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Nursing in the 1970’s: 'You are here to do the work, so get on with it'

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A time of great struggle and, consequently, great change for NHS nurses, Adrian O’Dowd looks at the decade’s events and achievements.

The third decade of the NHS was marked by dispute and staff were not afraid to challenge what they felt was wrong with the health service.

A large pay dispute kicked off this decade with the RCN’s Raise the Roof campaign – a highly ambitious call for increases of up to 50% to some existing pay scales. A campaign letter – written and distributed across the UK – asked the public to send it to then health secretary Richard Crossman. An incredible one million letters from the public were sent and car stickers and campaign posters appeared everywhere.

Support was widespread, including that of doctors and teachers, and NT gave its full backing to the campaign. Other observers noted the significance and Hospital World magazine reported that: ‘The campaign is war, make no mistake about that. It is a campaign without precedence in the history of nursing, this sudden, militant upsurge of feeling and action.’

The net result of all this effort was a 22% pay rise. Peter Ardern, nurse historian, says: ‘This was the first significant pay protest for nurses. There had been nothing on this scale before – you wouldn’t have seen nurses marching for a pay rise before.’

The decade’s first big strike was that of 1972, involving 97,000 NHS employees in industrial action. Nurses’ anger again boiled over in 1974, leading to their marching to Downing Street, demonstrating outside parliament and holding a rally in London’s Hyde Park. The call for an independent inquiry into nurses’ pay was answered – headed by Lord Halsbury, the resultant 1974 report led to a pay rise of on average 30%.

Medical progress continued with advances such as increasing use of endoscopies and the development of CT scans. Transplant surgery was also becoming more successful and ICUs were now widespread, as was kidney dialysis.

Worldwide health crises were still very much a reality and in 1969–1970 an influenza pandemic, ‘the Hong Kong flu’, killed around one million people across the globe and 30,000 people in the UK.

From 1968 to 1974, debate raged about how the NHS should be organised and the borders between health and social services were examined. This culminated in 1974’s NHS reorganisation that led to the division of health and social care, as well as creating regional and area health authorities that, for the first time, had responsibility for hospital services and community health services. Dame June Clarke, former RCN president and now professor emeritus of Swansea University, says: ‘People forget that up until 1974, local authorities ran community health services and my employer was a county council. It was a completely different world.’

The issue of nursing students’ status came to the fore in the 1972 Briggs report. The work of Professor Asa Briggs, who was asked to review the education and training required by nurses and midwives, said nurse training was inadequate and basic nursing could only be learnt properly in clinical settings. He proposed a two-tier training course leading to two grades of nurse, a large expansion of training and teaching, and a new statutory body to
take control of the nursing, midwifery and health visiting professions – the first step towards creating a new regulator for nurses (the UKCC) in later years.

Dame June says: ‘I think the key issue was whether nurses should be students or not. Every reform of nursing education was opposed by the matrons, especially the matrons of the big teaching hospitals – because they were afraid of losing their manpower resource.’

Matron was a dying breed during this decade but discipline was still strong in some places according to Val Cornish, who was an enrolled nurse in the 1970s before qualifying in 1979.
‘In the early 1970s, you were not allowed to go home in your uniform. You had a locker and you would put your uniform either in the laundry when you finished with it or put it in the locker.’

Despite this, discipline in hospitals was being relaxed and patients were encouraged to use nurses’ first names. Ward sisters were asked to consider their nursing staff’s requests for time off when planning duty rotas and flexible working patterns were considered in an attempt to build morale and boost recruitment.

Education was changing and the number of nursing schools halved to 200 as part of the NHS reorganisation. Dame June, who qualified in the mid-1960s, was a health visitor for much of the 1970s and was heavily involved in nursing politics, says training in her day was very different but defends today’s nurses.

‘It’s fashionable to say nurses were much better trained and prepared in the good old days than they are today,’ she says. ‘That is absolute rubbish. It’s in the context of what they had to be trained for in the 1970s that was very narrow and limited compared to today.’

Dame June remembers her first day on the ward as part of her training, helping a staff nurse to give drugs
to patients.

‘We got to the fourth bed and I thought to myself, “I am supposed to be here to learn”. So I said to the nurse:

“Can you tell me why we are giving these tablets to this patient and what they will do for him?”

‘I can remember her drawing herself up over her belt and saying: “Nurse, you are not here to ask questions, you are here to do the work, so get on with it.” The attitude was to do what you were told and not to ask questions.’

Mair Fear started as an enrolled nurse in the mid-1970s and became fully qualified in 1980. After a varied career in nursing, she is now a clinical nurse specialist in tissue viability in Plymouth. ‘It was a very changing environment being a nurse in the 1970s,’ she recalls. ‘People were beginning to see nursing not as a vocation but almost as a stepping stone to something else, which I was concerned about.

‘In the South Wales valleys we were very lucky because the miners used to come out on strike for the nurses. They could see that nurses were not in a position to go on strike and if there was a query about our pay, then the miners would threaten a strike on our behalf. There was a lot of unrest because there was a lot of change.’

In 1977 the RCN officially became a trade union – a coincidental sign of the unrest that occurred through much of the NHS’ third decade.

‘We worked hard but we had fun as well – sometimes at sister’s expense’

Nurses had real hands-on training that stood them in great stead for the job, says Gloria Mattison (pictured), who started nursing in 1969, qualified as an enrolled nurse in 1971, then as an RGN in 1990.
‘I have a feeling we were better trained than nurses are now because we had to learn on the job,’ says Ms Mattison, who now works as a practice nurse in east London.

‘Nurses today go to university and do a little bit of work on the wards and they observe and for some, that’s all they will do – observe. They won’t take a bedpan. We had to get on with it.

‘It was a better system of training and made you a more rounded nurse. When we qualified, we had better clinical skills because of the hands-on training.

‘Matron was still a strong figure when I started in nursing. In some ways, they appeared to be dragons, but they weren’t. They were very strict but fair – more like a mother figure. I remember being told off many times for popping to the shops when I wasn’t appropriately dressed.’

Ms Mattison believes that a lot of the basics of nursing practice have remained the same through the years but adds: ‘The healthcare assistants do just about everything now.

‘How nurses are seen has changed over the years. Sister was a manager and treated with more respect than they are now. We worked hard but we had fun as well, sometimes at sister’s expense.’

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