If you’re a British person (and indeed, perhaps, even if you aren’t), you’ll doubtless be familiar with the logo to your left. For my district nursing followers, it’s the logo of your boss, the organisation under which you work. We have all been beneficiaries of the NHS from our birth onwards. It hits the headlines on a regular basis: overmanaged, underfunded, constantly malfunctioning. Yet anyone who followed the struggle President Obama had to get his healthcare bill passed in America couldn’t help but feel proud of one of this country’s greatest achievements. The NHS provides free healthcare for all. We don’t really know how lucky we are.
The NHS was born out the revolutionary social changes inspired by World War Two. Even as the war was happening, the government was pondering how to provide for the British people after it had ended. In 1941, an Inter-departmental committee was appointed to consider ‘social insurance and allied services’. It produced the Beveridge report: the blue print for a welfare state with a comprehensive healthcare system. The public loved the idea. District nurses feelings were mixed. Being still largely upper class ladies, they distrusted the new ‘Socialist government’. They might too have feared for their positions within the NHS – for were they not funded quite happily by private charities and donations? Their customers would go elsewhere if they could get treatment for free.
They need not have worried. One of the fundamental principles of the NHS as it began in 1948 was to provide domiciliary nursing facilities as and when required. The axe had fallen on voluntary district nursing organisations. If people could be cared for in their home, free of charge, there was no longer any need for these bodies. Instead, district nurses were put upon the inevitable path of becoming employees of local authorities. In March 1948 this was agreed upon, veiled by flattering terminology to assuage the Queen Nursing Institute: local authorities would become ‘members’ of the institute, directly employing Queen’s Nurses themselves, whilst still maintaining the systems and training which the Institute had always offered.
In 1946, a working party on nurse training had agreed that it would be better in the future to distinguish between ‘student’ and qualified nurses, to move away from the old methods, ‘training on the job.’ The training of nurses, the government decided, had to be nationalised. Voluntary nursing organisations like the Queen’s Nursing Institute were unhappy about this. They clashed with local authorities about training, preferring their own methods. Nonetheless, the government had a point. In 1955, out of the 9203 district nurses employed by the state, 4032 had been trained by the Queen’s Nursing Institute, 88 by the Ranyard nurses, and another 4000 had no recognized qualifications at all.
This simply had to change – the state couldn’t promise to provide blanket healthcare for everyone, whilst offering nurses with a wide variety of approaches to treat them. In 1959, a nationalised system of nurse training came into place. For the Queen’s Nursing Institute, the heirs of the Rathbone and Lees tradition of district nursing, this was something of a death knell. Their one distinguishing feature – the training they offered, was eclipsed by national training. District nursing had broken free from the shackles of its Victorian past.
District nurses joined the modern age, as part of the NHS.