Black History Month 2024: The intertwined history of the Windrush generation and the NHS

29/10/2024

As we approach the end of Black History Month, a time to reflect on and celebrate the contributions and impact made by those from African and Caribbean descent, Atticus Partners reflects on the remarkable contributions the Black community has made to the NHS throughout history.

The Windrush Generation

The birth of the NHS in 1948 coincided with the arrival of the HMS Empire Windrush, the ship which carried over 1,000 passengers from the Caribbean to the UK and which historically is referred to as the Windrush Generation. 

Following the Second World War, the Government under Prime Minister Clement Attlee sought to increase the number of healthcare professionals in the UK. This led to the Ministries of Health and Labour, the Colonial Office, and other governmental bodies actively canvassing for workers across the British colonies, particularly the Caribbean.  

The British Nationality Act of 1948, which was implemented by Attlee’s Labour government to address post-war migration issues, granted citizenship and the right to reside in the UK to all members of the British Empire, including those from the Caribbean. The Act was initially welcomed as it played a key role in filling labour gaps in Britain, however as more migrants began to enter the UK, public sentiment began to shift, paving the way for more restrictive immigration laws in later decades.  

By 1977, 66% of overseas student nurses and midwives were from the Caribbean, showcasing the critical role these migrants played in sustaining the NHS. Many doctors were also recruited or offered the chance to pursue further studies in Britain, improving the NHS’s ability to handle more complex medical needs like psychiatry and obstetrics and gynecology.  

The careers the Windrush generation forged in the NHS came with numerous obstacles and adversity, however. Windrush nurses were often automatically enrolled in lower status training pathways, missing out on opportunities to learn leadership and ward management skills. They were also dispatched to the more unpopular, under-resourced areas of the NHS, such as psychiatric nursing, without much opportunity to progress.

Following pressure from the Conservative opposition, the Labour Government’s later restrictions on immigration from Commonwealth countries saw it impose the Immigration Acts of 1962 and 1968, which limited UK citizenship to those born in the UK and their children or grandchildren. Those living in the ex-colonies without a direct family connection to the UK were no longer entitled to enter the country as previous legislation had allowed them to. Edward Heath’s subsequent Conservative administration continued to impose restrictions, with the Immigration Act of 1971 significantly curbing the rights of those living in the UK who had been granted citizenship under previous laws. This legislative shift reflected a broader trend of increasingly hostile immigration policies that continue to affect migrant communities today, as seen in the Windrush Scandal.  

The Windrush Scandal, which broke out in 2017, revealed that hundreds of Commonwealth citizens were wrongly detained, deported, and denied legal rights. Many arrived as children on their parents’ passports, and after the Home Office destroyed key records, they lacked documentation to prove their right to stay. 

Misclassified as undocumented migrants, they lost access to housing, healthcare, and other services, with some facing deportation to countries they hadn’t seen since childhood. 

A significant backlog of unresolved cases remains, underscoring the need for urgent action from the new Labour Government to address this long-standing injustice. Ahead of the 2024 general election, Labour outlined a commitment in its manifesto to ensuring the voices of the Windrush generation are heard – a promise further reiterated by Home Secretary Yvette Cooper.  

However, with Labour facing considerable challenges in its first 100 days, and with anti-immigrant sentiment ever increasing in the UK, there is the potential for the Government to backtrack on its commitment in favour of less emotionally charged policy.  

Looking forward

June 2023 marked the 75th anniversary of the HMS Empire Windrush, and it provoked a deeper exploration of the contributions of its passengers to the UK, past and present. The pivotal role of the Windrush Generation in shaping the NHS is a narrative that must be foregrounded in discussions about healthcare policy and reform.  

Today, the service is renowned for its diversity; ethnic minority colleagues make up a quarter of the NHS workforce and 42% of medical staff. However, they make up only 10% of senior managers and 13% of board members. Alongside this, many NHS staff continue to face racism in the workplace; a report published by human rights charity BRAP this year found that 71% of UK-trained NHS staff from minority ethnic backgrounds complained of race discrimination. 

However, significant structural challenges still remain within the NHS, reflected in both ongoing racial discrimination within the organisation, and the legacy of past injustices.  

Moving forward, it is essential to go beyond symbolic recognition and commit to systemic reform. Prime Minister Keir Starmer recently announced plans for a Race Equality Act, which would include imposing a duty on public services, including the NHS, police, schools, and councils, to collect and report data on staffing, pay, and outcomes by ethnicity. 

By fully embracing diversity, addressing inequality, and ensuring that the voices and experiences of all communities are valued, the NHS can work towards better outcomes for its staff, patients, and future generations.