The 1955 Select Committee to investigate the Nursing Amendment Bill

On 15 March 1954, the South African Parliament appointed a Select Committee to investigate the draft Nursing Amendment Bill then before it (South Africa 1955:iii). The Select Committee sat for two years and had three chairmen (the third chairman stated that the committee needed more time for deliberation) before producing a preliminary report in 1955 (South Africa 1955:iv-vi). The 1955 report indicated that four groups gave evidence before the Committee: SANC, SANA, the Cape Provincial Administration and the Transvaal Provincial Administration. For historical clarity and context, brief reference is made to SANC’s testimony (as it influenced SANA).

7.4.1.1 SANC evidence

Although the Select Committee had the task to investigate the Draft Nursing Amendment Bill before it, SANC proposed a new Nursing Bill. The purpose of this new Bill would be to grant SANC discretionary, permissive (not compulsory) power to differentiate, based on race (as required by the government), between types of training – and thus types of registration. A long discussion ensued about the perceived academic abilities of Black

and Coloured nurses (in 1953 the student pass rate was 35.5%). In its testimony, SANC used socio-cultural and educational factors to explain why the nursing course topics for all nurses should remain the same, but that the content should differ (e.g. Western vs. African dietary teaching). SANC then explained that if the training course content differed, it stood to reason that the registration (of clinical skills) should also differ – although the same certificate would be issued. The SANC President, Miss Nothard, acknowledged that Black nurses opposed the idea, while some White nurses felt that such system might be beneficial. The SANC Board put the matter to the vote and was split. The decisive vote for differentiation in registration was then cast by the SANC President (South Africa 1955:5, 11, 48, 56, 58-59, 89). It implied that South African nursing’s governing body was asking for discretionary power to create racially segregated registers and rolls. This decision would create racial discord in South African nursing and would complicate the profession’s transformation process later, in the 1990s (note chapter 8).

The SANC also asked for control over nursing Auxiliaries who were not required to register, and so an untrained and unregulated group continued to practise the art of nursing. The Cape Provincial Administration objected to this, stating that SANC’s powers over training and training facilities created financial and logistical difficulties, which hampered nurse training (South Africa 1955:12, 118).

7.4.1.2 SANA evidence

The SANC’s proposed new Nursing Bill (part IV) included SANA, which implied that the Association would remain a statutory body. Section 25(1) suggested a White SANA Board and the establishment of a Black standing committee (South Africa 1955:30-32, 33, 35). SANA supported a consolidated (not only amended) Nursing Act, but testified that the proposed segregation clause was introduced by the Minister of Health, Dr Bremer. SANA was not consulted in that regard. In contrast with 1942 (the trade union crisis), the SANA Board did not conduct an active campaign to canvas members’ rejection of the proposed bill. Rather it relied on its branches, calling on them to vote on their support/rejection of the proposed Bill with its segregation clause (Nursing and Racial Issue 1956:4; South Africa 1955:116-117). South African nurses’ non-participation in the vote on branch level then changed the course of their history: of the 8765 SANA members entitled to vote, a

South Africa, was mandated (by a 286-vote margin) to support the Bill (Board of the Association … 1957:5). At the Parliamentary Select Committee hearing, the SANA representatives reflected that not all members could attend the branch meetings, and that a referendum would possibly have yielded better voting numbers (South Africa 1955:92, 109, 116). SANA later stated that such endorsement of the bill “is in direct conflict with the International Code of Ethics of the ICN” (Nursing and Racial Issue 1956:5). At the Select Committee hearing, SANA opposed auxiliary nurses becoming members of the association (South Africa 1955:113), possibly because it wished to maintain the exclusivity of having only trained and would-be-trained (students) registered nurses and midwives as members.

When asked for its opinion about the proposed separate SANC registers, the SANA representatives stated that it was a SANC matter and that SANA “did not consider the matter nor have we been asked for our opinion” (South Africa 1955:113). The researcher considers this statement as an attempt by the SANA leaders not to become embroiled in political issues. It is however, difficult to accept that SANA did not consider or discuss the issue – especially in the light of the fact that Miss Nothard gave evidence on behalf of SANC on 25-26 April 1955 (South Africa 1955:1, 59) and then formed part of SANA delegation that gave evidence on 2 May 1955 (South Africa 1955:91).

7.4.1.3 Role confusion and power play

From the 1955 Select Committee report, it is evident that the interconnected, yet distinct, roles of SANC and SANA were not always understood (also note sub-section 7.4.2.3.1), and that the power of SANC was not accepted by all. As mandated by the Nursing Act (45 of 1944), SANC was prescribing students’ training conditions and approving training schools. However, in the 1950s, student nurses were still considered a workforce and therefore SANA remained involved in its junior members’ work hours and conditions of service.

