'Can Mummy Come Too?' Rhetoric and Realities of 'Family-Centred Care' in One New Zealand Hospital, 1960-1990.

Abstract

The development of ‘family-centred care’ began in the United Kingdom during the 1950s and 1960s in response to ‘expert’ concern for the child as an ‘emotional’ being. John Bowlby’s maternal deprivation thesis suggested that constant maternal attention in the early years of life would ensure emotionally healthy future members of society. Application of this theory to the hospital children’s ward indicated that young children should not be without their mothers for long periods of time. This theory and the subsequent release of the Platt Report in the United Kingdom in 1959 provided the necessary ‘scientific’ justification allowing mothers greater access to the historically restrictive hospital children’s wards. Influenced by trends in the United Kingdom the tenets of the separation thesis were reflected in New Zealand government policy towards child care and the care of the hospitalised child. However, the wider societal context in which these changes were to be accepted in New Zealand hospital children’s wards has not been examined. This study explores the development of ‘family-centred care’ in New Zealand as part of an international movement advanced by ‘experts’ in the 1950s concerned with the psychological effects of mother-child separation. It positions the development of ‘family-centred care’ within the broader context of ideas and beliefs about mothering and children that emerged in New Zealand society between 1960 and 1980 as a response to these new concerns for children’s emotional health. It examines New Zealand nursing, medical and related literature between 1960 and 1990 and considers both professional and public response to these concerns. The experiences of some mothers and nurses caring for children in one New Zealand hospital between 1960 and 1990 illustrate the significance of these responses in the context of one hospital children’s ward and the subsequent implications for the practice of ‘family-centred care’. This study demonstrates the difference between the professional rhetoric and the parental reality of ‘family-centred care’ in the context of one hospital children’s ward between 1960 and 1990. The practice of ‘family-centred care’ placed mothers and nurses in contradictory positions within the ward environment. These contradictory positions were historically enduring, although they varied in their enactment.