WOMEN IN MEDICINE
Written by Steve Lawes, CW+ Heritage Officer
The last 150 years have seen huge shifts in the road towards gender equality, especially in the workplace. The hospitals of Westminster played a part in this struggle, and many significant players have rubbed shoulders at – or with – Westminster.
The Westminster Review of 1868: “Men have never made an outcry against women’s entering upon any occupation however hard or “degrading,” unless that occupation were one in which they would compete with men! “1
In 1865, Elizabeth Garrett Anderson became the first woman in Britain to qualify as a physician and surgeon after exposing a loophole in the Worshipful Society of Apothecaries’ admissions process, passing her exams first time. No hospitals would admit her as a Doctor, including Westminster – the then Chair of Medicine Dr Basham had denied her entry to study at the Hospital school in 18612– and so, she set up her own practice on Euston Road, London, run by women, for women. She became an inspiration for women everywhere, proving their worth in the medical profession. Her life was one of many pioneering firsts, including becoming the first female Mayor, the first female Dean of a medical school, and the first woman to ever sit on a school board of governors in Britain. Her example went a long way to liberalising admission policy at medical schools across the country: in 1876, partly due to Elizabeth’s open campaigning, an act was passed forcing the British Medical Register to accept women. By 1914, there were over 1000 female doctors in England. However, not everyone was happy about this, and the struggle for equal standing in the profession continued.
Westminster Hospital was slightly behind the times in this regard: until 1916, in the middle of World War I, women were still barred from the Medical School; it was only the loss of a substantial portion of the male population to the war effort which prompted the Hospital Board to temporarily allow entry to women. By January 1917, over half of all male doctors in the country had been called up to military service3,leaving a huge amount of medical work on the home front to be done by the women. This was not to last, however: women were admitted to the medical school at Westminster until 1928, coincidentally the same year that the United Kingdom legally extended voting rights to all women over the age of 21. They were not allowed back into the medical school again until after World War II in 1946.
The great steps forward in liberalising attitudes towards women in the workplace were achieved against a backdrop of resistance from the more conservative institutions, exemplified by this quote appeared in the Daily Mirror in 1928:
“Whenever women are present, the male students, instead of turning to athletics, which keep the place together and create a valuable esprit de corps, turn to social distractions. They tend to become what are called in the Navy ‘poodle fakers’, that is, fellows who like parties more than games.”4
During the 1920s, as admissions of men to the medical schools began to increase again after the war, there was a concern that women were creating a distraction for the men and encouraging a demasculinised culture. It was felt that women’s presence could harm the social fabric of the hospitals – which in no small part had been set up around athleticism, particularly rugby. The Broad Way, which was the Westminster Hospital’s inhouse gazette, had this to say on the matter:
“The men have displayed an apathy and lack of camaraderie that is disappointing, and they can take to heart, unpleasant though it may be, the example set by the lady students. One male student refused to play hockey on the ground that the game was too rough: one is left wondering whether this was but a feeble attempt at humour or merely the natural result of the…almost invertebrate attitude of the men towards an essential side of hospital life.“5
Clearly, then, women faced barriers to their ambitions at every stage, and this is also true within Westminster Hospital. The anxieties of the establishment, a sense of traditionalism and a societal doubt in women’s abilities to hold highly-skilled jobs all played a part in both preventing and discouraging women from entering the medical profession. Historian Carol Dyhouse has said:
“The outlook for women seeking clinical experiences in London, in particular, looked bleaker, in many ways in the late 1920s and in the 1930s than it had appeared in 1918. These were years in which a “culture of masculinity” based on public school values, rugby and athleticism, and buttressed by freemasonry, operated to the disadvantage of women, and even those women who had distinguished themselves as students frequently found difficulty in obtaining hospital appointments of lucrative positions in general practice.”6
We have an example of one woman at Westminster for whom this was true. in 1922, Katheleen Chevassut enrolled at the Medical School. In this renewed male-dominated culture, she earned her M.Sc. degree in Physiology gaining the Thomas Smyth Hughes Medical Research Prize in 1927, although for an unknown reason did not qualify as a physician. She was encouraged to conduct research instead, as this was ‘more suited to a woman’. She investigated possible causes of Multiple Sclerosis and was asked to develop a vaccine by her consultant supervisor. When in 1928 her research funders required her to become medically qualified, Westminster Medical school had just barred women again. Her research results were published early by her supervisor (against her wishes) whilst he was selling the vaccine to his private patients. The research was subsequently roundly disproved, and she was publicly discredited and disparaged as an unqualified and ‘feminine girl’. Her supervisor resigned and Chevassut appears to have disappeared from the medical world – perhaps a victim of her times.7
“…it never entered my head that a nurse would be capable of taking and recording temperatures.”8
- Dr F. de Havilland Hall, Physician to Westminster Hospital, 1894-1912, writing in 1899.
