| Authors: Heather Norris Nicholson and Milton Brown | The UKAHN Bulletin |
| Volume 9 (1) 2021 | |
Long before the Empire Windrush’s arrival in July 1948, career minded young adults travelled from different parts of Asia, Africa and the Caribbean to study and work in Britain’s hospitals and clinics. Many came as students on overseas scholarships who qualified and worked in the UK. Some returned overseas to become part of the professional elites and public services that accompanied the drive for political independence and emerging nationhood after the end of British colonial rule. They included student nurses from Nigeria, Ghana, Sierra Leone and Guyana.[1] In recent years, the significant contribution of overseas workers and their descendants to the evolution of the National Health Service (NHS) has become better known. By contrast, the stories of Britain’s earlier healthcare workers from overseas have survived more selectively and are less well known. The coincidental seventieth anniversaries for the setting up of the NHS and for the arrival of the Empire Windrush in July 1948 risk overlooking complex narratives about healthcare and migration that reflect Britain’s changing connections with its overseas citizens and subjects. This article focuses on a local film-making project which has prompted reflections upon how the contribution of Britain’s healthcare workers of African and Caribbean descent are made, shared and given historical meaning. The article draws upon the authors’ opportunities between 2018 and 2020 to document on video the lives of the Windrush Generation and their children’s experiences in Huddersfield, West Yorkshire.
Huddersfield and the NHS: The Caribbean Connection (KTLV, 2020) was the result of a project funded by the Society for the Study of Labour History and Social History Society and led by Milton Brown, CEO of Kirklees Local TV (KLTV) and locally-born son of Jamaican parents who came to the UK in the late 1950s.[2] Working with Heather Norris Nicholson, an independent researcher, the production focused on the occupational experiences of local and regional healthcare workers.[3] Milton and Heather also interviewed researchers with interests in the histories of nursing, mental health provision, public health and public sector labour relations. As with our earlier collaborative productions, combining archival and picture research with secondary sources to give further meaning to the spoken words was part of the creative process of visual storytelling that brought unknown historical and local perspectives into more familiar national narratives.
This discussion considers why public understanding of overseas contributions to Britain’s twentieth century healthcare story remains fragmentary. The article is very much ‘Work in Progress’ and has three parts. First, we consider how aspects of archival practice, oral history and family history in public history-making may enhance but also inadvertently perpetuate partial and selective ways of knowing about Britain’s diverse nursing history. Second, we pay tribute to earlier twentieth century nurses from parts of the Caribbean and West Africa who came as imperial citizens and acknowledge the growing body of work in this area. Third, we consider their post-war successors who came as British subjects with reference to KLTV’s recording of local experiences in West Yorkshire. While it is inappropriate to directly compare the different lives featured here, we conclude by revisiting the processes that shape the public use of history and its terms of reference.
Constructing knowledge beyond the academy
Since 2011, KLTV has produced over twenty-five video documentaries that gather, preserve and share the stories and experiences from the diverse communities of Huddersfield, in West Yorkshire. Voices and lived experiences that have been omitted from more established channels for research, teaching and safe-guarding historical memory are thus brought into alternative informal archival stewardship and learning spaces, via watching online or attending local screenings with friends, family and community Elders. Importantly, these historical experiences stay local and accessible, if not directly owned by the community.
Capturing memories of health workers’ experiences within the NHS fitted into KLTV’s established and ongoing community-based work but necessitated virtual screenings during the pandemic. Watching online brought previously unheard NHS experiences to fresh audiences: for some people drawing attention to the local African Caribbean contributions to NHS healthcare acknowledged a presence that was taken for granted but never really thought about. For others, it paid tribute to the achievements of family members and professionals who had often fought to gain recognition and acceptance in their chosen careers. Public history, a broad term, that loosely describes how historians and others engage wider audiences with their own research and findings and help to raise the level of interest in and appreciation for historical knowledge, thus broadly equates with KLTV’s self-appointed and evolving role as custodian and archive of community history and heritage. The public use of history has been criticised for its capacity to celebrate, over-simplify, appropriate and exploit in the sustaining of cultural narratives in palatable ways for public consumption.[4] On the other hand, its validation of oral history and memory helps to reposition individual lived experience within more inclusive historical understanding. Milton, as a research student within the Department of History at the University of Huddersfield, views his own production work as a conduit to sustaining local identities and the intergenerational passing on of values, traditions and culturally specific forms of knowledge.
Video documentaries and their online availability may be seen as part of a continuum that sustains historical and cultural expression and valued expertise, fluidly, outside the conventional academic and institutional gatekeepers of libraries and archives. For Milton, public history needs knowledge to be participatory and remain publicly available for others to use. This ensures its local dynamic quality, its urgency and its meaning. Documenting the historical contributions of African Caribbean descendants to the health service predates the National Health Service. It is important to tell the whole story, the nursing contribution, the innovation of new medical awareness, the auxiliary services and the perennial struggle for equality pay and equal rights. These add value to the political and social discourse of Britian’s social policy and social history. These are important stories from the past that will enrich the African Caribbean contribution to the NHS discourse. It is a duty and obligation: to celebrate the past in the present and inform the future.
Interviewing local NHS nurses and other health workers, whose memories spanned over sixty years, helped that connective process: to learn from others, to recognise their achievements and to inspire others and to focus on regional and local experiences and contributions that contribute vitally to a more inclusive national narrative.
Building alternative histories
Nurses travelling from Britain were at the heart of colonial and imperial endeavour.[5] Whether providers of battlefield comfort, respite and care or later arbiters of public health, hygiene and sanitary welfare as part of missionary outreach or colonial control, nurses from Britain were a highly regarded, versatile and often an under-protected part of the workforce. Surviving diaries, notebooks, memoirs and letters, news cuttings and mentions in other people’s writings offer important clues to their subjectivities and agency that flesh out entries in administrative records.
But what about tracing the nurses who came the other way, and stayed in Britain or found alternative career development elsewhere? The unevenness of historical record-making makes it much harder to trace personalised written traces for many nurses of African and Caribbean background. Mobility in people’s lives and careers often obscures the diasporic journeys of some healthcare workers who came, worked with the NHS and later left the UK, unless their work gained public prominence. If they did not stay in Britain, it may be hard to link their career journeys through hospital archives and other record-keeping systems overseas. Seeking overseas records may be hampered sometimes by materials lost during the administrative upheaval of later twentieth century decolonisation, archival creation being a necessary part of state-building after independence but often long-delayed and still under-funded.
Institutional archival survival is neither guaranteed, even in the UK, as seen by the loss of the film Nurse Ademola (see later) nor does it ensure access, when conventions on disclosing names may prevent locally recognised nursing biographies from being linked to other sources of information and knowledge. Copyright archive film and newspaper photographs are expensive for low-budget projects to reproduce whether controlled within or beyond the UK: such practices disconnect community groups from their own visual history and deny their capacity to take fresh pride in their own nursing celebrities from the past.
