–800.

[11] Anton McCabe and Ciaran Mulholland, ‘The Red Flag over the Asylum: the Monaghan Asylum Soviet of 1919’ in Asylums, Mental Health Care and the Irish, ed. by Pauline Prior (Dublin: Irish Academic Press Limited, 2017), part one.

[12]   See final paragraph of anonymous, ‘Strike burlesque at Radcliffe’, Nottingham Journal, 12 April 1922, 5.

[13]   Mick Carpenter, Working for Health (London: Lawrence and Wishart, 1988), 58.

[14]   MSS 229/6/C/CO/7/12 Interview with Hubert Hough, recorded 7 July 1979, Modern Records Centre, University of Warwick.

[15]   Ibid.

[16]  See Herbert Shaw (ed), ‘Reflections on the Radcliffe Strike. ‘A Deadly Blow at Conciliation’ The National Asylum Workers’ Magazine, 11/4 (1922), 7.

[17]   Carpenter, Working for Health, 91.

[18]   Anonymous, ‘Strike burlesque at Radcliffe’, 5.

[19]   Shaw, ‘Reflections on the Radcliffe Strike’, 7.

[20]   Anonymous, ‘The Battle of Radcliffe Asylum’, Nottingham Journal, 15 April 1922, 1.

[21]   Anonymous, ‘Editorial Comments: Bedlam’, Nottingham Journal, 12 April 1922. Reproduced in The National Asylum Workers’ Magazine, 11/4 (1922), 4.

[22]   Quoted in Claire Chatterton, The most sensational strike of modern times’. Remembering the Radcliffe strikers, UK Association for the History of Nursing (2022).  Available at: [Accessed 4 December 2023].

[23]   Herbert Shaw (ed.), ‘Reflections on the Radcliffe Strike’, NAWU Magazine, 11/7 (1922), 3.

[24]    Ibid.

[25]   Anonymous, ‘Joint Conciliation Committee’s Recommendations’, NAWU Magazine, 11/6 (1922), 8.

[26]   Roberts, Saxondale.

[27]  National Asylum Workers Union/Mental Hospital and Institutional Workers Union 1910–1946. Documents held at Warwick University: Modern Records Centre.

[28]   Unison (2022), Vote Yes for the NHS: UNISON urges backing for strike action.  Available at:[Accessed 4 December 2023].