WHY WE NEED THE NHS – WHAT LIFE FOR WOMEN WAS LIKE BEFORE by VIVIEN WALSH
In 1933 Margery Spring-Rice carried out a survey of the health of married working class women, called “Working Class Wives”, originally published in 1939 and re-published by Virago in 1981. It is illustrated by the photographs of the talented Edith Tudor Hart (step mother to a former president of SHA).
If a “social survey” sounds dull, the book was certainly not. When I first read it I was totally gripped and could not put it down. Much of the time the author lets the women she surveyed speak for themselves.
Even in today’s atmosphere of cuts to the NHS, increasing encroachment of the private sector into the provision of NHS services, and campaigns against privatisation of the health service, the book reveals conditions suffered by the women that seem unimaginable today – and the very reason why the NHS was the most important reform by the 1945 Labour Government. There are hardly any books about the lives of women at home in the 1930s, the problems they had to face and how they dealt with them.
“Mrs MacN of Glasgow lives in one room and kitchen. She says it has NO drawbacks. Her husband is an unemployed carter and she gets £2 unemployment money and 10/- (=50p) from one boy who is working. Out of this she pays 9/- (= 45p) rent. She is 37 and has had 14 pregnancies
…….Porridge and milk and vegetable soups are regular items of diet……She manages to feed herself and her family sufficiently well to maintain health.”“A woman at Cardiff aged 38 with 8 children, who says she feels fit and well, admits to decayed teeth, bronchitis every winter and a prolapsed uterus since her second pregnancy. For none of these conditions has she had any
Most of the women suffered from chronic ill health, especially anaemia and gynaecological problems, but couldn’t afford to pay a doctor or to buy themselves varied, nutritious food, and rarely had access to birth control. “I went to see Clinic Doctor. She advised me to go to own doctor and get a tonic. Said I was undernourished and run down: owe doctor two accounts so shall not go.”
At the time training in gynaecology was very limited in medical schools, while birth control was hardly ever mentioned. Midwives reported having to exercise enormous tact even to get doctors to wash their hands when attending a childbirth (as recently as the 1930s!) The women themselves said that doctors were always telling them not to have more children, but not how to achieve that.
“Mrs W.R. was advised rest, but she has 10 in her family and 30/6 (=£1.55) housekeeping money.” A midwife arrived at a childbirth to find the woman “lying on a bed without any bedclothes on it at all, and covered by her husband’s coat. There was no water in the house.” A woman from Rotherham who consulted her doctor about severe back pain was told: “all women get backache around 40 so why worry?”
The women’s day would usually begin at 6.30 am, or 4.00 am if they had husbands or sons who were miners or bakers. They would then do 12 hours or more of hard manual labour, mostly standing up. Washing up, for example, was a major task: the women often had to go down two or three flights of stairs for water, carry it up, and take it back down again to empty away. It would probably have to be heated on an open fire, while looking after a baby and a toddler at the same time. Washing was even worse: imagine washing the bedclothes for a family of 8 or
10, and drying them in time for the same night, in one or two rooms. Some women only got a rest when they sat down to breastfeed the baby or mend clothes, cloths & sheets.
Many of the women in the book, not only worked in the home, but, especially when their children were older, also fought to build the Labour Party, work tirelessly in elections and campaigned with the Women’s Labour League, on prices, housing and health.
The Labour Women’s organisation was an active, campaigning body in the 1930s, with nearly 200,000, mostly working class, members.
Labour women, for example, were responsible for agitation directed at the Ministry of Health on the maternal mortality rate. Women died in childbirth at four times the rate that coal miners died from work-related causes. Mining was then the most dangerous job for men then. Maternal mortality rates showed no signs of declining, even though infant mortality had more than halved since 1900.
There was a National Health Insurance Scheme but it only covered workers, not their dependents. Few married women worked. (Many of those that did were in Greater Manchester, in the cotton industry.) But even if women were covered by the National Health Insurance Scheme, medical treatment related to childbirth was excluded.
Labour women also campaigned for the state to provide birth control. In 1924 Labour women’s conference passed the first resolution demanding state provision of birth control, and then continued to do so almost every year for 50 years until 1974 when the NHS finally provided free contraception to all who wanted it.
The publisher’s blurb says “this book seems to emerge from the Dark Ages, and yet the lives recorded here are those of women in the 1930s”. Now, in the 2020s, it really does seem like another world. Most members of the Labour Party or Socialist Health Association today do not remember a time when we had no NHS: people born before the NHS would be 75 or more now. Even people born before there was free contraception available to all who wanted it would be nearly 50 now.
We have lived through a post-war boom in the economy and back to hard times, with disputes involving workers in all sections of the NHS and related areas, those in transport, postal services, teaching, journalism, the civil service, security, airports, fire-fighting and elsewhere, all feeling the pinch. We cannot go back to the world described by Margery Spring-Rice. In particular we must not only fight tooth and nail against any more areas of health care becoming business ventures, but on the contrary extend the NHS (or extend it once again) to areas it currently does not cover.