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Published online by Cambridge University Press: 26 January 2021
Nurses and their labor are essential to the provision of health care. Nowhere was this more apparent than in the flagship institution of postwar British welfare, the National Health Service. When it launched in 1948, a shortage of thirty-five thousand nurses endangered its future. This article examines the National Health Service's nursing shortage and its most enduring solution: the recruitment of Caribbean and African nursing staff for struggling British hospitals. It follows the manner in which British civil servants, hospital administrators, and nursing leaders came to recruit nurses from the colonies and the deep ambivalence that marked their project. What began as a reformulated colonial development project gave rise to a sprawling and unregulated market for nursing labor that powered the National Health Service for decades. The so-called dark stranger, deemed unworthy of membership in the national community, in fact carried out its most intimate work—caring for the bodies of sick white citizens.
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11 The National Archives [hereafter TNA], MH 55/2528, Summary of Hospital Survey Returns, 1961.
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21 “200 African Women Want to Be Scunthorpe Nurses,” Yorkshire Post, 12 October 1948.
22 Melosh, “Physician's Hand,” 24.
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30 Abel-Smith, History of the Nursing Profession,143–45.
31 Dingwall, Rafferty, and Webster, Social History of Nursing, 103.
32 “A New Era for Nurses,” Derbyshire Advocate, 22 October 1948.
33 “Too Few Nurses: Hospitals Have to Keep Beds Empty,” Nottinghamshire Guardian, 31 July 1948.
34 “Serious Shortage of Nurses,” Lincolnshire Standard and Boston Guardian, 4 August 1945.
35 “Lincoln Needs Nurses,” Nursing Times, no. 6 (1947): 116.
36 “Nursing Puzzle,” Star (London), 20 November 1946; “60 Patients—1 Nurse,” Nursing Times, no. 3 (1947): 38.
37 “Problems Facing Mental Hospitals,” British Journal of Nursing, no. 97 (1949): 7.
38 TNA, MH 55/2157, M. A. Bevan to C. G. Costley-White, 9 November 1948.
39 “British Nurses Wanted by Australia,” Manchester Guardian, 4 June 1946; “Australia Wants British Nurses,” Yorkshire Post and Leeds Intelligencer, 4 June 1946; “N. S. W. Priority for British Nurses,” Times (London), 25 February 1947; “Allotment of Berths for English Nurses,” Brisbane Telegraph, 24 February 1947.
40 TNA, MH 55/2157, Muriel Edwards to J. H. Dodds, 27 February 1947.
41 Abel-Smith, History of the Nursing Profession, 148.
42 “At the Ministry of Labour,” Nursing Times, no. 41 (1948): 738.
43 Rosemary White, The Effects of the NHS on the Nursing Profession, 1948–61 (London, 1985), 24–25.
44 Abel-Smith, History of the Nursing Profession, 185; Dingwall, Rafferty, and Webster, Social History of Nursing, 118; White, Effects of the NHS, 25.
45 Emily MacManus, “The Working Party Report: A Critical Survey,” Nursing Times, no. 46 (1947): 834–39, at 839.
46 Abel-Smith, History of the Nursing Profession, 269.
47 TNA, LAB 12/336, Recruitment of Nurses from Eire: Survey of Present Position, 1 July 1946. On nurse recruitment in Ireland, see Nicola Yeates, “A Dialogue with ‘Global Care Chain’ Analysis: Nurse Migration in the Irish Context,” Feminist Review 77, no. 77 (2004): 79–95; Louise Ryan, “Who Do You Think You Are? Irish Nurses Encountering Ethnicity and Constructing Identity in Britain,” Ethnic and Racial Studies 30, no. 3 (2007): 416–438. On postwar Irish migration in general, see Enda Delaney, Demography, State and Society: Irish Migration to Britain, 1921–1971 (Liverpool, 2000).
48 TNA, LAB 8/1385, P. Goldberg to J. Jackson, 2 December 1946. On the development of this scheme, see Diana Kay and Robert Miles, Refugees or Migrant Workers? European Volunteer Workers in Britain, 1946–1951 (London, 1992), 42–50.
49 Kay and Miles, Refugees or Migrant Workers?, 61.
50 For the Dutch government, see TNA, MH 55/1969, F. Bliss to Mr. Gedling, 9 Oct 1948; for the Dutch nurses’ association, see TNA, MH 55/1969, Daisy Bridges to Elizabeth Cockayne, 20 August 1948.