Undertaking and coordinating research across different hospital and other archives may be beyond the capacity of many community projects reliant on volunteers. Institutional-led projects with more funding and research capacity are usually better placed to generate more sustainable and inter-connected public histories on the NHS but sharing their findings beyond high profile local public events often relies on conventional academic publications rather than broader ways of reaching audiences. Community projects, by contrast, may generate new biographical materials that stay local and have websites that become dormant after funding ends. Such processes shape how the lives of individual nurses survive, surface or sink without trace; and, as a result, relatively few nursing histories of African Caribbean nursing pioneers are widely known, an exception being Mary Seacole, whose name and reputation have gained both popular and ideological resonance and meaning.
For many people, even though they archive their own lives through their photographs, news-cuttings and certificates, awareness of their professional diligence and commitment, so well-regarded by family, friends, patients and some colleagues, lessens over time, perhaps only resurfacing and gaining wider acknowledgement when they die. These family histories, reconstructed via obituaries, newspapers and memories valuably supplement conventional historical research: often circulated informally via online blogs and articles and highly ephemeral or hard to trace, they are integral to the building of more complete versions of healthcare, nursing and NHS histories. Such biographies may be discovered by chance, as happened during this project, but ideally, each new story that surfaces and reaches wider audiences, helps to build a more integrated understanding over time.[6]
Oral histories offer vital ways to understanding and giving meaning to the past but can only extend so far. KLTV’s interviews traced memories back to the early 1960s but some notable local pioneering histories had already been lost. We encountered problems of lost recordings from the 1980s and archival conventions that anonymised oral history transcripts and denied the very identities intended by their making. Gathering new local and regional nursing stories that revealed racism, dignity, resilience and public duty became our focus. Across the country, similar untold experiences are gaining prominence within more inclusive narratives of healthcare history via publications, community arts and heritage projects and greater access to digitised archival records.[7] Plays, readings, community history collaborations with libraries, archives, universities and many voluntary organisations, supplemented by written and spoken testimony from former nurses and members of their families have, in recent years, brought unprecedented recognition to the NHS contributions made by peoples of African and Caribbean descent but many remain hard to trace.
Unsurprisingly narratives associated with experiences in London predominate, not least because of the concentration of large teaching hospitals through which many nursing recruits passed; but local and regional perspectives, like those recorded in Huddersfield, help to build a more nuanced and comprehensive picture of NHS employment. Archival digitisation has made it easier to trace earlier entries across different hospital records although difficulties abound due to misspelling of names, incomplete entries of personal details and data protection rulings that limit access to later material. As KLTV has found from other projects, archives themselves are products of record-making, selective and incomplete in the versions of the past they preserve and make available for later interrogation and excavation. They contain, constrain and construct ways of knowing and marginalised voices, perspectives and experiences are silenced, omitted and overlooked. That has been the reality of archival power: in the past, the stories that institutions wished to tell about themselves, their accounts, their buildings and their personnel rarely provided easy means to reclaim inclusive versions of the past.
Family, oral and public histories all generate individual approaches, expectations and geographies within which meanings are sought, made and circulated. KLTV’s community-based recording involved conversations with known families and friends. There was a widespread wish to share stories that helped to put the NHS record straight: to acknowledge lack of choice over being channelled into unpopular areas of healthcare, low-pay, low status and high workloads. Our narrators were eager to acknowledge their sense of public service, the value of being appreciated, friendship and the solidarity that came from working unsocial hours. KLTV’s interviewees, some of whom were in their seventies and eighties, shared the sense of urgency and recognised that their words – their oral expression – could be a conduit for cultural knowledge and help to rectify an overlooked historical presence.
As with reminiscences gathered through family history-making, nursing and hospital workers’ memories gathered at community-level settings celebrate and pay tribute: these personal stories, confidences and disclosures may be less structured than some oral history or life history approaches might advocate but are no less insightful as long-term memories bring back considerable detail of experiences in hospital wards, corridors or kitchens in response to different questions and conversational triggers. Narrators recalled incidents, events, episodes, snippets of dialogue, inner thoughts, and what it meant at the time and may still mean. Their recollections were shaped through retelling, inflected by hindsight, reconfigured by the passage of time, but they also welled up, prompted by the relationship with the interviewer, empathy and emotional intensity of being recorded on video camera.
Oral histories do not simply reclaim hidden histories, capture untold stories or give voice to the unheard: their private narratives open consciousness, different points of view and opinion; they invite us to question the gaps in the historical record, realign our thinking and prompt questions about understanding and engaging with the past. They require us to search differently for the traces of past lives: to see how private and public memories coexist, are sometimes contradictory and disorderly as they blend, evolve and change over time. They also help to connect us directly with earlier lives, breathing reality and offering ways to bring understanding imaginatively to past experiences. Personal testimonies reinforce the message of determination, dedication and resilience often in the face of great adversity reinforced by the NHS’s workplace practices, hierarchies of power and expectations.
KLTV’s documentary contributes to an emerging but uneven geography about the NHS’s history as it brings a Yorkshire perspective to a national picture of a healthcare system reliant on its Black employees yet slow to acknowledge the discriminatory practices and prejudices within its own institutional frameworks. Locally focused community history and heritage initiatives are important elements of public history as their oral testimonies brim with references to familiar places, landmarks and street names that are meaningful to their audiences yet at the same time, their very localism risks severing them from the wider narrative. Finding ways to reposition local historical experience within an historical perspective is an important task ahead but first, attention turns to identify how peoples of African and Caribbean descent contributed to Britain’s healthcare before 1948.
Late imperialism and carers from Africa
Embryonic western healthcare systems grew first to support the colonial elites, enforcement and support systems of Britain’s overseas empire. In Ghana, for instance, setting up a civil hospital in 1878 was followed by establishing a basic healthcare system in 1880.[8] As awareness of local health needs grew, providing minimal healthcare provision required recruiting and training staff locally to work in British-style hospital-based care. In the former British Caribbean colonies, for example, locally recruited and trained nurses worked under the supervision of a regional medical officer. As such practices were gradually adopted and supported by colonial and medical professionals, local staff gained work in district and private hospitals, clinic, sanitoria and maternity wards. Across British imperial territories, colonialism thus had a profound impact on the subsequent evolution of emerging healthcare systems before and after independence.[9]
Colonial policies and imposed societal expectations meant that healthcare, like teaching and low-level civil service positions, was widely acceptable as female employment, even if long working hours, low wages and the requirement to live on site in dormitory style accommodation sometimes persisted, as in the British Caribbean until the mid-twentieth century.[10] Elsewhere, as in parts of East and West Africa, educated and/or ambitious young women, from wealthier backgrounds and families of social standing, also saw nursing alongside British trained medical personnel as respectable, socially and culturally valued contributions to civic life and public duty. For those able to travel, study and live aboard, overseas hospital training was the obvious next step: for citizens with a sense of imperial belonging and entitlement, British hospitals and nursing accommodation seemed to combine career opportunity and parental reassurance about their daughters’ wellbeing away from home.
