Everything comes back, any advance made by workers since Victorian times is being clawed back by anti-union legislation disguised in weasel words. Take, for example, the plight of modern day psychiatric nurses, and compare it to their forerunners, the assylum attendants.
In the 1860’s, the top branch of the assylum attendant tree was occupied by the staff of Broadmoor. The Journal of Mental Science, volume 14, Reports of the Superintendent and Chaplain of Broadmoor Criminal Lunatic Asylum, for the year 1867, gives ‘account of the singularly liberal arrangements made by the Council at Broadmoor as relates both to the wages and well-being of the servants:—
The married men are provided with board and uniform, the single men with board, lodging, and uniform. The female attendants are provided with board, lodging, washing, and uniform. Comfortable cottages are provided on the estate for married men at a reasonable rent; a day school for the children has existed from the opening of the establishment; a weekly payment in the shape of school pence is made by the parents, but the amount thus contributed covers but a small portion of the expense. A Sunday school, established in 1863, has been continued with great regularity. The single men and the female attendants occupy well furnished rooms in the asylum. A comfortable reading room, with a library, smoking room, and bagatelle room has been provided on the estate, outside the asylum walls, to the support of which the male officers and servants contribute by a payment of Is. on joining the service, and a monthly subscription of 6d. The female attendants and servants pay 6d. on joining, and 3d. monthly. In the reading room a dance is held every six weeks, and this winter penny readings have been established and most creditably supported’.
This regime was remarkable for its time, and was contrasted to less liberal staff conditions in the county assylums. Yet, all was not well in this flagship establishment, and retiement pensions were a particularly open wound. The case of the superintendant was highlighted in a ‘Memorandum submitted to the Commissioners in Lunacy by the Committee of the Medico-Psychological Association’, which stated the unfairness of him receiving less than two thirds of his salary as pension, on retiring with ‘shattered health’ caused by his duties.
The Medico-Psychological Association were of the opinion that ‘It is fortunate that some of the Commissioners know what the nature of life in a lunatic asylum is. If the superintendent is qualified by his disposition as well as his acquirements for such a life and all its duties, ten years will do their work upon him’. The Commissioners were appointed by an act of Parliament(Lunacy Acts Amendment Act, 1862), and their task was to inspect asylums, a major part of their remit being to cut costs.
They worked in tandem with the justices in quarter sessions (local courts) to ensure that the rate payer paid as least as possible. It was these courts that fixed the amount of the retirement pension of asylum workers under their prison and constabulary expenditure budget. Chairmen of Victorian county sessions did not have to be legally qualified. The quarter sessions in each county were made up of two or more justices of the peace, presided over by a chairman, who sat with a jury.
In other words, local businessmen decided levels of expenditure, with them being opposed to any increases, because it meant them having to pay higher business rates! Asylum Commisioners were often the same local businessmen!
Consequently the retirement benefits of asylum workers differed greatly from area to area. Many local court officials were aghast at Lord Shaftesbury reducing the term of service for which a pension could be granted to an asylum worker from twenty years to fifteen years (it was recognised that most asylum workers would be burnt out after 10 years service). They were very assiduous in calculating the maximum benefits in lodgings, rations, or other allowances enjoyed, to be deducted when calculating a pension benefit.
To put the matter of costs into perspective:
Male Principal Attendant £60-70, Female Principal Attendant £40-50.
Male Attendant £40-45, Female Attendant £25-30.
Male Assistant Attendant £35-40, Female Assistant Attendant £18-21.
In 1862, the average cost per patient was £59 14s. In county assylums, this figure was £24 10s 9d, with staff wages being typically 40% lower – at st Lukes, london, the wages of attendants were noticed to be particularly low, resulting in frequent changes in the staff. Between 1867 and 1869 the average cost per patient at Broadmoor was reduced from £67 4s 9d to £64 8s. Reducing costs were paramount.
What are these wages and costs in modern terms? Using economic status value of income, the value of £20 in 1867 was worth £17,440 in 2014, using the income index of per capita gp. Thus, using Broadmoor as an example, a Female Assistant Attendant (equivalent to a N/A) received about £17,000 per anum; a Female Attendant (equivalent to a staff nurse) received about £23,000, and a Female Principal Attendant (equivalent to a sister) received about £35,000. Male staff wages were at least 50% above these rates. Many from the same family would be employed.
Using the same measure, in 1862, the average cost per patient was about £50,000 per anum at Broadmoor, and about £20, 000 elsewhere.
‘The current average bed costs per annum for Broadmoor Hospital to commissioners is £325,000’ (Hansard, April 25, 2013).
These increased costs are not comparing like with like, of course. Since the 1860’s, psychiatry has become a mass industry that feeds many mouths, those of significantly more staff, including nurses, doctors, counsellors, and various support workers, and also the chasm-wide mouth of the drug manufacturers.
What can be gleaned from such a historical perspective? I suggest we are witnessing a return to a system (presented in propaganda as ‘regionalism’), whereby groups of local businessmen wil decide the limit of their business rate contribution, effectively placing a cap on the level of local wages in such jobs as nursing. This will lead to an end of nationally applicable rates of pay. There will be wide variations of pay received by people doing the same job.
This will not effect NHS pensions, for the simplistically brutal reason that, as an example, any RMN qualifying in 2016 at the age of 22 will not be able to retire until 2066, which will be at least 40 years after they are completely burnt out, just like their forerunners in the asylums.
What all people with a vested interest in the nurse training industry simply can not admit is that they are nothing more than a conveyor belt that delvers a constant stream of cannon fodder, who last between 5-10 years on the bomb-raining front line of nursing. The same with teachers.
These front line troops will not be able to buy a house in such places as London.
The Broadmoor Solution awaits.
Nigel and Nellie New Nurse will live on the job, but not in comfortable cottages, dearhearts! A tiny room near the ward awaits; as does the knock on the door: “Nellie, we’re short on Ward 101, get yourself there”! There may well be a library and snooker room, and a social club. Your laundry will be done; and there may be a weekly disco, but it will come at the price of unswerving obedience.
I remember all this as a young nurse, it’s just that the obedience bit did not apply. I once told a senior sister that I was not going to carry out her instructions because I didn’t think they were in the best interest of my patients, and, as I was in charge of my ward, I told her to stop interfering. How often does this happen now?
In the New Broadmoor of Nursing, there will be only obedience.
lenin nightingale 2015