THE FLINTSHIRE COUNTY NURSING ASSOCIATION* by J. Brian Lewis.

The first person in this country to realise that the poor needed skilled medical care in their homes was “William Rathbone, a Liverpool merchant who, in 1895, started a system of district nursing by trained nurses in his home city. The success of this experiment led to it being adopted by towns and cities throughout the land, and. before long, the district nurse became an established institution. Her work has been particularly valuable in rural areas where other medical or social services are scanty or wanting, and as the personal health services developed, the most practical and economical way of extending them to those areas where the population was too scattered to justify separate provision was found to be by enlisting the co-operation of the local district nursing association and extending the scope of the nurse’s care. Consequently, in many areas she became health visitor, midwife, child protection visitor, tuberculosis visitor and school nurse, as well as attending the sick….As time went on….the Queen’s Institute of District Nursing (originally the Queen Victoria Jubilee Institute for Nurses, founded by Queen Victoria with the money given by the women of the nation to celebrate her Golden Jubilee in 1887) was established to co-ordinate the work of the various voluntary committees in the different districts and to ensure that a good standard of nursing was maintained, and it arranges training courses for those nurses who wish to take up this branch of the profession.’ Several Acts of Parliament strengthened and supported this venture, namely The Midwives Acts of 1902 (see note 33) and of 1918 which authorised local supervising authorities to make grants towards the training of midwives and initiated the system of payment to medical practitioners called in under the Rules of the Central Midwives Board. The Midwives and Maternity Homes Act of 1926 made additions and amendments to the Act of 1918 and the Act of 1936 secured the organization of a service of salaried midwives employed directly by, or under the control of, the local Supervisory Authorities and laid the foundations of an improved midwifery service. Child Welfare was given impetus by the Maternity and Child Welfare Act of 1918. [I]
The Flintshire County Nursing Association (FCNA) was the coordinating body which the District Nursing Associations (DNAs), some founded prior to the FCNA, were affiliated. The FCNA was, in turn, affiliated to the North Wales Nursing Association (NWNA).
A midwife’s licence was granted to the Ordinary of Hawarden in 1674, but the first record we have of district nursing in Flintshire is in 1899 in Halkyn when the person who became the Secretary of the Halkyn DNA in 1900, H.Lester Smith of 5 Hunter Street, Chester and Halkyn Old Halfhad a cottage fitted up for the nurse, Miss Schonberg. She came from Clewer near Windsor and, though not a Queen’s Nurse (QN), was connected to the Queen’s Institute (QI) at Gloucester Gate. In 1899 there were 133 patients to whom Nurse Schonberg made 1,470 visits; there were eleven deaths and 274 children’s visits to the surgery. The first balance sheet for the Halkyn Branch appeared in 1900. The President of the Branch was the Duchess of Westminster and the Chairman was the Revd. A.J.M Green, Rector of Halkyn. The Hon. Secretary/Treasurer was H.D.Lynes of Halkyn Old Hall. [2]

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* This article refers to the pre-1974 county of Flintshire.
For this association fifty copies of the Rules have survived and a Queen’s Nurse, Miss M. M. Jones, who was Welsh-speaking, was employed from 1902. In 1905 we have a reply from H. D. Lynes to Miss Davies-Cooke informing her that the Halkyn DNA did not wish to join a proposed Flintshire County Nursing Association (eventually formed 1930). From 1913 E. Redfem was the Hon. Secretary. The Statement of Accounts for 31 December 1904 shows that the nurse’s salary was £68.17s.9d. and the balance was £27.2s.6d. The subscribers to the Halkvn Association in addition to the Duke and Duchess of Westminster were the Halkyn Mining Co., the East Halkyn Mining Co., North Hendre Mining Ltd., Halkyn Mines District Drainage Co. Ltd. and the local chapels and churches. In 1900 the nurse’s district covered Pentre Halkyn in the south, Rhosesmor in the north, Rhes-y-cae in the west and Halkyn in the east.[3]
At the beginning of the century the Flint DNA first appears in the records on 1 June 1901. The Flintshire County Council formulated a scheme for training three Victoria Nurses at the Plaistow Nurses’ Home for District Nursing and one place was offered to Flint. The Mayor, E. J. Hughes JP, called a public meeting in the Town Hall Flint on 29 April 1901 to form the Flint DNA. It was established and the Committee appointed Nurse Jones who was engaged at a salary of £35 per annum. The Flint DNA consisted of subscribers who all paid a subscription of 2s.6d. and upwards and of the medical men practising in the district. All depended on voluntary subscription and no aid was possible from the Town Council. Thomas W Hughes, Coleshill, was the first Hon. Secretary. Fourteen subscriptions from 5s.Od. to £3.3s.0d. were already promised. The President was Mrs Mould, Cornist Hall, and the Hon.Treasurer was E. Thomas of the North and South Wales Bank.[4]
In 1907 we find the Overton and District Trained Nurse Account linked to the Peel Memorial home (1907- 1915).[5] Subscriptions to this were given with fishing permits and concessions at the Steeple Chase.[6] This became Overton and District Nurse Fund which, by 1931, had a balance of £2.10s.7d. A nursing home was built by Major Peel of Bryn-y-pys in memory of Mr Edmund Peel, but bad feeling arose when it was proposed that this fund should join the Shropshire County Nursing Association. [7]
By 9 October 1912 the Flint DNA was raising funds with a Cycle Parade and Carnival which included the Flint and Denbigh Pack of Hounds with their huntsmen. They all marched from the Miners’ Arms public house, Bagillt, to Flint Town Hall.[8]
The North Wales Nursing Association (NWNA) was founded in 1910 and a report by Mrs Heaton, wife of the Vicar of St. Matthew’s Church, Buckley (he later became Rector of Overton) records that in 1915 the NWNA had become short of funds and an appeal was launched by W. A. Foster of Bangor, the Financial Secretary. This was signed in support by a veritable Debrett of North Wales.[9]
As to fees, when debtors could not pay, the Council could accept a smaller sum. Debts under £2 where the patient could not pay could be written off as irrecoverable; the complete scale of charges was :- up to £1 – no charge, over £1 to 30s.0d. one-third cost, over 30s.0d. to £2 two-thirds cost, over £2 full claim.[10]
In a letter from the Countess of March [11] to H. A. Tilby, Clerk to the Flintshire County Council, dated 16 January 1919, Lady march draws Tilby’s attention to the Scheme for County-Health Work ‘Showing how County Nursing Associations can co-operate with the County Councils in Public Health Work in connection with Health Visiting and allied work including School Nursing.’ The Scheme looks forward to the foundation of a Ministry of Health (subsequently established in 1919) to cover Health Powers under the National Health Insurance Act and Local Government Powers – Poor Laws and Workhouses, Board of Education requirementsfor the medical inspection of schools; Powers for training in health matters and the Mental Deficiency Act.