In the UK’s history of nursing, it is well-established that members from the upper echelons of society had a tradition of carrying out charitable and caring duties, including nursing.[11] African royalty was no exception. Princess Omo-Oba Adenrele Ademola, the daughter of the Alake of Abeokuta, a king in southern Nigeria had already attended a school in Somerset in 1935 before starting a career in nursing. Qualifying at Guy’s Hospital, her archival presence attests to her work in different London hospitals, wartime nursing and further training in midwifery, until the last record in 1949, where she was again working as a nurse, but now married. [12] Although her continuing royal duties remain traceable during the early years of her nursing career, Ademola’s professional history remains fragmentary and incomplete, further hindered by moves between hospitals and her name being recorded in different ways. In 1943 the Ministry of Information made a film based on Ademola’s work as a nurse, entitled Nurse Ademola (1943). The film was intended as part of wartime propaganda to encourage African support of Britain as an imperial duty; its focus upon Ademola’s nursing in London directly targeted overseas audiences.[13] Although a few surviving production stills survive, the film’s loss means a missed opportunity to trace the contribution of this high-profile nurse whose royal status and public service earned respect and popular interest appeal during wartime.[14]
More extensive archival and film records trace the nursing career of Princess Tsehai (Tsahai) Haile Selassie (1919-1942) who was born in Addis Ababa in Ethiopia to Menen and Emperor Haile Selassie of Ethiopia.[15] She attended schools in England and Switzerland, set up and worked (aged sixteen) with the Ethiopian Women’s Welfare Work Association (EWWWA) and the newly formed Ethiopian Red Cross. She accompanied her parents into exile in the UK following their country’s invasion by Mussolini and registered as a student nurse at the Great Ormond Street Hospital for Sick Children in 1936.[16] Though still a teenager, Tsehai was willing, like her father, to use publicity to advance their own national causes; she was quickly adopted by a British media and public attentive to stories of royalty fleeing from fascism and genocide and the Selassie family featured regularly in newspapers and Pathé News.
After qualifying as a State Registered Children’s Nurse, the outbreak of the Second World War disrupted Tsehai’s State Registered Nurse training which she was undertaking at Guy’s Hospital, as the probationers were relocated outside London to Pembury Hospital and later to Farnborough.[17] Recalled to Ethiopia by her father as war in Europe intensified and accompanied by her mother and other British Red Cross nurses, Tsehai visited medical and nursing services during her three-month long return via Nairobi. Back in Ethiopia, she undertook British-style nursing, delivered first aid and relief work as Haile Selassie led the offensive to liberate the country from Italian occupation. Her miscarriage and death in 1942, only months after getting married, prevented her plans for setting up hospitals and developing a modern national health service informed by British practice. The opening of the Princess Tsehai Memorial Hospital and nurses’ training school (1950), as the outcome of an international fund-raising campaign led by Sylia Pankhurst, the veteran suffragette, carried on Tsehai’s commitment to health, education and women’s empowerment as part of Ethiopia’s postwar recovery and into wider debate on the continent’s post-colonial future.
The daughters of other prominent families in different parts of Africa are also readily traceable due to their career achievements. Kofoworola Abeni Pratt (Nigeria, b.1915) followed her father’s wishes and qualified first as a teacher before undertaking nursing, after her husband, a qualified pharmacist, started medical studies in London. Four years later Kofoworola qualified as an SRN at the Nightingale School at St Thomas’ Hospital in 1950 and she worked within the NHS for four years before returning home to become a pioneer of nursing in post-independence Nigeria. She became the first Black matron of University College Hospital, Ibadan and in 1965 she was appointed Chief Nursing Officer for Nigeria, subsequently holding many other prestigious posts and receiving the Florence Nightingale Medal (the highest international distinction a nurse can achieve) in 1973.[18]
Dzagbele Matilda Asante (Ghana, 1927-) also taught briefly before travelling to England to start nursing, a profession deemed more suitable by her father, an employee at the Treasury during Ghana’s colonial administration. With brothers studying medicine and law in Leeds and Oxford, Dzagbele qualified as an SRN in 1950 (transferring from Barnet Hospital to the Central Middlesex Hospital) and later as a State Certified Midwife (South London Hospital for Women and Children/Kingsbury Hospital in north London) and Health Visitor before returning to Ghana with her husband and children to develop a career as senior public health practitioner.[19]
Let us fast forward to Professor Dame Elizabeth Nneka Anionwu (born 1947, UK) of Irish and Nigerian heritage.[20] Despite her own achievements, she opposes the deep-seated discrimination within nursing that still denies career progression. She brings prominence to how African and Caribbean peoples have contributed to the NHS’s own recognition and treatment of specific diseases and has championed better understanding of sickle cell anaemia and thalassemia. She has also campaigned for the public recognition of Mary Seacole who, like herself, was of dual heritage (in Seacole’s case Scottish and Jamaican) and has the status of a pioneer in Britain’s nursing history.
The stories of these exceptional women from elite backgrounds are known because of their status; they gain and retain prominence through circulation and dissemination of their stories. Their inclusion in nursing histories adds an element of diversity that may bring reassurance, pride or even seem to fulfil an equality agenda. Easily accessible for retelling, these stories risk distracting from a fuller understanding that remains piecemeal and incomplete. They are part of a wider narrative that includes many others, whose stories we do not know or acknowledge in different parts of Britain. Meticulous research has brought recognition to more of the Victorians and Edwardians of Black, shared and multiple heritage who studied, worked and lived as part of Britain’s professional and other occupational groups.[21] Much of that information remains hidden in academic publications or on the internet and inaccessible to readers and audiences, particularly outside London.[22] Britain’s nursing history, medical histories more generally and Black histories, despite impressive excavations into the past, require coordinated ways of knowing and accessing earlier lives and individual histories to create a fuller, truer and more representative understanding of local, regional and national historical experience. Reclaiming the unacknowledged dedication of many less well-known people, from more distant to recent times, remains urgent so that the stories told by our institutions and society more generally do not become tokenistic gestures towards equality. Better coordination also reveals historical continuities that include discrimination and racism.
