In 1893 and again in 1901, War Office committees were formed to look into the reorganisation of the army medical and nursing services.  Senior army medical officers and nurses were called to give evidence to the committees, and the following extracts give great insight into hospital life within the army framework, and also conditions for nurses at that time, in both military and civil hospitals. The proceedings are reported verbatim, which though unsusual adds greatly to the flavour of the proceedings. The Chairman in 1893 was Lord Sandhurst, and it was he who asked all the questions except where noted.  In 1901 the Chairman was The Right Honourable St. John Brodrick, Secretary of State for War. Please note that these extracts have been heavily edited, and there is often much discussion between the points entered below - please refer to the originals where necessary.


Report of the Committee appointed to consider the subject of the Nursing Service of the Army: Notes on the report.
Saturday, 11th February, 1893


Brigade-Surgeon Lieut.-Colonel C. G. Harrison, M.B., examined:

212. Besides nursing, it is the duty of the sisters to train the orderlies is it not?

213. Do they do so?

214. Do they take that con amore, or do you have to look after them to see that they do it?
They do take to it, but it depends very much upon the sister herself, some have an aptitude for teaching orderlies, whereas others do not.

215. Do you think the present class of nursing sisters is a good class for the work?
Yes, I do.

216. Do the ones that you have come across belong to what is styled the “lady” class?
Some, but not all, the class is mixed.

217. Which would you prefer, the “lady” class of the better portion of the domestic servant class?
I very much prefer the “lady” class, because they have their heart in the work; they are a better class altogether, and they maintain a higher tone in the hospitals, besides which the men are more respectful to them.

218. Are the soldiers generally respectful to the nursing sisters?

Same date – Miss A. E. Caulfeild examined. [See note at bottom of page]

239. You are Lady Superintendent of Nurses at the Herbert Hospital, Woolwich, I believe?

241. How many sisters have you?

242. Do you do any nursing yourself?
No, I only superintend the other sisters.

243. Do you do any teaching, or anything of that sort?

244. Have you had any experience of other hospitals besides the Herbert Hospital, have you been in any provincial hospital?
No, I have only been at Netley, and I went from there to Woolwich in 1877.

247. Were you ever in a civil hospital?
Yes, I was at King’s for about three months.

249. Is it not the case that the duties in a military hospital are much lighter than those in a civil hospital?

281. Do you consider the nursing sisters a thrifty class?
No, few of them are thrifty.

282. Do you consider them well paid?
I think they ought to be better paid.

283. How does their pay contrast with that given in the civil hospitals where the work is so very much harder?
It contrasts very well with that given in civil hospitals, but I think the nurses there are underpaid.

284. The present rate in military hospitals is £30 to £50 and allowances. Do you think they ought to have more to begin with?
Yes, I think they ought to begin at £40, because they are better trained now. In the old days they came to us with very little training, but how they have all spent at least three years, and many of them as many as five or six years in a civil hospital, and therefore they are worth more.

285. Would they be able to get good positions outside if they did not come into the military hospitals?
I do not think £30 a year is very much.

286. But you must add to the £30 the board and lodging and the pension?
Is not the pension a very vague thing, there is nothing settled about it?

287. (Mr. De la Bère) It is quite secure; it is as secure for them as it is for anybody else?
They all say that it is very vague, the regulations say we can retire at 60, with a pension. We should very much like to get a pension after a certain term of years, say after 20 years.

288. The Chairman. You are now touching on the age limit which is 60. Do you think that is a proper limit, or would you like to see it reduced to 50?
I should like to see it reduced.

289. On what grounds do you think a nurse is less capable after 50 than before?
Yes, it is a nuisance to keep a woman on till she is 60; she is past her work then, besides you would not send a woman nearly 60 on foreign service?

291. Do you think 30 is the fair average of the age of the sisters on entering the Service?
Yes; I think the present ages of 25 to 35 afford good limits.

292. And I understand you would like them to be pensioned off after 20 year’s service, because after 50 a woman has really run down?
Yes, that is so.

293 Would you like to see them begin their work at an earlier age, say between 23 and 28?
No, not younger than 25. Of course a woman coming in at 35 could not get 20 years’ service in by 50, but could not she be allowed to put in another five years’ service if she liked as a special case; it would be rather hard upon her to turn her out at 50 with nothing?

