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PUBLIC RECORD OFFICE
RECORDS INFORMATION Leaflet No: 113
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[Note: this and all other PRO Records Information leaflets are (c)
Crown Copyright, but may be freely reproduced except for sale or
advertising purposes. Copies should always include this Copyright
notice -- please respect this.] (C) Crown Copyright, June 1990
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CIVILIAN NURSES AND NURSING SERVICES: RECORD
SOURCES IN THE PUBLIC RECORD OFFICE
[[CIVILIAN NURSING: H[STORY]]
Prior to the Nurses Act of 1919, there was no central registration of
civilian nurses. In the first half of the 19th century a variety of
charitable and philanthropic movements committed to the care of the sick
had been established in Britain. The Nightingale Fund, set up as a result
of the Crimean War, enabled the Nightingale Training School to be opened
in 1860. Training was to be for one year, with two tiers of entry: the
ordinary "probationer" who received free training, and the "lady-pupil" who
paid for her training. This division in the method of entry was further
emphasised by the tendency for many of the lady-pupils to take up posts as
matrons. This made the profession "respectable", and encouraged single
women from the middle-class to apply for training.
By the end of the 19th century most of the larger, voluntary hospitals had
their own nurse training schools. In contrast, the workhouse infirmaries
largely relied upon the older, mainly female, pauper inmates to act as
unpaid nurses. It was difficult to attract paid, trained nurses as the pay
and conditions of work were unfavourable in comparison to the voluntary
hospitals. Experiments were tried in Liverpool and London of introducing
paid and unpaid nurses into infirmaries, which were eventually successful.
The Metropolitan Act 1867, following the public scandal of the death of a
pauper named Timothy Daly in Holborn Workhouse, established separate
institutions for the insane and the infectious sick. For the non-infectious
sick some of the smaller unions were grouped together to form sick asylum
districts. Larger unions were encouraged to provide separate infirmaries.
Outside London, the Local Government Board advised Boards of Guardians to
employ sufficient experienced paid nurses. Some of the larger infirmaries
established their own nurse training schools. But the situation varied
greatly between unions and pauper nurses continued to play a large part in
the nursing services provided.
As the demand for skilled nurses increased during the century, competition
increased between the different sectors to attract and retain nurses. One
of the biggest drains on the pool of trained nurses were the "private" or
domestic nursing agencies who provided nurses for the care of the well-to-
do in their own homes.
[[The State Registration Movement]]
The lady-pupils, who saw a threat to their professional standing, sought
to press for a set probationary period and rigorous training. The British
Nurses' Association (BNA) was formed to campaign for state registration.
Undesirable recruits were to be kept out by educational and financial
barriers. Opposition to these views was led by the voluntary hospitals, who
opposed any limitations to recruitment, both the Hospitals' Association and
the BNA opened registers of trained nurses. The difference lay in the
training standards required for entry. The Hospitals' Association thought
one year sufficient, but the BNA insisted on three years, after the initial
intake of nurses in 1889 who produced "satisfactory evidence of
professional attainment and personal character and of having been engaged
three years in nursing". The House of Lords Select Committee on
Metropolitan Hospitals adopted the BNA's recommendations on the length of
training required and in 1892 a Local Government Board order officially
laid down three years training as necessary for superintendent nurses in
workhouses. The BNA applied for a Royal charter which was granted following
a Privy Council enquiry in 1893. A significant amendment was the
substitution of "list" for "register", which made the exercise non-
compulsory. The "list" was not as successful as the now RBNA would have
wished. It was not well maintained, references were not always checked and
the numbers enrolling were low.
The Midwives Act 1902, which set up the registration of midwives, was an
important precedent. However, conflict between the different sections of
nursing work meant that all attempts to introduce legislation met with
failure. The use of partially-trained and untrained women as nurses in the
First World War in Voluntary Aid Detachments (VADs) renewed the fears of
the profession and calls for state registration. In 1916 a College of
Nursing to represent the interests of the nurses themselves was formed (as
a registered company). The College maintained its own register, which
excluded male nurses and mental nurses.