51 TNA, MH 55/1969, Daisy Bridges to Elizabeth Cockayne, 21 February 1949.
52 “200 African Women Want to Be Scunthorpe Nurses.”
53 Zig Layton-Henry, The Politics of Immigration: Immigration, “Race” and “Race” Relations in Post-war Britain (Oxford, 1992), 13.
54 British Nationality Act, 1948, 11 & 12 Geo. 6 c. 56.
55 Bivins, Contagious Communities, 12–13.
56 Tony Kushner, The Battle of Britishness: Migrant Journeys, 1685 to the Present (Manchester, 2012), chap. 7.
57 Nicholas Deakin, “The British Nationality Act of 1948: A Brief Study in the Political Mythology of Race Relations,” Race 11, no. 1 (1969): 77–83, at 82; Randall Hansen, “The Politics of Citizenship in 1940s Britain: The British Nationality Act,” Twentieth Century British History 10, no. 1 (1999): 67–95, at 73; Kathleen Paul, “‘British Subjects’ and ‘British Stock’: Labour's Postwar Imperialism,” Journal of British Studies 34, no. 2 (1995): 233–76, at 243.
58 Layton-Henry, Politics of Immigration, 12; Perry, London Is the Place for Me, 67.
59 Paul, Whitewashing Britain, 129–30.
60 On continuities and ruptures in British development policy, see Stephen Constantine, The Making of British Colonial Development Policy, 1914–1940 (London, 1984); Michael Havinden and David Meredith, Colonialism and Development: Britain and Its Tropical Colonies, 1850–1960 (London, 1993); Monica M. Van Beusekom and Dorothy L. Hodgson, “Lessons Learned? Development Experiences in the Late Colonial Period,” Journal of African History 41, no. 1 (2000): 20–33; Cooper, “Reconstructing Empire in British and French Africa”; Brittany J. Merritt, “Developing Little England: Public Health, Popular Protest, and Colonial Policy in Barbados, 1918–1940” (PhD diss., University of South Florida, 2016), chaps. 6–7.
61 Constantine, Colonial Development Policy, 229; Cooper, “Reconstructing Empire in British and French Africa,” 198.
62 Constantine, Colonial Development Policy, 225; Merritt, “Developing Little England,” 240–45.
63 Havinden and Meredith, Colonialism and Development, 22; Sabine Clarke, “A Technocratic Imperial State? The Colonial Office and Scientific Research, 1940–1960,” Twentieth Century British History 18, no. 4 (2007): 453–80, at 462; Merritt, “Developing Little England,” 241.
64 In this it lagged behind the International Health Division of the Rockefeller Foundation, which underwrote colonial nursing schools as well as an influential public health nursing program at the University of Toronto. See John Farley, To Cast Out Disease: A History of the International Health Division of the Rockefeller Foundation (1913–1951) (Oxford, 2004), 209–16; Catherine Ceniza Choy, Empire of Care: Nursing and Migration in Filipino American History (Durham, 2003), chaps. 1–2; Rosemary Wall and Anne Marie Rafferty, “Trouble with ‘Status’: Competing Models of British and North American Public Health Nursing Education and Practice in British Malaya,” in Translating the Body: Medical Education in Southeast Asia, ed. Hans Pols, C. Michele Thompson, and John Harley Warner (Singapore, 2017), 67–94.
65 Anne Marie Rafferty and Diana Solano, “The Rise and Demise of the Colonial Nursing Service: British Nurses in the Colonies, 1896–1966,” Nursing History Review 15, no. 1 (2007): 147–54, at 147. On the dynamics of this “white woman's burden,” see Antoinette Burton, Burdens of History: British Feminists, Indian Women, and Imperial Culture, 1865–1915 (Chapel Hill, 1994), chap. 5.
66 Mabel N. Piggott, untitled memo, July 1896, MSS Brit. Emp. s. 400/120/1, Bodleian Libraries, University of Oxford. On the early trials of Overseas Nursing Association nurses in the “white man's grave,” see Dea Birkett, “The “White Woman's Burden” in the “White Man's Grave”: The Introduction of British Nurses in Colonial West Africa,” in Western Women and Imperialism: Complicity and Resistance, ed. Nupur Chaudhuri and Margaret Strobel (Bloomington, 1992), 177–88.
