Royal New Zealand Plunket Society

1907 –

Royal New Zealand Plunket Society

1907 –

Theme: Health

Known as:

  • The Society for the Promotion of the Health of Women and Children
    1907 – 1914
  • The Plunket Society
    1914 – 1980
  • Royal New Zealand Plunket Society
    1980 –

This essay written by Lynne Giddings was first published in Women Together: a History of Women's Organisations in New Zealand in 1993. It was updated by Elizabeth Cox in 2018.

1907 – 1993

'Plunket', as the Royal New Zealand Plunket Society came to be popularly known, became a household word in New Zealand. [1] By 1947 the society's nurses saw 85 percent of all new babies, and by 1991 it was up to 92 percent. By 1993 the society had touched the lives of at least three generations of women and their families.

By the early 1990s, Plunket nurses were supported at the local level by women on the voluntary branch committees which managed the affairs of the society. Nurses had some input at the local level, but the overall policy of the society was directed by the Executive Council, made up of women elected from and representing each district. In 1992 there were 16 districts, 126 branches and 648 sub-branches.

The name of Frederic Truby King (1858–1938) became synonymous with the original ideology and work of the society. King's personal qualities, dramatic oratory and apparent lack of sensitivity to criticism enabled him to establish the organisation and remain its public spokesperson into the 1930s. The extent of the contribution made by his wife Bella (Isabella, 1860–1927) to the society's success eventually came to be better recognised, though she herself may have accepted her relative invisibility as proper for a wife of her time. [2] When a scholarship was set up to commemorate Lady King after her death in 1927, the first holder was a young woman doctor, Helen Easterfield, later Deem, who in 1939 became the first (and up until 1993 remained the only) woman to direct the society at national level.

Less commonly acknowledged was the voluntary work of the women on the founding committees of the society and the numerous supporting committees in small towns and cities throughout New Zealand. Indeed, the phenomenal growth of the society could largely be attributed to their work. But the stories of many of these remarkable women remained difficult to trace; their contributions were often not credited to them, recorded in the society's publications and reports, or reported in the media.

The first committee was formed in Dunedin in May 1907 and five other branches were established in Christchurch, Wellington, Auckland, New Plymouth and Napier by June 1908. By 1914 there were over 50 branches. The support of the upper middle class women in the major cities who formed the first committees gave the fledgling movement its initial credibility. They came from eminent and wealthy families and were often the wives of business and professional men. The final stamp of respectability was achieved when Lady Victoria Plunket, wife of the then Governor-General and mother of eight, gave her support and name to the society and its nurses.

By the 1920s the membership of the committees on the whole reflected the make-up of their local, mainly Pākehā communities. By the 1930s there were 125 branches and 700 sub-branches. A number of factors contributed to so many women being willing first to use the services of the society, and then to work for it. Extended family networks were weakening, and the traditional ways of learning about childcare were less available; the birth rate was declining, so that parents tended to became more involved with their smaller number of children; and 'scientific' motherhood appealed to women, reassuring them that what they were doing was right for their baby, or at least would do no harm. Plunket work was seen as a respectable and respected activity within the community; it provided an opportunity for women to meet away from the traditional environs of church and family, and increased their confidence and self-esteem.

As Mary King noted in her biography of her father, when the society was founded, 'the cultured and well to do' needed support and information on how to care for their infants as much as the 'poor and ignorant'. [3] King, in contrast to many of his medical colleagues then and later, strongly believed in giving women information about their children and 'how to do it better' – even if that information was directed at rather than for women. Over the years the society published numerous pamphlets and best-selling books. Literature was highly acceptable to the middle classes, who valued informed knowledge.

The continuing involvement of middle class women in the society not only gave it the respectability it required to be broadly accepted, but was a critical factor in obtaining financial support. Funding came from government, from grants by the Karitane Products Society Ltd, a company set up in 1927 to distribute special products developed for infant feeding and care, and from other outside sources; but the major source was the multitude of ingenious fundraising projects thought up by committee women, from annual balls and indoor bowls tournaments to baby photo, bride and beauty competitions – though the last created some controversy in the 1980s.