The Nurses Act 1919 established the General Nursing Council, with the
responsibility for setting up a register of nurses and for approving
training schools. Initially the register was to consist of 4 parts:
general; male nurses; mental nurses; and sick children's nurses. No
provision was made for the entry of nurses with a lower standard of
training. The early history of the GNC was stormy and controversial.
Difficulties arose over the implementation of all the major aspects of the
Act. In 1925 a select committee was set up to investigate the GNC, and in
1937 the Athlone Committee was established to look at the training,
recruitment and registration of nurses. An interim report in 1939
recommended higher levels of pay, the setting of hours of work and leave
entitlement and a review of the restrictions governing a nurse's life, with
the Government to bear the cost.
In the Second World War, the Nursing Committee of The Committee of Imperial
Defence formed a Civil Nursing Reserve, which was to fulfil similar
functions to the VADs in the First World War, and which created similar
problems.
In 1941 the Ministry of Health guaranteed cash salaries for student nurses
and urged hospitals to pay a minimum wage for nurses and in October 1941
established the Rushcliffe Committee on the Pay of Nurses (for England and
Wales) and the Taylor Committee (for Scotland). Their remit was later
widened to include conditions of work and other groups of nurses, such as
those on the special sections of the Register. At the same time steps were
being taken to recognise the role of the assistant nurse. In 1941 the now
Royal College of Nursing set up a committee to define the role of the
assistant nurse (the Horder Committee). Its recommendations were largely
implemented in the 1943 Nurses Act which established the Roll of Assistant
Nurses, with a two year training requirement. The GNC was given
responsibility for the Roll. The Act also introduced control and regulation
of nursing co-operatives and supply agencies .
The National Health Service was established on 5 July 1948. Regional
Hospital Boards (RHBs) were made responsible for the planning of hospital
services, but teaching hospitals were to have their own Board of Governors,
directly responsible to the Minister. The Rushcliffe and Guthries
(successor to the Taylor) Committees were replaced by a Nurses and Midwives
Whitley Council for Great Britain.
In 1946, as part of the planning for the NHS, the Ministry of Health
established the Wood Committee to examine the function of, recruitment of
and requirements for, nurses. The 1949 Nurses Act incorporated some of the
recommendations of the Committee: the constitution of the GNC was amended;
standing Nurse Training Committees were set up for each Regional Hospital
Board; the general and male nurse parts of the Register were amalgamated
and the other supplementary parts closed; and the "list" of nurses created
under the 1943 Act was reopened to admit those who had been prevented by
the war from applying at the time.
In 1970 the Committee on Nursing (Briggs Committee) was set up to review
the training of nurses and midwives, which led, in 1976, to the formation
of the Briggs Co-ordinating Committee to formulate a new statutory
framework for nursing education. The work of this committee led to the
Nurses, Midwives and Health Visitors Act 1979 which dissolved all statutory
and non-statutory training bodies, including the GNC and Central Midwives
Board. They were replaced by the United Kingdom Central Council for
Nursing, Midwifery and Health Visiting, with National Boards for England
and Wales.
[[CIVILIAN NURSES: RECORD SOURCES]]
The PRO holds few records relating to individual civilian nurses, in the
19th century. MH 9, Registers of Paid Staff, contains some registers of
workhouse medical staff which sometimes include the names of paid nurses.
Appointments of matrons and nurses may also be found among the
correspondence and papers in MH 12, Poor Law Unions and Local Authorities,
which are arranged by union within each county, eg MH 12/8469 includes the
certificate of appointment of Louisa Brown as a nurse in Lodden and
Clavering Union, Norfolk, April 1888.
As nurse training schools were largely attached to the major voluntary
hospitals, the records of these hospitals may contain details of nurses.
