Three Score Years and Ten

I was fortunate to volunteer on the 'Three Score Years and Ten' project. As a volunteer I interviewed nurses and others who'd worked for the NHS in the last four decades. Their stories were rich and fascinating. They offered their different experiences of changes, of the impact of managerialism that’s part of the modern day health service, and how such changes affected on their work. They had all been patients at various points as well. Everyone I interviewed had strong loyalty towards the NHS and saw it as an institution that does a lot of good. 


While we talked at some length about conditions and changes for patients and staff we didn't concern ourselves with discussing uniforms. It was some surprise then to visit the St Bart’s Hospital archive and see the detailed treatment given to uniforms in modern times since the Second World War. Many of these uniforms can be seen in the Royal London Hospital Museum. 


The nurse’s manual given to nurses about to go into training was very specific in what was and wasn't to be worn. Up to 1968 this was at the nurse in training’s own expense. In 1959 a Ministry of Health subcommittee came together to discuss design of nurses uniform. This was recommended to be "neither a standard uniform for all hospital nurses nor any radical alteration in traditional style is recommended". Hospital’s pursued their own different versions of nurse’s uniforms right up to the '90s when the tunic and trousers or "scrubs" came into wide usage. Possibly the starkest reflection of this was the Royal London Hospitals retention of the Norman Hartnell designed uniform up to the '90s.


Photographs in this wonderful archive show nurses wearing capes in the '40s and '50s, and caps right up to the '70s. The manuals have very prescriptive lists around shoes and stockings. One nurse’s manual from 1948 stated that "stockings may be silk, lisle, nylon or wool and must be dark beige in colour". Year on year the shoes were to be brown with 3 lace holes, flat to medium rubber heel. In 1960 the "K step" shoe was allowed as an exception, and there is movement to a microcellular sole and heel by 1963. By 1964 the lists shrink to simply wearing beige stocking and brown shoes. While shoes seem truly uniform and driven by safety measures, the style of dresses, skirts and aprons varied across hospitals. By the early '60s the skirt length shortened to twelve inches from the ground for most places. District nurses in contrast had no uniform; it was believed that patients at home may not want their neighbours to know they had been visited by a nurse. 


We may wonder today about the constraints of some of the flounce and frills on the wards as late as the '80s, but the wearers themselves often still have a strong attachment to their own hospital's style, even while they recall almost tripping over long skirts. In the '80s and early '90s discussion of uniform spills out from nursing journals into mainstream magazines and newspapers, and health minister Brian Mawhinney has been quoted as being "sympathetic to nurses wanting trousers". It is notable there was no parallel debate or restrictions proposed about what a doctor should or shouldn't wear. I searched in the archive and elsewhere for the rough date we started using the phrase "white coat syndrome" in relation to doctors and can’t find its origin, almost like it’s beyond question, doctors always wear a white coat. 


The Royal London Hospital Museum is open and free to the public. It has displays of artefacts from the past and also shows contemporary short films on current themes around health, and is a valuable and accessible source of NHS history.