At the zenith of DNA activity in Flintshire there were DNAs, all affiliated to the FCNA at :-
Bagillt                                                  Llanfynydd & District
Buckley & District                         Mold
Caerwys                                              Mostyn and Whitford
Connah’s Quay & District           Nannerch and Ysceifiog
Diserth and Cwm                          Nercwys and Gwernymynydd
Flint                                                      Newmarket (Trelawnyd)
Ffynnongroyw & District          Northop
Gwernafield,          Cilcain and Rhydymwyn Overton & District
Halkyn                                               Prestatyn
Hanmer & District                       Rhuddlan
Hawarden                                         Rhyl
Holywell and Greenfield               St. Asaph
Hope, Higher Kinnerton and Caergwrle   Tremreirchion and Bodfari
Leeswood & District                           Treuddyn
Llanasa, Gwespyr and Gronant
Worthenbury and Bangor-on-Dee [12]
The Holywell DNA was formed on 30 March 1910, when the President was Mrs Yates of Cilcain Hall, the Treasurer was H. J. Roberts of the LCM Bank and the Secretary, Mrs James Ayer of The Strand.[13] The Minutes which have survived concerning the Holywell DNA show that the meeting of the Committee on 3 October 1918, the nurse had made seventy-one visits for fees paid of 7s.6d. At the meeting in November 1918 it was noted that the County Council grant of £8.8s.0d. was given for Health Visiting and that the Association became affiliated to the Queen’s Institute. [14] In that same month the Secretary attended a meeting at Shotton Parsonage when Mrs Gladstone discussed the scheme for a Mothercraft Exhibition to be held in the County Schools. During that November 130 visits were made Holywell.[15]
In 1919 Mrs Gladstone opened the Exhibition on Child Welfare and in April that year there were three midwifery cases in Holywell, one maternity case and two of a general nature. The nurse made sixty-four visits and received fees of £2.l0s.0d. Father Ryan, the local Roman Catholic priest, joined the Committee.[16] Delegates were invited to attend a conference in London on Child Welfare on 1-3 July 1919 at which Mrs Carman represented the Holywell DNA. A representative also attended a meeting of the FCC at Mold on 9 February 1920, and in the same year a Child Welfare Centre was opened at Holywell.[17] In February 1920 one midwifery case was attended, fourteen patients were on the books and 208 visits were made. By 1921 the fees received in Holywell were £7.16s.0d. At a meeting on 12 January 1922 it was noted that the nursing of injured persons came into operation on 1 January that year and the payment of ls.6d. per visit was paid by the Insurance Committee.[18] By May 1925 there had been five midwifery cases, four medical, 114 visits and the fees collected in Holywell were £7.[19]
The Prestatyn DNA was formed on 23 November 1920 and from its inception it was affiliated to the NWNA. The Minutes have survived and the first Hon. Secretary was Edward T.Williams. The first Chairman was the Vicar of Prestatyn, The Revd. Dr. Meredith Hughes. The first nurse was Mrs M. Phillips – Jones who was appointed on 1 May 1921 at a salary of £2.2s.0d. per week together with rooms, light and coal provided. By July 1921 she had mad 87 professional visits. Funds for the work were raised by means of an annual Carnival.
By December 1921 the nurse had made 849 visits and there were eight maternity patients. In 1922 the Vicar advanced £4 to cover the immediate removal of a patient to Liverpool Hospital by motor car. By March 1922 the nurse had made 1,384 visits. On 5 May 1922 Mrs Mortimer of Golden Grove was elected President (she died in 1923). In 1923 Mr. Whipp, the chemist in High Street, was granted the patronage of the Association and in that year the Vice-chairman was Aid. T. Pennant Williams. In 1924 membership was open to those who subscribed not less than 10s.0d. to the funds of the Prestatyn Carnival and a minimum fee of 2s.6d. was charged for each professional visit. In this year Frank Mortimer was President and the Secretary was still Edward T. Williams; the total cost of running the DNA was £321.5s.4d. and there was a balance of £100.9s.lid. The nurse’s salary was by this time £2.10s.0d. per week. In 1926 Nurse Phillips-Jones was replaced upon her marriage by Nurse Violet Henson, who was previously nurse at Leeswood. There was concern for infant welfare and a centre for this was proposed. In 1927 the new spinal carriage/chair was to be housed in the Fire Station and in 1928 a cheque for £5 was sent to Bagillt DNA, which was experiencing difficulties. Because the Carnival began to divide its funds that year between three or four charities, DNA collectors were re-appointed to compensate for the shortfall.
