Black History

Windrush Migrants and “Our NHS Heroes”

Portrait of Encoch Powell in photographer’s apartment, Allen Warren

There exists in British politics a longstanding tradition of differentiating between ‘good’ and ‘bad’ immigrants. It has served historically to obscure opposition to black and brown migration under layers of suggestion, innuendo and proxy terms – ‘it is not that we don’t want immigrants, it is that we don’t want those immigrants’, so the argument goes. Whilst glaring examples of racial prejudice can be found in the post-war archives of government ministries, it is much more common to be confronted with a quintessentially British evasiveness. One which speaks of the ‘social problems’ of migration, and reveals itself only occasionally, when it lets slip a reference to ‘coloured’ migrants, instead of its guarded proxies, ‘Commonwealth’, ‘colonial’ and ‘overseas’.  Within this cautious lexicon the symbol of the Commonwealth National Health Service (NHS) worker should be understood as a political tool, meant not to praise Commonwealth migrants as a whole, but to denigrate those who were not to be found within the hospital’s hallowed halls.

In political discussions, Commonwealth ‘NHS workers’ were defined as nurses and doctors hailing from Britain’s former colonies, with typical archetypes being the West Indian nurse and the South Asian doctor. Migration from the Commonwealth began symbolically in 1948 with the arrival of HMS Windrush, but the migration of NHS workers specifically, really picked up in the latter half of the 1950s and continued throughout the 1960s and the early 70s. The fact that this group was primarily discussed during debates on immigration is revealing. In these discussions those calling for increasing restrictions often raised the spectre of the noble Caribbean nurse, or stoic Indian doctor, to lighten a tone otherwise universally hostile to black and brown migrants. Thus in his infamous 1968 Rivers of Blood speech, former Health Minister Enoch Powell, peppered his calls for the prohibition of non-white migration with the declaration that:

‘the Commonwealth doctors who […] have enabled our hospital service to be expanded faster than would otherwise have been possible […] are not, and never have been, immigrants’.

By contrast, migrant healthcare workers were very rarely, if ever, brought up in discussions of NHS staffing shortages. Migration was simply not positioned as a desirable, or even viable, staffing solution. Indeed if you were to look in certain archival bundles on NHS staffing shortages you’d be excused for coming away with the belief that no migrants worked in the NHS at all.

Norman Pannell, Conservative MP and vocal opponent of migration from the Commonwealth, was well aware of the political significance of migrant healthcare workers when he reached out to the Ministry of Health (MOH) on February 5th, 1961 (figure 1, below). Pannell contacted the office of then Health Minister, Enoch Powell,  requesting figures on the number of migrant nurses in the NHS, in advance of a debate for a private member’s bill on immigration scheduled to take place some days later on February 12th. In a statement of such explicit directness that it is somewhat shocking to see as a historian used to having to read between the lines, Pannell emphasises that he needs this information in order to answer to the claim ‘that hospitals could not carry on without coloured immigrant nurses’ and closes by stating he would ‘be grateful if you would let me know how many nurses in the hospital service are, in fact, coloured immigrants’ [emphasis added].

Figure 1: Pannell’s original request to MOH, February 5th, 1961. (Source: TNA MH55/2157).

In the days that followed a draft response to Pannell’s request circulated between civil servants in Enoch Powell’s Office at the MOH. The difference in lengths between the draft and the final version provides the first indication of the scope of these revisions. Whereas the initial draft was some 28 lines long, the version Pannell eventually received had only 19 lines, corresponding with a total reduction of 100 words. Most important however, was not the what was directly left out – which was largely a discussion about the limitations of available figures – but the change in tone for the information that made the final cut. Thus where the draft response states:

‘the above figure of 6,365 includes 1,148 nursing students from Nigeria which is now independent’ (Figure 2, below)

the final version read:

‘these figures show that 6,365 nursing students from the colonial territories (including Nigeria, since granted independence)’ [emphasis added] (Figure 3, below).

Figure 2: Excerpt from draft response to Pannell by the MOH, dated February 8th, 1961.  Statement on Nigeria fully cross out, corresponds with first two lines of second paragraph. (Source: TNA MH55/2157).
Figure 3: Excerpt from final response sent by MOH to Pannell, February 13th, 1961. (Source: MH55/2157).