An example of SANC/SANA role confusion (and perhaps role preferences) is evident in the Cape Provincial Administration’s testimony. Its representatives wanted the new Nursing Act to restrict SANC’s control (South Africa 1955:125, 129, 132-137), stating that nurses’ conditions of employment should not be dictated by them: “It must be remembered that some of the nurses serving on the council are paid officials of the

administration and for them to be able to dictate to the administration is an unsound state of affairs” (South Africa 1955:129). Furthermore, SANA must make representations and then leave decisions to the administration, because “the Association would not have the power to dictate or to lay down conditions for the recognition of training institutions” (South Africa 1955:128-129). The researcher noticed that the Select Committee asked SANA numerous training-related questions and that the association constantly referred to SANC’s standards and rules. In this way, SANA advocated a high standard of nurse training which would benefit society ‒ and by extension enhance the professional status of South African nurses.

The Cape Administration laid the current shortage of nurses before the door of SANC and reminded them that nursing was not a parallel profession, but an ancillary one. The nurses’ examination must therefore not be too technical ‒ something that the Directress of Nursing Services for the Transvaal declared “sheer nonsense” (South Africa 1955:136; Evidence given … 1955:756-757). To place the nursing shortage in perspective: South Africa’s population numbered 12 million in 1953, with 13 689 (323 male) registered nurses and 8666 midwives to attend to them (Kretzmar 1954:382). Of interest is the fact that SANA in earlier years had striven to assist with the nursing shortage. The association wrote letters to all four provinces suggesting a recruitment plan and requesting funds to implement it. All four provinces declined the offer and SANA dropped the matter (South Africa 1955:113-114; 135-136)).

In its evidence before the Select Committee, the Transvaal Provincial Administration’s Dr Wassenaar explained that hospital boards (prompted by the Wolmaransstad Hospital Board) in his province were concerned about SANA’s no colour-bar policy. The hospital boards’ concerns related to the risk of a multiracial SANA Board, the implication of multiracial “social and other functions” (South Africa 1955:147) and (considering the increasing number of Black registered nurses) the possibility of a Black majority on the SANA (and SANC) Board. The Transvaal Administration therefore wrote a letter to the Minister of Health, urging amendments to the Nursing Act to curb the danger of trade unions and lessen exposure “to the danger of Communism” (South Africa 1955:148-149). In response, the minister introduced a segregation clause to the proposed Nursing Bill. Uys (1987:55) effectively summarises the socio-political atmosphere: “Due to the

In her testimony, the Directress of Nursing Services for the Transvaal, the then Mrs Charlotte Searle, objected to the appointment of a medical doctor to SANC and supported the independent power of nursing’s governing body. Her pragmatic support of separate SANC registers must be regarded against the socio-political background of the era (note paragraph above and sub-section 7.2.1 of this chapter). The separate SANC registers would provide statistics to determine the number of Black nurses required to provide Black nursing services (as per government’s segregation policies). Furthermore, the proposed amendments would assist nurse managers in retaining White nursing candidates who otherwise would have resigned if they were to be managed by a Black registered nurse (South Africa 1955:143, 152-154).

Within the social restrictions imposed by government policy, the Directress of Nursing had to ensure that enough nurses were available to serve all sections of South African society. That meant knowing how many of each nurse category and racial origin had to be trained – while at the same time trying to retain staff. The complete segregation of nursing services was not possible due to the nursing shortage. Transvaal public hospitals were segregated; private hospitals were not (South Africa 1955:158). In her testimony, Mrs Searle’s abhorrence of trade unionists and strike action that potentially left patients unattended also came to the fore (South Africa 1955:152-153). This would influence the nursing profession in later years when she became the President of SANA (note sub- section 7.4.2.3.1 of this chapter).

Although the Select Committee requested more time to finish its work, the parliamentary session ended on 6 June 1955 and therefore the committee’s preliminary report was published. On 24 June 1957, Parliament approved Nursing Act no 69 and it came into force on 12 July 1957 (South Africa 1955:v-vi; South Africa 1957:2). In her welcoming speech at the sixth Biennial Congress (24-28 September 1956), the SANA Chairperson, Miss Borcherds, referred to the problems facing the association and stated that “perhaps we have arrived at the crossroads in our Professional Association” (Sixth Biennial Congress 1956:20). The Afrikaans version of the speech is more revealing, as it uses the word “samesyn” (Sixth Biennial Congress 1956:21) which in the context of the historical era can be translated as “togetherness” (Bosman, Van der Merwe & Hiemstra 1984:445).