Nurse Henson resigned because of illness and Miss Prytherch, Superintendent of the NWNA, was consulted about her successor; this was also the year in which it was proposed to award pensions to nurses. In 1929 Nurse A. Gunning was appointed at a salary of £2.2s.0d. per week plus £6 for uniform and rooms with a fire and lighting at a cost of 25s.0d. per week at The Grove, Victoria Avenue. In the same year the town of Prestatyn was divided into districts for the purpose of collections. The full subscription was 5s.0d. per annum and membership cards were issued. Eventually an advertisement in the Nursing Mirror secured the services of Nurse Blodwen Roberts in 1930 and in the same year there was a proposal to join a tontine society. In 1931 the new nurse made 1266 visits. In 1934 she attended a professional lecture in Liverpool and in 1935 she made 3125 visits during the year at a salary of £2.2s.0d. per week. In 1937 the District Nurse was employed as a midwife and she began paying Nurse’s Insurance Contributions in 1938. In 1941 she made 3658 visits, the increase occurring because of the influx of evacuees to the town. In 1943 the Rushcliffe Committee awarded a salary increase to all 17,000 nurses thence increasing the total bill to £500,000. The nurse at Prestatyn accordingly received a 40% increase bringing it up to £270 per annum plus £29 back pay and a £12 p.a. uniform allowance. The sum of £52 was deducted from this when the DNA provided her with furnished rooms. The subscription was 6s.6d. In 1945 the Association bought the nurse an Austin 7 car with 47,000 miles on the clock; this car caused much trouble! In 1946 the annual Garden Fete was held to raise funds and at the AGM it was noted that the Association had employed five nurses during its twenty-five years of existence, also that ‘the future of Nursing Associations are very uncertain.’
The last AGM of the Prestatyn DNA was held on 24 June 1948 when it was announced that in consequence of the new Health Act all Nursing Associations’ functions would pass to the County Councils on the ‘appointed day’, namely 5 July 1948. The Prestatyn DNA thereafter became the Voluntary Help Committee which remained in existence until 24 September 1954.[20]
Returning lo the 1920s, a surviving account book shows that the Hawarden DNA was operating in 1925 when the Treasurer was C. V. Harris, Manager of Lloyd’s Bank in the village. Nurse Hampson, who was paid £125.3s.4d. in that year, also made 2171 visits, of which twenty-six were surgical cases, twenty-two medical, thirteen maternity and eighteen midwifery. C.V. Harris was still the Treasurer in 1947 and Secretary was Mrs E. Hindley of 40 Glynne Way. The nurse was Nurse Bennion who was paid £320 minus £42.0s.7d. tax per annum; she made 2951 visits that year and attended 282 cases.[21]
Nurse Alice Griffiths representing Caerwys DNA, Alan Bank representing Caergwrle DNA and Nurse Bryant, the midwife at Holywell and Buckley, attended a meeting of the NWNA on 10 January 1922 at the Queen Hotel, Chester. Miss Davies from Bangor was there to answer questions about the Insurance Societies in relation to nurses attending patients in connection with approved Societies. The officers elected at the meeting were Chairman, The Hon. Mrs Henry Gladstone, Vice Chairman Mrs Yates, County Correspondent Mrs Owen. The NWNA required £400 per annum more to train the twelve extra nurses needed in the county. It was decided to hold a Flag Day on St. David’s Day, fetes and concerts and the money thus collected was to be returned by 30 August 1922. Mrs Theo. Jones, Hope Rectory, ‘gave the names of emergency nurses for holiday periods.'[22]
On 11 January 1922 we find the Caerwys & Ysceifiog DNA remarking that Dr. Morris of Holywell had asked them to supply an extra nurse to cover their nurse’s holiday. They comment that nothing could be done without more money, but propose to obtain this be means of a rummage sale to be held on 21 January.[23]
In 1929 the NWNA instituted pensions for district nurses with the Equitable Life Insurance Society. The pension for a half-yearly premium of £5 for a nurse who entered the scheme at age twenty would produce a pension at age fifty-five of £51.10s.Od. per annum for life.[24]
The Annual Report dated 31 December 1928 for the Connah’s Quay DNA has survived. The Treasurer was Arthur Deakin JP of Dee Road, Connah’s Quay.[25] The Secretary Arthur J. Mothersole, the local headmaster. In 1928 the nurse attended 208 patients, there were seven deaths, 148 ante-natal patients, thirty maternity patients to whom she made 480 visits, 176 of which were post-natal ones. She made 3421 visits in total. In attending some cases the nurse was engaged throughout the night. The fees received for her maternity work were £32.7s.6d. This was contrasted in the Report with the figures for 1927 which were 214 patients, twelve deaths, 514 ante-natal patients, fifty-one maternity patients to whom 1038 visits were made and of which 207 were post-natal. In total the nurse made 3558 visits. Her fees were £50.3s.6d. The Association received considerable support from John Summers & Sons Ltd and from Courtauld’s Aber Works. A house-to-house collection made £67.7s.9d. Both nurses were paid a salary of £140 per annum. The Connah’s Quay DNA received a Ministry of Health grant of £8 in aid of its work done for the past year 1929-30. On 31 December 1932 it was reported that ninety-three patients were attended to, there were nine deaths and, in total, 1286 visits made of which 222 were for natal work. The nurses received £36.14s.6d. in fees. [26]
The first meeting of the FCNA took place on 16 May 1930. The Ministry of Health grant for midwifery was £350. On 16 July 1930 the FCNA held a country fair at Hawarden Castle, the home of Mrs Gladstone, in aid of the funds and seventeen gardens in the county were similarly opened to increase the income. Much of what follows herein is taken from the FCNA Annual Reports.
