December 2019 marks 100 years since the passing of the Nurses’ Registration Act, which led to the opening of a compulsory register for nurses two years later. Below is a list of the key dates and developments on the road to regulation.
1874 – The president of the General Medical Council, Dr Henry Acland, suggested the introduction of a nurses’ register in his foreword to Handbook for Ward Sisters by Florence Lee.
1887 – The British Hospitals Association, founded by financier and philanthropist Henry Burdett, held a meeting to discuss a register for nurses. A breakaway group formed after the meeting due to disagreements over the style of the register, particularly between nurse Ethel Gordon Fenwick and Mr Burdett. Ms Gordon Fenwick believed a non-compulsory register, which the association advocated, was little more than a list that would achieve nothing for nursing.
1887 – The newly formed breakaway group held their first meeting on 21 November at the home of Ethel Gordon Fenwick at 20 Wimpole Street, London.
1887 – The British Nursing Association was formed on 7 December, with large numbers of matrons from London teaching hospitals making up its council. Ethel Gordon Fenwick’s husband, Dr Bedford Fenwick, was its first president. The BNA opened a register two years later in 1889. This register was not legally binding and nurses had no obligation to join it.
1889 – The British Medical Association passed a resolution which called for the opening of a register for nurses.
1893 – The BNA was granted a Royal Charter, becoming the Royal British Nursing Association, but still had no authority to form a compulsory nurses’ register.
1894 – Ethel Gordon Fenwick formed the Matron’s Council of Great Britain with her supporters to continue the campaign for mandatory registration.
1902 – The Society for the State Registration of Trained Nurses was established.
1903-04 – Both the Royal British Nurses’ Association and the Society for the State Registration of Trained Nurses presented bills to parliament proposing the introduction of a nurses register, but both failed.
1904 – A House of Commons select committee was set up on 24 June to debate nurse registration. It published a preliminary report and planned to reconvene in the following year.
1905 – The select committee reconvened and concluded in favour of the introduction of the State Registration of nurses.
1905-10 – During this five year period, several bills for registration are presented to parliament but are all blocked by anti-registrationists.
1910 – Ethel Gordon Fenwick united the the British Medical Association, the Royal British Nurses’ Association, the Matrons’ Council, the Society for the State Registration of Trained Nurses, the Fever Nurses’ Association, the Irish Nurses’ Association, the Scottish Nurses Association and the Association of the promotion of the registration of nurses in Scotland, to form the Central Committee for the State Registration of Nurses.
1919 – Both the Central Committee for the State Registration of Nurses and the Royal College of Nursing presented bills to parliament, but both sides were asked to withdraw. The government’s Minister of Health, Dr Christopher Addison, went on to present a bill on 6 November. It underwent its second reading on 22 November and was passed as the Nurses’ Registration Act in December 1919.
1920 – The first General Nursing Council, commonly referred to as the ‘Caretaker Council’, was appointed by health minister Dr Addison. They met to discuss the standard requirements to qualify as a state registered nurse. They agreed in the summer of 1920 that to be admitted to the register, aspiring nurses had to be aged over 21, be able to give three references of good character, and be able to demonstrate that they had had at least one year’s training and two years’ subsequent practice prior to 1 November 1919. The council also decided on disciplinary procedures, creating the Disciplinary and Penal Cases Committee. The committee had the power to discipline nurses who violated standards of practice.
1921 – The Nursing Register opened in September, irrevocably changing modern British nursing. Ethel Gordon Fenwick was the first to sign the register, becoming ‘state registered nurse number one’.
1983 – The United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) replaced the General Nursing Council.
2002 – The Nursing and Midwifery Council (NMC) replaced the UKCC on 1 April.
Adapted from Christine Hallett and Hannah Cooke (2011) Historical Investigations into the Professional Self-Regulation of Nursing and Midwifery: 1860-2002. Manchester University Press, held in the Nursing and Midwifery Council, p39.