Through their committees, women also pushed for Plunket Rooms to be available for 'their' Plunket nurses, and set up informal mutual support groups among the mothers attending them. They established homes for mothers and their babies, known later as Karitane Hospitals, and fought to save these when they were threatened with closure. [4] They undertook political action on other occasions too, in order to defend what they saw as their rights and the rights of their children.

Women working on ladder

Evening Post, 114/127/19. Alexander Turnbull Library.

The Plunket rooms at Strathmore Park being painted by Plunket committee members, 1950.

The society's relations with other health professionals and agencies were complex. From the beginning there was conflict with the newly forming professional nursing groups and the medical profession. In the society's early days in Dunedin, many local doctors resisted having nurses make home visits to 'their' mothers. There was also conflict with the Department of Health, which argued in the 1920s that the society should focus on the antenatal care of mothers, rather than exclusively on infant care. Then, as in later years, the voluntary committees acted swiftly to protect their Plunket nurses' domain and unique role.

The society's first slogan was 'To Save the Babies'. By 1938 the Pākehā infant mortality rate was 32 per 1000 live births, the lowest in the world. King and other writers attributed the improvement to the work of the society, although it has been argued that other factors, such as improved sanitation and an already steady decline in Pākehā infant mortality since 1875–76, were involved.

The Truby King system, as espoused by the society, emphasised a regular routine of feeding, sleeping and excreting for babies. Weight gain became the measure of success. To many women then and since, this authoritative advice was probably a relief. Over time, however, the focus on routine became formalised into a rigid set of rules thoroughly taught to Plunket and Karitane nurses in their training, and the nurses became authority figures in their own right.

For the most part, Plunket nurses had to reflect the dominant ideology of the society to gain acceptance with the women on their branch committee. If a nurse disagreed with the ideology or teaching of the medical director, the women on the committees did at times support the Plunket authorities rather than their local nurse. This rigidity of approach to infant care received much critical attention from the late 1970s, with historians linking it to paternalistic attitudes prevalent in New Zealand toward women and children.

From the 1980s, the society worked to dispel the view that all that Plunket nurses did was 'weigh babies', encouraging nurses to work with the mothers in ensuring the care and safety of their babies. Home visits remained a high priority, and were a life-saver for many women. The early mothers' groups were revamped and formalised as the invaluable New Mothers' Support Groups, which began in the 1970s. From that time, too, an increasing number of Plunket nurses were mothers.

Setting up a Research and Education Unit in 1986 was an important step in establishing a sound basis for the information and advice offered by the society. Changing social concerns and climate were reflected in its changes of slogan; in the 1990s it became 'Plunket – Caring for Young Families – Whanau Awhina'.

Although the morbidity and mortality statistics for Māori infants remained consistently higher than those for non-Māori, the society was slow to respond appropriately to the needs of Māori families. Early publications were translated into several other languages, but never into Māori. [5] No Māori branches, rural or urban, were formed; until the 1980s few Māori women served on local Plunket committees; and few Plunket nurses were Māori.

The society began employing Māori health workers in 1989, and from May 1992 started collecting data on the ratio of Māori to non-Māori Plunket nurses. In 1990, through the campaigning efforts of Plunket nurses, money from the voluntarily raised funds was allocated to Māori health initiatives for the first time.

In the 1980s and 1990s, campaigns involved both the professional and voluntary wings of the organisation. The most successful and best known was the campaign to introduce legislation for the compulsory use of infant and child car seats, accompanied by the car seat loan scheme. From the 1970s the society spoke out on a wide variety of issues, including child safety, immunisation, the need for centres for families in crisis, and various dangers to children such as lead poisoning and child abuse. In the 1990s, the issue of sexual abuse of children became a focus of Plunket education activities for nurses and public alike.