Hospital records have either been deposited in local record offices or
retained by the hospitals themselves eg St Bartholomew's Hospital by
London. The records of the Nightingale Training School are held by the
Greater London Record Office, 40 Northampton Road, London EC4. For advice
on the whereabouts of hospital records contact:
Wellcome Institute for the History of Medicine
183 Euston Road
LONDON
NW1 2BP
or: National Register of Archives
Quality House
Quality Court
Chancery Lane
LONDON WC2
The records of the General Nursing Council and the Central Midwives Board
have been deposited in the Public Record Office and are held under letter
codes DT and DV respectively.
DT 10 contains the bound volumes of the Register of Nurses (SRNs) 1921-
1973. Although the Register was opened in 1921 it includes details of
nurses who had qualified previous to this. Printed nominal indexes are held
under references DT 10/1-56. DT 10 also contains the "List" of nurses which
was opened under the 1943 Nurses Act to allow those who had failed to
register under the provisions of the 1919 Act to do so (DT 10/201). The
Roll of Nurses (SENs) which was opened in 1944 is held in record class DT
11. Both male and female assistant nurses, as they were called then,
are included on the same Roll, but assistant nurses who worked in mental
hospitals were not deemed to be eligible for inclusion. The change in the
name to State Enrolled Nurse took place in 1961. In 1962 the Roll of Mental
Nurses was established. The covering dates for DT 11 are 1944 to 1973 and
printed nominal indexes are also included (DT 11/1-9).
Both the Register and the Roll contain information of use to the family
historian and both are open without restriction. The type of information
given includes: full name, qualifications, where the individual trained,
and home address. Any alterations to this information may also be recorded,
such as change of name upon marriage, change of address, date of death and
any removals from the Register of Roll on disciplinary or other grounds.
After 1973 the Register and Roll were held on computer. A print of the
names of all the nurses still on the Register and Roll as at 30 June 1983
is held in DT 12. It does not include the "List" of nurses, nor those who:
a) were known to be dead
b) had been removed on disciplinary grounds but who might be
restored later
c) had failed to pay a consolidated retention fee, but might be
included later
d) were enrolled by virtue of having passed the final practical
examination for registration (known as enrolment by direct entry)
or who were later registered but had allowed enrolment to lapse.
This occurred from 1969 onwards.
Apart from DT 12/26-27, a printout of the names of deceased nurses, the
class is open without restriction.
The Midwives Roll has ben allocated the class reference DV 7 but has not
yet been transferred to the PRO. Penal case files relating to individual
midwives are in DV 5 but are subject to a period of extended closure of 75
years.
[[District Nurses: History and Records]]
Training of district nurses was carried out by voluntary organisations, the
chief among them being Queen Victoria's Jubilee Institute for Nurses, which
was granted a Royal charter to become the Queen's Institute of District
Nursing (reference HO 45/12900). Its functions were to train district
nursing associations and to supervise the county and district nursing
associations. Record class PRO 30/63 contains a selection of records in
respect of these functions, but mainly those in connection with the
associations: documents of association and annual reports made by the
Institute's inspectors. The records of the associations are largely held
in local record offices. The Institute holds its own records and those of
its predecessors, with covering dates 1840-1971. These records include
various registers of candidates and probationers, 1891-1969; QNI badge
registers 1907-1945; and registers of the Protestant Sisters of Charity,
one of the early groups interested in the care and cure of the sick,
founded in 1840 by Elizabeth Fry as the "Institution for Nursing Sisters".
Enquiries concerning these records should be sent to the Director, Queen's
Institute of District Nursing, 57 Lower Belgrave Street, London SW1.
In 1957 the Advisory Committee on the Training of District Nurses, Panel
of Assessors was appointed to draw up a national training syllabus, to
approve training establishments and to conduct national examinations.