Early Caribbean carers in Britain
Some of the historical connections between Britain and Caribbean nurses are better known than others. Mary Seacole’s significance is now recognised but the names of other early nursing pioneers are less familiar. Annie Catherine Brewster (St Vincent, b. 1858) came to England when her father, Pharour Chaderton Brewster, a wealthy merchant from Barbados, resettled his family in south London during the 1860s. In 1881 Annie Brewster joined the London Hospital in Whitechapel as a probationer and three years later, on qualification, she was appointed to the hospital’s nursing staff. She died undergoing emergency treatment in 1902, but her twenty years of service at the same hospital drew tributes in the local press that have helped to secure her position as a pioneer Caribbean nurse in Victorian London.[23]
Historical records identify a small but growing presence of Caribbean nurses in the UK from the Edwardian period onwards, again predominantly in London. Following the Nurses Registration Act (1919), the earliest currently identified Black nurse on the register is Eva Constance Nicholas Lowe, from Adelphi, Jamaica who started training at St Nicholas’ Hospital in Plumstead, south London in 1932.[24] Despite being qualified and registered with the Royal College of Nursing (1935), finding work proved difficult and sources suggest that she received vague and unsatisfactory excuses for being rejected, some on the pretext of concern for Lowe’s welfare. One hospital acknowledged that its nursing recruits ‘came mainly from British military family backgrounds and they would object to having to work with a black nurse’.[25]
Evidence of discrimination within hospitals and healthcare at this time may also be inferred from details about other pioneering healthcare practitioners. Status did not bring immunity, even for doctors such as James Jackson Brown (Jamaica, 1882–1953), John Alcindor (Trinidad, 1873-1924), Dr Harold Moody (Jamaica, 1882-1947) and Lord David Pitt, Baron Pitt of Hampstead (1975) for example, who all suffered varying degrees of discrimination.[26] Brown, a Canadian and British-trained practitioner in London, recognised that ‘every coloured person [in London] had a hell of a time’, suffered prejudice throughout his long career.[27] Moody, who studied and set up his own practice in London, was so concerned about the racial prejudice he had witnessed that he founded The League of Coloured Peoples in 1931, one of the earliest attempts to deliberately create a multi-racial organisation in Britain.[28]
Caribbean contributions to Britain’s peacetime healthcare provision resumed rapidly after the Second World War. The acute shortage of hospital staff even before the launch of the NHS prompted recruitment campaigns for trained and trainee nurses as well as ancillary and domestic workers. Stella Boston (née Benjamin), aged nineteen, along with Joyce Pollydore (later Nicholls) and a third scholarship holder, sailed from Guyana on a former troop carrier, HMT Atlantis, reaching the UK in October 1946.[29] They studied and trained at St James Hospital in Balham, south London and subsequently undertook training in midwifery at Robroyston Hospital, Glasgow. Stella later gained qualifications in nursing education from the University of London and her career spanned nursing practice, teaching and administration in the UK, Guyana and Canada. Another friend, two years younger, Daphne Steele (Guyana, 1929-2004), undertook nurse training in Guyana prior to arriving in the UK in 1951 and went on to be appointed Britain’s first Black matron at St Winifred’s hospital in Ilkley, West Yorkshire in 1964.[30]
NHS expansion and modernisation exacerbated the labour shortage and encouraged Caribbean recruitment to hospitals across the UK until 1973. Cynthia Stuart, chair of the Bedford branch of the Retired Caribbean Nurses Association (RCNA) travelled from Belize in 1965 to work as a nurse, first in Southampton and later in Bedford: another group member, Madge Sutherland, came to the UK in 1960 from Jamaica, first to work as an auxiliary nurse and later as a midwife.[31] Louise Da-Cocodia (1934-2008) travelled from Jamaica in 1955, qualified as a SRN (1985) and gained further qualifications in nursing, midwifery and health visiting. Her career of almost 30 years included becoming the first Black senior nursing officer in Manchester (1966) and working with the North West Regional Health Authority Training Division. For her commitment to tackling social inequalities and racial injustices, from local to national need over fifty years, she received an MBE (Member of the British Empire) in 2005. [32]
These are just some of the scattered profiles encountered during work on the KLTV production. They highlight individual lives and achievements and identify patterns of migration, recruitment, reception and subsequent endeavour. Long overlooked, these nursing narratives trace an emerging story, like those of the African nurses, of people travelling as imperial citizens and later as British subjects, who were eligible under the Nationality Act (1948) to train and work in the UK. Their belief that they were entitled to migrate, settle, study and work and have a relationship to the state and the rest of society that was indistinguishable from British-born subjects arose from a long-standing notion of imperial belonging and a sense of Britain as a Mother Country they could feel attached to and lay claim to. Decolonising processes brought pride too, that of independence (looming or achieved), self-belief and assurance borne from Black majority societies: these aspiring young and often female nurses were unprepared for the reality of subordination and inferior status they met in Britain. Educated to be British and yet treated upon arrival as second-class citizens, these newcomers and many other pioneers were crucial to the formation of the NHS, much needed but not much valued. Nursing students continued to travel from the Caribbean until c.1973 when UK membership of the European Union opened opportunities for NHS recruitment from Europe rather than the new Commonwealth.
The expectations and the sense of belonging which most African and Caribbean healthcare recruits and employees arrived with during the 1950s and 1960s were soon dashed when they ran directly into the everyday prejudices, institutional discriminatory practices and expressions of white superiority from people around them, at and away from work. A glimpse into the training and conditions that greeted young NHS recruits is seen in a film, Burnley School of Nursing (1953) made by an amateur filmmaker on behalf of the hospital and re-used with permission within the KLTV production.[33] Shot in colour, the historical imagery evokes the character of a northern regional hospital. It follows young recruits from initial interview to qualifying and shows varied aspects of student and hospital life, even though neither the African and Caribbean recruits and visitors nor a South Asian clinician also involving in teaching, are foregrounded. The images help to set the scene for when KLTV’s interviewees talk about their own early hospital experiences in Victorian buildings in and around Huddersfield.
Experiences in West Yorkshire
Concerns about cost and staffing were raised across the country early in discussions about the newly-established NHS, and Huddersfield was no exception. Finding enough doctors and nurses for the region’s hospitals and clinics had been a problem for years, despite a continuing reliance on Irish workers. Schemes brought some hospital domestic workers from mainland Europe but as those countries faced their own problems, by 1948, medical authorities in many parts of Britain, including Huddersfield, looked further afield. [34] A centralised recruiting system and selection committee to attract trainees, skilled and semi-skilled workers was set up and the then Minister of Health, Enoch Powell, better known for his anti-immigration stance and ‘Rivers of Blood’ speech in 1968, was directly involved in recruitment in the Caribbean. Denzil Nurse (Barbados, 1944) was one of Powell’s young nursing recruits. As an eldest son, Denzil’s ambitions were supported by his family. He travelled on a Geest banana boat to Barry in South Wales and reached West Yorkshire in 1963 where he started as a trainee mental health nurse at Stanley Royd, in Wakefield. He spent the next 23 years with the NHS before moving into community activism and health advocacy at national and international level.
