by Lynn McDonald, for the Nightingale Society
So many of the reforms that Nightingale sought in health care (nursing being a major part of it) required political change, sometimes legislation, sometimes new regulations and sometimes increased budget.
Politics was part of Nightingale’s own upbringing. Her mother’s father, William Smith, was a radical MP who worked with Wilberforce on the abolition of slavery. Her brother-in-law and various cousins were Liberal MPs. Her own father ran once, unsuccessfully, for the Liberal Party. She was both a Liberal Party supporter, lifelong, and a small-l liberal in her views.
Of course, as an activist, she needed, and had, allies in the Conservative Party as well. Leading Conservative MPs and peers worked with her. As well, she was often disappointed with what the Liberal government did.
Sir Edmund Boulnois, a Conservative businessman and Conservative MP, as chair of the Board of Guardians at the St Marylebone Workhouse Infirmary, was instrumental in getting trained nurses into it, and indeed a nursing school and a better building. He later served as chair of the Nightingale Fund.
Other prominent Conservative allies were Lord Stanley, the earl (who later became a Liberal), Lord Shaftesbury (the 7th earl), W.H. Smith, Conservative MP and war secretary; and Robert Loyd-Lindsay, later Baron Wantage (they worked together on the National Aid Society, forerunner to the Red Cross), She thought highly of Conservative viceroy of India, Lord Mayo. However, she had nothing good to say about “Derby and Dizzy,” while “Lord Randolph and me/We don’t agree.”
Legislation for workhouse reform
Reforming the dreaded workhouse infirmaries was an early and ongoing concern of Nightingale’s. The first reform, in Liverpool, in 1865, required only the consent of the workhouse Guardians and the donation of funds. To upgrade the London workhouse infirmaries, however, required legislation, achieved in 1867 with the adoption of the Metropolitan Poor Act. Nightingale submitted a comprehensive brief to the “Cubic Space Committee” studying workhouses, and did much behind the scenes on the legislation itself.
She had hoped that the Act would require workhouses to employ trained nurses, to replace the “pauper nurses” who drank their meagre wages. It did not go that far, but only permitted the hiring of trained nurses. Reforms had to be brought in piecemeal, which gradually happened. Nightingale’s Liberal brother-in-law, Sir Harry Verney, moved an amendment for another advance, to permit workhouse infirmaries to train nurses, which was accepted unanimously.
The bill itself was the work of a Conservative government, with Gathorne Hardy, president of the Poor Law Board, a Cabinet position, in charge.. Although Nightingale was disappointed with the bill, in time how much it achieved came to be recognized.
With the benefit of hindsight, the Metropolitan Poor Act can be seen as the first step towards universal access to health care, established with the launching of the National Health Service in 1948. The NHS could not have been created without the gradual transformation of the old workhouse infirmaries (used by 80% or more of the population) into regular hospitals, with trained nurses and adequate facilities (the old workhouses had bed sharing and lacked basic sanitation).
Petitions to Parliament
Nightingale signed the first petition to Parliament for the vote for women, in 1866, and many more after it. Some MPs in debate on women’s suffrage cited the anomaly that someone like Nightingale not have the right to vote. She also signed petitions for other reforms for women, notably the Married Women’s Property Act.
Nightingale’s name headed the list of signatures on a petition of 1873 to W.E. Gladstone, and on one in 1874 to Disraeli. Ironically, the Conservative Disraeli supported the vote for women, while her fellow Liberal Gladstone, who greatly liked and respected her, opposed it.
Support for key candidates
Nightingale, naturally, wanted MPs to be elected who would be strong advocates for reform on health care and on India. She wrote a letter of support for Dadabhai Naoroji, founder of the East India Association and the first Asian to be elected to Parliament.
Her regard for Parliament
When Italian independence leader, General Garibaldi, made a triumphant visit to England in 1864, and spoke in Parliament, he wanted to meet Nightingale. After their meeting, she complained that he wanted a representative government, like theirs, but could not “take the evils and the good of a representative government (as I have to do) every day.” She also noted that she, like Garibaldi, could not pass the House of Commons without tears.”
A printable PDF version of this paper can be downloaded in letter or A4 format: Florence Nightingale, politics and Parliament (letter, 1 page) | Florence Nightingale, politics and Parliament (A4, one page)