Rez Rodgers, Vice Chair of the University Hospital Plymouth BAME Network, pens a blog about the influence of overseas workers on the beginnings of the NHS…

The post-war labour minister Aneurin Bevin believed that society should collectively contribute to a healthcare system with equal opportunity and availability to all, and thus the foundation of the Nation Health Service was born in July 1948. However, due to the impact of World War I and II on the British economy, medical professionals were hard to recruit; men returning from the war did not want to fulfil a job requiring long working hours and women, after performing men’s jobs whilst at war, discovered more career opportunities and developments outside of the traditional marriage and domestic roles.
After World War II had left the British economy depleted, the government advertised to 16 of the then Commonwealth and former colonial countries, including Poland, Ireland, Malaysia, India and the Caribbean, to recruit nursing staff. Between 1948-1961, almost half a million people living in England and Wales were born overseas, the majority of which included the Caribbean Islands. Senior nursing staff travelled from Britain to Barbados, Jamaica, Trinidad and Tobago to recruit individuals between the ages of 18-30 years who were willing to commit to a three-year contract. Following the next two decades, steady streams of nurses were recruited to meet the demands of the UK and improved patient health conditions and staffing shortages within the NHS.
Upon arrival in the UK, only a few were met at train stations and taken to their contracted hospital, and many were left to find their own way. The nurses were grouped together in housing blocks next to the hospitals they were placed at, and were often placed with nurses from other Commonwealth countries. As one former nurse reported, “when anyone new came and brought food, the girls got together, sitting on the floor…like a big family…dividing it up between all of us.” This provided a support system and community whilst living away from their loved ones.

Two types of qualifications existed for nursing: the internationally recognised State Registered Nurse (SRN) and the State Enrolled Nurse (SEN) which allowed practice solely in the UK. After achieving and qualifying as a practising nurse, many could not progress higher and would not be promoted at all. Job roles were restricted to areas of the highest need, including psychiatry, geriatrics and hospitals for those terminally ill; overseas nurses were also more likely to be given anti-social hours and night shifts which were poorly staffed. During such shifts, nurses reported having to be wholly in charge of patients with no adjustments made in pay. Moreover, nurses were exposed to many discriminatory attitudes, racial slurs and even violence from patients who would throw their possessions at them; one nurse stated, “we were treated differently…but we didn’t worry because we know what we wanted to achieve and what we had to do and we did it.”
Nursing authorities argued that racial characteristics limited intellectual capabilities and motivational levels to achieve the international nursing qualification, thus many overseas nurses were forced into the state-enrolled nursing qualification which limited their options even further if they wanted to leave the UK.
In the 1960s, health minister Enoch Powell championed overseas recruitment as it provided ‘cheap labour, reduced wastage and undermined the [NHS staffing] shortage argument’ however this simultaneously strengthened his campaign against nurses’ pay claim, thus used the influx of BAME Nurses in 1960s as a weapon against unequal unequal/discriminatory pay.
References
Policy, H., 2020. Immigration And The National Health Service: Putting History To The Forefront. [online] History & Policy. [Online] http://historyandpolicy.org/policy-papers/papers/immigration-and-the-national-health-service-putting-history-to-the-forefron [Accessed on: 28/09/20].
McDowell, L. (2018) How Caribbean migrants helped to rebuild Britain. In British Library. [Online] bl.uk/windrush/articles/how-caribbean-migrants-rebuilt-britain [Accessed on: 28/09/20]
Ali, L. (2018) Caribbean Women and the NHS. In B:M 2020. [Online] blackhistorymonth.org.uk/article/section/windrush-day-2019/Caribbean-women-nhs/ [Accessed on: 28/09/20]