In kinder times

In the early days of the National Health Service, attitudes to staff and hospital life were very different

As we live through a worsening crisis in the NHS, with the government choosing to ignore the pleas of nurses and doctors for decent wages and conditions, it is revealing to see how such issues were dealt with 65 years ago.

The 1948 -1949 Management Committee Minutes for the Bristol Mental Hospital have just come to light at the Glenside Museum, and they offer a stark reminder that things were handled differently back then. 

For a start there was recognition and respect for the unions that represented the various trades needed for the hospital to function efficiently.

In those early days of the NHS wage rates in many industries were set through national negotiations between employers’ federations and the relevant unions. Then, as now, workplace issues would be tackled by the unions at a local level.

In July 1948, at the request of the National Union of Furniture Trade Operatives (NUFTO), the Management included a 4d an hour cost of living bonus when increasing the basic hourly rate of two shillings and eight and a half pennies for the hospital’s upholsterers.

NUFTO had been formed the previous year by a merger of two other unions and would continue to merge with others until 1971 when it became the Furniture, Timber and Allied Trades Union (FTAT) with six different trade groups. Nowadays it is part of the GMB, itself an amalgamation of more than 50 smaller unions in a history stretching back almost 100 years. 

Meanwhile the hospital’s only shoe repairer had left, leaving the Male Occupational Therapy Department overwhelmed. The Hospital Secretary was authorised to employ a replacement under conditions laid down in a national agreement with the National Union of Boot and Shoe Operatives.

NUBSO had begun life as the National Union of Boot and Shoe Riveters and Finishers in 1873, changing its name in 1897. With at least 38 footwear companies in the Kingswood area of Bristol alone, it would have had plenty of members locally. In the 1910 General Election it had sponsored the unsuccessful Labour candidate for Bristol East, Frank Sheppard. After a series of mergers in the last century NUBSO was subsumed into the general union Community in 2004.

By a decision of the Bakers Wages Council hospital caterers won a reduced working week from 48 to 46 hours, with an increased hourly rate of five farthings. With two of the three bakery staff about to retire the Committee agreed to hire two baker-confectioners, members of the Amalgamated Union of Operative Bakers (AUOB) so the hospital would no longer have to buy in confectionary. 

The Union owed its origins to a Manchester Friendly Society in 1847 which grew to encompass bakers in numerous towns and cities. In 1913 it opened membership to women and unskilled workers, and would become the Bakers Union the 1960s before settling as the Bakers, Food and Allied Workers Union (BFAWU) of today.

The adoption of the improved wages and conditions established by the National Joint Council for Staffs of Hospitals and Allied Institutions, the hospital’s management gave a big boost to Hall Porter Mr. L. Brown. Upgraded to Porter Class 1, his weekly wage packet went up by 4 shillings to £5/6/0d.

The Management Committee also agreed to a recommendation from the Bristol Association of Building Trade Employers (BABTE) of a half-penny an hour increase for the craftsmen on two shillings and ninepence an hour. Labourers got the same increase taking their hourly rate to two shillings and thruppence.

The Royal College of Nursing (RCN) gets no mention in the Committee Minutes, but it is clear that nurses were well respected. Set up in 1916 the College of Nursing only achieved its Royal status just before World War II. 

Any nurse who went off sick remained on full pay for several months before going onto half pay, sometimes for as long as another three months. Only then would they be examined to see whether they might be eligible for an Incapacity Pension. One nurse who had been off sick for three months, and whose doctor had advised a less strenuous occupation, was given a month’s salary in lieu of notice.

Informed that Barrow Gurney Nurses Home only had one wireless set, the Committee approved up to £30 each for sets in the Officers’, Sisters’, and Maids’ Lounges, on the proviso that any repairs would be down to the staff.

On her return to work from unpaid leave one married woman received a salary increase of £50 and designation as a Senior Psychiatric Social Worker. Meanwhile a newly appointed Psychiatric Social Worker was taken on at the enhanced salary of £425, rather than the normal rate of £370, with annual increments of £50 up to £530 in view of her previous experience.

However, while text books books were supplied for the nurses in training, the Committee was clear that the hospital would not meet the cost of examination entrance fees. 

Most of the staff were covered by agreements reached with the local branch of the recently formed Confederation of Health Service Employees (COHSE) set up in 1946 in anticipation of the need for a strong voice to represent health workers in a National Health Service. Formed by the merger of the Mental Hospital and Institutional Workers Union and the Hospital and Welfare Services Union, COHSE linked up with public sector unions NUPE and NALGO in 1993 to form UNISON, the country’s largest union. It continues to advocate for health workers in the current round of pay disputes.

COHSE did not win all its battles. It took up cudgels on behalf of three Charge Nurses who argued that their 11-month voluntarily supervision of patients should count towards their service record and make them eligible for Mental Health Officer status. That meant early retirement at 55 instead of 60. But the Committee turned them down saying, it did not fit with hospital conventions about volunteering. 

Dr Hemphill of the Staff and Finance sub-committee explained: ‘It has always been the policy at Fishponds and Barrow Gurney to use all the departments of the hospital for the occupation and employment of patients, and staffs of these departments have always been willing to take over suitable patients and give them the necessary supervision and even some instruction. For this service they receive no extra remuneration. I know of no other public department where similar conditions apply.’

[Staff] were within their rights to refuse to accept patients in their departments, and it would be unfair to ask them to do so.’ 

‘There are always patients in the laundry and sewing room and on the farm, but in the stores and steward’s department only when those who have some training or aptitude for this sort of work are available.’

His report provides an insight into the running of the hospitals in the Committee’s charge. ‘At Fishponds & Barrow Gurney there is the maximum freedom for patients, with few locked doors, and a continuous attempt is made to get every patient occupied. This policy obviously brings many more members of the staff – senior and subordinate into contact with patients than otherwise would be the case.’

COHSE also got a knock-back when they put in for a bonus for upholsters who were doing extra French polishing, furnishings and bed-making. The union argued that some firms in Bristol were paying 30% extra for such work. The Management Committee responded craftily responded they might reconsider the request if there were proof positive that the majority of Bristol firms were paying 30% over the odds

They also turned down a COHSE request for 6 porters to be upgraded, pointing out that the men could apply for promotion when opportunities arose. 

A somewhat puzzling minute recommends holding fire on the purchase of £85 of ‘Semtex’ as floor covering for the cricket pavilion at Fishponds, but £15 was approved for the purchase of six cricket bats and 12 cricket balls. And while the Committee could no longer approve an annual grant of £50 from the Canteen Fund towards staff entertainments, the hospital’s facilities would be made available to the staff for social events at no cost.

However 1948 ended on a slightly sour note. COHSE members were upset because the final payday of the year was switched from Thursday 30 December to Friday 31st, without any consultation!

Mike J

Journalist, trainer, editor; storyteller; amateur historian.


  1. One volunteer at the Glenside Hospital Museum who formerly worked in the sewing room, said she was paid 50p extra per hour for supervising patients helping out.

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