For years, regional and local newspaper advertisements sought nursing staff, domestic workers for catering, laundry and cleaning and many ancillary roles including orderlies, porters and telephonists. The government was recruiting nurses across sixteen British colonies and former colonies by 1955.[35] Local health boards and individual hospitals sought overseas labour directly too: at the psychiatric hospital, Storthes Hall, outside Huddersfield, recruitment of twenty-nine new nurses from Nigeria and Jamaica became contentious and prompted questions in Parliament. [36] NHS applicants needed to be between 18 and 30 years of age, able to read and write and willing to sign up for three years. For people in the war-impoverished economies of some Caribbean islands, it seemed attractive and worth the cost of travel and living away from home. Moreover, as Alda Flowers (Jamaica, born c.1932) recalls from her application interview before travelling, her plan to return to her own country with British qualifications and NHS nursing experience was persuasive and a compelling reason to train overseas.
Even when immigration from the Commonwealth was restricted severely by new immigration laws in 1962 and 1965, Enoch Powell, who had a particular interest in mental health, made a special plea for trainee and auxiliary nurses to still be admitted.[37] By December 1965, there were 3000-5000 Jamaican nurses working in hospitals mainly in London and the Midlands. By 1977, 66 percent of the overseas recruits to student nursing and midwifery came from across the Caribbean.[38] Changing immigration laws from the later 1960s onwards plus discrimination around training, low pay, unpaid overtime, long hours and poor career progression for Caribbean NHS workers eventually had an impact on recruitment and retention. Many in their children’s generation were less willing to accept the negativity and discrimination endured by their parents and sought alternative employment.
Family commitments and travel costs often changed original intentions to return to the Caribbean but the early wish to leave sometimes recurred. Alda recalled: ‘I applied to Poole General Hospital in Dorset and came in 1961 … After two weeks I wanted to go back to Jamaica.’ Denzil voiced his early dismay at the coldness of the weather and disappointment at his reception with characteristic understatement: ‘Within three weeks of arrival I was in the training school … Within that period … it took quite a bit of persuading me to stay because of what I saw as hostility. People didn’t know how to treat me. I was almost a stranger in their midst.’
Disappointment over lack of career progress was widespread and prompted people to look for alternative work including overseas. Denzil noted: ‘I recall having been qualified with another four or five nurses. We went to the Senior Nursing Officer… (and asked) “What are the chances of getting promoted?”… And he made two or three tuts… “I don’t know how my members are going to respond to taking orders from a black person, you know.” And we saw his level of discrimination. To tell the truth, within three weeks, most of the lads had left because they realised that their chances of promotion were zilch … I was the only one who stayed around.’ Denzil’s own plans to go to Canada fell through so he remained in West Yorkshire.[39]
Low pay and poor working conditions made some areas of the NHS unappealing for local jobseekers. West Yorkshire’s textile and manufacturing economies were still buoyant and expansion of the public, private and voluntary sectors offered alterative employment. Out of town psychiatric hospitals saw sustained staffing shortages despite attempts to provide bus services for employees and recruitment drives at local and regional level. Enoch Powell’s description of the nation’s psychiatric hospitals as ‘isolated, majestic, imperious, brooded over by the giant water tower and chimney combined, rising unmistakable and daunting out of the countryside’, seemed apt for West Yorkshire: Stanley Royd near Wakefield and Storthes Hall outside Huddersfield had suffered from overcrowding and poor staff/patient ratios for years.[40] The stigma then attached to mental illness , together with location and wider uncertainties over the future direction of psychiatric care and hospital administration meant that African and also Caribbean recruits, including Denzil, became a mainstay of mental health staffing.
Prevailing societal exclusion in a country where successive steps to introduce anti-discrimination measures only started with the 1965 Race Relations Act meant that young Caribbean newcomers to mental health nursing met many forms of marginalisation. Hospital farming was a remnant of pre-war mental health service.[41] It was still part of the care regime at Storthes Hall as Denzil recalled: ‘I was given all the menial jobs … I remember an officer sending me to work on the farm and I said to him, “But I’m here to do nursing”. He says “You’ll get to that.”’ Unequal treatment persisted as Denzil recalled after becoming charge nurse at Storthes Hall:
But even then, racism raised its ugly head. I remember the nursing officer was showing around some dignitaries and he told me these people were coming on the Monday … He didn’t tell me that I must stay in the background but it was obvious from what he did that I wasn’t supposed to be the up-front spokesperson.
Denzil’s commitment to equality was offended by the management’s hypocrisy and manipulation in the double indignity that denigrated him and substituted another individual and treated them both as puppets: ‘One of the nursing auxiliaries there was obviously Downs Syndrome … He was dressed in a suit, given questions and primed to answer [questions from the visitors] on my behalf.’
Discrimination permeated the routine allocation of NHS jobs, roles and opportunities within a hierarchical system. For Alda, who transferred to Huddersfield Royal Infirmary so that she could join her fiancé in West Yorkshire, lack of respect required countermeasures: ‘We had assistant nurses and auxiliaries [in the children’s ward] but it was always my job to go and clean the cupboards out and go and do the menial tasks rather than the medicines and what I’m trained to do.’ Employees developed strategies to counter and challenge the racism that former hospital porter Gus Morris identified as being ‘in the fibre of all areas of employment’ and ‘particularly in the NHS’ during the 1960s and 1970s. Denzil often used humour to deal with humiliation, in Milton’s words, ‘laughing in the face of adversity’. Alda, by contrast was more assertive in response to persistent indignities as apparent when ‘sticking up for herself’ led to her being sent to see the Matron:
I explained my situation and I’m saying to the Matron, “Why’s the auxiliary doing the medicine round and I’m to clean the cupboard? Why should the auxiliary do the round with Sister, with Doctor and I’m going to move a cot? This is one person who’s not going to do that. So if you want to tell me to leave, you can tell me now because I’m not going to stoop to that. And that was it.”
Alda’s principled insistence on the NHS’s own strict adherence to position and responsibility being applied fairly and refusal to be treated as an inferior challenged authority:
So I went to find the auxiliary and said to her, “Would you mind going and cleaning out the cupboards?” She went off and did that. The sister didn’t like that. She came and gave me the most menial tasks to do. All I did was to wait until the auxiliary finished and then ask her to do the other task … I was just trying to give back what was given to me.
Alda’s dignified insistence gained her respect that, in time, brought leadership and responsibilities but progression was hard work.