In 1931 the President of the FCNA was Mrs H.N. Gladstone, the Treasurer C.V. Harris and the Secretary Miss E.C. Vernon (from 1932, of Bryn Gwyn Hall, Caerwys). The County Superintendent was Miss Prylherch. The Superintendent of the Queen’s Nurses was Miss E.Smith of Chester. The annual subscription was set at not less than 10s.0d. and for life-membership donors of not less than £10. Affiliated DNAs were to pay a fee of £1.1s.0d. The salary of the Queen’s Nurse with midwifery was £63 per annum, rising by £3 per year to £80. There was in addition an £8 allowance for uniform and £52.12s.0d, per annum for board and lodging. Village Nurse Midwives (VNM) were paid £2 per week in their second and third year with £6 for uniform. The balance for the year was £214.14s.6d.
In 1932 the balance was £213.19s.3d.
In 1933 the Garden Scheme (still operating as The National Gardens Scheme Charitable Trust) realised £105.I4s.6d., 40% of which went to the Queen’s Institute and 60% to the FCA. Nurses were sent to Plaislow for training. A guide to cheap nourishing food was drawn up by Dr Rowlands and distributed in the county. For the services of the superintendent, the FCA joined with Anglesey and Merioneth. Miss Smith retired and Miss Prytherch became Superintendent of the Queen’s Nurses. Mrs Gladstone, the President, became Lady Gladstone and it was reported that, because of extra development, a third nurse would be required at Rhyl. A donation by the FCNA would henceforward be given to each new DNA to help it purchase the bicycle, drugs and stationery for the nurse. The balance in 1933 was £282.16s. 1 Id. [27] The FCC was paying £1 each towards the cost of each post-graduate training courses for nurses from Bagillt, Ffynnongroyw, Diserth and Prestatyn. The quota due to the NWNA from the FCNA was £110 per annum, for which they received a small rebate from the Ql. The Central Midwives Board informed the FCNA that ‘A midwife working on her own can choose her patients. One employed by a nursing committee must act in obedience to the committee.’ In 1933 the Chairman was D.F. Pennant. OAPs were to be attended free of charge and their fees paid by the Public Assistance Committee. The Garden Scheme made £51.1s.2d. In November 1933 Miss Prytherch made thirty-four inspections and six surprise visits and ‘found everything in order’ Miss Ferrant, the Inspector from the Queen’s Institute, paid the FCNA a visit in 1933, and the new rules governing the Pension Scheme for Nurses were adopted.[28] In 1934 the St. Asaph DNA was re-started after a lapse, and the Bagillt and Greenfield associations separated. A postgraduate course for nurses was held in Liverpool and the Garden Scheme realised £91.16s.2d. The FCNA Balance was £247.2s.4d. Lady Gladstone was President, Mrs Yates her deputy, D.F. Pennant was Chairman, C V.Harris remained as Treasurer and Miss Vemon as Secretary. Lady Gladstone opened her garden which made £5 for the funds. Mrs Summers of Emral Hall became Vice-President during the year and the AGM continued to be held at the Queen Hotel, Chester.
Miss Prytherch notes that ‘girls from Flintshire wishing to enter the nursing profession are most difficult to find.’ Nurses were to have one month’s holiday per year. The balance was £403..
In 1934 the FCNA employed twenty-five nurses, and nurses and midwives were forbidden to perform the last offices for the dead, although they could supervise a suitable local woman to do so. Miss Vernon proposed to the FCC, without success, that the grant should be greater since it was based on the many fewer former DNAs. The FCNA sent its nurses for training to the West Riding Home in Leeds.[29]
As a consequence of the Midwives Act 1918 by the mid 1930s, when private motor cars were becoming commoner, medical practitioners attending midwifery cases were allowed to charge 4 d. per mile for travelling expenses in Flintshire. (See note 10)
In 1935 a decrease in dividends from War Loan was reported at the AGM and this had reduced the balance to £l55.5s.6d. A difficulty was reported too concerning the rule about the performance of last offices where the nurse had traditionally done so. The Garden Scheme realised £110.[30] Miss Vernon noted that ‘the subscription would be down this year, since Mrs Summers, who usually gave £5 has died and her contribution was a very large help.’ There were 2549 general cases, 499 midwifery, 161 maternity cases and 57,260 visits paid in total.
