As we commemorate 70 years of the arrival of the Windrush, we also mark 70 years of the formation of the NHS. The two landmark events have an inextricable history. Isabel Appio pays tribute to Professor Nola Ishmael OBE, who came to Britain from Barbados in 1963 as a young NHS trainee nurse in the wave of the Windrush legacy, rose up the ranks to become the first Black Director of Nursing in London, and was voted the 5th most influential nurse in 60 years of UK nursing history.
In 1945, central to the post-war reforms was the formation of the National Health Service (NHS). The NHS was the world’s first, comprehensive healthcare service, which proved free healthcare for every British citizen. The NHS officially began its work on 5 July 1948.
In the same year, on 22 June 1948, the Empire Windrush docked in the UK and is remembered today for bringing one of the first large groups of post-war West Indian immigrants to the United Kingdom. The arrival of the SS Empire Windrush at Tilbury Docks, Essex, also marked the beginning of post-war mass migration, which filled labour shortages across all sectors in the UK.
The ship had made an 8,000-mile journey from the Caribbean to London, with 492 passengers on board from Jamaica, Trinidad and Tobago and other islands.
The majority of the passengers – ex-servicemen, who having fought for Britain during the war – were now needed to help Britain rebuild its industries. When they walked down the gangplank onto British soil, they could not have imagined their journey would begin an important landmark in the history of London and the rest of country.
From 1948, the British government began extensive recruitment drives throughout the Caribbean for much-needed nurses and ancillary workers essential to the effective running of the new health service. The response to recruitment in the UK from British-born women had been poor.
By 1955, the British government, supported by professional nursing bodies, had set up recruitment procedures throughout the Caribbean, which ensured a steady stream of high quality nursing candidates to the NHS for the years that followed.
There was almost no financial help from the British government. Most NHS recruits had to find money to pay for their own fares and expenses. From 1955 a limited loan system was introduced, but recruits had to pay this back in weekly instalments.
In later years, Enoch Powell, the Tory Health Minister from 1960-1963, was to personally invite more women from the Caribbean to Britain to train as nurses.
Since its very beginning, the NHS has depended heavily on a reliable supply of health professionals from the Caribbean and later from other countries, which to this day continues to be the backbone of Britain’s healthcare service.
Professor Nola Ishmael’s story of dedication, pure determination, professional and personal aptitude and groundbreaking achievement continues in the legacy of the Windrush years. Here Nola recounts her early years as a trainee nurse, newly arrived in the UK.
“My best friend wrote to me in Barbados, and told me what a great life she was having in England. At the time I was a primary school teacher.
I arrived on a grey August day in 1963 – the same day Ronnie Biggs and his friends had robbed a train. A crowd of us from Barbados came over on a plane to London Airport – that’s what we called it then. It’s Heathrow now. We were so excited: we’d never flown before; we’d never left home, and now everything was strange and different.
At first I had been placed on the Isle of Wight, but I’d said: “Why would I go from one small island to another small island?” I wanted to broaden my horizons. So I was offered Bishop’s Stortford in Hertfordshire, and after a train journey from Liverpool Street, I was finally at my new home. The Home Sister met us, and I tell you, I have never had a better cup of tea since – so restorative!
We lived by rules in the nurses’ home: we knew what time breakfast was; what time to get measured for our uniforms; what time to be at the PTS (Preliminary Training School). And we had to study, study, study. Reading the long names in the anatomy books, memorising how to spell them, and learning by heart every step for practical assessments. Who would dare forget one!
We formed study groups and did it the hard way. There was no ‘search option’ for us; we had to go to the library. Our objective was to pass our exams – getting that blue belt and a frill on our cap were the epitome of success.
There was warmth, too. We knew we had to follow order and be decent individuals, but there was chumminess, support and care amongst us too. We would go to parties and concerts, and watch television together. You had to get to the TV room early to get a seat for Ready, Steady, Go! There was none of this round-the-clock Netflixing. There was also the simple pleasure of chatting in each other’s rooms. My friend would say: “There’s no such thing as gossip, only ‘intelligence gathering’!”
Homesickness was inevitable, and we were sensitive to those who suffered. Some managed better than others. A few cried, but most of us laughed our way through it. There is a saying ‘Make a friend before you need a friend’ and it was so true for us.
We waited eagerly for letters from home – from our friends and family. And we did our duty in writing to our parents too. Letters home were filled with our studies, what exams we’d passed, and what we’d been doing. I never told my father about the boyfriends though! 8,000 miles away, and I could still feel the heat on the back of my neck!
I still remember how strange the meals seemed. There was a routine to what we ate. We had to learn to like porridge for breakfast, and we quickly discovered that main meals were meat and two vegetables, except for Fridays when we had fish, chips and one vegetable. Tea was cake and scones. Did we know whether to put the cream on first or the jam? Who cared, we were due back on the ward!
But where were the avocados, flying fish and snapper? Where were the rice and peas, curry and rum Christmas cake? Forget it, we were in England now. So, when you got a parcel from home, you delved in quickly to see what kind of cake you’d got. You knew you were going to share it, but you were excited to check.
I loved every minute of my journey to become an NHS nurse, and the career that followed. I knew what I wanted to do – I didn’t know how I was going to do it, but I found my way.
It took determination to get here, but I think that novice from Barbados, who’d never flown before, would be proud of the person I am now (still from Barbados, but an expert in England too!).”
See more at www.rcn.org.uk
PROFESSOR NOLA ISHMAEL OBE
Lifetime of achievement
Nola Ishmael left Barbados in 1963 to start her nursing career in the National Health Service (NHS) at a hospital in Bishop’s Stortford. She later moved to the Whittington Hospital in London to gain her State Registration Qualification. Within 18 months of qualifying as a nurse, she was promoted to Unit Sister in the Neurosurgical Unit of the Maudsley Hospital in London. Later, she went on to qualify as a health visitor. In 1981, she became a Community Manager and, in 1987, became Assistant Director of Nursing in Greenwich. Eighteen months later, she was appointed Director of Nursing, thereby becoming the first Black Director of Nursing in the NHS in London.
Nola was invited in 1994 to the Department of Health (DH) for six months, which evolved into a ten-year tenure. There she worked closely with ministers and chief nursing officers in different roles, including Professional Private Secretary to the Chief Nursing Officer. She later added Nursing Policy responsibilities in Public Health areas and Black and Minority Ethnic issues to her portfolio. During her 10 years at the Department of Health, she provided nursing input to policy development in a number of areas, including public health and the inequalities agenda, BME health, and the Mary Seacole Leadership Award, which is funded by the DH to support nurses in their leadership development.
Nola has been on the board of a number of charitable organisations, including Vice Chair of Greenwich Community College; patron to the Sickle Cell Society; Cancer Black Care, and the Sickle and the Thalassaemia Association of Counsellors. She was a Vice President of the Barbados Overseas Nurses Association, and is Adviser and Founder Member of the Confederation of Black and Ethnic Nurses, Midwives and Health Visitors.
In 2000, Nola was awarded an OBE for services to nursing. She also has an honorary doctorate by the University of Central England (now the University of Birmingham). In 2006, her portrait was featured in the ‘A Picture of Health’ Exhibition at the National Portrait Gallery, which celebrated the 15 most illustrious Health Leaders who have contributed to healthcare in the 20th century. In 2009, Nursing Times voted her the fifth most influential nurse in the last 60 years.
Nola lectures extensively at local, national and international level. She also mentors, coaches and nurtures individuals and groups as part of their career development. Nola continues to inspire and motivate others with her experience and knowledge.