Working unsocial hours and night shifts was widespread among NHS employees from African and Caribbean backgrounds and built up camaraderie. Milton recalls the coming and going of people in green, blue and brown uniforms from his own childhood and the informal childcare arranged between families to cover working shifts. For Alda, like many parents, working nights fitted in with being with her children before and after school, brought higher pay and was better than taking an additional job to supplement low pay. As her career progressed she became, in Milton’s opinion, ‘a stalwart for change’ who combined family roles with nursing for over 20 years.[42]
For decades, the African Caribbean NHS employees found themselves channelled into unpopular areas of patient care such as psychiatric, geriatric and care of the chronically sick.[43] By 1971 almost a quarter of the staff at Storthes Hall had been born outside the UK. Many were obliged to accept work of lower status too and surveys highlighted concern about the numbers working in SEN rather than SRN roles.[44] Mental health nurse, Kereena Roach (NHS, 1980s), born in the UK to Barbadian parents in the early 1960s, recalled the obstacles that faced her own generation: ‘Looking back, there were a lot of Black people [at St Lukes Hospital, Huddersfield] but they were nursing assistants, enrolled nurses. There were very few ward sisters, nursing officers or charge nurses [of African or Caribbean background].’ Her interview with Milton disclosed how, as two former classmates during the seventies, they found, shockingly, they had encountered parallel institutional behaviours and hostile attitudes during their respective years with the NHS and military in 1980s and 1990s Britain. Kereena recalled: ‘I did experience discrimination … mainly from the staff and from some of the patients [with mental health problems] so it was expected. But from some of the staff, it was done in such a subtle way.’ Her work at St Lukes Hospital spanned the transition from long-stay policies to short-stay but newly introduced community-based care approaches did not improve career development: ‘When it came to promotion, we were very much overlooked.’
Gus Morris reflects upon the systemic racism that disadvantaged many NHS employees: ‘This was quite prevalent. Their co-workers would from time to time isolate them very subtly so the struggles they had were to work collectively and form strength within that. Their aspirations and their progress were hindered by racism. It was very subtle but it was there.’
Gradually, as Carmen Gaye (NHS, 1990s) recalled, attitudes began to change:
I started in about 1989 and worked for about seven and a half years… I was quite proud … to say I worked [as cook] at Huddersfield Royal Infirmary …[I]t was a challenge each day to get 250 plus meals out on time and to a high standard… I didn’t face any challenges [due to ethnicity] but there was a bit of jealousy. As you know we’re workers and so when we go to work, we work…. I did come up against some jealousy in that respect.
Unions, keen to protect their existing members, were slow to tackle discrimination. Jack Saunders’ research into trade union history within the NHS identified the reluctance: ‘There’s a feeling in the white dominated trade union movement at this period that picking up issues of race is going to be divisive, is going to be alienating to their white members and therefore it would be better to avoid dealing with those kinds of issues.’ [45] He noted that: ‘Throughout the 1970s, you’d find that the unions would be disproportionately white-dominated senior officers and particularly are dominated by men. There’s some effort to redress this but not a great deal.’ Was it surprising that unions remained so unresponsive to workplace racism and discriminatory practices that affected so many Black employees and particularly those who were female and young? When change came, those who had been so marginalised brought their own collective power to the struggle for workers’ rights.[46]
Black nurses join the protest on fair pay on Ilkley Moor in December 1969. Image reproduced courtesy of Mirrorpix/Reach Licensing (www.mirrorpix.com)
Fear of reprisal deterred some nurses, auxiliaries and ancillary hospital workers of African and Caribbean descent from joining protests and campaigns against low pay and working conditions but evidence points towards growing activism and union support particularly among the NHS’s female workforce.[47] A series of dramatic images on Ilkley Moor of nurses campaigning for fair pay were recorded by a reporter working for the Daily Mirror in December 1969.[48] Tragedy ended the protest as a supporter slipped and died. Another decade elapsed before the growing calls for solidarity to end racism in the workplace gained support in the trade union movement where membership of Black workers remained low even in the later 1980s. By then, the NHS was the largest recruiter of people from African, Caribbean and Asian backgrounds in the country. A new pay structure was introduced, the position of the enrolled nurse was replaced by three-year training and nursing auxiliaries gave way to nurse-helpers and support workers, but for many the initiatives to improve pay, conditions and attitudes were too few and too late. As one nurse said during a survey by West Yorkshire’s Low Pay Unit, ‘I will stay in nursing, to keep my children out of it.’[49]
Conclusion
This discussion derives from the authors’ opportunity to work together on a production that involved former NHS workers talking about their experiences. Bringing those voices together highlighted how oral histories communicate past experiences, subjectivities and reflexivities powerfully to their subsequent audiences. Personal narratives offer alternative ways of knowing about what happened in the past as well as what it meant and felt at the time and now. Oral histories provide compelling material for reuse in community arts projects and when captured on video, these archived testimonies remain available and directly enable audiences to watch, listen and connect with memories just as they are shared to camera.
As an example of public history, KLTV’s productions made local and regional African Caribbean perspectives of their NHS work better known. Our interviews captured a sense of hospitals as a whole, the nursing staff plus those that supported them: our narrators spoke of recurring issues, their responses to the challenges they faced and their dedication over many years. This discussion has highlighted the value of inter-disciplinary approaches in helping to reposition historical knowledge. We acknowledge how the productions borrowed and drew upon the strengths of family history, biography, film history and spoken word as they built meanings around existing and previously untold stories.
Reflecting on KLTV’s project also revealed the importance of setting local and regional details within a broader national and international context. Public history draws much of its strength and appeal from being grounded in local memory and community endeavour yet those characteristics may fragment and disconnect historical knowledge. Seeing individual lives in isolation jeopardises seeing the wider context. Working in Britain’s NHS, particularly for doctors and nurses, has always involved movement and relocation for training and progression, or as part of changing policies and restructuring. More integrated ways of encountering these narratives would better identify the patterns, processes and experiences and create a more connected history of African Caribbean peoples’ contribution to the NHS. Greater online coordination and visibility would also acknowledge the growing body of related work, avoid duplication and bring more sustainable ways of building historical understanding incrementally from the lived experiences of individual NHS employees.
If synergies come from being able to compare the experiences in different NHS settings, then making connections through time seem important too. Acknowledging earlier prejudices helps to show differences and continuities before and after the Second World War and develops a stronger timeline. Evidence of racism uncovered by these interviews highlights the need for future historians to analyse the intersectionality of class, status and race within the NHS. Not only do the comments raise gender issues, such as constructions of black womanhood and how these affect choices made and opportunities available, but they also acknowledge the contribution of Black male nurses in England’s mental health nursing history. From this small film-making project, comes a call for wider qualitative and quantitative study of individual experiences that will help to better understand the professional contributions of African Caribbean health care workers to the NHS and their impact upon the institution.