The name and qualifications of a nurse to be appointed by a DNA were to be submitted to Miss Prytherch before hand. The Secretary of Llanfynydd DNA wrote to the FCNA that she had been ordered by the Superintendent to buy a mackintosh for the district nurse. Her committee stated that £6 pa. was too much for uniform and also they did not know why they should buy a mackintosh. In 1935 Miss Vernon was living at Maes Mynan Hall, Caerwys. The meeting of the NWNA Council held at Bangor University was unable to raise Miss Prytherch’s salary to bring her in line with the superintendents in English Associations, but they voted her an honorarium of £50. During the year 1934-5 there were 432 midwifery cases, 146 maternity and 2,120 general cases attended in the county, with 58,590 visits made. For the year 1935-6 the figures were: 434 midwifery cases, 166 maternity and 2,237 general cases, with 61,575 visits in total made.[31]
In 1936 the Garden Scheme realised £64.6s.5d. Subscriptions were down by £10, accounted for entirely by the deaths of Mrs Summers and Lord Gladstone. There were 2,549 general cases, 499 midwifery, 161 maternity and 57,260 visits paid. Merioneth decided to secede from the NWNA. 7,000 nurses were employed in England and 553 in Wales. The Garden Scheme made £105 and the balance for 1936 was £107. ls.7d. [32] It was suggested that nurses should be given one weekend off each month. The FCC made a grant of £350 per annum to the FCNA. In 1936 , in accordance with Section 1 of the new Midwives Act 1936 [33] securing an adequate midwifery service for the whole country nurses were to be employed by the DNAs who were then subsidised by the FCC. [34]
In 1937 Miss Vernon left Maes Mynan and Mrs Evans, Tremeirchion, took responsibility for the Garden Scheme. Flintshire shared the services of Miss Prytherch with Anglesey and Merioneth and that year, for the first time, a special service was held in churches for nurses, and nurses were to be remunerated by salaries and not emoluments which were to be fixed in consultation with the MOH. In 1937 there were 486 midwifery cases, 150 maternity cases, 2,570 general cases and a total of 66,103 visits for the county. [35] The block grant was £350 with an additional grant for £45 to cover the new DNAs Midwives Act. A special meeting of all the DNA Secretaries was held to find out if the county was covered by adequate midwifery services. It was stressed that more money was needed for increased salaries and better nurse transport. Miss Prytherch highlighted the ‘wastage’ of nurses: five to marriage, two to other work, one to a transfer and another to home duties. The balance for 1937 was £116.19s.7d.[36]
In 1938 it was proposed that Cheshire should share the Superintendent with Flintshire and salaries were increased by £10 basic, £20 for QNs plus 4s.Od. per case. The minimum salary was to be £130 plus a grant of £40 towards the purchase of a car for the nurse, £30 to maintain it, and £30 towards transport in midwifery cases together with £2 for telephone expenses. This £130 minimum wage included emoluments, uniform, insurance, house and health insurance. D.F. Pennant died 26 June that year and he had made a tremendous contribution to the FCNA since his election as Chairman in 1929. He was succeeded in November 1938 by Commander Heaton of Rhual, Mold. In December the FCNA joined the Equitable Life Insurance Society to provide pensions for nurses. [37]
Mrs Yates handed over the Vice Presidency to Mrs Humphrey Williams. QN’s salaries were to increase by £70 per annum to no maximum and each DNA was to decide on this maximum for themselves. VNMs were to be paid £130 p.a. minimum. A DNA was formed at Whitford; Buckley re-formed and employed a QN, Florence Dyke. The FCC placed three full-time midwives at Saltney, Queensferry and Buckley. Connah’s Quay, Hanmer & Overton became affiliated to the FCNA. The revised agreement between the FCNA and the DNAs was signed and to come into force on 1 April 1938. The NWNA was dissolved and became a consultative body called the Federation of North Wales Counties Nursing Association. Anglesey and Flintshire retained Miss Prytherch for another year. The balance was £92. Is.1d. [38]
On 1 April 1938 the FCC and FCNA and all the DNAs agreed to the employment of midwives approved by the County Medical Officer and to be under a supervisor. The Rushcliffe Report advised that non-contributors should pay fees not exceeding £2.2s.0d. for midwifery, and not exceeding £1.15s.0d. for maternity cases, and that contributors should pay fees not exceeding £l.l0s.0d. for midwifery and not exceeding £l.ls.0d. for maternity cases. [39]
In 1939 Miss Vernon and the Committee became very concerned about the number of evacuees that had arrived in Flintshire from Liverpool and Birkenhead. These women and children were dirty and verminous and the Committee asked either for help to cope or that they should be taken away. They were told that the nurse should register the name of the evacuee and send an account to the Liverpool and Birkenhead Authorities at their address in Sir Thomas Street, Liverpool. Nurse training was moved to the Alexandra Homes. The grant for 1939 was £924 allocated at between £80 (Rhyl) and £25 (e.g. Diserth) per DNA. In that year the £90 put aside for training was not used, since no candidate had come forward. In the matter of not being able to collect a maternity fee in Nannerch in 1939, Cope & Roberts, Solicitors, Holywell, advised Miss Vernon that if patients were very poor they were to charge a nominal fee, but, since the DNAs purpose was ‘to administer to the wants of the poor in case of sickness’, when the poor cannot pay the DNA should do the work and do it voluntarily. Lady Mostyn (Whitford DNA) reported that their nurse was under notice and that they could not carry on without assistance.  Gwernymynydd DNA was in a similar plight. The Chairman, Lady Kenyon, proposed special grants to aid them. [40]
