Murder, Mental Illness, and the Question of Nursing ‘Character’ in Early Twentieth Century England

Fig 1.

A ward in a children’s hospital, Lambeth, 1925.

On 17 May 1993 nurse Beverly Allitt, aged thirty-one, was convicted of the murder of four children who had all been patients on Ward Four at Grantham and Kesteven General Hospital in Lincolnshire. Allitt was also convicted of the attempted murder of three other children being treated on the ward, and a further six counts of causing grievous bodily harm to child patients.¹ Sentenced to life imprisonment on each count of murder, Allitt remained a patient at a forensic psychiatric hospital; a review of her case in 2007 recommended that she be detained there for a minimum of thirty years.² The fact that the killer was a nurse provoked a national outcry – even if she was an ‘enrolled’ rather than a registered nurse, which was a major distinction in terms of education, status and pay until enrolled nursing was abolished during the early 1990s.³ The trial prompted both an immediate inquiry by the Department of Health and an urgent review of guidelines for paediatric practice by the Royal College of Nursing.⁴ Allitt’s case was also documented in two ‘true crime’ books aimed at a popular audience, and in 2005 was dramatized by the BBC as Angel of Death: the Beverly Allitt Story.⁵ Largely as a result of the concerns raised by this case, the role of nurses in child-protection work has since become a key element of good practice in the United Kingdom.⁶ It is now an essential part of the pre-qualifying Registered Sick Children’s Nursing (RSCN – also known at as RN (Child)) course for students, as well as a post-qualification speciality in its own right.⁷

Although the serial killings of general practitioner Harold Shipman have since overshadowed the memory of Allitt in the public consciousness, for some time her name became a byword for monstrosity.⁸ As Bronwyn Naylor has shown, a significant amount of media coverage was given to Allitt’s trial, and much of it offered misogynistic and homophobic depictions of her as a mentally ill, demonic lesbian preying on vulnerable children.⁹ Part of the reason for this, I argue, is the perceived uniqueness of her crimes. Indeed, an article in the British Medical Journal explicitly referred to Allitt as ‘a once in a millennium case’.¹⁰ The Department of Health likewise insisted in its report that Allitt’s crimes were a shocking anomaly: ‘The only established instances of a nurse killing a child seem to have occurred outside this country. Statistically such an event was, and remains, a very remote possibility in the United Kingdom.¹¹ Yet Allitt was not in fact the first trained nurse in Britain to murder children whom she was supposed to be caring for. Eva Grace Thompson, a trained nurse, although her case has now largely been forgotten was charged with having murdered child patients at a residential paediatric facility in south-east London during World War One, and was found ‘guilty, but insane’. The coroner who dealt with the case later referred to it in his memoirs as ‘One of the most amazing inquiries I have ever known’.¹² Scandalous and distressing cases of the abuse and neglect of some patients by their nurses are of course not an invention of the 1990s, nor have such instances invariably been dismissed or ignored in Britain. High-profile controversy and public outrage were generated by this subject in regard both to nursing in late nineteenth-century workhouses and to care-of-the-elderly wards in psychiatric hospitals during the 1960s, not to mention in the separate Winterbourne and Mid-Staffordshire NHS Trust scandals since 2005.¹³ Nor, as Shula Marks has demonstrated, have historical cases of violence and abuse by some nurses towards their patients been confined to the United Kingdom.¹⁴ That despite these events Beverly Allitt is still perceived as setting a macabre precedent in nursing history is worth noting. Historical ignorance helps to explain the...