Connecting imaginatively, informed by an understanding of twentieth century history, avoids oversimplifying coincidental dates, illuminates the past and shines a light upon the lives and situations of earlier overseas contributors to Britain’s healthcare provision. Making inclusive nursing and healthcare histories better understood on that basis would reflect a public history that is truly participatory, emancipatory and revelatory in its remit to develop understanding about the links between the past, present and future.
References
[1] Lynne Eaton, ‘The story of black nurses in the UK didn’t start with Windrush’, The Guardian, 13 May 2020. Available at: https://www.theguardian.com/society/2020/may/13/black-nurses-in-uk-didnt-start-with-windrush-covid-19-deaths [Accessed on 7 June 2021].
[2] Professor Barry Doyle, Centre for Health History, University of Huddersfield secured funding for this project.
[3] Huddersfield and the NHS: the Caribbean connection (KLTV, 2020). Available at: Huddersfield and the NHS: The Caribbean Connection. All quotations in this article are taken from the film unless indicated otherwise. Archiving and further work on materials gathered as part of this project is ongoing on KLTV’s webpage.
[4] See for example, Jill Liddington, ‘What is Public History? Publics and their pasts: meanings and practices’, Oral History, 30,1 (2002), 89-90.
[5] Helen Sweet and Sue Hawkins, Colonial Caring: A history of colonial and post-colonial nursing (Manchester: Manchester University Press, 2015).
[6] Discussions with the Community Archives and Heritage Group (CAHG: https://www.communityarchives.org.uk) are exploring how to develop a dedicated part of KLTV’s existing website to archive aabout:blanknd share its community-related oral histories and archive materials.
[7] See for example public talks, blogs and twitter comments and extensive writings by Stephen Bourne that include Mother Country – Britain’s Black Community on the Home Front 1939-45 (Cheltenham: The History Press, 2010); War to Windrush: Black Women in Britain, 1939–1948 (London: Jacaranda Books, 2018) and Under Fire – Black Britain 1939-45 (Cheltenham: The History Press, 2020); Tom de Castella, ‘Play to ‘keep alive’ memories of pioneering nurses from Caribbean’, Nursing Times, 21 February 2021.
[8] Hester Klopper and Leana Uys, The State of Nursing and Nursing Education in Africa: A Country-By-Country Review (Sigma Theta Tau International, Indianapolis, 2012), 97
[9] ‘Nursing in the Caribbean’, Encyclopedia of African-American Culture and History. Available at: www.encyclopedia.com/history/encyclopedias-almanacs-transcripts-and-maps/nursing-caribbean, [Accessed on 13 January 2021]. ]
[10] Rhoda Reddock, Women, Labour and Politics in Trinidad and Tobago: a history (Kingston, Jamaica: Ian Randle, 1994), 62. See also, ‘Nursing in the Caribbean’, Encyclopedia of African-American Culture and History. Available at: www.encyclopedia.com/history/encyclopedias-almanacs-transcripts-and-maps/nursing-caribbean [Accessed 17 June 2021].
[11] See for instance: Sue Hawkins, Nursing and Women’s Labour in the Nineteenth Century (Abingdon: Routledge, 2010), Chapter 2, 35-72.
[12] Montaz Marché, ‘African Princess in Guy’s: The story of Princess Adenrele Ademola,’ 13 May 2020, https://blog.nationalarchives.gov.uk/african-princess-in-guys-the-story-of-princess-adenrele-ademola/.[Accessed 14 May 2021].
[13] Montaz Marché, ‘African Princess in Guy’s.’
[14] For wider consideration of wartime contributions, see Stephen Bourne, War to Windrush – Black Women in Britain 1939-1948 (London: Jacaranda Books, 2018) and Black Poppies – Britain’s Black Community and the Great War (Cheltenham: The History Press, 2014).
[15] Sioban Nelson, ‘Nursing experts, hygienic modernity, and nation building: the case of nursing in Ethiopia in the post-colonial era’, Canadian Bulletin Medical History 38 (2021), 63-92. Available at https://pubmed.ncbi.nlm.nih.gov/33831314/ [Accessed 7 June 2021].
[16] See also, National Heritage Lottery Fund, A Hidden History: African women and the British Health Service, 1930-2000. Available at: https://www.younghistoriansproject.org/african-women-and-the-health-service. [Accessed 20 June 2021]. A post by Olivia Mason includes an image of Princess Tsahai at Great Ormond Street Hospital, 1936. Available at: https://womenshistorynetwork.org/a-hidden-history-african-women-and-the-british-health-service-1930-2000-by-olivia-mason/.[Accessed 20 June 2021].
[17] Robin McKown, Heroic Nurses (New York: Putnam, 1966).
[18] Jane Cummings and Laura Serrant, ‘BME nurses and midwives instrumental in helping shape the NHS of today,’ NHS Blog, 30 May 2018. Available at: https://www.england.nhs.uk/. [Accessed 10 September 2020].
[19] Kwaku, Dzagbele Matilda Asante – I Was Nursing In the UK before Windrush and the NHS, 30 Sep 2020, Available at: https://www.blackhistorymonth.org.uk/article/section/bhm-firsts/dzagbele-matilda-asante-i-was-nursing-in-the-uk-before-windrush-and-the-nhs/.[Accessed on 20 June2021].
[20] Elizabeth N Anionwu, Mixed Blessings from a Cambridge Union (London: ELIZAN, 2016).
[21] See for example Jeffrey Green, Black Edwardians. Black People in Britain 1901-1914 (London; Frank Cass, 1998).
[22] This article highlights many materials in the public domain, including many materials available online and in printed form. There is no attempt to claim originality for the historical materials reproduced here. Their inclusion is part of a wider argument for better understanding of historical experiences that have gained visibility in an array of publications, blogs, websites, oral history projects and arts initiatives.
[23] Annie Brewster, The London Hospital’s ‘Nurse Ophthalmic’, Available at: https://eastendwomensmuseum.org/blog/annie-brewster-the-london-hospitals-nurse-ophthalmic [Accessed on 7 June 2021]. A biography of Annie Brewster has been published in Oxford Dictionary of National Biography recently (April 2021) and is reproduced elsewhere in this issue of the Bulletin. Stephen Bourne, ‘Brewster, Annie Catherine, (1858–1902)’ Oxford Dictionary of National Biography, https://doi.org/10.1093/odnb/9780198614128.013.90000380676. Published online: 08 April 2021
[24] Steve Ford, ‘RCN to launch exhibition to mark centenary of nursing registration,’ Nursing Times, 14 October 2019. Available at: https://www.nursingtimes.net/news/centenary-of-the-register/rcn-to-launch-exhibition-to-mark-centenary-of-nursing-registration-14-10-2019/ [Accessed 20 June 2021].
[25] Stephen Bourne, War to Windrush.
