What the UK’s NHS owes it black staff

Britain’s famed National Health Service celebrated its 70th anniversary last year. The bedrock of the institution has always been black nurses and medical staff but their contribution has not yet received the recognition it deserves. By Clayton Goodwin

In a year of significant anniversaries – for which I cannot recall another like it – one has stood out above all others. Seventy years ago on 5 July 1948, Aneurin Bevan, Minister of Health in the reforming administration of Clement Attlee, launched the National Health Service. Such was its importance that it has framed our lives ever since. The NHS was founded to meet the needs of everyone, to be free at the point of delivery, and to be based on clinical need rather than the ability to pay.

It is the pride of all Britons, whatever their age, class, religion or ethnic heritage, which politicians may threaten to disband only at their peril, and it would not have been possible without the considerable contribution of African / West Indian doctors, nurses and auxiliary staff.

Its establishment was a huge task requiring a labour force that was exceptional in both quantity and quality, for which the UK government launched a vigorous recruitment drive in its then colonies.

As well as men answering a similar call in the transport, construction and motor-building sectors, women and girls made their way to Britain, often meeting their own travel and accommodation costs, to take up a career in nursing. Even when immigration from the Commonwealth was restricted severely from 1962, the then minister of health, Enoch Powell, made a special plea for trainee nurses to still be admitted.

Nursing had not always enjoyed a good reputation, despite the high honour accorded now to Jamaican pioneer Mary Seacole and Florence Nightingale. Those attending the wounded and dying in the imperial/continental wars, being drawn from the most deprived social orders, were looked upon as being little more than drunks, sluts and thieves.

It was probably the only way they could endure the horrific sights and conditions. That attitude started to change when middle-class and even aristocratic women volunteered to serve on the wards in WW1.

Yet it took the arrival of the Africans/West Indians to raise the profession to the high respect it enjoys today. Sadly, they did not always receive a ready welcome from the people they had come to help. The older generation, particularly, doubted that black nurses could achieve the standards and qualifications of their white counterparts, and they resented having to rely on the care of people whom they thought of as their inferiors.

Trust and empathy

From the outset, the newcomers generated trust and empathy at a personal level. Even the year before the NHS came into being, my (white) grandparents visited their youngest daughter who had undergone a serious operation at Guy’s Hospital in London.

They lived in a remote, rural area and I doubt if until then they had had any dealings with black people.

Nevertheless, they were immediately impressed by the character and competence of the Nigerian nurse (‘Tunde’) who cared for my aunt.

So much so that, thereafter, they always held a positive opinion of people of African heritage, and many years later they welcomed my Jamaican wife-to-be without reservation and dubbed her ‘Tunde’ in appreciation of the nurse they had known.

That experience was far from being unique. The respect held by African/West Indies nurses has been a major factor in the immortalisation of nursing staff as ‘angels’ in long-running television series such as Angels, itself, Casualty, Holby City and Call The Midwife.

Not a level playing field

Today black nurses no longer have to settle for a career in the lower reaches of their calling. In August 2018 Professor Dame Donna Kinnair, herself of African heritage, was appointed Acting Chief Executive and General Secretary of the Royal College of Nursing. She has held too many senior roles in the profession for all to be cited here, and gained the attention of the general public by advising the Prime Minister’s Commission on the future of Nursing and Midwifery, and by serving as nurse/child health assessor in the Victoria Climbié Inquiry*.

Dame Donna is aware that there is still much more to be done. She has said: “Equality is a problem for everyone in the health service. When there is racial inequality in the workplace, patient care suffers – and that is not acceptable”.

Referring to black doctors and nurses being paid on average considerably less than their white colleagues, Dame Donna observed:  “I’ve spent a lifetime on the NHS frontline, and overcame these barriers and prejudices to reach the top of my profession. But I’ve never known why I was the lucky one, while others I worked with couldn’t advance.”

She added that while a quarter of NHS nurses are from black/ ethnic minority backgrounds, only 7% have become directors of nursing or hold senior positions; and that they are also more likely to experience bullying, harrassment and discrimination from their colleagues, in a range of ways. “This cannot go on… ensuring diversity on interview boards, and building understanding that different voices and different backgrounds are needed at senior level, can go some way to creating a level playing field,” she commented.

The struggle of the African/Caribbean population for local recognition, which has been led for decades by a few individuals, is at last attaining due recognition in communities throughout the country. Recently I was privileged to attend an evening of West Indian awards held in the Civic Centre, no less, and attended by leading representatives of the county at Gravesend, a regional town near where I grew up. The organiser was Michelle Bramble – her mother Claudette is a Justice of the Peace – whose family, coming from some of the smaller Caribbean islands, have been synonymous with the black community there for several generations. The outstanding award for excellence was given – to a standing ovation from the capacity crowd – to former nurse Urcilla Camella Sullivan, who arrived from Trinidad in 1954.

Urcilla acknowledged both the pain and fulfilment which she, and many others like her, have experienced. “At first it was terrible working in the hospital wards. White patients didn’t want me to touch them as they thought my black skin colour would rub off onto them.

“There was ignorance and prejudice towards Caribbean nurses. What helped was the team spirit, the unexpected people, lots of laughter, helping each other and most of all, job satisfaction. There was lots of job satisfaction in nursing… It was great seeing very ill people getting fit and going home. I qualified as a State Enrolled Nurse in 1959 and a State Registered Nurse in 1962. Becoming a Sister was a great moment for me. As a midwife I saw the beginning of life and the experience of happiness. I appreciated the joy, the love, the life and also the sadness.”

The image of the African nurse has become so iconic that it is often criticised as being too stereotypical, obscuring the fact that Africans / West Indians have achieved excellence in many other fields.

Yet if a single icon were to be chosen to represent the Commonwealth presence it would be difficult to find one more worthy to treasure than that of a nurse – the bedrock of the institution which the United Kingdom, itself, treasures most. 

*The case of Victoria Climbié, an eight-year-old born in Côte d’Ivoire, who was tortured by her great-aunt and her boyfriend in 2000, raised controversy because of the local authority’s perceived incompetence in protecting her welfare.