67 Rafferty and Solano, “Rise and Demise,” 150; Margaret Jones, “Heroines of Lonely Outposts or Tools of the Empire? British Nurses in Britain's Model Colony: Ceylon, 1878–1948,” Nursing Inquiry 11, no. 3 (2004): 148–60, at 157–59. On the mixed legacy of British nurses in the colonies, see Jones, “Heroines of Lonely Outposts”; Rafferty and Solano, “Rise and Demise”; Diana Solano and Anne Marie Rafferty, “Can Lessons Be Learned from History? The Origins of the British Imperial Nurse Labour Market: A Discussion Paper,” International Journal of Nursing Studies 44, no. 6 (2007): 1055–63; Helen Sweet and Sue Hawkins, eds., Colonial Caring: A History of Colonial and Post-colonial Nursing (Manchester, 2018).
68 Malcolm MacDonald, circular dispatch on the Colonial Nursing Service, 20 June 1939, Bodleian MSS Brit. Emp. s. 400/133/4.
69 Sir George Gater to M. Gawan Taylor, 20 September 1943, Bodleian MSS Brit. Emp. s. 400/141/1.
70 Clarke, “Technocratic Imperial State,” 457, 471; Bailkin, Afterlife of Empire, 59.
71 Bertha Howlett to M. Gawan Taylor, 24 February 1947, Bodleian MSS Brit. Emp. s. 400/148/1.
72 Rushcliffe Committee on Nursing, Report of the Committee on the Training of Nurses for the Colonies, 1945, Cmnd. 6672, at 3.
73 Bailkin, Afterlife of Empire, 59; Constantine, Colonial Development Policy, 289.
74 “Europe's No. 1 Nurse,” Evening Telegraph, 3 December 1944.
75 On similar “projects of professionalism” in India, a country in which the Overseas Nursing Association had little presence, see Madelaine Healey, “‘Seeds That May Have Been Planted May Take Root’: International Aid Nurses and Projects of Professionalism in Postindependence India, 1947–65,” Nursing History Review 16, no. 1 (2008): 58–90.
76 Rushcliffe Committee, Report on the Training of Nurses for the Colonies, at 15.
77 Denise Dane to M. Gawan Taylor, 16 December 1947, Bodleian MSS Brit. Emp. s. 400/147/1.
78 Meeting minutes, Committee on the Training of Nurses in the Colonies, sub-committee A, 18 May 1944, Bodleian MSS Brit. Emp. s. 400/141/3; Colonial Office circular dispatch, 24 January 1947, Bodleian MSS Brit. Emp. s. 400/133/4.
79 Eva Atkinson to M. Gawan Taylor, 9 September 1944, Bodleian MSS Brit. Emp. s. 400/148/1.
80 Jean Holland to M. Gawan Taylor, 8 April 1947, Bodleian MSS Brit. Emp. s. 400/148/1.
81 Jean Holland to M. Gawan Taylor, 29 August 1947, Bodleian MSS Brit. Emp. s. 400/148/1.
82 Jean Holland to M. Gawan Taylor, 12 November 1947, Bodleian MSS Brit. Emp. s. 400/148/1; “Newly Appointed Matron to Go,” Barbados Advocate, 16 November 1947.
83 M. Gawan Taylor to Jean Holland, 4 March 1948, Bodleian MSS Brit. Emp. s. 400/148/1.
84 TNA, CO 565/15, Vacancies: Nursing Staff, 5 January 1949.
85 Meeting minutes, Committee on the Training of Nurses in the Colonies, sub-committee A, 18 May 1944, Bodleian MSS Brit. Emp. s. 400/141/3.
86 Meeting minutes, Committee on the Training of Nurses in the Colonies, sub-committee B, 13 April 1944, Bodleian MSS Brit. Emp. s. 400/141/3.
87 Meeting minutes, Committee on the Training of Nurses in the Colonies, sub-committee A, 18 May 1944, Bodleian MSS Brit. Emp. s. 400/141/3.
88 Meeting minutes, Committee on the Training of Nurses in the Colonies, sub-committee B, 13 April 1944, Bodleian MSS Brit. Emp. s. 400/141/3.
89 TNA, MH 55/2787, Florence Udell to Katherine Watt, “Hospitals in England & Wales Which Have Been ‘Unable’ to Accept Colonial Student Nurses,” 23 October 1947.