[26] For details of the lives of these four Black doctors, see for instance: J.P. Green, ‘Jeffrey Green, John Alcindor and James Jackson Brown – Afro-Caribbean doctors in London 1899-1953’, Journal of Caribbean History, 20 (1985), pp 49-77; ‘African stories in Hull and East Yorkshire: Dr Harold Moody, physician and activist (1882-1947)’. Available at: https://www.africansinyorkshireproject.com/dr-harold-moody.html [Accessed 8 August 2020]; see also ‘League of Coloured Peoples’, Open University Making Britain Unit. Available at: https://www.open.ac.uk/researchprojects/makingbritain/content/league-coloured-peoples. [Accessed on 20 June 2021]; Phil Gregory, ‘Black people in health care’, Black Presence in Britain, 4 July 2011. Available at https://blackpresence.co.uk/black-healthcare-workers/. [Accessed 8 August 2020].
[27] Jeffrey Green, ‘034 034: Dr J. J. Brown of Hackney (1882-1953)’, Available at: https://jeffreygreen.co.uk/034-dr-j-j-brown-of-hackney-1882-1953/ [Accessed on 20 June 2021].
[28] ‘African stories in Hull and East Yorkshire: Dr Harold Moody, physician and activist’.
[29] Nicholas Boston, ‘My Mother’s NHS story, 1946 to now’, British Future, https://www.britishfuture.org/mothers-nhs-story-1946-now/. [Accessed 7 June 2021].
[30] BME trailblazers in the NHS – Daphne Steele NHS. Available at: https://issuu.com/wordsbyangela/docs/bme-trailblazers-in-the-nhs-daphne- [Accessed on 7 Oct 2020].
[31] The Retired Caribbean Nurses Association (RCNA) has its origins as an oral history project. Available at: RCNA Facebook For details of the Arts Council-funded play-writing collaboration with playwright Yasmin Joseph and virtual reading of First Winter (25 February 2021) involving members of RCNA (Bedford) see, Erica Roffe, ‘Bedford nurses to preserve and perform their story thanks to Arts Council collaboration,’ Bedford Independent, 17 Febrary 2021. Available at: https://www.bedfordindependent.co.uk/bedford-nurses-to-preserve-and-perform-their-story-thanks-to-arts-council-collaboration/ [Accessed 7 June 2021].
[32] ‘Louise Da-Cocodia and the discrimination faced by black nurses in the infant days of the NHS – The 70th anniversary of the Empire Windrush and the NHS,’ Manchester Archive Plus, 22 June 2018. Available at: https://manchesterarchiveplus.wordpress.com/2018/06/22/louise-da-cocodia-and-the-discrimination-faced-by-black-nurses-in-the-infant-days-of-the-nhs-the-70th-anniversary-of-the-empire-windrush-and-the-nhs/ [Accessed 30 Sept 2020].
[33] Sam Hanna, The Burnley School of Nursing (1953), North West Film Archive at Manchester Metropolitan University. Discussed in Heather Norris Nicholson, Amateur Film. Meaning and Practice, 1927-77 (Manchester; Manchester University Press, 2012), 167-69. Permission for film use by KLTV authorised by East Lancashire Hospitals NHS Trust.
[34] Emma L Jones and Stephanie J. Snow, Against the Odds: Black and Minority Ethnic Clinicians and Manchester: 1948 to 2009 (Manchester: Manchester NHS Primary Care Trust in association with the CHSTM, Manchester University, 2010), 10.
[35] Stephanie Snow and Emma Jones, ‘Immigration and the National Health Service: putting history to the forefront,’ History and Policy, 8 March 2011. Available at Immigration and the National Health Service: putting history to the forefront [Accessed on 20 Oct 2020].
[36] Rob Ellis, University of Huddersfield, 23 September 2020. Interviewed by Heather Norris Nicholson.
[37] Hugh Freeman, ‘In conversation with Enoch Powell,’ Psychiatric Bulletin 12 (1988), 402–6. Cited in Geoffrey Rivett, ‘Ch 4, 1958–1967: The renaissance of general practice’ The History of the NHS, (Note 142). Available at: https://www.nuffieldtrust.org.uk/health-and-social-care-explained/the-history-of-the-nhs/. [Accessed on 15 Oct 2020].
[38] Jones and Snow, Against the Odds, 10.
[39] Many nurses who originally came to England to train or work subsequently left to build new lives in Canada. Their experiences are discussed in Karen Flynn’s article, ‘“I’m not your typical nurse”: Caribbean nurses in Britain and Canada’, Women’s History Magazine, 69 (summer 2021), 26-35. This article is reproduced elsewhere in the current issue the UKAHN Bulletin (Vol 9, 2021).
[40] J. Enoch Powell, ‘Address to the National Association of Mental Health Annual Conference,’ 9 March 1961. Cited in Rivett,’ The History of the NHS’, (Note 142). [Accessed on 15 Oct 2020].
[41] Ministry of Health. Report of the Ministry of Health for the year ended 31 December 1954. Cmd 9566. London: HMSO, 1955. Cited in Geoffrey Rivett, The History of the NHS, Ch 4. (Note 213). Available at: https://www.nuffieldtrust.org.uk [Accessed on 15 Oct 2020].
[42] Authors in conversation, 5 May 2021.
[43] Marina Lee-Cunin, Daughters of Seacole. A Study of Black Nurses in West Yorkshire (Batley, West Yorkshire: Low Pay Unit, 1989), 22.
[44] Ibid., 58.
[45] Jack Saunders, Kings College London, 5 October, 2020. Interviewed by Heather Norris Nicholson.
[46] Jack Saunders, ‘Emotions, social practices and the changing composition of class, race and gender in the National Health Service, 1970–79: “Lively Discussion Ensued”’, History Workshop Journal, 88 (2019), 204–228. Available at: https://doi.org/10.1093/hwj/dbz023. [Accessed on 21 June 2021].
[47] Marina Lee-Cunin, Daughters of Seacole, 48–50.
[48] Andrew Robinson, ‘50 years ago, nurses marched on Ilkley Moor to demand fair pay – but it ended in tragedy,’ Yorkshire Live, 1 April 2020, Available at https://www.examinerlive.co.uk/news/history/gallery/50-years-ago-nurses-marched-18015483 [Accessed 20 Oct 2020].
[49] Marina Lee-Cunin, Daughters of Seacole, 59. See also: Lionel Murray, ‘Why we must be united against racialism,’ Race Relations at Work. Special bulletin produced for the TUC Conference on Race Relations, 17 July 1979. Modern Records Centre, University of Warwick. Available at: https://warwick.ac.uk/services/library/mrc/archives_online/exhibitions/tuc150/1979_292-pub-4-3-155-2.jpg [Accessed on 25 Oct 2020].