294. Is there any method by which you can get rid of a sister supposing she is not good enough to be promoted, or has she to keep on her old “humdrum” work as a sister after being at it already for 10 or 12 years?
As a rule we have to keep them on, but I think it would be better to get rid of them.

297. Have you ever heard any complaints from the sisters, who have been in general hospitals that the work in the military hospitals is dull and that there is not enough change in it?
I do not think they complain of that as a rule, of course there are more bad cases and more changes going on in a civil hospital, but then they will all tell you that they expect to break down in a civil hospital, whereas in a military hospital they work is much lighter and therefore they can go on longer.

302. Are you satisfied with the class you are getting now?
I think we ought to have nobody but ladies in the military hospitals, they are not all of that class now.

303. Do the sisters marry?
No, not very many, a few do.


[Anne Ellen Caulfeild was born in Ceylon in 1844, the daughter of the Hon. James Caulfeild of the Ceylon Civil Service.  She was appointed to the Army Nursing Service on the 1st July 1874, and rose to become Lady Superintendent at the Herbert Hospital, Woolwich - the equivalent of a Matron. She retired from the service on 1st September 1894, hopefully with a pension for twenty years service which she managed to squeeze in just before her fiftieth birthday!].


Report of Committee appointed by the Secretary of State to consider the Reorganization of the Army and Indian Nursing Service, 1901.
Monday 22nd July, 1901

Surgeon-General Hooper: If the Indian Nursing Service can still, as it at present does, give preference to the relatives of Military Officers, that is a great privilege, which is held to be so by both the Army Nursing Service and the Indian Nursing Service, and I think we should secure that very markedly; it entails social as well as professional qualifications, which is a very great desideratum.

Chairman: What number of nurses have you in India?

Surgeon-General Hooper: Thirty-nine, nine nursing sisters, and four superintendents.

Chairman: How are they recruited at this moment?

Surgeon-General Hooper: There is a register kept up of social and professional qualification, and practically the Military Committee select, with my help and suggestions about the professional qualifications and so on.
. . . . . .
[Chairman, discussing the point that “as a general rule hospitals containing fewer than 100 beds will not be provided with a regular female Nursing Staff.”]
     That clause will, no doubt, cause considerable question, that is to say, you will not provide them with a Nursing Staff, but on any emergency, the Nursing Board will send female nurses to those hospitals. I suppose one must remember that in a Military Hospital, where you deal so largely with syphilis, which is not nursed by women, at least under present regulations, you may very often have in a hospital with under 100 beds a very few cases indeed that require other nursing, but I should like to know whether anybody on this subsection has any opinions to express.

Sir Frederick Treves: I was wondering why the number 100 was introduced, because, of course, in a hospital of 50 beds, simply because there happen to be 50, it does not mean that the cases are trivial. There may be more serious cases in a hospital with 50 beds than in a hospital with 100 beds, and I should have thought there should be a Sister in every hospital. I do not know why this number was selected.

Surgeon-General Hooper: That will entail quarters at every hospital for nurses, which would be almost impracticable. It must be limited somewhere.

Chairman: I suppose there would be great difficulty about quarters in small hospitals.

Sir Edward Ward: With a small number of nurses the difficulty is in them putting themselves up and making themselves comfortable. The idea was that these special nurses would always be at hand and ready to go down at a moment’s notice, the same as they go to an ordinary sick case.

Dr. Perry: The experience of most outsiders, one may say, with regard to the Military Nursing Service is, that it has a distinctly deteriorating effect upon women to put down two or three women in a centre where they are surrounded by men, and that the system where they would be surrounded by men only, does mean less efficient nurses and exposure to certain influences which considerably mar their character as nurses ... If you put 10 or 20 women together, the moral standard as applied to the female sex will be kept up; if you put two or three, there is a considerable risk that they would become deteriorated ...
. . . . . . . . . .

[On the point “Submitting to the Secretary of State, through the Advisory Board, a Scheme for the organisation and development of the Queen Alexandra’s Imperial Military Nursing Service in India, which shall allow for adequate local control subject to the general authority of the Nursing Board.”]
Surgeon-General Hooper: I think so, Sir, provided that preference is always given to the relatives of Military Officers. It obtains in both Services, in the Army and in the Indian Service. I think we should provide that, or else the outsiders will swamp the Military candidates. It entails a good social qualification.