Miss Prytherch commented that there was a serious shortage of potential nurses coming forward for training and, in her opinion, this was partly caused by the fact that the examination set by the Central Midwives Board was too difficult. The enlargement of the district of Caerwys and Whitford meant that the nurse would be required to learn to drive a motor car. The Superannuation Act for nurses was discussed and it was proposed that Plaistow should be replaced for training by either Liverpool or Plymouth. There was some difficulty in obtaining candidates for V.N.M. work. The balance was £396.19s. 10d. [41]
 On 6 January 1940 it was noted that Liverpool City Council had no authority to reimburse for the care of its evacuees and it was the responsibility of the Ministry of Health to do so. This matter was resolved by the Rural District Councils’ having to foot the bill. In April 1940 Miss Grace Emily (formerly a superintendent in Warwickshire) succeeded Miss Prytherch from 1 May, and Miss Prytherch was given £20 as a leaving present to recognise her twenty-six years service. The House-to-House Collection Act of 1939 made it necessary for each collector to carry a permit. The affiliation fees remained the same for that year, but the connection with the NWNA was broken and nurses’ posts were advertised with 12% war bonuses and the FCNA offered free midwifery training for SRNs with a £30 per annum salary attached. The Garden Scheme, with fourteen gardens open, realised £45.[42] Miss Vernon was to sit on the FCC Public Health Committee. There was worry about the extra work placed on the FCNA during war time. Connah’s Quay DNA was to give up midwifery work, but was to keep general nursing. A second nurse was employed for Hope and Caergwrle and a third for Rhyl. Mrs Dalton of Rhyl ran the Garden Scheme. The balance was £404.14s.5d. [43]
In 1941 Miss Emily made twenty routine inspections and paid forty-five special visits, all nurses giving satisfaction. Nurses, it was proposed, were to be trained at the Liverpool Maternity Hospital at £25 per head. Lady Mainwaring reported that at Tremeirchion evacuees were paying for their own diphtheria inoculations. Nurses’ private property was insured under the Private Chattels Scheme. Mollington Banastre garden (the Chester home of Miss Vernon) was open and made £7.8s.0d. Lady Gladstone died. Mostyn, Llanfynydd, Newmarket and Pontblyddyn were not paying the £130 agreed for the nurse’s salary. Those who could not pay this had to apply to the FCNA for assistance. Miss Emily was to get a rise of £20 p.a. A fee of 25s.0d. was to be charged generally for both midwifery and maternity nursing. Amalgamations of DNAs were forced because of a shortage of nurses. Lady Mainwaring was elected President in place of Lady Gladstone. An appeal was made to Mr Rowlands for extra petrol for nurses. All Associations reported satisfactory progress. The increase in nurses’ salaries is to come possibly from the Welsh Church Eleemosynary Fund. The Garden Scheme made £63 and 60% of this went to the FCC and 40% to the QI as usual.[44] Miss Yates died. Gardens were opened at Hafod-y-coed, Lowther College (Bodelwyddan), Rhual, Penbedw, Bodrhyddan, Glasfryn Hall, Caerwys (Mrs Dalton), Highfield Hall, Fron Hall, Gwysaney and Glan-yr-afon (Mold). The balance was £425.16s.4d.[45]
In 1942 the salaries were to be not less than £150 p.a. in any DNA; St.Asaph paid £160 clear. There were difficulties in Treuddyn between the nurse and the doctor, but the Vicar advised the Committee that ‘things are righting themselves and settling down.’ There was an appalling lack of nurses that year and an advert for a nurse at £230 per annum and for a VN at £160 p.a. had failed to bring any reply. The Treuddyn DNA resigned from the FCNA since it could not carry on financially. It was proposed that in order to save the situation, subscriptions might be collected direct from the miners in the local collieries. A penny-a-week scheme was proposed at the four mills of Courtaulds and managers were asked to point out the advantages of this to workers.[46] Training began at a school for nurses in Plymouth. The balance was £520.1 ls.6d. [47]
On account of the acute shortages during World War I I transport for the district nurse became a major problem for some of the Flintshire Associations. On 6 May 1943 the Wales Civil Defence Region authorised the use of pool cars by nurses belonging to the FCNA for visits in Nannerch and Ysceifiog, St. Asaph, Holywell, Treuddyn and Llanfynydd DNAs. Harvey Davies, Clerk to the FCC, sent out a circular to the Associations to highlight difficulties in this matter. Mrs Marie R. Piatt of Highfield Hall, Northop., replied on 28 March 1943 that their nurse was conveyed by taxi car in Northop Hall village with no difficulty. A similar situation was reported at Prestatyn where the nurse used a bus and bicycle by day and a taxi for night visits. There was no difficulty at Rhyl but at Brynford and Pantasaph it was very difficult to get a car on winter nights, although the police had been very helpful. Miss Margaret Pennant reported that, although the Tremeirchion nurse had a car, she was careful about the petrol and walks or bicycles where possible. In Ellesmere the nurse was given extra petrol and more petrol was needed at Worlhenbury and Hanmer. There were no difficulties at Newmarket and Gwaunysgor, Hope, Halkyn and St.Asaph, but the worst situation was reported at Treuddyn and Llanfynydd and particularly, according to Mrs Laird’s reply, at Nannerch. Helena Philips of Rhual thanked Harvey Davies for intervening to increase the petrol allowance for Gwernaffield and so save them many difficulties.[48]