Photo above: St Katherine Order of Nurses at Westminster Hospital, 1879
The history of nursing – the traditionally assumed role of women in medicine – is no less dramatic than that of medicine in the hospital. The Westminster Hospital has played a pivotal role in the global development of nursing from the untrained women of the early 1800s, through a strong connection with Florence Nightingale’s revolution of the latter part of that century, the 1874 opening of the Westminster Nursing School and the later Wolfson School of Nursing, and the camaraderie of the Westminster League of Nurses which ran until 2013.
On December 16th 1720, one Mrs Jane Alden was appointed as the first Matron of the newly formed Westminster Hospital. Described as ‘generous, kind-hearted and good to her staff’, she remained with the hospital until 1734. Assumptions about women and their proper role and skills have been, and some might argue still are, quite contradictory: in the 1800s it was considered that women had an innate ability to care for the sick, and many hospitals were staffed by untrained working-class women. At the same time, it was considered that upper-class women were too ‘genteel’ to work in healthcare (a notion thoroughly rebuked by the superhuman efforts and career success of Florence Nightingale).
Miss Nightingale was a pioneer in improving the standards of nursing throughout the western world, and she was heavily influential on the activities of various major hospitals during her lifetime. On her expedition to Crimea, Miss Nightingale took with her a team which included nurses from Westminster Hospital. Of this party, two ‘achieved her strict standards’ – one of them, Mary Anne Noble, returned to Westminster in January 1856 with a letter from Miss Nightingale suggesting to the hospital that she be made Head Nurse on the Queen Adelaide ward. A month later, she was promoted to Sister on the King William ward, but died later that year.9
Miss Elizabeth Eager, Matron of Westminster Hospital from 1847-1873, had begun her own revolution in nursing within the confines of this one hospital; she was the first Matron to use the term ‘trained nurse’, reorganised the hierarchy of nurses under Sisters, and fixed hours of work, as well as laying the groundwork for a professional uniform. By 1874, against much opposition and in the face of various resignations from both within the nursing staff and on the board, a Nurses’ Training School was founded, taking up residence at 27 Queen Anne’s Gate10. This school had its own accommodation, a dining and sitting room, and an academic curriculum. This set up didn’t change much until the 1980s. By 1886, the BMJ noted that the Hospital had cut down alcohol consumption among patients to ‘less than any other London hospital.’ due to the introduction of new standards, and also of tea and coffee on the wards. As within medicine, this revolution in nursing was met with conflict from the establishment.
Photo above: Westminster Hospital nurses deliver some Christmas cheer to wounded soldiers
Patronage, Policy and Early Hospital Development
Some of society’s highest-ranking women throughout history have got behind the cause of the oldest voluntary hospital. In 1722, the hospital received its first legacy payment from the will of Isobel, Lady Dod, the widow of the late Lord Chief Baron. She left £42. Augusta of Saxe-Gothe, Dowager Princess of Wales and Mother of King George III, became the first royal patroness in 1738, beginning a lineage which has continued to the current day. The Book of the Westminster Hospital Bazaar of 1905 has an illustration showing 10 upper class women on its’ front cover, and inside lists 186 Patronesses, many of whom ran stalls and fronted the fundraising campaign of the hospital. This list included the Queen, 5 British princesses, 11 Duchesses, 3 foreign princesses, 7 Marchionesses and 26 Countesses. Quite an impressive roster for a hospital Bazaar! In 1993, Queen Elizabeth II opened the new Chelsea and Westminster Hospital. Additionally, Princess Diana was famously photographed holding the hand of a HIV patient at Westminster, helping to change public perception towards the disease.
We can see that women at every level of society have had a vested interest in the hospital and its development and have played a pivotal role in this. Their increasing presence in medicine is associated with the liberalisation of people’s attitudes, and we have a lot to thank pioneering and brave women for in our medical history.
1 The Westminster Review, Volume 34 (1868), p. 458
2 Tessa Rawlins RGN, DHMSA, DPMSA, Westminster Hospital: The Nursing Reformation and History, 1834-1900,(2005), p.14
3 Leah Leneman, “Medical Women at War, 1914-1918″, in Medical History Vol. 38 (1994), pp.160-161
4 From the Daily Mirror, March 1928, found in: Carol Dyhouse, Students: A Gendered History (Routledge, 2006), p. 152
5 The Broad Way, 1920s, found in Dyhouse, Students, p. 153
6 Carol Dyhouse, “Driving Ambitions: Women in Pursuit of a Medical Education, 1890–1939,” Women’s Hist. Rev., 1998, 7, 321–43, 337
7 An in-depth look at her story can be found here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071216/#fn38
8 Humble and Hansell, Westminster Hospital, p. 88
9 Rawlins, Westminster Hospital: The Nursing Reformation, p. 6
10 Humble and Hansell, Westminster Hospital, p. 92
While exploring the hospital archives, our drawer-in-residence Anouk Mercier, found a photograph of 50 anonymous nurses, taken in 1919. Struck by the fact none of their names had been recorded, Anouk began her 50 Nurses project, drawing portraits of each individual nurse to celebrate the important role they played in our hospitals history.