Not complete

Sir Henry Wentworth Acland, was interested in the registration of nurses. He had written to Florence Nightingale in 1867 asking her advice for training nurses at Radcliffe Infirmary in Oxford, where he was a physician. A few years later in 1869, he wrote to her again concerning training and the certification of women in several occupations. Florence Nightingale was opposed to the registration of nurses, as she felt 'that nursing and medicine must never be mixed up'. She felt that the less knowledge a hospital matron has the better, and that it would not improve relations between nurses and tutors.

Henry Acland went to the General Medical Council on 4^th March, 1872, proposing a qualifying certificate. The motion was seconded by Dr Stokes.

'that a committee be appointed to consider and report whether the General Medical Council has power to make rules for the special education' of women such as may entitle them to obtain a qualification to be certified by the Council; and that the Committee do further report for what purpose such qualifications if any, should be granted what are the most desirable means for educating, examining and certifying in respect of them with special reference to midwifery, the management of medical instructions, dispensing and nursing.

The resolution was passed by a narrow majority Henry Acland had written to Florence Nightingale, sending her the text of the proposed resolution. Also asking for her opinion and advice. Florence Nightingale disapproved of the whole idea, with exception of midwifery.

Florence Nightingale felt that nursing was mainly to do with character, which could not be obtained from taking an examination. She did feel never the less that if a nurse obtained sufficient nursing experience, her name could be entered on a register, without taking and examination. The training of nurses, in her view, should not be laid down by the Medical Council, and that midwifery, stood on a different plain from nursing. On the question of the management of Medical Institutions she could not understand how a superintendent would come under the province of a Medical Council examination. When the knowledge they need includes; sanitary knowledge, knowledge of management, administration, housekeeping, above all training and management of women both as to character and skill.

Florence Nightingale's criticism did not make much impression, on Henry Acland. Under his chairmanship the committee continued, Florence Nightingale's advice was only sought when a provisional report was drawn up.

Florence Nightingale replied:

'You are not yet in a position to move at all. You have no feet. What you ought to report to the Council is simply the information which you have collected ? and the information collected if not sufficient to enable steps to be taken. If you attempt to walk without feet either you stand still or fall over (so far Dr Acland). Would you not limit your report simply to a resume of existing information ? cut out all advice. Ask the Council to continue the powers of the Committee. Before your report is printed or adopted I shall be obliged to you to give me full opportunity of looking it over as at present my views do not appear to be correctly represented.'

The Council did not adopt the report, or make any opinion on it. The two main recommendations of the report were;

          'To enter into communication with any public institution in which there is provision for the education and examination of women as midwives, dispensers, superintendents of nurses and medical institutions.'

          'to consider and report whether and in what manner a public register of persons obtaining the qualification might be kept.'

The committee had also inserted a paragraph which indicated what they had in mind. This was that in any future amendment of the Medical Act, a clause should be added to give the power to the Medical Council to register the qualifications of midwives, dispensers and superintendents of medical institutions.

After the report had been presented to the Council, Henry Acland wrote to Florence Nightingale. He told her that he would now proceed with caution. In 1874 he wrote a preface to a book by Miss Florence Lees, which included the following paragraphs:

The Medical Act of 1858 allows women to be registered a medical practitioners. It makes no provision for the registration of trained nurses, however complete their education and however great their skill, whether as midwives or nurses. Many accomplished women might reasonably desire the name as well as the function as superintendents of hospitals, or of ward sisters, or of nurses.

At present they can have no such legal recognition of their qualification in either department, as is obtained by sisters who become schoolmistresses, or who are students and teachers of art. That this ought to be remedied can hardly admit of doubt; but it rests with the women of England to decide whether what is here advocated has their support as well as their approval.

This advance, he knew would never be achieved while Florence Nightingale was still alive. Three years after Henry Acland became 'Sir Henry Acland', the question of the registration of nurses came up again. This time not from the General Medical Council, but from those who it most concerned.

In 1886 Mr Burdett of the Hospital Association attempted to start a register of nurses, but it did not meet with their approval. In 1887 a number of nurses joined together, headed by Mrs Bedford Fenwick, started the 'British Nurses Association'.

Sir Henry Acland was a member of the Hospital Association, he joined the British Nurses Association, because they allowed medical men as members. There main aim was to standardise nurse training, and the registration of nurses.

Florence Nightingale saw that the support for examination and registration of nurses was growing. When the 'British Nursing Association' applied for a charter, she used her influence the President of the Board of Trade, Sir Michael Hicks Beach to refuse the granting of the charter.

Sir Henry Acland was still in correspondence with Florence Nightingale, he wrote and told her he had written to the Empress Fredrick about his ideas. He could not change her mind. He still supported her in her efforts to maintain the Army Medical College. He was created a baronet in 1890, and died at Oxford in 1900.)

(to be continued)