90 TNA, CO 876/82, Dorothy Bott to Arnold R. Watson, 21 June 1945.
91 TNA, CO 876/82, J. Dobson to Dorothy Bott, 21 June 1945.
92 TNA, CO 876/82, Dorothy Bott to Arnold R. Watson, 29 August 1945.
93 “Partnership Not Prejudice,” editorial, Nursing Times, no. 48 (1948): 863–64, at 863.
94 TNA, MH 55/2787, Florence Udell, internal minute, undated.
95 TNA, LAB 8/968, National Advisory Council on Nurses and Midwives, circular memorandum, “Training of Colonial Student Nurses in the United Kingdom,” 18 May 1948.
96 TNA, CO 876/82, G. W. Cole to J. L. Keith, 26 June 1946.
97 TNA, LAB 8/968, meeting minutes, Joint Committee on Nursing Applications, 7 July 1948.
98 For Odutola, see TNA, LAB 8/968, meeting minutes, Joint Committee on Nursing Applications, 14 August 1945. For Bowen, see TNA, LAB 8/968, meeting minutes, Joint Committee on Nursing Applications, 1 May 1946.
99 TNA, LAB 8/968, meeting minutes, Joint Committee on Nursing Applications, 28 July 1948.
100 TNA, LAB 8/968, meeting minutes, Joint Committee on Nursing Applications, 9 September 1946.
101 TNA, LAB 8/968, meeting minutes, Joint Committee on Nursing Applications, 28 July 1948.
102 TNA, LAB 8/968, meeting minutes, Joint Committee on Nursing Applications, 17 December 1946.
103 TNA, CO 850/252/7, Florence Udell, internal minute, 20 December 1949.
104 TNA, CO 28/339/4, Sir Hilary Blood to Sydney Beckett, 7 July 1948.
105 TNA, MH 55/1474, Betty Arne to F. Reynolds-Brown, 23 August 1949.
106 TNA, CO 565/14, Colonial Development and Welfare: Social Welfare Officer, Appointment Of, 25 February 1943.
107 TNA, MH 55/1474, A. C. M. Gulland to W. J. Thomas, 10 December 1949.
108 TNA, MH 55/1474, Report on the Placement of Women Recruited from Barbados for Hospital Domestic Work, 10 December 1949.
109 TNA, CO 318/478/4, Florence Udell, internal minute, 31 January 1950.
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111 Florence Udell, “Nursing in the Colonies,” Nursing Times, 30 May 1953, 532–33, at 532.
112 TNA, CO 318/478/4, Florence Udell, internal minute, 31 January 1950.
113 TNA, MH 55/2787, Florence Udell, internal minute, undated.
114 TNA, CO 318/478/4, Florence Udell, internal minute, 31 January 1950.
115 On official attitudes towards colonial students, see Bailkin, Afterlife of Empire, chap. 3.
116 Eva Atkinson to M. Gawan Taylor, 2 February 1946, Bodleian MSS Brit. Emp. s. 400/148/1.
117 TNA, CO 850/252/7, Colonial Office Circular Dispatch, 15 July 1950.
118 TNA, CO 876/93, Margaret M. Travers to Vera Chapman, 11 June 1949; “2 New W. I. Sisters Congratulated at G. H. Presentation,” Barbados Advocate, 7 June 1950.
119 Doreen Moorecroft to M. Gawan Taylor, 13 July 1953, Bodleian MSS Brit. Emp. s. 400/149/1.
120 TNA, MH 55/2787, Florence Udell, internal minute, undated.
121 TNA, CO 1028/38, G. W. Jamieson to B. G. Stone, 17 June 1954.
122 TNA, CO 1028/38, Florence Udell to B. G. Stone, 21 June 1954.
123 TNA, CO 1028/38, Florence Udell to B. G. Stone, 21 June 1954.
124 TNA, LAB 8/1804, H. E. Chester to F. Keegan, 5 November 1954.
125 TNA, CO 1028/40, Cyprus response to Colonial Office circular, 7 January 1955.
126 Perry, London Is the Place for Me, 92.
127 Perry, 92–94.
128 Reginald Crook, 9 November 1948, 159 Parl Deb. H.L. (5th ser.) (1948) col. 290; “Colour Bar at a Dance,” Daily Herald, 5 November 1948.
