Political intrigue twisted story of Plymouth man who laid the foundations for the NHS

Dr Austin Threlfall Nankivell is a name few people in Plymouth are familiar with, yet this man – who arrived as the new Medical Officer of Health (MOH) for Plymouth one hundred years ago – set the early foundations for health services many of us use today.

Six years after his arrival, Dr Nankivell’s “zeal, initiative and professional intelligence” was recognised by a Ministry of Health official, and Labour Alderman Bert Medland acknowledged “they all owed a deep debt of gratitude for his work”.

Despite this, in 1932, Dr Nankivell was sentenced to four years penal servitude on five charges of “gross indecency”. Sadly, his remarkable contribution is now largely forgotten, but there are good reasons for remembering his legacy.

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Dr Nankivell was one of 51 applicants who applied for the position of Medical Officer of Health in Plymouth, which became vacant after the resignation of the previous MOH.

Dr Nankivell had been an outstanding student and then had posts as MOH at St Austell, Poole and Hornsey, in London, interrupted by war service, when he was injured.

At the time, Plymouth politics was changing, and the Conservative majority had narrowed after Labour gained 15 seats in the three elections of 1924, 1925 and 1926. Dockyard engineering union leader Bert Medland was then appointed Chair of the Public Health Committee.

Dr Nankivell set about tackling issues of hospital reorganisation, meeting objections to proposals for “the complete co-ordination of the medical services of the Borough”.

His plans were opposed by organisations including the Plymouth Ratepayers’ Association and the British Medical Association.

Dr Nankivell’s response was a detailed report on local services. The report urged a greater role for municipal co-ordination, proposing the amalgamation of the three general hospitals to provide a casualty service, more bacteriological and pathological facilities, a cancer clinic with radium treatment, and an increase in the number of municipal clinics, including two maternity centres, an additional tuberculosis clinic, and a new dental clinic.

More political change came in 1929 with the election of Britain’s second Labour Government, with James Moses becoming Plymouth’s first Labour MP. The Conservatives also lost their overall majority on the council.

Progress was soon made on Dr Nankivell’s plans, and early the foll­owing year the council took control of the former Poor Law Infirmary at Freedom Fields, renaming it the City Hospital. Charges were set on a sliding scale, ranging from free treatment for those on the lowest income to full-cost payment for those at the higher end.

Mr Medland said the aim was to ensure “every individual, whether he be rich or poor, gets the complete medical service he has the right to expect and demand.” ( Western Morning News, October 15, 1930).

“In a sense”, said a Ministry of Health inspector, “Dr Nankivell has been living at the hospital for months past and his interest and keenness in the transformation of the institution is remarkable”.

Plymouth became the first local authority to reach an agreement for establishing a radium centre for cancer treatment. “This service”, said Mr Medland, “must be free to all, rich or poor.” ( Western Evening Herald, November 12, 1930).

Maternal and child health were priorities for Dr Nankivell, and in October 1929 Lady Astor said: “I sometimes think he is the best mother in Plymouth.”

Here too, though, he met opposition. The Plymouth Ratepayers’ Association wrote, in February 1927, “protesting against the proposal to appoint another dental surgeon for schools”, and protests delayed the construction of a child welfare clinic in Devonport for two years.

Objections from the Devonport Mercantile Association and the council’s Hoe and Parks Committee were overcome in 1930, but later that year the Conservatives regained an overall majority.

The new council quickly sought spending cuts. Targets were wide-ranging, including revising charges for the City Hospital and a 7.5% cut in nurses’ salaries. In May 1932, the council established a special committee to investigate the expenditure on health.

By now, controversy was developing around the provision of birth control advice for married women. Plymouth was the first local authority in the country to approve this service, following an approach from Dr Nankivell to what became the Family Planning Association.

Events then took a sudden turn on July 8, 1932, with the arrest of Dr Nankivell. It was alleged he had attempted or committed “gross misconduct” with two young men (minors under the law at that time).

Both were visited by police on an “unconnected matter” on July 3, and following this visit one made arrangements to meet Dr Nankivell on July 7. They apparently arranged to meet the following day at North Road railway station, where a police inspector was waiting and arrested Dr Nankivell.

This rendezvous formed the first of the charges. At the committal hearing, one of the young men claimed that between May 21 and June 26, Dr Nankivell took him to Barnstaple, Tintagel, Sidmouth, Looe, Southampton, Salisbury, Newbury, Blackpool and Ayr. Eventual charges involved Weymouth, Tintagel and Barnstaple.

Dr Nankivell said he wanted to help these two young men, and the prosecution accepted he had supported others, including one described as “adopted” who he was funding through university. ( Western Morning News, July 20, 1932).

Neither claimed any sexual activity had taken place, and, when hotel staff gave evidence, “all the witnesses, under cross-examination, agreed they had neither seen nor heard of any improper conduct during these visits”. ( Birmingham Gazette, July 20, 1932). However, the judge told the jury “there were some things that were always done in secret”. ( Western Morning News, November 8, 1923).

Dr Nankivell was unwell by the time of his trial, with physical exhaustion compounded by mental distress. On bail, Dr Nankivell stayed at a private mental asylum, near Bristol, taking a day trip in August, when he had an accident and was found guilty of dangerous driving and driving under the influence of drink.

On appeal, the second charge was dismissed, with evidence given by Dr Cates of the asylum that he was prescribed veronal, a barbiturate used to induce sleep.

An image of him, conveyed in pre-trial media coverage, included a “powder puff” being found in his car, along with “photographs”, and that he was unmarried. ( Western Daily Press, July 22, 1932).

It was reported that a Plymouth Alderman was willing to speak on Dr Nankivell’s behalf at the trial, although permission for this was refused by the judge. It is to Dr Nankivell’s credit that, even among the context of the politics and social attitudes of the time, the Alderman, who was likely Mr Medland, was prepared to advocate for him.

Dr Nankivell told the judge: “I have tried to spend my life helping other people. I must have saved thousands of lives in the 20 years I have been a medical officer of health in various places. I have prevented thousands and thousands of cases of sickness. I have always done my best. I have never done an unkind action willingly to anybody.” ( Daily Mirror, November 8, 1932).

When arrested, Dr Nankivell told police: “If even a charge is made against me, I will lose my job. I know what people are like in Plymouth.” ( Daily Mirror, July 20, 1932). It was a tragic end to a noble career, but by now spending cuts on Plymouth’s health services were underway.

In September, the Public Health Committee had cancelled the purchase of radium for a cancer clinic.

Launching Labour’s municipal election campaign two years later, Bert Medland responded to the Conservative focus on reducing the rates by saying: “Labour wanted a reduction in the rate – the death rate.” ( Western Evening Herald, September 25, 1934). But after Ministry of Health medical officers raised concerns about the city’s rising infant mortality, Mr Medland was unable to gain council support to immediately appoint two additional health visitors.

After serving his sentence, Dr Nankivell died in 1942, aged 58, having made no will.

Much of what he achieved during his tenure in the city laid the basis for what was to become the National Health Service – the remarkable legacy of an important, yet sadly almost forgotten, career.

• Dr Sheaff’s lecture, ‘Politics and public health in inter-war Plymouth’, takes place at the University of Plymouth’s Roland Levinsky Building next Tuesday, January 28, from 7pm-8pm. Tickets are £6, concessions £4, free to University of Plymouth students and Historical Association members.