Obituary: Monica Baly

THE FOUNDATIONS of modern-day nursing in Britain were little documented until, in retirement, Monica Baly put pen to paper with a series of influential studies on the history and development of the profession.

She based her findings on a first-hand understanding of it and a well-researched investigation of the social climate in which nurses worked. Her PhD thesis - prepared at the grand age of 70 - was a re- evaluation of Florence Nightingale, on whom Baly was a world authority. It was later developed into a book, Florence Nightingale and the Nursing Legacy, published in 1986.

This described how a Nightingale Council had been set up during the Crimean War to collect money from "a grateful nation" for the founding of nursing schools and had determined the direction of 20th-century nursing. Nightingale was none too pleased at the idea of being remembered this way and, according to Baly, "There was a lot of controversy which was hushed up at the time."

Like Florence Nightingale, Monica Baly battled throughout her life to improve nurses' training and conditions. She made her name in 1970 as an organiser of the "Raising the Roof" campaign which, after five weeks of intensive lobbying of parliament, saw nurses receive an unprecedented 22 per cent pay award. The dispute had, she conceded, contained "ugly and violent" elements, but she justified it by claiming that militancy had become a social fact: "When members of the community - including nurses - feel that they are being pushed down and lowly regarded, they manifest their anger with a response that has become successively more speedy and aggressive".

Monica Baly's concern for the profession stretched far beyond remuneration, however. At a speech marking her retirement from the Royal College of Nursing in 1974, she demanded that nurses be regarded as equals with doctors and administrators in deciding how Health Service resources are spent. She voiced the perpetual dilemma, as real now as then:

We must not delude ourselves that pay alone will solve our problems. Pay is important, but there is a much bigger thing than that - the question of rising demands and resources. Somewhere along the line somebody has got to decide how the Health Service will spend its money.

Monica Baly qualified as a nurse and midwife at the Middlesex Hospital, London, in 1938 and 1939 respectively. As a member of the Princess Mary RAF Nursing Service during the Second World War she was responsible for setting up a burns hospital in Foggia, Italy, earning a mention in dispatches for her work among the seriously injured.

The end of hostilities saw her dealing with a typhoid epidemic in Cairo, following which she took a Foreign Office posting to the British Zone of post-war Germany as chief nursing officer in the displaced persons camps. Disease was rife and Baly was short of staff. She overcame her superiors' suspicions about training German nurses, later saying:

They felt that there would be so much hostility the German nurses would never survive - but in fact it worked very successfully. When you're a desperate mother with a sick child you don't really care about the nationality of the nurse who comes to help you.

Ultimately hundreds of German nurses proudly boasted certificates in Public Health signed by Monica Baly.

Her one-woman campaign for improved pay and conditions for nurses began shortly after the war when she took her Health Visitors' Diploma at the Royal College of Nursing: "I was not the daughter of an accountant for nothing," she said.

We sat down and compiled a budget based on the current cost of living proving that you could not live any sort of reasonable life on the basic salary being paid to health visitors at that time. I later learned that my figures were incorporated into the case for new pay scales put before the Whitley Council. It was my first little bit of rebellion and it paid off.

A chance meeting in France with the chairman of the Royal College of Nursing in 1951 led to her next appointment as the RCN's Western Area Organiser, based in Bath, where her goal was to increase the degree of professionalism within nursing.

Hints of the writing that was to follow appeared in the mid-1960s when she twice won first prize in the British Medical Association's annual essay competition for nurses. Baly's genteel rebelliousness also continued and in 1970 she was called to London to organise the RCN's historic campaign. She was particularly proud that despite the militancy, there was no strike action:

There never seems to me to be any excuse for a nurse to withdraw her labour. Taken to its logical conclusion a strike by nurses would lead to the picketing of intensive care units - and who in our profession would ever sanction that?

Nursing and Social Change, published in 1973, was the first post-war book to cover the syllabus of the Diploma of Nursing, and was an illuminating and well-documented account of the influence exerted on the development of nursing by social and economic changes. Although the book concentrates on developments in the 19th and 20th centuries, Baly traced the profession back to the Middle Ages claiming that it was only the Victorians' infatuation with grandiose institutions that attracted prestige and glamour to hospitals. Most people, she argued, are ill at home and nursing would one day have to reassert itself in the community.

The following year Baly threw herself into retirement with the same degree of zeal she had exercised during her working life. Within a month of hanging up her thermometer she was back for a few months at a short-staffed RCN before launching herself into an Open University degree followed by post-graduate studies at London University.

Her other books included Professional Responsibility in the Community Health Services (1975), A New Approach to District Nursing (1981), As Florence Nightingale Said (1991), and The History of the Queen's Nursing Institute (1987), for which she was appointed Centenary Fellow of the QNI, "in recognition of her many distinctions in the field of nursing". She also became the first chairman of the RCN's History of Nursing Group and in 1986 was awarded a fellowship of the RCN.

Baly lived in the Royal Crescent in Bath for 47 years, campaigning with the same degree of vigour for its preservation and assiduously supporting other causes which she believed in, including the Royal British Legion's annual Poppy Day appeal, the Bath Festival, and Bath Abbey, where she was a devout member of the congregation.

An avid reader of The Independent, Monica Baly left a codicil to her will asking that, if she received posthumous recognition, it should be within this newspaper's pages.

Monica Eileen Baly, nurse and nursing historian: born 24 May 1914; Western Area Organiser, Royal College of Nursing 1951-74; died Bath 12 November 1998.