A short note on the Nercwys and Gwemymynydd DNA has survived; the Treasurer was Mostyn F.Ll. Tringham and the Secretary Mrs E.Gwenydd Tringham, both of Nercwys Hall. The balance sheet for the year ending 31 March 1943 shows a balance and petty cash account of £39.14s.5d.[49]
According to the FCNA Annual Report for 1943-4 [50] the President was Lady Mainwaring, the Chairman Lt Commander Heaton, the Vice-Chairman Lady Kenyon of Greddington, the Treasurer C.V. Harris and Secretary Miss E.C. Vernon. Miss Grace Emily of the Chalet, Queen’s Park, Chester, was the County Superintendent of Nurses. On the committee sal four County Council representatives of the Insurance and Education Committees, and Miss Gwendolen Davies-Cooke was the representative for the NSPCC. There also sat six representatives of the subscribers, the MOH, the Clerk to the FCC, the TB Physician; one or two representatives of each DNA, the Hon. Secretary of each DNA, one member representing the NW Home Teaching Society for the Blind. This report also mentions that at the AGM held on 6 May the Rushcliffe Report was adopted by the FCNA which recommended that the salaries of district nurses should be increased. This would necessitate the amalgamation of some Associations. Indeed, this had already taken place between Whitford and Mostyn, Caerwys and Nannerch, Holywell and Greenfield. Furthermore, to cover such an increase in salary, the minimum subscription would have to be increased to 6s.6d. p.a. However, it was also noted that the Garden Scheme, considering the shortage of petrol and transport had been very successful for the year and had realised the sum of £70. Miss Emily said that most nurses were feeling the strain of the war years and needed a holiday. Also, that it was very difficult to obtain new candidates for training and many nurses were leaving the service to get married. She stated that there were three Queen’s Nurses employed at Rhyl, Buckley and Holywell, seventeen Village Nurses, eleven Nurses and four with the qualification SRN and twenty-five with that of SCM. During the year 1943-4 there had been 413 midwifery cases, 173 maternity and 3264 general cases attended. There were 3592 ante-natal, 6875 midwifery, 2714 maternity and 53,655 general visits made. At 31 march 1944 the total expenditure for the County was £1,871, leaving a balance of £424.17s.l0d. The FCNA also held £132.1.19s.l0d. in 3 % War Loan and 250 National Savings Certificates which had been bought for £200 in November 1930.[51]
In 1943, after a public meeting with Miss Vernon and Miss Emily present, Treuddyn DNA decided to re-organize under a new committee. The Courtauld’s donation was not adequate for the nursing services received by their employees. Nurses were allowed seven coupons for uniform by the Board of Trade. Rhyl increased their nurses’ salary by £104.6s.lld. The Voluntary- Car Provisions Scheme was run by Mrs Valentine Herbert of Tyddyn (Mold) to obtain a supply of cars for nurses at night. [52] Mostyn and Whitford amalgamated. As a gift from the American Red Cross nurses were given three pairs of rubber ‘Wellingtons’ each. A uniform fee of 25s.6d. was agreed for maternity and midwifery work. The balance was £413.3s.7d.[53]
In 1944 the balance was £424.17s.l0d. and, on account of the Rushcliffe Report, the FCNA would have to find an extra $£720 per annum. The FCC gave a grant of £30 for midwifery and £50 for an emergency nurse with £70 for administration. The maximum fees for non-subscribers were to be £3.10s.0d. and £2.2s.0d., and for subscribers £2.10s.0d. and £1.5s.0d. respectively.[54] The minimum subscription was to be 6s.6d. and the Garden Scheme realised £70. The balance was £424.17s. 10d.[55]
In 1945 nurses were to be employed by the FCNA not the DNAs. The County Inspector of Midwives and the County Superintendent of the FCNA were to be amalgamated. The County Joint Supervisor appointed was Mrs Williams who came from Ventnor and lived in Rhuddlan. Every nurse was to have a car ‘to get to her cases dry’. If three DNAs amalgamated they could have two nurses and two cars. Miss Vemon resigned as Secretary after twenty-two years service and was succeeded by Mrs G.M. Heaton. The members of the former NWNA became independent in the following chronological order : Caernarfonshire, Merionethshire, Anglesey and Flintshire, as the NWNA became too unwieldy for the purposes of the Ministry of Health. Auditors arrived from the MOH for the first lime and C.V. Harris commented, ‘They have put us to a lot of trouble and expense in filling in the white paper forms.’ Five gardens were opened and made £33. [56] Queensferry and Shotton became affiliated to the FCNA. The QI became responsible for the training and inspection of district nurses. Harvey Davies resigned as Clerk to the FCC and was replaced by Hugh Jones. Seven gardens were opened and made £93. The balance was £561.18s.7d. [57]
In 1946 there was a new constitution and the Ministry of Health increased nurses’ salaries. There was a Health Bill. At Holywell and Greenfield DNA the President was Mrs T.C. Roberts, Chairman A.H. Rutt BEM, Treasurer J.R.L. Jenkins, Secretary Mrs Leo Schwarz. The QN was Mrs Jones who had full hospital and maternity training and the Subscription was 1 d. per week. The Village Nurse Midwives were to receive eighteen months district and midwifery training.[58] Commander Heaton resigned as Chairman and was replaced by Lady Kenyon.