Sir Edward Ward: It would be rather hampering the Board in their selection. You might in recommending a deserving case get a bad nurse by it.

Surgeon-General Hooper: They do not now; at present it rather secures a good nurse as well as a good social qualification. It is looked upon as very important in both Services now.

Sir Edward Ward: It is not laid down in any Scheme just now; both parties do it, but it is not laid down, and I think we might leave it so.

Dr. Tooth: I should like to see it left as a lex non scripta.

Chairman: Then, I think we ought to leave it to the Nursing Board. I am all for their doing it if they find that they can.
. . . . . . . . . .

[On the point about Matrons of hospitals having the power to forward confidential reports on their nursing staff direct to the Matron-in-Chief, without reference to the views of the senior medical officer of the hospital].
Lieut.-Colonel Keogh: If the Medical Officer has no voice in the promotion and selection of nurses under him, I think a good many will be selected who ought not to be if he has not sight of their confidential reports, upon which their retention, dismissal or promotion in the Service mainly hangs.

Chairman: The difficulty is to get any one to make a confidential report that is at all accurate; that is our experience. Of course Colonel Keogh very properly takes the point of principle about it, and, as I say, Lord Roberts is very strongly in favour of the complete autonomy of Matrons in this respect; and I shall be glad to hear the Military Members on this.

Sir James Willcocks: I do not see, considering that it is a Military Service, how it is to get on if the Medical Officer has nothing to do with it. I cannot see how the nurses can work in a hospital in which the Medical Officer, who is really in charge, does not know anything about what is going on. I do not know what the status of these ladies will be; but they will have to be of a very high status before they can report upon all these people, and nobody is to have anything to say when their future may depend upon these reports.

Lieut.-Colonel Keogh: You must remember that in a Civil Hospital the Medical Officers have nothing to do with the administration ...

Sir James Willcocks: ... I cannot understand how it would be possible for the work to get on if the nurses and Matrons are to have all this power in their own hands, and nothing whatever to do with the Medical Officer who is in sole charge of the hospital.

Chairman: ... I understand that what he [Lord Roberts] apprehends is, that if the Matron has to forward through the Medical Officer reports on her own nurses, she will say: “Oh, well, the nurses will be attacked altogether in this hospital if I give away anybody,” and will form square round her nurses. On the other hand, if she writes simply to her own Chief, the Principal Matron here, she will tell her anything that is going about her nurses.

Lieut.-Colonel Keogh: And she will tell you a good deal that is not going, Sir; that is my opinion. I do not believe you could trust a lot of women with the power you are going to give them here. I believe a man is much more honourable. I believe in petty spites. Look at what goes on in a garrison. These ladies are going out into society, going to tea and dances. They are taken up by certain people in the garrison. If the Matron is not taken up – if a pretty girl, or a taking girl, goes out into society more than she does, and people will not have anything to say to her – she will give it that girl very hot in her confidential report. Women have not the same feeling about these things. Theoretically it may be all right, but practically, in a garrison town, where these nurses are very much in society, going out to dinner parties, and all the rest of it, if the Matron-in-Chief is not the head in society that they are in, and goes amongst them and takes the lead, that is what she will do.

Sir Frederick Treves: Might I add one word in connexion with the paragraph? I think it would be impossible that this could be done without the Medical Officer. You must remember that the only person who can judge of the qualifications of a nurse quâ nurse is the officer in charge of the patient. I think if you take cases in private practice, you certainly would not go to this lady or that to know whether so-an-so is a good nurse. She may be ill-mannered, or what not, but the question is, is she a good nurse? And the only person capable of giving an opinion on that point is the Surgeon or Physician in charge of that individual patient ... the nurse does not care that for the Surgeon.

Chairman: One strong advocate of the nurses said, “Well, but may we report on the Doctors if they report on us?”

Sir Frederick Treves: I think that anything that can emphasise the fact that the nurse’s position is absolutely subordinate is to be desired. Unless it be subordinate, the nursing is fatal; it must be absolutely subordinate, and I should characterise the suggestion that the nurse should report on the Medical Officer as a piece of impertinence from a subordinate person.