129 TNA, MH 55/2787, Mabel Gordon Lawson to Elizabeth Cockayne, 11 July 1951.
130 TNA, MH 55/2787, Mabel Gordon Lawson to Gladys Martindale, 14 August 1951.
131 “Coloured Nurses Unwelcome,” Yorkshire Post, 18 November 1955.
132 “Hospital Staff United on Foreign Nurses,” Yorkshire Post, 19 November 1955.
133 “Five French Nurses at a Yorkshire Hospital,” Yorkshire Post, 25 July 1953.
134 TNA, MH 55/1969, E. Walsh to G. W. Jamieson, 17 September 1954.
135 Joseph Mallalieu, 14 December 1955, 547 Parl Deb. H.C. (5th ser.) (1955) cols. 1351–52.
136 Joseph Mallalieu, 14 December 1955, 547 Parl Deb. H.C. (5th ser.) (1955) cols. 1351–52.
137 Joseph Mallalieu, 14 December 1955, 547 Parl Deb. H.C. (5th ser.) (1955) cols. 1351–52.
138 McGann, Crowther, and Dougall, A Voice for Nurses, 332.
139 Patricia Hornsby-Smith, 14 December 1955, 547 Parl Deb. H.C. (5th ser.) (1955), cols. 1359–60.
140 Patricia Hornsby-Smith, 14 December 1955, 547 Parl Deb. H.C. (5th ser.) (1955), cols. 1359–60.
141 “Mental Hospital Problems,” Yorkshire Post, 25 November 1955; Mollie Staines, letter to the editor, Yorkshire Post, 25 November 1955; F. W. Sadler, letter to the editor, Yorkshire Post, 18 November 1955.
142 “Hospital Seeks Coloured Nurses,” Birmingham Post, 21 March 1955.
143 Collins, Marcus, “Pride and Prejudice: West Indian Men in Mid-Twentieth Century Britain,” Journal of British Studies 40, no. 3 (2001): 391–418, at 406–12CrossRefGoogle Scholar; Webster, Imagining Home, chap. 5.
144 On this depiction of nursing in the popular press and recruitment literature, see Julia Hallam, Nursing the Image: Media, Culture, and Professional Identity (London, 2000).
145 “Nurses Deny Colour Bar,” Aberdeenshire Evening Express, 2 March 1955.
146 “These Coloured Nurses Are Happy,” Daily Herald (London), 3 March 1955.
147 TNA, LAB 8/1804, D. A. Shortland to H. E. Chester, 14 March 1955.
148 “Mental Nurses in Different Category,” Western Mail and South Wales News, 8 March 1955.
149 Reverby, Ordered to Care, 200.
150 Claire Rayner, “Vocation,” letter to the editor, Nursing Times, 15 August 1958, 963.
151 This story is covered in Perry, London Is the Place for Me, chap. 3.
152 “Racial Prejudice,” News and Comment, Nursing Times, 10 October 1958, 1170–71, at 1170.
153 “Racial Prejudice,” 1171.
154 Bivins, Roberta, “Picturing Race in the British National Health Service, 1948–1988,” Twentieth Century British History 28, no. 1 (2017): 83–109, at 88Google ScholarPubMed.
155 Paul, Whitewashing Britain, 130.
156 TNA, MH 55/2157, Norman Pannell to Enoch Powell, 5 February 1961.
157 “Talking Point,” Nursing Times, 8 August 1958, 927–28, at 928.
158 TNA, MH 55/2789, D. M. O'Brien to B. F. M. Samuel, 10 November 1961.
159 TNA, MH 55/2196, meeting minutes, National Consultative Council on the Recruitment of Nurses and Midwives, 29 June 1960.
160 “Nurses from Overseas,” editorial, Nursing Times, 9 September 1960, 1101.
161 On the development of nursing in the Philippines, see Choy, Empire of Care.
162 Lawson, Nigel, The View from No. 11: Memoirs of a Tory Radical (London, 1992), 613Google Scholar.
163 Kushner, Battle of Britishness, 182.
164 Kline, Roger, The “Snowy White Peaks” of the NHS: A Survey of Discrimination in Governance and Leadership and the Potential Impact of Patient Care in London and England (London, 2014), 3–4Google Scholar, https://www.england.nhs.uk/wp-content/uploads/2014/08/edc7-0514.pdf.
