District nursing in England and Wales before the National Health Service: the neglected evidence.

In Britain, the nurse provided by the National Health Service to attend patients in their homes is always the "district nurse", despite other and later descriptions of her work as "home" or "community" nursing.' The popular usage not only betrays district nursing's philanthropic origins as a service organized on the district basis typical of Victorian visiting charities,2 but also testifies to the district nurse's ubiquity well before the state paid her wages in 1948, when home nursing became one of the responsibilities assigned to local authorities as part of the National Health Service.3 She was sufficiently enshrined in popular consciousness for audiences to appreciate the scene in Dodie Smith's Dear octopus, first produced in 1938, where children dispute the merits of "District Nurse" as a more powerful expletive than "Damn Blast Devil Hell and Strike me Pink".4 The film version of A. J. Cronin's The citadel, released in the same year, includes a vignette of a district nurse as a well-established local character.5 The particular interest of district nursing's history before 1948 lies in its character as a voluntary service. It was voluntary in the sense of being funded and controlled by private initiative rather than by statutory provision, yet was important enough to be incorporated in the National Health Service although it had hitherto received very little from public funds.