Government moves to alter the funding and provision of health care services and introduce a contract system challenged the primacy of the society in the delivery of health care to mothers and children. However, the continuing strong public support for Plunket was made plain in November and December 1992, when well attended rallies and marches were held in main centres throughout New Zealand. These culminated in the presentation of a petition of 100,000 signatures to Parliament, demanding support for Plunket services, and adequate funding so that qualified nurses could be employed.

In 1993, with the Plunket Society's long history of survival and established record of involving women in the community, it was well placed to face the future.

Lynne Giddings

1994 – 2018

In 2018 Plunket continued to be New Zealand's largest provider of services for the development, health and wellbeing of children under five and their families, and nine out of every ten babies were ‘Plunket babies’.

The major health restructuring which occurred during the 1990s, and the changing numbers of visits (or ‘core contacts’) funded by the government, had brought a number of significant changes to the organisation. Nevertheless, Plunket visits remained an integral part of its service to New Zealand families, including free home visits for babies in the early weeks, and then clinic or further home visits for children up to five years old, funded by the government through its Well Child Tamariki Ora framework. Plunket remained the biggest supplier of those Well Child visits, but it was no longer the only one. This led to some consternation, as the public perception of what the organisation was and had been did not always accord with the modern environment in which it operated. In 2018, Plunket’s funded core contacts with families numbered seven in total, and some regions were funded to provide other services, including parenting classes and the B4 school check for children at the age of four or five years.

Innovation continued to be important to Plunket, as its target communities evolved.  One of the most important was Plunketline, the call-centre staffed by Plunket nurses, giving advice to parents with healthy as well as sick children. Launched as a part-time service in 1994, it soon became a valued 24-hour operation, but faced an uphill battle to survive. The service was vulnerable to changes in government health policy funding and substantial sponsorship, particularly from the Karitane Products Society, and funding drives were required to keep it going.  In 1997 it was announced that the service would be cut back, and then the entire service was closed. A 60,000 signature petition saw government funding finally being provided, and it gradually went back to being round the clock. However, in 2004 Plunketline was merged with Healthline, but retained its own phone number to preserve its identity, and at the end of 2005 the government announced it would run a new stand-alone well-child service, and awarded the tender to a multinational provider.  Despite a protest at parliament (‘You can’t take the Plunket out of Plunketline’), government funding ceased, but Plunket continued to fund it, until it once again became a government-funded 24/7 service in 2009. It employed nurses with skills in a variety of languages, and in 2016 it received over 100,000 calls. 

To fill the gap left by the closure of the Karitane Hospitals in the 1980s, a number of regional family centres were established, staffed by Plunket nurses, community Karitane, Plunket Kaiāwhina (Māori health workers) and volunteers, to provide assistance with sleeping, feeding and parent/family needs. A number of these closed as a result of funding problems; some were reopened after public outcry, and in 2018 the model continued to be used in some areas. Plunket nurses often worked in a number of other community-based locations, including providing health checks at early childhood centres, kohanga reo, marae and other venues.  Mobile clinics, an innovation started after World War II, were also reintroduced. 

After 1993 the health of Māori and Pacific children remained a focus for the organisation. In 1994 two board positions were established for Māori, and increased to four in 1997. The number of Māori Plunket nurses increased, and Kaiāwhina were introduced, to work in partnership with local iwi, Māori health groups and other community agencies to support whanau, using tikanga and Māori models of health.  These efforts did bring an increase in contact between Plunket and Māori communities; in 1999 22 percent of clients were Maori, and in 2006 more than 112,000 face to face contacts with Māori families were made, an increase of 40 percent over four years.  Plunket faced competition with other providers in this field, and also some scepticism regarding its ability to deliver culturally appropriate services to Māori. [6] Yet in 2014, 21 percent of all its WellChild visits were with Māori children. 