In the draft version, the independence of Nigeria is stated as a matter of fact. In contrast, the final copy foregrounds the benevolence of the mother country: it is not that Nigeria is independent, it is that it has been allowed to be so by a magnanimous metropole.  This may seem like too close a reading of a statement which is not that important to the supposed purpose of the correspondence – that is, communicating to Mr Pannell that the figures he requests are not available – however, when one views it in tandem with some of the other revisions, it is clear that this change in tone is far from incidental. Most significantly, in the closing paragraph where the draft response stated:

‘Immigrants from the Commonwealth are certainly an important element of the total nursing staff in the hospital service at the present time and they are undoubtedly making a valuable contribution to the running of the hospitals.’ [emphasis added] (Figure 4, below)

the final version had removed almost all praise of Commonwealth migrants:

‘Immigrants from the Commonwealth are an important element of the total nursing staff in the hospital service at the present time and they make a contribution to the staffing of the hospitals.’ [emphasis added] (Figure 5, below)

Figure 4: Closing paragraph of draft response, dated February 8th, 1961. With original mark-ups from editor at MOH. (Source: TNA MH55/2157).
Figure 5: Closing paragraph from final response sent to Pannell, dated February 13th, 1961. (Source: MH55/2157).

As can be seen in Figure 4 above, where the handwritten mark-ups of a second MOH official are clearly visible on the initial draft, the muting of praise for Commonwealth migrants was a deliberate and targeted revision. Taken in conjunction with the earlier statements on Nigeria’s independence, these revisions should be read as clues left by Powell’s office, as to their views on the rightful place of both Commonwealth migrants, and the colonial structure as a whole. Both revisions may seem minor at first glance, but ultimately both sought to reassert the power structure of whiteness. Commonwealth migrants are downgraded from an invaluable labour resource instrumental in running the NHS, to one of many cogs in the machine. Likewise, Nigeria is downgraded from a country which had asserted its own independence, to a passive recipient of the same.  In short, the NHS is not dependent on Commonwealth migration, it is simply gracious enough to welcome them as an ‘important element’, just as Britain itself is gracious enough to generously bestow independence on its former colonies.

In the decade that followed this correspondence UK legislators would proceed to systematically strip away the immigration and residency rights of black and brown Commonwealth citizens. Beginning with the Commonwealth Citizens Act of 1962 – which tried to hide its preference for white migrants from the Dominions behind exemptions for those with demonstrable ‘ancestry’ in the British mainland – the roll back of black and brown Commonwealth migration reached its legislative apex with the passage of the 1971 Immigration Act. In a decade, individuals from the Commonwealth went from being ‘Citizens’ to being ‘Immigrants’. As we can see from the correspondence here, the underlying logic that facilitated this shift, had already been internalised by the MOH in 1961. Crucially, MOH officials viewed Britain’s relationship to the Commonwealth as an essentially charitable one, and what is given freely can be taken away as well. This view of migration to Britain, as something that primarily benefits the immigrants themselves, and which the nation charitably tolerates, endures to this day.

In the present day, discussions of racism in Britain tend towards complacency and they manage this by focusing on what British racism is not: by focusing on what is not said, on what is not done, on what is absent that make us ‘better’ than the United States. These discussions miss the point, it is often in the silence, in the space left by what is not said, that we see the true shape of British anti-blackness. Silence in this case was not the absence of something, it was its conscious removal.

Acknowledgements: I am particularly grateful for the support given by the Leverhulme Trust in this line of research.



  1. Anna, your analysis is highly revealing. Another distinction (which the drafting does not make) is between ‘students’ and ‘immigrants’. Overseas ‘students’, on whom the 1970s NHS was dependent for doctors and nurses, were expected to return to their countries of origin. Another distinction needed for NHS workers is between those from the Commonwealth who were already UK residents and those who came specifically to work in the NHS.

    1. Thank you for your comment David – yes I totally agree! I also noticed this desire to return overseas students in some Colonial Office records from the late 40s and early 50s and was initially very surprised to find what you have described. I think this goes to show how ahistorical contemporary narratives about Windrush can be, wherein our efforts to celebrate Windrush migration tend to gloss over the hostility with which they were met at the time, including by the NHS itself. I believe Kennetta Hammond Perry wrote an excellent article on this in 2018 also for History Workshop.

  2. great work anna, very factual information look forward to reading more from you. kind regards

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