A HIDDEN HISTORY:
African Women and the
British Health Service
1930–2000
PRE–1930s
1832
In July 1832, the British Medical Association (BMA) is founded.
1858
The Medical Act is introduced to regulate who could legally practise medicine.
The General Medical Council is established.
1874
The London School of Medicine for Women is founded by activists such as Sophia Jex–Blake (1840–1912). It was the first medical school in Britain to allow women to train to become fully qualified doctors.
1876
The Medical Act of 1876 allowed all qualified applicants to be licensed regardless of gender. Before this, women practiced as unlicensed physicians, which was also not uncommon for men. However, the Act faced significant opposition and universities could still legally exclude women from medical schools.
1880
The British Dental Association is founded by the Dental Reform Committee. The Committee was concerned with dental malpractice and campaigned for regulatory laws around the profession.
1914
By 1914, there were over 1000 female doctors in England.
1916
The Royal College of Nursing (RCN) is founded with 34 members, serving as both a membership organisation and a trade union.
1919
The Nurses Registration Act of 1919 established the first register for nurses. The General Nursing Council was formed the following year to maintain the register.
1923
In November 1923, Lulu Coote (1890–1964), the daughter of a Congolese woman and a Belgian sailor, registers as a nurse after training in Ashton under Lyne from 1911–1913.
1925
The West African Students Union (WASU) is founded by Ladipo Solanke and Herbert Bankole-Bright in London.
1928
In July 1928, the Equal Franchise Act is passed, allowing women over 21 to vote for the first time.
1929
Agnes Yewande Savage (1906–1964), hailing from Nigeria, becomes the first African woman become a medical doctor in Britain. She received a first class degree in medicine from the University of Edinburgh in 1929.
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1930s
1935
Susan Ofori-Atta graduates from Kole-bu Midwifery Training School in Accra, Ghana.
1936
In the 1930s, Britain experienced profound economic depression. In 1936, a governmental report on food, health, and income revealed that about half of Britain could not afford basic food needed for growth and health. The idea that the state should have a larger responsibility in the health and welfare of the nation became popularised.
1938
Elizabeth Abimbola Awoliyi (1910–1971), hailing from Nigeria, becomes the first West African woman to earn a licence from the Royal Society of Medicine from the Royal College of Surgeons in Dublin.
1939
Princess Tsehai Selassie (1919 –1942), daughter of Ethiopian Emperor Haile Selassie, graduates as a State Registered Children's Nurse in London after training at Great Ormond Street Hospital. She continued her studies at Guy’s Hospital to become a 'State Registered General Trained' Nurse.
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1940s
1941
Nigerian princess and nurse Adenrele Ademola (1916–?) receives training as a midwife at Guys Hospital during the Second World War. During 1942–3, a film titled 'Nurse Ademola' was produced and released by the British Colonial Film Unit. The footage has since been lost.
1943
The Nurses Act of 1943 formally recognises the roles and qualifications of assistant nurses, later known as 'State Enrolled’ nurses.
1944
Sierra Leone’s first female doctor, Dr. Irene Ighodaro (1916–?) qualifies in medicine from Durham University.
1945
The 5th Pan African Congress is held in Manchester. The link between the anti-colonial struggle and trade unionism was strengthened by the involvement of many trade union delegates.
1946
The West African Women’s Association is formed with Dr. Irene Ighodaro as a co-founder.
In October 1946, the 'Marriage Bar' is abolished in the Home Civil Service. This meant that married women were barred, resigned, or terminated from working in the Civil Service, which included the healthcare sector.
1947
Susan Ofori-Atta (1917- becomes the first Ghanaian woman to graduate in medicine from the University of Edinburgh.
1948
The National Health Service (NHS) is founded.
In November 1948, the South London Press reported on a 'colour bar' in place at St Benedict’s Hospital, Tooting. The matron imposed a ban on 'coloured' guests attending a nurses dance. Clara Brown, an assistant nurse of Jamaican descent, was barred from inviting her friend Cecil Holness, a Jamaican RAF serviceman, to any events. After a letter of protest was sent to the chairman of Wandsworth's hospital management committee from about 100 members of staff, the matron withdrew the racist policy.
The British Nationality Act is enacted, which gives all Commonwealth citizens the right to live and work in Britain.
1949
The health and labour ministries begin recruitment campaigns in an attempt to restore a war–torn Britain.
Matilda Clerk becomes the first west African woman to receive a post graduate diploma from London School of Hygiene and Tropical Science.
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1950s
1950
Kofoworola Abeni Pratt, from Nigeria, qualifies as a state-registered nurse, becoming one of the first qualified black nurses in the NHS.
1951
Male nurses joined the main nursing register. They had previously formed part of the Supplementary Register, but this was abolished following the 1949 Nurses Act.
1953
Dolupo Ransome Kuti, of Nigeria, graduates from Gracefields nursing school at Rushgate.
1955
Howa Salih Kabashi becomes the first Sudanese woman to come to the United Kingdom on a British Council bursary to study nursing, midwifery, and hospital administration.
Official nursing recruitment programmes began across sixteen British colonies and former colonies. Due to NHS staffing shortages, new sources of labour were sought out.
The British Colonial Office introduces a new policy encouraging male married students who planned to spend more than nine months studying in Britain to bring their wives with them.
1956
The first Nursing Studies unit in the UK is established at the University of Edinburgh.
1957
The Nurses Agencies Act is established.