These efforts were replicated for Pacific and other ethnic communities. The first full-time adviser to Pacific communities was appointed in 1993, and in 2002 the first Pacific nurses graduated as Plunket nurses. Some clinics operated an open clinic system to allow nurses to be available whenever mothers visited, and group sessions also proved popular with Pacific families. In 2013 Plunket reviewed its provision of care to both Asian families and Pacific families, and found that barriers such as language, a small workforce of people from those communities, inconsistent levels of cultural awareness, and a perception of Plunket being Pākehā and child-centred, rather than family-centred, all continue to prove a challenge.  By 2018, however, many playgroups and other services were being provided in other languages and proving popular.  Plunket also made a special effort to work with migrant and refugee communities, unfamiliar with the New Zealand health system. 

The longstanding connection with Dunedin ended when Plunket headquarters moved to Wellington in 1996. In 2007 the organisation celebrated its centenary with a programme of 22 events over a year, including a conference for 1500 delegates, the issuing of commemorative stamps, the launch of Jim Sullivan’s book about the history of the organisation, and a children’s roadshow national tour. In its centennial year, the organisation was visiting 91 percent of New Zealand’s babies.

Parenting had changed significantly by then, with more hands-on fathers, children spending more time in day-care from earlier ages, and women becoming mothers at later ages. Like other longstanding women’s organisations, Plunket also changed as the implications of the internet became apparent, and it interacted with increasing numbers of women via websites, Facebook pages and podcasts. Plunket’s parenting book, Thriving Under Five, was provided to all parents accessing the Plunket service.

In the face of rapidly worsening poverty statistics from the 1990s on, advocacy increasingly focused on children living in poverty and the connection between poor housing and childhood illness, as well as on promoting paid parental leave and healthy food. Plunket was a founding member of Every Child Counts, established in 2004 to promote the idea that children's needs should be at the centre of government policy and planning. Plunket also took part in supporting other initiatives, for example the 2005 scheme to improve the uptake of Meningococcal B vaccine among Māori, which saw uptake rates rising from 10 percent to 35 percent.

Plunket nurse at fundraising event

Fiona Bawden.

Plunket nurse and local volunteers getting involved in the 2014 Island Bay Festival, along with the Plunket Bear, who was a feature of Plunket's 'Bear Hug' fundraising campaign during the 2010s.

The year 2016 was crucial: Plunket’s members voted to transition from an area-based structure into a single national organisation, in an effort to ensure that equitable access to services could be provided throughout the country. This process took around 18 months, and Plunket became a single national charitable trust in January 2018. The integration of $52 million worth of assets, plus the operations of the area societies, was complex and controversial. Some areas, particularly those with well-established branches and volunteer networks, were concerned Plunket was moving away from its core services, or taking money and buildings that did not belong to it, because they had originally been gifted by local people to their local community. The national organisation responded that Plunket must prioritise its services, to ensure equitable services to all vulnerable families and others with high needs.

Although the government contract paid for the delivery of the Plunket nursing service, everything else was still funded through the efforts of local and national fundraising. This required a great deal of effort by the organisation, although it had developed long-lasting relationships with some corporate sponsors. Fundraising was made more difficult by a common public perception that government paid for all Plunket’s costs.

Plunket nurses continued to be supported at the local level by women on the voluntary branch committees, although, like many women’s organisations, numbers of volunteers had declined. Plunket’s volunteers numbered around 1,000 in 2017, a significant drop from its heyday of around 35,000 in the 1950s and 1960s.

By 2018, parents were interacting with the organisation in a wide variety of ways.  For example, an internet search for Plunket services in Taranaki brought up 37 results, including Plunket clinics in each small town (with Plunket nurses visiting on a revolving roster), parenting and child safety education programmes, coffee groups, with some in different languages and for teen parents, and drop-in centres allowing more flexible interactions with parents, who could bring their babies in for feeding, changing, weighing and advice without appointments. In other regions Plunket volunteers or nurses also managed the installation of car seats, toy libraries, parenting education in secondary schools, special support groups, e.g. for LGBT parents or parents of twins, and music groups. In both rural areas and in cities, these groups continued to be an invaluable support for parents and their communities.  In 2018, Plunket’s vision was: ‘In the first 1,000 days we make the difference of a lifetime.’