The Treuddyn DNA was ‘wound up’ on 31 March 1946 but the district was to be covered for maternity and midwifery by the Leeswood and Nercwys DNA. Mrs Heaion became the FCNA representative on the Council of the QI to ‘keep an eye on the National Health Bill’. [The National Health Service was inaugurated in 1948] The M.P for Flintshire was approached to help to keep nursing on the same footing as at present. The balance was £540.11s.1d.[59]
On Monday, 19 May 1947, Dr A.E. Roberts, MOH for Flintshire, asked the FCNA ‘ I f you are soon to be dependent to the extent of 100% on FCC grants, can you still be said to be a voluntary organisation?’ C.V. Harris ‘regretted the picture given by the MOH’ stating ‘that, in his opinion, the work of voluntary organisations was being cast on one side without due acknowledgement and appreciation.’ Representatives from former DNAs were to sit on area sub-committees of the FCC Health Committee. Dr A.E. Roberts was to approach nurses individually about their future employment with the FCC. The assets of the FCNA and DNAs were to form a fund to give annuities to the thirteen elderly nurses who could not qualify for the government superannuation scheme and to some ex-nurses. The QI Appeal was for the QNs only. In the event, Nurses Ives, Dyke, Parry, Prince, Bennet, Jones, Williams, Phillips-Jones, Wynne-Jones and Brockley benefited as agreed by the Charity Commissioners,£4,270 in total being distributed to them. The twelve DNAs sent their surplus funds to this and it was implemented in 1949. In 1947-8 there were 671 midwifery cases, 11,827 visits, 245 maternity cases and 4,454 maternity visits. There were 4,317 general nursing cases with 86,409 visits. The Appointed Day was 5 July and the Superintendent was Mrs F.M. Williams, appointed 1948. [60]
The new constitution (1946) had made administration easier. Meetings were held in Mold at the School Clinic, King’s Street, and Mrs Williams’ appointment avoided overlapping. Most DNAs were able to fund the Ruschcliffe 50% increase in salaries without help, but there were widespread anxiety about the National HealthBill. Mrs Jones-Bateman was in charge of the Garden Scheme and raised £44.13s.0d. [61]
The Leeswood & Pontblyddyn DNA closed their account in 1970. The final balance was £148.4s.2d. less postage of 3s.2d. The money was divided between the churches and chapels receiving £21.3s.Od. each.[62]
An organization like the FCNA and its affiliated DNA members depended on the dedicated and signal service of its officers such as Lady Gladstone, D.F. Pennant, Miss Vernon and C.V. Harris. They, in turn, were supported by sympathetic Clerks to the FCC, MOHs and Councillors. At the ‘chalk face’, as it were, in the affiliated associations similar commitment was found. Two lists of officers of the FCNA and affiliated DNAs attending the AGM survive: for 1938 and 1946. Mrs Wright of Mold, Mrs Lewis of Buckley, Mrs Heaton of Gwernymynydd, Mrs Tringham of Nercwys, Mrs Pugh of Hope, Mr Harris and Miss Vemon appear on both.[63] These people, from various strata of society, gave their services to foster and promote the health of the county through two World Wars and the intervening period and the foundations they had laid became the NHS in 1948.
NOTES
All references refer to deposits at the Flintshire Record Office, Old Rectory, Hawarden., unless otherwise specified.
  1. M.P. Hall, The Social Services of Modern England (1959),68-9; W.M.Frazer, History of English Public Health, 1834-1939 (1950), 248, 418, 447.
  2. D/BJ/A13; D/GR/1129and 1325(Halkyn). All ‘GR’ references are included by kind permission of His Grace the Duke of Westminster.
  3. D/GR/1129 and 1325. A map in the collection shows the full extent of the Halkyn DNA.
  4. D/DM/1165/92.
  5. D/BP/889.
  6. D/BP/892.
  7. D/BP/888-94.
  8. At the Denbighshire Record Office,Ruthin.,DD/GR7357.
  9. D/DM/448/90.
  10. FC/T/33/2.
  11. FC/C/6/583. Hilda Madeleine, Countess of March,CBE was the wife of Charles Henry, later 8th Duke in 1928. She was President of Queen Victoria’s Jubilee Institute for Nurses.
  12. D/LE/1750. FCNA Report for 1943-4.
  13. D/DM/47(1)
  14. D/DM/47(1)
  15. D/DM/47(1)
  16. D/DM/47/1-2.
  17. D/DM/47/1-2.
  18. D/DM/47/1-2.
  19. D/DM/47/1-2.
  20. D/DM/17/2. The Rushcliffe Committee was called after Baron Rushcliffe (1st Baron b.1872), Chairman of the Nurses’ and Midwives’ Salaries Committee.
  21. D/DM/130/1-13.
  22. D/DM/709/1.
  23. D/CL/201.
  24. D/DM/130/1-13. (9)
  25. Lived 1890 – 1955; C.H.(1949); Chairman of the TUC. {DNB )
  26. FC/C/6/546.
  27. D/DM/130/3.
  28. D/CL/218-19. [ I am indebted to Miss E.L.Pettitt for drawing my attention to this deposite in the archive.]
  29. D/CL/218-19.
  30. D/DM/130/3.
  31. D/CL/218-19.
  32. D/DM/130/3 and A Survey of District Nursing in England & Wales (Queen’s Institute, 1936).
  33. The Midwives Act 1902 ‘No woman should use the title of midwife without being certified and after April 1st 1910 they must only attend cases under the direction of a qualified medical practitioner’
  34. D/CL/218-19.
  35. D/CL/218-9. 50. D/LE/1750.
  36. D/DM/130/3. 51. D/LE/1750.
  37. D/CL/218-19. 52. D/CL/218-18.
  38. D/DM/130/3. 53. D/DM/130/3.
  39. D/DM/130/1-13. 54. D/CL/218-19.
  40. D/CL/218-19. 55. D/DM/130/3.
  41. D/DM/130/3. 56. D/CL/218-19.
  42. D/CL/218-19. 57. D/DM/130/3.
  43. D/DM/130/3. b 58. D/DM/47/2.
  44. D/CL/218-19. 59. D/DM/130/3.
  45. D/DM/130/3. 60. D/CL/218-19.
  46. D/CL/218-19. 61. D/DM/130/3.
  47. D/DM/130/3. 62. D/LE/1730.
  48. FC/C/6/584. 63. D/CL/218.
  49. At the Denbighshire Record Office, Ruthin.,DD/DM/456/3.

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