1958
Adenike Grange, the former minister in charge of the Nigerian Federal Ministry of Health, begins her degree in medicine at the University of St Andrews. In 1967, she became senior house officer in paediatrics at the St Mary's Hospital for children. In 1969, she obtained an additional Child Health Diploma.
1960s
1960
RCN Membership opens to all registered nurses, including men for the first time.
Edna Adan Ismail graduates as a State Registered Nurse, becoming the first Somali woman to work as a qualified nurse in the UK.
The Ghana Registered Nurses Association (GRNA) is founded by Docia Kisseih.
By 1960, there were 11,000 Africans studying in Britain, as well as tens of thousands of 'private' students, meaning those who had come without government funded scholarships.
1962
The Commonwealth Immigrants Act is passed. However, exceptions to immigration controls were made for essential workers and well-qualified staff, such as nurses and doctors.
1965
Dolupo Ransome Kuti, of Nigeria, obtains a diploma in nursing administration from Halifax Hospital, Rochdale.
1966
The Cogwheel Report recommends administrative changes for hospitals, like the creation of a 'clinical division' and consultant speciality groupings. This allowed for specialisations for 'Black' issues like Sickle cell.
Racial segregation and discrimination was common across Britain. The 'colour bar' significantly impacted housing and employment for black and asian people in many sectors. For example, companies like British Rail had a 'whites–only' recruitment policy. However, in August 1966, Asquith Xavier became the first black train guard at Euston station after a legal campaign and union backing. His campaign, credited with ending the colour bar at all London stations, is one of the earliest successful cases.
1968
The Commonwealth Immigrants Act introduces more restrictions – requiring certain migrants to supply proof that either they, their parents, or their grandparents had been born in Britain.
The Race Relations Act is enacted and makes it illegal to refuse housing, employment, or public services to a person on the grounds of colour, race, ethnic or national origins in Great Britain.
Conservative MP Enoch Powell gives his ‘Rivers of Blood’ speech, criticising Commonwealth immigration to the UK.
Under the United Nurses' Association, Sister Patricia Veal led a march of 1000 nurses to Downing Street for equal pay.
The Times estimated that up to 5,000 African children were privately fostered in Britain annually, with African parents paying up to £3 per week for child care. Following growing reports of child abuse, neglect, and deaths within foster families, the Colonial Office was urged to reverse its policy of allowing African students coming to the UK to bring their partners and children.
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1970s
1976
The New Race Relations Act passes, making it unlawful to discriminate on grounds of race, colour, nationality (including citizenship), and national or ethnic origin. The Act covers employment, education, training, housing, and the provision of goods, facilities and services.
1977
Rose Amankwaah, Ghanaian former athlete, once crowned the "fastest woman in Africa", is appointed theatre matron at Central Middlesex Hospital.
1979
The Nurses, Midwives, and Health Visitors Act makes new provisions with respect to the education, training, regulation and discipline of nurses, midwives and health visitors and the maintenance of a single professional register.
Dame Elizabeth Anionwu (1947–present) becomes the UK's first sickle cell and thalassemia nurse specialist after forming The Sickle Cell Society; a registered health charity.
Kofoworola Abeni Pratt, one of the first black registered nurses in the NHS, is awarded an Honorary Fellowship from the Royal College of Nursing.
1980s
1981
The British Nationality Act is enacted and reclassifies citizenship of the United Kingdom and Colonies (CUKC) into three categories: British citizenship, British Dependent Territories citizenship (BDTC); and British Overseas citizenship.
The number of registered nurses of African descent increases alongside the general numbers of African migrants.
1983
Work permits for nurses are abolished – prohibiting further entry of overseas nurses to train in Britain.
A report for the Commission of Racial Equality found that there was a higher proportion of trained overseas-born nurses, than overseas-born nurses in training. It also stated that less than 9% of nurses employed by the NHS were born in developing countries.
1987
Janet Adegoke, a Nigerian nurse, becomes the UK’s first black woman mayor after being elected mayor of Hammersmith and Fulham.
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1990s
1990
A plan designed to move nursing education from hospitals to universities titled 'Project 2000' is introduced.
1997
The Ghana Nurses Association is formed by five nurses in London to foster friendship and support within the nursing field and to contribute to healthcare and education in Ghana. It maintains close relationships with other black and ethnic minority nurses associations.
1998
In January 1998, the Nigerian Nurses Charitable Association is formed. Its mission is to provide a forum for collective action by Nigerian nurses to "investigate, define and determine issues affecting its members with a view to implement change to alleviate and improve living and working standards amongst members".
2000s
2001
The Nursing and Midwifery Order is created to establish and maintain a register of all qualified nurses and midwives eligible to practise in the UK.
2002
The Nursing and Midwifery Council, a regulator for nursing and midwifery professions in the UK, is founded.
2009
It is announced that all new nurses entering the profession from 2013 will have to hold a degree–level qualification. Prior to this, nurses could qualify with diplomas after two to three years of training.
2014
Cecilia Anim is elected president of the Royal College of Nursing, becoming the first black person and the first Ghanaian in this position.
2015
The Workforce Race Equality Standard (WRES) is introduced.
2020
The World Health Organization (WHO) designates 2020 as the “Year of the Nurse and Midwife”, in honour of the 200th birth anniversary of Florence Nightingale.
The COVID-19 pandemic sees NHS workers on the frontline in the fight against the disease. African women were among many of the NHS staff who died amid the health crisis. There are widespread reports published on the disproportionate number of healthcare workers from ‘BAME’ backgrounds affected by Covid-19.
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