Elizabeth Cox

Notes

[1] The society was first called The Society for Promoting the Health of Women and Children, but it was registered in December 1907 as The Society for the Promotion of the Health of Women and Children. Though officially recognised as The Plunket Society from 1914, by 1980 it had had three further formal titles: The Society for the Health of Women and Children (1909), The Royal New Zealand Society for the Health of Women and Children (1917) and the Royal New Zealand Plunket Society (Inc.) (1980).

[2] See Philippa Mein Smith, 'Isabella Truby King', in Book of New Zealand Women, pp. 354–56.

[3] Mary King, Truby King: The Man, 1948, p. 154.

[4] By 1927 six Karitane Hospitals were established. They were to remain until the late 1970s, when they were viewed as too expensive to run. The last, in Invercargill, was closed in March 1980, after much resistance from women in the local branch of the society.

[5] Maui Pomare, first medical officer for Māori health, produced a manual on infant care, written in both Māori and English, in 1909. Truby King worked on revising it, but did not complete the work. In 1915 Pomare, then MP for Western Māori, commissioned a revision by Māori health nurses, which was published in 1916.

[6] Becky Fox, Plunket’s Māori advisor, quoted in Lynda Bryder, 2003, p. 249.

Unpublished sources

Cox, Elizabeth L., ‘Plunket plus Common Sense: Women and the Plunket Society 1940 to 1960’, Masters thesis, Victoria University of Wellington, 1996

Milne, Lynne S., 'The Plunket Society: An Experiment in Infant Welfare', BA (Hons) long essay, University of Otago, 1976

Royal New Zealand Plunket Society collection, 1908–1974, Hocken

Royal New Zealand Plunket Society clippings file, National Headquarters, Wellington, 1974–April 1992

Published sources

Bryder, Linda, A Voice for Mothers: The Plunket Society and Infant Welfare, 1907–2000, Auckland University Press, Auckland, 2003

Catherall, Sarah, ‘Inside the Plunket controversy: Why volunteers are up in arms’, New Zealand Listener, 9 July 2018

Dunphy, Lynne, 'Without Plunket, Who'd Be Left Holding the Baby?', More, 1988, pp. 79–84

King, Frederic Truby, Feeding and Care of Babies, [F.Truby King], Christchurch, 1908

King, Frederic Truby, The Expectant Mother and Baby's First Month, Angus & Robertson, Sydney, 1923

Mein Smith, Philippa, 'Truby King in Australia: A Revisionist View of Reduced Infant Mortality', NZJH, No. 22, 1988, pp. 23–43

Olssen, Eric, 'Breeding for the Empire', NZ Listener, 12 May 1979, pp. 18–19

Olssen, Eric, ‘Producing the Passionless People', NZ Listener, 19 May 1979, pp. 20–21.

Olssen, Eric, ‘Truby King and the Plunket Society: An Analysis of a Prescriptive Ideology', NZJH, Vol. I5 No. 1, 1981, pp. 3–23

Powell, Joyce, A Suitable Job for Young Ladies: Karitane Hospitals and Nurses, New Zealand and Overseas, 1907 to 2007, Heritage Press, Palmerston North, 2007

Stewart, Matt, ‘Plunket controversy deepens as the lawyers are called in’, 25 March 2018, https://www.stuff.co.nz/national/102556887/Plunket-controversy-deepens-as-the-lawyers-are-called-in

Sullivan, Jim, I was a Plunket Baby: 100 years of the Royal New Zealand Plunket Society Inc., Random House, Auckland, 2007

Woodbury, R.M., Infant Mortality and Prevention Work in New Zealand, Publication No. 105, US Department of Labour Children's Bureau, 1922

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