Papers on the creation and disbandment of the Committee in 1960 are in MH
55/259-2596. A permanent Panel of Assessors was set up in 1959. It also
maintained a register of district nurses and a roll of district nurse
tutors. The Panel was replaced in 1983 by the District Nursing Joint
Committee, a statutory committee of the UKCC. Minutes of meeting and papers
of the Panel and its committees, sub-committees and working parties are
held in record class BN 63. Some material on district nursing associations
is also held under LAB 23/49-52
[[Colonial Nurses]]
Confirmation of the qualification of colonial nurses may be found in the
government gazettes of the respective country eg those for Palestine for
1942 will be found under CO 742/19. Policy material will be found in the
relevant country class of original correspondence.
[[CIVILIAN NURSES: POLICY AND ADMINISTRATION: RECORD SOURCES]]
In the 20th century, the two major record sources are the records of the
General Nursing Council for England and Wales (DT group) and the Ministry
of Health (MH group).
The records of the GNC have been organised in the following record classes:
constitutional and related matters such as uniform and badges (DT 1-4);
minutes and papers of the Council and its committees (DT 5-9 and DT 48);
registration, including Register and Roll (DT 10-14); records of the
Registrar (DT 15-21); examinations (DT 22-32); education (DT 33-38);
personnel (DT 39); solicitor (DT 40); research unit (DT 41); data
processing (DT 42); reciprocal arrangements overseas (DT 43); general
administration (DT 44); and finance (DT 45-47).
The main class of Ministry of Health records is MH 55 Public Health
Services. It contains general subject files relating to the administration
of public health services. Although there is some earlier material, most
of the records date from 1919. There is a subject index to the descriptive
list which includes such topics as nursing, the GNC and other nursing
bodies, and midwifery. Welsh Board of Health registered files are in MH 96.
Other record classes that may contain useful material are:
i) MH 12 Poor Law Unions and Local Authorities: correspondence
ii) MH 17 Asylum Districts 1845-1930. Correspondence with the boards
of management of Sick Asylum Districts in London, the
Metropolitan Asylum Board and other authorities.
iii) MH 48 Public Health and Poor Law Services, Local Authority
Correspondence, Series I, 1868-1935.
iv) MH 58 General Health Questions. Also includes references to
voluntary hospitals and professional registration.
v) MH 71 Various Committees, 1916-1958. This includes minutes
and papers of the Interdepartmental Committee on Nurses and
Nursing, 1935-1939 (Ministries of Health and Education).
vi) MH 76 Emergency Medical Services 1935-1970.
vii) MH 77 National Health Service: Post War Planning and National
Health Service Act 1946, 1935-1968.
viii) MH 80 Bill Papers 1885-1953.
The records of the Ministry of Labour also contain valuable material on the
policy and administration of the nursing profession. LAB 8, Employment,
includes papers on most aspects of the employment of nurses and midwives,
including the minutes and papers of the National Advisory Council for the
recruitment and distribution of nurses and midwives. LAB 26, Welfare
Department, contains some files on the conditions of service of nurses and
on Rest Break Homes for nurses and midwives. Some statistics on the
employment and wastage of nurses will be found in LAB 17 Statistics. LAB
19, Youth Employment, also contains material on nursing recruitment and
hospital cadet schemes.
Records relating to publicity for nursing recruitment for both civilian and
military nurses will be found in various Ministry of Information record
classes. Recruitment posters are in INF 13.
The Board of Trade file relating to the College of Nursing Limited
(registered number 143404) is held under reference BT 31/23218/143404.
Papers on the charter of incorporation and supplementary charter of the
British Red Cross Society, 1908-1947, are in HO 45/20838.
In addition, the published Sessional Papers of the House of Commons and the
House of Lords contain valuable reports and papers relating to the history
of the nursing profession and its progress towards state registration.
Although a few of Florence Nightingale's letters are to be found among War
Office records, the majority of her papers are held elsewhere. Two major
collections are held by the British Library and the Greater London Record
Office.
[[Further Reading]]
Brian Abel-Smith <> (Heinemann, 1960
and 1975)
Eve R D Bendall & Elizabeth Raybould <> (London, 1969)
Peta Allan & Moya Jolley (ed) <> (Faber and Faber, 1982)
Mary Stocks <> (George Allan & Unwin,
1960)
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